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Rels 300 / Nurs 33019 November 2015

Surrogacy

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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

Traditional Surrogacy

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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 birth2. Mary Beth Whitehead

o agreed to artificial insemination and to form no “parent-child relationship” with fetus/infant

o agreed to assume all risks of pregnancy and childbirth

o at birth, to surrender her parental rights to William Stern

Terms of the Contract: 3 parties

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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

o Elizabeth Stern – no part in contract; after birth, she would adopt baby; Elizabeth Stern was not infertile

Terms of the Contract: 3 parties

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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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Mary Beth HAD bonded with the fetus/newbornoafter conceiving, gestating and giving birth to

Baby M, she felt like the baby’s motheroshe refused the $10,000 and refused to terminate

her maternal rightsNew Jersey Supreme Court overturned lower

court’s ruling:osurrogacy contract was invalidated; adoption was

annulled; Mary Beth’s parental rights were restored

oWilliam Stern awarded custody; Mary Beth had significant visitation rights

What went wrong?Mary Beth changed her mind

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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?

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?

What have we learned from the case of Baby M?

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GESTATIONAL SURROGACY: 1

More complex forms of surrogacy

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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• donor egg, father’s sperm

• intended mother has no ova; or

advanced maternal age

• no female partner• maternal genetic

concerns• use IVF technology

• embryo transferGESTATIONAL SURROGACY: 2

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• contracting woman’s egg, donor sperm

• poor sperm motility or mobility; male infertility

• paternal genetic concerns

• IVF technology• embryo transfer• surrogate gestation

GESTATIONAL SURROGACY: 3

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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

AVERAGE = $70,000

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DAY & EVENING1-888-SURROGATE

(317) 996-2000scl@surrogatemothers.com

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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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For $100,000 . . .

What are you paying for?What should you expect to get for your money?

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compensation for gestation - $25,000 egg donor - $5000 support group attendance - $100/month maternity clothing - $600 IVF attempt - $600 insemination attempt - $250

Typical Fees Paid to Surrogatesand Donors in the US

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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

Other Costs

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I would consider using a gestational surrogate if:

I would never use a gestational surrogate

because:

I would consider being a gestational surrogate if: I would never be a gestational surrogate because:

Would YOU engage in Surrogacy?

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AutonomyBeneficenceNon-maleficenceJusticeConfidentialityTrust / truthfulnessPrivacyParenting

Deontological issues

Utilitarian analysis

Virtue perspectives

Natural law concerns

Feminist / care issues

What ethical concerns does surrogacy raise in your mind?

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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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When 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 . . .

SURROGACY & DISABILITY

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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.

 Assisted Human Reproduction Act:

Prohibitions related to surrogacy

Health Canadawww.hc-sc.gc.ca