Thai Surrogacy Fiasco–What Can We Learn?

There’s a story that has been all over the media the last few days involving an Australian couple who used a Thai surrogate.  I’m sure you can find a dozen different versions of the story, but I’ll start with this one from the Washington Post.  One of the reasons I’ll use this one is that it makes it clear that a lot of the details are unknown and/or unclear.

That said, here’s the bare-bones account.    (I’m trying to stay to the facts we know, but I think I have to make some assumptions, too.   I’ll try to identify them.).  An unnamed (and presumably heterosexual) Australian couple went to Thailand to hire a surrogate.   (While it doesn’t say this, I think we can assume that part of the reason they went to Thailand is that compensated surrogacy is prohibited in Australia.)

Pattaramon  Chanbua is a 21-year-old Thai woman.   She is food vendor and earns $622 per month.   A surrogacy agency offered to pay her somewhere between $9300 and $16,000 to serve as a surrogate.   She agreed to do so. 

Chanbua became pregnant with twins for the Australian couple.  (I’d guess via IVF using embryos from the couple’s own genetic material, but I don’t know that.).  At some point during the pregnancy it became clear that there were problems.   The surrogacy agency (or in some accounts the Australian couple) suggested abortion.   Chanbua refused.

She gave birth to twins–a boy named Gammy who has Down Syndrome and some heart issues and a girl who was apparently normal.   The Australian took the girl to Australia and did not take the boy.   (That might have been their idea but it is also possible that they didn’t even know of the existence of the boy.).  The boy remains with Canbua who is hardly in a position to care for a child with disabilities.

This story has generated lots of fallout. I would note two pieces:  First, there is now a fund with over $200,000 in it that is dedicated to caring for Gammy.   That’s a lot of money by almost any standards but probably particularly a lot for an impoverished Thai food vendor.   (I don’t believe that Chanbua set up the fund, by the way, but it is for the care of her child.)

Second, the Australian government is under pressure to do something.  There are several possible courses of action–not mutually exclusive.   Some expect Australia might try to ban use of overseas surrogacy.   (I have to wonder if such a ban could be legal and, even if legal, effective.  Can a country prohibit its citizens from travelling to receive medical care?).   At the same time Australia is apparently looking into the possibility that Gammy is an Australian citizen and therefore entitled to state-sponsored medical care.   (Oh, those lucky people in single-payer land.).

Now what to think/say/do about all this?   I find it hard not to respond viscerally to the behavior of the Australian couple.   That’s actually not fair–what if the agency never told them about the boy?– but still, I think I should say it because it is right there in the front of my brain.

The lack of clarity about the facts can be really problematic.   For instance, judgment about the morality of the Australian couples’ conduct depends (for me, anyway) on the specific facts.

But there are other things to think about where the details don’t matter so much.   Even if the Australian couple didn’t drop by the hospital to pick up one twin, leaving the other behind, I think they could have done this.  And, it seems to me, no system of law should sanction that behavior.

Indeed, even without certainty about the details it seems to me this case exemplifies some of the problems of the global surrogacy trade.   Because Australia won’t allow paid surrogacy people go to countries that do allow it.  And those countries–at least some of them–lack basic protections for surrogates and the children conceived via surrogacy.

I’m actually surprised that there is no discussion (that I’ve seen, anyway) of consequences for the Australian couple.   And (though I don’t like to think of myself as vengeful) this is a case where perhaps there should be consequences.   Maybe Canbua wants to raise Gammy and, under the circumstances, maybe she should be allowed to so.   But I think the Australian couple should be held responsible for the costs of her doing so.   It’s too crude to say that they commissioned this child and therefore must bear the costs, but that is the general idea.

I’m also haunted here by imagining the life of the girl who was taken back to Australia.  Will she ever know her story?  Will she know she has a twin brother?   And if she does, how will she ever be able to accept her parents decision to leave him behind?  (Even if they didn’t know of his existence at the time they left Thailand, they surely do know.).

Much to consider.

 

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22 responses to “Thai Surrogacy Fiasco–What Can We Learn?

  1. Josephine Wilson

    Hi Julie, thanks for your post, and as you say, much to consider. I live in Perth, about 250 kms north of where the papers are now telling us this couple live. Apparently they have been identified on some sites already; the papers are now reporting that the man has prior convictions (some 15 years ago) for offences against children. You can imagine the journo digging that one up. It seems that the man is a lot older than the woman. He met her on a website that features young Chinese women, all available for dating. The couple are denying, apparently (though who knows the truth?) that they asked the mother to have an abortion; they are also reported as denying that they chose to abandon the twin, but claim that they were told by Thai doctors the baby was too sick to leave Thailand. Australia has very strict laws around the entry into the country of adopted children with medical needs; there is no guarantee the child would have gained right of entry, although I do not know when and how the legal side is resolved with surrogacy. The plot does not so much thicken as swirl in what is a most unsavoury and unethical manner, methinks. The story was broken by our national broadcaster, and when the dust settles there will be a great deal to sift through and many questions about that original report. As you say, surrogacy is not the same in Australia, and adoption from overseas is even more difficult than it is in America, as there is no private adoption agencies.

