Moral-ethical issues of surrogacy














Study programme:   Economics and management

Degree of study:       Management in healthcare

Academic year:         2021/2022

Student:                     M20991 Dr.Tetiana Prokhorenko

Subject:                     Healthcare Ethics

Educator:                  doc. Ing. Alena Klapalova, Ph.D.





Introduction

Recently, the development of assisted reproductive technologies has moved forward. The reason for
this is the modernity of concepts and the desire of the population for something new, as well as
the significant deterioration in the reproductive health of men and women. This is the progress of
various medical technologies and at the same time maintaining the integrity of many families.


The use of reproductive technologies is in great demand. Surrogate motherhood, which is not
sufficiently regulated by laws, is a pressing problem. The perception of this issue is far from
clear.

Supporters believe - surrogacy gives a chance to those families who have already lost hope of
having their own child. Opponents say that surrogacy turns children into commodities, and maternity
becomes a highly paid job. There are moral, ethical and material considerations. In this way, the
baby gives the mother the opportunity to continue to work, build a career and, however strange it
may be, does not torment herself with toxicoses, swelling and other inconveniences, going to the
decree and associated with hormonal changes in the body mood. A woman, expecting a child from a
surrogate mother, may not limit herself not only in earning money, but also in the joys of life:
travel, shopping, sports, dancing and a glass of wine.

But there are a number of completely different facts:

- A woman who for some reason can not have children well or does not want, lays great hopes on a
surrogate mother. But no one can guarantee that she will get everything she dreams of.

- The genetic material of the embryo belongs to the parents without children, and the surrogate
mother acts as an incubator. But the child lives and develops in her bosom, and in time she may
well begin to regard it as her own, because it is not foreseen by nature and she can actively
develop motherly instinct. And it is not known what she will feel and how she will behave when the
time comes to part with him forever. Parents who decide to receive a child in this way will not be
able to feel calm and it is normal considering elementary human factors.



- A child who is born from a surrogate mother may never really become his/her own to the end. It
can also have a negative impact on the child himself, he may consider himself a stranger in the
future, while the parents will do for him everything and fulfill any of his whims.


- The husband of a surrogate mother, if there is one! Not every man will be able to understand and
survive what a woman carries a child from another man. The result may be a feeling of inferiority.
And the question arises, what are you for the man, if the wife has to earn money in this way? This
can be a severe blow to the man's ego.

It is also necessary to take into account the important fact that a surrogate mother can only be a
woman who has reached the age of 18, who has given birth to at least one of her children, and this
should make it easier for her to part with a strange baby. And if you really look at life, how do
you explain to the older child where the brother or sister who lived with the mother in the tummy.

The opinions of different spheres of society are very different:

The opinion of Archpriest Dimitri Smirnov about surrogacy. Opinion of the Orthodox Church. He says
that there is a concept like "prostitution". It is the trade of people with their bodies, or the
use of themselves as money. Surrogacy is the same. Because a woman uses her body to give birth to
someone, that is, not for her pleasure, but for someone else. It is a great pleasure to be a mother
and a father. The fact is that God did not create man as an instrument of pleasure for other
people. Because they are put in an unequal position - it turns out that one pays another not for
his work, not for his talent, and for the exploitation of what God gave them. The Church has always
opposed prostitution, and hence trafficking. Medicine’s Opinion on Surrogacy Medicine has no
contradiction, but there should be no contraindications: - infectious diseases

Diseases of the female genital organs (deformation of the cervix, adhesions of the uterus)

genetic predisposition to various diseases woman should be mentally healthy multiple unsuccessful
attempts of in vitro fertilization. Before you fertilize a future non-biological mother, you need
to undergo a series of comprehensive examinations.



 - Examination and conclusion of therapist, psychiatrist, gynecologist, oncologist, if possible
geneticists.

 -To perform tests for HIV, hepatitis B, C, syphilis, general blood test, biochemical blood test,
blood group and rhesus factor test, blood coagulation test, general urine test, fluorography,
examination for infections such as gonorrhea, chlamydia, genital herpes, etc.

