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Opinion 'Surrogacy proposals would make process costly, time consuming and frustrating'

It seems like Irish policy-makers are in fact trying to discourage domestic surrogacy, writes Dr Brian Tobin.

THE GENERAL SCHEME of the Assisted Human Reproduction Bill was recently published. Part 6 provides for the regulation of altruistic surrogacy arrangements in Ireland.

However, the proposals contained in Part 6 are so complex that one might be forgiven for thinking that Irish policy-makers are in fact trying to discourage domestic surrogacy.

Setting up a Regulatory Authority

The General Scheme provides for the setting up of an Assisted Human Reproduction (AHR) Regulatory Authority that must, among its many functions, approve a surrogacy agreement before any treatment in a clinic will be permitted. This regulatory oversight might help to assuage the fears of those who are uncomfortable with surrogacy being practiced in Ireland.

Indeed, in 2013 a nationally representative sample survey carried out by the Royal College of Surgeons in Ireland found that only 52% of those surveyed were in favour of surrogacy.

However, the surrogacy agreement will be a costly venture for the intending parents (the couple that commissions the arrangement) even before its submission to the Regulatory Authority for approval, as their chosen surrogate must undergo a medical and psychological assessment in order to be approved to act as a surrogate and to comply with Part 6.

Medical and legal expenses

The General Scheme also requires the surrogate and her husband, if any, to receive independent legal advice on the surrogacy agreement. These medical and legal costs are unlikely to be borne by the surrogate; instead, they will probably form part of the “reasonable expenses” agreed between the parties as part of the surrogacy agreement. Such expenses are permitted under the General Scheme.

These initial costs might not deter intending parents from engaging a surrogate in Ireland. However, following these steps, the AHR Regulatory Authority’s “approval” of their surrogacy agreement will really be limited to the approval of treatment, not parentage.

Despite all parties having received independent legal advice and consented to the terms of the surrogacy agreement between them, legal parentage of the child born as a result of the surrogacy arrangement will not be determined at this pre-birth “approval” stage.

Instead, the intending parents must soldier on after permission for treatment has been obtained in the hope that the surrogate will consent to the transfer of legal parentage to them after she gives birth to the child. They will also most likely be contractually liable for all the surrogate’s “reasonable expenses” that are associated with the pregnancy and the birth.

The surrogate will be child’s legal mother

At birth, the surrogate will be the child’s legal mother. The intending parents can only apply to the court seeking a Parental Order that will transfer legal parentage from the surrogate to them six weeks after the birth of the child, and only then if the surrogate consents to this.

Part 6 makes it clear that the parties’ “approved” surrogacy agreement may not be used as evidence of the surrogate’s consent to a Parental Order. However, there is potential relief for intending parents where the surrogate refuses to consent to a Parental Order.

The court can waive the requirement for the surrogate’s consent “for any other reason the court considers to be relevant.” While this offers a potential life-line to intending parents in such an unenviable predicament, it is a broadly drafted provision that leaves far too much to judicial discretion in each particular case.

Regulating gestational surrogacy

The General Scheme only proposes to regulate gestational surrogacy in Ireland, where the surrogate does not use her own genetic material (ova) but instead carries an embryo formed from the genetic material of others.

Thus, it is unclear as to why Part 6 does not propose to settle the issue of parentage in favour of the intending parents at the pre-birth approval stage, especially when one considers that Part 6 requires one of the intending parents to use his or her genetic material in the formation of the embryo and consequently be genetically related to the surrogate-born child.

The proposed regulatory approach is at odds with the pre-birth approval approach adopted in California, New Hampshire, Delaware, and many other US states, and Greece in the EU. In these jurisdictions parentage can be allocated in favour of the intending parents prior to the birth of the child.

Complex, lengthy and time consuming

This provides a greater incentive to intending parents to choose surrogacy as a viable means of assisted reproduction as their parental rights can be established early on in the process. There is less risk involved for intending parents.

Further, with a pre-birth approval of parentage there is no need to apply to the court for a Parental Order post-birth, so there should be less cost involved for intending parents.

The General Scheme creates a complex, hybrid pre-birth and post-birth approval model for surrogacy which, if ultimately enacted, will prove rather costly, lengthy and time consuming, and potentially even frustrating for intending parents if the surrogate’s consent is not forthcoming after the birth of the child.

Rather than facilitating domestic surrogacy arrangements, these muddled proposals might in fact prove far more likely to discourage them.

