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Ethical Issues Paper
Brooke Thompson
on campus
Submitted in partial fulfillment of the requirements in the course
N330: Nursing Care of the Childbearing Family
Old Dominion University
NORFOLK, VIRGINIA
Spring, 2012
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The Ethical Issue of Surrogate Motherhood
Surrogacy can be defined as an arrangement established where one woman bears
a child for another woman, with the intent of surrendering that child at birth. The Center
For Disease Control states that 10% of women (6.1 million) cannot either get pregnant or
sustain a viable pregnancy and therefore turn to artificial measures to start a family
(CDC, 2012). Because of the limited forms of regulation controlling the process, some
1400 births are estimated to occur in the United States using surrogate mothers (CDC,
2012). This paper will discuss the opposing positions surrounding the ethical debate of
surrogate motherhood.
Pro's of The Issue
Having a child, some would say, fulfills a desire in most women that they begin to
imagine from childhood. The realization of this desire may come to be a challenge to
many women, and therefore, countless years of research has been conducted to help make
this dream come true. Surrogacy gives a childless couple a chance at starting a family
that many claim to be a basic human right. There are many reasons that prevent couples
from having a child ranging from a disease that makes the woman unable to carry a baby,
or infertility problems that prevent reproduction. In either scenario, forms of surrogate
motherhood offer solutions to help the couple. Couples have a process by which they
may start a family using this type of assistive reproduction.
Two different types of surrogacy are available depending on the situation the
couple faces. Gestational surrogacy is used when the male and female can offer both
sperm and egg to be fertilized then implanted in the host or surrogate mother. This child
will be couple's genetic child. Another type of surrogacy is traditional, or partial, and this
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is a situation where the female cannot offer her own egg due to a health, or disease
process, and the surrogate mother offers her own egg. The male's sperm is used however,
so that the couple has partial genetic connection to the child. Most surrogate mothers
have children of their own, and volunteer to use their bodies for the pure sake of giving
that same gift back to a woman who so yearns for that to add to her life. Many surrogate
mothers experience immense joy in being able to give a child to a childless couple and
may volunteer to complete the process multiple times. Using a surrogate mother can be
viewed as the only safe and cost-effective way to produce a biological offspring to a
couple struggling with infertility issues. Sperm from the man and ova from the woman
can be fertilized in a laboratory setting and placed inside the uterus of the surrogate
mother who serves as the "womb" for the entire pregnancy. Because most surrogate
women must undergo strict physical and emotional testing, couples can feel secure in that
their surrogate pregnancy will go smoothly . Many women volunteer as a way to
supplement their income. It is estimated that a surrogate mother can make up to $40,000
for the process of producing a child. That can be a positive benefit to someone who is
struggling financially.
There are many agencies in place to help couples find surrogate mothers, and help
with the legal contracts to ensure proper placement of the child after it is born. These
agencies will help secure the surrogate, locate proper medical help for the pregnancy, and
secure hospital/birthing centers that welcome these types of situations. It is possible to
locate hospitals that embrace the art of surrogacy and support the pregnant surrogate to
ease the emotional process of labor and delivery. Also important during this phase of the
process, is the nurse's role in encouraging the biological parents involvement in the
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baby's first few days, and so, many hospitals have arranged for hospital rooms to be
secured for the biological parents so they may be close to their child those first
instrumental days (Sharan,Yahav, Peleg, Ben-Rafael, Merlob, 2001).
Con's of the Issue
Some may argue that being a parent is not a human given right. The argument
being that we were designed and created specifically the way we are and maybe some
people were not meant to procreate. While most of this argument can be slanted at a
religious angle, who is to say that science can intervene in what is supposed to be a
natural event in a person's life. When can the medical community help and when are they
crossing the line? Most surrogate processes challenge the normal process of fertilization.
