Against the advisory Opinion No. 86 of the Belgian Consultative Bioethics Committee

This analysis was carried out jointly by ICASM, the Université des Femmes and Women against Surrogacy Belgium

To counter this shameful opinion, sign this petition which is promoted by  fourteen women’s organizations, most of which are active in Belgium.



On April 17, 2023, the Belgian Bioethics Committee issued an advisory Opinion No. 86 on the legal framework for surrogate motherhood, updating Opinion No. 30 of 5 July 2004. The Minister for Social Affairs and Public Health, Frank Vandenbroucke, has asked the Committee to review the policy on surrogacy. In Belgium, surrogacy is conducted but not regulated; it is neither banned nor legal, and therefore flourishes in a legal vacuum.

We express our total disagreement with the Committee’s Opinion on all the points raised, all of which – without exception – are in favour of legalising surrogacy on Belgian territory. This opinion blatantly undermines the rights of women and children and acts as a mouthpiece for the market, which seeks to develop the commodification and instrumentalisation of women’s bodies, and the commodification of children.

It should also be noted that the parties and experts heard were strongly in favour of reproductive  surrogacy and that no organisation defending women’s rights or holding opposing views was heard. This report is therefore de facto biased and cannot claim to be an impartial one.

We would therefore like to highlight the more than worrying arguments put forward, which are even dangerous for the respect of the institutions’ role and for the respect of women’s and children’s rights.


Using terms developed and popularised by the market to gloss over or conceal the violence of surrogacy against women exploited for their reproductive capacity.

The Committee rightly notes that the terms used are far from neutral and are the result of implicit positions taken. For example, the beginning of the report justifies the choice of terms used, such as gestational carrier or intended parent. However, these terms are in no way objective or scientific; on the contrary, they reflect the language of the market. From the very first lines, we understand the Committee’s position: a position in favour of surrogacy, with a viewpoint focused exclusively on the interests and satisfaction of the client.

Surrogacy, a biased definition.

In this advisory opinion, surrogacy is defined as “the practice whereby a woman carries an embryo and then a foetus, and continues the pregnancy until the child is born with the intention of subsequently transferring all parental rights and responsibilities to the intended parent(s)” [1, p. 4]. This definition refers only to the surrogate mother, the only actor in the practice, who would undertake this pregnancy for the benefit of third party.

Contrary to the Committee, we choose to take the side of women’s rights : we support a definition of surrogacy that shows that, in this practice, women are instrumentalised for the benefit of others and that they are not the instigators. We consider surrogacy to be “the practice of recruiting a woman, whether or not in return for payment, to carry one or more child(ren), whether or not conceived with her own oocytes, for the purpose of handing them over to one or more person(s) who wish to be designated as the child(ren)’s parent(s)”.

“The Intended parents” : commissioners considered as the child’s author !

In the name of their “desire for parenthood”, people who resort to surrogacy to have a child are immediately honoured as the “intended parents”, a concept similar to that of intellectual property. However, being a parent implies the birth of a child; intention does not create a parent, but rather the birth of a child does.  Furthermore, as surrogacy is a financial transaction, we prefer the term  “clients” or “commissioners” to “intended parents”, since it is in fact an order placed by the clients, with the aim of obtaining a child and its lineage.

Gestational carrier, to erase the mother and motherhood.

By choosing the term “gestational carrier” [2, p. 4] instead of “surrogate mother”, the members of the Committee have deliberately chosen to erase women’s place as mothers, and their maternity. In this way, women are reduced to the sole function of their wombs. It should also be remembered that in correct language, it is the organ that is the “gestator”, not the person, and that it is dehumanising to refer to a person by an element of her or his anatomy.

By denying her maternity, the Committee is cleverly trying to eliminate the possibility of her claiming parentage with the child she gave birth to. Finally, this misogynistic terminology flouts the legal and customary definitions of the word mother: a mother is “a woman who has given birth to (or adopted) one or more child(ren)” [3].

