Hazel McHaffie


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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The Snow Child

It was billed as ‘A bewitching tale of heartbreak and hope set in 1920s Alaska’, and as ‘an instant classic’. It was recommended by the Richard and Judy Bookclub and received enthusiastic reviews. It’s been on my to-read list for ages. It’s Eowyn Ivey’s debut novel, The Snow Child, and it intrigued me enough to become my first read of 2013.

The Snow ChildPart fairytale (based on a Russian folk story ‘Snegurochka, the Snow Maiden‘ and Arthur Ransome’s ‘Little Daughter of the Snow‘), part family saga about love and loss and the craving for motherhood, it was certainly different.

Jack and Mabel have left behind a comfortable life in Pennsylvania and are desperately trying to make a fresh start for themselves in a simple homestead in the raw Alaskan wilderness. But as winter approaches Jack struggles to clear the land and make ends meet, and Mabel mourns the child she lost ten years before when it was stillborn. Life is hard and the new environment is not bringing them closer or offering them hope of better times.

On the day of the first snow fall, in a rare moment of childish spontaneity and tenderness, the couple play outside and build a snowgirl together. The next morning, all trace of her has gone but small footprints lead into the forest. They begin to catch glimpses of a child wearing the scarf and mittens they’d used to dress the snowchild. Faina (an appropriately fey name, I thought) runs in and out of their lives, through the spruce trees of the forest, fending for herself amongst the wild animals, even befriending a fox, and learning to trust this strange and sad couple. They welcome her with a kind of breathless caution, and she leads them to new places, new experiences and a gentle kind of happiness.

If you enjoy reading large swathes of description; if you’re happy with a slow pace – a very, very slow pace – and interested in the minutiae of farming and trapping in the icy wastes, then this is your kind of novel. I’m not usually … and yet I found much to commend this book to me. The writing has a certain lyrical beauty; the landscape Ivey describes has an ethereal quality – something of the magic unique to each individual snowflake, as well as to a bigger pristine and mysterious world of snow and ice. (Curiously we’re experiencing our own first snowfall of 2013 as I write!)

But I was less enamoured with the big chunks of the book where nothing happened. And with the curious juxtaposition of the fairytale and the reality. The author has used a technique of omitting quotation marks when the snowgirl is present to convey a doubt as to the reality of the child, but seems to me to have thrown away her advantage when she dips into earthy descriptions of childbirth and illness associated with the same otherworldly figure.

And the element of implausibility throughout made it difficult to grasp exactly what was being conveyed. Flesh-and-blood small girls don’t survive alone in the wilderness … but what of that grisly corpse? The treatment for puerperal fever is not freezing the patient outside in sub-zero temperatures … but what of that discarded nightdress in the empty bed under the stars? I’m perfectly willing to suspend disbelief in the interests of a gripping read, but … well, this one stretched my credulity a tad too far for comfort.

On the other hand the development of the relationship between Mabel and Jack once Mabel has established herself as a partner on the land they call their own, is well wrought. The robust contributions of the neighbours, the thawing of Mabel’s heart, are warming threads in the story. I liked the underlying messages of love and loyalty.

So, although I was delightfully entertained by The Snow Girl, overall I’m afraid the different strands failed to gel for me. It wouldn’t be in my top ten. But I’m probably in a small minority. Which is partly why I’ve devoted a whole post to this book.

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IVF – a luxury or a right?

It’s odd how when your mind is steeped in a particular subject you see related things everywhere, isn’t it?

As part of preparing for the publication of Saving Sebastian I’ve been thinking a lot about fertility treatments, the rights and wrongs, benefits and risks, should we-shouldn’t we? Because as well as working on the book itself, I’ve had to bend my mind to the assorted peripheral tasks that dog any writer – publicity and marketing, updating my website, events, that sort of thing. Not nearly as much fun as the creative writing but just as necessary, I’m afraid. Anyway, I was deep into drafting questions for bookclubs, and challenges for teachers and students of related subjects, when lo and behold, two articles jumped out at me.

One was a news item saying that a Brazilian fertility expert – the very one who helped the famous footballer, Pelé, become the father of twins – is suspected of having deceived patients at his Sao Paulo clinic into raising children who were not biologically their own by implanting other couples’ embryos to boost his success rates. Wow!

And why did this leap out and sock me between the eyes? Because in Saving Sebastian, a Nigerian couple have twins through IVF – one black, the other coffee coloured – and there’s a big old stooshie going on in the fertility centre to establish just what went wrong. Was it deliberate? Was it a genuine mistake? Is there something else lurking in the undergrowth? Too bad real life beat me to it, eh? If my publisher had stuck to the original publication date of 1 May my novel would have been out a fortnight before this Brazilian story broke. Heigh-ho.

The other sucker-punch was by Daily Telegraph columnist, Dr Max Pemberton (16 May). He starts by saying he thought long and hard before writing this particular article because he knew he’d attract condemnation. OK, I’m listening, Doc. The gist of his argument – please note his not necessarily mine (I want to keep my powder dry meantime!) is
– the NHS is strapped for cash
– hard decisions have to be made about how to use limited resources
– there is now an expectation that the NHS will provide fertility treatment on demand and the belief that everyone has a right to be a parent
– childlessness is not a disease but a grief based on people being unable to have what they want
– in these straightened times life-threatening and debilitating diseases should take precedence
– therefore, he concludes,  ‘IVF is a luxury the NHS just cannot afford‘.

And the relevance of this piece? Well, in Saving Sebstian, Yasmeen and Karim Zair are fighting to have a baby by IVF who is the same tissue type as their son, Sebastian. The little lad has a rare blood disorder from which he will die if he doesn’t get stem cells from a saviour sibling. And already he’s having punishing treatment to keep him alive. At four years of age … imagine! Should they be allowed to have this treatment? There are plenty of people opposing them. What do you think?

Maybe reading the book will help to crystallise your own thinking so you can agree or disagree with Max Pemberton more logically. But in the meantime please do have your say on my blog if your dander is up, steam is exploding out of your ears, and you feel like adding to the debate right now! You can always publish an addendum or a retraction later. Remember …

The man who never alters his opinion is like standing water, and breeds reptiles of the mind (William Blake).

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