- The Current State of Surrogate Conception in Japan and the Ethical Assessment of Dr. Yahiro Netsu:An Ethical Investigation of Japanese Reproductive Medicine (Surrogacy)
The only obstetrician and gynaecologist in Japan who has continued to implement surrogate conception, even before the TV personality Aki Mukai brought attention to the surrogate conception issue in Japan, lives in Nagano prefecture. This man is Dr. Yahiro Netsu, the director of the Suwa Maternity Clinic (hereafter, SMC).
Since 1996, Dr. Yahiro Netsu has been practising procedures in advanced reproductive technology such as non-spousal IVF and surrogate conception in Suwa city, Nagano prefecture, based on his medical conviction that “as long as there are suffering patients, they are not to be left to their fate” and “one must focus on the needs of patients, no matter what happens”.1 At the SMC, based on the clinic’s guidelines, the creed has always been “treatment before regulatory report”,2 while the Japanese government has not made any progress in the creation of legislation regarding surrogate conception, and although the Japan Society for Obstetrics and Gynecology (hereafter, JSOG) and the Science Council of Japan Committee for Deliberating the State of Assisted Reproductive Technology have extolled a general prohibition of surrogacy in place of the Japanese government releasing reports like Opinion regarding Surrogate Conception (April 2003) and Issues in Assisted Reproductive Technology centering on Surrogate Conception — Towards a Social Consensus (8 April 2008). [End Page 55]
The purpose of this article is to investigate advanced reproductive medicine (surrogate conception) ethics in Japan based on a three-layered structural analysis, as part of the basic scientific research fund (B) project entitled “a three-layered analysis-based investigation of bioethics in Asia” (Representative: Professor Takao Takahashi, Faculty of Arts, Kumamoto University). In this article, I will introduce the current state of surrogate conception in Japan (layer 1), investigate Dr. Yahiro Netsu’s ethical assessment of surrogate conception based on his experience (layer 2), and Dr. Netsu’s unique standpoint towards medical science in support of his ethical assessment (layer 3). In the conclusion, I will provide an overview of a topic for future research.
The Current State of Surrogate Conception in Japan (Layer 1)
(a) Surrogate conception regulations of the Science Council of Japan Deliberative Committee on the State of Assisted Reproductive Technology
While the director of the SMC Dr. Yahiro Netsu was raising one issue after another to the society, on 30 November 2006, the Japanese government (both the Ministries of Justice and of Health, Labour and Welfare) requested for the Science Council of Japan (president Ichiro Kanazawa) — in a communication cosigned by the Minister of Justice and the Minister of Health, Labour and Welfare — to hold deliberations on the state of assisted reproductive technology (infertility treatment) focusing on surrogate conception (“surrogate mother” in artificial insemination type surrogate conception/“host mother” in IVF type surrogate conception). The Science Council of Japan immediately established (21 December 2006) a deliberative committee on the state of assisted reproductive technology and requested an investigation.3 The fruitful products of this investigation resulted in the external report Issues in Assisted Reproductive Technology Centering on Surrogate Conception — Towards a Social Consensus (8 April 2008).
The main points of the external report concerning the state of assisted reproductive technology centring on surrogate conception (“surrogate mother” in artificial insemination type surrogate conception/“host mother” in IVF type surrogate conception) are as follows.
(1). As for surrogate conception, legal regulation, e.g., a Bill on Assisted Reproductive Technology (tentatively named) is required and, based on this law, as a rule the prohibition of surrogate conception would be advisable. [End Page 56]
(2). Surrogate conception done for honour and profit shall be dealt with by punishment. The performing physician, intermediary and requestor will be subject to punishment.
(3). In light of the necessity to provide for the safety of the mother and the rights and welfare of the child that is born and to comprehend medical, ethical, legal and social issues, trial implementations of surrogate conception (clinical tests) under strict control limited to women who congenitally lack a uterus or whose uterus has been removed as a method of treatment can be considered.