Optimism bias is not universal: Sharot has pointed out that ‘people with mild depression show no bias when predicting future events, and people with severe depression tend to expect things to be worse than they turn out’. 60 This, according to Sharot, leaves approximately 80% of the population who ‘expect the future to be slightly better than it ends up being’, a tendency which she describes as ‘one of the most consistent, prevalent, and robust biases documented in psychology and behavioral economics’. 61 In the UK’s ‘altruistic only’ system, it is an offence for anyone other than the surrogate and the intended parents to negotiate a surrogacy arrangement ‘on a commercial basis’, and it is a criminal offence for intended parents, surrogates and agencies to advertise their willingness to participate in or facilitate surrogacy. As a result, as McFarlane J explained in Re G (Surrogacy: Foreign Domicile), 30 the role of facilitating surrogacy arrangements has traditionally been left to ‘groups of well-meaning amateurs’. If the mischief to which the ban on commercial involvement is directed is the prevention of exploitation, the evidence is by no means clear that this is best achieved by discouraging professional agencies’ involvement in surrogacy. On the contrary, as Natalie Gamble has explained:

Jill Peay'Mental Health, Mental Disabilities and Crime' in A. Liebling, S. Maruna and L. McAra (eds) The Oxford Handbook of Criminology6th Editon, (2017) [FORTHCOMING] The relationship between medical law and good medical ethics' (2015) 41 Journal of Medical Ethics 41 (1): 95-98 To inform a more nuanced approach to the provision and regulation of fertility treatment, we must attend to the subjective experience of risk, quality, and care in CBR, especially when this involves what Angela Campbell calls ‘morally ambiguous’ or even ‘ostensibly self-injurious’ choices. 20 In this article, we suggest that it is impossible to properly evaluate the role of law in CBR without attending to its impact upon participants’ lived experiences, and that, in the light of a dramatic mismatch between law’s goals and reproductive travellers’ experiences of law, there may be grounds for some form of realignment. II. ALTRUISTIC OR COMMERCIAL: AN UNTENABLE DISTINCTION? Challenging the comparison in Montgomery between patients and “consumers exercising choices"'(2021) Medical Law Review online first Compensating Egg Donors' in Sumi Madhok, Anne Phillips and Kalpana Wilson (eds) Gender, Agency and Coercion (Palgrave, 2013) 181-194.Although the internet is the primary source of ‘soft’ information about the experience of fertility treatment, it is also worth noting the growing popularity of fertility and surrogacy ‘fairs’ or ‘roadshows’, which are huge exhibitions in which visitors can gather information from regulated clinics and the local regulator, while also meeting people from overseas clinics and ‘alternative’ therapists. Discussions about one’s need for fertility services have emerged from the strict confidentiality of the doctor-patient relationship to become instead a marketing opportunity for private providers. But while these ‘fairs’ provide clinics with the chance to sell their services, potential patients also value the opportunity to find out if they feel a ‘connection’ with the clinic staff and their approach. In addition to considering their own wellbeing, patients are often concerned about the impact of their condition and its treatment upon their dependants. 23 Patients are therefore making multi-faceted and challenging decisions, from a position of vulnerability, and in the context of a doctor–patient relationship where there may be a high level of trust, and even dependence. Indeed, this is why, as Purshouse has explained, invoking the metaphor of ‘patients as consumers’ in an informed consent case represents a departure from the more usual depiction of patients in clinical negligence cases as potentially, if not inherently vulnerable. 24 One response to the issues raised by overseas travel is to try to educate people about the implications of undertaking CBR, by providing information about clinical standards of care and the legal status of children born from such arrangements. Counsellors and patient support group representatives interviewed by Culley et al in the UK, for example, thought the only feasible response to reproductive travel is to educate people, and ensure that ‘they go into it with their eyes open and fully aware of the implications’. 52 Regulating Embryo Research: A Regulator’s Perspective’ in Mark Flear et al (eds) European Law and New Health Technologies(Oxford University Press, 2013) 275-281.

Legalising assisted dying: cross purposes and unintended consequences’ (2018) 41 Dalhousie Law Journal 60-91. Should a patient choose a riskier procedure that may lead to the best possible outcome but with the greatest potential side effects, or the safer option where the patient knows the outcome will not be ideal? How should a patient choose between the psychological burden of a wait-and-see approach versus the potential complications and cost of a serious surgery? How does a patient weigh the cost in taking extended time away from work for recovery against a longer-term reduction in ability from not acting? 22 Death, Euthanasia and the Medical Profession’ in M Johnson, J Herring, B Brooks-Gordon, M Richards (eds) Death Rites and Rights (Hart, 2007) 37-55The process of giving birth is rightly termed ‘labour’. It is hard work, often painful and sometimes dangerous. It brings the pregnancy to an end but it does not bring to an end the changes brought about by the pregnancy. It takes some time for the body to return to its pre-pregnancy state, if it ever does, especially if the child is breast fed. There are well known psychiatric illnesses associated with childbirth and the baby blues are very common … Criminalising the supply of tobacco’ Health Economics, Policy and Law Volume 6 / Issue 02 (2011) pp 279 - 281