A diagnosis of fetal abnormality presents parents with a difficult – even tragic – moral dilemma. Where this diagnosis is made in the context of surrogate motherhood there is an added difficulty, namely that it is not obvious who should be involved in making decisions about abortion, for the person who would normally have the right to decide – the pregnant woman – does not intend to raise the child. This raises the question: To what extent, if at all, (...) should the intended parents be involved in decision-making? In commercial surrogacy it is thought that as part of the contractual agreement the intended parents acquire the right to make this decision. By contrast, in altruistic surrogacy the pregnant woman retains the right to make these decisions, but the intended parents are free to decide not to adopt the child. We argue that both these strategies are morally unsound, and that the problems encountered serve to highlight more fundamental defects within the commercial and altruistic models, as well as in the legal and institutional frameworks that support them. We argue in favour of the professional model, which acknowledges the rights and responsibilities of both parties and provides a legal and institutional framework that supports good decision-making. In particular, the professional model acknowledges the surrogate's right to decide whether to undergo an abortion, and the intended parents' obligation to accept legal custody of the child. While not solving all the problems that arise in surrogacy, the model provides a framework that supports good decision-making. (shrink)

Conservative ethical systems, particularly organized religions, are frequently at odds with the means, if not the goals of the new reproductive technologies. Among the most problematic measures adopted in recent years to allow childless women to raise genetically related offspring is surrogate motherhood. Traditional Jewish law, or Halakha, notwithstanding this reluctance, is, nevertheless, more likely than many others to find reasons to justify the practice, given its well-known stance viz procreation and its leniency regarding the new reproductive technologies. In (...) the following article, we ask whether Halakha, which allows abortion to save the life of a mother, would sanction the employment of a surrogacy arrangement in the case where pregnancy threats her life, in order to save the fetus as well. (shrink)

Because it is often argued that surrogacy should not be treated as contractual, the question arises in which terms this practice might then be couched. In this article, I argue that a phenomenology of surrogacy centering on the notion of trust provides a description that is illuminating from the moral point of view. My thesis is that surrogacy establishes a complex and extended reproductive unit––the “surrogacy triad” consisting of the surrogate mother, the child, and the intending parents––whose constituents are (...) bound together by mutual trustful commitments. Even though a trust-based approach does not provide an ultimate answer to whether surrogacy should be sanctioned or prohibited, it allows for at least some practical suggestions. In particular, I will argue that, under certain conditions, surrogacy is tenable within familial or other significant relationships, and I will stress the necessity of acknowledging the new relationships and moral commitments that result from this practice. (shrink)

