Controversial Issues in Obstetrics
SUKHIT PHAOSAVASDI, M.D.*, CHUMSAK PRUKSAPONG, M.D.***, SURASAK TANEEPANICHSKUL, M.D.* HENRY WILDE, M.D.**, YUEN TANNIRANDORN, M.D.*,
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkhon University, Bangkok 10330, ** Queen Saovabha Memorial Institute, The Thai Red Cross Society, Bangkok 10330, *** Department of Surgery, Police Hospital, Bangkok 10330, Thailand.
Managing reproductive issues in Thailand
today presents many old and new ethical dilemmas.
This essay is not about to solve any of these but
hopes to initiate constructive discussions. Our peri-
natal and neonatal mortalities are 15 and 7 respec-
tively ; compared to those of Holland which are 11
and 4. Are Thai doctors and midwives really doing
their best in providing antenatal care to all? Thai-
land has done very well in reducing the population
growth from 2 per cent in 1970 to 1.3 per cent
today. Will that provide enough young workers to
nurture our aging population one generation from
now?
Should we, as we are in a severe recession,
allow using expensive resources in public hospitals
to perform in vitro fertilizations and related proce-
dures which are still controversial even in pros-
perous countries( 1 ). Surrogate mothering is also
not unknown in Thailand. It is a true ethical night-
mare and almost akin to slavery; the buying and
selling life. A poor desperate mother has often no
other choice, given that abortion is illegal and diffi-
cult to obtain for the very poor. Surrogate mothering
can also be a legal and ethical nighmare when the
mother later decides to reclaim her rights and wants
to keep her baby. Are Thai courts prepared to
handle such issues fairly? New issues concerning
parenting are now surfacing in America. This was
brought home to all of us the other day on CNN
(an American TV newsprogram). A male gay couple
(one was a cardiologist), who live in a monogamous
relationship, are now having "their" second surro-
gate child on the way. The first one, a girl now 3-4
years old, was fertilized with the sperm of one
partner and a donated ovum from a "bank". The
111ew baby is from the sperm of the second partner
and a donor ovum. The surrogate mother collects
US$ 15,000 for each child. Is this technology to
be introduced soon to Thailand '? Should this pro-
cedure be introduced to Thailand ? Pe1haps it has
already been done as the technology invoi vt>d is
nothing new.
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