Organisation: Surrogacy Australia
6.1.2 Clinics should help prospective recipients to understand the significant biological connection that their children have with the gamete donor.
Recipients should be advised that their children are entitled to knowledge of their genetic parents and siblings; they should therefore be encouraged to tell their children about their origins.
Q13. Does the statement in Paragraph 6.1.2 need to be strengthened? o If so, in what ways?
It should be recommended (but not mandatory) to be open and honest with children born with the assistance of a gamete donor. We agree that clinics should help prospective recipients to understand the significant biological connection their children have with the gamete donor and in addition recipients have the responsibility to their children to be open and honest with their children about their genetic heritage.
Q15. Paragraph 6.1.3 o Who should be involved in the dissemination of information to gamete donors (or gamete providers for donated embryos) about children born as a result of their donation? (see also questions in relation to Section 6.12) o How can gamete donors and donor-conceived persons be encouraged to register their consent to being contacted?
 Should this guidance be included in the ART guidelines?
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Australian ART clinics should be responsible for disseminating this information at their own expense
Section 6.5
Q20. In view of developments in other countries allowing women to receive compensation above medical and travelling expenses for donating eggs, should it be permissible for Australian women to also be compensated for the reproductive effort and risks associated with donating their eggs?
(See also Section 13 Surrogacy)
Yes, clearly there is a need for change here, as currently there is such a lack of eggs within Australia, that Australian clinics are recommending their patients travel to South Africa or Spain to source eggs, or (in the case of
Monash with has a financial interest) the World Egg Bank ex USA. There is great concern that Australian IVF doctors are receiving kick-backs from overseas clinics to which they refer patients. By allowing greater compensation to Australian egg donors for the reproductive effort and risks associated, would increase the availability of known Australian donors and hence reduce the use of unknown offshore donors whom the child has little chance of being able to meet if so desired. greater compensation to Australian egg donors is hence in the best interests of the children that result.
Q21. Should more guidance be given about the reimbursement of legitimate expenses? What guidance would you recommend?
Travel, medical consultations if billed, time taken out from work and child-care for: medical consultations, going through the hormonal treatment, egg retrieval and recovery time. Being rewarded for emotional effort. We strongly recommend speaking with women who have donated in the past and taking their views into account.
Section 6.9 (see also Section 7.6)
Q23. Should conditional donation of sperm, eggs or embryos such as stipulating certain race or social attributes be permitted? e.g. a sperm donor not wanting his sperm to be used for a single woman, a lesbian couple, or a particular race?
Sadly yes, prejudice remains a prominent issue in Australian society and the children born through such donation may want to contact the donor when they are old enough and encountering prejudice from the donor would not be in the best interests of the child. It therefore makes sense for the families formed
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Template for response through donor gametes and the gamete donors to minimise potential harm.
You may want to speak to children born through gamete donation to get their views.
Section 6.10
– 6.11
Gamete recipients need information about gamete donors that is relevant for the care of their donor-conceived offspring. Clinics must allow recipients of donated gametes access, through either a medical practitioner or an appropriately qualified health professional, to at least the following information about gamete donors:

details of past medical history, family history and any genetic test results that are relevant to the future health of the person born (or any subsequent offspring of that person) and the recipient of the donation;
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details of the physical characteristics of the gamete donor; and
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the number and sex of persons conceived using the gametes
Q24. Do you think the current ethical guidance is adequate?
Yes.
Q25. Do you consider 18 years of age too late to have access to this information? o Should earlier access to the information be possible?
Yes, if required.
Section 6.12
Q27. Should the donor be able to receive identifying information with the consent of the donor-conceived person?
Yes
Q28. Should donor and recipient information be completely confidential or do you think that this information should be available to all individuals involved?
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Donor and recipient information should be completely available to all individuals involved.
Q31. Is it acceptable to take donations from dying or deceased persons? o If so, under what circumstances? o Should this rely on prior consent?
This seems to depend on whether you prioritise a) the rights of the intended parents to create offspring who will not know their (dying) father/mother b) the right of the unborn child to meet/know its bio mother/father
Section 9.2
Q42. Among the information which should be discussed, should there be specific reference to the significance of biological connection between donor-conceived persons and the donors of gametes, and to the right of these donor-conceived persons to knowledge of their genetic parents and siblings? (see also questions in relation to Section 5 and
Paragraphs 6.1.1 and 6.1.2) yes
Section 9.3
For participants in a gamete or embryo donation program, counselling should include a detailed discussion of the complex issues relating to gamete or embryo donation, including the following specific aspects:
 the long-term psychosocial implications for each individual and each family involved;
 the psychosexual implications;
 the motives of the gamete or embryo provider for becoming involved in a donated gamete program;
 the need to ensure that gamete or embryo donors make their own independent decision to participate and that this decision is reached free from coercion in any form; and
 the right of persons born to have identifying information about their genetic parents and information about the possibility that they will make contact in the future.
Agreed, counselling must include all of the aspects above.
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General Questions
In order to facilitate the exchange of information between donors, recipients and the persons conceived by gamete or embryo donation (as required by paragraphs 6.10 to 6.12), clinics must have appropriate arrangements/systems for data collection, data storage and information release.
