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SurrogacyRels 300 / Nurs 33019 November 2014
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Traditional Surrogacy
ova of gestational/surrogate mother sperm of contracting father; AI (or IVF)
both genetic link and biological link between surrogate and baby
after birth, surrogate terminates her parental rights
contracting man is recognized as father contracting mother does a step-parent
adoption e.g., Baby M
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Terms of the Contract: 3 parties
1. Richard Whitehead (husband of Mary Beth Whitehead)o gave consent for Mary Beth to be inseminated with
sperm of William Sterno agreed to terminate his parental rights and surrender
custody of infant upon birth
2. Mary Beth Whiteheado agreed to artificial insemination and to form no
“parent-child relationship” with fetus/infanto agreed to assume all risks of pregnancy and
childbirtho at birth, to surrender her parental rights to William
Stern
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Terms of the Contract: 3 parties
3. William Sterno agreed to pay $10,000 to Mary Beth W. upon
surrender of live childo if miscarriage prior to 5th month, no paymento if miscarriage after 5th month, $1,000o if stillborn, $1,000
o agreed to pay lawyer Noel Keane $10,000 for arranging contract
Elizabeth Stern – no part in contract; after birth, she would adopt baby
o Elizabeth Stern was not infertile
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In the Matter of Baby M: 1988Plaintiffs: William and Elizabeth Stern
Defendant: Mary Beth Whitehead
Plaintiffs' Claim: That Mary Beth Whitehead should surrender the child she conceived via artificial insemination with William Stern's sperm, in compliance with the terms of the "Surrogate Parenting Agreement"
Verdict: Mary Beth Whitehead's parental rights were terminated and Elizabeth Stern was granted the right to immediately adopt William Stern's and Whitehead's daughter.
The New Jersey Supreme Court overturned this verdict in part on February 2, 1988, when it restored Whitehead's parental rights and invalidated Elizabeth Stern's adoption of Baby M, but granted William Stern custody of the infant.
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What went wrong?Mary Beth changed her mind
Mary Beth HAD bonded with the fetus/newborno after conceiving, gestating and giving birth to Baby
M, she felt like the baby’s mothero she refused the $10,000 and refused to terminate
her maternal rightsNew Jersey Supreme Court overturned lower court’s
ruling:o surrogacy contract was invalidated; adoption was
annulled; Mary Beth’s parental rights were restoredo William Stern awarded custody; Mary Beth had
significant visitation rights
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What have we learned from the case of Baby
M?
Significance: 25 years ago; This was the first widely followed trial to wrestle with the ethical questions raised by "reproductive technology."
What does it mean to be a “mother” or “father”, or to “parent” an infant?
What do you think?
Who should be recognized as the father of Baby M?
Richard Whitehead: yes? no? why?
William Stern: yes? no? why?
Who should be recognized as the mother of Baby M?
Mary Beth Whitehead: yes? no? why?
Elizabeth Stern: yes? no? why?
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More complex forms of surrogacy
GESTATIONAL SURROGACY: 1
Gestational mother has no genetic link to childusing ova and sperm of contracting couplecycles of 2 women are synchronized using hormonesova fertilized using IVF technologyembryo(s) transferred to surrogate
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GESTATIONAL SURROGACY: 2
• donor egg, father’s sperm
• intended mother has no ova; or
advanced maternal age
• no female partner• maternal genetic
concerns• use IVF technology
• embryo transfer
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GESTATIONAL SURROGACY: 3
• contracting woman’s egg, donor sperm
• poor sperm motility or mobility; male infertility
• paternal genetic concerns
• IVF technology• embryo transfer• surrogate gestation
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GESTATIONAL SURROGACY: 4
donor egg, donor spermgenetic concerns for both contractorsdesire for no biological / genetic link with offspringadvanced parental ageIVF; ET; surrogate gestation
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Application Fee $500
Consulting & Legal Expenses $15,000 – $20,000
Medical Expenses $5,000 - $50,000
Advertising/Administrative Expenses $5,000
Psychological Fees $1,600-2,000
Miscellaneous Surrogate Benefits $750 - $2,000
Surrogate's Fee $0 - $20,000 http://
www.surrogatemothers.com/expense.html
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http://surrogate-donation.com/surrogates_catalog.shtml
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MomService Surrogate Catalogue:
http://surrogate-donation.com/surrogates_catalog.shtml
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WHAT ARE YOU PAYING FOR?WHAT SHOULD YOU EXPECT TO GET FOR YOUR MONEY?
