mixed AE
Content
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN
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Issue that Rises Regarding Surrogacy in Japan Mastenbroek Elson Anak John Edan B1100962 HELP University
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN Outline I.
2
II.
III.
IV.
V.
Introduction A. Opener: B. Thesis Statement: This research paper is to clarify the issue and problem regarding surrogacy which happens in Japan begin with prohibition of surrogacy, then implementation of trial surrogacy and finally is Prohibition of commercial surrogacy and acceptable expenses. For the first issue regarding surrogacy is problem that will be arising if surrogacy ware prohibited. A. Survey carried out 1. sample size 2. understand surrogacy meaning B. Travel overseas C. Internet based surrogacy The Assisted Reproductive Technologies Review Committee of the Science Council of Japan (ART Review Committee) stated that so trial cases might be allowed but in condition that the infertile couple children, the surrogates, will be monitored since birth by a Japanese special organization. A. Monitoring 1.Long term 2.Without consent B. Outcome from monitoring 1.Psychologically 2.physically C. For future studies Next, the ART Review Committee had suggested the prohibition of commercial surrogacy and compensation but it is hard to define the meanings of commercial surrogacy, non-commercial surrogacy, compensation, and reasonable expenses due to practical matter. A. In United Kingdom 1.Cost 2.Childlessness Overcome Through Surrogacy (COTS) B. South Korea and Taiwan 1.Cost 2.No under law control Conclusion
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN Issue that Rises Regarding Surrogacy in Japan Acton (2011) stated: “As of 2008, surrogacy is legal and openly practiced in various places; Japan, however, has no regulations or laws regarding surrogacy.” (p. 25). In year 1991, surrogacy in Japan started and the Information Center for Surrogacy was founded in Japan main city, Tokyo. The infertile couples hope to help themselves from the surrogacy services began to travel overseas with the Center‟s back up and aid. In year, the Information Center for Surrogacy had receives helps from 300 to 400 infertile couples
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(Semba, Chang, Hong , Kamisato, Kokado, & Muto, 2010). In vitro fertilization (IVF) using donated eggs, sperms and embryo plus it had to be performed under Japan Society of Obstetrics and Gynecology (JSOG) guidelines which mean only „legally‟ married couples are qualified to for IVF. Then donor insemination (DI), same guideline of JSOG applied and the individual donors require being anonymous (Semba et al, 2010). What is surrogacy? It is when another woman gave birth for infertile couples (Human Fertilisation & Embryo Authority, 2012). This research paper is to clarify the issue and problem regarding surrogacy which happens in Japan begin with prohibition of surrogacy, then implementation of trial surrogacy and finally is Prohibition of commercial surrogacy and acceptable expenses. For the first issue regarding surrogacy is problem that will be arising if surrogacy ware prohibited. Before start with the main point, a survey regarding assisted reproductive medicine in Japan was carried out by research team of Health, Labour and Welfare Ministry in year 2007 (Ministry of Health, Labour and Welfare, 2007). About five thousand Japanese citizen both men and women between 20 – 69 years old were chosen randomly for the survey. 3412 out of 5000 responded which mean 68.2 percent. From the respondents, 54 percent stated that „agreed,‟ while 16 percent does not accept it by stating „surrogacy not acceptable socially.‟ However, after the Ministry researcher analyzed these result indicate
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN that the respondents‟ knowledge about surrogacy was pointed out in their respond (Ministry of Health, Labour and Welfare, 2007). Generally, those have history of childbirth will have proper knowledge regarding maternal health surrogacy attempt to against surrogacy. To
4
those agree with surrogacy did not understand the meaning of surrogacy accurately (Ministry of Health, Labour and Welfare, 2007). While in France, surrogacy strongly prohibited in that country does not mean surrogacy in Japan will be gone if the Japanese government prohibit it. The reason is people are willing to go to overseas for surrogacy (Semba et al, 2010). There will be always infertile couple cannot accept their life without having children. In that case, surrogacy will never disappear. Besides that, by prohibiting surrogacy in Japan also might causes internet-mediated surrogacy. This happened in other country also, even France also, which has prohibited surrogacy (Semba et al, 2010). The individual can look for surrogates through Internet discussion board, forum or underground website. Based on the both example has shown, surrogacy can be prohibited but it only on surface. Surrogacy still can be happened in underground, illegal surrogacy (Semba et al, 2010). The Assisted Reproductive Technologies Review Committee of the Science Council of Japan (ART Review Committee) stated that so trial cases might be approved but in condition that the infertile couple children, the surrogates, will be monitored since birth by a Japanese special organization (Semba et al, 2010). If compare with other country, there is no such policy exists since it only in Japan. ART committee also stated that the purpose of such monitoring is beneficial for Japan so society can learn about the ethical, legal, and special problem that faces by surrogates and effects on their physical and psychology aspect; however the surrogates involve in this study without their consent. This study considered ethically problematic if it based on Ethical Principles for Human Subject Research in the Nuremberg Code (1947) and the Declaration of Helsinki (1964) (Semba et al, 2010). In Swedish law, such system exist for medical or scientific research suggested to monitoring all
