BBC1
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.
Nothing new under the sun
Big sigh!
Publishing anything – a letter/article in a newspaper, a research paper, a novel – is always subject to time. Will someone else pip me to the post? Will I appear to be a plagiarist rather than an original thinker? Two incidents have stirred that old anxiety for me recently.
It’s a while since I read a novel which explores an ethical issue in my own sphere of interest, so I was intrigued by Susan Lewis’ 2017 book, Hiding in Plain Sight, especially when I kept reading and found her story overlaps with no less than three of my own novels.
* One of her principal characters is Penny Lawrence who led a disturbed childhood before running away aged 14. In Over my Dead Body (2013), I tried to get inside the mind of a child who struggles to relate to her family, and a mother who agonises over her own response to her child.
* Penny Lawrence gets involved in the world of selling babies to infertile couples. I asked a lot of what-if questions about surrogate pregnancy in Double Trouble (2005).
* When Penny Lawrence meets up with her mother and sister almost thirty years later, all three are forced to face the fractures in their family lives foursquare. In my current novel, Killing me Gently, I’m delving into the effect parents’ and children’s behaviour and emotions can have on family cohesion and integrity.
And curiously one of the titles I considered for my book was Killing in Plain Sight.
But there the similarities end. Susan Lewis’ take on these issues, her writing style, her whole approach, are completely different from mine. Character and plot tend to be far darker, the psyche more tortured, the secret lives more sinister. She’s quick to reassure us that her books are not intended to leave us feeling frightened or miserable but they do dabble in disturbing and sensitive subjects – in this case family tragedy and mental illness. I too deal with sensitive and troubling issues, I have even been known to end on a sad note, but I do aim to have redeeming features in my characters, and to leave lots of breathing space for the reader to form his/her own opinion on the rights and wrongs of what happens.
There’s ample room for both of us to be writing on these issues, I think.
So hopefully this same maxim will apply in the case of the new Sunday evening drama, The Cry, which started this week on BBC1. I couldn’t believe my eyes when the trailers started just after I finished my latest edit of Killing me Gently. Difficult to predict the degree of overlap at the moment but there are uncanny similarities.
I’ve never seen so many flash-backs and flash-forwards before, but we know this is about a young mum (played by Jenna Coleman aka Queen Victoria!) struggling with a fractious baby who vanishes mysteriously, and now the mum’s on trial for something baby-related. The series will be finished before my book comes out, so if push comes to shove I can always tweak my own plot if necessary, but of course, I devoutly hope it won’t be. Months, if not years, of blood, sweat and tears have gone into creating and realising this psychological thriller, getting it balanced, making the point.
Assisted dying wrapped in silk
Image courtesy of Fotolia
Joanna is a young woman in constant pain. She’s tetraplegic following a car accident, totally dependent on others for her every need 24 hours of every day, and facing the prospect of another 20-30 years in a similar state. A bright nimble brain in a paralysed body. Trapped. She isn’t physically able to end her own life; the law doesn’t allow her to be killed by others. No wonder she’s depressed.
But so too, is her mother Sarah, trapped with her. She asserts that her daughter said on many occasions, ‘If you loved me, you’d kill me,’ although, as the prosecuting lawyer reminded her, ‘We only have your word for that.’ And yes, Sarah is in court because she has admitted to killing Jo with a lethal cocktail of drugs.
On the surface it looks like a straightforward battle about the morality of helping someone to die. It’s not until Sarah is under questioning that her own defence lawyer senses something is wrong with her testimony. Who is she protecting? What did actually happen in that bedroom?
That was the essence of the story in the courtroom drama, Silk, on BBC1 on Monday 10 March. It’s a programme I enjoy watching normally – although I confess the private shenanigans between the characters often make me cringe. When the topics creep into my areas of particular interest I’m doubly hooked. And this particular storyline was particularly timely because the papers at the weekend were predicting significant developments in the legalisation of assisted suicide. In the next airing of the Assisted Dying Bill, due in a few months, Conservative and Liberal Democrat MPs and peers – including Coalition ministers – will be given a free vote on the Bill that would enable terminally ill patients to be helped to die. And although neither the prime minister nor his deputy are in favour of a change in the law, the Government has now made it clear that it would not stand in the way of such a Bill where strict safeguards are in place. (Incidentally Joanna wouldn’t qualify as she’s not terminally ill, though she is in constant pain.)
