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Iran's experience with surrogate motherhood: An Islamic view and ethical concerns
Abstract
Gestational surrogacy as a treatment for infertility is being practised in some well-known medical institutions in Tehran and some other cities in Iran. While the majority of Muslims in the world are Sunni, the majority of Iranians are Shiite. Most Sunni scholars do not permit surrogate motherhood, since it involves introducing the sperm of a man into the uterus of a woman to whom he is not married. Most Shiite scholars, however, have issued jurisprudential decrees (fatwas) that allow surrogate motherhood as a treatment for infertility, albeit only for legal couples. They regard this practice as transferring an embryo or fetus from one womb to another, which is not forbidden in Shiite jurisprudence. Nevertheless, there are some controversies concerning some issues such as kinship and inheritance. The main ethical concern of Iran's experience with gestational surrogacy is the monetary relation between the intended couple and the surrogate mother. While monetary remuneration is practised in Iran and allowed by religious authorities, it seems to suffer from ethical problems. This article proposes that this kind of monetary relation should be modified and limited to reimbursement of normal costs. Such modification requires new legislation and religious decrees.
... 177 Studies show that the vast majority of Muslims are against surrogate treatments, since procreation and childbearing must be carried out only under the framework of marriage. 178,179 However, some acknowledge this may be ethically justified and medically necessary. 180 Polls in Iran, Jordan, and Lebanon revealed a predominant negative attitude among healthcare workers and students toward surrogacy, mainly driven by religious beliefs. ...
... 155,238 Iranian legislation is not clear regarding surrogacy and it is not an uncommon practice in the country. 179 In Saudi Arabia and in the United Arab Emirates, surrogacy is completely forbidden. 178,179 Oceania In Oceania, altruistic surrogacy may be performed in Australia and New Zealand, but commercial surrogacy is illegal (►Fig. ...
... 179 In Saudi Arabia and in the United Arab Emirates, surrogacy is completely forbidden. 178,179 Oceania In Oceania, altruistic surrogacy may be performed in Australia and New Zealand, but commercial surrogacy is illegal (►Fig. 4). ...
Objective Surrogacy is the process in which a woman carries and delivers a baby to other person or couple, known as intended parents. When carriers are paid for surrogacy, this is known as commercial surrogacy. The objective of the present work is to review the legal, ethical, social, and cultural aspects of commercial surrogacy, as well as the current panorama worldwide.
Methods This is a review of the literature published in the 21 st century on commercial surrogacy.
Results A total of 248 articles were included as the core of the present review. The demand for surrogate treatments by women without uterus or with important uterine disorders, single men and same-sex male couples is constantly increasing worldwide. This reproductive treatment has important ethical dilemmas. In addition, legislation defers widely worldwide and is in constant change. Therefore, patients look more and more for treatments abroad, which can lead to important legal problems between countries with different laws. Commercial surrogacy is practiced in several countries, in most of which there is no specific legislation. Some countries have taken restrictive measures against this technique because of reports of exploitation of carriers.
Conclusion Commercial surrogacy is a common practice, despite important ethical and legal dilemmas. As a consequence of diverse national legislations, patients frequently resort to international commercial surrogacy programs. As of today, there is no standard international legal context, and this practice remains largely unregulated.
... culture (Aramesh, 2009). Concerns about interactions with relatives, finding a suitable and trusted surrogate mother (Akhondi & Ardakani, 2008), prenatal care, and financial problems are the most important problems for couples (Aramesh, 2009). ...
... culture (Aramesh, 2009). Concerns about interactions with relatives, finding a suitable and trusted surrogate mother (Akhondi & Ardakani, 2008), prenatal care, and financial problems are the most important problems for couples (Aramesh, 2009). The effects and consequences of surrogacy create many problems for those who want to use it, which is mostly due to the lack of information about the phenomenon (Zandi et al., 2013). ...
... In all societies, the role of extended family is influential in couples' decisions. This role is more prominent in Iran, due to the type of culture and the interactions of families (Aramesh, 2009). In explaining the results, in many societies, couples are recognized as a family when a child or children are born. ...
Identifying the process of making the decision to use a surrogate mother can create a broad knowledge of this concept. In this grounded theory study, participants were selected through snowball sampling method and obtaining an informed consent, in-depth interviews were conducted face to face and recorded. Then, all the interviews, field notes, and memos were analyzed using Strauss-Corbin 1998 method. Analysis of the statements of the participants boiled down to 487 initial codes, 311 codes, 14 subcategories, and six categories. In the conceptual model of this process, “the hope to have a child” was an influential concept that interacted with other concepts.
... Zira Sünni İslam bu noktada kıyas'ı (qiyas) dikkate alırken, Şiilik'te yerini akıl (aghl) alır. Aghl ile qiyas, İslam'ın bu iki kolu arasındaki farklılığın önemli bir bağlamını oluşturur (Aramesh 2009 Söz konusu Fetvalarda, Sünni İslam ülkelerinin çoğundaörneğin Mısır-yapay döllenmeye izin verilmektedir. Ancak yumurta ve spermlerin evli olan çifte ait olması ve aynı kadında kullanılması koşulu bulunmaktadır. ...
... Nasıl ki alkol alım ve satımını içeren hiçbir işlemin hukuki bir geçerliliği yoksa, benzer şekilde evli çift ile taşıyıcı anne arasındaki sözleşme, zina unsuru içerdiğinden geçersizdir (Ebrahim 1990: 38;Muaygil 2017. Ayrıca rahmin "kiralanabilecek" ya da "satın alınabilecek" bir meta düzeyine indirgenmesi, üremenin "doğal"lığından ayrıştırılması anlamına gelir (Aramesh 2009). Sözleşmenin psikolojik boyutunda ise hamilelikte anne-çocuk arasında oluşan bağ öne çıkar. ...
... Fedakâr taşıyıcı anneliğe Avustralya, Kanada ve İngiltere gibi ülkelerde de izin verilmektedir (11). Çoğu Orta Doğu ülkesinde dini otoritelerin taşıyıcı anneliğe izin vermediği, buna rağmen İran'da evli çiftlerin üreme hücrelerinin kullanılması şartıyla taşıyıcı annelik uygulamasının gerçekleştirildiği bildirilmektedir (12). ...
... Ülkelere göre taşıyıcı annelik uygulaması(6,(10)(11)(12)(13)(14)(15)(16)(17)(18). ...
The progress of science and its reflections on technology make new methods applicable in the diagnosis and treatment of diseases in the field of health. In this way, assisted reproductive techniques can be applied to couples who cannot have children due to biological deficiencies. One of these techniques is surrogacy, which is among the heterologous fertilization methods. According to the way surrogacy is practiced, it affects the reproductive perspectives of societies and compels the norms of having children. For this reason, it is not accepted legally and morally in many countries such as our country. Despite this, it is becoming widespread due to reproductive tourism to countries where the practice is legal. In this study, it is aimed to share current and important data about the surrogacy practice, which has become widespread with reproductive tourism, and to evaluate the subject in terms of biomedical ethics. In the study, it is predicted that societies that are not ethically and legally ready for surrogacy practice will inevitably encounter major problems in the future. For this reason, it is considered important to establish a legal basis for surrogacy with reproductive tourism within the framework of ethical evaluations.
... While taking in and raising orphaned children is encouraged in Muslim societies, adoption is more similar to the Western concept of foster care or guardianship, as the child keeps their biological father's name [12,15]. Surrogacy is prohibited in Sunni Islam, again due to involvement of a third party [7,23], but Shia scholars are accepting of the practice [11,17]. Still, a debate remains over who should be regarded as the "real" mother of a child born via surrogate: the birth mother, or the woman who will ultimately raise the child [11,[22][23][24]. ...