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN children that born through IVF (Ngyren, 2002). The outcome from this monitoring will be import for future discussion about implementation (Semba et al, 2010). This monitoring system is compulsory to ascertain the different between child born from donated eggs and normal pregnancies and to studies the physical and psychology outcome for children born through the surrogacy. The question is, is it fair for children born through surrogacy are monitored, so should they born from donated eggs? Based on the ethical viewpoint, the
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children that born through surrogacy should be given consent for being monitored or they can refuse to cooperate with the research (Semba et al, 2010). Next, the ART Review Committee had suggested the prohibition of commercial surrogacy and compensation but it is hard to explain the meanings of commercial surrogacy, non-commercial surrogacy, compensation, and acceptable expenses due to practical matter (Semba et al, 2010). In United Kingdom (UK), Surrogacy Arrangement Act had prohibited commercial surrogacy; however, the Act unsuccessful to explain the detail of „acceptable expenses‟ as mentioned before. Based on parental right, section 30 of the HFE Act 1990 stated „couples must not pay compensation to surrogates‟ but it not clear it is included within „acceptable expenses.‟ In between 1988 to 1999, there is 188 agreement handled by Childlessness Overcome Through Surrogacy (COTS), a group that support surrogacy in UK, stated that the cost to pay surrogacy is from zero to £20,000. Most of the time it will cost to £7000 to £15,000, with average about £7573. While in United State of America (USA), in some states like California, commercial surrogacy‟s are allowed. The compensation had been set by agency coordination surrogacy is about 16,000 USD to 22,000 USD for surrogates without experience without surrogate and more than 23,000 USD with experience (Semba et al, 2010). The money consider as income to those surrogates for profit therefore it subject to income tax. Even though UK prohibited receiving compensation, there is different in amount paid to the surrogates for profit in USA while those paid to surrogates for acceptable prices in
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN UK. Semba et al. (2010) found out that there is no legal restriction for compensation to surrogates women in South Korea and Taiwan. Internet searching is most common method
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for surrogacy in South Korea and it cost about 25 million won to 80 million won. Half of the cost is for brokerage fee is deducted. While it Taiwan the compensation fee is about 4.5 million (in New Taiwan Dollar). Furthermore, problems related to compensation for surrogacy continues in cases such as those in South Korea and Taiwan, where does not have control of the law existed. Semba et al. (2010) found that surrogates sometimes received a large number of compensation. In USA, this quite rare to happen, where commercial surrogacy is legal. Besides that, the fee structure for contract-based surrogacy in the USA is more obvious than in other countries, and it also said that the necessary amount to pay income tax on the progress of surrogacy assists transparency (Semba et al, 2010). In brief, various issues still remain even if surrogacy were prohibited. In addition, Semba et al. (2010) had found out that each country or region had it own law regarding surrogacy whether is it surrogacy prohibition by law, allowing surrogacy as long it on court rule or there is no rules for surrogacy. Moreover, France not only one that prohibited surrogacy, but also UK which allow surrogacy as long it not commercially-based surrogacy, childless infertile couple willing to travel overseas for surrogacy services. From this, it obviously that surrogacy will never wipe out from Japan if it is prohibited by legislation in that country (Semba et al, 2010). Plus, even if government prohibited surrogacy, there still couple willing undergo underground surrogacy within Japan. And the problem occur when there agreement among themselves which they wan not able to ask for assistance from professional or lawsuit to the court. This case can be seen in South Korea and Taiwan example shown where the result causes complicated problem either socially or psychologically toward the children. Besides that, Semba et al. (2010) also conclude that there is dissimilarity between commercial and non-commercial surrogacy regarding in the
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN absence of accurate meaning of „acceptable surrogacy.‟ In addition, for the basic issue stays regarding compensation for surrogacy and it is needed for appropriate authority in this field such as lawyer, psychologist or lawyer in order to secure transparency and minimize the contingency (Semba et al, 2010). To conclude this whole research paper, there is prejudice and social pressure toward infertility in Japan society so they should overcome this entire obstacle. However, it is still difficult to prohibit surrogacy at this point so Semba et al. (2010) conclude that the surrogacy should be legal in Japan under proper re4gulations or guidelines to avoid all these issue stated in this research paper.
