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Reproductive Ethics in Commercial Surrogacy: Decision-Making in IVF Clinics in New Delhi, India

Journal of Bioethical Inquiry volume 12, pages 491–501 (2015)Cite this article

Abstract

As a neo-liberal economy, India has become one of the new health tourism destinations, with commercial gestational surrogacy as an expanding market. Yet the Indian Assisted Reproductive Technology (ART) Bill has been pending for five years, and the guidelines issued by the Indian Council of Medical Research are somewhat vague and contradictory, resulting in self-regulated practices of fertility clinics. This paper broadly looks at clinical ethics in reproduction in the practice of surrogacy and decision-making in various procedures. Through empirical research in New Delhi, the capital of India, from December 2011 to November 2012, issues of decision-making on embryo transfer, fetal reduction, and mode of delivery were identified. Interviews were carried out with doctors in eighteen ART clinics, agents from four agencies, and fourteen surrogates. In aiming to fulfil the commissioning parents’ demands, doctors were willing to go to the greatest extent possible in their medical practice. Autonomy and decision-making regarding choice of the number of embryos to transfer and the mode of delivery lay neither with commissioning parents nor surrogate mothers but mostly with doctors. In order to ensure higher success rates, surrogates faced the risk of multiple pregnancy and fetal reduction with little information regarding the risks involved. In the globalized market of commercial surrogacy in India, and with clinics compromising on ethics, there is an urgent need for formulation of regulative law for the clinical practice and maintenance of principles of reproductive ethics in order to ensure that the interests of surrogate mothers are safeguarded.

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Statement of Competing Interests

The authors have stated explicitly that there are no conflicts of interests in connection with this article.

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Authors and Affiliations

  1. Institute of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark

    Malene Tanderup

  2. Centre of Social Medicine and Community health, Jawaharlal Nehru University, 110067, New Delhi, India

    Sunita Reddy

  3. Department of Sociology, Delhi School of Economics, Delhi University, Delhi, 110007, India

    Tulsi Patel

  4. Department of Obstetrics and Gynaecology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark

    Birgitte Bruun Nielsen

Authors
  1. Malene Tanderup
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  2. Sunita Reddy
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  3. Tulsi Patel
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  4. Birgitte Bruun Nielsen
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Correspondence to Malene Tanderup.

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Tanderup, M., Reddy, S., Patel, T. et al. Reproductive Ethics in Commercial Surrogacy: Decision-Making in IVF Clinics in New Delhi, India. Bioethical Inquiry 12, 491–501 (2015). https://doi.org/10.1007/s11673-015-9642-8

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  • DOI: https://doi.org/10.1007/s11673-015-9642-8

Keywords

  • Reproductive ethics
  • Surrogate mothers
  • Informed consent
  • Decision-making
  • Embryo transfer
  • Fetal reduction
  • Delivery