    I too am haunted by the children in this story – how will they feel when they are old enough to understand it all? The story is going out further and further. And with all surrogacy – and perhaps adoption – there is the issue of money. Would women in Thailand or Mexico (or the USA?) be doing this for love, or altruism? And now that all this money has been raised, can you blame the mother for thinking that she can raise the two children?

    • Thanks for the details. Ugh. It’s a little hard for me to see what the right resolution is, actually. I could say the siblings should be reunited, but where? Does the little girl (who has been in Australia for about six months?) get taken from her home? Do the surrogate and Gamay get moved to Australia for medical care? Do both children end up in yet a different household (which I think is what John Howard suggests in his comment)?

      It’s easy for me to say some things–like that the intended parents, who now do know about the second child, do not seem to be behaving well. But it hard for me to say what the ultimate resolution should be.

  2. Here’s where I say that babies created like this should not be awarded to the contracting party, even if they are genetically related, but should be placed with some proven stable family far away, to raise like any adopted baby taken from unfit bio parents. Eventually adopted kids learn the facts of their adoption.

    • I’m not sure I understand who the last sentence (which I think is generally true) connects to the rest of what you say. If one uses gestational surrogacy I think it is possible a child won’t learn–DNA testing won’t reveal it at a later date.

      But maybe this is beside the point. The sanction you suggest is an interesting one. It would certainly discourage the practice of surrogacy were it put in force. It seems like it is mostly punitive–designed to punish (and therefore deter) all those involved in surrogacy? (Unless you mean this to be applied only in some subcategory of cases?). If it is to deter surrogacy generally then it only makes sense if one things surrogacy is generally wrong, of course.

  3. A lot of commentors on the various news sites are insisting that she should have had an abortion like she was told to. Most are ignorant to the fact that abortion in Thailand isn’t exactly legal.

    • Wow–I haven’t seen that comment (but I’ve not looked very far). I’m appalled. Not only because it is illegal but because it seems to me so clear that it is the surrogate’s right to make that decision. If she thinks it is wrong and won’t do it, then I don’t care if it is legal. That’s one of the things one would do well to discuss before contracting with a surrogate (in my view).

  4. Julie,

    I’m not sure how you can compare people going overseas to seek medical treatment with surrogacy. One is treatment of the person’s body (health or cosmetic) the other is contracting someone else’s body to produce a child/ren for you. Night and day difference. Pregnancy and delivery of your child in someone else’s body you paid to rent, does not stretch that far to me – that is a transaction, not a medical procedure.

    What I can say is that it isn’t the voices against paid surrogacy that makes people who participate in it look bad, the actions of the participants do it all by themselves. One can state they didn’t know the agency was shady and they aren’t to blame, but honestly how far does that fly to reduce culpability?

    You can state that people have a right to become parents, but at what point is a line drawn in the sand – that the cost to everyone else involved is too much? At some point those that are paying, must make a choice that if they are having children – it’s done the right way, or not at all. Life isn’t always fair but you live with what life threw your way.

    How on earth can you tell your child that it didn’t matter who got hurt (including your child) – you were willing to do whatever you had to do to get them? I can’t imagine growing up knowing that I was picked, and my twin discarded as nothing more than trash, even if they didn’t know then, they know now. They know that the brother of their child (and presumably their genetic child) was abandoned by them, and doing nothing now makes it a willing abandonment.

    • I guess the differences just don’t seem quite so stark to me. That’s probably because we (you and I) have different ways of thinking about surrogacy. I don’t think there’s anything necessarily wrong with surrogacy, though like anything else it is subject to abuse. Thus, it isn’t clear to me there is a defining difference between going overseas for knee replacement and going overseas for surrogacy.

      I do see, though, that there are many ways others could reach a different conclusion. One might think that surrogacy is qualitatively different (and wrong). One might think that there is no real medical need for surrogacy. Certainly surrogacy may be more prone to abuse than other surgeries. All important things to consider. The last in particular worries me.

      All that said, I rather agree with you on the last point–and I think it will be the subject of my next post. It seems pretty clear to me that you need to be honest with children about their origins–certainly that is true for adoption and I believe it to be true about use of third-party gametes, too. It seems to me it is also true where you use surrogacy. I’ve seen almost nothing written about how people plan to talk to children born of overseas surrogacy. How do you explain that you never even bothered to meet the woman? And how do you explain that you left a twin behind?