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Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN References Acton, Q. A. (2012). Issues in Ethics Research and Application: 2011 Edition. Atlanta, Gorgia:ScholarlyEditions. Human Fertilisation & Embryo Authority. (2012, May 28). Retrieved from http://www.hfea.gov.uk/fertility-treatment-options-surrogacy.html#1 Ministry of Health, Labour and Welfare. (2007). Attitudinal Survey Regarding Assisted Reproductive Medical Technology. In In Project Report of the Emergency Countermeasure for Assisted Reproductive Medicine in 2006 (pp. 1–199). Tokyo: Ministry of Health, Labour and Welfare. Ngyren, K. (2002). The Swedish Experience of Assisted Reproductive. In Current Practices and Controversies in Assisted Reproduction: Report of a WHO Meeting. , 351 - 354. Semba, Y., Chang, C., Hong , H., Kamisato, A., Kokado, M., & Muto, K. (2010). Bioethics.
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SURROGACY: DONOR CONCEPTION REGULATION IN JAPAN , 24 (7), 348-357.
1
Issue that Rises Regarding Surrogacy in Japan Mastenbroek Elson Anak John Edan B1100962 HELP University
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN Outline I.
2
II.
III.
IV.
V.
Introduction A. Opener: B. Thesis Statement: This research paper is to clarify the issue and problem regarding surrogacy which happens in Japan begin with prohibition of surrogacy, then implementation of trial surrogacy and finally is Prohibition of commercial surrogacy and acceptable expenses. For the first issue regarding surrogacy is problem that will be arising if surrogacy ware prohibited. A. Survey carried out 1. sample size 2. understand surrogacy meaning B. Travel overseas C. Internet based surrogacy The Assisted Reproductive Technologies Review Committee of the Science Council of Japan (ART Review Committee) stated that so trial cases might be allowed but in condition that the infertile couple children, the surrogates, will be monitored since birth by a Japanese special organization. A. Monitoring 1.Long term 2.Without consent B. Outcome from monitoring 1.Psychologically 2.physically C. For future studies Next, the ART Review Committee had suggested the prohibition of commercial surrogacy and compensation but it is hard to define the meanings of commercial surrogacy, non-commercial surrogacy, compensation, and reasonable expenses due to practical matter. A. In United Kingdom 1.Cost 2.Childlessness Overcome Through Surrogacy (COTS) B. South Korea and Taiwan 1.Cost 2.No under law control Conclusion
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN Issue that Rises Regarding Surrogacy in Japan Acton (2011) stated: “As of 2008, surrogacy is legal and openly practiced in various places; Japan, however, has no regulations or laws regarding surrogacy.” (p. 25). In year 1991, surrogacy in Japan started and the Information Center for Surrogacy was founded in Japan main city, Tokyo. The infertile couples hope to help themselves from the surrogacy services began to travel overseas with the Center‟s back up and aid. In year, the Information Center for Surrogacy had receives helps from 300 to 400 infertile couples
3
(Semba, Chang, Hong , Kamisato, Kokado, & Muto, 2010). In vitro fertilization (IVF) using donated eggs, sperms and embryo plus it had to be performed under Japan Society of Obstetrics and Gynecology (JSOG) guidelines which mean only „legally‟ married couples are qualified to for IVF. Then donor insemination (DI), same guideline of JSOG applied and the individual donors require being anonymous (Semba et al, 2010). What is surrogacy? It is when another woman gave birth for infertile couples (Human Fertilisation & Embryo Authority, 2012). This research paper is to clarify the issue and problem regarding surrogacy which happens in Japan begin with prohibition of surrogacy, then implementation of trial surrogacy and finally is Prohibition of commercial surrogacy and acceptable expenses. For the first issue regarding surrogacy is problem that will be arising if surrogacy ware prohibited. Before start with the main point, a survey regarding assisted reproductive medicine in Japan was carried out by research team of Health, Labour and Welfare Ministry in year 2007 (Ministry of Health, Labour and Welfare, 2007). About five thousand Japanese citizen both men and women between 20 – 69 years old were chosen randomly for the survey. 3412 out of 5000 responded which mean 68.2 percent. From the respondents, 54 percent stated that „agreed,‟ while 16 percent does not accept it by stating „surrogacy not acceptable socially.‟ However, after the Ministry researcher analyzed these result indicate