... Surrogacy is prohibited in Sunni Islam, again due to involvement of a third party [7,23], but Shia scholars are accepting of the practice [11,17]. Still, a debate remains over who should be regarded as the "real" mother of a child born via surrogate: the birth mother, or the woman who will ultimately raise the child [11,[22][23][24]. ...
... Infertility may cause intolerable situation for many couples by their family, particularly, who have come from conservative and traditional Islamic family 13 . Procreation potentiality dignifies the Muslim women, increases their social status, their dignity and self-esteem. ...
... Consequently, contemporary emerging ethical issues are discussed and categorized in the light of both scripture and intellect and provide verdict (Fatwa). Highest-ranked religious authorities (Grand Ayatollahs) can only issue a fatwa 13 . In 1999, Ayatollah Ali Hussein Khamanei, the Supreme leader of Iran, issued a religious verdict on reproductive technology that permitting the donor technologies including surrogacy. ...
More than half a million couples may be suffering from infertility in the world. When in vitro fertilization is unsuccessful, surrogacy may be a substitute choice for many couples. Literature shows that ten million Muslims are infertile worldwide. According to Islamic theology the concept of surrogacy is null and void as formation of blastocyst constitutes from sperm that is transferred to the uterus of a woman who is not married to him. In Islam, marriage is the only legal procedure to procreation for preservation of lineage, inheritance, prevention of adultery and prevention of possibility of incest among the half-siblings. Genetic gestational surrogacy (sperm of husband and ovum of wife is fertilized by IVF procedure and transfer the embryos to the surrogate mother) may be free from social, legal and moral complications. Some Islamic countries have reluctant law in favour of surrogacy, as for example Iran, Lebanon and sporadic parts of the Muslim world. This article has attempted to find out a valid notion for accepting genetic gestational surrogacy in major part of the Muslim world that may reduce the peril of women who can not give a birth baby.
... Infertility may cause intolerable situation for many couples by their family, particularly, who have come from conservative and traditional Islamic family 13 . Procreation potentiality dignifies the Muslim women, increases their social status, their dignity and self-esteem. ...
... Consequently, contemporary emerging ethical issues are discussed and categorized in the light of both scripture and intellect and provide verdict (Fatwa). Highest-ranked religious authorities (Grand Ayatollahs) can only issue a fatwa 13 . In 1999, Ayatollah Ali Hussein Khamanei, the Supreme leader of Iran, issued a religious verdict on reproductive technology that permitting the donor technologies including surrogacy. ...
More than half a million couple may be suffering from infertility in the world. When in vitro fertilization is unsuccessful, surrogacy may be a substitute choice for many couples. Literature shows that ten million Muslims are infertile worldwide. According to Islamic theology the concept of surrogacy is null and void as formation of blastocyst constitutes from sperm that is transferred to the uterus of a woman who is not married to him. In Islam, marriage is the only legal procedure to procreation for preservation of lineage, inheritance, prevention of adultery and prevention of possibility of incest among the half-siblings. Genetic gestational surrogacy (sperm and ovum of husband and wife is fertilized by IVF procedure and transfer the embryos to the surrogate mother) may be free from social, legal and moral complications. Some Islamic countries have reluctant law in favour of surrogacy, as for example Iran, Lebanon and sporadic parts of the Muslim world. This article has attempted to find out a valid notion for accepting genetic gestational surrogacy in major part of the Muslim world that may reduce the peril of women who can not give a birth baby.
... The experiences of surrogate mother from ethical issues were assessed by Aramesh. Sunni jurists have rejected surrogacy while Shia jurists have acquiesced in it only under legitimate marriages and certain conditions (23). ...
... Economical Impasse One of the extracted subthemes was economical impasse imposed on these women. Aramesh (23) has also suggested that the main concern of surrogate mothers is economic relationship between recipient (biologic mother) and donor (surrogate mother) family and this relationship should be improved and contracted in normal ranges costs. ...
Objectives: Infertility is the absence of pregnancy after 1 year of intercourse without contraceptive methods. This research aimed at exploring primary factors leading to surrogacy. Materials and Methods: The present qualitative study was based on phenomenology approach. Participants were pregnant surrogate mothers referring to Isfahan Fertility and Infertility Center in 2014. Sampling was conducted using purposeful method through which 5 women were selected. Data collection was done utilizing deep and unstructured interviews which were then analyzed based on Colaizzi method. Reliability and validity of this study consisted of 4 elements including dependability, credibility, transfer-ability and confirm ability. Results: The mean age ± standard error (SE) of participants was 32.4±0.4 years. Overall, after analyzing the interviews, 74 primary codes associated with leading factors of surrogacy were extracted. The primary codes were categorized into 7 subthemes, namely, life background, failures and ineffective efforts to improve life, economical impasse, seeking independence, altruism, compulsion, sin atonement and making a trade with God. Finally, these 7 subthemes were integrated and the theme of “primary factors leading to surrogacy” was made. Conclusion: Care and support systems should be invigorated in Iran so that derelict women could have insurance and are not compelled to donate ovum or undertake surrogacy several times. Exploitation of these women should be prevented and harm to human dignity must not happen.
... Classification of surrogacy(1) Sperm and ovum of both intended parents: if the wife cannot give birth to her child because of any disease or as per her desire, then the egg and sperm are donated, and the embryo is injected into the womb of the surrogate mother via an artificial method(Lasker & Ghilardi, 2018;Samani et al., 2009). (2) Sperm of intended father and ovum of any donor: due to some medical reasons or due to the wife's desire, if the wife does not offer her ovum, then the ovum of any other woman is fertilized by the sperm of the intended father artificially and then injected into the womb of the surrogate mother(Aramesh, 2009; Gloria Torres et al., 2019). (3) Ovum of intended mother and sperm of any donor: if the husband is not able to provide his sperm or because of his will, then the ovum of the intended mother is fertilized by the sperm of the donor artificially taken from the sperm bank, and then the embryo is injected in the uterus of a surrogate mother(Inhorn & Tremayne, 2016;Samani et al., 2009). ...
... Surrogacy is permissible according to Shia jurisprudence, while it is not allowed in the Sunni denomination (41). There have been reports of ethical problems with existing financial transactions (42), but this appears to be acceptable among infertile women (43). In a qualitative study in Iran, it was reported that surrogate mothers experience conflicting feelings of internal satisfaction and social stigma during surrogacy. ...
This study explains the lineage in embryo donation and the inheritance of born children. This study was conducted with a library, descriptive and analytical design, relying on books of jurisprudence and laws of Shia and other Islamic religions, as well as citing some legal studies. Under Ayatollah Khamenei’s original fatwa in 1990, which permitted gamete donation by third parties. This legal approach paved the way for the adoption of the Embryo Donation to Infertile Spouses Act in 2003. The embryos formed from a man’s sperm and the ovum of his legitimate wife, with any methods of embryo formation and its transfer to the aforementioned man and woman, have a legitimate lineage and there will be no problem in the inheritance for the baby. However, the embryos formed from the sperm of another man (other than a legal husband) or the egg of another woman (other than a legal wife) regardless of the method (natural or artificial) will not have legitimate lineage, and as a result, donated children are deprived of inheritance. To ensure the financial future of children born through embryo donation, solutions such as an official will or using the life insurance industry can be considered as a temporary solution. However, it is necessary to review the embryo donation law by religious and legislative authorities.
