Ethical Issues in Gestational Surrogacy

The introduction of contraceptive technologies hasresulted in the separation of sex and procreation. Theintroduction of new reproductive technologies (mainlyIVF and embryo transfer) has led not only to theseparation of procreation and sex, but also to there-definition of the terms mother and family.For the purpose of this essay, I will distinguishbetween:1. the genetic mother – the donor of the egg;2. the gestational mother – she who bears and gives birth to the baby;3. the social mother – the woman who raises the child.This essay will deal only with the form of gestationalsurrogacy in which the genetic parents intend to bethe social parents, and the surrogate mother has nogenetic relationship to the child she bears anddelivers. I will raise questions regarding medicalethical aspects of surrogacy and the obligation(s) ofthe physician(s) to the parties involved. I will arguethat the gestational surrogate is “a womb to rent,”that there is great similarity between gestationalcommercial surrogacy and organ transplant marketing.Furthermore, despite claims to freedom of choice andfree marketing, I will claim that gestationalsurrogacy is a form of prostitution and slavery,exploitation of the poor and needy by those who arebetter off. The right to be a parent, although notconstitutional, is intuitive and deeply rooted.However, the issue remains whether this rightoverrules all other rights, and at what price to theparties involved. I will finally raise the followingprovocative question to society: In the interim periodbetween today's limited technology and tomorrow'sextra-corporeal gestation technology (ectogenesis),should utilizing females in PVS (persistent vehetativestate) for gestational surrogacy be sociallyacceptable/permissible – provided they have leftpermission in writing?     

“八胞胎”事件引发的伦理思考

震惊全国的广州“八胞胎”事件逐渐淡出公众的视野,但它带给我们的思考并未结束.从伦理视角对该事件中暴露出的亲子关系的界定、“子宫”商品化、公平公正、多胎妊娠、代际伦理等问题进行了深入思考,并针对ART技术自身特点,从强化医疗机构和ART技术从业人员的职业道德和法律意识;加强卫生行政部门的监管;加强顶层设计,完善ART技术的法律法规;提高不孕症患者对辅助生殖知识的认知,加强生殖伦理教育等方面提出了探讨性建议.     

The journey of gestational surrogacy: religion,spirituality and assisted reproductive technologies

This article discusses the intersection of women’s experiences with the assisted reproductive technological practice of gestational surrogacy and spirituality and religion. During the interviews of eight gestational surrogates themes of spirituality-, religion- and faith-based language emerged as these women shared their narratives of assisted reproductive technologies in this Canadian study. Professionals supporting women before, during and after the experience of gestational surrogacy need to be mindful of the significance of spirituality and religion in third party reproduction practices for many women. In discussing these topics with gestational surrogates counsellors, child and youth care practitioners, faith leaders, social workers, and educators need to remain open and attentive to a multiplicity of diverse theological negotiations.     

Social Anxiety and Social Surrogacy in College Roommate Relationships

The social surrogate hypothesis proposes that people with higher social anxiety (HSA) recruit others to accompany them into social situations. We tested this hypothesis with college roommates using both hypothetical (Study 1) and retrospective (Study 2) measures, while assessing roommate's perceptions of recruitment and how social surrogacy might influence liking between roommates. Across two studies, we found that HSA participants were less likely to enter social situations alone (i.e. higher conditional entry); however, HSA was related to recruitment only when participants considered hypothetical scenarios, not when recruitment was assessed globally or retrospectively. There was little evidence that HSA participants' roommates were aware of these behaviours, although there was preliminary evidence that less social anxiety might increase liking when roommates perceived more conditional entry. We also found preliminary evidence that social anxiety may be negatively related to liking when participants were less likely to recruit an alternate surrogate if their roommate was unavailable. Taken together, these preliminary findings emphasize the importance of studying the surrogacy process from an interpersonal/dyadic perspective and using methods that will differentiate between anticipated (which may be assessed by hypothetical scenarios) and enacted recruitment behaviours. Copyright © 2017 European Association of Personality Psychology     

Global surrogacy: exploitation to empowerment

Commercial surrogacy has gone global in the last decade, and India has become the international centre for reproductive tourism, boasting numerous high-quality and low-fee clinics. The growth of the surrogacy industry in India raises serious concerns of global gender justice, in particular whether the option is inordinately enticing for women who lack other remunerable options and whether the conditions are adequate and the compensation fair. In this paper I argue that the moral harm of global commercial surrogacy lies in the exploitative nature of transactions involving unequally vulnerable parties. More specifically, I argue that the practice exploits Indian surrogates on the basis of an inter-contractual failure of both justice and consent. I go on to consider an important objection to my use of exploitation as the relevant conceptual tool of analysis. The ethnographic challenge holds that the exploitation lens Occidentalizes surrogacy by conceptualizing the practice in universalizing terms, thereby eclipsing the particularities of the global surrogate's lived experience. I respond by showing that in fact the exploitation and the ethnographic models are not so at odds as they might seem. Provided we are careful in our use of the former to nuance our analysis by appeal to narrative evidence supplied by the latter, we are thereby best situated to identify and address the moral difficulties generated by commercial surrogacy under conditions of global injustice.     