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN that the respondents‟ knowledge about surrogacy was pointed out in their respond (Ministry of Health, Labour and Welfare, 2007). Generally, those have history of childbirth will have proper knowledge regarding maternal health surrogacy attempt to against surrogacy. To
4
those agree with surrogacy did not understand the meaning of surrogacy accurately (Ministry of Health, Labour and Welfare, 2007). While in France, surrogacy strongly prohibited in that country does not mean surrogacy in Japan will be gone if the Japanese government prohibit it. The reason is people are willing to go to overseas for surrogacy (Semba et al, 2010). There will be always infertile couple cannot accept their life without having children. In that case, surrogacy will never disappear. Besides that, by prohibiting surrogacy in Japan also might causes internet-mediated surrogacy. This happened in other country also, even France also, which has prohibited surrogacy (Semba et al, 2010). The individual can look for surrogates through Internet discussion board, forum or underground website. Based on the both example has shown, surrogacy can be prohibited but it only on surface. Surrogacy still can be happened in underground, illegal surrogacy (Semba et al, 2010). The Assisted Reproductive Technologies Review Committee of the Science Council of Japan (ART Review Committee) stated that so trial cases might be approved but in condition that the infertile couple children, the surrogates, will be monitored since birth by a Japanese special organization (Semba et al, 2010). If compare with other country, there is no such policy exists since it only in Japan. ART committee also stated that the purpose of such monitoring is beneficial for Japan so society can learn about the ethical, legal, and special problem that faces by surrogates and effects on their physical and psychology aspect; however the surrogates involve in this study without their consent. This study considered ethically problematic if it based on Ethical Principles for Human Subject Research in the Nuremberg Code (1947) and the Declaration of Helsinki (1964) (Semba et al, 2010). In Swedish law, such system exist for medical or scientific research suggested to monitoring all
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN children that born through IVF (Ngyren, 2002). The outcome from this monitoring will be import for future discussion about implementation (Semba et al, 2010). This monitoring system is compulsory to ascertain the different between child born from donated eggs and normal pregnancies and to studies the physical and psychology outcome for children born through the surrogacy. The question is, is it fair for children born through surrogacy are monitored, so should they born from donated eggs? Based on the ethical viewpoint, the
5
children that born through surrogacy should be given consent for being monitored or they can refuse to cooperate with the research (Semba et al, 2010). Next, the ART Review Committee had suggested the prohibition of commercial surrogacy and compensation but it is hard to explain the meanings of commercial surrogacy, non-commercial surrogacy, compensation, and acceptable expenses due to practical matter (Semba et al, 2010). In United Kingdom (UK), Surrogacy Arrangement Act had prohibited commercial surrogacy; however, the Act unsuccessful to explain the detail of „acceptable expenses‟ as mentioned before. Based on parental right, section 30 of the HFE Act 1990 stated „couples must not pay compensation to surrogates‟ but it not clear it is included within „acceptable expenses.‟ In between 1988 to 1999, there is 188 agreement handled by Childlessness Overcome Through Surrogacy (COTS), a group that support surrogacy in UK, stated that the cost to pay surrogacy is from zero to £20,000. Most of the time it will cost to £7000 to £15,000, with average about £7573. While in United State of America (USA), in some states like California, commercial surrogacy‟s are allowed. The compensation had been set by agency coordination surrogacy is about 16,000 USD to 22,000 USD for surrogates without experience without surrogate and more than 23,000 USD with experience (Semba et al, 2010). The money consider as income to those surrogates for profit therefore it subject to income tax. Even though UK prohibited receiving compensation, there is different in amount paid to the surrogates for profit in USA while those paid to surrogates for acceptable prices in