... As in many countries in the Middle East, surrogate pregnancy in Lebanon remains illegal. The Islamic Republic of Iran remains the only country in the Middle East to legalize surrogacy [13], this is because jurisprudence is based on Islamic Sunni Sharia in most Middle Eastern countries while Iran follows Shiite sharia law [14]. ...
Background
Little is known about the acceptance of specific populations of decision makers in Lebanon regarding surrogacy. This study aimed to explore the acceptance and attitude of Lebanese Lawyers and Medical Students regarding surrogacy.
Methods
In total 248 medical students and 204 lawyers completed a questionnaire to assess socio-demographic data, attitude toward surrogacy, and three different clinical scenarios to assess patterns of thinking. Finally, we validated a scale to assess the acceptance of surrogacy in these two populations.
Results
Concerning medical students, 54.8% reported they were supportive of surrogacy, 35.1% were neutral and 10.1% were against. For lawyers, 52.9% were supportive, 25% were neutral and 22.1% were against. Lawyers were more likely to be against surrogacy (p = 0.001).
After conducting a multivariate analysis on the whole studied population to find predictors of acceptance of surrogacy, the best predictors were being single (OR 0.415; 95% CI 0.228, 0.753; p < 0.01), a supportive reported attitude regarding surrogacy (OR 5.464; 95% CI 3.65, 8.13; p < 0.001) and believing that surrogacy is a solution worth discussing in Lebanon (OR 4.186; 95% CI 1.709, 10.256; p < 0.01).
Concerning the clinical scenarios, they showed that lawyers were more likely to oppose abortion regardless of the reason (p < 0.01). Also, in a case of gestational surrogacy, lawyers were more likely to give the right to the gestational carrier to keep the baby compared to medical students (p < 0.001).
Conclusion
In conclusion, this study shows that only a minority of medical students and lawyers in Lebanon oppose surrogate pregnancy which warrants exploration of the perspective of other populations of decision makers in Lebanon to better guide legislations.
... Since the surrogate carries the fertilized egg of someone who is not a legal husband, the child produced has no progeny by legal marriage and would have to be considered illegitimate." Both the product (child) and the process (surrogacy) are therefore haram or prohibited by Islamic law (Aramesh, 2009;Deonandan, 2020). ...
Individuals may develop different attitudes on bioethics in general and reproductive ethics in particular, due to the effects of different sociocultural environments. Individuals' attitudes toward surrogacy are affected positively or negatively depending on religious and cultural environments. This study was conducted to determine and compare the attitudes of different religions toward surrogacy. This study is cross-sectional and collected from individuals living in Turkey, India, Iran, the Turkish Republic of Northern Cyprus, Madagascar, Nepal, Nigeria, Pakistan, Mexico, England, and Japan between May 2022 and December 2022. The study was conducted with individuals belonging to Islam, Christianity, Hinduism, Buddhism, and Atheism. The study was conducted with 1177 individuals from different religions who agreed to participate in the study by snowball sampling method. The introductory Information Form and "Attitude Questionnaire Toward Surrogacy" were used as data collection tools. R programming language 4.1.3 was used for regression analysis with machine learning approach and artificial neural networks, and SPSS-25 was used for other statistical analyses. There was a significant difference between the total mean score of the individuals' Attitudes toward Surrogacy Questionnaire and their religious beliefs (p < 0.05). When the results of the analysis of the regression model with the dummy variable, which was carried out with the aim of revealing the effects of religious belief on the attitude toward surrogacy, are examined, statistical estimates of the regression model show that the model is significant and usable F(4,1172) = 5.005, p = 0.001). It explains 1.7% of the total variance of the level of religious belief's attitude toward surrogacy. In the regression model, when the t-test results regarding the significance of the regression coefficient are examined, among the participants, it was determined that the mean score of those who believed in Islam (t = − 3.827, p < 0.001) and those who believed in Christianity (t = − 2.548, p < 0.001) was lower than the mean score of those who believed in Hinduism (Constant) (p < 0.05). Individuals' attitudes toward surrogacy differ according to their religion. The best performing algorithm for the prediction model was random forest (RF) regression. The contributions of the variables to the model were calculated with Shapley values (Shapley Additive Explanations (SHAP)). The SHAP values of the variables in the best performing model were examined to avoid bias in terms of comparison in the performance criterion. SHAP values (Shapley Additive Explanations) show the contribution or importance of each variable in the estimation of the model. It is determined that the most important variable that should be in the model to predict the Attitude Toward Surrogacy Survey variable is the Nationality variable. It is recommended that studies on attitudes toward surrogacy should be conducted by taking religious and cultural values into consideration.
... As can be seen, if these elements are observed, it is possible to identify precisely who the biological parents of the new being are and what the role of the surrogate mother is. Under these conditions the right of the child to know the identity of the parents is not violated (Aramesh, 2009, p. 320). ...
Este ensayo reflexiona sobre la impermisibilidad de la maternidad subrogada en la mayoría de los países del Islam, con la excepción de Irán. Sin ser un estudio omnicomprensivo, se realiza una valoración de las principales razones que impiden a las parejas musulmanas acceder al método de asistencia reproductiva de la maternidad subrogada.
El planteamiento de este ensayo es que la maternidad subrogada no es permitida dado que bajo el derecho islámico no es posible negar la maternidad. La presunción de la maternidad está sustentada tanto en el Corán como en el idioma árabe y se refleja en las interpretaciones que realizan los estudiosos del Islam. Se concluye que la maternidad subrogada gestacional es la única variante de la maternidad subrogada que puede ser compatible con los principios del Islam.
... Egypt does not permit the surrogacy, as it is immoral. In Saudi Arabia, the religious authorities do not allow the use of surrogate mothers [31]. ...
The assisted reproductive technology was initially considered to be a treatment tool for infertile couples. However, as it was started in time to use the uteri of other women for the embryos of the other ones, the concept of surrogate maternity appeared. The surrogate maternity is practiced in three types. In the first type of surrogate maternity, the sperm of the spouse of the prospective mother is inseminated with the ovum of the surrogate mother. The second method is the in-vitro insemination of the ovum of the prospective mother with the sperm of her own spouse, and then transferring it into the uterus of the surrogate mother. The third method is to use the sperms and ovum of the third persons for insemination. The surrogate maternity comes with a number of ethical problems. It is reported that this practice may induce such risks that the natural reproduction would be withdrawn, and that the female body would become and sold as a reproductive box, the natural process would be medicalized, and some risks associated with the pregnancy and delivery would likely be experienced. For such reasons, there is a need to discuss the potential losses and benefits of the surrogate maternity.
... In addition, Saudi Arabia and Egypt prohibit surrogacy as well as the use of donor eggs and donor spermatozoa (26,27). Like Catholics, one of the reasons why Sunni Muslims do not allow surrogacy is adultery (23). ...
In November 2018, all types of Assisted Reproductive Technologies (ART) involving third parties, including surrogacy, were prohibited in Turkey. In-Vitro Fertilization (IVF) methods for married heterosexual couples, however, are highly promoted by the official-legal framework despite the fact that the number of people seeking surrogate mothers abroad has been increasing dramatically. This reveals not only several ethical questions about the practice of surrogacy but also legal debates both in Turkey and in the world. Thus, this article presents a conceptual and legal framework for the practice of surrogacy in Turkey. It aims to make a basic examination of surrogacy and introduce some of the ethical questions and their implications for law in this area.
