Ethical and deontological code
GestLife® is a company belonging to the British group INVESTMEDICAL whose mission is to provide legal and medical advice with the aim of facilitating the objective of paternity to certain fathers who for various reasons have not had the opportunity to achieve it so far.
This code of ethics is intended to be a decalogue of incomplete and non-exclusive values that should guide our professional activity and the relationship with our clients, collaborators and society as a whole.
Who it affects
GestLife® and all subsidiaries of the INVESTMEDICAL group ensure that all their personnel, including management, as well as their collaborators abroad comply with and are aware of the following code of ethics..
The values that define us are the following:
1. Independence: We are totally independent of agencies, we do not owe them any loyalty or depend hierarchically on any foreign agency or clinic, so we defend exclusively the interests of our clients.
It is strictly forbidden to charge commissions from agencies or clinics abroad. Our clients are the parents who want to be parents in spite of everything. We owe ourselves to them and not to third parties.
2. Professional Rigour and Ethical Conduct:
The GestLife® team and its subsidiaries are not only made up of lawyers, but our permanent staff is made up of professionals from different disciplines such as psychologists, gynaecologists, embryologists, doctors, etc., who are essential in the journey of surrogacy.
The people who work at GestLife® have been selected for their experience and professional competence.
All actions carried out in the exercise of their functions must be presided over by rigour and professional responsibility.
All personnel must conduct themselves honestly and ethically in accordance with the values of this code, respecting above all "professional secrecy".
3. Quality and Continuous Improvement:
We are non-conformist and critical of our own work. The "department of Inspection, innovation, development and constant improvement", is in charge of reviewing in a methodical way and reiterated in the time, all the procedures of the company, the verification of the maintenance of the standards of quality, as well as the implementation of changes that result in a possible improvement of the services given to the parents, pregnant women and donors.
We are committed to quality in all our actions, both internally and externally, affecting the entire team.
We encourage change and continuous improvement of structures, processes and systems.
Our strategy is based on a job well done and the collaboration of the whole tea
4. Globalization and Internationalization:
Our vocation is international, transnational and multicultural. Our team is made up of people of different nationalities and work continuously with a common goal in different countries.
In relation to our customers
We work with and for people. Taking care of them is our number one objective, and our reason for being, so we will accompany you at all times throughout the process to make it easier for you, with psychological support if you need it.
We owe it to our customers to fully and consciously, ensuring to meet their needs in a manner committed to the values of this code.
We are concerned about all the implications of a complex process such as surrogacy, whether personal or social. Our staff receives specialized training to help, advise and accompany our clients.
Our work does not finish until the newborn is in the country of origin of the parents, correctly registered and legalized and we take care of these formalities if the client requests it.
2. Honesty and Objectivity:
We are not dependent on others nor do we have other interests to defend.
Our recommendations are tailored to previously defined customer profiles, their economic and personal situation, as well as their specific needs or their own interests.
The information provided to our clients must be objective, contrasted and updated at all times. Clarity and truthfulness must prevail in all communications.
We maintain absolute anonymity (unless otherwise ordered by the client) to parents who are undergoing a surrogacy process, before, during and after the process.
Non-public information regarding GestLife® or its businesses, employees, customers and suppliers is confidential. Every worker is entrusted with this information exclusively for the development of his or her assigned functions and tasks. The entire organization must ensure that it is kept safe and secure. All personal data will be treated with strict security measures in compliance with current legislation.
4. Tolerance and Respect for diversity:
Our customers are as diverse as our employees. The relationship with our customers must be built on the values of tolerance, full equality and respect for diversity. All of our clients are treated without discrimination and we provide solutions for each of their personal needs and interests.
No one likes to go on a trip alone. The process that we undertake is a complex and long way so the relationship with our customers must be sustained in mutual trust. GestLife® assigns each family a "personal manager" who accompanies them throughout the process. The manager must carry out his functions in a way that is "close" to the client, understanding his needs, resolving his doubts and guiding him throughout the process.
