User:Jkgrewal/sandbox

Article Evaluation
After reading the article regarding Koch's postulates, I did think that the information presented in the article was accurate and relevant. However I did notice that some of the writing made statements that were not elaborated on. I found those pieces of information distracting because I didn't really understand how it connected to the article itself. The article was updated to mention the relevancy of Koch's postulates in the 21st century which I thought was a nice follow up, but the information in that section was repetitive of things mentioned before in the article and I think a lot of the information put in this section would have been better off in its own section that outlined the limitations of the postulates. Also, the entire last section of the article was missing citations, so the legitimacy of what is written there is questionable.

Overall, the tone of the article was neutral and appropriately discussed both the value of Koch's postulates and their limitations.

The linked citations reference neutral and credible sources. As I mentioned before, the latter half of the article did not have any references so it's unclear if that information is accurate or reliable.

On the talk page, users are going back and forth discussing their viewpoints on certain things mentioned in the article and discussing the relevancy of certain points made. They also had a section that discussed possible bias in the tone discussing certain aspects of the article. The article is C-rated and is a part of WikiProject Microbiology, WikiProject Biology, WikiProject Medicine, WikiProject History of Science, WikiProject History, and WikiProject European history.

Article Selection
I've chosen the article Surrogacy to evaluate and improve. This article has an extensive talk page detailing the issues with the article. A large majority of the content on this page seems to go off onto a tangent detailing the laws regarding surrogacy. This seems irrelevant to fully detail on this main surrogacy page considering an article regarding surrogacy laws in different countries already exists. I also think the article lacks some crucial components like the process of surrogacy and more comprehensive outline of issues that can arise. The article does include legal, religious, and ethical issues with surrogacy. However, the ethical section is all sourced from one source and the legal issues section sounds very similar to the section regarding surrogacy laws. The religious issues section also seems like it could be expanded on and made more up to date. Upon first read through, I didn't notice the tone of the page, but after reading the discussion on the talk page, I did notice that the tone could be more neutral in certain sections instead of mainly discussing surrogacy positively.

= Surrogacy Draft =

Ethical Issues
Numerous ethical questions have been raised with regards to surrogacy. They generally stem from concerns relating to social justice, women’s rights, child welfare, and bioethics.

Surrogate Mother
Those that view surrogacy as a social justice issue argue that it leads to the exploitation of women in developing countries whose wombs are commodified to meet the reproductive needs of the more affluent. While opponents of this stance argue that surrogacy provides a much-needed source of revenue for women facing poverty in countries like India, others purport that the lack of legislation in such countries often leads to much of the profit accruing to middlemen and commercial agencies rather than the surrogate mothers themselves. It has been argued that under laws of countries where surrogacy falls under the umbrella of adoption, commercial surrogacy can be considered problematic as payment for adoption is unethical, but not paying a surrogate mother for her service is a form of exploitation. Both opponents and supporters of surrogacy have agreed that implementing international laws on surrogacy can limit the social justice issues that surrogate mothers face in transnational surrogacy.

Other human rights activists express concern over the conditions under which surrogate mothers are kept by surrogacy clinics which exercise much power and control over the process of surrogate pregnancy. Isolated from friends and family and required to live in separate surrogacy hostels on the pretext of ensuring consistent prenatal care, it is argued that surrogate mothers may face psychological challenges that cannot be offset by the (limited) economic benefits of surrogacy. Other psychological issues are noted, such as the implications of surrogate mothers emotionally detaching themselves from their babies in anticipation of birth departure.

The relevance of a woman’s consent in judging the ethical acceptability of surrogacy is another point of controversy within human rights circles. While some hold that any consensual process is not a human rights violation, more extreme human rights activists argue that human rights are not just about survival but about human dignity and respect. Thus, decisions cannot be defined as involving agency if they are driven by coercion, violence, or extreme poverty, which is often the case with women in developing countries who pursue surrogacy due to economic need or aggressive persuasion from their husbands. On the other end of the spectrum, it has been argued that bans on surrogacy are violations of human rights under the existing laws of the Inter-American Court of Human Rights reproductive rights landmark.