... In a very interesting description of surrogacy in an Islamic country [37] , it was affirmed that gestational surrogacy is being practiced in some medical institutions in Tehran, and in some other cities in Iran and stated that most "Shiite scholars, but not Sunni, have issued jurisprudential declarations (fatwas) that allow surrogacy as a treatment for infertility". The main ethical concern with surrogacy in Iran is of a financial nature. ...
Surrogacy is a treatment option available to couples with certain medical difficulties, in order to help them have their own genetic children, to single women with medical problems desiring pregnancy, or to homosexual men wishing to become parents. There are two forms of surrogacy. In the first (traditional surrogacy), the surrogate mother’s own egg cell is used to conceive the child. In the other (gestational surrogacy), there is no genetic relationship between the surrogate mother and the child, and the technique relies on in vitro fertilization (IVF) of the intended genetic mother’s ovum, or that of a third-party donor, with her partner’s sperm or donor sperm. IVF allows the creation of embryos from the gametes of the commissioning couple and subsequent transfer of these embryos (fresh or frozen/thawed) to the uterus of a surrogate host. The indications for treatment include absent uterus (congenital or after hysterectomy), recurrent miscarriage, repeated failure of IVF, and certain severe medical problems. The results of treatment are more than satisfactory, with up to 60% of surrogate mothers achieving live births. Surrogacy may be commercial or altruistic, depending upon whether or not the surrogate receives economic remuneration for her pregnancy.
Ethical, religious and legal problems have arisen around surrogacy; therefore, it is imperative that both the gestational carrier and the intended parent(s) be granted rigorous safeguards and protections.
... A very interesting description dealing with surrogacy in an Islamic country was reported (Aramesh K., 2009), affirming that gestational surrogacy is being practiced in some medical institutions in Teheran, and in some other cities in Iran and mentioning that most «Shiite scholars, but not Sunni have issued jurisprudential declarations (fatwas) that allows surrogacy as a treatment for infertility». The main ethical worry of Iran's practice with surrogacy is financial concern. ...
... Among the factors mentioned in this domain are legal and religious issues in societies regarding the use of this method that can lead to its selection or non-selection. For example, in a study conducted in 2009, experiences by some individuals about ethical issues were examined which pointed to the fact that only Sunni jurists had rejected using surrogacy and Shia ones had confirmed this method just for couples legally married and under certain conditions (25). In another study in 2003, different results were obtained. ...
Objective: Our study aimed to clarify of factors affecting decisions to use a surrogate mother can create broad knowledge of this concept.
Materials and methods: For This qualitative research, participants were selected through snowball sampling methods out of couples with a history of using surrogacy as an alternative treatment for having a child. As well, sampling continued until data saturation was reached. Finally, 23 persons participated in study (9 couples, 5 related persons). After selecting the participants and obtaining informed consent, in-depth and semi-structured interviews were conducted and most of them were recorded with participants’ consent. Then, all the interviews were analyzed using a conventional method.
Results: Content analysis of the statements condenced to 311 codes, 13 subcategories and 5 categories including the absence of parental role, perceived norm, hope for parenting role, mental challenge, and decision to use surrogacy were extracted.
Conclusion: The results indicated that numerous variables had an effect on decision-making process to use a surrogate mother, but the variable of hope for parenting role was an influential concept that not only interacted with other concepts but also caused optimism and motivation in families to decide in this respect.
... En Iran, des fatawas ont autorisé le don d'ovule, de sperme et d'embryons créés par fertilisation in vitro (Afshar, 2012). Elles ont aussi autorisé le portage pour autrui (Aramesh, 2009). L'hindouisme ne considère pas la reproduction assistée comme incompatible avec les enseignements sacrés (Kumar, 2007). ...
... Sunni and Shia Muslims differ in their opinions about ART 8 . Most of the Muslims is Sunni in the world, but Shia in Iran (about 90%) 11 . There are considerable differences in use of donor gametes in assisted reproduction between Sunni and Shia Muslim authorities 9 . ...
Amaç: Bu çalışmanın amacı, Türk halkının oosit / sperm bağışı hakkındaki görüşlerini belirlemektir.Gereç ve Yöntem: Tanımlayıcı kesitsel tipteki bu çalışma bir üniversite hastanesinin kadın hastalıkları ve doğum polikliniğine, kadınlar ve eşlerine veri toplama formu uygulanarak yürütüldü. Veri toplama formu katılımcıların demografik özelliklerine ve oosit/sperm bağışı hakkındaki düşüncelerine ilişkin 35 sorudan oluşmaktadır. Örnekleme çalışmaya katılmayı kabul eden 323'ü kadın, 105'i erkek toplam 428 kişi dahil edildi. Bulgular: Kadınların %64.3’ü, erkeklerin %71.4’ü infertile çiftlerde bağışlanmış oosit/sperm kullanımını uygun bulmadığını belirtti. Katılımcıların %63.0’ü, oositler/sperm bağışçılarının ve bağışı kabul edenlerin danışmanlık alması gerektiğini söyledi. Uygun bulan kişilerin %21.5’i akraba (örneğin kızkardeşi) ve arkadaş tarafından yapılan oosit/sperm bağışını uygun bulurken, %31.8'i yabancılardan almayı uygun bulmaktadır. İlkokul mezunlarının %88.7’si, üniversite ve üzeri düzeyde mezunların %73.4'ü, çalışanların %76.7'si, gelirleri giderlerinden daha düşük olanların%86.2'si ve yaşayan çocuğu olanların %77,1'i eşlerinde çocuk sahibi olmayı engelleyen bir problem varlığında bağışlanan oosit/sperm yoluyla çocuk sahibi olmayı kabul etmeyeceklerini belirttiler. Sonuç: Katılımcıların yarıdan fazlası, infertilitede bağışlanmış oosit/sperm yoluyla çocuk sahibi olmasını uygun bulmadığını beyan etmiştir.
... [24] In most Middle Eastern countries, religious authorities do not allow surrogacy. [25] Surrogacy was previously illegal in Bulgaria; however, due to high illegal and underground practice, the government decided to sanction it. Instead of using the term surrogate, Bulgaria calls it the "substitute mother." ...
Surrogacy is an important method of assisted reproductive technology wherein a woman carries pregnancy for another couple. Number of couples around the world require surrogacy services for various reasons. Although this arrangement seems to be beneficial for all parties concerned, there are complex social, ethical, moral, and legal issues associated with it. It is these complexities that have made this practice unpopular in many parts of the world. Surrogacy in India has had its own journey from India becoming popular as a surrogacy center since 2002 to the Surrogacy (Regulation) Bill, 2016, which would restrict the option of surrogacy for many. Surrogacy is an important medical service for all those couples who would otherwise not have been able to produce a child. Surrogacy would be practiced harmoniously if delicate issues associated with surrogacy will be addressed properly through appropriately framed laws which would protect the rights of surrogate mothers, intended parents, and child born through surrogacy.
... Surrogacy, or surrogate motherhood, is a method of assisted reproduction whereby a woman agrees to become pregnant for the purpose of gestating and giving birth to a child to be raised by others. 4 It is both the oldest and the most controversial of all assisted reproductive technologies. 5 While banned in many countries, surrogacy is legally practiced but inadequately regulated in some others, driving the need for a better level of regulation. ...
Purpose
This study aims at investigating the perspectives of Jordanian medical and paramedical students on surrogate pregnancy.
Methods
A questionnaire-based cross-sectional study design was used. The sample consisted of n=328 students of both genders. The questionnaire responses were numerically coded and analyzed across gender and the level of education.