GestLife® is committed to providing comprehensive care to its customers by offering more and better services every day. Our customers' problems are our problems. Problems can always arise, but our obligation is to offer one or several solutions that irremissibly lead to the desired objective.
We maintain a policy of absolute transparency, informing at all times, from the moment they have knowledge of it, any information that affects the client.
The communication with our clients must be continued with the commitment of sending a weekly report as a minimum.
In a process that requires a significant investment, we account for every penny spent on behalf of the client.
In relation to pregnant women
1. Pregnant women are treated with the same protocol of care as the parents, without distinction or preferences.
2. Pregnant women have the right to legal advice on the process, carried out by lawyers other than those assigned to the parent/guardian. This service is extended up to one year after the end of the process.
3. Pregnant women have the right to a psychological support service provided by a company psychologist, for any help they need in this area. This service is extended until two years after the birth of the child.
4. The comfort and well-being of pregnant women is paramount, and therefore if a pregnant woman comes from a city other than the city where the clinic where the assisted reproduction process is to be carried out is located, she will be provided with accommodation and diets for her food, so that she can always rest when she arrives in the city before the treatment.
5. In the event that the pregnant woman has a minor child who still requires her care, the pregnant woman will have a babby sitter service available for the times when she must be absent for medical treatments.
6. Pregnant women have the right to receive a fair financial compensation, in accordance with the compensation they pay in other countries in relation to the standard of living of each of them. GestLife® will fight openly and courageously against the exploitation of pregnant women by some clinics, where they may receive inhuman, degrading, discriminatory, or exploitative treatment.
Implementation, monitoring and control
This code will be implemented and communicated in accordance with the instructions of the GestLife® Management.
The Management undertakes to monitor compliance with this code and will settle the consequences that may involve the violation of it.
Finally, it will establish deadlines and procedures for the control, revision and updating of the code.
The code of ethics and deontology also controls professional and ethical standards when performing Assisted Reproductive Technology (ART) and Surrogacy (GS) treatments.
The Code is used as a reference point for all fertility centres with which we work in an effort to seek and ensure the highest standard of practice for all personnel involved in clinical activities as well as ethical/moral medical dilemmas.
The Code of Ethics is based on the four main principles that exist in modern medicine:
1. First, do no harm (primum non nocere): the safety and health of patients is the most important value in medicine. Health professionals should always make sure that patients are not harmed.
2. Beneficence: Health professionals should always act in the best interest of the patient, doing everything in their power to improve the health situation of patients and their quality of life. They are expected to choose the most appropriate and beneficial methods of treatment.
3. Autonomy: patients should have the full right to make a free and independent decision when considering medical treatment. Consent to treatment shall be sought only on the basis of clear and balanced information provided by physicians.
4. Justice: all patients should be treated equally and have similar access to medical advice, diagnosis and treatment.
5. Frequent technological and scientific advances in the field of fertility medicine constantly pose new ethical dilemmas. The Code of Ethics will be a dynamic document that will require continuous development as new problems arise.
The Key Principles provide a clear statement of the good medical standards underpinning the delivery of care within INVESTMEDICAL Fertility Centres. These key standards serve as a means of communication for staff, patients, donors, people conceived by donors, and the public to which INVESTMEDICAL Fertility Centers are committed.
1. We will treat potential and current patients and donors fairly and will not discriminate against them illegally.
2. We will have due respect for the privacy, confidentiality, dignity, comfort and well-being of patients and donors.
3. We will have due respect for the special status of the embryo when performing clinical and laboratory procedures.
4. We will give due consideration to the welfare of any child born as a result of treatment provided by INVESTMEDICAL clinics.
5. We will provide patients and potential and current donors with sufficient, accessible and up-to-date information to enable them to make informed decisions.
6. We will ensure that patients and donors have provided all relevant consents prior to carrying out any authorized activity.
7. We will conduct all activities with appropriate skill and care and in an appropriate environment, in accordance with good clinical practice, to ensure optimal outcomes and minimal risk to patients, donors and offspring.
8. We will ensure that all facilities, equipment, processes and procedures used in the conduct of authorized activities are safe, secure and fit for purpose.