High-tech and low-tech surrogacy.

The authors of the Opinion do not wish to distinguish between “high-tech surrogacy” and “low-tech surrogacy” [4, p. 5]. Low-tech surrogacy involves artificial insemination in which the surrogate mother is genetically linked to the newborn child. High-tech surrogacy, on the other hand, is riskier than artificial insemination, as it is involves in vitro fertilisation (IVF), with a double donation of gametes – male and female – all foreign to the surrogate mother [5][6][7][8]. This technological choice is often used to remove the surrogate mother from the child’s genealogy and deny her the maternal status. However, she remains biological mother of the child, in the name of the biological process that she, and she alone undertakes, namely pregnancy followed by childbirth.


Presenting surrogacy as progressive by associating it with the word “ethical”.

There can be no ethical surrogacy.

To avoid the suspicion of promoting the exploitation of women’s bodies or commodifying children, the Committee advocates “ethical” or “altruistic” surrogacy, as opposed to commercial surrogacy. From this point of view, surrogate mothers receive compensation – the components of which are not defined in the Committee’s Opinion – and not remuneration, in exchange for handing over the child [9, p. 6]. However, this compensation is indeed the counterpart of the handover of the child.

The whole surrogacy process – whether it is described as altruistic or not – is carried out on a commercial basis, where the parties involved (laboratories, doctors, psychologists, lawyers, advertisers, etc.) are under no obligation to moderate their profits. All are paid, except the surrogate mother. As a result, all surrogacy is commercial per se, regardless o the strategies developed to mitigate its brutality.

In the face of the unfulfilled desire for a child, compassion is often expressed for the commissioners. In an effort to soften the harmful aspects of surrogacy, it is the regulated version – limited to predefined cases – that is highlighted and described as altruistic or ethical to suggest its harmlessness. However, this method of implementing surrogacy does not reduce  the risks to the life and health of the surrogate and does not change the fact that the child is the subject of commercial transactions. Once again, this approach is essentially geared to satisfying demand, to the detriment of the surrogate mothers and the children born of them. Its legal and marketing cloak helps to ease the consciences of the actors involved in the practice and to present it as socially acceptable to the wider public.

The use of the term “ethical” is an abuse. Surrogacy is a form of violence against women’s reproductive rights. No violence can be ethical, and neither can surrogacy.

Lastly, by deploring the fact that “the process can be long and difficult for intended parents wishing to use surrogacy in Belgium, especially  for male homosexual couples as they also have to find an egg donor” [10, p. 7], the Committee takes up the cause of the sole clients and at no point does it take into consideration the surrogate mothers’ condition. Is the Committee unaware that any pregnancy is risky and that surrogate pregnancies are even riskier ? [11][12] Do they ignore that surrogate mothers, hope to improve their economic and social condition by agreeing to engage in this practice, ? Do they not know that the social and economic situation of surrogate mothers is far lower to that of the commissioners ? [12][13] Do they ignore that all surrogacy contracts require surrogate mothers to give up their fundamental rights for the entire duration of their pregnancy? And finally, that there is no justification for depriving surrogate mothers depriving surrogate mothers of their rights in favour of the commissioning people ?

A slippery slope towards the development of commercial surrogacy.

The report mentions an “evolution in the social acceptance of surrogacy by increasing number of countries that provide a legal framework” [14, p. 8]. It is unacceptable for a Bioethics Committee, issuing an advisory Opinion that will affect many women, to base its reasoning – which is supposed to be neutral – on the criterion of a supposed change in society in favour of surrogacy, as if any change was necessarily beneficial.

This Opinion highlights the countries where surrogacy is legally available (United States, Canada, Greece, United Kingdom, etc.), but fails to point out that the vast majority of European Union countries prohibit surrogacy in the name of human dignity [15].

