Gamble & Ghevaert

Archive for December, 2010

Natalie writes editorial in the Guardian: Can the UK deliver surrogacy reform?

Wednesday, December 29th, 2010

Natalie Gamble has written a comment piece for the Guardian, and you can join the discussion about possible reforms to the UK’s surrogacy laws. Do support us with this – we need your help!

Here’s the link: http://www.guardian.co.uk/commentisfree/2010/dec/29/elton-john-david-furnish-surrogacy-law?

And here’s our article in full:

After the birth of Elton and David’s son, can the UK deliver surrogacy reform?

Elton John and David Furnish’s announcement of the birth of their son through a Californian surrogacy arrangement follows hot on the heels of a high court decision allowing payments for foreign surrogacy just a few weeks ago. Brits building their families through surrogacy seems to be a growing trend, prompting some conservative groups to cry “baby buying” and to raise concerns about the treatment of children as commodities.

But as those affected by surrogacy know, this is far from the reality. Having advised hundreds of families created through surrogacy, I know that parents do not choose that option lightly. The vast majority have heart-wrenchingly long and painful journeys behind them (tales of miscarriages, stillbirths and gruelling years of IVF disappointments). For gay couples, surrogacy gives the hope of a much-wanted family, and arrangements are entered into with planning and care. Surrogate mothers take pride in helping to create families and, whether or not they are paid, the parents involved do not treat the enormous and life-changing gift they make lightly. Children born through surrogacy arrangements are far from commodities or accessories.

The bigger question here is not whether surrogacy is a good thing – and my experience suggests that properly regulated surrogacy is unequivocally good for families – but whether our laws are up to scratch for the 21st century.

UK surrogacy law has its roots in the 1980s and has always been a fudge. Surrogacy is restricted (advertising and commercial agencies are banned) but endorsed where arrangements are deemed “acceptable” (most comfortably, where everyone consents and no more than “reasonable expenses” is paid). It isn’t a workable compromise, since there is little control in practice of what happens when people go outside the “acceptable” framework.

Over the past 20 years, other countries have pinned their colours to the mast more confidently. Many Catholic European countries have prohibited surrogacy altogether (although these restrictions are increasingly proving untenable and reform is afoot in many places). At the other end of the scale, certain US states, Ukraine and India allow enforceable commercial surrogacy. In California, couples have for many years been able to enter into a binding surrogacy agreement with the help of a professional agency (having undergone psychological counselling, legal advice and medical vetting) and obtain a court order during the pregnancy that allows the intended parents to be named on the birth certificate from the outset.

The patchwork global approach to surrogacy drives people to cross borders, and the disparity of law creates grave (and often unforeseen) problems for the families involved. Most starkly, in a landmark 2008 case , much-wanted twins born to a British couple were left stateless and parentless in Ukraine (and at risk of being placed in a Ukrainian orphanage) because neither Ukrainian nor British law recognised its own citizens as the parents. Whatever we think of surrogacy and the practices of other countries, surely everyone would agree that this is unacceptable.

UK law on parenthood in surrogacy cases is ridiculously complex, and (being designed to exclude the status of biological donors in donation situations) very often makes the surrogate and her husband the parents to the exclusion of the intended biological parents. The parents (including gay couples as from April 2010) can apply to court to remedy the situation, but the post-birth “parental order” is a clumsy retrospective tool.

Our current legal system leaves children in limbo for far too long (often up to a year while the court application is processed), in the care of parents who technically don’t even have the legal authority to take them to the doctor. Intended mothers sometimes have to give up their jobs to look after their newborn children because their lack of recognition means they have no rights to maternity leave. The court cannot extend deadlines if missed (no matter how unwittingly). Applications from single parents are prohibited, which is disastrous if one intended parent dies unexpectedly during a surrogate pregnancy (believe me, it’s happened). And that’s before we even get started on the conflicts of law and immigration issues that arise where parents go abroad for surrogacy.

