Abstract:
This research aimed at determining the ethical issues that surround surrogacy. Surrogacy being an issue that has elicited much debate is gaining traction because of the many childless couples out there that either suffer from infertility or are involved in same sex marriages (Gunputh & Choong, 2015) It both has the positive and negative which have been explored in this research. The research involved going through already existing information provided in accredited books, journals and websites. The research first explores the information that surrounds the positive side of surrogacy before delving into the negative side of the issue. Further reviews of these sources revealed that there are a myriad of ethical issues surrounding surrogacy. These include legal and technological concerns, dehumanization and emptiness of the surrogate mothers, religious as well as health and emotional wellbeing of the surrogate mothers. Those that are often affected mostly by surrogacy are the surrogate or gestational mothers who bear all the risks associated with the process. In conclusion although many attribute this as a success in providing hope for those that cannot bear children, the negative effects of surrogacy far outweigh the advantages it brings.
Gunputh & Choong, (2015) argue that commercial surrogacy has been on the increase globally. This is mainly because of gestational surrogacy where in vitro fertilization is used in order to ensure that the surrogate mother does not have any genetic ties to the resulting offspring. The article further states that in this form of surrogacy the surrogate mothers receive monetary compensation in order to server as a gestational surrogate (Gunputh & Choong, 2015). It is important to note that while a desire may exist for many couples to have children, the ability of having children is not guaranteed. This is attributable to infertility, single individuals with a desire for children, or same sex couples. Brezina & Zhao (2012), write that assisted reproductive technology (ART) has provided hope to many couples who have fertility issues. In turn, this has led to numerous ethical and legal challenges (Brezina & Zhao, 2012).
A survey conducted by the Center for Disease Control (CDC) in a National Survey of Family Growth between 2006 to 2010 in the United States, indicated that 1 out of every 8 couples (12% of married women) have difficulty in getting pregnant or sustaining pregnancy. The problems surrounding infertility are many and in many cases result in physical, emotional and financial stress among couples. There are many options available in seeking help from infertility with many seeking after medical intervention through drug therapy or surgical procedures. Many have also opted for advanced reproductive technologies that include procedures such as vitro fertilization (IVF) (Brezina & Zhao, 2012).
Gunputh & Choong, (2015) point out that in vitro fertilization is a process, which involves the use of a surrogate mother who is used to carry and deliver a child for an infertile woman or couple. This method has gained familiarity among many infertile couples and has been possible with through advancements in the medical field. It is an option that is highly being explored by many infertile women and couples, but while it may seem convenient, this option can expose an array of ethical issues (Dougherty, 1992).
Positive Attributes of Surrogacy
Besides the many concerns surrounding surrogacy that have been raised, it is an important fact to understand that the reality is, infertility is something that a couple may not have much control over. It is also important to underline that with the advent activism throughout the world on issues to do with same sex marriages, surrogacy is one option that may provide an avenue for such like couples to have children of their own (Brezina & Zhao, 2012). Many researches have ignored the fact that some of the surrogates actually are happy about helping childless families have the hope of having children.
Research by Jadva, Murray, Lycett, MacCallum, & Golombok (2003) indicates that some surrogate mothers feel a sense of self-worth when they help others with fertility issues have families. In a society that views a complete family as being one where the couples have children, societal pressure pushes the childless couples to seeking alternatives of having children of their own. As this might be the case the nature of the family unit in the society has been changing over the decades. Brezina & Zhao (2012) point out that the use of assisted reproductive technology had been at the forefront of challenging the way society views a biological offspring.