Results
Approximately, 18% of the students reported good awareness about the ethical dilemmas of surrogacy. The results showed a general reluctance to accept surrogate pregnancy as the majority (80.5% of male students and 97.6% of female students) had a negative attitude toward surrogacy. In addition, undergraduate students were less supportive to surrogate pregnancy than graduate students. Religious considerations were the main reason (accounts for about 70%) for driving negative attitude toward surrogacy.
Conclusion
The findings of the study indicate a general reluctance toward accepting the concept of surrogate pregnancy, which is mainly due to religious reasons.
... In Saudi, Arabia religious authorities do not allow the use of surrogate mothers. 9 In China, Ministry of Health banned surrogacy in 2001. Despite this regulation it is reported that illegal surrogacy "black market" is still fl ourishing in China. ...
... The current technology allows for the broader use and trade of body parts, including "wombs for rent" by surrogate mothers, which is legal in some countries. However, it also poses problems which are often, at least partly, shared by the kidney trade [18][19][20]. ...
Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments.In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of "reverse" informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties.
... Judaism permits both IVF and surrogacy if the gametes come from the husband and wife, and religious scholars debate under what circumstances the donation of sperm or eggs might be acceptable (Schenker, 2005(Schenker, , 2008Teman, 2010). Shia Muslims in Iran and Lebanon are, in contrast to Sunnis, very permissive about ART (Inhorn, 2006;Tremayne & Inhorn, 2012); fatawas in Iran have allowed the donation of eggs (Schenker, 2005) and even of sperm (Afshrar, 2012), as well as the donation of in vitro fertilised embryos (Afshar, 2012) and the use of surrogate mothers (Aramesh, 2009;Serour, 2008). Among Hindus, ART is not seen as infringing on religious beliefs (Kumar, 2007). ...
Objective: to find out what is the range of French lay people’s positions concerning assisted reproductive technology. Background: Legislation and religious positions regarding assisted reproductive technology (ART) vary considerably from one country to another and from one religious tradition to another. The few studies of people’s opinions, mostly in the USA, also show wide variation. The full range of French lay people’s personal positions concerning ART was examined. Methods: Three hundred and fifty-one participants were presented with stories composed according to a five-factor within-subject design: the purpose of the procedure (e.g. trying to repair a marriage), the origin of the sperm, the origin of the egg, the number of children in the family, and the person to whom the embryo is transferred (e.g. a surrogate mother). They assessed the extent to which ART would be, in each case, an acceptable procedure. Results: Five qualitatively different positions were identified by cluster analysis: (i) gamete donation (27%), (ii) family donation (13%), (iii) in vitro combination of spouses’ gametes (22%), (iv) mainly acceptable (15%), and (v) care and love (23%). Conclusion: Not a single participant considered ART as unacceptable in itself. Participants’ positions can be seen as compatible with current law either in France or in other countries such as Germany and India; that is, within-country variation in views about ART largely parallels between-country variation. A huge majority of people agreed, however, on one point: children must not be conceived in order to serve others’ interests.
... The current technology allows for the broader use and trade of body parts, including "wombs for rent" by surrogate mothers, which is legal in some countries. However, it also poses problems which are often, at least partly, shared by the kidney trade [18][19][20]. ...
Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments.
In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties.
Surrogacy is the practice involving assisted reproductive technology ("ART") presenting important ethical and legal concerns, notably in the realm of a third-party parenting. However, its journey to reality remains riddled with legal as well as moral quandaries. While the Surrogacy Act of 2021, which went into force, seeks to deconstruct the different legal complexities involved as well as to provide guidance. Considering the socioeconomic norms that govern the real circumstance at ground zero. Surrogacy may either be commercial or altruistic, depending on whether a surrogate is compensated financially during her pregnancy. This approach is becoming more widespread; estimated that over 30,000 patients obtain donor eggs each year to support their families. Surrogacy cycles have become easier for assisted reproductive technology (ART) clinics with better embryology laboratory and freezing facility, as a result of the development of efficient vitrification methods. The primary risk of surrogacy is obstetric complications, with multiple order pregnancies usually more prevalent. Although American Society for Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology committees make several recommendations for single embryo transfer, barely 15%-20% of clinics adhere to single embryo transfer criteria. Over the future decades, humans may witness the first offspring produced with synthetic eggs and sperm and "born" by ectogenesis (artificial womb technology). In summary, surrogacy laws and regulations are evolving both in India and globally, efforts are being made to regulate and restrict commercial surrogacy, prioritizing the needs of infertile couples and safeguarding against exploitation and unethical practices in the surrogacy industry..
Reproductive health technology allows married couples who experience infertility to have a child through assisted reproductive technology (ART), such as the in vitro fertilisation (IVF) process. The transfer of the extracted embryo to the woman’s womb is called surrogacy technology (gestational surrogacy). The legality of the practice of surrogacy is still questionable, both on a national and international level. This research discussed the legality of surrogacy in some religious countries, focusing on Indonesia. This research used normative juridical research methods or literature review through a comparative religion-legal approach. This study indicated that most do not have a specific legal instrument regarding surrogacy practice. International law also does not have a standard legal instrument regarding the legality of surrogacy. Legality is determined by each religious country’s national laws and customs. For example, Indonesian law prohibits this practice implicitly under Law No. 36 of 2009 concerning health. The United Kingdom legalised surrogacy through the Surrogacy Agreement Act 1985, which was amended to the Human Fertilization and Embryology Act 2008, Greece through the Greek Legislation Law 3089/2002 and Law 3305/2005, and India through the 2019 Surrogacy Regulation Bill. Those countries have their limitations and characteristics that rule surrogacy. Surrogacy is indeed a technological advancement in the health sector. However, for countries that are influenced much by religion, technological advances sometimes conflict with the culture and the belief that has long been followed by most of the population. For Indonesia, the largest of Sunni Islam ruled surrogacy against the law. Next, Iran, as a Shia Islam country, ruled that surrogacy is a legal action.
Contribution: The research provided information and knowledge regarding the different settings of surrogacy practice. Most religious countries bravely rejected or put strict limits on the practice of surrogacy.
This article focuses on the use of Qurʾān LVIII ,2 by contemporary Muslim jurists in debates about surrogacy arrangements. As argued by Ayman Shabana in a rich article published in 2015, the majority of those jurists claim that Qurʾān LVIII ,2 provides an unequivocal legal definition of maternity and establishes that pregnancy and delivery provide the decisive criteria to determine whether a woman is the mother of a child instead of her contribution to that child’s genetic constitution. Since I am not convinced that the verse in question says exactly that, I have turned to authoritative interpretations of Qurʾān LVIII ,2. Being a scholar of Islamic law familiar with legal sources from the pre-modern Islamic West, I have selected the well-known Qurʾān commentaries by Ibn Barraǧān, Ibn ʿAṭiyya, Abū Bakr Ibn al-ʿArabī, Ibn al-Faras al-Andalusī, and al-Qurṭubī. My intention is not to advocate for or against surrogate maternity but to delve into Andalusī Qurʾānic exegesis and show its interest to explore issues such as the legal definition of maternity that have acquired greater relevance in the wake of modern medical technologies.
After expanding the context of the examined exegetical works towards Arabic lexicography and pre-modern Islamic medical views on procreation and embryology, I show that Andalusī exegetes were aware of debates about women’s contribution to procreation, took a position in those debates and deemed the issue worthy of inclusion in their tafsīr s. Eventually I argue that none of the examined tafsīr s can be cited in support of the idea that Qurʾān LVIII ,2 provides the textual basis of the Islamic legal definition of maternity let alone that legal maternity is determined by pregnancy and delivery to the exclusion of conception.
