A bibliometric analysis of research on surrogacy: Current trends and gaps between international law and new technology

Surrogacy or surrogate motherhood is a global phenomenon that has been on the rise since the 1980s. Academic research on surrogacy has adapted to the emerging challenges of this practice by becoming vast and highly multidisciplinary. To orient future research, we employ a bibliometric analysis to make a radiograph of past and current trends in the surrogacy literature. Our results indicate that (1) despite surrogacy being a global market, perspectives from economics and international law are being neglected; (2) research is not addressing the most concerning issues for policy, such as exploitation or human trafficking and the impact of technologies for the protection of the rights of the parties involved; and (3) surrogacy literature output is largely clustered in a handful of Western countries. Taken together, these results point to a huge gap between research and policy. Future research should address these neglected issues to better inform policy makers and the impact of technology on the law.

Surrogacy in international private law and public law aspects

The proposed article is devoted to the issue of surrogacy in its international private law and public law aspects. The complexity and multidimensionality of issues, the emergence of which is due to the birth of children as a result of agreements on surrogacy, have been investigated. Taking into account the three main approaches to the problem of surrogacy existing in the world, namely: the first is a number of states and organizations that categorically deny the very possibility of trade in the context of surrogate motherhood, noting that the child is not talking about any deal; the second approach is that a significant number of stakeholders express concern about the potential merger of surrogate motherhood and child trafficking, which could lead to the criminalization of surrogate mothers and future parents, as well as possible violations of the right to sexual and reproductive health; the last group is a number of states and organizations that have spoken out in favor of a complete prohibition of surrogacy without any restrictions, the consequences of such approaches have been analyzed. Within the framework of this article, the author considers it appropriate to cite the position of the UN Special Rapporteur on the sale of children and the sexual exploitation of children, including child prostitution, child pornography and the production of other materials on sexual abuse of children, the Permanent Bureau of the Hague Conference on Private International Law, as well as the European Court of Justice on human rights on the issues considered. The article draws a number of conclusions. First of all, compliance with the recommendations of the Special Rapporteur requires the adoption of urgent measures to prevent violations of the rights of all participants in a surrogacy relationship due to their vulnerability. Also, regarding the lack of regulation of these legal relations at the level of law within the jurisdiction of Ukraine, the author expresses his opinion about the certain justification of such a situation until a unified normative act is adopted based on the results of the work of the Hague Conference on Private International Law. Harmonization of legal norms at the national and international levels will allow in the future to avoid conflicts in relations of cross-border surrogacy, taking into account the issues of child trafficking, non-discrimination and the right to health of children born through surrogacy, citizenship, name and family ties in the framework of respect for the child’s right to preserve his identity, as well as access to information on origins and rights to family life, etc

Adoption v. Surrogacy: New Perspectives on the Parental Projects of Same-Sex Couples

In Italy all forms of surrogacy are forbidden, whether it be traditional or gestational, commercial or altruistic. Act n. 40 of 19/2/2004, entitled “Rules about medically-assisted reproduction”, introduces a prohibition on employing gametes from donors, and specifically incriminates not only intermediary agencies and clinics practising surrogacy, but also the intended parents and the surrogate mother too. Other penal consequences are provided by the Criminal Code about the registration of a birth certificate where parents are the intended ones, as provided by the lex loci actus (art. 567 of the Italian Criminal Code, concerning the false representation or concealment of status). Apart from the mentioned criminal problems, several aspects of private international law are involved. In the cases where national rules forbid the transcription of birth certificates for public policy reasons, specifically the prohibition of surrogacy, Italian Judges often seek solutions to enforce the status filiationis. In this case, the Italian Supreme Court intervenes in the debate, allowing the recognition of a foreign adoption order related to a procedure of surrogate motherhood in favour of a same-sex couple. Focusing on the recent evolution of the notion of international public policy the Supreme Court affirms that the inherent adoptive parental status acquired by a homogenitorial couple is not contrary to international public policy, when the effects of the act from which this status derives are not incompatible with the limits that cannot be exceeded constituted by the founding principles of the relational choices between intended parents and child (Article 2 of the Constitution, Article 8 ECHR), by the Best interest of the child as codified in the Italian Law 219/2012, by the principle of non-discrimination, by the principle of solidarity that is the basis of social parenting. Splitting the problem of the surrogacy, underlying the adoption order to recognize in this case, and narrowing the public policy exception, is highly evident the risk to suggest to same-sex couples to realize their parental projects putting in place the surrogacy within the legal systems where contemporary it is possible to carry out the adoption of the child born as a result of this procedure.

