ALMOST weekly, advancements in science and technology are occurring by leaps and bounds globally. New frontiers are being pushed, many of which pose new challenges for our mores and traditional values.

This is particularly significant for Jamaica, where many people are conservative in their outlook, especially regarding what constitutes the family, acceptable ways of adding to the family, and the roles that people of different sex and gender should play within the family.

BASIC BIOLOGICAL NEEDS

An occurrence that challenges such values and perceptions took place in Britain last year, using assisted reproductive technology methods. There, Kyle, a 28-year-old homosexual man, wished desperately to have a child.

We should note that, biologically, a person’s sexual preference has no bearing on their emotional need for love, attention, companionship, and parental nurturing – desires that are present in all humans. While some of these basic desires may be suppressed, they are a natural part of our human existence.

One of Kyle’s relatives volunteered to be a surrogate, whereby an egg – donated by a third party or from an egg donor bank – would be fertilised by his sperm, and then surgically implanted inside her womb. The relative would then carry the pregnancy to term, so that Kyle could have the baby that he so greatly desired.

However, she withdrew from the venture for medical reasons. As a consequence, Kyle’s mother, Anne, volunteered to do the job.

With that, Kyle shopped around for an egg donor that had the right hair and eye colour that he wanted in his child, and then organised the egg’s fertilisation at an invitro fertilisation (IVF) clinic, with subsequent implantation into his mother. Nine months later, his 46-year-old mother gave birth to his son, Miles, by Caesarean section. This occurence is believed to be the first time that a single man has had a baby through surrogacy in the United Kingdom.

ETHICAL AND LEGAL ENTANGLEMENTS

As you would expect, the relationship of the three people involved are very tangled. Anne is the mother of Kyle as well as both the mother and grandmother of the newborn, Miles. Miles is both the half-brother as well as the son of Kyle. And Kyle is both the son of, and babyfather for Anne. However, despite being her babyfather, Kyle never had any sexual relations with his mother Anne, which ostensibly would have been incest.

Notwithstanding these ethical complexities, Kyle reported that he is not concerned as he is very happy to finally have a son. He thinks that as long as people can provide a home and have support, no one should be denied the right to be a parent.

Regardless of the preferred sexuality or gender of the parent, as long as he or she can provide for the child, Kyle does not think there should be a problem. He had paid for all the charges, has his own home and is gainfully employed.

Naturally, this case also carried legal entanglement. Under English law, Anne and her husband are the legal parents. Kyle, therefore, had to apply to adopt Miles, but normally a surrogate mother must hand over the child to two parents. However, the judge handling the matter ruled that the child would be properly cared for and so the adoption could proceed. She observed that whilst the arrangement was “unusual”, it was “entirely legal”.

The judge was particularly impressed by the fact that Kyle had given his decision careful consideration, and said the court’s paramount consideration was the little boy’s lifelong welfare. She said it was apparent to her, from all reports, that the parties had thought carefully about the arrangement, pausing, reflecting, and seeking advice at each stage of the process.

THE PERCEIVED WELFARE OF CHILDREN

Challenging ethical issues such as this are becoming increasingly prevalent, and the numbers of children born through surrogacy are increasing worldwide. For example, more than 1.5 per cent of all live births in the USA in 2013 were by invitro fertilisation methods.

Further, while anonymous donations of eggs and sperm are acceptable in many countries, the issue has spawned another set of ethical issues. Recently proposed legislation in Ireland seeks to ban such anonymous donations by creating a registry, but some oppose such a measure as an intolerable intrusion into the lives of sub-fertile couples, claiming it would stigmatise them and their children.

These opponents also claim that IVF clinics would lose business as prospective clients would seek treatment in countries like Spain, the Czech Republic and the United States, which offer the option of donor anonymity. Proponents have countered that the new proposals, which would require clinics and hospitals to provide details of donors and children to a national donor-conceived person register, were meant to benefit the welfare of the child.

The important consideration is to enable the child to know his or her identity, which is prohibited under anonymous donation.

As Jamaicans, we are all a part of the global community, and so we should proactively begin to engage in deliberations such as these. Consequently, what are your thoughts on such issues?

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA)