The Problems With Surrogacy

¶ … yes, I do see a parallel between being paid to be a surrogate and the prohibition against being paid to donate one's organs. The prohibition is clearly designed at least in part to prevent people who are financially desperate being exploited by wealthier individuals. We cannot have a caste system in our nation where the bodies of the poor can be bought by the wealthy. Yet surrogacy does that very same thing, in effect paying less financially well-off women to carry the babies of wealthier women. A not atypical scenario for a surrogacy is a poorer young women being paid by an older, more educated dual income couple that has postponed childbirth so they have time to develop their careers. In almost all instances, the couple is more educated and financially well-off than the surrogate, effectively create a power relationship that is highly asymmetrical.

Pregnancy, like organ donation, is not without considerable financial and psychological risks. Someone who donates a kidney may have his or her one remaining kidney fail. A woman who is a surrogate might experience complications during her pregnancy that could pose serious risk to her health on a permanent basis. Even being placed on bed rest is an economic and psychological risk as the woman will not be able to earn income at this time. The law against paid organ donation is designed to protect the poor against such temptations.

Secondly, there are psychological risks. Even if a woman is convinced she will have no emotional attachment to the child she carries, that will not necessarily be the case. Surrogacy cannot be ethical: unpaid surrogacy forces a woman to risk her body with no compensation for her medical, financial, and psychological suffering while paid surrogacy effectively attempts to put a price upon this medical, financial, and psychological risk even though the damage may be long-lasting.

Q2. Yes, paying the surrogate does harm her dignity because it effectively puts a price upon her body and her reproductive capacity. On the other hand, not paying the surrogate does not compensate her for the time she must take off of work, the physical stresses of pregnancy, medical costs, and other hazards. The woman needs additional food, clothing, and possibly medical attention and counseling that she would not need otherwise. However, just paying her for these expenses clearly is not enough since pregnancy poses risks, including the risk of death, as well as weight gain, changes in hormone levels, and other hazards (including the opportunity cost of time that the woman must sacrifice, when she could be engaged in other pursuits) that must be compensated for by the parents.