9. We will ensure that all personnel engaged in authorized activity are competent and recruited in sufficient numbers to ensure safe clinical and laboratory practice.
10. We will maintain correct and accurate records and information about all clinical and laboratory activities.
11. We will keep records of all adverse incidents (including serious adverse events and reactions) and investigate all complaints appropriately and share lessons learned throughout the organization.
12. We will ensure that all authorized research carried out meets appropriate ethical standards, and is only carried out when there is a clear scientific justification.
13. We will conduct all activities with due regard to the regulatory frameworks governing treatment and research with gametes or embryos within the particular country in which the services are provided.
The following section explores a number of specific situations encountered in fertility service delivery that raise ethical issues of concern to professional staff and service users. It provides a brief background, highlights key issues and sets out a policy for practice related to the Key Principles (above).
1. The moral state of the pre-implantation embryo
The preimplantation embryo is a symbol of human life. This special status of the embryo will be adequately respected when Assisted Reproductive Technology treatments are performed, reflecting a responsible attitude towards the child who will be born as a result of these treatments. The preimplantation embryo cannot reach its potential to become a fetus and potentially a child unless it is transferred to the uterus. Therefore, the attitude towards the pre-implementation and post-implementation stages should be classified according to their potential to lead to the development of a human being.
2. The handling of cryopreserved embryos and the fate of supernumerary embryos
After an IVF cycle, 1-2 of the previously created embryos are transferred to the patient's uterus, while the remaining good quality embryos are cryopreserved. In some cases, when patients have not expressed their wishes about the fate of their embryos and cannot be contacted, excess cryopreserved embryos are stored, causing problems in the fertility clinic due to high maintenance costs.
Cryopreserved pre-implanted embryos represent the first stage of human life, their main use will be for the original couple, but it is also accepted the option of donating to another couple or researching.
1. In all INVESTMEDICAL Fertility centers, an agreement is signed with the intended parents prior to the start of treatment on the destination of the supernumerary cryopreserved embryos; this includes a request to keep them for the couple, including the obligation to cover costs, and consent to donate them to another couple or for research. Within the contract/consent for storage, it is imperative that patients agree to inform the clinic of any changes in contact details. Consent should refer to the problem of embryo handling if couples separate.
2. Under normal circumstances, the duration of storage should be a maximum of 10 years. INVESTMEDICAL provides a mechanism for successive 10-year storage extensions.
3. Oocyte donation
When a woman cannot use her own eggs for IVF, donor eggs can be used instead. Young, fertile women are willing to donate their oocytes. Donors are usually compensated for their efforts. Short-term medical risks (due to hormones used for ovarian hyperstimulation, anaesthesia and the surgical procedure) and unknown possible long-term health outcomes may be associated with the oocyte donation process.
1. All oocyte donors and recipients will be informed of possible legal, medical and emotional problems involved in oocyte donation.
2. An egg donor may receive compensation to reasonably cover any financial loss incurred in connection with the donation.
3. Donors should be offered the option of entering the egg donation program as an identifiable or anonymous donor, but are encouraged to remain identifiable in the interest of the resulting child or children.
4. Donors will be informed that they no longer have dispositional control over their oocytes once they have been retrieved, and that they have no legal rights or duties to raise the resulting children.
5. Donors will be informed that they will be screened for infectious diseases and other health-related risk factors, which will be provided with test results, and recommended for further counseling or medical care if necessary after the evaluation. 6. INVES MEDICAL has a duty to provide written information on the form and timing of conception to both the recipient and other health professionals involved in their care if requested.
4. Gender selection prior to conception for non-medical reasons
After natural conception, the probability that a child is of a particular gender is about 50%. People may want to choose the sex of their baby for medical or non-medical reasons:
• Medical reasons: to avoid or reduce the risk of inheriting known genetic diseases that affect children of a specific sex or diseases that show an unequal sexual incidence.
• Non-medical reasons: social or economic reasons for preferring a child of one sex over the other, "sex balance" when there are already only children or predominantly children of one sex.