Surrogacy is an emerging issue of the world, different countries and sects are overanxious about its legality. This paper unfolds its current situation in Pakistan and Iran, subsequently through a comparative study we will be able to explore the reason behind contradiction between two Muslim countries and by analyzing their pros and cons we will try to found out a suitable solution.
Objective: To assess the attitude of Jordanian health care workers toward surrogacy.
Materials and methods: Three municipalities in Jordan were randomly selected, one from each region: north, south and central of Jordan. A total of: four public hospitals, three private hospitals, one university hospital, 40 health centers and 40 private clinics were included in the study. Healthcare workers in the selected facilities were randomly approached using a self– administered questionnaire to collect data. Distributions of attitude by gender, job title, and physician’s specialty were used to describe participants’ attitude toward surrogacy.
Results: Responses of 382 participants were reported, of whom, 230 (60.2%) were females. Three in every four participants didn’t support legalizing surrogacy in Jordan. Majority reported negative attitude toward commercial surrogacy (85.1%) and noncommercial surrogacy (76.4%). Religious considerations were the main reason (71.1%) for the attitude toward surrogacy. Most items describing attitude toward surrogacy were significantly distributed across different job titles: nurses, medical doctors, and other healthcare workers (p < 0.05).
Conclusion: Negative attitude among health care workers toward surrogacy was mainly driven by religious beliefs. However, there are core cultural changes in the community which might alter the attitude toward surrogacy in the future.
In Islam, debate and controversy on normativity started from the first centuries after the foundation of the religion by the Prophet Muhammad. One of the very first questions that occurred to the forefathers of Islamic Theology was on the theological bases of normativity. This debate divided Muslim theologians into two major branches: the Mu’tazilites, who believed that independent reason can be relied on as a source of normativity, and the Asha’rites, who believed that the only legitimate source for uncovering moral goodness or badness is the Holy Scripture. Shiite theology, after its initial development in the eighth and ninth centuries CE, was more inclined to the Mu’talizites’ because of the latter’s recognition of independent reason as a source of normativity.
Despite the possibility of having HIV-infected children and the vulnerability of families, women living with HIV/AIDS still tend to have children. The aim of this study was to explore the childbearing experiences among women living with HIV in Fars, Iran. This is a qualitative content analysis. Twenty-two participants were selected from the married HIV-infected women who referred to the Voluntary Counseling and Testing (VCT) center in Fars province. The concept of “childbearing dilemma” consist of “childbearing stimulants” and “childbearing deterrents,” which emerged from women’s descriptions of the childbearing decision. Different motives and obstacles affected their decision. Interestingly, financial problems were not mentioned as a significant issue and the decision to have a child was an emotional factor rather than financial. Hence, understanding the motives and obstacles is important, and the decision to have a child is anyone’s right, which should not be deprived of.
It is not possible to generalise about national and international or cross-border surrogacy as there are vastly different national laws, clinical success rates, population attitudes and ethical principles operating between the participating countries, but there are similarities in the risks identified. In all cases it is unlikely that a surrogate mother will be socioeconomically better off than the commissioning parent(s), but in one country there will be a certain amount of legal involvement and clinical procedures, whereas in another country the law may be non-existent or ill-prepared to deal with surrogacy—and information provision, economic deprivation and educational and gender inequality can be rife. The multiple risks to parents and children identified in cross-border surrogacy are therefore the focus of this chapter.
In this chapter, ethical and moral principles and issues of human rights are explored in the context of surrogate motherhood arrangements. It draws upon different conceptualisations of surrogacy as a social, legal or medical contract. The ethical problems associated with contracting pregnancies are discussed as they apply to accountability, moral obligations, social and psychological aspects of parenting and in relation to maintaining optimum human rights principles for the commissioned children, surrogate mothers and commissioning parents. The commodification and exploitation known to be practised in the twenty-first century is likely to come to haunt the offspring in later years. The complications arising from national guidelines which clarify local, but obfuscate international, surrogate motherhood arrangements are also explored.
Introduction: Assisted reproductive technique is one of the methods to help the infertile couples. Needing to the
participation of a third person in the process of infertility treatment by surrogacy will have various human
rights, legal, religious and ethical aspects. This review article was performed with aim to evaluate the studies
about the human rights, legal, ethical, and religious aspects of surrogacy in Iran with an emphasis on its
counseling issues.
Methods: This study reviews the findings of published papers regarding different aspects of surrogacy in Iran between 2006 and 2016 in Persian databases of SID and Iran Medex and English databases of Pub Med, CINAHL, and Google Scholar. Data were collected using the key words of " surrogacy ", "surrogate mother", "third party reproduction ", "infertility", "law ","religion " and, " ethics" alone or in combination of these words. Among 706 articles, 42 articles eligible for the study were selected.
Results: In Iranian law, various aspects of surrogacy is not clear. Surrogacy is not accepted by the majority of Sunni scholars and there is disagreement between Shia scholars. Legal issues such as inheritance and possible ethical dimensions including the risk for surrogate mother increase the need for continuous and comprehensive counseling.
Conclusion: Collecting comprehensive and accessible counseling guideline is essential to answer the medical, legal and religious questions of candidate couples before choosing this treatment method.
Key words: Ethics, Human rights, Religion, Counseling, Surrogacy
Background & Aim: Investigating the knowledge and attitude towards reproductive donation procedures is one of the important steps in recognition of infertile problems in couples using assisted reproductive donation procedures as the only therapeutic option. Few studies have been carried out regarding this field; therefore, this study aimed to compare the knowledge and attitude towards reproductive donation procedures between recipient and non-recipient infertile couples at Mashhad Infertility Center.
Methods: This descriptive/analytical study carried out on 115 infertile couples referring to Montaserieh Infertility Center in Mashhad through convenience sampling. Data were collected using questionnaire of measurement of attitude and knowledge towards donation procedures, and analyzed using statistical tests.
Results: There was a significant difference between attitude and knowledge of two recipients and non-recipients groups (P=0.000), so that female and male recipients had more positive attitude and knowledge towards donation procedures (P=0.000). Moreover, there was a significant difference between attitudes of two groups in terms of the confidentiality of donation process (P=0.015), using donated oocyte (P=0.002) and embryo (P=0.000), surrogacy (P=0.002), public attitudes (P=0.001), importance of childbearing (P=0.010) and genetic bond (P=0.017).
Conclusion: According to the findings despite of have more positive knowledge towards
donation procedures but their attitude is not influence of knowledge, against non-recipients groups, that show according to special situation of recipient group, their attitude can be influenced by many factors including Socio-cultural belief. It seems that incorporating of these factors into care plans helps to alter the non-recipients couples’ attitude and also decrease psychological tension due to selection of these procedures by recipients which in turn could provide appropriate bases for the logical decision in both groups.
Key words: Attitude, Assisted reproductive donation procedures, Infertile couples
Surrogacy is a promising treatment for infertility. It can potentially solve many intolerable difficulties that the infertile couples and their families face. Although initially frowned upon, evidence shows that the surrogacy arrangements are more acceptable now than when it was first introduced. Therefore, changes in the attitude in decision making about surrogacy can also be seen in some countries, but there are still indications of the degree of divergence between discourse and the actual practice of different forms of surrogacy around the world. Social, ethical and legal problems are subject to major debates and disagreements in natural or partial surrogacy or genetically unrelated full surrogacy. Genetic gestation surrogacy may largely free from social, legal and moral complications. It is a great choice of infertility treatment if the couple want their own genetic baby, but it still requires more thoughts and discussion. This chapter attempts to discuss the different notions related to surrogacy worldwide.