Dr Brian Tobin is a lecturer in law at NUI Galway.

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    Mute will
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    Jun 20th 2016, 1:47 PM

    He wasn’t well. I don’t doubt the family and state are happy with the verdict. Sad day for all involved

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    Mute The Girl
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    Jun 20th 2016, 1:57 PM

    How do we deal with stigma attached to mental health?

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    Mute Giant Reid
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    Jun 20th 2016, 2:00 PM

    We can’t, we just have to make sure the next generation don’t have the same sigma.

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    Mute will
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    Jun 20th 2016, 2:04 PM

    Here here .. we’re all battle some sort personal issues. If your offerd help you should listen to it and not be embarrassed or ashamed . We’re not all the same,we’re all unique.

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    Mute The Girl
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    Jun 20th 2016, 2:21 PM

    Sometimes that help doesn’t come. A few months ago, I had been battling depression. I lost my job over 2years ago, cut backs, my spouse’s income was not enough for a young family, we were stuck in a lease that couldn’t be broken and renting a new place was impossible as we’d need deposit and 1month rent that we couldn’t afford. I sort help from my GP and was sent to this place where I was asked to pay 25euro a session. I went twice but could not afford to keep going. I went to DSP and begged for financial help till I got a new job. I was told there’s nothing they could do because one spouse was working and his income was 10euro above the treshhold. I’m much better now because I told myself I’ll be strong for my family. Some people don’t know how to cope and gradually fall off the cliff.

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    Mute Giant Reid
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    Jun 20th 2016, 2:30 PM

    It’s not about knowing how to cope. This is an illness that will get u weather you’re depressed or not. To much emphasis is put on depression and anxiety and not enough info or discussion on the serious illnesses.

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    Mute Harlowe Brendan
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    Jun 20th 2016, 2:42 PM

    I think depression is a serious illness as well. The difference between mental health and mental illness is huge. We could have one without the other.

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    Mute The Girl
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    Jun 20th 2016, 3:02 PM

    They all go together@Giant. The sucide rates are high because people don’t know how to cope, don’t get help or are worried about getting help due to stigma. and in this case remember his mum was worried about the stigma. The conversation is wide and we need to talk about mental health

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    Mute Charles Williams
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    Jun 20th 2016, 4:08 PM

    “He wasn’t well” This man was a clear danger to himself his family and the wider community, The authorities should have intervened earlier and taken the burden of a decision on commital from the family. It was a clearly a public safety issue which went well beyond the family. This is not the first and it won’t be the last ssuch incident.

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    Mute Martin Bonner
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    Jun 20th 2016, 6:36 PM

    The Girl, go to your GP and get a long term illness form.

    Depression is one of the conditions that is on the long term illness list.

    Your GP can help with the diagnoses and you will be entitled to a medical card so that you can get whatever help you need.

    Remember , you’re not alone.

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    Mute Stephen murphy
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    Jun 20th 2016, 7:16 PM

    Don’t forget, how shame and judging was used by religious organisations as a tool of control of the population and we are paying the price of that abuse now or in the future.

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    Mute will
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    Jun 20th 2016, 7:55 PM

    GPs are very understanding to the cause of stress there harm in sitting an chatting there him/her and they can point u in the right direction. There’s always some out there to talk too.i know the cost is a barrier but there’s way round that.. Best if luck the girl :)

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    Mute Carina Clarke
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    Jun 20th 2016, 9:20 PM

    My heart goes out to this family. I hope their brother gets the help he so badly needs. I cannot begin to imagine the pain this whole family are going through.

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    Mute Ciarán Masterson
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    Jun 20th 2016, 1:45 PM

    @Eugene

    He’s better off in the Central Mental Hospital because he is mentally ill.

    He killed his parents but he didn’t know what he was doing. Therefore, he is not a murderer.

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    Mute Giant Reid
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    Jun 20th 2016, 1:52 PM

    I feel sorry for that guy and the family. When he gets back to some level of reality he will be devastated. He will be medicated and watched and will be mentally alone for the rest of his life

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    Mute Giant Reid
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    Jun 20th 2016, 4:28 PM

    His mother didn’t get him help because of sigma. If he got help she wouldn’t have been killed cause he would have been admitted to hospital until he came back to reality. He didn’t have help did u not read it. And yes people with this type of serious illness are monitored everyday until they are not delusional.

