Legislation for Regulating ART Clinics in India (Pages: 0-0)


Sharma RS *,

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The advent of any new scientific development that have wide applications and which impinge on human life raise several technical and moral dilemmas and poses many ethical and technical challenges. The assisted reproductive technology (ART) is no exception. ART also raises questions from society on their ethics and safety; in some instance moral issues also are raised. An additional factor arises when technology becomes privatized with a possible loss of Govt. control. Unlike most other medical techniques success rate using ART is poor. However the desire of those whose marriages have remained barren to have children specially in our country is so great that many infertility clinics with little expertise or reliability have come up all over the country. The services offered by some of these clinics are questionable. There is no formal training in this discipline in the country. The mushrooming of infertility clinics in India has been therefore a matter of great concern. This in turn creates pressure on politicians and legislators to scrutinize understand and control these practices. The reasons for this state of affair is the lack of National Guidelines and an Accreditation Supervision and Regulatory body under which all infertility clinics offering ART would be placed. The Indian Council of Medical Research (ICMR) had developed "National Guidelines for Accreditation Supervision and Regulation of ART Clinics in India" in consultation with the National Academy of Medical Sciences (NAMS) (India). The draft guidelines were widely publicized discussed and debated by expert groups of the ICMR and then by practitioners of ART and the public throughout the Country. The National Human Rights Commission (NHRC) and National Commission for Women (NCW) have also approved the guidelines. The final guidelines have also been accepted by the Ministry of Health and Family Welfare Govt. of India. To implement these guidelines in the country the guidelines have been translated into draft Assisted Reproductive Technologies (Regulation) Bill & Rules -2008 which was also subjected to public debate. Based on the comments & suggestions of various stake holders both nationally and internationally and after consultation & approval of the experts the draft ART (Regulation) Bill & Rules has been revised and after the approval of the respective Ministries Govt. of India it will be placed in the parliament of Republic of India for approval. Artificial insemination by sperm (AID) has long been used to achieve successful pregnancies when the male partner is unable to father a child or when there is a danger of transmitting a hereditary disorder to the offspring. After the development of IVF the donation of eggs and embryos has also become a possibility. There are clear ethical parallels between sperm and egg donations. Like sperm donor eggs can help infertile individuals achieve a pregnancy and have a child who is genetically related to one parent. In the case of Donor embryos it is enabling a woman to go through pregnancy and childbirth. Even in surrogacy the child genetically belongs to either both the parents or at least one parent. However for some couples sperm or eggs might be thought to raise problems in so far as the social father or mother may feel less attached to a child that is not genetically his/her. This problem could be compounded by the use of donor embryos in few cases. But such problems should largely be able to be overcome by adequate counseling prior to the use of donor gametes or embryos. One of the central ethical questions relating to egg sperm and embryo donations is whether a child conceived in this way should or should not be told to her or his origin and what would happen in each case. Traditionally as also in past it was the almost universal practice to keep the identity of both the sperm donor and the recipient confidential. This practice has been challenged on the grounds that the child has a “right to know the truth” or that it is too difficult to hide the truth. Several countries now allow children when they reach majority to access at least non-identifying information about their genetic parents. Surrogacy is another important issue as infertile couples from different parts of the world comes to India for hiring Surrogate mother. There are number of issues both nationally and internationally in engaging surrogate mother and needs proper attention. Appropriate measures have been recommended in the Councils guidelines for ART Clinics in India as well as in draft Assisted Reproductive Technologies (Regulation) Bill & Rules -2009 on various issues related to AID ovum donation & surrogate mother and will be discussed during the presentation.