If there is to be any reform, the most tricky issue to resolve will undoubtedly be payments: in the UK surrogates are supposed to be reimbursed for their expenses only (although in practice the English court can, and does, authorise payments which exceed expenses). It is not illegal for Brits to pay more than expenses, nor to travel to a country with a more liberal regime. While we may prefer surrogacy to be entirely non-commercial, we need to recognise the global realities here, and also to understand with greater sophistication that payment and altruism are not necessarily mutually exclusive.

UK surrogacy law is riddled with flaws and desperately needs reconsideration. Yes, surrogacy involves some sensitivities and yes, we need to take care to protect the interests of all those involved and ensure there is no exploitation. But if surrogacy law is to be reviewed, we need to look at this in a sensible way that understands the subtleties and complexities of real surrogacy arrangements. Let’s embrace surrogacy and recognise the hope and wonderful gift that it brings, and let’s celebrate and support families created in this way. I, for one, send Elton and David my wholehearted congratulations and wish them every bit of luck on their parental journey.

Natalie quoted in today’s Guardian on the Elton John story

Wednesday, December 29th, 2010

From the Guardian, 29 December 2010 (Helen Pidd):

You can tell everybody this is our son

Helen Pidd byline. Helen Pidd

Elton John and David Furnish John and Furnish announced that their son had been born on Christmas Day. Photograph: Theo Wargo/Getty Images/Time Inc
When the Beatles imagined their lives aged 64, they sang of knitting sweaters by the fireside, doing the garden and balancing grandchildren on their knees. Three months off that landmark birthday, Elton John might have partly retired from the pop music industry, but he is set to be busier than ever after becoming a father for the first time. The singer announced today that he and his partner, David Furnish, who is 48, have become parents after using a surrogate mother in the US.
The boy, Zachary Jackson Levon Furnish-John, was born in California on Christmas Day, weighing 7lb 15oz, John’s LA-based publicist confirmed. The name Levon is the title of a track on John’s 1971 album Madman Across the Water. In a statement, the couple said: “We are overwhelmed with happiness and joy at this very special moment. Zachary is healthy and doing really well, and we are very proud and happy parents.” The identity of their son’s surrogate mother is being protected by the new parents, and all questions about the birth and conception were answered “no comment” by the singer’s UK-based publicist.

It is not known who is the father, but Natalie Gamble, a specialist in fertility law at Gamble and Ghevaert LLP, said that one or both men will have provided sperm. She said that in all Californian cases of which she was aware, prospective parents must provide the sperm, and the egg would come not from the surrogate but a second woman.

John has spoken in the past of his desire to become a father, announcing last autumn that he wanted to adopt a 14-month-old boy from an orphanage in Ukraine. He said then that the couple had always talked about adoption, but that he had objected because of his age.

It was the death of his keyboard player, Guy Babylon, that helped to change his mind. Babylon, who died of a heart attack aged 52 last year, had two children whom John described as “wonderful”. He said at the time: “What better opportunity to replace someone I lost than to replace him with someone I can give a future to?” His plans to adopt were reportedly thwarted by Ukrainian laws. Instead, the couple turned to the US, a popular destination for UK citizens hoping to enter into surrogate arrangements.

In some US states, including California, parents who have paid a surrogate can apply for a prebirth order. This means that they, and not the woman who carried the baby, will be listed on the birth certificate as parents, regardless of whose egg and sperm was used in conception. And in California, unlike in Britain, surrogates can be paid an unlimited fee.

Olga van den Akker, professor of health psychology at Middlesex University, said the potentially enormous sum paid by John – who has an estimated fortune of £185m, according to the Sunday Times Rich List – could cause problems for his son further down the line. “We don’t know how much Elton John paid for him, but it was almost certainly a lot more than he would have paid in the UK, where around £10,000 per child is the norm. In the US, babies can cost a lot, lot more than that, especially where celebrities are involved. “Problems could arise if he thinks that he has been sold by his ‘mother’ – either the surrogate, and/or the egg donor, if one was involved.”

