10.- Gestation pour autrui / Surrogacy — CHURCH OF FRANCE / — États généraux de la bioéthique — Which world do we want for tomorrow? The brave new world…

http://eglise.catholique.fr/sengager-dans-la-societe/eglise-et-bioethique/comprendre-les-enjeux/

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Status of the issue

Sur­ro­ga­cy (GS) is the name giv­en to the tech­nique known as “sur­ro­ga­cy”. It belongs to Assist­ed Human Reproduction[1]. With its own char­ac­ter­is­tics, it is part of an inter­na­tion­al repro­duc­tive mar­ket. It is pro­hib­it­ed in France and many oth­er countries.

GPA uses a woman to car­ry the child dur­ing preg­nan­cy so that the so-called “inten­tion par­ents” can recov­er the child once born, so that it is con­sid­ered their own. This is reflect­ed in an agree­ment between this woman and the par­ents of intent. The child is almost always giv­en to them for a price. Pri­vate inter­me­di­aries have been set up to estab­lish these agree­ments and guar­an­tee their execution.

GPA comes in sev­er­al forms: insem­i­na­tion of the sur­ro­gate moth­er with the sper­ma­to­zoa of the inten­tion father who will also be the bio­log­i­cal father, or with those of a donor; in vit­ro con­cep­tion of a human embryo, from the gametes of the inten­tion par­ents, or from one of the par­ents with one donor, or from two donors, which will be implant­ed in the uterus of the sur­ro­gate mother.

Appli­cants are male/female cou­ples whose wives can­not bear chil­dren, sin­gle men or cou­ples of men, or even fer­tile women who, refus­ing the “incon­ve­nience” of ges­ta­tion and child­birth, resort to GS “for rea­sons of con­ve­nience” (CCNE, Opin­ion 126).

The Court of Cas­sa­tion (judg­ment of 31 May 1991) stat­ed as a prin­ci­ple that “the agree­ment by which a woman under­takes, even free of charge, to con­ceive and bear a child in order to aban­don it at birth con­tra­venes both the prin­ci­ple of the unavail­abil­i­ty of the human body and the prin­ci­ple of the unavail­abil­i­ty of the state of per­sons”. The Act of 29 July 1994 intro­duced arti­cle 16–7 into the Civ­il Code: “Any agree­ment con­cern­ing pro­cre­ation or ges­ta­tion on behalf of anoth­er is null and void.

To cir­cum­vent the French ban, French peo­ple go abroad, to a state where GS is autho­rised. On their return to France, they request that the child’s birth cer­tifi­cate, drawn up in the coun­try of birth, be tran­scribed in the French civ­il sta­tus reg­is­ters. Since 2015, the Court of Cas­sa­tion has accept­ed the tran­scrip­tion when this act says real­i­ty: the par­ents are the “sur­ro­gate moth­er” and the bio­log­i­cal father, accord­ing to the prin­ci­ple cer­ta mater is[2]. In three judg­ments of 5 July 2017, the Court extend­ed this prin­ci­ple by spec­i­fy­ing that if the moth­er is not the “sur­ro­gate moth­er”, tran­scrip­tion can­not be authorised.

The father’s spouse can then apply to adopt the child. Since a fourth judg­ment of 5 July 2017, the Court of Cas­sa­tion has accept­ed adop­tion (in this case sim­ple) while the courts on the mer­its have not fol­lowed it and have reject­ed appli­ca­tions for adop­tion (in this case in ple­nary ses­sion) (Paris Court of Appeal, 30 Jan­u­ary 2018). Until this deci­sion of July 5, 2017, the Court of Cas­sa­tion refused adop­tion, sim­ple or ple­nary, since the GPA, by orga­niz­ing the removal of the sur­ro­gate moth­er — the woman who gave birth — in order to make the child adopt­able, diverts adop­tion from its mean­ing: giv­ing par­ents to a child who has been deprived of it (by the mis­for­tunes of life and not by a contract).

Although French law inval­i­dates any GPA agree­ment, its effects are, to a large extent, accept­ed in France by the courts[3]. There­fore, it is dif­fi­cult for France to fight against GS.

Questions this raises

The Nation­al Con­sul­ta­tive Ethics Com­mit­tee stress­es that “of all MPA pro­ce­dures, GS is the only one that sep­a­rates the child from the woman who bore it, and the only one also capa­ble of com­plete­ly dis­so­ci­at­ing bio­log­i­cal trans­mis­sion (genet­ic via gametes, epi­ge­net­ics via preg­nan­cy) and social trans­mis­sion (parental care of the child at birth), since par­ents of inten­tion may not par­tic­i­pate in any stage of pro­cre­ation and gestation[4]”.

GPA estab­lish­es a rup­ture of the ges­ta­tion­al bond con­tract­ed between the child and the woman who bore it. If the sur­ro­gate moth­er has been insem­i­nat­ed, there is a dis­junc­tion between the bio­log­i­cal ges­ta­tion­al moth­er and the edu­ca­tion­al moth­er of inten­tion. If the moth­er of inten­tion has donat­ed her oocyte so that the embryo can be con­ceived and implant­ed in the uterus of the sur­ro­gate moth­er, there is a dis­junc­tion between the ges­ta­tion­al moth­er and the moth­er of inten­tion, who is also the bio­log­i­cal moth­er. The dis­junc­tion is even stronger when GS is per­formed for the ben­e­fit of a cou­ple of men: the child, sep­a­rat­ed from its ges­ta­tion­al moth­er, is also moth­er­less. It would be ille­git­i­mate to legal­ize the birth of chil­dren with­out mothers.

