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The harm argument against surrogacy revisited: two versions not to forget

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Abstract

It has been a common claim that surrogacy is morally problematic since it involves harm to the child or the surrogate—the harm argument. Due to a growing body of empirical research, the harm argument has seen a decrease in popularity, as there seems to be little evidence of harmful consequences of surrogacy. In this article, two revised versions of the harm argument are developed. It is argued that the two suggested versions of the harm argument survive the current criticism against the standard harm argument. The first version argues that the child is harmed by being separated from the gestational mother. The second version directs attention to the fact that surrogacy involves great incentives to keep the gestational mother’s level of maternal-fetal attachment low, which tend to increase the risk of harm to the child. While neither of the two arguments is conclusive regarding the moral status of surrogacy, both constitute important considerations that are often ignored.

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Notes

  1. For instance, see Medical Tourism Corporation (online) and Shetty (2012). The prices seem to have undergone a sharp increase. Compare with the prices cited in Lee (2009, p. 278) and Humbyrd (2009, p. 111).

  2. For instance, see Rimm (2008–2009, p. 1444), Shetty (2012) and Growing Generations (online). Again, the sharp increase in prices is an indication of the booming market for surrogacy. For examples of price levels just a few years ago, see Drabiak et al. (2007).

  3. Hence arguments referring to societal or systemic harms are excluded from the harm argument as characterized above. For examples of such arguments, see Anderson (1990, 1993, 2000), Satz (2010), Wertheimer (1992, 1996), Wilkinson (2003).

  4. That said, Jackson’s argument is hardly reassuring, since, first, the law is an imperfect moral guide and, second, parents are normally “best” able to make decisions regarding their children’s wellbeing in some areas in life, not generally—not, for instance, when it comes to education, medical needs, and so on. As Jackson herself points out, thorough research on this subject is lacking, and it is precisely this that entails that we do not yet know if this is one of the areas to which parental expertise extend.

  5. However, recent developments in epigenetics show that the fetus is highly receptive to genetic “reprogramming”, meaning that the gestational mother can actually influence the genetic setup of the fetus she is carrying (Nafee et al. 2008). Hence, not even genetics offers a completely stable connection.

  6. MFA is a one-sided emotional connection – an aspiring caregiver relation—on behalf of the gestational mother. The connection described above has the nature of a dependence relation, according to which the fetus is dependent on the proximity to the gestational mother for aspects of its development.

  7. The theory describing such attachment is known as Attachment Theory (originally explored by Bowlby 1969); not to be confused with MFA.

  8. For instance, consider an example offered by Shiffrin (1999, pp. 127–128), in which a golden bar is dropped from the sky and hits an (non-wealthy) individual out for a stroll, breaking his arm. While the gold makes him obscenely rich—and thus presumably better off overall—it seems that he has nonetheless suffered a harm; a harm that, I believe, warrants additional compensation.

  9. The fact that the adverse effects of low levels of MFA are culturally dependent—e.g., drinking will be less of a problem in some highly religious cultures—does not invalidate the argument, as the problem of low levels of MFA is a motivational problem rather than one concerned with specific acts.

References

  • Allen, Anita. 1987. Privacy, surrogacy, and the Baby M case. Georgetown Law Journal 76(5): 1759–1792.

    Google Scholar 

  • Anderson, Elizabeth. 1990. Is women’s labor a commodity? Philosophy & Public Affairs 19: 71–92.

    Google Scholar 

  • Anderson, Elizabeth. 1993. Value in ethics and economics. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Anderson, Elizabeth. 2000. Why commercial surrogate motherhood unethically commodifies women and children: Reply to McLachlan and Swales. Health Care Analysis 8: 19–26.

    Article  Google Scholar 

  • Andrews, Lori. 1995. Beyond doctrinal boundaries: A legal framework for surrogate motherhood. Virginia Law Review 81: 2343–2375.

    Article  Google Scholar 

  • Andrews, Lori, and Lisa Douglass. 1991–1992. Alternative reproduction. Southern California Law Review 65(1): 623–682.

    Google Scholar 

  • Appleton, Tim. 2001. Surrogacy. Current Obstetrics & Gynaecology 11(4): 256–257.

    Article  Google Scholar 

  • Baykal, Baris, Cem Korkmaz, Seyit Temel Ceyhan, Umit Goktolga, and Iskender Baser. 2008. Opinions of infertile Turkish women on gamete donation and gestational surrogacy. Fertility and Sterility 89: 817–822.

    Article  Google Scholar 

  • Bowlby, John. 1969. Attachment. New York: Basic Books.

    Google Scholar 

  • Brazier, Margaret, Alasdair Campbell, and Susan Golombok. 1998. Surrogacy. Review for health ministers of current arrangements for payments and regulation: Report of the review team. UK: Stationery Office.

    Google Scholar 

  • Brinig, Margaret Friedlander. 1995. A maternalistic approach to surrogacy: Comment on Richard Epstein’s surrogacy: The case for full contract enforcement. Virginia Law Review 81: 2377–2399.

