Creating Humans: Ethical Questions, Parts 6 & 7

~Lectures 6 and 7 of the course discuss the ethical and legal issues surrounding abortion and surrogacy, respectively.  I've already covered most of the thorny issues surrounding the ethics and legality of abortion, and it's a depressing topic to revisit, so I'll be brief.  The lecture reiterates that the "debate" between moralistic crusaders consists of two utterly irreconcilable positions, while the actual laws in most countries are an elaborate series of legal compromises.  The lecture did, however, note that the rate of abortion in nations with few restrictions vs those nations with tight or full restrictions are actually not that different.  To the moralist, this fact is irrelevant: the principle of the position often outweighs the actual effects of enacting such a principle on either side of the debate.

I see the ossified abortion debate as a form of smoke and mirrors, masking more challenging, less clear-cut moral issues.  Instead, marching in pro-life & pro-choice rallies and so forth is an easy way for protesters to feel better about themselves on what they see as a clear moral issue.  After all, if the abortion question was "solved" to the satisfaction of one side or the other, those same marchers might have to put just as much effort into other moral issues such as poverty, corruption, and social justice -- things that most people just don't want to think about or deal with.

The importance of these other issues is masked or otherwise ignored by the imperative that because abortion is the murder! of helpless children! or a violation! of a woman's rights! over her body!, the issue renders all other moral issues utterly irrelevant by comparison.  In other words, many people seem to feel that because abortion is so important, all other issues must remain on the back-burner until abortion is legally "solved" (not going to happen...).  I find this to be a dangerous and manipulative way of looking at the many ethical challenges humans face today

Moving on, surrogacy is a fascinating area of medical ethics and laws, and contains many possible and actual problems that society and the law are forced to confront.  The origin of surrogacy -- having a woman bear a child for another couple -- stretches back thousands of years.  For example, the book of Genesis in the bible tells the story of Sarah, wife of Abraham, who was unable to conceive a child.  To "solve" this problem, she gave her maid, Hagar, to Abraham, so the maid could have his child, which would be raised by Sarah.  Obviously, Hagar and Abraham used a controversial (to say the least) standard method of surrogate insemination, but surrogacy in the modern sense usually refers to the use of in-vitro fertilization, allowing a woman to bear a child for another couple, while not herself being genetically related to the child.

Even with technology removing the sexual aspects of surrogacy, the practice is still controversial.  Some feel that surrogacy is a commercialization of reproduction, which, being such an intensely personal and private act, should not involve a third party.  We saw this same argument earlier in the course, during the discussions of genetic donors.  But surrogacy is a far more obvious, in-your-face commercialization: a couple pays a woman (almost always a less-well-off woman) to bear a child for them.

The question here is: does surrogacy result in children becoming a commodity?  Is it ever acceptable to pay money for a child?  Of course, a proponent of surrogacy would argue that the payment is not for the child, but for the services of the mother, much in the same way that an adoption fee is not tantamount to buying a child (such as buying a slave might have been).  Our modern legal system clearly distinguishes between parental rights and ownership rights; parents have near-total control over their children, but do not own them and cannot sell them.  What do you think?  Is it acceptable to exchange childbearing services (in a crude sense, to rent a womb) for money?

This involvement of money for services can create the perception that surrogacy is exploitative, because in almost every case it involves a couple paying a less-economically-advantaged (i.e. poor) single mother to bear their child.  Some would say that this is market economics at work, but is it really alright to allow it for reproductive purposes?  What do you think?

Another argument against surrogacy is that even though the child is not genetically the offspring of the surrogate mother, parenthood is so strongly ingrained into us that many find it disturbing that a mother would ever give up a child she bore in exchange for cash.  This becomes an even more difficult issue when you consider the question of whether or not a surrogate mother has any legal rights or legal relationship to the child she bears.  Consider the example of a surrogate mother who agrees (and signs a legally binding contract) to bear a child for a couple, but upon having the child, finds herself so attached that she no longer wants to give it up.

While the contract may be binding and enforced by the law, many people would find it very difficult to literally pull a child out of its mother's arms and hand it off to another person.  Whose moral rights are stronger, the genetic donors', or the surrogate mothers'?  What do you think should happen in this scenario?  Does the law trump all emotional considerations, or should there be exemptions?

Surrogacy laws by state in 2007.  It's not easy to read, but note that the white states have no regulations covering surrogacy.  See this page for details by state.

The lecture brought up the fascinating (and again, disturbing) example of the Beasley-Wheeler dispute.  In this case, a British legal secretary named Helen Beasley agreed to be a surrogate mother for the Wheelers, a couple living in California, in exchange for $19,000.  Embryonic implantation went normally until the seventh week of Beasley's pregnancy, when she discovered that the embryo had divided into twins.  The Wheelers requested that she abort one of the fetuses (!), as the contract they'd made with Beasley stipulated that she bear one child for them; the Wheelers didn't want two.  Beasley sued them in court in 2001 to terminate the Wheeler's parental rights and collect the unpaid fee; she found another family to pick up the contract and adopt the twins.

While I haven't been able to find the outcome of this case (perhaps it hasn't been resolved, as the wheels of justice can grind more slowly than those of Amtrak), it shows how complex surrogacy can be.  I imagine that most people, upon reading the above paragraph, would be horrified at the behavior of the Wheelers and consider them bad people for not agreeing to take both children.  Whether or not you agree with this assessment, it shows the weakness of the law in this area.  In many states and nations, there are few or no laws explicitly regulating surrogacy to prevent these sorts of practices.  Do you think there should be?  Or would that be an unacceptable government interference in the market for surrogates?

Finally, we must consider the legal rights of children born to surrogate mothers.  Does a child have the right to know that they were carried by a surrogate?  Most of us would agree that an adopted child has the right to know that he or she was adopted, and to know the identity of his or her biological parents.  Is surrogacy different? How so?

Modern IVF-assisted surrogacy, like many of the other reproductive technologies in this course, are still in their infancy and the law has, in many cases, not caught up with the available technologies.  For example, the above chart shows that the legislatures of many U.S. states haven't taken up the issue of surrogacy or are unwilling to do so.  The Beasley-Wheeler dispute (which was between a British woman and an American couple) also shows us yet again that laws regulating reproductive practices can only have a real effect if they are international conventions; otherwise, bans on practices such as abortion, surrogacy, genetic enhancement, and so forth can be easily flouted by those with the means to travel to places where such practices are allowed.

I hope this lecture analysis has made you think about the legal and ethical dimensions of some highly controversial subjects.  My next lecture analysis will be on the fascinating issue of pre-natal screening, so look forward to it!