Lawyers said that the sum paid would become legally important if John and Furnish want to bring up Zachary in the UK, where surrogacy is legal only for altruistic and not commercial reasons. Surrogacy has been regulated in Britain since 1985, after Kim Cotton was paid £6,500 to carry a child conceived using her own egg and the sperm of a man whose wife was infertile. Gamble said: “The immigration and nationality rules are complex, and John and Furnish’s child may require special permission from the Home Office to enter the UK. In any event, their legal status in California will not be automatically recognised here, and they will need to apply to the UK high court for a parental order which legally recognises them as parents.”

A judge must then weigh the child’s welfare against the need to uphold public policy – in other words, recognising the child’s need for loving parents while acknowledging that UK law does not encourage the commercialisation of surrogacy, said Gamble. “Of the three publicly available judgments made on foreign surrogacy arrangements in the UK court since 2008, all three have allowed the child to stay with the parents,” added Gamble, who this month represented a couple in a similar situation to John and Furnish.

In that case, the couple were deemed to have paid more than just “reasonable expenses” to an American surrogate. But Mr Justice Hedley allowed the couple to keep the child after ruling that the existing rules on payments were unclear, and that the baby’s welfare must be the main consideration. Only in the “clearest case” of surrogacy for profit would a couple be refused the necessary court order to keep the baby, he said.

Andrea Williams, director of the Christian Legal Centre, said: “Children are not commodities to be bought and sold. It is not the case that everybody has the right to a child, whatever the cost.”

Potential legal issues aside, several celebrities congratulated the singer, with Elizabeth Hurley among the first to offer her best wishes. She wrote on Twitter: “Massive congratulations to David and Elton on having their beautiful son. Can’t wait for my first cuddle.” Lord Sugar expressed disbelief at the news, tweeting on the microblogging site: “Am I hearing things right on Sky news Elton John becomes a surrogate father.” He added about an hour later: “Oh well congratulations to him.”

Surrogacy and the law

UK

• Only non-commercial (ie altruistic) surrogacy is legal.

• Surrogates cannot be paid a fee for carrying a child. They may only charge “reasonable expenses” ranging from £12,000 to £15,000, according to the voluntary organisation Childlessness Overcome Through Surrogacy.

• UK law does not recognise surrogacy as a binding agreement on either party. There is little the intended parents can do to secure their position before the birth, even if baby is genetically related to both intended parents and not the surrogate. It is illegal to advertise for surrogates or intended parents.

• The surrogate is always registered as the legal mother of the child, even if an embryo from the recipient couple was used, as in gestational surrogacy.

California

• Commercial surrogacy is legal.

• Surrogates can be paid unlimited fees for carrying children.

• The commissioning couple have parental responsibility, not the woman who gave birth to the child. Californian courts have consistently upheld the intended parents’ rights and obligations to their parenthood when they use a surrogate or egg donor to help create their families.

• Surrogacy agencies are legal. Surrogates and egg donors can advertise themselves on websites.

• California recognises a contractual intent as a basis for parentage, meaning that prospective parents using surrogates can get their names on the child’s birth certificates.

There is more information about gay surrogacy law and international surrogacy law on our website

Congratulations to Elton John and David Furnish

Tuesday, December 28th, 2010

Many congratulations to Elton John and David Furnish on the arrival of their son Zachary, born through a surrogacy arrangement in California on Christmas Day.

Important changes to the law were passed in 2008 giving equal treatment to same sex parents who conceive a child together and, just as Elton and David were among the very first gay couples to register their civil partnership when the new laws came into force in 2005, they stand to be one of the first gay couples named as joint legal parents of a surrogate child. Surrogacy law in the UK is complex and, as parents who have entered into an arrangement abroad, they will need to grapple with immigration and nationality issues as well as a court application here in the UK within six months of the birth to be recognised as Zachary’s legal parents.

They are just one of many gay couples starting a family through surrogacy, adoption and co-parenting. We send many congratulations to their new exceptional family, and we wish them the very best of luck with their parenthood journey.

There is more information about surrogacy law for gay couples on our website.

Landmark international surrogacy case – child’s welfare is paramount

Friday, December 24th, 2010

We are pleased to report that we have successfully won legal parenthood status for a British couple who entered into an international commercial surrogacy arrangement with a surrogate mother in Illinois.