Human trafficking and surrogate motherhood: challenges

Owing to modern scientific advances prospective parents, among other opportunities, enjoy the opportunity, which has not been available before. It consists in giving birth to a child by using another woman’s reproductive capacity when the situation seems hardly improvable. The paper examines surrogate motherhood as one of the reproductive methods through the prism of human trafficking. It aims at studying and differentiating such legal phenomena as the sale of human beings and surrogate motherhood, which is provided primarily on a paid-for basis, whose consequences (transferring irrevocably a child from one person to another), are externally similar. The comparative legal and formal legal methods have been employed to provide a general description of international experience in regulating surrogate motherhood. Examples of absolutely opposite ways of pursuing state policy on the legalization of this type of reproductive methods in foreign countries are suggested: from a complete ban to legislative approval and even further simplification of the applying procedure. It has been proved that there is no connection between acknowledgement of the legality of this procedure and the geographical location of states, the level of their economic development, the specifics of the legal system, and the like. It has been stated that none of the countries can be considered a universal example of solving these issues. Based on the example of Ukrainian legislation, the author suggests distinguishing between the objective aspect of selling human beings and surrogate motherhood, which is provided, first of all, for a fee. It is emphasized that due to the peculiarities of reproductive technologies only a child should be the object of trade, not a person’s gametes, zygote, embryo or fetus. When a child is sold, in view of the objective aspect, the child is illegally transferred from one person to another. In legal surrogate motherhood agreements the object of the agreement concluded between the surrogate mother and the future parents is not the child, but the service related to embryo implantation, pregnancy and childbirth, id est, a long process. Based on criminal law, there have been modelled the peculiarities of surrogate motherhood and its assessment used in determining the signs of human trafficking largely depending on genetic relationship between a child and customers (potential parents), as well as a child and a surrogate mother. The mental element making the distinction between surrogacy and the trafficking of newborns is described. It is emphasized that qualifying as «trafficking in human beings» necessitates the proof of direct intent to unlawfully «transfer» a child, primarily in return for a fee. It has been concluded that the legal regulation of surrogacy requires further improvement and consolidation at the legislative level. Investigators and prosecutors should investigate all the circumstances that were associated with the surrogacy methods applied in order to establish whether child trafficking occurred in each specific case.

ON THE NEED FOR SOCIOLOGICAL RESEARCH ON THE INTRODUCTION OF ASSISTED REPRODUCTIVE TECHNOLOGIES IN BELARUS

Background. At present there are no scientifically substantiated data on the problems of introducing assisted reproductive technologies (ART) in the Republic of Belarus. The relevance of developing approaches, organizing opinion polls and processing data on a representative sample of Belarusians does not raise doubts in view of the relationship between social attitudes in the field of reproductive health and the national security of the country. Purpose. Substantiation of medical and sociological study of ART in the population of the Republic of Belarus. Material and methods. The bibliographic analysis included the study of Russian and foreign experience in assessing the sociological aspects of reproductology (materials of Springer Link, Oxford University Press, The New England Journal of Medicine, The British Medical Journal, the SCOPUS database of Elsevier, the EBSCO platform), as well as the analysis of the legislation of the Republic of Belarus in the field of reproductology. Results. In the country, the interests of the party that wants to become a parent (surrogate motherhood, donation) are respected as much as possible. The medicalized approach to the definition of ART methods in Belarus is typical, as in other post-Soviet countries, which are characterized by a classical (nuclear) understanding of the family. Taking into account the current trends in the development of the market for reproductive technologies and those techniques that are used in reproductive centers of the Republic of Belarus, it is necessary in the legislative framework to provide for the rules and possibilities of using such methods as hatching (dissection of the embryo membrane), intracytoplasmic sperm injection, intracytoplasmic sperm injection after selection according to morphological criteria, preimplantation diagnostics. Conclusions. The following areas are relevant for Belarus: 1) study of the awareness of the population of the Republic of Belarus about ART; 2) assessment of social trust in ART on the part of the population; 3) development of technologies for positive reproductive attitudes in society, including the use of ART.

