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Power and feminist bioethics
Published in Wendy A. Rogers, Jackie Leach Scully, Stacy M. Carter, Vikki A. Entwistle, Catherine Mills, The Routledge Handbook of Feminist Bioethics, 2022
A simplistic account of power and of resistance is still not uncommon in academic bioethics writing, for example in discussions of global surrogacy, where ethical questions often focus on the lack of power-to (and of the “right kind” of autonomy and agency) of surrogates from the Global South. A feminist approach might raise many ethical questions around surrogacy, including ones that interrogate power structures and relations, as well as questions of exploitation. But these need not work with a model that disallows the existence and the practice of agency or power-to (power to choose, and power to resist) on the part of surrogates (Ganguli-Mitra 2014).
Reproduction
Published in Gary Chan Kok Yew, Health Law and Medical Ethics in Singapore, 2020
There are generally two forms of surrogacy: Traditional surrogacy: where the surrogate is the biological mother and the surrogate’s own egg is artificially inseminated with the intended father’s (or a donor’s) sperm.Gestational surrogacy: where the surrogate carries a baby that is conceived through fertilising the egg of the intended mother or a donor with the sperm of the intended father or a donor.
Surrogate non-motherhood: Israeli and US surrogates speak about kinship and parenthood
Published in Zeynep B. Gürtin, Charlotte Faircloth, Conceiving Contemporary Parenthood, 2020
The argument follows three common findings from the two studies. First, surrogates do not bond with the babies they carry for IPs. They draw on ideas about technology, genetics and intent in order to explain that they are not the mother and thus do not bond with the child. They see gestation as instrumental in ‘nurturing parents’, the purpose for which they hold themselves accountable, rather than creating kin-ties between themselves and the baby. They do not feel the way many of the scholars who theorize about surrogacy think they should feel. Second, while surrogates in the respective studies saw bonding and motherhood in very similar ways, they differ in their definitions of what constitutes parenthood. In both contexts, however, they draw clear boundaries between their own family and that of the IPs’. They do not consider their ‘surrobabies’ their own children's siblings. Third, surrogates view surrogacy as an endeavor to create babies, parents and families, as a ‘journey of love’ they ideally share with IPs. In both countries surrogates expect a special bond with their intended mothers (IM). They see their contribution as exceptional moral work which involves nurturing, caring, friendship and solidarity. They are disappointed and hurt when IPs drift away, cut ties, or even worse, redefine the relationship as ‘only business.’
Attitudes Toward Transnational Surrogacy, Ambivalent Sexism, and Views on Financial Allocation
Published in Women's Reproductive Health, 2023
Prianka H. Hashim, Kenneth Michniewicz, Kate Richmond
In the United States, between 1999 and 2013, the number of assisted reproductive technologies (ARTs) cycles that included a gestational carrier rose from 0.5% of all in vitro fertilization cycles to 2.2% (Perkins et al., 2016), indicating that there has been an increase of ARTs associated with surrogacy practices. Within the United States, ARTs, including those used for surrogacy, were estimated in 2017 to be a $21 billion business with the potential to increase by 10% annually (Salter, 2021). Commercial transnational surrogacy is estimated to be a multi-billion-dollar industry (Cottingham, 2017; Kohli, 2011) and mostly consists of individuals from high-resource countries purchasing services from clinics and women in low-resource countries (Rudrappa & Collins, 2015). Such an arrangement exists because surrogacy costs are much more affordable in low-resource countries. For example, in India and Mexico, costs associated with surrogacy generally are $20,000 (Rudrappa, 2012) and $35,000 (Lozanski & Shankar, 2019), respectively, compared to $80,000 to $120,000 in the United States (Rapp, 2009).
The nexus between self-perception and behavioural responses of gestational surrogates’ risk experiences
Published in Human Fertility, 2022
Public debate regarding surrogacy and the associated risks spans four decades. Indeed, in the United States, the landmark 1986 case of Baby M brought the pitfalls of surrogacy to the fore, when a surrogate famously chose not to relinquish the child to the intended parents (Morrissey, 2015). The risks associated with surrogacy arrangements are broad in scope, particularly in commercial surrogacy arrangements where women agree to carry the pregnancy arrangement involves compensation (beyond the reimbursement of medical fees) (Armour, 2012). Physical risks are extensively discussed including multiple pregnancy and its adverse consequences following multiple embryo transfer which seems to be routine practice in commercial surrogacy arrangements (Attawet et al., 2020; Duffy et al., 2005; White, 2016, 2017). Other risks include emotional, legal, ethical and socio-economic risks (Patel et al., 2018; Söderström-Anttila et al., 2016). Several high-profile surrogacy arrangements have gained media attention and were examples of risks to commercial surrogates. For example, the high-profile case of thirty-three surrogates who were imprisoned and charged with human trafficking after Cambodia banned commercial surrogacy in 2016 (Handley, 2018). Another example of the high-profile case—baby Gammy, who is Down’s syndrome, was left with his commercial surrogate in Thailand by the intended parents, whilst his twin sister, who did not have Down’s syndrome, was taken back to Australia (Whittaker, 2016)—was a risk to the surrogate for parental responsibility for the baby who was not her biological child.
Clinical considerations in the psychological evaluation of gestational surrogates: uses of narrative assessment
Published in Human Fertility, 2022
Mary P. Riddle, Sharon R. Jenkins
The role of the mental health professional (MHP) in the consideration of gestational surrogate (GS) candidates has evolved with increasing awareness of the psychosocial complexities of the carrying process. In the U.S., commercial arrangements are common and referral sources such as clinics, agencies, and lawyers have the expectation that the MHP will serve as a gatekeeper to provide psychological clearance of a GS to proceed (Braverman, 2015). The American Society for Reproductive Medicine’s Practice Committee has issued guidelines in regard to the consideration of a woman to be a gestational surrogate (ASRM, 2017). In the U.S., current guidelines for the psychological screening of GSs by a MHP include a psychosocial consultation and psychological testing (where deemed appropriate) (ASRM, 2017), although there is no uniform interpretation of the guidelines with regard to what should be included in the evaluation process. In particular, what would be deemed appropriate for the psychological testing component is not defined and there is little research into what might be the best testing protocol to meet the expectation of the role of the MHP in these arrangements.