“When money is exchanged for pregnancy, some believe, surrogacy comes close to organ-selling, or even baby-selling”
– Thomas Frank
1. WHAT IS INITIAL CONSENT
Women can have various reasons for becoming a surrogate. They can have one predominant reason, or a combination of wanting to: help complete another family, feel biologically “useful”, help a family member or friend, receive compensation, or have the benefits of pregnancy. There are more, but these are the main influences that women feel.
3. REGIONAL CONTEXT
All over the world, religion plays a considerable role in morals; what is right and what is wrong. In Jordan, surrogacy and IVF are available, but nothing about it is publicized. To get a view on how the majority of people view surrogacy in this country, taking the most prominent religion in the area and finding what is taught in each will give an understanding of the common view.
In Islam, according to a Shaykh, the use of a surrogate by either traditional or gestational method is akin to adultery, since the semen impregnating the egg is from another man, not the host’s legal husband. Also, mothers are defined as those who conceive and give birth to the child. So with surrogacy, the host is defined as the “real” mother of the child, not the parents the baby is assigned to go to. This can create legal and ethical issues if any complications or issues arise. The surrogate is then defined as the real mother, and has autonomy over the fetus, the same as if it were her own child.
4. HOW INITIAL CONSENT COMES INTO PLAY AND CONTROVERSY THAT FOLLOWS
When a woman becomes a surrogate, she is host to a fetus. Because it is within her body, and she is essentially creating a baby, she has autonomy over the baby like any mother should. However, with initial consent, there is the understanding that the fetus does not belong to the mother like her own child would, even if it may be biologically hers. The baby will go to the designated parents after birth, so even while the host is pregnant, the person(s) the child will go to has autonomy, the same as if they were carrying the child themselves or a spouse to the one carrying. However, there are cases when the host purposefully goes against the wishes of the parents.
In this video, a surrogate does not get an abortion, like the parents requested. To fully understand the implications of this action, each of the principles of bioethics will be analyzed for this specific case.
|Principle of Autonomy||Principle of Justice||Principle of Beneficence||Principle of Non-maleficence|
|The couple the surrogate was helping had legal autonomy over the fetus, so all rights a mother physically carrying would have are given to the parents. This principle was violated the moment the surrogate chose to continue the pregnancy after they couple requested an abortion.||With regard to equality, all stakeholders should have an input when deciding a course of action. In this clip, the couple and the surrogate are the main stakeholders. However, because the surrogate is aiding the couple, and the couple have autonomy rights over the fetus, a greater “say” is placed upon the couple. Although the surrogate wanted to give birth, by doing so has disregarded the effect upon the other stakeholders.||By giving birth to the baby, the surrogate believed she was following the principle of beneficence, since she wanted to give the child a chance at life instead of taking it away.||By not terminating the pregnancy, the surrogate violated the principle of non-maleficence. The decision to abort the fetus was made due to medical complications, and by intentionally allowing the baby to live, is creating even more pain and harm. The parents of the child are harmed, knowing their biological child suffers, and the child will have to live her whole life with the medical condition that was supposed to be avoided.|
5. HOW SHOULD INITIAL CONSENT BE CHANGED
The process to become a surrogate is extremely selective, and after being matched with a person or couple needing one, consent is required. Throughout the process, assent is given, but to obtain real informed consent, comprehension of all information must be determined. Although it’s already a lengthy legal process , I want consent to be stricter. There are too many cases when surrogates either change their mind, wish to keep the baby, or defy a couple’s request, because either comprehension and understanding of the process and what it entails wasn’t made clear enough to the surrogate, or laws didn’t protect the wants of the parent’s. Along with being stricter, extending the time period to determine consent will be more beneficial, to all stakeholders involved. Continuing to do so throughout the pregnancy might be beneficial as well, to remind hosts that the child is not theirs, to help continue the essential understanding that was required in the beginning of the process.
In a short video below, it is shown how complicated surrogacy can become without initial consent.
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