Moral quandaries in the age of surrogate pregnancy

Posted 21st October 2014 by Clare O'Neil in Articles | 0 Comment

Over the past year, surrogacy has moved from the fringe of reproductive techniques towards the mainstream. Elton John, Sarah Jessica Parker and Nicole Kidman lead a long list of people, celebrity and otherwise, who have used surrogacy to fulfil their wish for a child.

Reporting has focused on best-case outcomes: happy couples, happy infants, happy surrogates. Few commentators have explored the moral ambiguities, most of which apply to commercial surrogacy, where a surrogate mother is paid (usually on delivery of the infant to the new parents) to bring a child to birth.

If we allow babies to be bought, why not a two-year-old child? Should we allow babies to be sold at auction?

Views on the moral dimensions of commercial surrogacy are important because regulation is still in an early phase. I want to highlight two issues of concern. First, commercial surrogacy can be exploitative because the contracting parties are not always free and equal. Second, by allowing commercial surrogacy, we step closer to commodifying pregnancy, motherhood and babies, leading to a potential change in how we perceive and treat the people involved.

No doubt, many women who agree to act as commercial surrogates are empowered to make good decisions and are well compensated for their role.

Equally indisputable is that some surrogates are poor and uneducated. Many come from developing countries. Often enough, the future parents come from wealthy nations, and are wealthy even by the standards of their home country. An intermediary, or ”baby finder”, who seeks to make a profit from the exchange, completes the recipe for exploitation.

The specific situation of concern goes like this: a poor woman, desperate for funds, agrees to act as surrogate under terms for which she is not properly counselled. She grows attached to the child during gestation. Then, she is intimidated by a profiteer into selling her infant. A fair society would not support and uphold such a transaction.

Designing regulation in this context is difficult. How can we allow women the right to do with their bodies as they please – at whatever price they please – while protecting vulnerable people? Preventing enforceability of surrogacy contracts is one way; another is legislating so that only non-profit organisations can act as intermediaries.

A second, more complex set of moral concerns is that commercial surrogacy could commodify pregnancy, babies and motherhood, leading to the breakdown of cultural beliefs we may not wish to change.

Babies and pregnancy are seen by society as sacrosanct. Through commercial surrogacy, they are given a price, and sold and exchanged much like other goods and services. If we allow babies to be bought, why not a two-year-old child? Should we allow babies to be sold at auction? For many, these (albeit extreme) hypotheticals feel intuitively wrong, contravening a basic belief that some things simply should not be bought and sold.

If the principle alone isn’t convincing, commodification of pregnancy and motherhood could bring tangible detriments. Some philosophers have argued that if more pregnancies are motivated by profit, the revered role of women in pregnancy and motherhood would be diminished, leading to less social protections for mothers and babies. These outcomes may sound far-fetched. But we should at least acknowledge the possibility that social views many of us value could be disturbed.

These are just two in a mass of legal and moral issues surrounding commercial surrogacy. The rights of the child to have relationships with surrogate parents and vice versa; any distinction we might draw when the ovum is from the surrogate mother versus the future parents; who is responsible for surrogate children born with severe disabilities; even what to do when the surrogate mother has multiple births – all these remain largely unsettled in ethics and in law.

We can’t avoid these questions for much longer. Commercial surrogacy will continue to grow because it can help couples and single people, who may otherwise face a life without children, to build a family. This is the substance of many happy commercial surrogacy stories. But you don’t have to look far to find unhappy ones. We must account for both when determining our stance on the moral issues surrounding commercial surrogacy and, ultimately, how we regulate this practice.

Clare O’Neil is a freelance writer and has a master of public policy from Harvard University.

Originally published March 4, 2011 in The Age

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