This book delves deeply into modern surrogacy arrangements, responding to both practical and ethical critiques by offering a radically new model for surrogate motherhood. Current practice distinguishes between two models of surrogacy – the altruistic model and the commercial model, both of which present social, ethical, and conceptual challenges. This book proposes a novel arrangement for surrogate motherhood – the professional model. Inspired by professions, such as nursing, teaching, and social work, the professional model acknowledges the caring motives (...) that surrogate mothers have while at the same time compensating them for their work. Walker and Van Zyl adopt an evidence-based approach to explain that the professional model enables trust between intended parents and surrogates, provides professional support at every stage of the relationship, affords legal protections against exploitation and commodification, and recognizes the rights and interests of all parties, including the intended baby. The model applies to both transnational and domestic surrogacy and will be of great interest to policy makers, social researchers, bioethicists, legal scholars, fertility professionals, clinicians, and graduate students in psychology, philosophy, medicine and ethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical Ethics: Balancing Praxis and TheoryEdmund D. Pellegrino (bio)When André Hellegers founded the Kennedy Institute, he envisioned a close collaboration between ethics and clinical practice. He even called for physician specialists whose expertise would be in both fields (Reich 1994, p. 324). A quarter of a century later, his vision and prediction have become realities. Clinical ethics is today a thriving entity with its own literature, practitioners, and methodology.This (...) clinical turn has, on the whole, been salutary. The abstractness of ethical theory has been tempered by the concreteness of clinical realities; clinicians have been helped to make bedside decisions even in the face of theoretical uncertainty and dissonance; and a variety of disciplines besides theology and philosophy have entered ethical discourse and enriched it.These advantages notwithstanding, clinical ethics has certain inherent traits that make it problematical. Some seek its norms in what “works” in practice or in paradigm cases (Jonsen and Toulmin 1988); others shape it to achieve consensus or satisfy the needs of public policy (Meilaender 1995); still others reduce bioethics to merely a method for the resolution of moral conflict. Rather than simply modulating theory by practice, clinical ethics can end up by repudiating theory entirely (Toulmin, in press). Taken to their logical conclusion, these tendencies make clinical ethics a species of the antifoundationalism that has strongly influenced moral philosophy in the last decade (Tollefsen 1995, pp. 3–18; Rockmore and Singer 1992). But antifoundationalism itself is a theory of ethics even though it supposedly denies the validity of any overarching theories.Antifoundationalism presents its own difficulties. For one thing it begs important questions that will not go away: for example, how do we know that a decision is a good one? what does it mean to say that a decision “works”? is the [End Page 347] outcome of a good decisional procedure itself a good decision? and to what extent are compromise and exigency admissible in moral decisions? Theoretical and “foundational” questions of this sort will not evaporate because they are ignored. They inevitably will be answered by begging the essential questions or grounding them solely in prelogical presuppositions.To avoid these difficulties, the advantages of clinical ethics must be retained without capitulation to the anti-theory bias of contemporary philosophy. This means that theory and practice must both be retained and be conceptually related to each other. To effect this we must take account of the long intellectual history of the relationship between the speculative and the practical intellect—i.e., between knowledge sought for its own sake and knowledge sought for some use beyond simply the possession of it (Lobkowicz 1967, pp. 78–81). Suffice it to say that medicine has long been the paradigm case for the union of theory and praxis. Relating them conceptually is an essential propaedeutic to any theory of moral praxis in medicine.The rest of this essay examines the inextricability of theory and practice in two of the three major branches of clinical ethics—the substantive and the professional. The third branch, procedural ethics—i.e., the ethics of the process of decision making—deals with informed consent, with respect for persons, professional colleagues, and families, and with the ethics of conflict resolution. Obviously, there are theoretical issues here as well. For want of space, procedural ethics will not be discussed, but it presents the same conjunction of theory and practice encountered in professional and substantive ethics.Substantive EthicsSubstantive ethics refers to the moral content rather than the process of moral decisions, to the moral status and permissibility of the specific clinical medical acts themselves—e.g., abortion, euthanasia, pre-implantation diagnosis, surrogate motherhood, withholding and withdrawing treatment, the physician as gatekeeper, and the like—the whole range of moral questions clinicians face in treating patients. Moral diversity and plurality on these issues is the most powerful force behind the dominance of procedural ethics. But, unfortunately, a morally valid decision-making procedure does not confer normative validity on the decision itself. Moral validity rests on questions that go beyond prevailing practices, on what we take to be the nature and moral status of persons, fetuses, and brain-damaged humans, the value or disvalue of... (shrink)

In a host surrogate motherhood arrangement, the surrogate agrees to be implanted with, and carry to term, an embryo created from the commissioning couple9s gametes. When the surrogate child is born, it is the surrogate mother who, according to UK law, holds the legal status of mother. By contrast, the commissioning mother possesses no maternal status and she can only attain it once the surrogate agrees to the completion of the arrangement. One consequence of this (...) is that, in the event that a host arrangement fails, the commissioning mother is left without maternal status. In this paper, I argue that this denial of maternal status misrepresents the commissioning mother9s role in the host arrangement and her relationship with the surrogate child. Consequently, I suggest that commissioning mothers participating in host surrogacy arrangements ought to be granted the status of mother in the event that the arrangement fails. (shrink)

Studies on surrogate motherhood have mostly explored paid arrangements through the lens of a contract model, as clinical work or as a maternal identity-building project. Turning to the under-examined case of unpaid, so-called altruistic surrogate motherhood and based on an analysis of interviews with women who had been unpaid surrogate mothers in a full gestational surrogacy with a friend or relative in Canada, the United States or Australia, this article explores altruistic surrogate motherhood as relational work. (...) It argues that this form of surrogate motherhood within close interpersonal relations can be conceptualised through the relational work involved in hosting a child for the intended parents. The article explores how relational work in this context implies an embodied, asymmetrical and far-reaching sense of responsibility that surrogate mothers describe as characteristic of their surrogacy experience. In this way, the article sheds light on feminist concerns about surrogacy as an embodied and objectifying work of women while at the same time illuminating how surrogate mothers respond to the intended parents in light of their pre-surrogacy relationship, how meanings are negotiated by them and how relationships are managed during the pregnancy. (shrink)