Nowadays not so many women fit this medical framework, but nevertheless it exists and develops.

What does Islam say about surrogacy?

In Islam, all sexual relations are strictly limited to marriage. They may conceive a child only
with the husband and wife and not with any third party. The participation of someone third in this
process is a severe violation of the principles of purity of marriage ties. The Islamic religion is
based on the preservation of genealogy. Genealogy is a collection of information from each
generation, i.e. the origin of family names and all family ties. Many religious leaders believe
that surrogacy is a sin, because the father of the future child is not married to the woman who
gave birth. And this is sin. The only way out if medicine is really powerless is guardianship.
Another fact contradicting this fertilization is the violation of spiritual and emotional closeness
between the mother and the child, which is laid down during pregnancy.

Common Society's Opinion

Some skeptical people propose legislation to ban such commercial money-making. In several countries
of the world, politicians have introduced forbidden laws thanks to such well-wishers and banned any
payment to surrogate mothers under the pretext that it is "immoral" and is the exploitation of
women.

To which supporters answered: What is bad in the birth of a new man? And it does not matter which
way, while observing all the rules that are required in this case for surrogacy. Exploitation of
women? Or is it better for women to install railroad sleepers or use asphalt for 20,000? This is
the real exploitation of the weak floor. Putting a child to other people is a responsible mission,
for which only those who cannot have children pay compensation. All work must be paid, let alone
paid.



History of surrogacy

The history of surrogacy began in ancient civilization. The first case of surrogacy was recorded
two thousand years BC. The story is described in the Old Testament, Sarah, Abraham's wife, was
barren and had to ask Hagar's servant to bear Abraham's child. Abraham at that time was already 86
years, but it did not prevent conception. Hagar bore Ishmael's son. Sarah accepted him as her own
son. And 14 years later, in 1897, a miracle happened and Sarah herself was able to conceive from
her Abraham, at that time he was a hundred years old.

In ancient Egypt, the Pharaohs had to ask for the help of slaves, and use them as surrogate
mothers, for the continuation of a sort. Such cases, as history says, were used by wealthy,
aristocratic families. Naturally, at that time reproductive technologies were not developed and a
simple insemination of a surrogate mother was applied, but, despite this, the child was given to
the couple for upbringing and further maintenance. Semination is the introduction of prepared sperm
of a man directly into the uterus.

Ethical issues

In the case of surrogate motherhood, the children born are legally children, the mother who gave
birth to them, but the laws may differ from country to country. Let's suppose the law grants the
right to a child only to biological parents. "Mother-incubator" will give birth without any rights.
This means that the newborn will be forcibly removed.

If the law allows S. mother to refuse the transaction immediately after delivery, problems arise
with the biological parents of the child. And they are doomed to live their entire lives with the
idea that their child lives in a different family. Surrogate mother can be understood in such
situation. It turns nine months of bearing the child, heard his heartbeat, felt the first stir, and
it is not so little and it is quite enough to get used to the baby. Naturally, the motherly feeling
and love for this child as for their own awakens. The surrogate mother is in any case in a state of
physiological stress caused by the removal of the child. This is fraught with many, a number of
standing problems with women's health.



Potential conflict situations between biological and surrogate mother are already in the process of
surrogate motherhood and lead to insoluble deadlock. Even legally, it is not always possible to
solve the problems that have arisen. And even if the parties "dispersed" by peaceful means, the
probability of lawsuits and proceedings in court is very high.

Embryos, human beings whose lives have already begun, are at the clinic's complete disposal. After
they can be frozen and stored for a long time, and can be implanted to any mother without the
consent of biological parents. Again, there is no legal obstacle to transferring the embryo to
others, nor is there any control by the State. Moreover, doctors may not inform

anyone about the presence of extra embryos and the resulting ethical problems, so as not to puzzle
their clients. Couples who have opted for artificial insemination are not even aware of the
possibility of having their biological children in other families. Not only that, children can be
simply a commodity, because surrogacy clinics do not all work fairly and honestly. In any case,
when dealing with an embryo, it is not part of the body or a separate organ, it is not even a
sexual cell. It has the same genotype as an adult. If we speak the language of Christian ethics,
the embryo is a man, just without documents: passport, certificate, birth certificate.

