Dr. Minori Kokado, Assistant Professor, Department of Biomedical Ethics and Public Policy, Graduate School of Medicine
"Thinking about the users of reproductive technologies"
The rules and regulations of reproductive technologies
Assisted reproductive technologies (ART) are a variety of medical technologies used by couples and individuals who want to have children but are unable to conceive. These people may use their own sperm and eggs, or receive donor’s sperm, eggs, or embryos. In addition, couples or individuals who wish to have children may opt for surrogate births, in which a woman is asked to hand over the child after birth. Who will be allowed to use what technology? Will it be limited to couples of men and women, or will access be extended to same-sex couples and single people? Are there any age restrictions? If a couple divorces or one of them passes away after freezing their sperm, eggs or embryos, should this ART be able to continue? Which technologies involving donors should be approved? How is donor information stored, and what information is conveyed to the children? Are the fees related to ART paid by users or are they covered by public insurance?
With regulations in place in various countries and regions, I have been conducting bioethical research on the requirements for persons who are recognized as having access to ART in France.
"Qualification for parenthood" through medical technology
In France, ART has been managed within a legal framework collectively known as “bioethics laws,” which were enacted in 1994 and revised in 2004 and 2011, with a third revision currently in progress. Surrogacy is prohibited, and only couples which consist of a man and a woman both alive and of reproductive age have access to ART, including donations.
The requirements for access to ART could be rephrased as "qualification for parenthood through medical technology." In France, this qualification is given only to a couple consisting of both a man and a woman; more specifically, surrogacy is prohibited, so only women who are able to give birth and their male partners have this status.
On the other hand, restricting access to ART to couples consisting of a man and a woman is sometimes criticized as violating the principles of equality. The use of ART by same-sex couples is a key topic of discussion in the 2019 revision of Bioethics Law, and reports issued by the Lower House Committee, Conseil d’État, and the National Ethics Committee (CCNE) give positive opinions about the use of ART by female couples and single women. However, these reports propose that the prohibition of surrogacy will be maintained.
Equal access to ART
The issue of access to ART by male and female couples has brought up a new question: considering men and women have very different ways of engaging in reproductive activities, what exactly constitutes equal use of ART by men and women? This raises some new challenges. I believe that discussions on this "qualification for parenthood through medical technology" will enable us to understand both how society as a whole perceives the “desire to have children” as well as how individuals themselves view having and raising children.