    Google Scholar 

  • Cassidy, Jude, and Phillip Shaver (eds.). 2010. Handbook of attachment: Theory, research, and clinical applications, 2nd ed. New York: Guilford Press.

    Google Scholar 

  • Ciccarelli, Janice, and Linda Beckman. 2005. Navigating rough waters: An overview of psychological aspects of surrogacy. Journal of Social Issues 61(1): 21–43.

    Article  Google Scholar 

  • Constantinidis, Deborah, and Roger Cook. 2012. Australian perspectives on surrogacy: The influence of cognitions, psychological and demographic characteristics. Human Reproduction 27(4): 1080–1087.

    Article  Google Scholar 

  • DiPietro, Janet. 2010. Psychological and psychophysiological considerations regarding the maternal-fetal relationship. Infant and Child Development 19: 27–38.

    Article  Google Scholar 

  • Drabiak, Katherine, Carole Wegner, Valita Fredland, and Paul Helft. 2007. Ethics, law, and commercial surrogacy: A call for uniformity. Journal of Law, Medicine & Ethics 35: 300–309.

    Article  Google Scholar 

  • Edelmann, Robert. 2004. Surrogacy: The psychological issues. Journal of Reproductive and Infant Psychology 22(2): 123–136.

    Article  Google Scholar 

  • Fischer, Susan, and Irene Gillman. 1991. Surrogate motherhood: Attachment, attitudes and social support. Psychiatry 54(1): 13–20.

    Google Scholar 

  • Goecke, T., F. Voigt, F. Faschingbauer, G. Spangler, M.W. Beckmann, and A. Beetz. 2012. The association of prenatal attachment and perinatal factors with pre- and post-partum depression in first-time mothers. Archives of Gynecology and Obstetrics 286(2): 309–316.

    Article  Google Scholar 

  • Golombok, Susan, Jennifer Readings, Lucy Blake, Polly Casey, Alex Marks, and Vasanti Jadva. 2011. Families created through surrogacy: Mother-child relationships and children’s psychological adjustment at age 7. Development Psychology 47: 1579–1588.

    Article  Google Scholar 

  • Growing Generations. http://www.growinggenerations.com. Accessed 16 July 2013.

  • Gugucheva, Magdalina. 2010. Surrogacy in America. Cambridge, MA: Council for Responsible Genetics.

    Google Scholar 

  • Gupta, Divya. 2011. Inside India’s surrogacy industry. Guardian Weekly, December 6. http://www.guardian.co.uk/world/2011/dec/06/surrogate-mothers-india. Accessed 22 July 2013.

  • Hepper, Peter. 1996. Fetal memory: Does it exist? What does it do? Acta Paediatrica Supplement 416: 16–20.

    Article  Google Scholar 

  • Hofer, Myron. 2006. Psychobiological roots of early attachment. Current Directions in Psychological Science 15(2): 84–88.

    Article  Google Scholar 

  • Hrubý, Radovan, Jozef Hašto, and Peter Minárik. 2011. Attachment in integrative neuroscientific perspective. Activitas Nervosa Superior Rediviva 53(2): 49–58.

    Google Scholar 

  • Humbyrd, Casey. 2009. Fair trade international surrogacy. Developing World Bioethics 9: 111–118.

    Article  Google Scholar 

  • In Re Baby M. 1988. Family Court Review 26: 69–77.

  • Jackson, Emily. 2001. Regulating reproduction: Law, technology and autonomy. Oxford, UK: Hart Publishing.

    Google Scholar 

  • Jadva, Vasanti, and Susan Imrie. 2014. Children of surrogate mothers: Psychological well-being, family relationships and experiences of surrogacy. Human Reproduction 29(1): 90–96.

    Article  Google Scholar 

  • Jadva, Vasanti, Clare Murray, Emma Lycett, Fiona MacCallum, and Susan Golombok. 2003. Surrogacy: The experiences of surrogate mothers. Human Reproduction 18(10): 2196–2204.

    Article  Google Scholar 

  • Kisilevsky, Barbara S., Sylvia M. J. Hains, Christine Ann Brown, Charlotte T. Lee, Bernadine Cowperthwaite, Sherri Schmidt Stutzman, Melissa L. Swansburg, Kang Lee, Xing Xie, Hefeng Huang, HaiHui Ye, Ke Zhang, and Zengping Wang. 2009. Fetal sensitivity to properties of maternal speech and language. Infant Behavior and Development 32(1):59–71.

  • Kovacs, Gavor, Gary Morgan, Carl Wood, Catherine Forbes, and Donna Howlett. 2003. Community attitudes to assisted reproductive technology: A 20-year trend. Medical Journal of Australia 179: 536–538.

    Google Scholar 

  • Krishnan, Vijaya. 1994. Attitudes toward surrogate motherhood in Canada. Health Care for Women International 15(4): 333–357.