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    Mute Tess Mullally
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    Jun 20th 2016, 6:47 PM

    How sad for the poor family. And for anyone even considering trying to hide mental health issues from “the neighbours” just remember if you threw a stone into a crowd in any town, village or crossroads in Ireland you’d hit someone who suffer with mental health problems, your not alone please get help for the people you love it’s a tough journey but they need you to be strong for them, just like you would for physical health problems, hold your head up and be proud that you are doing something good for the person you love. X

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    Mute Harlowe Brendan
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    Jun 20th 2016, 2:44 PM

    Yeah good point, lock very one up then next. We could have ten new ballinasloe s filled by the end of the year if we really discriminate and try not to understand ! :/

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    Mute Proinsias Ó Foghlú
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    Jun 20th 2016, 3:01 PM

    I know a lot of people will say he can get better with meds but personally I’d prefer if he spent the rest of his life in the CMH. I think he could do the same again if he stopped taking his meds.

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    Mute Demise Grad
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    Jun 20th 2016, 6:04 PM

    Proinsias I doubt he will be let stop taking his meds it’s quite common that people with schizophrenia believe they don’t need their meds or even that they are being controlled through them and so endeavor not to take them. In these instances and I’m sure in cases like this involving such high risk, depot neuroleptics are administered to prevent avoidance of taking medication

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    Mute Dell
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    Jun 20th 2016, 5:31 PM

    Giant Reid is correct and they are monitored long after they are no longer delusional by both family members and the HSE. Life can go on once people just accept that it is what it is and it needs monitoring and not judgment or stigmatisation. The way I see it, there isn’t enough help and support for families when someones mental health does start to deteriorate and there isnt enough done to inform people and educate them with regard to people with mental illnesses.

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    Mute Demise Grad
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    Jun 20th 2016, 5:53 PM

    Karen somebody at high risk like that would be given depot neuroleptics once a month or so which are slow release to avoid situations like that where they don’t take their meds.

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    Mute Karen Doyle
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    Jun 20th 2016, 4:05 PM

    There is a stigma against people with mental illness who kill their parents? And probably rightly so! Right Giant, so he was very much supervised to the extent he was able to kill his parents, so what about next time? Why will he be better supervised now if he is allowed out into the community even though this area is hugely under resourced. If allowed out into the community will there be somebody monitoring him all the time? No.

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    Mute Carina Portman
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    Jun 20th 2016, 2:29 PM

    What? You mean he didn’t get a suspended sentence and a telling off on the promise that he’s bound by the peace for 2 years? Imagine an Irish judge jailing you for such a trivial matter at this. I’m shocked.

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    Mute Elaine Quinn
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    Jun 20th 2016, 11:43 PM

    Perhaps people who arent qualified mental health professionals should not post remarks regarding the risk they perceive people with mental illness to pose. We are trying to decrease the stigma attached to mental illness. Trained professionals are best placed to make risk assessments & provide support. Every one of us has a body and a mind so every one of us is susceptible to physical & mental illness.

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    Mute Eugene Comaskey
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    Jun 20th 2016, 8:15 PM

    I think the Doctors report said that he was suffering from whatever on the day that he killed his parents. I don’t think it said that he was suffering from the same illness on the following days . Anyway I have great sympathy for all that family and their friends. At the outset, my point was that if he was convicted of murder he would probably be released after 10 or12 years. Committed to CMH is probably a different thing.

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    Mute Marie Gunbay
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    Jun 21st 2016, 1:16 AM

    By law (Mental Health Act) a person can refuse depot injections even as an inpatient which some clients where I work do. A lot of people after they are discharged are given a follow up appointment in the outpatient clinics in the community. Some attend a couple of appointments and then stop coming for whatever reason.

    On the day of their missed appointment a standard ‘did not attend ‘letter is sent out to their GPs to inform the GP.

    A second appointment is sent out again to the client and if they miss the second appointment they are given a final appointment.

    Failing to attend again they are then discharged back to care of their GP.

    People are re-admitted mainly because of non compliance with their medication. They start to feel well they stop their medication and end up back on the unit. For some sadly it’s a revolving door which they have been in and out for years.

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    Mute Francis Mc Carthy
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    Jun 20th 2016, 6:04 PM

    ” She was also worried that Julian would resent his parents for committing him against his will.”

    She would have been more than likely correct on him resenting them forever more if they had committed him …

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    Mute Jeffre Tomred
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    Jun 26th 2016, 2:41 AM

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