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Surrogacy

Rels 300 / Nurs 33029 January 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

Legal Expenses $15,000

Medical Expenses $5,000 - $20,000

Advertising/Administrative Expenses $5,000

Psychological Fees $1,600-2,000

Miscellaneous Surrogate Benefits $750 - $2,000

Surrogate's Fee $0 - $20,000

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The feeling you get when you donate is a priceless memory. It's not just about the money, it's about the unforgettable life experience which stays in your heart forever. This compensation is for the dedication, effort, time, and any possible discomfort associated with the egg donation process.

Financial compensation begins at $7,000 / $8,000 for Premier.

Donors are compensated more for subsequent cycles.

http://www.eggdonation.com/becoming-an-egg-donor/Donor-compensation.php

; http://www.eggdonation.com/becoming-an-egg-donor/BecominganEggDonor.php

http://www.eggdonation.com/recipient-parents/RecipientParents.php

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MomService

Egg Donor Catalogu

ehttp://surrogate-donation.com/egg_catalog.shtml

Ekaterina, 25 http://surrogate-donation.com/surrogates_s6.shtml

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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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Case Study #1 Charles Wheeler and Martha

Berman hired Helen Beasley to bear them a child

Helen became pregnant by IVF

an ultrasound revealed twins Wheeler & Berman had a

clause in their contract requiring selective reduction abortion if more than 1 child

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Helen agreed to the abortion, but due to travel from England to California, and scheduling problems, it was now in the 2nd trimester

Helen balked; there would be no abortion Wheeler & Berman said, either abort one or

both; we don’t want twins both parties were willing to find other parents for

the twins but no agreement on reimbursement for IVF costs

and egg donation could be reached; couple is seeking $80,000

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Breach of Contract Helen is suing the couple for her surrogacy

fee; contract was signed in California US law gives intended parents all legal rights British law gives the surrogate 6 wks to either

keep or relinquish parental rights; contracting couple has no legal rights

Helen must now also sue to terminate legal rights of couple in order to find new parents

hundred of couples indicated interest in adopting the twins

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Case Discussion Who is responsible for the $80,000

costs of egg donation and IVF cycles? Does Helen have a right to $20,000? Who has the right to decide what will

happen to the twins? Who should be regarded as the legal parent(s)?

Should the contracting couple be able to insist on abortion or selective reduction?

What if the fetus had a disabling condition? Or was the “wrong” sex?

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SURROGACY & DISABILITYWhen a surrogacy contract has been entered into, how

should parenting responsibilities be determined if the infant is born with cerebral palsy or Down syndrome or spina bifida?

1. The contract should be enforced so that the contracting parents assume parenting responsibilities.

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 . . .