Long debated have been the ethics of surrogacy, in vitro fertilization, and other assisted reproductive technologies. In debating the ethics of surrogacy, one must consider all of the varied nuances of the subject. Gestational or traditional? Altruistic or commercial? Does the commercialism of surrogacy prey on poor women? Should surrogacy be available to homosexual couples? Is the commercialisation of surrogacy promoting a classist society, allowing for genetic heirs to be available only to the affluent? The questions and debates surrounding surrogacy can be dizzying and discouraging for some. We'll try and break it down into manageable topics discussed from a perspective based on scientific research and pre-existing laws and practices.
Gestational or Traditional
Gestational surrogacy is the most widely recognized and supported form of surrogacy in contemporary law and medicine. Gestational surrogacy is when all genetic material is contracted from either the intended parents, or a donor, with no genetic material coming from the surrogate. The egg is then fertilized in vitro (outside of the body) and implanted via IVF into the surrogate mother. Traditional surrogacy is performed when the surrogate mother is artificially inseminated with the intended fathers sperm, leaving the egg to be supplied by the surrogate.
Gestational: In Ukraine surrogacy, a country that is known for its clear laws in support of the practice, law states that all genetic material must be supplied from a donor or the intended parents, essentially outlawing traditional surrogacy, to ensure that the surrogate mother has no genetic link (and therefore lawful privilege) towards the child. In essence, tipping the law entirely into the favor of the intended parents, allowing no paternal rights to the surrogate at any time.
Traditional: The closest thing to traditional surrogacy that is commonly performed in this day and age is in Vietnam, where the surrogate must be genetically related to the intended parents, however, no genetic material can be taken from the surrogate mother to create the child. Traditional surrogacy has largely been outmoded owing to the legal and ethical complications that arise when there is a genetic link between surrogate mother and child.
Altruistic or Commercial
Probably the most contentious of all of the debates you will see revolving surrogacy. The world itself is divided into factions, some advocating for commercial, while others strictly forbid it. Altruistic surrogacy is defined as the process in which the surrogate mother is not paid for her services and can only be reimbursed for certain expenses that have been sanctioned by law. In commercial surrogacy, the surrogate is paid reparation for her services, generally anywhere from $16,000 to $20,000, in conjunction with reimbursement for medical and living, or any other agreed upon expenses.
Altruistic: Nations such as Canada and Australia allow only altruistic surrogacy. It is predetermined by law what expenses the surrogate mother can claim and be reimbursed for. There are absolutely no protections, and even criminal charges, for any monetary gifts paid to the surrogate mother.
Commercial: Ukraine surrogacy and surrogacy in some states of the US allow for commercial employment of surrogate mothers. While some contend that this causes other problems ethically, these states suggest that the availability of commercial surrogacy creates a win/win situation for all parties involved. Another proposed downfall of commercial surrogacy is the difficulty in regulation, where an intending couple could possibly procure the assistance of a surrogate mother that is not in appropriate financial, physical, or mental health to carry the child, exploiting the plights of poor and desperate women. Many states with laws regulating commercial surrogacy also have recognized surrogate agencies, that help circumvent this issue.
Does Commercial Surrogacy Prey on Women?
Information regarding the efficacy of commercial surrogacy varies from nation to nation, and seems to lean heavily on the laws that govern it. Commercial surrogacy in India was found to be exploitative, and even dangerous to the women involved, leading to a nationalized shut-down of any foreign commercially contracted surrogacies in 2015. This information caused further scrutiny to be applied to nations that have laws allowing commercial surrogacy. Other national laws, such as Ukraine surrogacy laws, allow for the surrogate mother to be gainfully compensated, but require medical health consultations and financial evaluations of the woman prior to allowing her to become a surrogate mother. Also, sanctions have been placed upon prospective parents as well, among them the requirement of documented medical need of surrogacy, secondary to infertility. States with friendly commercial surrogacy laws in the US, like California, have very few limitations and sanctions placed on prospective parents and surrogate mothers, which is implied to allow for surrogacy to be available to a more varied group of prospective parents. However, with employee and women's rights protected firmly within the US constitution, reports indicate that through the contract of a reputable agency, many of the possibly dubious outcomes for surrogate mothers can be avoided.
Should Surrogacy be Available to Homosexual Couples?
The information surrounding this particular ethical tide pool depends mainly on your stance on homosexuality itself. The ethics of this particular question- when viewed from the perspective of psychology is conclusive: Children have the same chance to thrive with same sex parents as they do with heterosexual parents. A new study published in Developmental Psychology affirms and validates this assertion by following the experience of more that 100 children raised in household by equal samples of gay and hetero parentage. None of the many outcomes that were measure suggested any difference in between childhood outcomes in families of heterosexual or homosexual households. Even in light of this information, many European countries with surrogate friendly law do not allow homosexual partners to apply for surrogacy.
Is the commercialisation of surrogacy promoting a classist society, allowing for genetic heirs to be available only to the affluent?
While this is still widely debated with little to no evidence in favor of either side of the argument, conclusions can be drawn that affluent couples are the only ones that have surrogate services available to them. Ukraine surrogacy, known for it's reasonable price, still costs anywhere from $30,000 to $80,000, which is not at any stretch of the imagination, pocket change. However, this price tag is roughly one third lower than the costs associated with surrogacy in any other country, including Canada, where only altruistic surrogacy is allowed. The low cost of living and high unemployment rates in Ukraine also suggest that surrogacy is an option that is favorable among women in low income households. One report notes that affluent women don't generally rent out their wombs. In contrast, Ukraine surrogacy agencies protest that their potential surrogates go through a myriad of tests, to include financial assessment, ensuring that they do not select desperately poor women into their services, as this could arise complications for the health of the child. Other reports indicate that even though financial gain is part of the motivation to become a surrogate, it is in no way the only factor. During a BBC news interview with a Ukraine surrogate mother, she detailed the experience as being more than just monetary, and described the gift of giving life and it's positive effects on not only the intended parents, but for herself as well.
While the ethical standing of surrogacy is hotly debated, the assertions of any given faction vary greatly. With surrogacy itself becoming more and more prominent in modern day society, I think we can expect new answers, and questions, to arise.