Hazel McHaffie

exploitation

Justice, rights, entitlement

The latest casualty of the coronavirus lockdown in this country is fertility care. As of Wednesday of this week, no new patients will be accepted, and even those in mid-treatment, those for whom this is their last hope, those who will be too old to qualify or stand a chance of success by the end of lockdown, will not now receive the necessary procedures towards which they’ve been working for so long. Yet another tragedy. More heartbreak. More hopelessness.

Which brings my thoughts to the ethical issues around assisted conception …

It’s now fifteen years since I wrote Double Trouble, a book about surrogate pregnancy. Fifteen years! Yoiks. But as with so many ethical dilemmas in medicine, the issues are still relevant today.

I was fascinated then, to watch the serialised BBC1 drama, The Nest, which finished this week, about a very wealthy but childless couple, Glasgow property tycoon Dan and his beautiful pampered wife Emily, who decide to go down this route. Click on the picture for the official trailer.

All attempts at IVF have proved unsuccessful. Dan’s sister has already tried to carry a baby for them but miscarried. They have one precious embryo left. One. Only one more chance. Emily meets the troubled teenage Kaya when she accidentally knocks into her in her car. Kaya sees an opportunity to get out of her impoverished life, and offers to be a surrogate for them in return for £50K. But as the story unravels we find that Kaya has secrets in her past and a very dubious pedigree indeed …; the would-be father Dan is something of a rough diamond too, dealing with a lot of shady characters and skullduggery …; Emily is single-minded about motherhood and what she wants, but privately troubled by the morality of what they are doing – always setting herself up as ‘the principled one‘ according to her sister-in-law. No-one in the UK will implant the last embryo. However, the Dochertys can well afford to go abroad for the simple procedure, and they do so.

On the face of it everyone stands to win. Kaya will be set on her dreamed-of pathway to becoming a successful business woman, able to ‘go on a plane, have one of these pull-along cases‘. The wealthy couple get their hearts’ desire. Better yet, surrogate and intended parents establish a relationship, even friendship. Kaya moves in with the Dochertys and gets a taste of a life of privilege. The baby will not only be much wanted, but will have every advantage money can buy.

Naturally – this is, after all, fiction, drama, a series requiring cliff hangers – things go pear-shaped. Relationships get confused. Loyalties are divided. Dubious and unsavoury motives emerge. But the underlying questions and challenges remain pertinent.

Is parenthood a right?
Is ‘want’ the same as ‘need’ in childbirth terms?
Payment for this service in the UK is forbidden. Should it be?
How binding should a contract between intending parents and surrogate be?
Should private arrangements for surrogacy be permitted?
Does a woman have the right to do whatever she likes with her own body?
What constitutes ‘reasonable expenses’?
Should those with the wherewithal be allowed to circumvent ethical and medical guidelines?
Does using someone far less powerful in this way constitute exploitation?
In the event of a dispute about whose baby it is, whose rights should take precedence, and who should decide?
What if the child is damaged/imperfect/not what was expected? Should the contract still stand? Who should accept responsibility for him/her?
What of the baby’s rights?
How much of its origins should a child be told?

Back to the drama … enter Kaya’s long-estranged mother, who encourages her to renege on the contract, hang on to the baby, become a mother herself, a better mother than she has been. But Dan already loves this child. Even when he finds out she is not his genetically, she’s still his daughter in his heart. The Dochertys call in their lawyer; the case goes to court. It’s left to the judge in the Family Court to put things into perspective – severely castigating their self-serving recklessness, the complete imbalance of power, the undesirable qualities on both sides. But, she says, at the end of the day it’s not a question of how she would judge them; it’s about what is in the baby’s best interests.

Contrary to expectation, there is a happy ending to this story, and both sides demonstrate they’ve learned important lessons about what matters in life. But the drama perfectly illustrates the power of fiction to challenge us to think about what society today should endorse, and how far the law can go in dealing with the fine nuances of moral questions in assisted reproduction. Well done, screenwriter Nicole Taylor.

 

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Tragic deaths

It’s hard for healthy busy contented people to understand the mind of a youngster who will go to any lengths to be extremely thin; almost impossible to comprehend the anguish of their parents, powerless to halt the deadly progress. But that’s what I’ve been trying to do for my latest novel, so perhaps it’s not surprising that news of youngsters who die as a result of this craving hits me foursquare.

Memorial to a young life lostSerious eating disorders have a profound and devastating effect on both patient and family, and it’s well known that the death rate among young people with anorexia is frighteningly high. So exploitation of such vulnerable people seems particularly heinous.

This week saw the inquest into the death of 21-year-old Eloise Parry who, after years of bulimia, sent away for diet pills online to hasten the slimming process by speeding up her metabolism. They contained an industrial chemical, DNP (dinitrophenol) a dangerous toxic substance which is commonly used in explosives and dyes and pesticides. Online marketing describes it innocuously as ‘fat-burning’; experts agree it is not fit for human consumption.

So what persuades an intelligent person to acquire this unlicensed ‘medication’ in the first place, and what drives them to even exceed the recommended dose? Real desperation, distorted thinking, and perhaps too a level of naivety about the dangers of unlicensed drugs acquired online from companies with no scruples as to legality, purity, cleanliness or even authenticity.

Things certainly went catastrophically wrong for Eloise when she took 4 pills at 4am in the morning of April 12, (2 represents a fatal dose) and a further 4 when she woke up later that same morning. Shortly afterwards she drove herself to hospital, aware that she was in big trouble. She even sent a text message to one of her college lecturers at 11.31 saying she was afraid she was going to die, apologising for her stupidity. Her prediction sadly came true at 3.25 that same afternoon. Eloise is the sixth Briton to die in this horrible way – the body’s metabolism speeds up so violently that they burn up inside; nothing can be done to reverse it. What an appalling tragedy.

Eloise’s mother has appealed to others not to buy anything containing DNP. The coroner says he will write to the Government to recommend such products are not accessible. The Department of Health put out an urgent warning to the public. Interpol has issued a global warning. And yet there is clear evidence that some companies are still fraudulently importing this deadly substance under various guises heedless of the consequences.

Bad enough when the mental state of the young person drives them to starve themselves slowly. To have their susceptibility and fragility exploited so shamelessly is nothing short of evil.

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