surrogate pregnancy
Take it as read
It takes a while to catch up with news after a break away, but in this week’s trawl, two headlines in particular caught my attention. 
The first was this one: ‘Take it as read – good fiction teaches us how to be human beings‘, a thoughtful article by Graeme Archer in The Daily Telegraph, where he said:
‘… it’s not the novels where one sees oneself in a character that matter: it’s the ones where you learn to see properly, from the perspective of another. If we don’t see people properly, then we can never empathise with them, and if we can’t empathise with others then we’re not properly human. No matter how socially awkward you are, a great novel will train you to do this.’
Very much the premise upon which I write my own novels.
Indeed, I was thinking about this a lot while I was on holiday in Italy. 
I took the trusty Kindle well-loaded and managed to read two and a half novels in airports and trains and planes and odd moments of inactivity: Emotional Geology and Untying the Knot both by Linda Gillard, and A Sister’s Gift by Giselle Green. Through these tales I was taken into the lives and minds of characters grappling with mental illness, obsessive personalities, infertility, conflicted family relationships, surrogate pregnancy. Easy reads all (as befits a holiday break), but it’s fair to say they enriched my understanding of the challenges and thinking of other people in these situations. I shan’t ever experience most of these things personally, but I’d like to think I’d have empathy enough should I come into contact with those for whom these things are a lived reality.
The second headline was attached to an article my daughter cut out of the newspaper for me: ‘Why did my brother die in agony?’, subheaded: ‘Terminally ill patients are suffering slow and painful deaths because doctors dare not fall foul of the law against assisted suicide.’ Yep, it instantly grabbed me by the throat, as she knew it would.
Well-known cookery expert, Prue Leith, was describing her brother David’s terminal battle with excruciatingly painful cancer of the bones. When the morphine was doing its job, he was pain-free, joking, and sharing quality time with his wife and four children. But the dosage of morphine was sufficient for only three hours out of every four for which it was prescribed. For that fourth hour he was in agony. The solution seems obvious and simple, doesn’t it? Naturally enough, various relatives appealed, nay, ‘pleaded’, for help. The answer though was what shocked me: the nurses ‘couldn’t’ give any more pain relief. They sympathised, even told the family they would personally be willing to increase the dose, but they were powerless to do so; the law precluded it. They also said, no one admitted these situations existed. (By this time I was at fever pitch!)
Now, of course, no one with warm blood coursing through their veins could fail to be moved by the obvious distress the Leith family all suffered. But the story left me personally feeling frustrated and vexed. This man clearly needed more medication. And it can, it really can be given without breaking the law. Palliative medicine is an extremely well developed discipline; dedicated teams of experts in pain management are fully empowered to administer effective measures (drugs and others treatments) in these circumstances, to ensure ongoing comfort and dignity and a peaceful death. Which they are able to do in all except a limited number of situations. And by Prue’s own admission, David’s pain came into the category of controllable by morphine.
Both the subheading and Prue’s concluding message – ‘The present state of affairs is monstrous. With 80 percent of the population in favour of assisted dying, what are they waiting for?’ – missed the point. It wasn’t assisted death this man needed, it was legal and legitimate, adequate pain relief.
There are indeed exceptional cases where the laws relating to assisted dying need to be challenged (I’ve discussed them at length on this blog in the past), but this is not one of them. Instead of saying they couldn’t give adequate medication, those staff caring for David should have been calling for a man/woman who could. Let’s not confuse the two issues.
The Surrogate
Whenever I hear of a book that falls into the same category as mine (medical-ethical novels) I tend to pounce. Is this book serious competition? Has this author stolen my thunder? Can I learn anything from the way he or she has tackled the subject? What should I avoid? 
So when I found three all called The Surrogate I just had to buy them, didn’t I? They came out in 2004 (Mackel’s book); 2006 (Wall’s) and 2009 (Carver’s).
I find it curious that the publishers didn’t choose alternative titles, but hey ho, maybe Sphere and Simon & Schuster have confident marketing departments. Or the authors were insistent. Or maybe nobody bothered to check.
My own novel on the same subject was published in 2005, so writing it pre-dated these. Now I’m doubly glad I gave it a different title: Double Trouble.
Researching and writing Double Trouble revealed how complex the social and emotional issues around surrogacy are. The procedure can be fraught with peril, practical as well as emotional, for both the surrogate mother who carries the child, and the adoptive couple (whether or not one is the biological parent) who raise him or her. So I was intrigued to know how these other authors addressed the various ramifications.
I’ll give you a quick summary.
Kathryn Mackel’s The Surrogate
Bethany Testamarta is an acclaimed pianist with everything she wants – except one thing. A baby.
In desperation her husband, Kyle Dolan, enlists the help of a girl calling herself Laurel Bergin. Her credentials seem perfect. She becomes surrogate mother to the Dolans’ last remaining embryo. But Laurel isn’t who she claims to be and gradually a nightmare scenario unravels that takes the Dolans into an underworld of such darkness and evil that Bethany fears for her sanity as well as her family’s safety.
