A Background and Ethical Considerations of Commercial Surrogacy

A Background and Ethical Considerations of Commercial Surrogacy

At its basis, surrogacy is the practice of a woman carrying a pregnancy for another individual or couple [1].  Intended parents pursue surrogacy for several reasons and come from all sorts of backgrounds. Currently, there are two forms of surrogacy: traditional surrogacy and gestational surrogacy [2].

In traditional surrogacy, the surrogate uses her own egg and is artificially inseminated by a donor sperm [3]. The surrogate mother, after carrying and delivering the baby, returns the child to the intended parents. In this method, the surrogate mother is in fact the baby’s biological mother and has a genetic connection to the child. This form of surrogacy has been around for centuries.

Nowadays, gestational surrogacy is much more prevalent than the traditional form. In 1985, the first gestational surrogate pregnancy took place [4]. In this form, the surrogate carries a baby that has been conceived using both the egg of the intended mother and the sperm of the intended father [3]. As a result, a gestational surrogate mother has no genetic connection to the child.

Countries around the world differ vastly in regards to their views on surrogacy. The majority of countries have banned all forms of surrogacy (both altruistic and commercial). These nations include China, France, England, Japan, Italy, Canada, and Germany [5]. Even in the United States, only a handful of states permit commercial surrogacy. In the few states in which commercial surrogacy is legal, the average price is well over $100,000 [6]. The lack of legalization coupled with the exorbitant price tag has forced couples to search for alternate surrogacy opportunities. As a result, India has become the primary hotspot for individuals and couples wishing to have a child via surrogacy [5]. This is due to the low price and prevalence of surrogacy clinics as well as the lack of government regulation and oversight. In particular, many US couples pay for a surrogate mother in India, and after the baby is born, travel over to pick up the child and pay the surrogate. Applying ethical frameworks to the current state of surrogacy yields several very interesting dilemmas.

Proponents of commercial global surrogacy have many valid points. For example, many argue that the autonomy of both the individuals seeking a child via surrogacy and the surrogates themselves should be respected. In other words, if both parties are willing, morally they should be allowed to create a surrogacy contract. Using a utilitarian perspective, commercial surrogacy can also be viewed as ethically valid. This is because all of the parties involved can be viewed as benefitting from the process. In India, lower-class women who would otherwise struggle to provide for their families, are able to put food on the table through surrogacy contracts. Couples, who otherwise would be unable to have a child, are granted the extra happiness and satisfaction that comes with having a child that they are related to.

On the other side of things, there are many ethical issues that arise from the present structure of commercial surrogacy. In the United States, there are currently over 110,000 children up for adoption [7]. As the prevalence of commercial surrogacy rises, less and less of the kids who are currently orphans will ever be taken in by families. Using the same utilitarian model, this would deem commercial surrogacy as a whole ethically invalid.

Detractors might also argue that the legalization of commercial surrogacy in third world countries might actually hurt the autonomy of lower class women. In India, an extremely patriarchal society, lower-class women might be pressured by their husbands to partake in the act of surrogacy in order to provide for the family [8]. Since surrogacy is still considered very taboo in India, these women are then often forced into a very unfortunate positive feedback loop[9]. This is because women, who act as a surrogate even once, are often shunned from their entire community. As a result, these same women might feel that they have no future job prospects and as a result are forced to act as a surrogate again [9]. Another issue with the structure of commercial surrogacy in India is the middleman. With so many lower-class women being willing to act as a surrogate, the surrogacy clinics have almost total bargaining power in regards to the revenue split. It is reported that the surrogates themselves receive less than 20% of the total revenue [6]. This issue of manipulation must be addressed promptly.

All in all, there are no clear-cut answers when it comes to dealing with the issues of commercial surrogacy, especially in third world nations. One suggestion that I propose is to adjust the current adoption protocol in the United States. I personally know many people who, even after trying for years, are unable to successfully get approved to adopt a child. As a result, they resort to commercial surrogacy instead of being able to take in a child who is already looking for a family. I also believe that, in order to protect vulnerable, low-income women, there must be increased regulation of the existing commercial surrogacy systems in third world countries.


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