family law, surrogacy, stem cells, artifical insemination, Human Fertilisation and Embryology Act
There have been some very
complex and ethically difficult cases arising from artificial insemination and
disputes afterwards in the last 2 years. A development in science might lead
to some even more difficult legal issues.
Randall Monroe’s excellent book,
What if, posits a number of peculiar questions and provides answers to them.
One of the 'What if'
questions is the theoretical possibility that stem cell research might advance
sufficiently such that a stem cell taken from a person’s bone marrow can be
altered into becoming a sperm cell. The
'What if' question is – 'what if a woman used her own stem cell to become a
sperm cell, and then used that sperm cell to impregnate herself?'
This is not possible yet, but
it could be in the future.
Scientists have already been able to turn stem cells taken from males into sperm cells.
Randall Monroe sets out in
very zingy and cogent style that to create a child that has paternal and
maternal DNA from the same source runs a considerable risk for the child; it is
in effect a shortcut to being where the Royal families of central Europe ended
up after three generations of in-breeding.
The issue with having the
same person provide both male and female DNA is that you don’t end up with a
clone of the mother as you might initially think.
The child has DNA that only
exists in the mother, but not the SAME mix of DNA. Instead, the mother’s ‘sperm cell’ contains
one shuffled set of DNA, the egg cell contains another, and the child ends up
with a fresh shuffled set.
Why that is problematic is
that the whole mixing and shuffling of DNA that is the consequence of sexual
reproduction is a good method of avoiding nasty genetic disorders. If the
mother has any genes that are hereditary diseases that don’t get passed on
unless both parents have the gene, then having all of the DNA come from one
source is bad news.
If it became possible then,
there are good ethical reasons not to do it. But at the moment, there are not
necessarily
legal reasons why it could not be done.
The Human Fertilisation and
Embryology Act 1990 (HFEA) makes it an
offence to 'store' gametes without a licence, but not to 'create' them. [Rather obviously, human beings are
creating gametes fairly regularly as an organic and natural process and you’d
have to live in quite a dystopian society to demand that they only do so if
they have a licence.]
One couldn’t undertake a
clinical artificial insemination without a licence, and one would imagine that
any clinic would be ringing up the Human Fertilisation and Embryology Authority
if a woman came in with the test tube of male gametes and revealed that they
had been made from her own stem cells.
But that only covers
insemination done in a clinic – if it is a licensed one, they probably won’t do
it, and if they are not licensed then they are committing lots of offences
under the HFEA. The Act as it stands
would not really cut it for anyone who decides to go the ‘turkey baster’ route.
Would there be potential
child protection issues? One might argue
that knowingly or recklessly conceiving a child in circumstances where he might
acquire your hereditary disease might be s 31 significant harm, and that
the harm is attributable to an action ‘not
being what it would be reasonable to expect a parent to give to him’
However:
(a) The wording of
s 31 is not ‘action’ but ‘care
given’.
(b) At present, a
child is not a legal creature until birth, so ‘care given in the womb’ isn’t a
threshold issue. (it can come into
issues of risk of future harm – if the mother abused drugs or alcohol in
pregnancy that increases the possibility that she will do so when caring for
the child, and in a similar way if the mother is assaulted by her partner
during pregnancy the risk of the child being exposed to violent behaviour once
born is increased).
(c) If we were going
to interpret s 31 this widely, you’d also be inadvertently scooping up parents
who were in loving relationships and just happened to share those hereditary
disease genes and passed them on. Were they reckless in having a child? What if
they knew that say Huntingdon’s chorea had been in both of their families
historically? Nobody surely would want
to see care proceedings being issued on parents in those circumstances.
Even the criminal law doesn’t
seem to help. If someone makes their own sperm cells and impregnates themselves
with them, they’ve consented, so there’s no suggestion of sexual assault. Even
the widely drawn s 1 of the Children and Young Person’s Act 1933 (the one that was used in the Ashya King case)
doesn't assist:
'(1) If any person who has attained the age of sixteen
years and [F1has responsibility for] any child or young person under that age,
wilfully assaults, ill-treats, neglects, abandons, or exposes him, or causes or
procures him to be assaulted, ill-treated, neglected, abandoned, or exposed, in
a manner likely to cause him unnecessary suffering or injury to health
(including injury to or loss of sight, or hearing, or limb, or organ of the
body, and any mental derangement)',
surely requires there to be a
child at the time the offence was committed, and here the 'offence' is in the
moments before the child is conceived and thus not in existence.