Some of the potential pitfalls of a surrogate pregnancy are dealt with in this book, but I confess neither the writing style nor the storyline appealed greatly for a variety of reasons. Issues need to be handled with more subtlety in my judgement. Mackel has a strong religious message that dominates to the detriment of the whole. Nor was the plot very convincing, I found, although I did persist to the end.
Judith Henry Wall’s The Surrogate
This one takes the reverse position: trustworthy surrogate, ruthless would-be parents.
Again, surrogate pregnancy is at the centre of the story and the issues of emotional attachment and contracting and blurred boundaries and long-term consequences are all there.
Amanda Hartmann is the head of a famous evangelical family. She wants a family. Jamie Long is a penniless twenty-year-old. She needs money. Surrogate motherhood seems to combine an altruistic act with a financial opportunity. But once pregnant and under contract Jamie unearths dark secrets in Amanda’s family and a ruthlessness that scares her. She flees for her life, and searches for a way of freeing herself and her baby from the stranglehold of the Hartmanns.
Of the three I enjoyed this one most. The writing style is confident and fluid, and the plotting careful and well-paced. Even if hard to believe in places. One hidden relative? – maybe. Two? – surely not. Wall, like Mackel, is American, and again there’s a strong religious component, but in this case it has a context and doesn’t distort the narrative.
Tania Carver’s The Surrogate
Carver’s debut novel uses the title The Surrogate cleverly; it isn’t about intentionally carrying a baby for someone else. I won’t say more lest I spoil the story for you.
Its central theme is of a serial murderer who targets pregnant women, drugging them and ripping out their babies. Shocking, horrifying, macabre – just a few of the words used by reviewers. The unusual psychology behind the killings, and the relationship between DI Phil Brennan and criminal profiler Marina Esposito, keep the pages turning. I did actually guess the twist at the end far too early but that didn’t detract much from the overall experience.
The verdict?
After reading all three books, where am I? Envious but still hopeful.
Envious, because the others all have much better covers than mine. Sigh. But it’s an old battle; long forgiven. My present publisher is good at covers and my last three books have had superb designs.
And I’m still hopeful because whilst Double Trouble does revolve around a surrogacy arrangement, and does involve deceit and a crime, it isn’t anything like these potential competitors. Phew again! So I don’t think I need to throw in the towel and say, I give in, you can do it much better than I can, just yet. There is still a tiny little niche with my name on it.
Better get on with the next book though in case someone right now is about to produce its perfect rival!
Do I want … or do I need?
Little did I think back in 2005, when I wrote Double Trouble, that surrogate pregnancy would hit the headlines in quite the way it has.
Don’t get me wrong, I have huge sympathy for people who are genuinely unable to have children. Goodness, I’ve written two novels on the subject already. And I do believe surrogacy may well be a viable option for some couples. But what’s exercising my mind right now is the dividing line between a desperate ‘we need’ as against a petulant ‘I want’ – with real live children pawns in the game. And I guess it’s the juxtaposition with celebrity and wealth and selfish attitudes that’s disturbed me most.
First gay 64-year old Elton John. 
And now, married 43-year old Nicole Kidman. Positively flaunting the production (and I use the term advisedly) of children by this means.
Of course, I don’t have the ear of Kidman and her husband Keith Urban; there may be intimate factors about which I know nothing. But their story does prompt all sorts of questions. Off the top of my head:
a. What will baby Faith Margaret feel in years to come when she sees the news clippings of her parents thanking their ‘gestational carrier’ for her?
b. Is it right for anyone at any age to be encouraged to have children?
c. Should limits be imposed on assisting conception or pregnancy?
d. What sorts of circumstances justify ‘renting a womb’?
e. Does money buy happiness for children?
f. Should babies ever be saleable commodities?
g. Or the latest must-have accessory?
h. Are there doors which fame and fortune shouldn’t be able to open?
And I’m sure you’ll be able to think of plenty more.
I’m feeling the impact of these cases powerfully this week because I’m back to editing my forthcoming novel, Saving Sebastian. Sebastian Zair, is just four years old, a beautiful child, bright and lovable. But he suffers from a serious blood disorder. He requires frequent unpleasant treatments; his prognosis is grim. 
His parents, Yasmeen and Karim, are desperate to save his life. In order to give him a chance they’re seeking to create a matched child by IVF, using their own eggs and sperm. But the embryo will need to be carefully selected, other potential lives will be destroyed in the process, there are no guarantees. And consultant fertility expert, Justin Blaydon-Green, is juggling all sorts of competing interests; there’s already a shadow hanging over his unit, awkward questions are being asked. Campaigners are on the warpath. The press smell a story. But for the Zair family, time is running out …
Well, stack that against a convenient gift-wrapped bundle bought by celebrity parents … I rest my case.
Not good for my peace of mind, or my creative flow!
New Year, new impetus
Well, it’s here! 2011. And a very happy New Year to you all.
The bells rang, the pipes skirled, 80,000 people partied in the streets of Edinburgh to the thunder and shimmer of thousands of pounds worth of fireworks … and yes, it is worth saying, because the official celebrations have been cancelled before, and the jolly old weather certainly threatened to be agin us this time.