For $100,000 . . .
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Typical Fees Paid to Surrogatesand Donors in the US
compensation for gestation - $25,000
egg donor - $5000
support group attendance -
$100/month
maternity clothing - $600
IVF attempt - $600
insemination attempt - $250
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Other Costs
health insurance, life insurance, psychological counselling, child care, lost wages, housekeeper, multiple pregnancy, medications, court fees, legal fees, parental relinquishment fee, step parent adoption, paternity testing…
total cost (in the US), with a surrogacy agency, ranges from $27,000 to $120,000
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Would YOU engage in Surrogacy?
I would consider being a gestational surrogate if: I would never be a gestational surrogate because:
I would consider using a gestational surrogate if:
I would never use a gestational surrogate
because:
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What ethical concerns does surrogacy raise in your mind?
Deontological issues
Utilitarian analysis
Virtue perspectives
Natural law concerns
Feminist / care issues
Autonomy
Beneficence
Non-maleficence
Justice
Confidentiality
Trust / truthfulness
Privacy
Parenting
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Australian couple abandons Down syndrome baby from Thai surrogate“Surrogacy Australia says it is shocked and outraged that an Australian couple abandoned a baby in Thailand with his surrogate mother after he was found to have Down syndrome and a life-threatening heart condition.“Pattaramon Chanbua has told the Australian Broadcasting Corporation (ABC) she gave birth to twins after agreeing to be a surrogate with a promised payment of about $16,000.”
http://www.cbc.ca/news/world/australian-couple-abandons-down-syndrome-baby-from-thai-surrogate-1.2726057 (video)
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“She said she refused, as it was against her Buddhist beliefs. Abortion on the grounds of foetal impairment is illegal in Thailand.”The contracting parents said “they were angry
that the surrogacy agency had not conducted tests earlier because by the time they found out about the baby's condition, it was too late in the pregnancy to abort the foetus.
“Had they known earlier, he said, they probably would have terminated the pregnancy.”
http://www.bbc.com/news/world-asia-28732511
Pattharamon Chanbua, who has two other
children, said the couple had asked her to have an
abortion when she was told of the baby boy's
condition four months after becoming pregnant.
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SURROGACY & DISABILITYWhen a surrogacy contract has been entered into, how should
parenting responsibilities be determined if the expected infant is twins, is born with cerebral palsy, Down syndrome or spina bifida?
1. The contract should be enforced so that the contracting parents assume parenting responsibilities for the infant/twins.
2. The contract should be written in a way that assigns parenting responsibilities to the surrogate.
3. The pregnancy should be closely monitored so that a handicapped fetus can be identified and aborted.
4. The contract should stipulate that parental responsibilities may be refused in the case of a handicapped infant.
5. We think that . . .
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Assisted Human Reproduction Act:Prohibitions related to surrogacy
In Canada, it is a crime to pay (in cash, goods, property or services), offer to pay or advertise to pay a woman to be a surrogate mother.
The AHR Act does not:Prohibit surrogacy itself, as long as a surrogate
mother in Canada makes this decision for altruistic reasons (i.e., without financial or other gain);
Criminalize a woman who agrees to be or becomes a surrogate mother. It is paying, offering to pay or advertising that consideration will be paid to a woman for surrogacy that is illegal.
Health Canadawww.hc-sc.gc.ca
