Jeffrey Taylor-Kantz

9-29-2018
HONORS 220 C
Medical Ethics
Paper 1
Balancing the rights of a parent and the rights of their child both before and after birth

has always been extremely ethically complicated. Adding a surrogate mother into the equation

makes it exponentially more so. If we are to allow the commercialization of surrogacy, then we

must treat that pregnancy as a form of labor and protect the surrogate from exploitation with the

appropriate legal rights.

Pregnancy is an extremely dangerous and difficult endeavor. According to the CDC’s

Pregnancy Mortality Surveillance System, there are 18 deaths per 100,000 live births as of 2014.1

That is a higher occupational mortality rate that mining, quarrying and oil and natural gas

extraction, which had a mortality rate of 10.1 fatal injuries per 100,000 workers as of 2016.2 If

we consider a surrogate a laborer, then this high level of risk, not to mention the non-life-

threatening physiological trauma caused by pregnancy, must entitle a surrogate to an extremely

high wage, if only as a form of hazard pay. Such high risk necessitates the need to consider what

should be done if the surrogate’s life is put in immediate danger. In situations where doctors

must choose whether to save the life of the child or the life of the mother, that decision is already

extremely difficult. Sometimes a mother is willing to die for the life of her child, and sometimes

the decision is based on who is more likely to live. But a commercial surrogate would not be

considered a mother, she is a laborer. They are providing a service and product for pay, and no

one should be expected to die for their job. Therefore, a surrogate’s life must always take

precedence in such situations, no matter what. This devalues the child as a product rather than a

person.

Furthermore, what should be done if the pregnancy fails, such as when it results in a

miscarriage or stillbirth? Is a surrogate still entitled to full compensation? After all, they did all
Jeffrey Taylor-Kantz
9-29-2018
HONORS 220 C
Medical Ethics
Paper 1
the labor asked of them, and risked their lives for an inherently uncertain outcome. According to

the CDC, 1 in 100 pregnancies result in stillbirth.3 However, the surrogate did not deliver the

promised product, and thus it could be argued they are not entitled to their wages.

And herein I believe this argument goes down a dangerous rabbit hole. In light of the

previously discussed considerations, I argue that commercializing surrogacy is inherently

unethical. Commercializing surrogacy reduces pregnant women to an expendable labor force and

reduces infants to inanimate products to be bought and sold. This would be comparable to

allowing people to pay for the ability to adopt. The buying and selling of human beings is

unequivocally considered unethical in the United States and by the United Nations. The fact that

this line of thinking naturally leads to considering infants to be products, elucidates the fact that

commercialization is the wrong framework for surrogacy to exist in.

A much more appropriate framework for surrogacy would be that of organ donation.

Instead of being payed by someone to have a child for them, a surrogate would rather be

donating their functional reproductive system. Because of the National Organ Transplant Act, it

is illegal in the United States to pay someone for an organ donation.4 In organ donation, this

reduces the incentive for illegal organ harvesting for profit. In terms of surrogacy, this would

make it more difficult for people to economically coerce poor and vulnerable women to be

surrogates. Though this solution would nullify many of the most pressing concerns about

surrogacy, there are still very complex scenarios to consider. Some surrogates agree to have a

child for someone else, but after going through the entire pregnancy process and actually give

birth, they realize they have grown attached to the child and do not want to give them up. In this

situation, defining the actual mother of the child is a very murky situation. One the one hand, the
Jeffrey Taylor-Kantz
9-29-2018
HONORS 220 C
Medical Ethics
Paper 1
surrogate agreed to donate their reproductive system for the benefit of another hopeful mother.

But on the other hand, the surrogate has been caring and supporting the fetus and later the child

throughout the entire process, which puts them in a more clearly defined motherly role than the

intended recipient. No solution to this scenario is perfect, but one possible answer is to force the

surrogate to respect the agreement and release custody of the child to the recipient but give the

surrogate legal visitation rights to the child.

Surrogacy should be a valid option for women who are biologically unable to have a

child, but many steps must be taken to ensure that surrogates are not exploited.

Commercialization of surrogacy is inherently exploitative of both surrogates and infants, and is

therefore not an ethical framework for surrogacy policy.

References

1. Pregnancy Mortality Surveillance System. (2018, August 07). Retrieved from

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-

surveillance-system.htm

2. United States, Federal Bureau of Labor Statistics, Department of Labor. (n.d.). Census of

Fatal Occupational Injuries Charts, 2016. Retrieved from

https://www.bls.gov/iif/oshcfoi1.htm#2016

3. Facts about Stillbirth. (2017, October 02). Retrieved from

https://www.cdc.gov/ncbddd/stillbirth/facts.html

4. 98th Cong., U.S. G.P.O. (1984) (enacted).