The choice of use of having a family through surrogacy is one of the moves away from the traditional life scripts and empirical researches show that unlike many beliefs these kind of families do very well. One such study by Jadva et al (2003) assessed thirty-four women that had given birth to a surrogate child found out that surrogacy had been generally a positive experience for the surrogate mothers interviewed. The study indicates that unlike many of the negative widespread concerns spread through the media, an issue like relinquishing the child after birth was not difficult because the mothers knew that the child they were carrying was not theirs by (Jadva et al, 2003). The relationships between the commissioning couple and the surrogate mother showed that there was a good relationship even after the child was born as many maintained contact after (Jadva et al, 2003)
Finally, contrary to much of the research conducted, the fear of the possibility of adverse psychological effects was not a problem as the perceived problems in few cases were not severe while many tended to be short-lived and faded away with time. It is therefore safe to express the fact that surrogacy can be a positive experience either for the commissioning couple or the surrogate mother (Jadva et al, 2003)
Ethical Issues Surrounding Surrogacy
Much of the attention surrounding surrogacy has been on the multiple negative issues that may arise because of the same. Further, much of the research that has been conducted has been on the potential negative effects of surrogacy as many of the studies have conclude that the negatives outweigh the positives. Klein (2015) argues that even with the regulation of the surrogacy sector it still brings harm to the exploited women and children. While most of the first-world countries can attribute much of the successes in natal care to the advent improvement of medical technologies, there still loom significant risks that much of the population may not wholly comprehend (Klein, 2015). Such risks include increased risk to pre-eclampsia and blood pressure related problems to the surrogate mother. For many women across the globe who are at a reproductive age, childbirth is one of the highest cause of mortality rates among these women. Klein (2015) also points out that much of the debate surrounding surrogacy has also been focused on the exploitation of poor women who come from poor rural backgrounds and whom have low literacy levels. Many of the women that are lured into being surrogate mothers are attracted by the perceived easy way of earning money unaware of the serious negative drawbacks that may arise thereof (Klein, 2015).
Legal and Technological Concerns Surrounding Surrogacy
There are complex issues that surround the issue of surrogacy and of these are to do with the legal and technological side of it. In many parts of the world, there is lack of proper legislation and regulation concerning surrogacy. In addition, in countries where laws exist are often very weak. As a result, surrogacy has been declared illegal in many parts of the world because it is deemed quite complex and much debate on the ethical grounds often defeating any legislation to support it (Gunputh & Choong, 2015). However, commercial surrogacy is still a reality in many parts of the world and often prior to initializing the process of surrogacy there are rights that need understanding by both parties (Gunputh & Choong, 2015).
Citing Gunputh & Choong (2015), the surrogate and the commissioning couple often need to read and understand the rights contained in a contract before either of them can sign. However, in a study conducted by Saxeena, Mishra, & Malik (2012) on issues surrounding ethical and legal aspects of surrogacy in India, it was the conclusion that because the process is highly profitable there are many intermediaries and commercial agencies involves. Most the intermediaries are keen on earning a share of the profits who exploit both parties. The study also point out to the issues that come with cross border legality issues which give rise to issues to do with citizenship, nationality, motherhood, parentage, and the rights of the child (Saxeena, Mishra, & Malik, 2012).
According to Dougherty (1992), the greed for the monies involved has created a global industry for its commercialization in what may be referred to as surrogate tourism. The lack of proper legislation and transparency in the legal system gives a glimpse into the foreseeable legal problems and unpredictable regulations that arise due to surrogacy (Gunputh & Choong, 2015). Technologically the development of new approaches to Assisted Reproductive Technologies (ART) are only set to make both the ethical and legal issues surrounding surrogacy worse as it does not concern itself with answering some pertinent questions. The technological aspect of it has changed how society perceives human life and other values and norms associated with it making it more disastrous (Brezina, & Zhao, 2012).
Dehumanization and Emptiness
Borrowing from an earlier study by Jadva et al (2003) that involved the experiences of thirty-four women who had experienced surrogacy, while many of them pointed out to easily relinquishing the ties with the child because they knew the child was not theirs, many surrogates do not agree with that conclusion. The gestational mother endures a taxing job to physically carry through the pregnancy until the child is born and in the end has to let go of the child both physically and emotionally. It is highly probable that during the period of pregnancy the surrogate mother develops an attachment to the baby, which was not a foreseeable eventuality while agreeing to be a surrogate (Gunputh & Choong, 2015).