How­ev­er, ges­ta­tion can­not be erased in the con­struc­tion of the child. Epigenetics[5] shows that the bio­log­i­cal (and psy­cho­log­i­cal) envi­ron­ment dur­ing ges­ta­tion is not with­out impor­tance for the child who will be born and devel­op. The child aban­doned by the sur­ro­gate moth­er imme­di­ate­ly after birth there­fore suf­fers harm. More­over, child aban­don­ment is pro­hib­it­ed by law.

To avoid an exces­sive link between the sur­ro­gate moth­er and the child, con­ven­tions favour or even oblige that the oocyte does not come from the sur­ro­gate moth­er, and impose (in the Unit­ed States) that the par­ents of inten­tion be rec­og­nized as the par­ents before the birth, which caus­es an admin­is­tra­tive act of birth not cor­re­spond­ing to the real­i­ty of the facts: the reg­is­tered moth­er is not the woman who gave birth. Again, this is harm­ful to the child.

GPA uses a wom­an’s body dur­ing the nine months of ges­ta­tion, most of the time for remu­ner­a­tion or finan­cial com­pen­sa­tion, with­out always ensur­ing her phys­i­cal and psy­cho­log­i­cal integri­ty (espe­cial­ly in Asia). They are often poor women who need mon­ey. This “use” of a woman is con­trary to her dig­ni­ty and the prin­ci­ple of the unavail­abil­i­ty of the body.

We speak of “eth­i­cal GPA”: it would be real­ized free of charge thanks to a woman friend or mem­ber of the fam­i­ly, who offers her body to car­ry the child of a cou­ple who could not. In fact, GS always has a cost, which claims either com­pen­sa­tion or com­pen­sa­tion. In addi­tion to the seri­ous eth­i­cal ques­tions, there are also risks due to the prox­im­i­ty of the two moth­ers in every­day life: will the sur­ro­gate moth­er not be intru­sive in the cou­ple’s life by con­sid­er­ing that the child is also hers?

GS makes a child’s parent­age unread­able if more than two adults are involved (up to five adults) in its exis­tence and devel­op­ment before and after birth.

It is ille­git­i­mate to pay a sum to have a child, accord­ing to a con­tract. Even if GS were free, there would still be a con­tract orga­niz­ing the dis­po­si­tion of the child as prop­er­ty. How­ev­er, “in the GS con­tract, the body and the per­son of the child are in a posi­tion of object of the con­tract, incom­pat­i­ble with the gen­er­al prin­ci­ples of law. This object posi­tion has effect because the con­tract must pro­vide for what hap­pens if the object of the con­tract does not con­form to what is expected.

The desire for a child is com­mend­able and the suf­fer­ing due to med­ical infer­til­i­ty is to be accompanied[7]. But this desire can­not become a “right to the child”, espe­cial­ly in the face of the seri­ous harm that GS creates.

Since 1987, the Church has been neg­a­tive­ly dis­cernible about GS: “Sur­ro­ga­cy rep­re­sents an objec­tive breach of the oblig­a­tions of mater­nal love, con­ju­gal fideli­ty and respon­si­ble moth­er­hood; it offends the dig­ni­ty of the child and his right to be con­ceived, borne, brought into the world and edu­cat­ed by his own par­ents; it cre­ates, to the detri­ment of fam­i­lies, a divi­sion between the phys­i­cal, psy­cho­log­i­cal and moral ele­ments that con­sti­tute them (8).

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[1] Voir J.-R. Binet, Droit de la bioéthique, LGDJ, 2017, p. 174–176.

[2] La femme qui accouche est la mère. Ce principe ne rend pas compte de la dis­so­ci­a­tion entre géné­tique et gestation.

[3] Voir J.-R. Binet, « Ges­ta­tion pour autrui : le droit français à la croisée des chemins », n. 9 – sep­tem­bre 2017, LEXISNEXIS.

[4] Avis n. 126 du 15 juin 2017. Voir aus­si les Avis n. 90, du 24 novem­bre 2005 et n. 110, du 1^er avril 2010.

[5] Par la géné­tique, on étudie le génome et son envi­ron­nement biologique. Cet envi­ron­nement a une telle influ­ence sur l’expression des gênes (et non sur leur struc­ture interne) qu’il mérite d’être étudié pour lui-même : c’est l’épigénétique.

[6] Comité Con­sul­tatif Nation­al d’Éthique, Avis n. 126, p. 34. Cet avis expose quelques sit­u­a­tions dra­ma­tiques sur la GPA.

[7] L’accompagnement d’un cou­ple hétéro­sex­uel infer­tile n’est pas le même pour un cou­ple homo­sex­uel. Voir l’arrêt de la Cour Européenne des Droits de l’Homme, du 15 mars 2012, n. 25951/07, qui ne juge pas dis­crim­i­na­toire le refus de la France à la demande d’un cou­ple de femmes pour pou­voir recourir à la PMA. (Voir fiche sur l’assistance médi­cale à la procréation).

[8] L’accompagnement d’un cou­ple hétéro­sex­uel infer­tile n’est pas le même pour un cou­ple homo­sex­uel. Voir l’arrêt de la Cour Européenne des Droits de l’Homme, du 15 mars 2012, n. 25951/07, qui ne juge pas dis­crim­i­na­toire le refus de la France à la demande d’un cou­ple de femmes pour pou­voir recourir à la PMA. (Voir fiche sur l’assistance médi­cale à la procréation).