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN UK. Semba et al. (2010) found out that there is no legal restriction for compensation to surrogates women in South Korea and Taiwan. Internet searching is most common method
6
for surrogacy in South Korea and it cost about 25 million won to 80 million won. Half of the cost is for brokerage fee is deducted. While it Taiwan the compensation fee is about 4.5 million (in New Taiwan Dollar). Furthermore, problems related to compensation for surrogacy continues in cases such as those in South Korea and Taiwan, where does not have control of the law existed. Semba et al. (2010) found that surrogates sometimes received a large number of compensation. In USA, this quite rare to happen, where commercial surrogacy is legal. Besides that, the fee structure for contract-based surrogacy in the USA is more obvious than in other countries, and it also said that the necessary amount to pay income tax on the progress of surrogacy assists transparency (Semba et al, 2010). In brief, various issues still remain even if surrogacy were prohibited. In addition, Semba et al. (2010) had found out that each country or region had it own law regarding surrogacy whether is it surrogacy prohibition by law, allowing surrogacy as long it on court rule or there is no rules for surrogacy. Moreover, France not only one that prohibited surrogacy, but also UK which allow surrogacy as long it not commercially-based surrogacy, childless infertile couple willing to travel overseas for surrogacy services. From this, it obviously that surrogacy will never wipe out from Japan if it is prohibited by legislation in that country (Semba et al, 2010). Plus, even if government prohibited surrogacy, there still couple willing undergo underground surrogacy within Japan. And the problem occur when there agreement among themselves which they wan not able to ask for assistance from professional or lawsuit to the court. This case can be seen in South Korea and Taiwan example shown where the result causes complicated problem either socially or psychologically toward the children. Besides that, Semba et al. (2010) also conclude that there is dissimilarity between commercial and non-commercial surrogacy regarding in the
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN absence of accurate meaning of „acceptable surrogacy.‟ In addition, for the basic issue stays regarding compensation for surrogacy and it is needed for appropriate authority in this field such as lawyer, psychologist or lawyer in order to secure transparency and minimize the contingency (Semba et al, 2010). To conclude this whole research paper, there is prejudice and social pressure toward infertility in Japan society so they should overcome this entire obstacle. However, it is still difficult to prohibit surrogacy at this point so Semba et al. (2010) conclude that the surrogacy should be legal in Japan under proper re4gulations or guidelines to avoid all these issue stated in this research paper.
7
Running head: ISSUE THAT RISES REGARDING SURROGACY IN JAPAN References Acton, Q. A. (2012). Issues in Ethics Research and Application: 2011 Edition. Atlanta, Gorgia:ScholarlyEditions. Human Fertilisation & Embryo Authority. (2012, May 28). Retrieved from http://www.hfea.gov.uk/fertility-treatment-options-surrogacy.html#1 Ministry of Health, Labour and Welfare. (2007). Attitudinal Survey Regarding Assisted Reproductive Medical Technology. In In Project Report of the Emergency Countermeasure for Assisted Reproductive Medicine in 2006 (pp. 1–199). Tokyo: Ministry of Health, Labour and Welfare. Ngyren, K. (2002). The Swedish Experience of Assisted Reproductive. In Current Practices and Controversies in Assisted Reproduction: Report of a WHO Meeting. , 351 - 354. Semba, Y., Chang, C., Hong , H., Kamisato, A., Kokado, M., & Muto, K. (2010). Bioethics.
8
SURROGACY: DONOR CONCEPTION REGULATION IN JAPAN , 24 (7), 348-357.