Six years ago we took a party of guests to our usual vantage point shortly before midnight and … waited … and waited … and well, nothing happened. Apparently there were ‘safety concerns’. In our embarrassment and frustration we instantly thought Thou-shalt-not-play-conkers-without-safety-helmet-plus-padded-gloves-plus-visors writ large. But nobody wants a fatality for the sake of a mere pyrotechnical spectacular, and we learned later it was something to do with a dodgy roof and the strength of the wind. At least that was the official version.
But it’s not just dynamite that has ignited the change to a new year. The bells have been ringing for other major shifts close to my heart. Indeed the news during this past seven days has been jammed full of my kind of subjects. In no particular order (as they say on ‘talent’ shows) …
Organ donation included on driving licence applications
From July drivers applying for a licence will be asked to indicate which of the following applies to them:
• Yes, I would like to register on the NHS Organ Donor Register
• I do not want to answer this question now
• I am already registered on the NHS Organ Donor Register.
It’s an official step towards increasing the pool of donors. Around 90% of people favour donation but only 27% are registered donors. And given that about 1,000 Britons die each year for want of an organ, and thousands more wait an indecently long time for one, we need to do something. Maybe there should have been one more question:
• Would you be prepared to receive a donated organ for yourself or someone you love?
The novel I’m writing just now is about organ donation so I can get quite fired up on the subject.
Sir Elton John has become a dad
Put aside for a moment any qualms about the 63-year old temper-tantrum-on-short-legs with a £290,000 flower habit as a role model, and disregard the rumours about payment to ensure the birth happened on 25th December as the ultimate Christmas present, and think instead of the whole picture of a financial arrangement between an unknown surrogate mother in California and an aging, overweight, homosexual with dubious priorities. And spare a thought for the resultant offspring: Zachary Jackson Levon Furnish-John.
Admittedly the pop star did try recently to adopt an HIV-positive toddler from a Ukrainian orphanage, but he was denied on the grounds of his age, and the fact that his civil partnership with David Furnish was not recognised. So what isn’t good enough for an abandoned Ukrainian is suddenly acceptable for Zachary? Hello? How many tribunals in this country would grant permission for such an arrangement without the pressure of fame and fortune, I wonder? OK, it did become legal in April here in the UK for two men to have a child by a surrogate and to have both their names on the birth certificate. But we aren’t talking about your average ordinary man here. Children are not commodities. Nor are they fashion accessories.
Surrogacy was the subject of my 2005 novel, Double Trouble.
A nine-year old becomes a bone marrow donor
Robert Sherwood is only nine. His brother Edward is just five. But Edward has aplastic anaemia; his bone marrow fails to produce sufficient new blood cells. Robert’s donation has the potential to save his brother’s life. But … should he have been subjected to this procedure before the age of informed consent? Does the end justify the means? Should he be permitted to say no?
It’s the bread and butter of my working life!
A grandfather has become the first to donate an organ to a grandchild
John Targett, aged 59, couldn’t bear to see his little one-year-old grandson growing sicker and sicker as a result of biliary atresia. So he offered part of his own liver and had the operation just before Christmas. What a gift: the gift of life.
Another British person has ended his life in Switzerland
Andrew Colgan was only 42 (not much older than my son) but he’d suffered from Multiple Sclerosis for ten years and his condition had markedly worsened recently. He died in that now infamous Dignitas room in Zurich. My own feeling is of immense sadness that this young man had been desperate enough to go abroad for a solution to his terrible dilemma.
I really agonised over these questions for Right to Die; I’m still struggling with them three years after publication.
Volunteers keep libraries open
A new report has revealed that libraries in England are increasingly being staffed by volunteers, to prevent closure under cost-cutting exercises. And this at a time when it ought surely be a priority to make books available to those struggling to find employment or to make ends meet. Books can change lives. Penny-pinching in this area is surely stealing vital resources from the future.
Hundreds of people only read my books as library copies. I want them to continue to have this opportunity. It represents something much more exciting than sales figures.
Bishops defend the rights of Christians
Lord Carey, former Archbishop of Canterbury, has urged the prime minister to review the laws which discriminate against Christians in our supposedly-Christian country. And the Bishop of Winchester has reinforced this message. We’ve all heard about the airline worker denied the right to wear a crucifix; the couple denied the opportunity to foster children because of their religious scruples; and the bed-and-breakfast proprietors who won’t take same-sex couples in double rooms in their guesthouse. The law does seem to have sided against ordinary Christians following their consciences.
Religion is closely interwoven with law and ethics and this subject too is a matter of ongoing interest to me.
There was something too about managing Alzheimer’s more cost effectively but I can’t seem to find that. No, it’s NOT a joke about dementia: I genuinely can’t. I looked and in the search found this site which might be comforting for those people struggling alongside this disease. But in the absence of a link to the news item I was looking for, I didn’t want to ignore another topic that I’ve delved into in depth for one of my novels, Remember Remember, because of course, it leapt out of the page at me.
So you see, just in a few days I’ve had my belief that people do care about ethical dilemmas reinforced over and over again. A great spur to another year of writing.