The authors also fail to mention that, where governments have attempted  to regulate surrogacy in order to limit excesses and protect all parties involved, the meagre protection granted to surrogate mothers and the measures taken to avoid the risks of human trafficking have been quickly withdrawn. Let’s focus on the case of Greece, which in 2005, in a attempt to regulate altruistic surrogacy on its territory, first restricted the possibility of being a surrogate mother to Greek residents only, before finally recruiting foreign women… due to a lack of candidates ! This change directly contributed to European human trafficking and the development of mafia networks [16]. Similar developments can be observed in Holland and the United Kingdom [17].

According to the Committee, the Belgian context – which neither regulates nor condemns surrogacy – is responsible of a “lack of legal certainty” [18, p. 8]. Here too, the concern for legal certainty extends only to the commissioners and their desire to be guaranteed a child and its parentage, without the surrogate mother possibly interfering in in their plans. Yet, agencies and brokers promoting surrogacy recognise that there is a greater risk of the commissioners abandoning the children at birth than of the surrogate mothers claiming custody . Children born through surrogacy and rejected by foreign clients in Ukraine accounted for half of the children admitted to orphanages each year [20].


In order to create the illusion of a socially acceptable practice, the hijacking of concepts previously centered on women’s emancipation and protection of human dignity.

  • Referring to “personal autonomy” [21, p. 9], i.e. the free choice of the clients in the matter of surrogacy, is tantamount to granting them the right to a child, combined with a right to exploit a women in order to satisfy this desire, which has been elevated to the status of a right. To invoke “the right to control one’s own body” [22, p. 16] and the so-called informed consent of women as constituting their freedom to become surrogate mothers, relieves all those involved in this practice of their responsibility and their conscience. The feminist demand for the right to control one’s own body applies to all women who are forced to reproduce. Neo-liberalism has hijacked this demand and given it an individualistic interpretation for the benefit of the market.
  • Equating surrogacy, contraception and abortion as a reproductive choice [23, p. 9] borders on intellectual fraud. In fact, surrogacy is not a choice, but a deliberate act of exploitation of a third party. Contraception and abortion, on the other hand, are the expression of full freedom with regard to the choice of procreation, by and for oneself.
  • Claiming that surrogacy is a form of “reproductive solidarity” [24, p. 15] is an unprecedented reversal of the concept of solidarity, which in this case is exercised by the weaker towards the stronger. The economic and social asymmetry between clients and surrogate mothers has been widely documented [12][13].
  • Pretending that clients are not buying a child, but a “pregnancy service” [25, p. 10], is a legal argument based on bad faith or a denial of reality. In surrogacy, the clients demand a child from the surrogate mother and a parentage with that child, regardless of the risks she takes.
  • The human body would not be “unavailable” [26, p. 9] since “a person may him or herself performs acts of disposal concerning certain body parts, for humanitarian or therapeutic reasons or to participate in scientific research” [27]. However, pregnancy does not involve a single part of the body, but rather the whole body. Furthermore, surrogacy does not save lives, does not cure anyone, and does not contribute to science or society in any way. It is based on the principle that the surrogate mother’s body is at disposal, from pregnancy to childbirth and even beyond. It also based on providing a child by contract. But to possess a human being is an affront to human dignity which the abolition of slavery normally prohibits.


Instrumentalisation of the case law of the European Court of Human Rights (ECHR).

In referring to the case law of the ECHR in recent years, the authors of the report have deliberately emphasise the judgments condemning States that do not recognise parentage between the commissioners and children born through surrogacy abroad. Reference is then made to the “right to respect for private and family life” [28, p. 9] and “the best interests of the child” [29, p. 11], highlighting judgments such as Mennesson v. France of 26 June 2014, in which the ECHR ruled in favour of the commissioning couple and condemned France.

In contrast, the authors make only partial reference, in a footnote, to the case of Paradiso and Campanelli v. Italy of 24 January 2017, in which the ECHR initially ruled in favour of the Italian couple in 2015, recognising their right to build a family. However, the ECHR then reversed its jurisprudence in 2017, recognising the right of the Italian government not to recognise parentage in the absence of a biological link, in order to “protect the child against illegal practices, some of which can rightly be described as human trafficking” [30] according to the European Bioethics Institute.

