Surrogacy, From a Bioethics Perspective

This week's cover story about a gay couple who had twins through surrogacy in Panama raises ethical questions inherent to the surrogacy process. Though the couple in the New Times feature took every precaution imaginable to ensure that agreements with their egg donor and surrogate were ethically and legally sound, questions still abound in the realm of bioethics:

Is there a fair price for childbearing? Is it exploitative? Is there a proper way to negotiate the genetic, emotional, and hormonal bonds intertwined in surrogacy?

These loaded questions are emerging as childbirth through surrogacy gains momentum on an international level at a time when laws, even in the United States, are inconsistent and incomplete. To further explore the issue, New Times spoke with Dr. Kenneth Goodman, bioethics program director at the University of Miami, who brought up a lot of interesting tensions -- none with easy resolutions.

"You could argue that [some surrogacy cases] are collateral damage of an

unethical policy that discriminates against homosexuals," Goodman says, referring to Florida's adoption laws. Florida was the only state in America to uphold a ban on gay adoption until it was overturned last September. This had forced gay couples to think about other means of starting a family. "Florida's utterly preposterous ethical stance on gay adoption is itself

morally indefensible. It's when you don't let gay people marry and then you invoke this rule. It seems like a whole lot of government intrusion.

"The human urge to make babies runs pretty deep," Goodman says, acknowledging that there are two sides to the ethical conversation surrounding surrogacy. "It sounds ethically creepy to pay someone who's poor to do something you're unwilling or unable to do," he adds, presenting one side of the story. Then, he says, many surrogates may argue, "I'm going into this eyes wide open, and that I want the money does not make me incompetent to make judgments... Stop patronizing poor women.

"Here we have the shape of a really interesting tension," Goodman continues, "At what point are protections overbearing?" He adds that strict agreements among everyone involved in the process are crucial. "You have to have all your bolts in really tight... to prevent future disputes," he says, emphasizing the necessity of "some process that makes it clear that the surrogate is not being exploited or used inappropriately... [but] some people could argue this is too intimate to legislate."

A fair price for a woman to give birth to another person's child is a murky notion. "One of the general objections to [surrogacy] is it comodifies intimate personal functions... the commodification of childbearing," Goodman says. "The [ethical] line is going to depend on what we know about the woman who's the surrogate, how she's being paid, what the agreement is."

This 2008 Newsweek article provides an interesting glimpse into the motivations and emotions of the surrogates themselves.