Further, while surrogacy is viewed as another way of forming a family, one study suggests that the reality of surrogacy is that it creates one parent-child relationship while destroying another child-parent relationship. The author further claims that the term surrogate mother is designed to purposely dehumanize the mother and eventually alienate her form her child (Klein, 2015). The feeling of emptiness cannot be ignored because in the end as the author puts it, surrogacy is founded on commodifying of children, where they are forcibly separated from their natural mothers and transferring them to perhaps uncertain family relationships (Gostin, 1990). The surrogate mothers are in effect left with nothing to hold on their hands after a long enduring struggle with pregnancy.
Religion, Health and Emotional Wellbeing
Apart from the legal and vies on dehumanization of the surrogate mother, they also have to bear the risk associated with health and emotional wellbeing. It has already been painted as dangerous because it often involves taking of drugs that would prepare the surrogate mother for pregnancy. Drugs have side effects and for most of these drugs they may have long time effects on the victim. Furtthermore, there are numerous tests and proceedures carried out on the surrogate mother that pose risks to her health (Klein, 2015). There is also the risk of pregnancy complications that may give rise to different medical conditions, whereby the risks are very high for those women who get pregnant with eggs from another woman. The worst is when these surrogates are forced to either consent to an abortion, selective reduction or fetal surgery in the womb in cases where the commissioning couple deems the child as being flawed (Klein, 2015).
The surrogates are prone to health risks which even if it was their choice to do it, they cannot predict the resultant health risk caused by the drugs, the pregnancy and eventually birthing itself. Religious believes have also been a part of the debate because many religious people point to the sovereignty of God as being the sole controller of life, and surrogacy in any sense cannot be deemed to be as God-honoring. Science and religion are often pitted against each other and while science is free to research on how to provide life, religion is against it (Eckman, 2014).
Conclusion
In conclusion, despite the fact that it is considered as a hope for the childless, surrogacy has its fair share of objections and issues. By comparing the positive and negative sides of the issue, the negative issues associated with it seem to bear more weight. This was also the conclusion by eight scholars at a conference held at Creighton University, who gave reasons against surrogacy. Certainly ethical issues were raised but the most significant of all is the negative effects on the surrogate mothers themselves, whether motivated by money or otherwise, the risks are enormous and certainly they cannot escape the ethical issues as discussed (Dougherty, 1992).
References
Brezina, P., & Zhao, Y. (2012). The ethical, legal, and social issues impacted by modern assisted reproductive technologies. Obstetrics and Gynecology International. Retrieved from http://www.hindawi.com/journals/ogi/2012/686253/
Dougherty, C. (1992). What's wrong with surrogacy? Center for Health Policy and Ethics, 3(2). Retrieved from http://moses.creighton.edu/csrs/news/S92-1.html
Eckman, J. (2014). Ethical issues: Gestational surrogacy. Retrieved from https://graceuniversity.edu/iip/2014/11/ethical-issues-gestational-surrogacy
Gostin, L. (1990). Fairy tales surrogate mothers tell. In Surrogate motherhood: Politics and privacy. Indiana University Press.
Gunputh, R., & Choong, K. (2015). Surrogacy tourism: The ethical and legal challenges. International Journal of Tourism Science, 15(1-2), 16-21. Retrieved from http://www.tandfonline.com/doi/pdf/10.1080/15980634.2015.1119388
Jadva, V., Murray, C., Lycett, E., MacCallum, F., & Golombok, S. (2003). Surrogacy: The experiences of surrogate mothers. Oxford Journals,8(10), 2196-2204. Retrieved from http://humrep.oxfordjournals.org/content/18/10/2196.full
Klein, R. (2015). Can surrogacy be ethical? Retrieved from http://www.abc.net.au/religion/articles/2015/05/18/4237872.htm
Saxeena, P., Mishra, A., & Malik, S. (2012). Surrogacy: Ethical and legal issues.Indian of Journal of Community Medicine, 37(4), 211-213. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531011/
