Specific studies of the “situated ethics” of international surrogacy that address the structural conditions and local moral economies that sustain the trade are needed. In this essay, I describe the intimate industry of surrogacy in Thailand, exploring the local moral economy in which surrogacy is described as a form of Buddhist merit making and an opportunity to provide for one’s own children. This offers a further example of how other ethical values beyond the strictly economic are negotiated in commercial surrogacy (...) relationships. Situated ethics allow us to locate and understand the tensions, competing logics, and contradictions within ethical practices. (shrink)

Transnational surrogacy involves the movement of people, gametes, embryos, and surrogates across international borders. It is now possible to obtain ova from Ukraine and sperm from Denmark, and have the resulting embryos transferred to a Thai surrogate for gestation. This new trend in reproductive travel highlights the increasingly globalized, disaggregated, and commodified nature of reproduction. The demand for transnational surrogacy derives from the differential legal status of surrogacy across jurisdictions. Commercial surrogacy is banned in most European countries, Australia, China, Taiwan, (...) Japan, Mexico, Turkey, and some U.S. states. Other countries, such as Brazil, Israel, and the United Kingdom, have .. (shrink)

The rapid development of assisted reproduction technologies for the treatment of infertility appears to empower women through expanding their individual choice, but it is also creating new forms of suffering for them and their collaborators, especially in the context of transnational third-party reproduction. This paper explores the possibility of framing the ethical discourse around third-party reproduction by bringing attention to concerns of altruistic empathy for women who collaborate in the reproductive process, in addition to those of individualistic choice. This would (...) entail moving beyond an ethic of liberty that is based on self-interest and the language of rights, to an alternative ethic of care that is based on self-restraint and the language of responsibilities. An ethic of care and responsibility would cultivate the empathetic self-reflection of the autonomous actor in relation to those others who are part of the enterprise of bringing a child into the world. (shrink)

Increasing globalisation and advances in artificial reproductive techniques have opened up a whole new range of possibilities for infertile couples across the globe. Inter-country gestational surrogacy with monetary remuneration is one of the products of medical tourism meeting in vitro fertilisation embryo transfer. Filled with potential, it has also been a hot topic of discussion in legal and bioethics spheres. Fears of exploitation and breach of autonomy have sprung from the current situation, where there is no international regulation of surrogacy (...) agreements—only a web of conflicting national laws that generates loopholes and removes safeguards for both the surrogate and commissioning couple. This article argues the need for evidence-based international laws and regulations as the only way to resolve both the ethical and legal issues around commercial surrogacy. In addition, a Hague Convention on inter-country surrogacy agreements is proposed to resolve the muddled state of affairs and enable commercial surrogacy to demonstrate its full potential. (shrink)

The law ordinarily recognises the woman who gives birth as the mother of a child, but in certain jurisdictions, it will recognise the commissioning couple as the legal parents of a child born to a commercial surrogate. Some commissioning parents have, however, effectively abandoned the children they commission, and in such cases, commercial surrogates may find themselves facing unexpected maternal responsibility for children they had fully intended to give up. Any assumption that commercial surrogates ought to assume maternal responsibility for (...) abandoned children runs contrary to the moral suppositions that typically govern contract surrogacy, in particular, assumptions that gestational carriers are not ‘mothers’ in any morally significant sense. In general, commercial gestational surrogates are almost entirely conceptualised as ‘vessels’. In a moral sense, it is deeply inconsistent to expect commercial surrogates to assume maternal responsibility simply because commissioning parents abandon children for one reason or another. We identify several instances of child abandonment and discuss their implications with regard to the moral conceptualisation of commercial gestational surrogates. We conclude that if gestational surrogates are to remain conceptualised as mere vessels, they should not be expected to assume responsibility for children abandoned by commissioning parents, not even the limited responsibility of giving them up for adoption or surrendering them to the state. (shrink)

I consider how a feminist account might address the practice of surrogacy in Japan, both domestically and in the transnational context. Japanese culture emphasizes traditional values, family heritage, and the value of reproduction. Japan offers an interesting case study, since surrogacy is currently under review, and the government is in the process of determining its stance on the practice. I will advocate for legal changes to how surrogacy is treated, suggesting that Japan should eliminate the koseki, or the Family Registration (...) Act, which stipulates that only birth parents may register children as their natural children. A principle of respect for women should be explicitly adopted in setting regulations or guidelines surrounding this practice; additionally, attempts should be made to address citizens’ reproductive needs domestically, thus reducing the global demand for these arrangements. (shrink)

Transnational reproductive travel is symptomatic of insufficient supplies of reproductive resources, including donor gametes and gestational surrogacy services, and inequities in access to these within domestic health-care jurisdictions. Here, we argue that an innovative approach to domestic policy making using the framework of the National Self-Sufficiency paradigm represents the best solution to domestic challenges and the ethical hazards of the global marketplace in reproductive resources.