      • I don’t have a firm opinion on surrogacy per se as to it’s rightness or wrongness that would allow me to draw a line in the sand. My concern in this subject is simply the protection (or lack of protection) in regards to surrogates, and the potential for abuse and harm. It’s power and economic imbalances that have the potential to go horribly wrong whatever the geography it happens in. When I think of how structured live donation is, the level of ethical mandates and requirements that must be met to donate a kidney compared to surrogacy where you also have a risk to your life – it’s clear the power imbalance even in developed countries. I understand why paid surrogacy is frown upon and see why it is.

        • I share your general concerns, but I may not reach all the same conclusions. Power imbalances are exactly what I worry about. Money (as in paid surrogacy) can make it worse, but I’m not sure that it has to be that way. (This is an idea I’m working on in something I’m writing just now. Will expand when I have a bit more clarity.).

      • i’m with tao on this one. you can’t claim to be receiving medical care if its happening to someone else’s body. to speak as such denies the personhood of the surrogate, as if she eas am appendage of the commissioner.

        • I don’t think the IPs can assert that they are receiving medical care, except maybe the IVF part. Not sure about that, but I certainly see your point and I accept it. It’s important to me NOT to treat the surrogate as appendage.

          I do think they are partaking of reproductive health services in that other country. But I am not sure why this bit of wording matters so much.

    • “What I can say is that it isn’t the voices against paid surrogacy that makes people who participate in it look bad, the actions of the participants do it all by themselves. ”

      I disagree Tao because the voices against surrogacy only point to the situations that go horribly wrong and ignore the situations where there are no issues. Like with Adoption I think you need that balance to improve things. You need the stories of adoptions done well (or as well as they possibly can) to use as a guide of what you can do and the stories where adoption is done wrong as a guide of what not to do. Same goes for surrogacy.

      As I said in the previous thread, banning surrogacy isn’t the solution because as long as the desire to have children is there people are going to pursue these methods to become parents. Education and Regulation is the way to go. Sure you’ll still have people that will go around the system but it is less likely to happen if there is a regulated way of doing so.

      • Greg,

        You misread what I was saying.

        • I read what you said but I don’t think that their intention is to say that it’s the people not the practice. Their exact argument is that it is the practice.

          • Greg – you may have read it, but you didn’t hear what I was saying – there is a world of difference between what you think I am saying, and what I am saying. Please stop.

            • Tao,

              If the message is consistently that the practice needs to be banned then the intention in exploiting these stories are that it needs to be banned.

              Let me be clear though I’m not saying that this is your personal position that it needs to be banned, I’m saying this is the position of those groups out there that are looking to ban surrogacy, third party reproduction and all other types of infertility treatments. My disagreement with you is what these group’s intentions are not your personal stance on the issue that I don’t think you have made clear.

              • GREG, I was NOT talking about them. I was SIMPLY pointing out that they don’t need to say ANYTHING. It’s the people PARTICPATING in these types of surrogacy arrangements that MAKE THEMSELVES LOOK BAD ALL BY THEMSELVES.

                Seriously, I’m done, I asked you to stop and you continued on.

                • Yet these groups exploit these stories as a tool to make all surrogacies look bad. They use it as a tool not so much to make the people look bad but the practice. And it’s self serving and wrong of them to do so. That is my point.

                  • Greg,

                    From your first comment where you “disagree” with me and I said you did not understand what I was saying.

                    To your second comment where you continued to ASSUME that I was saying “I don’t think that their intention is to say that it’s the people not the practice. Their exact argument is that it is the practice.”

                    To your third comment “My disagreement with you is what these group’s intentions are not your personal stance on the issue that I don’t think you have made clear.”

                    I never once stated in my comment what their intentions were as a group, or weren’t, I don’t care what they are, or aren’t, I don’t care. It wasn’t the point I was making and you can’t seem to grasp that fact, even though I have repeatedly pointed that out to you three times now.

                    You need to stop creating rebuttals in you mind while you skim someone’s comment. If you don’t understand what the comment was supposed to mean, ASK, don’t ASSUME and then go off on a tangent about something completely irrelevent to the point I was making in that sentence.

                    Just stop.

  5. While supporting surrogacy in the US, I’m opposed to surrogacy in other countries such as Thailand where exploitation is quite possible.

    Additionally, intended parents need to understand that you get what you get in terms of the child. Just because you’re using surrogacy doesn’t mean you should be allowed to shirk your parental responsibilities simply because the baby was born with some irregularity or disability. Having kids is a risk no matter what way you go about creating your family.

  6. In this particular case, I read they could not have used an American surrogate due to the father being a convicted child molester. I’m worried for the child that is in his custody. 😦

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