Surogacy – challenge to the legislation of the Republic of Bulgaria

Surrogate motherhood is a modern socio-economic phenomenon that needs legal regulation in the Republic of Bulgaria. This article presents the generally accepted view of it and the differentiated types of surrogacy. With the comparative method, the legislative approach to it was analysed in the countries of the European legal family and beyond. Finally, is presented position in the Republic of Bulgaria.

Ethical context of legally regulated surrogate and genetic motherhood in Russia

Aim: to assess the compliance of legal norms regulating surrogate motherhood and moral concepts about motherhood and childhood in society.Materials and Methods. The Articles 55 (clause 9) of the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation", the principles of the Constitution of the Russian Federation, and traditional moral concepts common in society of the Russian Federation underwent a comparative analysis.Results. Discrepancies between moral and legal norms were revealed in 3 issues. Issue 1 is related to the rights for surrogacy of unmarried persons and the rights of single citizens. In an ethical context, the statement of their rights does not correspond to the rights of children to a dignified upbringing in a family composed of a mother and father. Issue 2 refers to the ethical incorrectness of compensated surrogacy contracts. Commercial surrogacy cannot be separated from transformed forms of child trafficking. Issue 3 is related to the moral degradation of motherhood upon using technologies of surrogate and genetic motherhood.Conclusion. It is necessary to conduct additional studies on using surrogate motherhood in order to prevent abuse and violations upon its application in Russia as well as open up a public discussion on this matter.

MEDICAL ASPECTS OF SURROGATE MOTHERHOOD

Surrogacy is associated with a wide range of factors that increase maternal and perinatal risks. The use of in vitro fertilization and embryo transfer technologies determines the higher frequency of multiple pregnancies that enhances the risk of cesarean section, premature birth, low body weight in newborns, etc. in case of surrogacy. Genetic differences and immunogenetic reactions increase the risk of pre-eclampsia, placental pathology, abortion, intrauterine growth retardation. Hormonal disbalance under the effect of adverse factors during surrogate pregnancy may initiate prenatal reprogramming of morphogenesis through epigenetic mechanisms. This can affect the organogenesis and predispose to susceptibility to various diseases. Psychological factors and emotional link between a surrogate mother and a fetus are associated with increased levels of hormones of stress-releasing systems, which affect the formation of neurohumoral systems of the fetus and can modulate its mental development.

Medicina, pravo in družba: sodobne dileme IV

The monography "Medicine, Law and Society: Contemporary Dilemmas IV" is already the fourth such book. It contains current contributions related to the central theme of liability in healthcare. In their contributions, the authors analyze and discuss various open legal, ethical, and medical issues and dilemmas facing healthcare today in Slovenia and comparative legislations and globally. The monography contains content that addresses selected topics related to civil and criminal liability issues (e.g., medical chamber, doctors, other health professionals, patients,…), euthanasia, surrogate motherhood, and mental health. The second group of articles focuses on current topics, which connect law, sport and medicine (e.g., gender and sex reassignment, doping, athlete employment issues, responsibility in sport, etc.). The third group consists of contributions related to the topics of infectious diseases (Covid-19, SARS, H1N1, Ebola…) and selected aspects regarding medicines (financing of medicines, search for new medicines, pharmaceutical law…).