    Article  Google Scholar 

  • Lasker, Judith, and Dawn Murray. 2001. Attitudes toward technologies for conception: A 15-year follow up. Journal of Applied Social Psychology 31: 2165–2183.

    Article  Google Scholar 

  • Laxton-Kane, Martha, and Pauline Slade. 2002. The role of maternal prenatal attachment in a woman’s experience of pregnancy and implications for the process of care. Journal of Reproductive and Infant Psychology 20(4): 253–266.

    Article  Google Scholar 

  • Lee, Ruby. 2009. New trends in global outsourcing of commercial surrogacy: A call for regulation. Hastings Women’s Law Journal 20(2): 275–300.

    Google Scholar 

  • Lindgren, Kelly. 2001. Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health 24: 203–217.

    Article  Google Scholar 

  • Mampe, Birgit, Angela Friederici, Anne Christophe, and Kathleen Wermke. 2009. Newborns’ cry melody is shaped by their native language. Current Biology 19: 1994–1997.

    Article  Google Scholar 

  • Medical Tourism Corporation. http://www.medicaltourismco.com/assisted-reproduction-fertility/low-cost-surrogacy-india.php. Accessed 16 July 2013.

  • Mennella, Julie, Coren Jagnow, and Gary Beauchamp. 2001. Prenatal and postnatal flavor learning by human infants. Pediatrics 107(6). http://www.pediatricsdigest.mobi/content/107/6/e88.short. Accessed 22 July 2013.

  • Moriceau, Stephanie, and Regina Sullivan. 2005. Neurobiology of infant attachment. Development Psychobiology 47(3): 230–242.

    Article  Google Scholar 

  • Nafee, Tamer, William Farrell, William Carroll, Anthony Fryer and Khaled Ismail. 2008. Epigenetic control of fetal gene expression. BJOG: An International Journal of Obstetrics & Gynaecology 115(2): 158–168.

    Google Scholar 

  • Parfit, Derek. 1984. Reasons and persons. Oxford, UK: Oxford University Press.

    Google Scholar 

  • Parks, Jennifer. 2010. Care ethics and the global practice of commercial surrogacy. Bioethics 24: 333–340.

    Article  Google Scholar 

  • Rimm, Jennifer. 2008–2009. Booming baby business: Regulating commercial surrogacy in India. University of Pennsylvania Journal of International Law 30: 1429–1462.

  • Satz, Debra. 2010. Why some things should not be for sale: The moral limits of markets. Oxford, UK: Oxford University Press.

    Book  Google Scholar 

  • Schneider, Carl. 1990. Surrogate motherhood from the perspective of family law. Harvard Journal of Law & Public Policy 13(1): 125–131.

    Google Scholar 

  • Scott, Elizabeth. 2009. Surrogacy and the politics of commodification. Law and Contemporary Problems 72: 109–146.

    Google Scholar 

  • Shetty, Priya. 2012. India’s unregulated surrogacy industry. The Lancet 380: 1633–1634.

    Article  Google Scholar 

  • Shiffrin, Seana. 1999. Wrongful life, procreative responsibility and the significance of harm. Legal Theory 5(2): 117–148.

    Article  Google Scholar 

  • Suzuki, Kohta, Rintaro Sawa, Kaori Muto, Satoshi Kusuda, Kouji Banno, and Zentaro Yamagata. 2011. Risk perception of pregnancy promotes disapproval of gestational surrogacy: Analysis of a nationally representative opinion survey in japan. International Journal of Fertility & Sterility 5: 78–85.

    Google Scholar 

  • Tong, Rosemarie. 1990. The overdue death of a feminist chameleon: Taking a stand on surrogacy arrangements. Journal of Social Philosophy 21(2): 40–56.

    Article  Google Scholar 

  • van den Akker, Olga. 2007. Psychosocial aspects of surrogate motherhood. Human Reproduction Update 13: 53–62.

    Article  Google Scholar 

  • Walsh, Judi. 2010. Definitions matter: If maternal-fetal relationships are not attachment, what are they? Archives of Women’s Mental Health 13: 449–451.

    Google Scholar 

  • Warnock, Mary. 1984. Report of the committee of inquiry into human fertilisation and embryology. Cmnd 9314. London, UK: HMSO.

  • Wertheimer, Alan. 1992. Two questions about surrogacy and exploitation. Philosophy & Public Affairs 21: 211–239.

    Google Scholar 

  • Wertheimer, Alan. 1996. Exploitation. Princeton: Princeton University Press.

    Google Scholar 

  • Wilkinson, Stephen. 2003. The exploitation argument against commercial surrogacy. Bioethics 17: 169–187.

    Article  Google Scholar 

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  1. Department of Culture and Communication, Philosophy, Linköping University, 581 83, Linköping, Sweden

    Marcus Agnafors

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Agnafors, M. The harm argument against surrogacy revisited: two versions not to forget. Med Health Care and Philos 17, 357–363 (2014). https://doi.org/10.1007/s11019-014-9557-x

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