Thus, if it becomes possible
for a female to produce their own sperm cells, not only will the male species
become utterly redundant (save for breaking things around the home, explaining
the first two minutes of a movie and removal of excessively large spiders)
there will be some need for some rewriting of statute, depending on how easy it
is to do this.
[If it were to be criminalised, it would be a fairly
simple test if someone is suspected of it. It would be beyond any prospect of
chance that a person’s baby has DNA that only comes from the mother unless
either (a) this has happened or (b) they have had sex with their twin in which
case the cuffs are still going on.]
I’m going to coin a phrase
for it, in the hope that when it takes off as a phenomenon historians will find
that I gave it a name: 'Narcissistic
Pregnancy'.
[It all seems very far-fetched now, but the ‘gesture
control’ in the 2002 film Minority Report seemed utterly amazing when we first
saw it and now you can buy a mobile phone that will do it for about £50.]
Very well, the 'Narcissistic
Pregnancy' is a relatively unlikely scenario. Even if the technology becomes
possible, would women really want to do that in the real world? Even if they
wanted a baby, and even if they REALLY REALLY loved themselves, wouldn’t the
risk of genetic disease put them off?
Probably.
But where else does this
technology go? Well, one possible avenue
would be for homosexual couples. At present, homosexual couples who want to
have a baby are restricted to artificial insemination (if female) or surrogacy
(both male and female couples). The
drawback of that, is that the child is the biological and genetic child of only
ONE of the couple.
That of course might not be a drawback for many
couples, but there will be some for whom the idea of having a child that is
genetically related to both is deeply attractive (that’s a very primal and natural drive and
this represents a method by which that might be possible in the future. It is
something that we take for granted in heterosexual couples that part of the
underlying thinking of having a child is to create a life together, to share in
that process and to pass on ones genes).
As I understand things, turning stem cells
into sperm is more feasible than turning them into egg cells (as egg cells are
the largest cells in the body, it would involve the stem cell becoming bigger
rather than smaller and it might be
IMPOSSIBLE – I am not Robert Winston) but it may be that once this
technology advances, it will advance quickly.
Assuming that a woman can
create sperm cells and a man can create egg cells, that does create the ability
for a same sex couple to produce a baby that is one where both are genuine
biological and genetic parents.
And one can see that there
would be a target audience for that facility, and clinics who would want to
provide it.
But if a child is conceived
in this way (let’s dub it 'Stem-Swap Conception') are the couple then the
child’s legal parents?
The HFEA 2010 establishes
that legally, a mother is the person in whose womb the child grows (it doesn’t matter if the egg cell that made
the child is from another woman – or indeed in our theoretical discussion a
man).
'Section 33 - Meaning of "mother"
(1) The woman who is carrying or has carried a child as
a result of the placing in her of an embryo or of sperm and eggs, and no other woman,
is to be treated as the mother of the child.'
So, we have as our couple
Bella and Alice. They decide to undertake a Stem-Swap Conception. Alice has her stem cells converted to sperm
cells, and impregnates Bella with them.
They are both the biological and genetic parents. The LEGAL mother is
Bella, as she carried the baby to term.
Where does that leave
Alice? If she’s not the mother, is she
the father?
It is s 37 of the HFEA 2010 that sets
out the various situations in which a person becomes the father of a baby; but
each of them specifies that the father must be a man. So, Alice won’t be the
father (which is probably a relief to her).
If Alice and Bella were in a
civil partnership or marriage, and Alice consented to the insemination then
Alice will acquire Parental Responsibility as a result of s 42 of the HFEA 2008:
'Woman in civil partnership at time of treatment
(1) If at the time of the placing in her of the embryo
or the sperm and eggs or of her artificial insemination, W was a party to a
civil partnership, then subject to section 45(2) to (4), the other party to the
civil partnership is to be treated as a parent of the child unless it is shown
that she did not consent to the placing in W of the embryo or the sperm and
eggs or to her artificial insemination (as the case may be).'
If they weren’t in a civil
partnership, then they can still agree that Alice will have PR by virtue of s 43 of the HFEA 2008 (particularly since we can be
damn sure that no man will be treated as a father of the child):
'Section 43 - If no man is treated by virtue of section 35 as
the father of the child and no woman is treated by virtue of section 42 as a
parent of the child but—
(a) the embryo
or the sperm and eggs were placed in W, or W was artificially inseminated, in
the course of treatment services provided in the United Kingdom by a person to
whom a licence applies,
(b) at the time when the embryo or the sperm and eggs
were placed in W, or W was artificially inseminated, the agreed female
parenthood conditions (as set out in section 44) were met in relation to
another woman, in relation to treatment provided to W under that licence, and
(c) the other woman remained alive at that time, then, subject to section 45(2) to (4), the other woman
is to be treated as a parent of the child.'