Omitting the rest of these judgments is a deliberate strategy and an instrumentalization of the ECHR’s jurisprudence in order to present only those aspects that are conducive to justifying the use of reproductive surrogacy.


To the extent that they recommend the compulsory execution of contracts in favour of the commissioners.

The experts regret that the Belgian government does not recognise surrogacy contracts; as this practice is not regulated, the contracts are therefore null and void.  They refer to the  decision of Constitutional Court no. 56/2023 of 30 March 2023 (§ B.4), which states that “although surrogacy is not regulated by Belgian law, it is de facto practised in Belgium. On the other hand, any contract intended to bind the parties involved in surrogacy, for example concerning the delivery of the child at birth, is illegall. Such a contract has no legal effect and cannot be enforced [31, p. 13].

The Opinion comments on this decision as follows: “This statement is not accompanied by any explanation or development. However, it is not self-evident” [32, p. 13]. The Committee is thus openly in favour of the enforcement of contracts, apparently with the sole aim of protecting clients if the surrogate mother decides to keep the child instead of handing it over. The forced execution of such unfair contracts is shocking; as is the one-sided view that considers the possibility of forcibly handing over the child, exclusively in favour of the clients,. Why not take this line of reasoning to its logical conclusion and consider symmetrically the enforcement of contracts by commissioners in cases where they refuse to take charge of the ordered child? This case of refusal is perfectly illustrated by the well-known situation of “baby Gammy” [33], born with Down’s syndrome, where the clients decided to keep only his healthy twin. For us, the birth of a child under contract is a dehumanising enterprise that must be fought.


Praising surrogacy and vilifying adoption.

The experts explain that surrogacy and adoption are two practices that have nothing in common. According to them, in the case of adoption, the adoptive parents obtain only “legal ties” [34, p. 14]; in the case of reproductive surrogacy, on the other hand, the parents are designated as the child’s legal parents from birth, and the child is not considered to be born “of another person and at odds with his or her family of origin” [35, p. 14]. The experts therefore reject the procedure used in most countries – a procedure which consists in granting parentage to the commissioners who provided the sperm, on the basis of the genetic link between him and the child, and organising an adoption procedure for his or her spouse. The experts want both commissioners, to be granted parentage from the outset. In this way, they erase and  deprive the child of any information about his or her origins and how he or she came into the world.

The experts justify this automatic attribution of parenthood to the commissioners on the grounds that “the process of parenthood begins with them. They initiate the conception of the future person they consider to be their child” [36, p. 14]. In other words, the parental project, born from the intention of the commissioners, works in a similar way as copyright (Cf. § 8). It is this project that creates a right of the clients over the child, concretised by parentage,  which directly undermines the credibility of adoption procedures as not resulting from a “parental project”, in addition to disqualifying and denying the role of the surrogate mother.

Article 4 of the Convention on Protection of Children and Co-operation in Respect of Intercountry Adoption [37] states that the consent of the mother, if required, must be given only after the birth of the child. This provision is intended to define the boundary between adoption and the sale of children. In surrogacy, the surrogate mother agrees by contract, often even before conception, to hand over the child to the clients at birth. This practice can therefore be described as the sale of children. All those involved in surrogacy are therefore in breach of the prohibition on the disposal of a human being, are practising the sale of children and are complicit in it.


Qualifying surrogacy as a reproductive option among others.

According to this report, surrogacy would be a “reproductive option” [38, p. 16] among others, in the same way that women can choose their contraception, thus enjoy “freedom of choice in matters of reproduction and contraception” [39, p. 16]. However, the choice of contraception is made by the women themselves, in accordance with their life choices, with effects on their own bodies and without the involvement of another person. In the case of surrogacy, it is not the life or body of the commissioning people that is at stake, but the life, body and rights of a third party – the surrogate mother. The use and exploitation of a woman can never be justified by a person who is free from the traumas intrinsic to the practice requested. The desire for a child, no matter how painful, can never justify the use and exploitation of another person.