Both biological mother and surrogate mother endure weeks and months of rigorous
testing and sometimes painful preparations that tax their bodies both physically and
emotionally. Testing can sometimes be inaccurate, and there is always a small change
some type of infectious disease, or genetic issue may be passed to the child. Parents must
be informed of the fact that this may be possible and take as many precautions possible.
Many embryo placements aren’t successful and don’t end with a pregnancy and the
process must be multiple times. This can be a huge financial, emotional and physical
burden on both families. In some cases, women begin the process trying to use their own
eggs, only to find they cannot be used. This presents a huge disappointment in the
journey for some women, being that they are forced to use another woman’s egg.
Using a surrogate mother can be very financially draining. The couple must pay
for legal, medical, emotional and some physical daily expenses of the pregnant mother
during pregnancy, and post-delivery. Most health insurance policies do not cover these
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types of arrangements. Many couples endure a huge financial strain using surrogacy. This
financial aspect and the fact that surrogacy can be a commercial type of arrangement
leads to an argument that it’s socially unethical. Unethical being that one is paying for
use of another person's body part. An increasing demand of surrogacy has pushed an
huge wave of use of women in foreign countries instead of local women. By using
women in lower economic countries for a cheaper rate, couples find that they can save
thousands of dollars. This has been referred to as "renting wombs". For example, many
women in impoverished villages in India are hired by foreigners to be a surrogates for
their babies. These women are paid about five to seven thousand dollars which equals
about ten year’s salary for them (Cohen, 2009). Many women volunteer because of their
poverty levels and not being able to take care of their own children. Many thoughts exist
about this "renting of wombs" in the media today because there aren’t concrete ways to
manage and restrict the process. Few countries have legal measures to enforce the safety
of the surrogacy process. Also, many commercial arrangements with foreigners cannot
hold up in the judicial systems in many of these countries. This is a huge area of concern
for the future of surrogacy.
Another strong opposition to the surrogacy issue, is the emotional roller-coaster is
may enact on both biological parents, and surrogate. The ten months the surrogate mother
grows this child in her belly, gives her time to attach her emotionally, and many problems
have arisen from that. She encounters a desire to keep the child, and multiple legal battles
have arisen because of the mothers' not wanting to continue the contract, either before the
baby is born or at birth. Many states have passed legislation that prevents the commercial
contract of surrogacy, and so many custody battles have caused great anguish with
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parents trying to gain back their child they so longed for. Because of the partial
surrogacy arrangement, the surrogate mother has a genetic link to the child, and the court
system has a very difficult time deciphering which way to lean as far as who is the legal
parent/s of the child.
Conclusion
It's apparent that the debate of surrogacy has many points to consider on both
sides of the argument. Because of the numbers of couples that face the problem of
fertility and reproduction, there is always going to be a need to some type of assisted
reproduction. Whether it lies with the process of surrogacy, we cannot decipher. Until
then, it will still be used and appreciated all the while frowned upon, and fought over in
the court systems.
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References
Bhatia, K., Martindale, E., Rustamov, O., Nysembaum. (2009). Review Surrogate
Pregnancy: an essential guide for clinicians. The Obstetrician and Gynecologist,
11, 49-54. doi: 10.1576/toag.11.1.49.27468.
Centers for Disease Control and Prevention. (2012). Reproductive Health. Retrieved
February 12, 2010 from http://www.cdc.gov/reproductivehealth/Infertility/
Cohen, Margot. (2009, October 9). A search for a surrogate leads to India. The Wall
Street Journal, p.W8.
Sharan, H., Yahav, J., Peleg, D.,Ben-Rafael, Z., Merlob, P. (2001). Hospitalization for
early bonding of the genetic mother after a surrogate pregnancy: Report of two
cases. Birth, 28, 270-273.
"I have neither given nor received unauthorized aid on this (exam, test, quiz, etc.)
nor do I have reason to believe that anyone else has."
Signature:
--
Brooke Thompson Date: 2-16-2012