Moving now to Jacob and
Edward. Jacob has the easy task and
provides his sperm for an artificial insemination of a surrogate mother. Edward
has his stem cells converted to an egg cell and has his egg cell implanted into
the surrogate mother for Jacob’s sperm to fertilise. (That must be a Stem-Swap Conception
Surrogacy.)
The surrogate mother has PR
and is the legal mother (s 33 of the HFEA 2010 – she carries the baby, she’s the legal
mother even though she has no genetic relationship with the child).
Edward and Jacob had the
sense not to choose a surrogate mother who was married (because if not, then
the husband would be the legal father).
Jacob is the legal father
PROVIDED there was a written agreement between himself and the surrogate mother
about this:
'Section 37 - The agreed fatherhood conditions
(1) The agreed fatherhood conditions referred to in
section 36(b) are met in relation to a man (“M”) in relation to treatment
provided to W under a licence if, but only if,—
(a) M has given the person responsible a notice stating
that he consents to being treated as the father of any child resulting from
treatment provided to W under the licence,
(b) W has given the person responsible a notice stating
that she consents to M being so treated,
(c) neither M nor W has, since giving notice under
paragraph (a) or (b), given the person responsible notice of the withdrawal of
M's or W's consent to M being so treated,
(d) W has not, since the giving of the notice under
paragraph (b), given the person responsible—
(i) a further notice under that paragraph stating that
she consents to another man being treated as the father of any resulting child,
or
(ii) a notice under section 44(1)(b) stating that she
consents to a woman being treated as a parent of any resulting child, and
(e) W and M are not within prohibited degrees of
relationship in relation to each other...
(2) A notice under subsection (1)(a), (b) or (c) must
be in writing and must be signed by the person giving it.'
Edward will not be, as a
matter of law either the mother (because he didn’t carry the child in his
non-existent womb) or the father (because he didn’t provide the male gametes).
So he would need a Parental
Order, under s 54 of the HFEA 2008:
'Parental orders
(1) On an application made by two people (“the
applicants”), the court may make an order providing for a child to be treated
in law as the child of the applicants if—
(a) the child has been carried by a woman who is not
one of the applicants, as a result of the placing in her of an embryo or sperm
and eggs or her artificial insemination,
(b) the gametes of at least one of the applicants were
used to bring about the creation of the embryo, and
(c) the conditions in subsections (2) to (8) are
satisfied...
(2) The applicants must be—
(a) husband and wife,
(b) civil partners of each other, or
(c) two persons who are living as partners in an
enduring family relationship and are not within prohibited degrees of
relationship in relation to each other.'
If your head isn’t already
hurting from all of this (and remember that the High Court has declared that
all family lawyers need to be capable of advising on the HFEA and it is not a
specialised area(!)) we are about to
kick it up a notch.
The possibility exists to
freeze sperm cells for use after death, and the HFEA makes various provisions
for that, and there’s been a lot of litigation about consent and whether the
right forms are filled in, and timescales. That litigation is mind-bendingly
hard. But like I said, we’re kicking it
up a notch.
All of the HFEA provisions
about the use of sperm cells after the death of the donor, are expressly about
the donor of such cells being
a man. [Oddly,
this provision, which probably looked at the time to be a redundant inclusion,
might potentially become important if women can produce sperm cells by genetic
manipulation of their stem cells.]
So the HFEA doesn’t cover the
use of sperm cells created by a woman AFTER her death. Nor does it cover the
conversion of stem cells provided by a woman into sperm cells and then use,
after her death.
Given that this technology
might exist in the future, might women with a terminal illness who are in a
same-sex partnership want to donate their stem-cells and leave instructions
that they be converted to sperm cells once this is possible? And thereafter use
those sperm cells to impregnate their partner? And would we need regulation
about that?
Apologies for anyone who now has a headache.
Andrew has been shortlisted for the 2014 Family Law Awards - Commentator of the Year for the second year running. The Awards Ceremony will take place at The Brewery, 8 October.
The views expressed by contributing authors are not necessarily those of Family Law or Jordan Publishing and should not be considered as legal advice.
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