The attitudes and knowledge of medical students towards surrogacy

Commercial Surrogacy: An Overview

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 21st 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.

Mapping people's views regarding the acceptability of surrogate motherhood

The aims of the present study were to map French laypersons' views regarding the acceptability of maternal surrogacy and to delineate the circumstances under which surrogacy is considered, by different groups of people, as especially problematic. Participants (N = 236) were presented with a number of scenarios depicting the circumstances in which a couple has contracted with a surrogate mother and were asked to indicate the extent to which such a contract may present a moral problem. The scenarios were created by varying four factors: the type of surrogacy (traditional or gestational), the surrogate mother's level of autonomy, the family context in which the surrogate mother lives, and whether surrogacy was commercial or altruistic. Three qualitatively different personal positions were found: (a) a majority group for which surrogacy always (30%) or often (34%) presents a moral problem, (b) a minority group (14%) for which maternal surrogacy does not systematically present a moral problem, and

Attitudes toward surrogacy among doctors working in reproductive medicine and obstetric care in Sweden

INTRODUCTION

The aim of this study was to investigate attitudes and opinions towards surrogacy among physicians working within obstetrics and reproductive medicine in Sweden.

MATERIAL AND METHODS

Physicians working within medically assisted reproduction (MAR), antenatal care and obstetrics were invited to participate in a cross-sectional nationwide survey study. The study-specific questionnaire measured attitudes and experiences in three domains: attitudes towards surrogacy, assessment of prospective surrogate mothers, and antenatal and obstetric care for surrogate mothers.

RESULTS

Of the 103 physicians who participated (response rate 74%), 63% were positive or neutral towards altruistic surrogacy being introduced in Sweden. However, only 28% thought that it should be publicly financed. Physicians working at fertility clinics were more positive towards legalization as well as public financing of surrogacy compared than were those working within antenatal and delivery care. The majority of the physicians agreed that surrogacy involves the risk of exploitation of women's bodies (60%) and that there is a risk that the commissioning couple might pay the surrogate mother "under the table" (82%). They also expressed concerns about potential surrogate mothers not being able to understand fully the risks of entering pregnancy on behalf of someone else.

CONCLUSION

There is a relatively strong support among physicians working within obstetrics and reproductive medicine for the introduction of surrogacy in Sweden. However, the physicians expressed concerns about the surrogate mothers' health as well as the risk of coercion. Further discussions about legalization of surrogacy should include views from individuals within a wide field of different medical professions and laymen.

Survey shows that Swedish healthcare professionals have a positive attitude towards surrogacy but the health of the child is a concern

AIM

In February 2016, Sweden upheld its ban on surrogacy following a Government enquiry. This survey investigated attitudes towards surrogacy among primary health professionals working with children and their experiences of working with families following surrogacy abroad.

METHODS

From April to November 2016, nurses, physicians and psychologist working in primary child health care in four counties in Sweden were invited to participate in a cross-sectional online survey about surrogacy.

RESULTS

The mean age of the 208 participants was 49.2 years (range 27-68) and nearly 91% were women. Approximately 60% supported legalised surrogacy. Wanting a conscience clause to be introduced in Sweden was associated with not supporting surrogacy for any groups, while personal experiences of infertility and clinical experiences with families following surrogacy were associated with positive attitudes towards surrogacy for heterosexual couples. The majority (64%) disagreed that surrogate children were as healthy as other children, and many believed that they risked worse mental health (21%) and social stigmatisation (21%).

CONCLUSION

We found that 60% supported legalised surrogacy, but many expressed concerns about the children's health and greater knowledge about the medical and psychosocial consequences of surrogacy is needed.

The opinion of Iranian students about the society's perception on using surrogacy as an infertility treatment in the future community

BACKGROUND

Surrogacy is one of the challengeable treatments for infertility; therefore, it seems necessary to learn the attitutude of people toward it, especially the opinion of those who are working in infertility treatment. Students studying midwifery, medicine, psychology and law are involved in this process to various degrees. The aim of this study was to investigate the students' opinions about the perception of the society on using surrogacy.

MATERIALS AND METHODS

This study was a descriptive cross-sectional survey. The sample of this study included 200 students of the Isfahan University and Isfahan University of Medical Sciences from the following courses: Midwifery, Medicine, Psychology and Law. Since the number of students in different discipline was not equal, we therefore used quota sampling. The data collection instrument was a researcher-made questionnaire. The questionnaire included questions on their knowledge, attitude and surrogacy acceptance in the future in Iran.

RESULTS

The students of the medical course were mostly in the category "strongly agree" and "agree" with surrogacy (43 students which constitute 79.6%), then, midwifery students (15 students which constitute 78.9%) and finally, the students of other courses agreed less with this method. According to chi-square test, there was no significant difference between attitudes of students (P=0.08). Individuals mostly assert their acceptance of this method through "increasing tendency to this method in the future" (77.1%).

CONCLUSION

Students in this study had a positive attitude toward surrogacy and they accepted it as a norm; despite this, it is essential to make some changes within cultures to improve the situation.

Attitudes of graduating medical doctors toward using sex selection techniques in Jordan in 2009

OBJECTIVES

The aim of this study was to describe the attitude of graduating medical doctors toward the use of sex selection techniques in Jordan in 2009. MATERIALS AND METHODS (DESIGN): A self-administered questionnaire was used to assess attitude toward using sex selection. Demographic variables, gender preference of future children, and score on attitude toward using technology scale were used as independent variables.

RESULTS

A total of 254 doctors (178 males, 76 females) completed the questionnaire. Forty-one (16.1%) doctors thought that sex selection as PGD should be strictly prohibited and 45 (17.7%) thought it should be allowed freely. More than half (54.7%) of them thought it should only be available for medical reason. Only 59 (23.2%) reported that they may consider the use of sex selection technology to choose their future children. Participants who preferred their firstborn child to be a boy or those who preferred their first born child to be a girl were more likely to use sex selection than those without preference. Christian participants were more likely to use sex selection technology than Muslim participants, 9 (47.4%) versus 50 (21.3%). For each one-point increase in Attitude score, the odds of using sex selection increased by 20%.

CONCLUSIONS

The majority of graduating medical doctors believed that sex selection should be restricted and they were not willing to use it.