Surrogate motherhood-at least if carefully structured to protect the interests of the women involved-seems defensible along standard liberal lines which place great stress on free agreements as moral bedrocks. But feminist theories have tended to be suspicious about the importance assigned to this notion by mainstream ethics, and in this paper, we develop implications of those suspicions for surrogacy. We argue that the practice is inconsistent with duties parents owe to children and that it compromises the freedom of surrogates (...) to perform their share of those duties. Standard liberal perspectives tend to be insensitive to such considerations; we propose a view which takes more seriously the moral importance of the causal relationship between parents and children, and which therefore illuminates rather than obscures the stake that women and children have in surrogacy. (shrink)

In this essay, I draw on Kant’s legal philosophy in order to defend the right to voluntary motherhood by way of abortion at any stage of pregnancy as an essential feature of women’s basic rights. By developing the distinction between innate and acquired right in Kant’s legal philosophy, I argue that the viability standard in US law (as established in Planned Parenthood v. Casey) misunderstands the nature of embodied right. Our body is the site of innate right; it is the (...) means through which we can set and pursue ends in the world. The law, therefore, cannot adjudicate the relationship between the will and the body: it cannot require us to allow our bodies to be used against our will. By comparing unwanted pregnancy to sexual assault, I problematize the notion that consent to pregnancy, like consent to sex, can ever be conclusive. I examine Kant’s own account of unwanted pregnancy, in which he describes mother and child finding themselves “in a state of nature” in order to rethink the status of the fetus in law, and I argue that we should understand the fetus’s right to life as provisional, rather than as enforceable by law. (shrink)

To make progress on the moral status of abortion, it turns out, requires us not just to arbitrate already familiar controversies in metaphysics and ethics, but to attend to the distinctive aspects of pregnancy that often stand at their margins. In the following, I want to argue that if we acknowledge gestation as an intimacy. motherhood as a relationship, and creation as a process, we will be in a far better position to appreciate the moral textures of abortion. I explore (...) these textures, in the first half on stipulation that the fetus is a person, in the second half under supposition that early human life has an important value worthy of respect. (shrink)

The US Supreme Court’s abortion decisions over the past forty years have helped to shape cultural beliefs and practices concerning heterosexual relationships, marriage, and parenting. This is true both in the practical and in the legal senses. Practically speaking, definitively separating sex from childbearing, as only abortion can do (given how often contraception fails), inevitably changes the meaning of sex, and therefore of heterosexual relationships. Legally speaking, the Court’s influence was mediated significantly by its decision to locate the (...) right of abortion in an area of constitutional law—substantive due process—which claims to contain only those rights that are indispensable to our national understanding of freedom, both at the level of the individual and respecting our overarching democratic order. In particular, over the course of forty years of abortion opinions, the Court’s reflections on a claimed link between abortion and freedom have led it to conclusions broadly reflected in modern American beliefs and practices insofar as sex, marriage, and parenting are concerned. These include, inter alia, a suspicion of motherhood on the grounds of its risks and harms, the dispensable roles and violent characters of men, the great importance of adults’ wishes, and the importance of sexual expression for individual identity, divorced from consequences for partners or children. (shrink)

This study analyzes the meaning employed mothers give to having others take care of their children. In-depth interviews with 31 employed mothers of preschoolers, toddlers, and infants revealed three interpretations of child care: custodial care, surrogate care, and coordinated care. These meanings mediated the tension between the dominant cultural construction of motherhood and the reality of their lives as both mothers and wage earners. Their perceptions of child care were constructed in accordance with how they defined the relationship between (...) “child rearing” and “child care,” the degree to which they acknowledged their child care providers' care of their children, and definitions of their own mothering. These microideologies of child care demonstrate that mothers are contesting the assumptions of the dominant cultural ideology of motherhood and are rethinking child care as a socialized activity. (shrink)