Feminists have also argued that surrogacy is an assault to a woman’s dignity and right to autonomy over her body. By degrading impoverished women to the mere status of “baby producers”, surrogacy has been accused by feminists of commodifying women’s bodies in a manner akin to prostitution. Feminists also express concerns over links between surrogacy and patriarchal expressions of domination as numerous reports have been cited of women in developing countries coerced into surrogacy by their husbands wanting to “earn money off of their wives’ bodies”.

Supporters of surrogacy have argued to mandate education of surrogate mothers regarding their rights and risks through the process in order to both rectify the ethical issues that arise and to enhance their autonomy.

Child
Those concerned with the rights of the child in the context of surrogacy reference issues related to identity and parenthood, abandonment and abuse, and child trafficking.

It is argued that in surrogacy, the rights of the child are often neglected as the baby becomes a mere commodity within an economic transaction of a good and a service. Such opponents of surrogacy argue that transferring the duties of parenthood from the birthing mother to a contracting couple denies the child any claim to its “gestational carrier” and to its biological parents if the egg and/or sperm is/are not that of the contracting parents. In addition, they claim that the child has no right to information about any siblings he or she may have in the latter instance. The relevance of disclosing the use of surrogacy as an assisted reproductive technique to the child has also been argued to be important for both health risks and the right's of the child.

Child welfare concerns also relate to the abandonment and abuse of children that may occur in cases where the intending parents divorce, change their minds, or decide they want a different child. For example, the abandonment of a twin boy with Down syndrome by an Australian couple resulted in Thailand banning surrogacy.

Those which deem surrogacy as a violation to the rights of the child often cite cases of trafficking and selling of surrogate children across borders in Cambodia and other countries, leading to statelessness and lack of citizenship amongst other issues.

Methods
The genetic origin of the egg and the sperm differentiate the two approaches to surrogacy: traditional surrogacy and gestational surrogacy. In the United States, gestational surrogacy is more common than traditional surrogacy and is considered less legally complex.

Traditional
In traditional surrogacy (also known as partial, natural, or straight surrogacy), the surrogate mother's egg is used and the sperm of the commissioning father or a donor is used for fertilization. Insemination of the surrogate can either occur through natural or artificial insemination. Using the sperm of a donor results in a child that is not genetically related to the intended parent(s). If the intended father's sperm is used in the insemination, then the resulting child is genetically related both the intended father and the surrogate.

In some cases, an insemination may be performed privately by the parties without the intervention of a doctor or physician. In some jurisdictions, the 'commissioning parents' using donor sperms need to go through an adoption process in order to have legal parental rights of the resulting child. Many fertility centers that provide for surrogacy assist the parties through the legal process.

Gestational
Gestational surrogacy (also known as host or full surrogacy ) was first achieved in April 1986. It takes place when an embryo created by in vitro fertilization (IVF) technology is implanted in a surrogate, sometimes called a gestational carrier. Gestational surrogacy has several forms, and in each form, the resulting child is genetically unrelated to the surrogate:


 * the embryo is created using the intended father's sperm and the intended mother's eggs.
 * the embryo is created using the intended father's sperm and a donor egg.
 * the embryo is created using the intended mother's egg and donor sperm.
 * a donor embryo is implanted in a surrogate. Such an embryo may be available when others undergoing IVF have embryos left over, which they donate to others. The resulting child is genetically unrelated to the intended parent(s).

Surrogate
Anthropological studies of surrogates have shown that surrogates engage in various distancing techniques throughout the surrogate pregnancy so as to ensure that they do not become emotionally attached to the baby. Many surrogates intentionally try to foster the development of emotional attachment between the intended mother and the surrogate child.

Some surrogates describe feeling empowered by the experience.

Although surrogate mothers generally report being satisfied with their experience as surrogates, there are cases in which they are not. Unmet expectations are associated with dissatisfaction. Some women did not feel a certain level of closeness with the couple and others did not feel respected by the couple.Some surrogate mothers report emotional distress during the process of surrogacy. There may be a lack of access to therapy and emotional support through the surrogate process.

