Doctors demand tighter laws on surrogacy

Doctors yesterday called for the law on surrogacy to be tightened - particularly concerning money paid as expenses - after a mother revealed she had not, after all, aborted a child she was carrying for a Dutch couple.

Karen Roche was said to have panicked about Clemens and Sonja Peeters' commitment to the baby, and falsely claimed she had had an abortion to break the contract with them. She and her husband now intend to bring up the child as their own.

Kim Cotton, Britain's first commercial surrogate mother and founder of the surrogacy agency Cots, which introduced them, said that she was delighted the abortion had not taken place but said she had "grave concerns" over the Peeters' conduct during the pregnancy - for which they were paying Mrs Roche pounds 12,000 expenses. She added that there was no way she could make Mrs Roche hand over the baby.

Dr Bill O'Neill, ethics and science adviser to the British Medical Association, said the case demonstrated "a need for greater monitoring and perhaps, in time, regulation".

Baroness Warnock who chaired the Human Fertilisation committee which looked at surrogacy in the 1980s said that she felt the practice of surrogacy was exceptionally dubious . "If it was up to me it would be an offence to act as a surrogate mother or select a surrogate mother," she told the BBC Radio's World at One, and she urged the Human Fertilisation and Embryology Authority to use it as a test case in order to make recommendations for future legislation.

There are currently two recognised surrogacy agencies in Britain, the better-known of which is Cots (Childlessness Overcome Through Surrogacy), set up in 1988 by Mrs Cotton.

It is a non profit-making organisation staffed completely by volunteers. Women are usually paid around pounds 10,000 expenses' for carrying the baby - to include lost earnings and maternity wear. Although it offers guidelines, the agency - which is said to have made introductions resulting in 200 surrogate babies - is unable to enforce any deals.

While Mrs Roche's case demonstrates the problems with the way surrogacy is managed, it also highlights the difficulties of regulation. As Ruth Deech, chairman of the HFEA points out short of installing a "policeman in every bedroom" there is no way the law can stop a man donating sperm and a woman inseminating herself to carry a child for another. She said it might be time to to look again at the 1985 Act to define more closely "legitimate" expenses.

Peter Brinsden, medical director of Bourn Hall, which has carried out the largest series of IVF surrogacies in Europe [in which an embryo provided by the couple is implanted in the surrogate's womb], said the emphasis should be to combat commercialism. And he called for tighter regulation so that surrogacy could be carried out under the aegis of licensed clinics.

A spokesman for the Department of Health said serious consideration would be given to any concerns or suggestions.

The storm over surrogacy broke in 1985 when Mrs Cotton was revealed as Britain's first commercial surrogate. The subsequent Surrogacy Arrangements Act banned advertising for surrogates or payment for surrogacy beyond reasonable expenses. The BMA initially advised doctors not to get involved in surrogacy arrangements but last year endorsed it as an acceptable treatment for infertility. The first surrogate birth on the NHS - Jack Wells - took place just over a year ago.

In other countries the situation varies, but most countries still prohibit it. In the Netherlands - the Peeters' home - it is illegal. In Israel, while commercial surrogacy is illegal, a public committee made up of two doctors, a clinical psychologist, a lawyer, a social worker and a clergyman supervises any appeal for surrogacy and it is a criminal act to make an arrangement without the committee's permission.

The US has gone furthest. Although laws differ from state to state, in some it is fully recognised and a mother can be forced to hand over the baby if she has signed a contract.

Suzanne Moore, page 21