In only the third published decision of its kind (Natalie having also acted for the parents in the first High Court decision of this kind, Re X and Y, made in 2008), the court upheld the best interests of the child and authorised payments of more than expenses to the surrogate mother.

The court’s decision in the case of Re L made the front page headline in the Daily Telegraph (http://www.telegraph.co.uk/health/children_shealth/8190131/Childless-couples-win-the-right-to-pay-surrogate-mothers.html) with a further article, following an agreed statement made anonymously by the parents (who wished to tell their side of the story), several days later (http://www.telegraph.co.uk/news/uknews/8194099/Surrogacy-couple-paying-American-woman-was-our-last-chance-for-a-child.html).

The case is important in establishing that, following changes to the law made in 2008, the welfare of the child is now the court’s ‘paramount’ consideration. Judgment was published on 8 December 2010 by Mr Justice Hedley and it has been heralded as a landmark decision awarding legal status to the parents notwithstanding the public policy ban on commercial surrogacy in the UK.

More information about international surrogacy law is available on our website.

Natalie Gamble speaks at Progress Educational Trust Annual Conference: Cross Border Reproductive Care – Who oversees overseas?

Sunday, December 5th, 2010

Natalie Gamble was delighted to address the Progress Educational Trust’s Annual Conference on 24 November 2010, speaking to an eminent audience about the legal issues for patients having fertility treatment overseas, including donor conception and international surrogacy.

Reproduced below is Rachel Lyons’ article about the event, which appeared in BioNews 586

In a cold room at the Institute of Child Health in London, talk turned to warmer climes during session two of the Progress Educational Trust (PET)’s conferencePassport to Parenthood’. Even though the temperature of the room was cold, the debate surrounding who does (and should) oversee overseas cross-border reproductive care ‘hotted up’.

The session was chaired by Dr Evan Harris, adviser to the Social Liberal Forum and former Liberal Democrat Shadow Science Minister. The main aim of this session was to provide an overview of the current legal and regulatory frameworks surrounding cross-border care and to establish whether any changes are required.

The first panellist of the session was Juliet Tizzard, Head of Policy at the Human Fertilisation and Embryology Authority (HFEA). The HFEA is the UK’s fertility regulator and has a clear responsibility for regulating the activities of fertility centres in the UK. Juliet’s talk mainly focused on the question of whether this responsibility applies to overseas reproductive treatments.

Juliet began by outlining three ways in which the HFEA (and its clinics) has a responsibility, role or duty in relation to cross-border reproductive care. Namely: to inform the patient about the possibility of going abroad for services, to refer them abroad for reproductive services, or to be involved in the shared care arrangement system between the UK, European Union (EU) member states and internationally.

Juliet said the circumstances surrounding shared care arrangements cause the most problems for the HFEA. According to Juliet, the HFEA has sought legal advice on the extent of its powers to regulate the activities of UK licensed clinics which enter into a shared care arrangement. The advice that the HFEA received was unequivocal. The HFEA has almost no powers over clinics that provide information about or refer patients to clinics in other countries.

Regardless of this however, Juliet explained that the HFEA does expect centres, whether referring patients abroad or recommending shared, cross-border care, to provide patients with information about the consequences of having treatment outside the UK. For instance, patients having donor conception treatment abroad should be made aware that they (and their resultant child/children) will not be able to request information from the HFEA about their donor.

Juliet concluded by saying the HFEA will soon be revising the information they provide to patients and will make details available after they’ve concluded a consultation in January 2011. The HFEA hopes this will help those considering whether or not to travel abroad to understand the advantages and disadvantages. This, in turn, will help patients find the clinic that best meets their needs and will enable them to make informed treatment choices at their chosen clinic.

Second to speak was Natalie Gamble, who was introduced as the UK’s leading fertility lawyer and a founding partner of Gamble and Ghevaert LLP. The main focus of Natalie’s talk was the issues surrounding the patchwork of laws and regulations governing cross-border reproductive care. As she said: ‘the law is struggling to catch up’. Natalie’s primary concern was the information available on donor rights, parenthood and international surrogacy arrangements.

