Implicaciones éticas y jurídicas de la maternidad subrogada: aproximación a una visión europea / Ethical and juridical implications relating to surrogate pregnancy: an overview from a european perspective / Implicações éticas e jurídicas da maternidade por substituição: aproximação de uma visão europeia

Resumen: avances biotecnológicos son abrumadores y la realidad social cambia con ellos. En efecto, la nueva ley en España sobre los matrimonios homosexuales ha propiciado que parejas de mujeres y de hombres que se casan puedan procrear no solo mediante la adopción, sino también por la fecundación in vitro. Así, la gestación por sustitución se está convirtiendo en la vía preferente para que parejas heterosexuales u homosexuales con problemas específicos, parejas de hombres y para el varón sin pareja puedan tener descendencia. Esta situación crea múltiples conflictos éticos y jurídicos difíciles de resolver: filiación del menor, mercantilización de la mujer, instrumentalización y compraventa de niños, etc. En este artículo se analizarán los aspectos bioéticos en conflicto, sin olvidar la regulación jurídica que existe al respecto.

Abstract: We find ourselves in a time of far reaching biotechnological breakthroughs and alongside with this, society is also experiencing changes. In this sense, new regulations regarding homosexual marriage have opened an scenario where same sex couples of men or women, may "procreate", not only by means of adoption - not permitted for homosexual couples in many countries - but also through in vitro fertilization. For this reason, surrogate pregnancy is becoming the option of choice enabling heterosexual couples with specific problems, male couples, and males without a female partner to have a child. Indeed, as surrogate pregnancy techniques proliferates, ethical conflicts arise: the possibility of men to have their own children, problems relating filiation, instrumentalization of women and babies, legal solutions given by different European countries. In this article, both bioethical and legal issues regarding surrogate pregnancy will be analyse looking for the best interest of the minors.

Resumo: Os avanços biotecnológicos são avassaladores e a realidade social se transforma com eles. Com efeito, a nova lei espanhola sobre o casamento homossexual tem propiciado que casais de mulheres e de homens que se casam possam procriar não só através da adoção, mas também por fertilização in vitro. Assim, a gestação por substituição está se tornando a alternativa preferida para que casais heterossexuais ou homossexuais com problemas específicos, casais de homens e homens solteiros possam ter filhos. Esta situação cria vários conflitos éticos e jurídicos que são difíceis de resolver: filiação da criança, mercantilização da mulher, instrumentalização e compra e venda de crianças, etc. Este artigo irá analisar os aspectos bioéticos, sem esquecer a regulação jurídica a este respeito.

Surrogacy World’s Perspective – A Review.

Nowadays surrogacy is a process practiced in many countries of the world and spark a deep interest in many couples that consider it as the only way to realize their dream to have a family.This article focuses on the increasing conclusion of international surrogacy agreements as a consequence of the different countries’ approaches, and aims to provide analysis of the different attitudes shown, specifically, by the Italian, Californian, Indian and English legal system. The article highlights the importance of the protection of human rights of people involved in surrogacy process underlining that,in particular with regard to the unborn child, it will be the best interest of the child to represent the guiding principle.

Subrogación uterina: Aspectos médicos y jurídicos del primer caso con sustento legal en la Argentina / Uterine subrogation: Medical and legal aspects of the first legally supported case in Argentina

Una mujer de 38 años de edad fue derivada a nuestro centro para un tratamiento de maternidad subrogada, por haber sufrido la ablación subtotal de su útero a causa de una hemorragia puerperal grave. Su perfil hormonal y estructura ovárica eran normales. El esposo tenía fertilidad probada y un espermograma normal. La subrogante era una mujer de 39 años, fértil, con dos hijos propios y con un largo vínculo de amistad con la paciente. Luego de una estimulación con gonadotropinas y antagonista de Gn-RH se obtuvieron 6 ovocitos maduros por punción folicular, que originaron 4 embriones por fertilización in vitro. Tres de ellos evolucionaron y fueron transferidos a la subrogante, lográndose un embarazo único que concluyó con el nacimiento de una niña normal que ya tiene dos años cumplidos. Se inició una acción solicitando la inscripción de la beba ya nacida a nombre de los padres procreacionales. El juez finalmente la otorgó basándose en las pruebas y testimonios aportados, los antecedentes en la jurisprudencia internacional, y el hecho de que según el artículo 19 de la Constitución Nacional: "Ningún habitante de la Nación será obligado a hacer lo que no manda la ley, ni privado de lo que ella no prohíbe". Este es un ejemplo casi ideal de cómo se puede desarrollar un caso de subrogación. Sin embargo, hay que tener en cuenta que en nuestro país no existe aún un marco regulatorio para estos tratamientos, por lo que no queda exenta la posibilidad de conflicto.