This chapter examines the intersections of religious and spiritual beliefs with preimplantation genetic diagnosis, prenatal diagnosis, and management decisions accompanying them. Attention to these intersections is important because they may influence long-term psychological health.
Introduction: Infertility as a stressful life crisis can devastate person’s mental health. One of the latest methods of assisted reproductive technology is surrogacy. This technique is considered as the most controversial reproductive techniques in recent years because of its unique aspects. So, this study was performed with the purpose of determining the knowledge and attitude of infertile women about surrogacy.
Methods: This descriptive and cross sectional study was conducted on 150 infertile women who were referred to Fatemieh infertility treatment center in Hamadan, Iran, 2010 to 2011. Samples were selected by systematic randomized method. Data gathering tools was interviewing with a questionnaire. Data were analyzed using SPSS software version 16, and descriptive analytical spearman tests. P value less than 0.05 was considered significant.
Results: 65 infertile women (43.3%) was agree with using surrogacy if necessary. 74 women (49.3%) preferred using known surrogate mother. 103 women (68.6%) agreed with disclosure to child about the fact. 101 women (67.3%) did not have received any educational information about surrogacy. However only 15 infertile women (10%) did not had enough knowledge toward surrogacy, but 80 women of them (53.3%) had positive attitudes toward surrogacy.
Conclusions: Despite of good knowledge of infertile women toward surrogacy, their attitudes about this technology are not so positive. So, changing the cultural background in the society for better acceptability of this technique seems to be necessary.
An increasing number of contemporary research publications acknowledge the influence of religion and culture on sexual and reproductive behavior and health-care utilization. It is currently hypothesized that religious influences can partly explain disparities in sexual and reproductive health outcomes. In this paper, we will pay particular attention to Muslims in sexual and reproductive health care. This review reveals that knowledge about devout Muslims' own experience of sexual and reproductive health-care matters is limited, thus providing weak evidence for modeling of efficient practical guidelines for sexual and reproductive health care directed at Muslim patients. Successful outcomes in sexual and reproductive health of Muslims require both researchers and practitioners to acknowledge religious heterogeneity and variability, and individuals' possibilities to negotiate Islamic edicts. Failure to do so could lead to inadequate health-care provision and, in the worst case, to suboptimal encounters between migrants with Muslim background and the health-care providers in the receiving country.
This essay traces the emergence and development of the consensus against surrogacy arrangements, mostly in the Sunni world, on the basis of a number of institutional fatwas, recommendations, and decisions. Despite this consensus against surrogacy, jurists discuss in detail its potential effects if it is performed. This juristic attitude reflects an understanding of sharīʿah as a legal system that not only institutes rules for cases that match its moral vision but also regulates the consequences of cases that do not match that vision. In the absence of clear and binding legislation on surrogacy in most Muslim-majority countries, this body of religious and ethical deliberations represents the main resource for moral decision-making on surrogacy and its impact on the genealogical connections within the nuclear family.
During the first decade of the 21st century, the growing global surrogacy industry brought renewed attention to surrogacy as a social problem and a health policy issue.
Is surrogacy described in the Bible? If so, who was a surrogate mother? How did it happen? What were consequences? What is the definition of surrogacy? Types? Historical aspects? Legal, moral, ethical and social aspects? Religious issues? What are psychological aspects of surrogate mother? Outcome of children born after surrogacy? What are surrogacy arrangements for singles, same-sex, and shorter-term heterosexual couples? What is international surrogacy? Non-commercial and commercial surrogacy? What is attitude towards surrogacy?
This research examines surrogacy from the contemporary perspective, evaluating its definition, types, historical aspects, epidemiology, legal and ethnic issues, arguments for and against surrogacy, religious issues, psychological aspects, relationships with surrogate mother, outcome of children born after surrogacy, international surrogacy, attitudes towards surrogacy, and non-commercial and commercial surrogacy.
All biblical texts were examined and one character who suffered from infertility was studied.
Infertility is a social onus for women in Iran, who are expected to produce children early within marriage. With its estimated 1.5 million infertile couples, Iran is the only Muslim country in which assisted reproductive technologies (ARTs) using donor gametes and embryos have been legitimized by religious authorities and passed into law. This has placed Iran, a Shia-dominant country, in a unique position vis-à-vis the Sunni Islamic world, where all forms of gamete donation are strictly prohibited. In this article, we first examine the “Iranian ART revolution” that has allowed donor technologies to be admitted as a form of assisted reproduction. Then we examine the response of Iranian women to their infertility and the profound social pressures they face. We argue that the experience of infertility and its treatment are mediated by women’s socioeconomic position within Iranian society. Many women lack economic access to in vitro fertilization (IVF) technologies and fear the moral consequences of gamete donation. Thus, the benefits of the Iranian ART revolution are mixed: although many Iranian women have been able to overcome their infertility through ARTs, not all women’s lives are improved by these technologies.
The Iranian civil law emphasizes that family is a warm and placid institute founded upon the authority of the husband and the father. Motherhood and doing housework are the woman’s responsibility, and outside work is the man’s; and the man is the breadwinner. Such policies reinforce the traditional patriarchal relations within the family. (Sarokhani and Raf’atjah 2004)
This 10th statement of the Task Force on Ethics and Law considers ethical questions specific to varied surrogacy arrangements.
Surrogacy is especially complex as the interests of the intended parents, the surrogate, and the future child may differ.
It is concluded that surrogacy is an acceptable method of assisted reproductive technology of the last resort for specific
medical indications, for which only reimbursement of reasonable expenses is allowed.
#### Summary points
Around 9% of couples are involuntarily childless. At least a quarter of couples experience unexpected delays in achieving their desired family size,1 although only a half seek treatment. In recent years, publicity about infertility treatments has increased, and couples are now more willing to seek advice. The first of these two brief reviews covers the main causes of infertility, with particular reference to advances in the past five years; the second review will look at polycystic ovary syndrome and anovulatory infertility.
The role of the general practitioner is to initiate the investigation of both partners and ensure timely onward referral to a specialist clinic. Treatments for infertility are never far from the public eye, often courting controversy and ethical dilemmas. This article aims to provide general practitioners with a balanced and evidence based overview of the latest advances and where they fit into current practice.
We referred to the Cochrane database of systematic reviews, NICE guidelines for the investigation and management of infertility (2004), and our knowledge of the current literature.
#### Ongoing research questions and projects
The provision of infertility treatment in developing countries is controversial. Reports over the last decades have inculcated in people from Western countries the belief that overpopulation is the major problem of developing countries. This paper will analyse the different arguments advanced for and against providing infertility treatment to resource-poor countries. There are two arguments in favour: reproductive autonomy and the huge burden of infertility in these countries. Pronatalism, which reigns in almost all developing countries, is to a great extent responsible for the devastating effects of infertility. The five arguments against the application of infertility treatment are overpopulation, prioritization of limited resources, prevention rather than cure, justice and equal access and risk of abuse. The importance of a person's reproductive autonomy demands that efforts should be made to enable people to determine how many children to have. This is equally true in developing countries. However, given the enormous difficulties of resource-poor countries to provide even the most basic goods, the contribution by society should be directed mostly at prevention and should depend on a strong cost reduction for assisted reproductive technology.
This book presents a critical analysis of the debate at the religious, legal and political level sparked off by the introduction of new biomedical technologies (cloning, genetics, organ transplants, IVF, etc.) in Muslim countries. It compares the positions of "classic" Muslim law and contemporary religious authorities; laws in Muslim countries; the attitudes and concrete behaviour of populations, families and individuals, as well as the regulations of medical associations, bioethics committees etc..