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings , is exploitative of surrogate women. Arising out of consideration of (...) the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative. (shrink)

A growing number of infertile couples and other individuals desiring children are seeking to fulfill their desire for parenthood transnationally through the use of donor gametes and a surrogate. The number of “fertility tourists” from developed countries to low-income countries is growing phenomenally. Indian women, too, are participating as producers in these “biocrossings,” turning India into the surrogacy outsourcing capital of the world in the globalized bioeconomy of assisted reproduction. I argue for a ban on commercial egg donation and surrogacy (...) and a social-justice approach that would hold the state responsible for providing basic social goods to low-income households. I also argue for a gender-justice approach so that women would not be compelled to adopt surrogacy as a strategy for survival and upward social mobility. (shrink)

The 2004 Canadian Assisted Human Reproduction Act bans commercial contract pregnancy and egg provision, but Canadians undertake cross-border reproductive travel to access these services. Feminist bioethicists have argued that the ethical justification for enforcing the ban domestically, namely exploitation, grounds its extraterritorial enforcement. I raise an additional problem when Global Southern or low-income countries are destinations for travel: neocolonialism. Further, I argue that a ban on commercialized reproduction is problematic. Although well-suited to address neocolonial forces of exploitation and commodification, a (...) ban reinforces neocolonialism by paying insufficient attention to the agency of gestational laborers and egg providers. (shrink)

Next SectionReproductive medical tourism is by some accounts a multibillion dollar industry globally. The seeking by clients in high income nations of surrogate mothers in low income nations, particularly India, presents a set of largely unexamined ethical challenges. In this paper, eight such challenges are elucidated to spur discussion and eventual policy development towards protecting the rights and health of vulnerable women of the Global South.

La gestación subrogada se ha convertido en los últimos años en un tema de radical actualidad en nuestras sociedades. Son muchas las personas que en los países ricos han aprovechado las nuevas posibilidades de utilizar un “vientre de alquiler” para alcanzar sus anhelos de paternidad o maternidad. No obstante, esta práctica atenta a menudo contra la dignidad de la mujer portadora, sostenida sobre un principio de autonomía basado en un ficticio libre consentimiento propio de la bioética neoliberal, ciego por otro (...) lado al principio bioético de justicia. (shrink)

With advances in assisted reproductive technologies, globalization, and the ease of contact via the internet, the use of gestational surrogates as a family building option has grown significantly over the past decade. In a gestational surrogacy arrangement, unlike a traditional surrogacy arrangement, the surrogate is not the genetic mother of the child she carries; the genetic mother is either an egg donor or the commissioning parent. There are only a handful of countries in which commercial surrogacy is permitted, with the (...) United States and India prominent among them. More surrogacy arrangements are carried out in the United States than in any other nation, and the number of gestational.. (shrink)

Because it is often argued that surrogacy should not be treated as contractual, the question arises in which terms this practice might then be couched. In this article, I argue that a phenomenology of surrogacy centering on the notion of trust provides a description that is illuminating from the moral point of view. My thesis is that surrogacy establishes a complex and extended reproductive unit––the “surrogacy triad” consisting of the surrogate mother, the child, and the intending parents––whose constituents are bound (...) together by mutual trustful commitments. Even though a trust-based approach does not provide an ultimate answer to whether surrogacy should be sanctioned or prohibited, it allows for at least some practical suggestions. In particular, I will argue that, under certain conditions, surrogacy is tenable within familial or other significant relationships, and I will stress the necessity of acknowledging the new relationships and moral commitments that result from this practice. (shrink)

Transnational reproductive travel is a largely unfettered multibillion-dollar global industry that flourishes, in part, by capitalizing on differences in legal regimes, wages and standards of living, and cultural and ethical norms. Indeed, as Scott Carney explains with respect to the commercialization of human eggs for third-party reproduction, “internationalization has made oversight laughable. … [R]egulators are dogs with no teeth” . While professional organizations can introduce guidelines and nation-states can introduce laws, the fact is that patients can travel to places where (...) there are no restrictions on .. (shrink)

In Canada, the use of reproductive technologies is largely governed by the Assisted Human Reproduction Act . One of the founding principles of the AHR Act is that “trade in the reproductive capabilities of women and men, and the exploitation of children, women and men for commercial ends raise health and ethical concerns that justify their prohibition” ). This principle is instantiated in several sections of the AHR Act, including s. 7, which prohibits the purchase of gametes. It follows that, (...) in Canada, the legal supply of human eggs is limited to eggs from donors.1Donors, by definition, are women who do not receive payment for their eggs. Typically, known .. (shrink)

