Ethical Issues in Surrogacy
Introduction The rapid developments in medical technology have caused ethical and moral dilemmas which directly affect the way we understand reproductive ethics - Ethical Issues in Surrogacy introduction. Since the birth of the world’s first surrogate baby in the 1980s, surrogacy has become a controversial ethical issue in countries all around the world. (Carr 2007: 1) The proponents of the surrogate mother movement argue that couples have rights of giving birth to children and establish their family integrity, the assisted reproductive technology and surrogacy render a great chance of reproduction to the infertile couples.
However, the opponents point out that so increasingly, couples who desire the services of surrogate mother for reasons other than infertility, such as the career development opportunities, fears of losing figure after having a baby and the painfulness of childbirth. (Macao Daily 31/10/20120) Further, they argue that surrogacy goes against nature and undermine the traditional family values. Even, use of surrogacy motherhood is a disrespect to human dignity in an unscrupulous way, the so-called “rent-a-womb”, women are regarded as childbearing machine which means their sole function is to give birth to male offspring.
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Nowadays, although such new medical technology has brought up questions regarding its ethical goodness or badness, the commercial surrogacy is still legal in several countries like United States and India while illegal in many other countries. India has become the world capital of outsourced pregnancies. Surrogacy, what cannot be denied is that the practice of surrogacy is not new, and even tends to prevail. In the next part, I will give definition of the relevant terms, so that it is easier for us to understand about surrogacy.
Then, I will analyze ethical issues in surrogacy in respect of the relevant parties, and the outcomes of their acts. Finally, I will make a conclusion on ethical issues in surrogacy. Definitions Surrogate Pregnancy refers to the practice that one woman (the surrogate mother) carries a child for another person(s) (the commissioning couple), as the result of an agreement, the child should be handed over to that person after birth. (Gibbs 2008) There are two types of surrogacy: partial surrogacy and full surrogacy. Partial Surrogacy refers that the surrogate mother is also the genetic mother of the child, (i.
e. using her own egg) and conception usually occurs by artificial insemination (???? ) using the commissioning father’s sperm. (Gibbs 2008) Full Surrogacy refers that the gametes of both commissioning parents are used; both gametes come from donors or one of the commissioning parents provides the gametes and a gamete donor the other. The conception takes place through In-Vitro Fertilization (IVF-???? ) and embryo transfer (???? ). (Gibbs 2008) Generally, there are mainly three parties involved in surrogacy: the commissioning couples, the surrogate mother and the child.
The Commissioning Couple are the people (or in some cases, person) who wish to bring up the child after his or her birth. (Gibbs 2008) The Surrogate Mother is the woman who becomes pregnant, carries and gives birth to a child on behalf of another couple. (Gibbs 2008) The Child who is the surrogate mothers gives birth but handed over to the commissioning couple after his or her birth. (Gibbs 2008) The Commissioning Couple in Surrogate Pregnancy Originally, the aim of the surrogate pregnancy is to serve couples who are unable to become pregnant, unable to carry a baby or should not attempt pregnancy because health risk in medical reasons.
Such assisted reproductive technology and surrogate pregnancy give hopes and opportunities of reproduction to infertile couples and help them maintain their family integrity. In some sense, it may understandable for the infertile couples have children through surrogate pregnancy. However, surrogate pregnancy not only becomes a viable alternative for the infertile couples, but also renders a way for homosexuals, single man and single woman to have their children. In this sense, surrogacy may further complicate and undermine the reproductive ethics.
The famous controversy in Peter Lee’s case of surrogacy in Hong Kong, Mr. Lee, became the single father who gave birth to three children through surrogacy, which has became the talk of the city in 2010. Some argue that his act undermines the traditional family values, and further, his children may similarly think they could do whatever they wanted as long as they had money. (SCMP 29/10/2010) Concerning such issue in depth, Mr. Lee hired surrogate mother may not only intend to satisfy his desire of giving birth to children, it may involve high profits behind.
Some scholars pointed out that there is a change in motives for giving birth to children. Children are not conceived for their own sakes, but for another’s benefits. (Meinke 1984: 2) The Surrogate Mother in Surrogate Pregnancy Surrogate mothers usually come from the low income family and have few financial resources. Therefore, the financial motivations usually are the primary reason for them to participate. (Reame 1991: 152)Surrogate mothers are regarded as receptacles that being “used” by others for their own ends.
Surrogacy is a means to instrumentalize and exploit low-income women for the interest of high-income people. In fact, besides the disrespect to human dignity, surrogate mothers are high-risk obstetric patients both physically and psychologically. Physically, chances of death or injury to health whilst undergoing IVF procedure or taking a pregnancy are real. A woman who submits to IVF to bear a child for another places herself at a significant risk, there are at least 18 women have died during undergoing the IVF procedure by anaesthetic misadventure or other causes.
(Scutt 1991) In addition, pregnancy carries a maternal death rate around 10 in 10,000. (Gibbs 2008) Most of the commissioning couples are unwilling to provide more than a small sum for legal expenses of the surrogate mothers. (Reame 1991: 152) On the other hand, surrogate mothers are suffered from psychological distress at many stages of the process, form failure of the surrogate process to the difficulty once the baby has been relinquished to the commissioning couple.
