Hazel McHaffie

fertility treatment

A serendipitous find

Well, what d’you know?! In amongst the plethora of books the kind people of my neighbourhood are putting on the communal bookshelves, I found one that grabbed my attention. There, on the back cover – fertility treatment, human experimentation … wahey! My kind of key words!

And the author? Val McDermid, whose skill with words leaves me battling the green-eyed monster. This particular edition of Blue Genes might look as if it’s been dropped in the bath, and stuffed under a pillow, and bent backwards energetically enough to release the middle pages from their moorings, but it nevertheless did a wee detour into my hands, and I devoured it over two days. Pure diversion.

Kate Brannigan is a private investigator whose life is disintegrating all around her.
a) She’s on the verge of buttoning up a case of fraudulent exploitation of bereaved people, posing as a new widow herself, when the supposed deceased man erupts into the scene at precisely the wrong moment, and blows her case to kingdom come.
b) Her partner in the firm, Bill, is selling out and she can’t afford to buy his share of the company.
c) And she discovers her best friend, Alexis, has been concealing a massive secret about the child she’s having with her lesbian partner, Chris.

Now she’s suddenly deep in an investigation where one of the chief protagonists is lying murdered on her own kitchen floor.  Her name’s Dr Sarah Blackstone, a leading gynaecologist, specialising in sub-fertility in Leeds. Her picture’s in the paper. Or … is it? Not according to Alexis, who identifies the murdered woman in the photo as Dr Helen Maitland, the Manchester specialist who helped her towards her dream of parenthood. So why has this doctor been practising under two different names? And why has she been killed? And why has she adopted the name of a real live medical colleague high-profile enough to have published extensively on recent advances in gene replacement therapy? And just how far is someone pushing at the frontiers of what is allowable in fertility treatment?

Criminal, legal and ethical quagmires aplenty. My kind of territory. What a treat!

And all delivered with Val McDermid’s customary brio. I don’t want to deliver any spoilers but I can share a few literary gems with you:

Ironing out the problems in my relationship with Richard would have taken the entire staff of an industrial laundry a month. It had taken us rather longer.

Alexis grinned and blew a long stream of smoke down her nostrils. Puff the Magic Dragon would have signed up for a training course on the spot.

As well as the red-rimmed eyes and the stubble, a prospective employer had to contend with a haircut that looked like Edward Scissorhands on a bad hair day, and a dress sense that would embarrass a jumble sale.

… a three-bedroomed semi with a set of flower beds so neat it was hard to imagine a dandelion would have enough bottle to sprout there.

The devil finds work for idle hands; if you can’t manage any other exercise, you can always push your luck.

Treasures one and all.

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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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