Myriad contemporary public-policy issues--including physician-assisted suicide, medical marijuana, abortion, surrogate motherhood, gay rights, conscription, and markets in human organs--raise the following important question: what rights should individuals have over their own bodies? The concept of self-ownership offers one way to answer this question. Just as ownership of an external object involves having rights, liberties, powers, immunities, etc., with respect to it, so self-ownership involves having these incidents of ownership with respect to one's own body and labor power. Much of (...) the contemporary debate over self-ownership has been about which of these incidents should be included in its definition. This dissertation endorses a particular configuration of incidents called Control Self-Ownership, consisting of permanent rights in rem of use, exclusion, and transfer over one's own body and labor power. As I show, this conception of self-ownership is coherent--two of its incidents can be either directly or indirectly derived from the third--but it creates difficulties for the political theorists who use it. For example, liberal egalitarians' tentative adoption of CSO forces them to be not only more liberal but also less egalitarian than they would otherwise be, whereas libertarians' efforts to adopt CSO but also extend it to include a right to labor income are unsuccessful, leaving their opposition to redistributive labor taxation ungrounded. The dissertation also shows that CSO can act as a mediating concept between the abstract political value of autonomy and a variety of concrete policy prescriptions, including the decriminalization of victimless crimes and the abolition of forced labor. More specifically, I demonstrate that CSO is tightly linked to autonomy by developing two distinct but interrelated Kantian defenses of it. I also argue that CSO is highly inconsistent with several existing and proposed nonmarket institutions to allocate transplantable human organs but that it can provide moral support for markets in human organs. The dissertation concludes with a critical examination of anticommodificationist and social-contract critiques of self-ownership. (shrink)

Reproductive techniques and practices, ranging from ordinary birth-control measures and artificial insemination to embryo transfer and surrogate motherhood, have greatly enhanced our range of reproductive choices. As a consequence, they pose a number of difficult moral and legal questions with regard to the formation of a family and our conception of parenthood. A view that is becoming increasingly common is that parental rights and responsibilities should not be based on genetic relationships but should instead be seen as arising (...) from agreements or contracts between individuals. Accordingly, a man who consents to his wife's artificial insemination by donor (AID) and not the sperm donor, is the legal father of the child; in surrogacy agreements, the intending mother, and not the surrogate, has the right to raise the resulting child. While agreeing that biology should not form the basis for assigning legal parenthood, I argue that the theory of intentional parenthood, despite being put forward as a liberal theory, is geared toward or will have the function of protecting the nuclear family and inhibiting the formation of alternative family forms. (shrink)

Contemporary medicine offers more and more possibilities as far as procreation is concerned. They are available, first of all, to infertile couples (IVF – In Vitro Fertilization). However, the advanced reproductive technology is also used by people who are biologically capable of having children. These people are ready to resign voluntarily from pregnancy and childbirth difficulties. The surrogate motherhood appears as a phenomenon known already from biblical times but existing nowadays in a different context. At the same time, some (...) issues are emerging – questions concerning social, ethical, moral and legal consequences. This paper presents the issue of surrogate motherhood in the context of social changes, which could lead to a development of such practices as well as the reasons of parents and surrogate mothers. Can this phenomenon be perceived as a service for people who want to fulfill their desires for having children? Would surrogate motherhood become a socially approved practice? What are the ethical, religious and legal norms concerning this phenomenon? The religious norms are connected, first of all, with an attitude of the Catholic Church which recognizes surrogacy as unacceptable and states that “it offends the dignity and the right of a child to be conceived, carried in the womb, delivered to the world and brought up by their own parents”. The ethical norms refer to the biotechnological issues and include matters of creating and implanting human embryos as well as the problem of the surrogate mother – child – biological parents relationship. As far as legal norms are concerned, the case is still open hence Polish law does not take into consideration in vitro fertilization or the admissibility of surrogate motherhood. (shrink)

It has become common to distinguish between altruistic and commercial contract motherhood (or ‘surrogacy’). Altruistic arrangements are based on the ‘gift relationship’: a woman is motivated by altruism to have a baby for an infertile couple, who are free to reciprocate as they see fit. By contrast, in commercial arrangements both parties are motivated by personal gain to enter a legally enforceable agreement, which stipulates that the contract mother or ‘surrogate’ is to bear a child for the intending parents (...) in exchange for a fee. She is required to undergo medical examinations and to refrain from behaviour that could harm the foetus. The intending parents are the child's legal parents from the outset. The parties to the contract can, but are not expected to, maintain contact after the transaction is completed. We argue that contract motherhood should not be organized according to the norms of the gift relationship, and that contract mothers should be compensated for their labour. However, we accept that there are good reasons for rejecting the commercial model as a suitable framework for contract pregnancy, and argue, instead, in favour of viewing it as a profession. (shrink)

A scientist at Edinburgh University announced in 1994 that he had removed ovaries from, mouse fetuses and transplanted them, to adult mice. The ovaries released eggs, and conceptions occurred. Although this was not the first such attempt with mice, the study attracted attention because the researcher suggested, that fetal to adult ovarian transplants were a theoretical possibility for humans. If aborted, fetuses were used, as egg sources in assisted conception, a new entity would arise: the never-born genetic mother. Using eggs (...) from aborted fetuses for conception would lead to quixotic and novel family ties. Its use would echo surrogate gestational motherhood, in which a child has both a genetic mother who contributed her egg and a gestational mother who contributed her uterus for gestation and childbirth. With fetal egg use, however, the child's genetic mother would be a never-born fetus without sentience or known, physiology. (shrink)