1. Gender selection must be allowed if the health risks to the offspring are to be avoided, including reducing the chances that a child will be affected by a disorder with an unequal sexual incidence.
2. Gender selection for non-medical reasons is not accepted. It is also not accepted when it can be applied as an additional selection in the context of medically indicated PGD / PGS Preimplantation Genetic Diagnosis procedures.
5. Fertility treatments when prognosis is useless or very poor
Patients may reach a point where their chances of achieving a live birth are very low or non-existent. Some of these patients have difficulty interrupting treatment. These situations can lead to conflicts of interest between doctors and their patients. While patients will try to do anything to have a child and may wish to make autonomous decisions regarding medical treatments, physicians have professional interests in minimizing the harm and avoiding the frustration (and cost) of providing virtually useless treatments.
6. The well-being of the child in medically assisted reproduction
Fertility treatments treat or prevent medical problems that may be interfering with the ability to have children. Fertility specialists usually focus on the medical aspects of the situation, but sometimes face patients who do not appear to be well-suited to provide safe and appropriate care for children. Concerns about parenting ability and the possibility of causing significant harm to a future child are legitimate.
1. Those seeking treatment have the right to a fair evaluation. The wishes of all involved will be taken into account and the evaluation will be carried out in a non-discriminatory manner.
2. Services may be retained on the basis of well-founded judgments of the patient's inability to provide minimally adequate or safe care for offspring. Assessment of the patient's inability to care for a child or the possibility of harm to a child should be made jointly by the different professionals on the team, always including an independent opinion. In some cases, the psychological assessment must be supplemented by social welfare professionals.
3. People with disabilities should not be denied fertility services solely because of their disability.
7. Medically Assisted Reproduction in Single, Lesbian, Gay and Transgender Couples
Medically assisted reproduction is offered primarily to heterosexual couples (whether married or in a stable relationship). However, there are increasing applications from single people and people with other sexual identities, including partners of gay women (lesbians), partners of gay men (homosexuals) and, more recently, transgender men and women.
Reproduction is a basic element of people's autonomy regardless of their sexual orientation. Medically assisted reproduction in the situations described above is morally good in many cases. There is no good reason to rule out a priori access in these situations.
Health is not only defined by medical facts but also by social conventions and justifications. Medically assisted reproduction in these cases can be seen in this broader sense.
1. INVESTMEDICAL fertility clinics will always take into account the legal frameworks in the countries where they operate, while fulfilling their mission of helping those who wish to procreate and create a family.
2. If there are concerns about the implications of assisted reproduction for the well-being of any of the persons involved, including the future child, a surrogate mother or the applicants themselves, these concerns should be carefully considered in the light of the available evidence.
A gestational carrier is a woman who has a child who has no genetic relationship with herself for a person or couple who claims to be the legal parent of the parent. Initially, gestational surrogacy was applied to cases of intended parents of the opposite sex who had fertility problems or medical conditions that prevented the female partner from carrying the pregnancy. Today, the process is also used for same-sex individuals and couples who wish to become parents.
1. Subrogation may be facilitated through assisted reproductive technology, but only if it is permitted by law within the country where the centre operates.
2. There must be legal agreements to spell and then protect the roles and responsibilities of each participant.
3. The pregnant woman must be at least 21 years of age, be healthy, have a stable social environment and have had at least one pregnancy that resulted in the birth of a child.
4. It is the duty of the treating physician to inform all parties of medical, social, psychological, emotional, moral and legal problems related to subrogation.
5. Where local laws and regulations permit, pregnant women should receive fair and reasonable financial compensation.
6. Pregnant women have the right to adequate medical care during treatment and throughout pregnancy.
7. Pregnant women will be assessed and receive appropriate counselling to consider the potential impact of surrogacy on their own families.
8. The same precautions should be implemented as for the donation of gametes, including the detection of infectious diseases (HIV, hepatitis B and hepatitis C) and those that the physician deems appropriate.
9. Only one or two embryos of good quality shall be transferred as a general rule, and in no case may more than three embryos be surpassed.