Within-family reproductive technologies as a solution to childlessness due to infertility: Psychological issues and interventions

Patients choosing new reproductive technologies benefit from psychological consultation as they face unforeseen emotional and interpersonal sequalae from these procedures. This paper focuses on those patients who choose family members or close friends (i.e., known donors) to donate sperm or eggs or uteri in order to conceive and produce their babies. Medical family therapy offers these patients and families a framework from which to examine the biological, psychological, and interpersonal issues involved in these within-family solutions to childlessness due to infertility.This paper is a revision of a talk, Medical Family Therapy, Infertility, and the New Reproductive Technologies, given at the 1994 annual meeting of the American Psychological Association on August 4 in Los Angeles, CA, as part of the Mini-convention on Families panel on Clinical Issues in Families and Health.     

英国“代孕”合法化二十年历史回顾

在英国,代孕人工生殖是合法的医疗手段。《布雷热报告》等调查报告对英国代孕立法产生了深远影响。为实现生殖自由、子女利益和社会秩序的平衡,英国拟制定一部专门的《代孕法》。     

INTRODUCTION: RETHINKING PHILOSOPHICAL PRESUMPTIONS IN LIGHT OF COGNITIVE DISABILITY

Abstract: This Introduction to the collection of essays surveys the philosophical literature to date with respect to five central questions: justice, care, agency, metaphilosophical issues regarding the language and representation of cognitive disability, and personhood. These themes are discussed in relation to three specific conditions: intellectual and developmental disabilities, Alzheimer's disease, and autism, though the issues raised are relevant to a broad range of cognitive disabilities. The Introduction offers a brief historical overview of the treatment cognitive disability has received from philosophers, and explains the specific challenges that cognitive disability poses to philosophy. In briefly summarizing the essays in the collection, it highlights the distinctive contributions the collection makes to ethics, political philosophy, bioethics, and the philosophy of disability. We hope that the richness of the topics explored by these essays will be a spur to further investigation.     

EQUALITY, FREEDOM, AND/OR JUSTICE FOR ALL: A RESPONSE TO MARTHA NUSSBAUM

Abstract: This essay is a reply to Martha Nussbaum's "Capabilities and Disabilities." It endorses Nussbaum's critique of the social-contract tradition and proposes that it might be productively contrasted with Michael Walzer's critique of John Rawls in Spheres of Justice . It notes that Nussbaum's emphasis on surrogacy and guardianship with regard to people with severe and profound cognitive disabilities poses a challenge to disability studies, insofar as the field tends to emphasize the self-representation of people with disabilities and to concentrate primarily on the aesthetic and political representation of physical disability. The essay concludes with an account of a recent exchange with Peter Singer on the question of our social expectations of people with Down syndrome.     

Surrogacy and the Construction of the Maternal-Foetal Relationship: The Feminist Dilemma Examined

The feminist movement remains fundamentally divided over the issue of surrogacy. Within the confines of this article it is argued that the inadequacy of positions on both sides of the debate rests upon their common tendency to deal with the ethical consequences of surrogacy for isolated agents, without sufficient concern for the broader social implications for all pregnant women in society. In order to clarify the issues involved, feminist theorists must consider the implications of surrogacy in a broader social spectrum. Such an analysis will illustrate that the two-person dichotomous model of the maternal-foetal relationship proposed by the surrogacy arrangement has hugely prejudicial effects on the treatment received by non-contract mothers when they interact with agents of certain social institutions whose prior contact with surrogate mothers has made them more susceptible to conceiving the maternal-foetal relationship as fundamentally disconnected. In a climate of increased medical surveillance and intervention in the non-clinical context of pregnancy, the dangers of adopting this dichotomous model are palpable. Given the oppressive physical and psychological effect that this would have upon the liberty of the majority of pregnant women in society, this article argues that the feminist movement must abandon any promotion of the abstracted model of the mother-foetus relationship that is implicit in its arguments in favour of surrogacy.