Commentary: Ethical issues in surrogate motherhood

Abstract

T he ACOG Committee on Ethics issued a thoughtful opinion on surrogacy (Number 88, November 1990). I find myself in agreement with virtually all points in the opinion, with the exception of the committee's endorsement of commercial surrogacy. Commercial surrogacy arrangements, whether they involve payment to a broker in addition to the surrogate, or to the surrogate alone, are ethically unacceptable and ought to be prohibited by law. Some critics of surrogacy contend that the practice itself constitutes exploitation of women. makes it appear as if surrogacy is unethical because it is an instance of a more general moral wrong. According to one feminist who opposes surrogacy, a woman provides womb service, the feminist issue surfaces. Women object to being baby factories or sex objects because it offends their human dignity . . . . ,,1 And further: This is going to end up as the final exploitation of women. It is always going to be poor women who have the babies and rich women who get them. These statements confuse two distinct issues: first, the alleged exploitation of individual women; and second, a potential for class exploitation, because poorer women will be the ones serving as surrogates for the more well-to-do. These would be sound objections to surrogacy if it were clearly a form of exploitation. When feminists charge that surrogacy itself exploits women, they are being paternalistic. They are questioning women's ability to know their own interests and to enter an agreement knowingly and competently. It is likely that commercial surrogacy does have a coercive aspect, because moneyespecially a large enough sum--can serve as a coercive inducement to do something a person might not otherwise do voluntarily. But that speaks more to the exploitation of poorer classes of women, which is a genuine moral worry, than it does to the exploitation of women in general. Feminists who oppose surrogacy presume to speak for all women. But what they are really saying is that those who elect to enter surrogacy arrangements lack the capacity to choose, and stand in need of protection. It is difficult to identify the precise features of surrogacy that could justify calling it exploitation. Evidence suggests that women who have served as surrogates are not the poorest of the poor. For the most part, their personal or family income levels fall in the range of lower-middle-class, rather than © 1991 by The Jacobs Institute of Women's Health 1049-3867/91/$3.50