The conflation here between the right to contraception, abortion right and surrogacy as a reproductive choice is extremely misogynistic and shows great contempt for women’s rights. The right to contraception and abortion are two fundamental rights that are part of women’s freedom, unlike surrogacy which contributes to the exploitation of women’s bodies.


Presenting surrogacy as a model of parenthood.

The report also claims that the commissioners appear to be “parents who show a high level of satisfaction and emotional commitment to the child” [40, p. 18], which would contribute to the fact that “parent-child relationships are sometimes better” [41, p. 18] – by which it is implied, that they are better than in families created by  in any other means. But how can we judge the degree of love present in a family? What is the basis of such assertions? It is hard to believe that the studies on which this report is based have been able to prove this postulate. Moreover, we know that all studies on parenthood through surrogacy are biased: they never include cases of child abandonment.

It is written that children born from surrogacy “seemed (…) indifferent to their mode of conception” [42, p. 18]. We conducted a survey of several websites [43][44] that collect the voices of children born through surrogacy. Most of these blogs refer to cases of children disillusioned by the loss of their origins, with feelings of rejection from the sperm and egg donors and the surrogate mothers, as well as feelings of betrayal towards the commissioners who often have concealed that they are born through surrogacy, as Olivia Maurel explains in her recent testimony.[45].

This Opinion, systematically underestimates the medical risks and downplays the psychological consequences for surrogate mothers and children, so as to present surrogacy as a harmless practice. Although it is clearly stated that “the possible medical and psychological risks for the gestating woman must be consented to in an informed manner” [46, p. 16] and that there must be prior discussion on “possible medical interventions (…) concerning the methods of monitoring the development of the foetus, and its possible treatment” [47, p. 16], the risks in question clearly only concern “the product”, i.e. the baby ; the woman is once again forgotten. The risks to which she is exposed are overlooked: pre-eclampsia, gestational diabetes, uterine rupture and possible hysterectomy, caesarean section for convenience (at the request of the commissioners or imposed by agencies and clinics), risky and sometimes unnecessary tests such as amniocentesis, and of course, the risk of maternal death… Urgent decisions (embryo reduction, elective or therapeutic abortion, etc.) may be necessary during pregnancy and childbirth, but who will make them ? In most cases, it is the clients who demand this right, to the detriment of the woman and her body.

The risks for the child are also significant. Once again, based on an initial intention to have a child through a contract, pregnancy timing and childbirth “hazards” change the deal.



This report is therefore totally one-sided in that it does not question  surrogacy as a potentially dangerous and reprehensible practice. It is formulated exclusively for the benefit of the clients, i.e. the market; it never takes into account all the parties involved in the process, in particular the surrogate mothers and the children born of them, whose best interest is never to be “exchanged for a check” [45].

This Opinion could be described as a neoliberal “textbook case” in favour of surrogacy. The Committee is pushing hard for the liberalisation of surrogate motherhood, with this advisory position which lacks objectivity. Opponents to surrogacy will have to do their utmost to steer the debate back onto a more reasonable path, one that respects the human rights of women and children.




[1] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[2] Ibid.

[3] Centre National de Ressources Textuelles et Lexicales, MÈRE. Paris, 2012. [Online]. Available:ère

[4] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[5] R. Tocariu et al., « Incidence of complications among in vitro fertilization pregnancies », Journal of Medicine and Life, vol. 16, no 3, p. 399–405, 2023. [Online]. Available:

[6] M. Fishal Bartal et al., « The Impact of Sperm and Egg Donation on the Risk of Pregnancy Complications », American Journal of Perinatology, vol. 36, no 2, p. 205–211, 2019. [Online]. Available :

[7] S. Berntsen, E. C. Larsen, N. la Cour Freiesleben et A. Pinborg, « Pregnancy outcomes following oocyte donation », Best Practice & Research Clinical Obstetrics & Gynaecology, vol. 70, p. 81–91, 2021. [Online]. Available :

[8] M. Storgaard et al., « Obstetric and neonatal complications in pregnancies conceived after oocyte donation: a systematic review and meta-analysis », British Journal of Obstetrics and Gynaecology, vol. 126, no 4, p. 561–572, 2016. [Online]. Available :

[9] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[10] Ibid.