The result is a mosaic of positions which are often different (including from the point of view of ethics) but all in pursuit of legitimisation according to the Koran and the Shari’a.
The work has an interdisciplinary approach, drawing on law, sociology, anthropology, politics and the history of science. For this reason it will be of interest to scholars and operators in a wide variety of disciplines and fields.
For some couples, surrogacy is the only hope but many feel that it is an emotional minefield. It is where one woman offers to carry a child for another and, after the pregnancy and birth, hands the child to the commissioning couple. It is a last resort form of treatment. The UK Parliament allowed for surrogacy, but it is an area that needs a considerable amount of heart searching and planning on behalf of all that are considering it - expert counselling must be available. The British Medical Association provided a useful and wise warning. The aggregate of foreseeable hazards should not be so great as to place unacceptable burdens on any of the parties, including the child.
Regulations relating to assisted reproduction in the Arabic-speaking world are derived mainly from religious regulations. The basic concept of Islam is to avoid mixing genes, as Islam enjoins the purity of genes and heredity. It deems that each child should relate to a known father and mother. Since marriage is a contract between the wife and husband during the span of their marriage, no third party intrudes into the marital functions of sex and procreation. A third party is not acceptable whether he or she is providing a spermatozoon, an egg, an embryo or a uterus. Transfer of frozen–thawed embryos, or using frozen–thawed spermatozoa after termination of the marriage contract by divorce or death of the husband is also forbidden. The orthodox Christian belief in the Arab world concerning assisted reproduction treatment is identical to that of Muslims. If it is not possible to perform assisted reproduction treatments under these regulations, the patient may be able to travel abroad for gamete donation. There are no laws governing assisted reproduction in the Arab world, with the exception of Tunisia that has a law conforming to religious regulations. Most of the Arab countries have recommendations and guidelines issued by ministries of health or fertility societies.
The growing potential of biomedical technologies has increasingly been associated with discussions surrounding the ethical aspects of the new technologies in different societies. Advances in genetics, stem cell research and organ transplantation are some of the medical issues that have raised important ethical and social issues. Special attention has been paid towards moral ethics in Islam and medical and religious professions in Iran have voiced the requirement for an emphasis on ethics. In the last decade, great strides have been made in biomedical ethics, especially in the field of education, research and legislation. In this article, contemporary medical ethics in Iran, and the related moral philosophy, have been reviewed in brief and we have discussed some of the activities in the field of medical ethics that have been carried out in our country within recent years. These activities have included the establishment of the National and Regional Committees for Medical Research Ethics and the production of national codes of ethics in biomedical research in the 1990 s and the introduction of a comprehensive strategic plan for medical ethics at the national level in 2002. This paper will discuss these issues, along with the production, in 2005, of the Specific National Ethical Guidelines for Biomedical Research.
This paper discusses the exploitation argument against commercial surrogacy: the claim that commercial surrogacy is morally objectionable because it is exploitative. The following questions are addressed. First, what exactly does the exploitation argument amount to? Second, is commercial surrogacy in fact exploitative? Third, if it were exploitative, would this provide a sufficient reason to prohibit (or otherwise legislatively discourage) it? The focus throughout is on the exploitation of paid surrogates, although it is noted that other parties (e.g. ‘commissioning parents’) may also be the victims of exploitation.
It is argued that there are good reasons for believing that commercial surrogacy is often exploitative. However, even if we accept this, the exploitation argument for prohibiting (or otherwise legislatively discouraging) commercial surrogacy remains quite weak. One reason for this is that prohibition may well ‘backfire’ and lead to potential surrogates having to do other things that are more exploitative and/or more harmful than paid surrogacy. It is concluded therefore that those who oppose exploitation should (rather than attempting to stop particular practices like commercial surrogacy) concentrate on: (a) improving the conditions under which paid surrogates ‘work’; and (b) changing the background conditions (in particular, the unequal distribution of power and wealth) which generate exploitative relationships.
Does Islam allow ''surrogate motherhood
- Islamonline
IslamOnline.net; Kutty A. Does Islam allow ''surrogate motherhood''? 7 January 2007 http://www.islamonline.net/servlet/Satellite?pagename=IslamOnline-English-Ask_Scholar/FatwaE/FatwaE&cid=1119503546938 (accessed 18 March 2009).
Ghavaed Figh-hi [The rules of Islamic jurisprudence
- E Velaee
Velaee E. Ghavaed Figh-hi [The rules of Islamic jurisprudence]. (In Farsi.) Ghom: Dar-ol-fekr, 2008:10–5.
European Society of Human Reproduction and Embryology. ESHRE monographs: guidelines for counseling in infertility
- Surrogacy
- In
Surrogacy. In: European Society of Human Reproduction and Embryology. ESHRE monographs: guidelines for counseling in infertility 2002:37–8.
Islamic bioethics: problems and perspectives
- D Atighetchi
Atighetchi D. Islamic bioethics: problems and perspectives. Dordrecht: Springer, 2007:143–4.
Encyclopedia of bioethics
- S G Post
Post SG. Encyclopedia of bioethics. 3rd edn, vol 4. New York: Thomson Gale, 2004:2265–6.
Surrogacy: definition, types and its necessity in treatment of infertility. (In Farsi.) In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy
- Akhoundi
- Z B Ardakani
Akhoundi MM, Ardakani ZB. Surrogacy: definition, types and its necessity in treatment of infertility. (In Farsi.) In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy. Tehran: Samt, 2007:3–14.
Rental womb: eight million toumans. (In Farsi
- Bbc Persian
BBC Persian.com; Tousi M. Rental womb: eight million toumans. (In Farsi.) 2007 http://www.bbc.co.uk/persian/interactivity/debate/story/2007/01/printable/ 070125_h_surrogatemum.shtml (accessed 18 March 2009).
Sperm and embryo banks: a comparative study of Islamic jurisprudence and man-made law. (In Arabic.) Cairo: Dar Al-Nihzah Al-Arabia
- Al
- Sunbati
- Aa
Al-Sunbati AA. Sperm and embryo banks: a comparative study of Islamic jurisprudence and man-made law. (In Arabic.) Cairo: Dar Al-Nihzah Al-Arabia, 2001:274.
The surrogate womb]. (In Arabic.) In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy
- A Ghaeni
Ghaeni A, Al-Rahem-OlBadil [The surrogate womb]. (In Arabic.) In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy. Tehran: Samt, 2007:66–121.
Assessment of jurisprudential aspects of surrogacy. In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy
- Z Govahi
Govahi Z. Assessment of jurisprudential aspects of surrogacy. In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy. (In Farsi.) Tehran: Samt, 2007:122–38.
Surrogate mother and different ways of becoming a mother: a new approach to Qurâanic verses and sayings of Prophet and Imams. In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy
- S M Movvahed-Abtahi
Movvahed-Abtahi SM. Surrogate mother and different ways of becoming a mother: a new approach to Qur'anic verses and sayings of Prophet and Imams. In: Medical, legal, Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy. (In Farsi.) Tehran: Samt, 2007:139–51.
Sperm and embryo banks: a comparative study of Islamic jurisprudence and man-made law
- A A Al-Sunbati
Reproductive infertility: prevalences, cases, trends and treatments. Ottawa: Parliamentary Research Branch, Library of Parliament
- S Norris
Does Islam allow surrogate mothers?
- Islamiccity
- A A Al-Jibreen
Islamic jurisprudential, ethical-philosophical, sociological and psychological aspects of surrogacy
- A Ghaeni
Rental womb: eight million toumans
- Bbc Persian
- M Tousi