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November - December 2014 Global Health and Travel
Approximately 800 to 1000 babies are born per year
in Thailand through surrogate mothers who enter into
commercial arrangements with foreign couples seeking to
conceive, according to Julie Munro, president of the Medical
Travel Quality Alliance (MTQUA). Couples typically pay
US$45,000 to $80,000 for a surrogacy arrangement, which
includes a payment of $10-20,000 to the surrogate mother,
$18-20,000 in medical fees, $3-4,000 in agency fees, and
2-4,000 in DNA testing and legal fees, according to a MTQUA
report. Couples seeking commercial surrogacy in Thailand
largely come from Australia, Israel, Japan, and greater China;
however, there are some Americans as well as a smattering of
other nationalities, Munro says.
In addition, Munro says a large number of gay and lesbian
couples and single parents are taking advantage of commercial
surrogacy. "In fact, those using surrogacy are often people
who don't or can't qualify for standard adoption: homosexual
couples, singles, those who are past the age cut-off in most
countries, those who would not pass a social worker's inspection
of home, financial, health or criminal check," she says.
Worldwide, around 6,000 babies are delivered via
surrogates for international medical tourists each year,
according to the MTQUA.
Despite challenges in pushing the law through the
country's legislative body, Munro, who conducted independent
evaluations of several fertility clinics in Thailand, says she
believes the anti-commercial surrogacy law will eventually
pass, because the holes exposed in the legal framework
following the Baby Gammy scandal are too great for the
government to ignore.
"There's an awful lot of sentiment along this issue people
want to get some kind of resolution," Munro says. "The junta
keeps talking about how important it is for Thais to come back
to living a more Buddhist-type lifestyle. They will be quite
keen on passing this."
Closing loopholes on commercial surrogacy
The new law would make it illegal for commercial surrogacy
agencies to operate in Thailand, as well as prohibit clinics,
hospitals, and doctors from performing IVF procedures if
they know that it is for the purposes of commercial surrogacy.
However, foreign couples would still be able to obtain fertility
treatments at licensed hospitals and clinics and Thailand;
and heterosexual couples would still be able to obtain IVF
treatment for an altruistic or non-commercial surrogate
mother, as long as the surrogate is a blood relative.
The law would also make it more complicated for foreign
couples to obtain custody if the baby is born through a
commercial surrogate a point that is making couples waiting
for unborn surrogate babies in Thailand extremely nervous.
Thus far, there has been no clear policy on how to handle these
cases, although foreign embassies have been getting involved
in the negotiations, Munro says.
Historically, Thailand has been generally tolerant
when it comes to satisfying international demand for
taboo procedures like gender reassignment surgery, but
the phenomenon of Thailand as a commercial surrogacy
destination is relatively new.
Wilson Chan, a Hong Kong-based medical tourism
facilitator who helps Hong Kong and Mainland Chinese
couples arrange fertility treatments at Samitivej Hospital
in Bangkok, says that guidelines on commercial surrogacy
established by the Medical Council of Thailand in 2002, which
stipulated that doctors should not participate in surrogacy
services if they know the service is for commercial purpose,
failed to curb commercial surrogacy in Thailand.
"The only rule available in Thailand so far was a one-page
Medical Council guideline notification published in 2002," Chan
says. "In 2010, the previous cabinet did draft a law for legislation,
but for whatever reasons, [it was] not enacted by the legislature."
In the past few years, the lack of regulation by the previous
Thai government, coinciding with the tightening of laws in
other countries like Australia, led to Thailand's surrogacy
boom, Chan says. Once the scandals broke, however, critics
were quick to blame a system that profited heavily with little
enforcement of the 2002 Medical Council guidelines.
"The surrogacy business in Thailand at world-class private
hospitals and fertility clinics where doctors are highly skilled
in reproductive medicines has enjoyed a great deal of success
that suits both surrogate mother and soon-to-be parents,"
says Renee-Marie Stephano, president of the US-based Medical
Tourism Association (MTA). "Now that problems have surfaced,
we should be asking why and how could they have happened?
The answer appears to be that government officials and
responsible parties looked the other way."
Commercial surrogacy tourism to Thailand may generate
up to US$100 million per year, Munro says; however, this
is still a fraction of the country's overall medical tourism
revenues, which the Tourism Authority of Thailand (TAT)
estimates at US$4.3 billion annually.
"This is a niche business that probably would have
continued operating in the shadows had the Gammy story
not been publicised so widely," says Ruben Toral, a principal at
Intermedika Consulting Ltd., a healthcare and medical tourism
consultancy based in Bangkok.
69 Thailand Report.indd 71
21/10/2014 11:17 PM