One of the arguments against surrogacy is that it is harmful to both the surrogate mother and the child. Numerous strands of this argument are collectively referred to as the ‘harm factor’. A version of the argument says that surrogacy interrupts the Mother-fetal affection which develops between the surrogate mother and the child. If this is true, what implication does it have for the concept of motherhood? Does the biological connection between the fetus and the surrogate put (...) the latter in a better position as a mother than the commissioning mother? This paper examines the relationship between surrogacy and motherhood within the context of Yoruba culture. It argues that the culture emphasizes the sociological dimension of motherhood more than the biological. This, the paper argues, is because of the culture’s emphasis on the significance of nurture and care to the development of a meaningful and stable life. The paper thus concludes that while Yoruba traditional society lacked the scientific wherewithal to undertake a successful surrogacy procedure, its conception of motherhood, prevalently held even in contemporary time, is normatively compatible with surrogacy. (shrink)

In this anthology of new and classic articles, fifteen noted feminist philosophers explore contemporary ethical issues that uniquely affect the lives of women. These issues in applied ethics include autonomy, responsibility, sexual harassment, women in the military, new technologies for reproduction, surrogate motherhood, pornography, abortion, nonfeminist women and others. Whether generated by old social standards or intensified by recent technology, these dilemmas all pose persistent, 'nagging,' questions that cry out for answers.

No other cluster of medical issues affects the genders as differently as those related to procreationcontraception, sterilization, abortion, artificial insemination, in-vitro fertilization, surrogate motherhood, and genetic screening. Rosemarie Tong s approach to feminist bioethics serves as a catalyst to bring together different feminist voices in hope of actually doing something to make gender equity a present reality rather than a mere future possibility.".

What is the basis for arguing that a volunteer army exploits citizens who lack civilian career opportunities? How do we determine that a doctor who has sex with his patients is exploiting them? In this book, Alan Wertheimer seeks to identify when a transaction or relationship can be properly regarded as exploitative--and not oppressive, manipulative, or morally deficient in some other way--and explores the moral weight of taking unfair advantage. Among the first political philosophers to examine this important topic from (...) a non-Marxist perspective, Wertheimer writes about ordinary experience in an accessible yet philosophically penetrating way. He considers whether it is seriously wrong for a party to exploit another if the transaction is consensual and mutually advantageous, whether society can justifiably prohibit people from entering into such a transaction, and whether it is wrong to allow oneself to be exploited. Wertheimer first considers several contexts commonly characterized as exploitive, including surrogate motherhood, unconscionable contracts, the exploitation of student athletes, and sexual exploitation in psychotherapy. In a section outlining his theory of exploitation, he sets forth the criteria for a fair transaction and the point at which we can properly say that a party has consented. Whereas many discussions of exploitation have dealt primarily with cases in which one party harms or coerces another, Wertheimer's book focuses on what makes a mutually advantageous and consensual transaction exploitive and analyzes the moral and legal implications of such exploitation. (shrink)