Natalie started by confirming information on country of conception is key for patients. Potential patients may not have the same protection that they might have had in their home country. The problem is many are not aware of this and how it might impact on their situation.

People need to be concerned about whether they will be treated as the legal parent of a child born to a surrogate. Natalie said the law of the person’s home country applies. In the UK, a child’s father and mother have parental responsibility for the child if they were married to each other at the time of his or her birth. Where a child’s mother and father were not married to each other at the time of his or her birth, only the mother has automatic parental responsibility for the child.

Natalie used surrogacy in cross-border situations as the perfect illustration of where the intended mother and father may have immense difficulty claiming legal parenthood over the child. As Natalie put it, ‘there is no harmonisation here’. Different countries take radically different stances. She cited the case of re X and Y (Foreign Surrogacy) 2008 to highlight how difficult the situation can be. The case concerned a British couple who went to the Ukraine to undergo surrogacy, but the child faced considerable immigration difficulties. Under Ukrainian law, the commissioning couple were treated as the child’s parents from birth so the surrogate mother was not the child’s mother.

Under UK law, which applied to the commissioning couple, they could not be treated as the child’s parents without a court order. The child was potentially then both stateless and parentless. The judge in the case The Hon. Mr Justice Hedley cautioned those contemplating parenthood by entering into a foreign surrogacy agreement because of the possibility of unintended consequences.

Natalie concluded her talk by making three clear statements. First, there needs to be better public information available for those considering cross-border reproductive care. Second, the law globally is struggling immensely with this area. And lastly, we have to remember that ultimately, the first priority is to the resulting child and ensuring that they are protected.

The third speaker on the panel was James Lawford-Davies, who is a solicitor and partner at Lawford Davies Denoon. His talk focused on the EU’s approach to cross-border care. He explained each EU member state has an obligation to protect the free movement of persons and services and there should be no restrictions on this right. He provided the example of the landmark case of Yvonne Watts who challenged this right all the way to the European Court of Justice.

Even with this landmark case, James emphasised that the law remains uncertain. However, it is hoped that the draft Directive concerning the application of patient’s rights in cross-border healthcare will provide more legal certainty on the quality and safety standards across the EU. James did show slight concern for the margin of appreciation aspect of the Directive, which will mean provisions will be in place to enable member states to enact limitations on certain treatments. However, James (and the audience) did seem pleased the Directive might enforce the requirement that Member States have to provide information about the procedures and services available.

The final speaker of the session was Zeynep Gürtin-Broadbent, a research fellow at the Centre for Family Research at the University of Cambridge. Zeynep began her talk by discussing the difficulty in defining cross-border reproduction, as it is a new and rapidly evolving problem with a lack of empirical data. However, she was comforted by the fact that there are a large number of studies being undertaken, which should provide us with greater insight in the near future.

Zeynep questioned the diversity of cross-border reproduction, namely who/what is doing the travelling (intending parents, donors, the import and export of gametes) and the reason for this travel. Zeynep suggested four categories illustrating why people might go to a different country for reproductive treatment: 1) travel for legal restrictions, 2) resource scarcity, 3) safety concerns and 4) personal preferences.

Zeynep believes that it should be down to the regulators to tackle the issue of patients going abroad. She believes the regulators need to assess whether the current law is fit for purpose. She suggested the harmonisation of laws is a burden for the EU and individual member states to resolve. Zeynep believes there needs to be sound empirical evidence and creative thinking to solve these dilemmas.

The discussion that followed covered issues of the welfare and interest of the child, the disparity of the information available and the issues surrounding surrogacy and legal parenthood. The final word final word must go to Juliet Tizzard who said that ‘[the HFEA] is not wanting to wash their hands of this issue’. We await the results of the consultation, which will be launched in January, with interest. A report on the third session of the conference will be published in next week’s BioNews. PET is grateful to the conference’s gold sponsors Merck Serono.

There is more information about international surrogacy law, fertility law in the UK and donor conception law on our website.