Indian Reproductive Tourism in Light of Assisted Reproductive Technology Regulation Bill 2020

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Approval of Assisted Reproductive Technology Bill 2020 and the Surrogacy (Amendment) Bill 2020 will impact on the once booming Medical Tourism Industry of India.

Medical Tourism is travelling for medicinal treatment and/or improving health and fitness. The driving factor of this industry is the difference in the cost of healthcare across the globe. Reproductive tourism is a subset, and people also travel to seek, Assisted Reproductive Technologies. The driving factor in this case is the laws and regulation governing the reproductive sector as well as the costs and expenses. Therefore, the travel can be both domestic as well as international. 

Indian Scenario 

Marriage, children and family planning is an essential pillar of the Indian society. No society is completely free from diseases and stigma. Infertility is a disease and yet having the desire of having a child is understandable. Assisted Reproductive Technology (hereinafter referred to as ‘ART’) helps such people to have their own child/children. 

Over the years India has seen one of the highest growths in the ART sector! The number of the ART cycles performed each year, keeps increasing. ART includes services like gamete donation, artificial insemination, intra cytoplasmic sperm injection (ICSI), in-vitro fertilization (IVF), and gestational surrogacy. These are all offered by the Indian ART clinics. A procedure, in this case, like ART brings with itself a list of social, ethical and legal issues also. Therefore, it is necessary to ponder upon these.

The ART Bill 2020 thus, formulates and addresses most of the issues and the possible solutions. It establishes a code and protects the involved parties from exploitation. The steps taken by the Bill will help resolve a lot of socio-legal issues and complications that may erupt.

Prominent Features 

Safe Practice

  • Code of Conduct – formulated for the professionals and workers at the clinic. ‘National Board’ will track the same.
  • Establishing minimum standards for the banks and clinics on physical infrastructure, expert manpower and diagnostic equipment.

Mandatory Pre-implantation Genetic Diagnosis (PGD)

PGD will also detect any defect or abnormal chromosome in the embryo before its implantation in the uterus. It will help avoid the presence of genetic disorders in the children born through ART.

Penalty Provisions

Inclusion of strict punishment for people (and agencies)/rackets/organizations involved in these unlawful practices) practicing sex selection of the embryos and sale of embryos. 

Trafficking and sale of embryos is a crime and penalized heavily. The first strike will attract a fine up to Rs. 10 Lakh. A second instance will attract a punishment of imprisonment for up to 12 years.

Regulatory Boards

Mandatory constitution of a Regulatory Board for all States and Union Territories in their region. (Within 3 months of notification by the Central Government). These will ensure the following of plans and policies as laid by the National Board.

National Registry & authority

To is to maintain a database to assist the functioning of the National Board.

Confidentiality

This is to keep confidential the information of intending parents.

Social Impact

The society will face a positive impact on the effect of this Act. The objectives and the features of the Act also address the social concerns which existed. 

The Act classifies the process of sex selection of the embryo as unlawful. It is a much-needed step in ensuring no discrimination between a female and a male child. It may also help stabilize the sex ratio of the population. There are also stern provisions against trafficking of embryos. This is due to the immoral and exploitative in nature of the act.

The provision of ‘confidentiality’ of intending parents is vital to instill confidence. It will provide the required help as well as reduce the stigma of the process over a period of time. 

Mandating Pre-implantation Genetic Diagnosis aims to avoid birthing children with genetic defects. This will help the child and parent both! It will also help establish a healthy population. 

The main purpose, however, is the protection of women and children from exploitation. Women involved in ART will receive an insurance cover. The children born will have the rights equivalent to biological children! The scope of malpractice which existed before the defined legislation will reduce. 

Economic Impact 

Surrogacy is dependent on ART procedures. The Rajya Sabha approved Surrogacy (Amendment) Bill 2020. Considering the relation between ART and surrogacy, it is also advisable that the ART Bill comes into force before the Surrogacy Bill. This will ensure better surveillance and functioning of the system. 

India peaked as a $2.3 billion reproductive tourism industry around 2013. Surrogacy was the prime reason for the growth of the industry. The Bill now restricts the provisions of ART to only Indian heterosexual married couple, or single women (widow or divorcee). The denting impact on the economy is irrefutable. 

There is an attempt to justify this as a result of balance. In the big picture, the balance between ethics, morality and social justice is desirable. Therefore, the Bill will now ensure that the balance that it ought to maintain is achievable.

Impact of the Coronavirus 

The umbrella of issues that COVID-19 has managed to include under it is remarkable! Therefore, every industry has had to face the brunt of COVID 19. The ART industry was not left behind either.

The most primary impact is in the form of travel chaos, rather shutdown. Both cross-international borders shut down, as well as domestic transport, is on hiatus. Nationwide shutdowns and implementation of lockdowns have affected this industry. The economic impact is an obvious link, but there is also impediment on family planning. There is a disturbance in the charting of family planning, now for an uncertain period of time. 

Contacting surrogates and donors, their presence, transportation as well availability is all uncertain. Health insurance coverage is also a grey area. Direct implications on all the related contracts and agreements will be a result of the delay caused by the pandemic.

The American Society for Reproductive Medicine (ASRM) issued recommendations and guidelines to aid the participants of ART. It is in special regards to people who are currently entangled with ART. They include suspension in the initiation of new cycles, cancellation of embryo transfers amongst others. A reference will prove fruitful in case the pandemic lasts post the enactment of the Act in India.

Conclusion

It is imperative to note here that though the Bill has taken commendable steps in ensuring social and legal protection. There also exists an exception in ensuring the most benefit to the economic sector. The ART Bill will form a governing regulation for the Surrogacy (Amendment) Bill 2020 too. The influx of foreign ‘reproductive tourists’ will now be NIL. 

The cost and pricing of other ART procedures, in global comparison, is very reasonable in India. Therefore, India will remain a part of the global fertility industry. Its reigning position may face hesitation.

The contention of Bill’s social benefits and strong regulation also outweighing the negative factor of exploitation will hold strong. Exploitation is a major concern of the ART industry, and the Bill aims to curb it. The Bill sure does entail great social benefit and legal regulations. But, it also definitely classifies as a great first step in this sector.


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