The Science Council of Japan's subcommittee on reproductive assistance medicine recently issued a report that said surrogate births should, in principle, be prohibited through legislation.

It concluded that surrogate births, in which fertilized eggs are placed in the womb of a surrogate mother, should be banned, with the exception of further clinical research that would be overseen by a public organization.

The Suwa Maternity Clinic in Nagano has conducted eight surrogacy procedures.

However, the recommendation reflected divisions on the subcommittee over whether surrogate births should be banned, with some members urging total prohibition, while others said it should be allowed in some cases.

The main argument cited by the committee for prohibiting surrogate births was the risk to the surrogate during delivery. The committee noted that about five in every 100,000 mothers die during childbirth, and the report concluded that passing this risk on to a third party is ethically troubling.

The report also argued that some women may be coerced into becoming surrogate mothers, and that children born through surrogacy may suffer psychologically if they are told the circumstances under which they were born.

The main benefit of allowing surrogate births is that it allows infertile couples to have children.

One woman interviewed recently by The Yomiuri Shimbun, for example, was born without a womb. But she became a mother last month through a surrogate birth in which her egg was fertilized with her husband's sperm and then transplanted into the womb of her biological mother.

"I couldn't believe it when my baby was born--I never thought I would be able to hold my own baby," she said in the interview. "But now I'm getting chance to experience the joy of being a mother, of feeding and cradling him."

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Setting priorities

If you asked most people which is a more fundamental right--the right to join a demonstration or the right to have children--most people would probably say the latter.

Yet although the Constitution protects the right to demonstrate under freedom of expression, constitutional scholars are split on whether the right to have children is also guaranteed, though some argue it may fall under the right to pursue personal happiness.

This question should have been the starting point for any discussion on reproductive assistance medicine, but the subcommittee failed to present a clear judgment on this matter.

Prof. Kiyoko Kinjo of Ryukoku University Law School, an expert in family law, said, "The freedom of infertile people to have babies should be respected in the same way as it is for those who are naturally fertile."

But she added that it should only be respected as long as it does not "infringe on other people's rights."

The problem of passing the risk of childbirth on to another person could, therefore, be seen as infringing on another person's rights.

But what if there are women who, despite being fully aware of the risks, wish to be surrogate mothers anyway?

As one subcommittee member, Hisatake Kato, professor emeritus at Kyoto University and a scholar of philosophy and ethics, said: "We can't stop people risking their lives when they go skiing. So likewise, surely it's impossible to suppress a woman's will if she wants to be a surrogate mother and knows all the risks involved."

Surrogate births clearly pose a number of problems, and it is therefore important to hold proper discussions on how best to tackle any potential adverse effects.

Concerns over women being coerced into becoming surrogate mothers, and of the negative psychological impact on the children, could be eased by offering counseling and other services, a point not made in the report.

The report therefore does not appear to have taken seriously the desperation felt by many sterile couples, and it is questionable how effective the decision to allow further research will prove to be.

The report said that if further clinical tests can prove surrogate births do not pose additional risks, then appropriate laws can be revised to allow surrogate births, while if the tests prove the technique is risky, research can be discontinued.

Typically, clinical research used to check the impact and possible side effects of drug therapies and surgical techniques is undertaken with a significant number of participants.

But in the case of surrogate births, it is unclear what areas the research should cover and how many participants can be found for the experiments. As such, it is questionable whether any clinical tests on surrogate births will be able to scientifically determine the merits and drawbacks of the practice.

Surrogate births are prohibited in France, Germany and Italy, but allowed in a number of other countries, including Belgium, Britain, Canada and the Netherlands, and almost half of U.S. states.

With the difficulty in making a purely scientific judgment on whether surrogate births should be allowed, the key is what the public feels about this issue.

In the countries that allow surrogate births, the rules were decided after thorough discussions were held on reproductive assistance medicine.

Japan should therefore establish a permanent government body that can hold comprehensive discussions on reproductive medicine and engage in a deeper debate on the rights of sterile people, among other issues.