To avoid the commercialization of reproduction, the Canadian Assisted Human Reproduction Act prohibits the purchase of human eggs. We endorse this legal prohibition and moreover believe that this facet of the law should not be allowed to have as an unintended consequence an increase in transnational trade in human eggs. In an effort to avoid this consequence, and to be consistent with the AHR Act, we advocate the pursuit of national altruistic self-sufficiency. This article briefly outlines a number of strategies (...) to increase the domestic altruistic supply of third-party eggs and decrease the domestic demand for them. (shrink)

When it comes to discourses around women's labor in global contexts, we need feminist philosophical frameworks that take the intersections of gender, race, and global capitalism seriously in order to arrive at a comprehensive understanding of women's lives within global processes. Women of color feminist philosophy can bring much to the table in such discussions. In this essay, I theorize about a concrete instance of global women's labor: transnational commercial gestational surrogacy. By introducing a “racialized gender” analysis into the philosophical (...) debate on this issue, I argue that women's reproductive labor is becoming increasingly stratified within the global economy along racial and other lines. This paves the way for a “transnational reproductive caste system,” which ends up reifying various social hierarchies and sustaining existing global inequities. I aim to expose the kind of violence that surrogates experience due to such stratification as women of color in a transnational space. I discuss how discourses of race and existing racial hierarchies play out in international surrogacy and ways in which these, and indeed, the very category of “woman of color” get complicated in international contexts when they intermingle with other localized social forms and global inequities. For the purposes of my argument, I engage several insights from feminist of color Dorothy Roberts's work on race and reproductive technologies in the US. (shrink)

I argue for a deflationary answer to the question, “What is it to be a woman?” Prior attempts by feminist theorists to provide a metaphysical account of what all and only women have in common have all failed for the same reason: there is nothing women have in common beyond being women. Although the social kinds man and woman are primitive, their existence can be explained. I say that human sex difference is the material ground of systems of gender; gender (...) systems serve to enable male control of female reproductive capacities. This explains the fact that most women are female, but it does not entail that all women are female or that all females are women. To clarify my position, I draw an analogy between the kind woman and the kind parent. While it is difficult to come up with necessary and sufficient conditions for being a parent, it is clear that the social institution or practice of parenting has its material ground in the biological facts about human reproduction together with facts about infantile dependency. Saying this does not entail that all and only biological progenitors are parents. (shrink)

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. (shrink)

Since the 1980’s, surrogacy has become a popular reproductive alternative for individuals experiencing infertility. The ethical and legal analyses of surrogacy have been rich and varied. Some bioethicists have charged the commercial surrogacy industry with the exploitation of global southern women or with the impermissible commodification of children and women’s reproductive capacities. Others have praised the potential for economic empowerment and bodily autonomy that surrogacy may accord to women. However, throughout these explorations of the ethics of surrogacy, comparatively little attention (...) has been paid to the moral status of a crucial actor: the fertility doctor. Without doctors willing to provide prenatal and postnatal care to surrogates and make use of assisted reproductive technologies (ARTs), commercial surrogacy would not take place. Yet, doctors’ involvement in surrogacy is far from morally neutral. In my thesis, I aim to explore what duties doctors have in the context of commercial surrogacy. To do so, I take up the framework of fiduciary obligation. I argue that doctors have fiduciary obligations to surrogates, and that these obligations shape if and when doctors can ethically facilitate surrogacy. My thesis is divided into four chapters. The first defends the view that the doctor-patient relationship is fiduciary in nature. The second chapter extends this view to the realm of commercial surrogacy, arguing that doctors also owe the surrogates they treat fiduciary obligations. The third chapter addresses a challenge posed by my view, namely that surrogacy seems to place doctors in positions where they constantly face conflicts of interest, and are therefore unable to uphold their fiduciary duty of loyalty to surrogates. I address this concern by arguing that conflicts of interest are not inherent in surrogacy, but that surrogacy arrangements must be substantially rethought in order to safeguard the doctor-surrogate fiduciary relationship. The final chapter considers the obligations doctors have to the children they help create through surrogacy and through assisted reproduction more generally. (shrink)

Through the vehicle of Nicolas Sarkozy’s so-called “Dakar Address” we will analyse the West’s persisting lack of insight into the need for a Western decolonization. We will try to identify the dangers that come from this refusal, such as the abidance in colonial patterns, the enduring self-understanding as superior com-pared to Africa, and the persisting unwillingness to accept the colonial guilt. Decolonization has to be understood as a two-fold business. Decolonization is over-coming endured and perpetrated violence. It is not only (...) important that the colonial oppressed regain strength, it is equally important that the perpetrator of colonial violence understand their excess of violence and work on effecting its return impossible. We explain how Western thinking remains dangerous and untrustwor-thy if it refuses its own decolonization. Finally, we will draw attention to a fundamental pattern of Western thought that clashes with the fundamental values of the West: contempt. In a final step we suggest how this contempt can be overcome through desuperiorisation and the establishment of elative ethics. (shrink)