A woman aged 38 was referred to this center for surrogacy treatment, after subtotal ablation of her uterus due to a severe postpartum hemorrhage. Her hormonal profiles and ovarian structure were normal. The husband proved fertile and semen analysis was normal. The carrier, a woman 39 years old, fertile with two children of her own, and a long bonding friendship with the patient. After hormonal stimulation with gonadotropins and GnRH antagonist, six mature oocytes were obtained. These originated four embryos after in vitro fertilization, three of which were transferred to the carrier, achieving a singleton pregnancy which led to the birth of a normal child, now more than a year old. A lawsuit was filed after birth requesting the baby be registered with the biological parents name. The judge granted the request based on evidence and testimonies provided, international jurisprudence history and specification in Article 19 of the Argentine Constitution: "No inhabitant of the Nation shall be obliged to do what the law does not demand .nor be deprived of what it does not prohibit". This is an almost ideal example of the proceedings in a case of subrogation .However, we must always bear in mind the fact that in our country there is as yet no regulatory framework for these treatments, therefore there is a high probability of conflict.

Assisted reproductive techniques ethical and legal issues.

The rapid advancements in sciences have revolutionized modern medicine in a number of ways; genetic engineering, Assisted Reproductive Technologies (ART), human cloning, stem cells etc. has opened up the unimagined and promise unquestionable and undreamed benefits to mankind. At the same time, they raise many questions of law and ethical issues relating to public interest, social and religious sentiments and family concern. Although ethical judgments may indeed express personal preferences and may be connected in complicated ways with cultural conventions, ethics itself is a form of rational inquiry that concerns how we should live and what we should do. Some ethical issues are matters of debate. The Delhi Government has promulgated legislation in this regard which is cited as “The Delhi artificial insemination (Human) Bill 1995. The Indian Council for Medical Research has laid down certain guidelines for clinics practicing of assisted reproductive techniques and handling of surrogates in India. There is a certain element of risk associated with all assisted reproductive procedures. It is, therefore, necessary to ascertain the therapeutic and research value of the AR procedure in each case.

Gamete and embryo donation and surrogacy in Australia: the social context and regulatory framework

The social and legal acceptability of third-party reproduction varies around the world. In Australia, gamete and embryo donation and surrogacy are permitted within the regulatory framework set out by federal and state governments. The aim of this paper is to describe the social context and regulatory framework for third-party reproduction in Australia. This is a review of current laws and regulations related to third-party reproduction in Australia. Although subtle between-state differences exist, third-party reproduction is by and large a socially acceptable and legally permissible way to form a family throughout Australia. The overarching principles that govern the practice of third-party reproduction are altruism; the right of donorconceived people to be informed of their biological origins; and the provision of comprehensive counselling about the social, psychological, physical, ethical, financial and legal implications of third-party reproduction to those considering donating or receiving gametes or embryos and entering surrogacy arrangements. These principles ensure that donors are not motivated by financial gain, donor offspring can identify and meet with the person or persons who donated gametes or embryos, and prospective donors and recipients are aware of and have carefully considered the potential consequences of third-party reproduction. Australian state laws and federal guidelines prohibit commercial and anonymous third-party reproduction; mandate counselling of all parties involved in gamete and embryo donation and surrogacy arrangements; and require clinics to keep records with identifying and nonidentifying information about the donor/s to allow donor-conceived offspring to trace their biological origins

