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Some countries with fewer laws regarding the strictness of medical procedures may attract foreign visitors that come with the sole purpose of getting a treatment they could not secure in their home regions. Panama is one such country, as this South American nation does not possess sufficient laws that control critical healthcare operations (Vergès et al., 2016). For example, the lack of policies regarding in-vitro fertilization (IVF) and surrogacy in Panama introduced a slew of issues. Their resolution is essential for ensuring a safe environment for accessing IVF Panamanian mothers. This paper will discuss ethical concepts from the case “Medical Tourism and Surrogate Pregnancy.”
The case discusses the detrimental impact of unethical behavior on vulnerable parts of the population. At the same time, it is clear that Panama’s government failed to protect its citizens, as the knowledge regarding medical tourism has been in open access since 2007 (Vergès et al., 2016). The most glaring problem that needs to be resolved by the ethics panel is the harm that is brought to the involved sides in case of surrogacy gone wrong. Ortmann et al. (2016) argue that a legal system’s “power can be rightfully exercised […] to prevent harm to others” (p. 25). As Panama’s committee did not put any basic regulations in this field, the situation will require drastic changes to the related healthcare policies. Officials must be given the authority to enforce certain conditions in surrogacy contracts on both of their sides to prevent confusion such as the one described in this case. The partnership between private clinics and official agencies is an essential step for regulating the current situation with surrogacies in Panama. The council should also consider suggesting stricter control over these institutions and expanding the power of the government to punish facilities that fail to abide by the law.
Individual rights of surrogate mothers in Panama are heavily subjugated and enable women to trap themselves in situations where they have to choose between personal health and bankruptcy. In this case, it is clear that the surrogate mother’s rights were not protected by any law, leading to her being abused by the system and her clients simultaneously (Vergès et al., 2016). The ethics panel has an obligation to create a clear and concise set of rules. Interventions must be designed not against surrogacy as a practice but against its abuse by the “fertility tourism” industry (Piersanti et al., 2021). The government must describe how people’s fundamental rights, such as one’s well-being, can be protected during such complex medical agreements.
Informed consent forms must be updated with the latest legal developments in the world. Ortmann et al. (2016) argue that coercion might be perceived as immoral by some, yet it is a vital part of equalization between people over a situation and ensures “the consent of the governed” (p. 25). Therefore, informed consent forms must share the knowledge on how to protect one’s rights, avoid breaking the law, and ensure that contractors perform their part of a bargain to the fullest. It is essential to prevent future conflicts between a surrogate mother and her clients from affecting the future of a baby. Therefore, contracts must be enforceable and explicitly describe what issues may lead to legal problems for either side (Igareda González, 2020). Consent forms should serve as short yet complete reiterations of people’s rights and duties.
In conclusion, the ethical issues that the situation in Panama currently encompasses are related to the power, individual rights, and coercion of people involved in surrogacy contracts. The case outlines the damage that is being done by the inactivity of authorities. Without addressing these problems, Panamanians who find themselves in challenging financial situations will continue to suffer from being exploited by unfair treatment from healthcare organizations, governmental bodies, and medical tourists.
References
Igareda González, N. (2020). Legal and ethical issues in cross-border gestational surrogacy.Fertility and Sterility, 113(5), 916-919.
Ortmann, L. W., Barrett, D. H., Saenz, C., Bernheim, R. G., Dawson, A., Valentine, J. A., & Reis, A. (2016). Public health ethics: Global cases, practice, and context. In D. H. Barrett, L. W. Ortmann, A. Dawson, C. Saenz, A. Reis, & G. Bolan (Eds.), Public health ethics: Cases spanning the globe (pp. 3-36). Springer.
Piersanti, V., Consalvo, F., Signore, F., Del Rio, A., & Zaami, S. (2021). Surrogacy and “Procreative tourism”. What does the future hold from the ethical and legal perspectives?Medicina, 57(1), 47.
Vergès, C., Rodríguez, K., & Mock, R. (2016). Medical tourism and surrogate pregnancy: A case of ethical incoherence. In D. H. Barrett, L. W. Ortmann, A. Dawson, C. Saenz, A. Reis, & G. Bolan (Eds.), Public health ethics: Cases spanning the globe (pp. 216-220). Springer.
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