Surrogate mothers may struggle with postpartum depression and issues with relinquishing the child to their intended parents. Immediate postpartum depression has been observed in surrogate mothers at a rate of 0-20%. Some surrogate mothers report negative feelings with relinquishing rights to the child immediately after birth, but most negative feelings resolve after some time.

Child and parents
A systematic review of 55 studies examining the outcomes for surrogacy for surrogate mothers and resulting families showed that there were no major psychological differences in children up to the age of 10 years old that were born from surrogacy compared to those children born from other assisted reproductive technology or those children conceived naturally.

Gay men who have become fathers using surrogacy have reported similar experiences to those as same sex couples who have used surrogacy, including their relationships both their child and their surrogate.

A study has followed a cohort of 32 surrogacy, 32 egg donation, and 54 natural conception families through to age seven, reporting the impact of surrogacy on the families and children at ages one, two, and seven. At age one, parents through surrogacy showed greater psychological well-being and adaptation to parenthood than those who conceived naturally; there were no differences in infant temperament. At age two, parents through surrogacy showed more positive mother–child relationships and less parenting stress on the part of fathers than their natural conception counterparts; there were no differences in child development between these two groups. At age seven, the surrogacy and egg donation families showed less positive mother–child interaction than the natural conception families, but there were no differences in maternal positive or negative attitudes or child adjustment. The researchers concluded that the surrogacy families continued to function well.

Risks
The embryo implanted in gestational surrogacy faces the same risks as anyone using IVF would. Preimplantation risks of the embryo include unintentional epigenetic effects, influence of media which the embryo is cultured on, and undesirable consequences of invasive manipulation of the embryo. Often, multiple embryos are transferred to increase the chance of implantation, and if multiple gestations occur, both the surrogate and the embryos face higher risks of complications.

Gestational surrogates have a smaller chance of having hypertensive disorder during pregnancy compared to mothers pregnant by oocyte donation. This is possibly because surrogate mothers tend to be healthier and more fertile than women who use oocyte donation. Surrogate mothers also have low rates of placenta praevia / placental abruptions (1.1-7.9%).

Children born through singleton IVF surrogacy have shown to have no physical or mental abnormalities compared to those children born through natural conception. However, children born through multiple gestation in surrogate mothers often result in preterm labor and delivery, resulting in prematurity and physical and/or mental anomalies.

Indications for Surrogacy
Opting for surrogacy is often a choice made when women are unable to carry children on their own. This can be for a number of reasons, including an abnormal uterus or a complete absence of a uterus either congenitally (also known as Mayer-Roakitansky-Kuster-Hauser syndrome) or post-hysterectomy. Women may have a hysterectomy due to complications in childbirth such as heavy bleeding or a ruptured uterus. Medical diseases such as cervical cancer or endometrial cancer can also lead to surgical removal of the uterus. Past implantation failures, history of multiple miscarriages, or concurrent severe heart or renal conditions that can make pregnancy harmful may also prompt women to consider surrogacy. The biological impossibility of single men and same-sex couples having a baby also may indicate surrogacy as an option.

Jkgrewal's Draft Peer Review by EricChau (talk) 19:26, 3 April 2019 (UTC)
It is good that you identified what areas may need revamping. I like that you made the gestational section more succint with the bullet points. The ethics portion of your article is pretty extensive already. For the scope of our class; if you were able to find any articles for your precis that relate to any of these topics, you could possibly add more. Alternatively, you could remove some extraneous information — however creative you want to be.

Peer Review Response & Final Article Edits Plan Jkgrewal (talk) 22:25, 7 April 2019 (UTC)

 * 1) Incorporate information for current/more up to date articles to existing sections (i.e: ethical issues, psychological concerns, indications for surrogacy, surrogacy agencies)
 * 2) Copy edit article for unnecessary info and conciseness
 * 3) Possibly create a section discussing altruistic surrogacy and commercial surrogacy
 * 4) Add citations to lead/intro section