Gravidez de substituição / Surrogate pregnancy

A tecnologia e a ciência médica aplicada tem criado as condições para tornar possível que casais inférteis, antes condenados a não ter filhos pelos meios biológicos usuais, hoje alcancem este objetivo. Os formidáveis progressos científicos com a reprodução medicamente assistida, num primeiro momento, permitiram superar a infertilidade causada por ovulação insuficiente ou um número pequeno de espermatozóides com a fertilização in vitro. Num segundo momento, depois de gerado o embrião, implanta-lo no útero materno e, finalmente, conseguir a sua implantação em outro útero que não o da dona do embrião gerado em laboratório. Neste estágio - a gravidez de substituição - tem gerado inúmeros questionamentos de ordem ética e religiosa e jurídica. Se de um lado a lei já tem uma visão relativamente pacificada - dentro da ótica da estrutura familiar vigente - e os fóruns éticos já tenham definido deontologicamente os passos deste processo, o campo religioso continua postando-se de maneira contrária e com uma abertura muito estreita para discussões sobre o tema. No maior país católico do mundo, no entanto, muitos casais - mesmo sabendo estar contrariando normas explicitadas por documentos eclesiásticos - têm buscado, cada vez mais, este recurso que a ciência lhes põe a disposição.

Applied medical science and technology have now created the conditions where it is possible for infertile couples, who would previously have been condemned not to have children by the usual biological means, to achieve this objective. First, stunning scientific advances in medically assisted reproduction have made it possible to overcome infertility arising from insufficient ovulation or low sperm-count by way of in vitro fertilization. Secondly, the embryo thus produced can now be implanted in another womanïs uterus. This surrogate pregnancy has given rise to a number of ethical, religious and legal questions. On the one hand, the law has a relatively benign view of this practice-so long as it remains within the context of the conventional family structure. Likewise ethics has already marked out the stages in this process. Religious leaders, however, remain deeply opposed and unwilling to enter into dialogue on the issue. Although Brazil is the largest Catholic country in the world, increasing numbers of couples in this country are taking advantage of this new scientific resource, even though they are aware that it conflicts with official religious doctrine. Bioethical debate of this issue has only recently begun and needs to bear in mind the extent to which reproductive technology involves new groups who are not covered by the classical definition of the nuclear family.

Cessão temporária de útero: aspectos éticos e ordenamento jurídico vigente / Surrogate motherhood: ethical aspects and established juridical order

Maternidade de substituição é a técnica de reprodução assistida que consiste na inseminação artificial ou fertilização in vitro, em que uma mulher (doadora) gera um bebê com intenção de entregá-lo para outra mulher (receptora), solicitante do procedimento. Apesar de ser uma prática antiga, com relatos de casos na Bíblia, não há, atualmente, legislação que regulamente a prática no Brasil. Há opiniões controversas por todo o mundo - entre os países que permitem a prática e os que a proíbem e ainda entre os que se mostram ambíguos frente ao assunto. Na tentativa de estabelecer critérios para a prática, o Conselho Federal de Medicina instituiu normas éticas no que diz respeito à gratuidade da doação e à necessidade de parentesco entre as partes, além de limitar os procedimentos às situações nas quais há um problema médico que impossibilite a solicitante de gerar um filho. Trata-se de uma situação complexa, envolvendo muitos indivíduos, além de ser uma questão não somente legal, mas sobretudo ética. Esta revisão visou estimular e dar subsídios à reflexão por parte dos médicos ginecologistas que se deparam com essa questão em seu dia a dia

Surrogate motherhood is an assisted reproduction technique that consists of artificial insemination or in vitro fertilization, in which a woman (donor) generates a child with the intention of giving his/her to another woman (receiver), who is the solicitant of the procedure. Although it is an ancient practice, with cases related in the Bible, it does not have, nowadays, a legislation that regulates its practice in Brazil. There are controversial opinions in the entire world: among countries that allow the practice and those that forbid it, besides the countries that are ambiguous about the subject. In the attempt to establish criteria for this practice, the Brazilian Federal Medical Council instituted ethical rules that concern the gratuitousness of the donation and the need for kinship between the parts, and limited the procedures to the situations in which there is a medical problem that disables the solicitant to generate a child. This is a complex situation, which involves many individuals, and it is not only a legal issue, but also an ethical one. This review intended to stimulate and give subsidies for reflexion of gynecologists, which have to face this issue