For those women who do relinquish the child, the risk of post-natal depression, as well as feelings of anger or guilt, may further add pressures to the women’ psychological health. Motherhood is not something just give birth to a child, it is a developmental process over time, arising out of the reality that a fetus is a part of a woman’s body until separated upon birth. To develop into a child, the surrogate mothers devote energy, life, time, emotional effort, and psychological sustenance. Her bloodstream, oxygen system and nutrient system, all these link to the baby.
Although IVF may bring with it the possibility that the woman who gives birth is not “related” to the child in a genetic sense, the reality of the relationship between mother and child already develops through the term of the pregnancy. (Scutt 1991) In fact, wherever the egg derives from the surrogate mother or not, baby develops inside her body, the baby is a part of herself. Scholars argue that gestation and birth always is weightier than genetic link between the baby and the commissioning parents.
(Reame 1991: 153) The highly publicized lawsuits between commissioning couples and surrogate mothers provide evidence of strong maternal feeling on the surrogate pregnancy. The famous Baby M case in 1986 caused much controversy about moral issues in United States. After the surrogate mother had given birth to a baby, she refused to relinquish the child to the commissioning couples because of her maternal instinct. Finally, although the commissioning couple gets the baby and the surrogate mother can visit the baby once a week, all the involved parties suffered from surrogacy.
(Ming Pao News 28/10/2010) The Children in Surrogate Pregnancy Some argue that in use of surrogacy, the children suffered the most. Contract surrogacy is means to commodify children. The children are bought whether with money, gifts, (material) or through emotional and psychological satisfactions (non-material) for surrogate mothers. (Anderson 2000:20) Moreover, children born of surrogate mothers may suffer from the mother-child relationship that they wonder who their real mothers are. Further, they may be liable to the role confusion.
In case of single man and single women, the child will have no mother or no father to take care them since they were born. In the worst situation, both the commissioning couples and the surrogate mother do not want to bring up the baby. In 1983 in United States, a surrogate mother gave birth to a baby who soon was found by bacterial infection that may lead to blindness and deafness. No one can imagine that the child suddenly became a “ball” that both the commissioning couple and surrogate mother made excuses to abandon the handicapped baby.
Finally, such incident caused the commissioning couple to divorce, and added extra burden for the surrogate mother. Again, all the involved parties suffered from surrogacy, especially the baby. The Society Surrogacy directly affects the way we understand reproductive ethics. It raises questions for us to rethink about what are family, mother-child relationship, father-child relationship, motherhood and fatherhood and so forth. More importantly, when consanguinity is uncertain, incest may happen. One the other hand, some argue that surrogacy is an acceptable procedure if it is an altruistic act.
Altruistic surrogacy refers that a women help a couple who is impossible or medically contraindicated to carry a pregnancy, that women do so not for the money but for the special joy it brings to the lives of those who cannot have children themselves. Therefore, altruistic surrogacy should be the only acceptable form. (Shenfield 2005: 2706) However, it arises another question that when it is fully altruistic? Just complete the wishes of others without pay and whatever? How about the expenditure in relation to pregnancy? Therefore, how to define altruistic surrogacy is still an open question.
Conclusion After analyzing different parties involved in surrogate pregnancy, we can see that surrogacy is damaging or potentially damaging to those parties involved in it, the child, the surrogate mother who agrees to give the child, and the commissioning parent(s). Surrogate pregnancy treats children as commodities, renders possibility to exploit women and even is destructive of the family members. It is an unwarranted use of a person as a means to an end. Concerning the surrogacy in depth, it may further undermine the social ethics, the social impacts of such acts are immeasurable.
It is important to know that infertility is not a life threatening condition but chances of death or injury to health to surrogate mothers is real during the surgical operation or taking a pregnancy. It is unacceptable that people find his profit in another’s loss there. Therefore, in conclusion, without being fully aware of the potential risk, I think that no matter in any form, commercial or noncommercial, surrogacy should be discouraged and prohibited. Reference Anderson Elizabeth S. 2000. “Why Commercial Surrogate Motherhood Unethically Commodifies Women and Children: Reply to McLachlan and Swales” Health Care Analysis 8: 19–26.
Carr Ken. 2007. “Surrogate Motherhood” Discussion Document pp. 1-3. Gibbs Rebecca. 2008. ” Surrogacy: Medical, Ethical and Legal Issues to be Considered” Surrogacy. Jadva Vasanti. et al 2003. “Surrogacy: the Experiences of Surrogate Mothers” Human Reproduction Vol. 18, No. 10 pp. 2196-2204. Meinke Sue A. 1984. “Surrogate Motherhood: Ethical and Legal Issues” National Reference Center for Bioethics Literature pp. 1-11. Reame Nancy E. 1991. “The Surrogate Mother as a High-Risk Obstetric Patient” Commentary WHI Vol. 1, No. 3 pp. 151-154.
Scutt Jocel Ynne A. 1991. “At Issue: Whose Surrogate? Surrogacy, Ethnics, and the Law” Issues in Reproductive and Genetic Engineering Vol. 4, No. 2 pp. 93-107. Shenfield F. et al 2005. “ESHRE Task Force on Ethics and Law 10: Surrogacy” Human Reproduction Vol. 20, No. 10 pp. 2705–2707. Markens Susan. 2007. “Surrogate Motherhood and the Politics of Reproduction” Library of Congress Cataloging-in-Publication Data pp. 20-49. “Surrogacy”, Ming Pao News, 28/20/2010. “Use of Surrogacy Draws Catholic Diocese Rebuke”, SCMP, 29/10/2010. ????????????? ,31/10/2010?