In itself and IVF, and especially surrogacy - completely unnatural ways of conceiving children.
Even in our time there is no real evidence that this does not harm the health of the mother and
child in the future. The consequences can be manifold. In addition, in the case of keeping the
embryo in frozen form, the lifespan is extended indefinitely at the request of the owners. The age
will be as long as the storage of the embryo. Frost slows down most biochemical processes, but not
all. During storage, the already fertilized egg cell is exposed to ordinary background radiation
and can develop various mutations. The presence of these mutations is difficult to identify, as
virtually all hereditary diseases are transmitted by recessive way and can manifest only in
subsequent generations.

No matter what motherhood words are used, new technologies of surrogacy are commercial services,
i.e. for money and money. With the development of these technologies, the mechanisms of market
schemes money - a commodity - money only increase. In this process, the life of man and the man
himself, acquires the properties of goods. Ethical problems, human relations and the value of life
have no place in this scheme. There are things that cannot be bought or sold. And society has
crossed this border, and becomes the society where it is possible, in fact, to buy human life.
There are already "nurseries" where mothers from the poorest countries give birth to children and
thus earn their living. There is a clear analogy of human "farms" that existed in America during
the days of slavery. A new form of body trafficking had emerged, such as prostitution, which
dehumanized any woman, although in both cases it seemed to be voluntary. And it is not yet known
what consequences this industry, which does not have any moral barriers, can lead to. In
reproductive technologies not small money revolves. And as we know, money has long led the world.
The price for surrogacy services varies from 10 to 50 thousand US dollars and it is not all
expenses. An IVF attempt alone costs around $4,000. And yet the problem of orphans has not been
solved in many countries. Thousands of children without parents are awaiting adoption, and adoptive
parents receive very modest assistance from the State. Often the parents of a child who needs an
operation that will save his life, try to find, ask people huge amounts of money for the necessary
operations.

Not for nothing the image of the Mother of God with the Child on hand is one of the most revered
icons. The transformation of motherhood into a trade in children and in its own body destroys the
institution of motherhood, turns it into a handicraft. All unethical sides of such reproduction
have agreed in surrogate motherhood, and are gaining momentum.

We can even suppose that soon the companies that make money on surrogacy will ask for state
financing. This absurd paradox, otherwise it is difficult to name, will turn the taxpayers into
unrealistic sums, which it would be wise to spend on providing orphans in families, that they were
taken and on arranging orphanages.

Another ethical problem: to hide or not to hide? No law requires parents who use IVF services to
tell their children about it. Because it´s interference in private life and violation of
relationships and personal views of the family. The parental problem is that they have to decide
for themselves whether to lie to their child or not. After all children necessarily ask questions
"Where did I come from?" and so on. How to answer them if surrogacy was used? As a rule, biological
parents do not spread the fact that their child was born to another aunt, but, of course, there are
exceptions. Perhaps a child will want to know his or her real mother and will maintain a
relationship with her and thank her for carrying him out.



References:


1.      Contraception, Communication and Counseling for Sexuality and Reproductive Health in
Adolescents and Young Adults with CF, Author : Anna Tsang, Carmel Moriarty, Susan Towns,
Periodical : Pediatric Respiratory Reviews, Issue :  2010,2,


2.      Surrogacy in modern obstetric practice. Author: Celia Burrell, Leroy C. Edozien,
Periodical : Seminars in Fetal and Neonatal Medicine, Issue :  2014,5


3.      Assisted Reproductive Technology (ART). Author: S. Kol. Source Name : Reference Module in
Biomedical Sciences, Issue :  2014.