[11] Louisiana Department of Health. « WOMEN’S RIGHT TO KNOW : Pregnancy Risks ». Louisiana Department of Health. [Online]. Available :

[12] J. Lahl, K. Fell, K. Basset, F. H. Broghammer et W. M. Briggs, « A comparison of american women’s experiences with both gestational surrogate pregnancies and spontaneous pregnancies », Dignity: A Journal of Analysis of Exploitation and Violence, vol. 7, no 3, 2022, art. no 1. [Online]. Available :

[13] C. C. Weis, « Reproductive Migrations : Surrogacy workers and stratified reproduction in St Petersburg », Thèse de doctorat, De Montfort University, Leicester, 2017. [Online]. Available :

[14] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[15] F. G’sell, « La légalisation de la maternité pour autrui à l’étranger : exemples de droit comparé », Cahiers Droit, Sciences & Technologies, vol. 7, p. 93–111, 2017. [Online]. Available :

[16] « 66 suspected of arranging illegal adoptions and surrogacies, and human egg trafficking in Greece | Europol ». Europol. [Online]. Available:

[17] « Observatoire de la GPA : Royaume-Uni ». CIAMS. [Online]. Available:

[18] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[19] [20] Abolition GPA. Surrogacy in Ukraine. (11 mai 2022). [Online Video]. Available: (4’:58”et 5’:38”)

[21] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[22] Ibid.

[23] Ibid.

[24] Ibid.

[25] Ibid.

[26] Ibid.

[27] Although embryo transfer is, strictly speaking, the transplantation of a group of cells into the body of a recipient, i.e. the surrogate mother, it is excluded from the notion of donation, and therefore from the bioethical principles governing transplants at international level. This means that the commissioners remain the owners of the embryo once it has already been transplanted into the recipient’s body, that they retain ownership of it during gestation and demand its return after pregnancy and birth, turning the surrogate mother into an embryo “incubator”, and the child into a product manufactured on demand both deprived of their human dignity. B. O. García, « En las entrañas de la gestación subrogada : Secrets and lies », Tribuna Feminista, 13 mai 2022. [Online]. Available :

[28] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[29] Ibid.


[31] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[32] Ibid.

[33] S. Moore, « The case of baby Gammy shows surrogacy for the repulsive trade it is », The Guardian, 4 août 2014. [Online]. Available: 

[34] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[35] Ibid.

[36] Ibid.

[37] Pays-Bas, Conférence de la Haye de droit international privé. (1993, 29 mai). Convention no 1-V-1995, 33 : Convention du 29 mai 1993 sur la protection des enfants et la coopération en matière d’adoption internationale (Art. 4, 2-3). [Online]. Available:

[38] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[39] Ibid.

[40] Ibid.

[41] Ibid.

[42] Ibid.

[43] « I am a product of surrogacy ». The other side of surrogacy. [Online]. Available: ; « »

[44] « Anonymous Us ». Anonymous Us. [Online]. Available:

[45] Casablanca Declaration for Abolition of Surrogacy. About Surrogacy at the Czech Parliament – Olivia Maurel, Born of Surrogacy. (30 nov. 2023). [Vidéo Online]. Available:

[46] Comité consultatif de Bioéthique de Belgique, « Encadrement légal de la gestation pour autrui (actualisation de l’avis n° 30 du 5 juillet 2004) », Avis n° 86, avr. 2023. [Online]. Available:

[47] Ibid.



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