Of course, opposition remains. Doctors, disability campaigners and church leaders are still cautioning that a relaxation in the law could put vulnerable people at risk, and damage the doctor-patient relationship. Furthermore, it’s argued, this is a dangerous time to consider a relaxation because of ‘an atmosphere of growing hostility towards disabled and elderly people‘ in the wake of the recession.
Is there ever a good time? Which way would you vote? Given your own circumstances? Or if you were Sarah, experiencing at first hand the impact of extreme disability of your beloved daughter, and on the rest of the family? Or if you were Joanna herself, facing unremitting pain and indignity for the rest of your life?
At the same time as this play was airing, I was reading Debbie Purdy‘s book, It’s Not Because I Want To Die. You’ll remember she’s the doughty fighter with MS who fought through the courts for the right of her husband to help her die at a time of her choosing, without fear of prosecution. And as the title of her book suggests, she contends that the reassurance that he would not be prosecuted means that she can prolong her life with impunity – prolong not shorten, please note. But, wait a minute … the new Bill wouldn’t help her either because she’s not terminally ill. Hmmm. So who exactly needs new legislation?
I’m with a certain AMS Hutton-Wilson writing in the letter pages of the Telegraph on 11 March: ‘The people most in need of a change in the law are not the terminally ill but those who, although still mentally capable of making an informed judgment and expressing it clearly, have had their quality of life profoundly compromised by conditions leading to an inability to talk, swallow or breathe without difficulty.’
What would you do about them?
Wishing you a thought-provoking and happy Christmas!
Christmas week! Looks like it’ll be a white one at that, too. (Funny how that prospect has rather lost its sparkle this year.)
But as I mess about with the usual preparations, thoughts keep turning to the reason for the season. So my blog ought to reflect that.
I guess it all dates back to October. 
Then, visiting Morocco, I felt as if I was walking through a film-set during a Biblical epic. I even wrote notes at the time to accompany photos, so strongly evocative were they of familiar scenes from the New Testament.
And recently, with Christmas very much in mind, I’ve been sharing reflections with friends about the sense I had that Moroccan cities, villages and landscapes, dress and customs, are so much closer to the kind of life Mary, Joseph and Jesus would have known, than anything we in the UK take as the norm today.
Well, it looks like someone else got the same feel. This week the BBC has been showing a four-part drama, The Nativity. And where has it been filmed? In Morocco! I’ve just finished watching the last in the series.
My interest was piqued originally by two articles in The Daily Telegraph on Saturday. The first was a rather touching piece by Olly Grant in the Review pages. As he says, the fact that the BBC is showing a Bible story on prime time feels ‘like something of a miracle,’ given the decline in religious programmes over the year, and all the talk of political correctness and discrimination, etc etc etc. And the second was an interview with the screenwriter, Tony Jordan, who didn’t believe the gospel story three years ago when he began working on the play, but now does.
Well, The Nativity wasn’t ever your average religious programme. And what’s more, the author set out quite deliberately to make a film that would ‘reach beyond the “God Channel” fringe’. So he framed the story in a way that would bypass the usual scepticism about angel visitations and virgin births, and instead unravel a young couple’s relationship in a meaningful way – a ‘marriage in meltdown’. As he says, we may know that Joseph and Mary were caught up in an incredible event, but they didn’t. How did these happenings affect them?
He has researched his subject thoroughly, and been remarkably faithful to the gospel accounts. Having said that, only two of the gospels mention the nativity at all, and those that do (Matthew and Luke) devote a mere 120 verses to the subject. So there’s not a lot of material to go on; lots of room for the imagination to manoeuvre then. But Jordan has created a narrative that challenges the viewer to look again at the impact of these events … on a young woman who finds herself unexpectedly pregnant at a time and in a place where adulteresses were stoned to death; on her devastated parents; on a man who feels betrayed by his promised wife; on his family; on a debt-ridden shepherd … I for one see no harm in a little speculative artistic licence if it provokes healthy challenge and helps us engage with the big questions, though others beg to differ.
Jordan’s aim was for those who have a faith, to have it reinforced; and for those who haven’t, to think: ‘Wow, I don’t know … maybe …’ I suspect that there are hundreds of clergy this week wanting exactly that. But they don’t all have Morocco as their backdrop, prime time TV as their conduit, or key figures being converted along the way.
For me personally, though, this approach has an extra allure. It’s trying to combine entertainment and authenticity with emotional and intellectual challenge. Much as I’m trying to do with medical ethics. Would that I had their publicity machine and audience ratings! Maybe a word in the ear of Tony Jordan …?
But in the meantime, Happy Christmas, everyone!