10.3.1 Clinics should collect the following information from gamete donors (or gamete providers for donated embryos):
 name, any previous name, date of birth and most recent address;
 details of past medical history, family history, and any genetic test results that are relevant to the future health of the person conceived by gamete donation (or any subsequent offspring of that person) or the recipient of the donation; and
 details of physical characteristics.
Q46.
Do you think that there are gaps in the current ethical guidance in
Section 10?
Should it also include Drivers licence number or Medicare card number of the donor to facilitate tracing them if required
13.1 Do not undertake or facilitate commercial surrogacy
It is ethically unacceptable to undertake or facilitate surrogate pregnancy for commercial purposes. Clinics must not undertake or facilitate commercial surrogacy arrangements.
Q56.
Do you think that there are gaps in the current ethical guidance in
Section 13?
Commercial purposes
Many others involved in surrogacy arrangements in Australia have the right to charge for their services including the counsellors, lawyers and
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IVF clinics. The central person in these arrangements is prohibited from earning money
– we could argue that lawyers, IVF clinics and counsellors are in fact making money out of surrogate’s altruism. This is exploitative and unfair. Compensated (and not commercial) surrogacy is a fair option. Intending parents are willing to pay surrogates for their work and in fact benefit from being allowed to offer a token sum of money as a gift in exchange for the priceless gift of their own child.
In addition, we need a more comprehensive approach to the law when it comes to commercial surrogacy. Banning commercial surrogacy will not stop Australian’s from seeking these arrangements out. This approach only serves to drive the issues underground, stigmatising children and families created through overseas commercial surrogacy, and does not do justice to this complex method of family formation that is growing world-wide.
What Australian ARTs regulation requires is a bipartisan approach that focuses on minimising harms associated with the uptake of commercial surrogacy. In doing so it should be noted that:
· - rates of children born from overseas surrogacy are increasing;
· - state laws currently prevent intended parents through commercial surrogacy being recognised as parents, a situation which is highly undesirable and not in children's best interests;
· - this should be addressed by changing law and by ensuring that there are appropriate safeguards: against the risk of child-trafficking; to protect the interests of surrogates; to protect childrens' best interests; and to protect best interests of intending parents.
· - This should be done through significant community consultation and connecting to relevant research.
· - Drivers for cultural change (e.g. regulation, establishing a third party/body to provide monitoring) within the intended parent community and overseas commercial surrogacy agencies, need to be recognised and developed, to provide a more sophisticated and ethical approach to commercial surrogacy.
· - development of a sophisticated national commercial surrogacy framework that supports overseas commercial surrogacy where it meets particular regulation/standards, identifies intending parents, particularly those that are the genetic parent and their partner, as legal parents.
· - Rather than state that commercial surrogacy arrangements are unethical, this sweeping statement should be replaced with ‘prevent the exploitation of people for the purposes of human reproduction’ and any reference to criminalising overseas commercial surrogacy be
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Section 13.2
Non-commercial surrogacy
Non-commercial surrogacy (whether partial surrogacy or full surrogacy) is a controversial subject (see Appendix C) and is prohibited in some states and territories. In other states and territories, clinics must not facilitate surrogacy arrangements unless every effort has been made to ensure that participants:
 have a clear understanding of the ethical, social and legal implications of the arrangement; and
 have undertaken counselling to consider the social and psychosocial significance for the person born as a result of the arrangements, and for themselves.
Q57. In view of developments in other countries, should there be compensation, more than expenses, for gestational mothers congruent with the reproductive effort contributed?
Currently over 90% of Australians who engage in surrogacy do so offshore, exposing themselves to high levels of emotional, financial and medical stressors as they engage in unregulated markets.
. Quantitative research by Surrogacy Australia with 259 intended Australian parents, conducted following ethics approval with Monash University and soon to be published in the Medical Journal of Australia, shows that close to half this population (44%) does not even consider surrogacy in Australia. The inability to compensate a surrogate in Australia was the fourth most cited barrier (44%).
Under the UK’s very successful non-commercial model, UK courts accept additional compensation of £13,000 - £15,000 to UK surrogates above expenses, to allow for lost wages and the reproductive effort contributed.
This has become a standard payment to UK surrogates. NSW and
Queensland surrogacy legislation contains provisions for the payment of similar unreceipted amounts to those in the UK, however there remains great confusion on this matter amongst IPs and surrogates alike.
Compensation of more than just expenses to the level noted above is likely to go a long away to increasing the pool of potential Australian surrogates, thereby lessening the need for intended parents to offshore surrogacy arrangements.
A further advantage to allowing some compensation for Australian surrogates is the greater likelihood of IPs engaging with the Australian IVF
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Template for response sector and taking advantage of its world-renowned expertise
Research by Surrogacy Australia and M.Stockey-Bridge (an anthropologist [NHMRC has removed third-party information] researching
Australian IPs and their use of commercial surrogacy in India) has shown evidence that intended parents are often uncomfortable accepting the
‘gift’ of surrogacy in the absence of any financial compensation beyond expenses.
13.2.1 Clinicians should not advertise a service to provide or facilitate surrogacy arrangements, nor receive a fee for services to facilitate surrogacy arrangements.
Q58. Paragraph 13.2.1 – Is this guidance still appropriate?
Yes
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