Who owns frozen human embryos? Are "surrogate motherhood" arrangements dangerous for women? Should access to in vitro fertilization be limited or increased? With the development of complex reproductive technologies and the ensuing controversies in reproductive ethics, there is an urgent need for more careful examination of moral principles, current practices, and social policies pertaining to reproduction. The issues examined in this collection of nine papers focusing of the Canadian experience include abortion, the cryopreservation of embryos, the selective termination of (...) fetuses within multiple pregnancies, social policy for gestational "surrogacy," and the regulation of in vitro fertilization. Adopting a feminist perspective, the book places reproductive autonomy at the center of debates about the control of reproduction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Procreative Liberty, Biological Connections, and MotherhoodMargaret Olivia Little (bio)Given the complex and dramatic array of issues currently facing us in reproductive ethics, bioethicists working on the topic might be forgiven feelings of trepidation when they cast their minds toward the next century. Currently, technologies such as artificial insemination by donor (AID), once the source of intense controversy, are used on a routine basis; mainstream newspapers carry advertisements offering “excellent (...) compensation” to ova “donors;” courts are arguing whether women who serve as gestational or “surrogate” mothers have any parental rights; and proposals resurface to jail pregnant women who take street drugs. Sorting out which developments are to be welcomed and which are to be resisted—and why—will require us not only to clarify some of our most basic value commitments, but also to reflect on our understanding of concepts, such as motherhood, that we previously had the luxury of thinking obvious. Let me highlight two issues I think we will be forced to confront as we try to navigate the ethics of reproduction into the twenty-first century—namely, the value of biological connection and the meaning of motherhood.Procreative Liberty and the Value of Biological ReproductionPeople who are unable to conceive a child or to carry one to term now face a variety of extraordinary means of procreative assistance: they can buy sperm and ova, undergo in vitro fertilization, or contract another woman to gestate and give birth to the baby. Those who are enthusiastic about these new technologies [End Page 392] and arrangements often explain their support in terms of many people’s deep desire or even right to bear children biologically related to them; those who are suspicious of the techniques often explain their resistance by criticizing our culture’s “pronatalist” emphasis on biological rather than social relations with children. Focusing on such clear-cut positions, though, undersells the complexity and difficulty of the issues involved. Few want to dismiss altogether the importance of biological connection; but the question remains, what measure of importance should it be granted? Or again, while most agree that procreative liberty is one of our most fundamental rights, the question remains, whose procreation, in what context, and by which means? The truly difficult questions, that is, pertain to how we are to value biological relatedness and how we are to draw the contours of procreative liberty.One perspective emerging in current debates urges an expansive answer to these questions, arguing that the new reproductive technologies and arrangements deserve constitutional protection. Procreative liberty is deeply important, it is urged, given how fundamental the decision to have or to refrain from having children is to our sense of dignity, identity, and meaning of life. But if we recognize a right to reproduce coitally, it is claimed, we should also recognize a right to reproduce noncoitally: people with infertile partners should no more be barred from exercising their right to “beget, bear, and raise” children biologically linked to them by using surrogate arrangements or AID than those who are blind should be barred from exercising their right to written information by using Braille texts. 1The fundamental question is whether the value of biological reproduction persists when pursued outside of the intimacies of marriage and family that form its traditional home. The new reproductive technologies and arrangements, after all, represent a departure not simply because they are noncoital but because they involve reproduction with strangers, under contract, and for pay. One question that demands our reflection, then, is whether the procreative liberty we value attaches to individuals atomistically, as it were, or to individuals only insofar as they are in relationships of an intimate and ongoing nature.Other developments on the horizon sound a restrictive note about procreative liberty. Many IVF clinics, for instance, have denied services to would-be single parents or to gay or lesbian couples. Some legislators have proposed making certain welfare payments for women conditional upon their use of contraceptives such as Norplant—an odd view if one regards procreative liberty as a fundamental right. After all, we do not usually make the receipt of public aid contingent on waiving a constitutional right. (Imagine the government stipulating that... (shrink)

A collection celebrating some of the best essays from the Blackwell journals, Bioethics and Developing World Bioethics. Contributors include Helga Kuhse, Michael Selgelid and Baroness Mary Warnock, former Chair of the British Government’s Committee of Inquiry into Human Fertilization and Embryology’s. Traces some of the most important concerns of the 1980s, such as the ethics of euthanasia, reproductive technologies, the allocation of scarce medical resources, surrogate motherhood, through to a range of new issues debated today, particularly in the field (...) of genetics. Includes contributions that are still as hotly debated today as they were 20 years ago and serves as a salutary reminder that free and open discussion is vital to the health of the discipline itself. Includes eight sections comprising some of the journals' best publications in methodological issues, the health care professional-patient relationship, public health ethics, research ethics, genetics, as well as beginning- and end-of-life issues. Will serve the academic bioethicists as well as students of bioethics as an excellent source book. (shrink)

In this anthology of new and classic articles, fifteen noted feminist philosophers explore contemporary ethical issues that uniquely affect the lives of women. These issues in applied ethics include autonomy, responsibility, sexual harassment, women in the military, new technologies for reproduction, surrogate motherhood, pornography, abortion, nonfeminist women and others. Whether generated by old social standards or intensified by recent technology, these dilemmas all pose persistent, 'nagging,' questions that cry out for answers.

What is the basis for arguing that a volunteer army exploits citizens who lack civilian career opportunities? How do we determine that a doctor who has sex with his patients is exploiting them? In this book, Alan Wertheimer seeks to identify when a transaction or relationship can be properly regarded as exploitative--and not oppressive, manipulative, or morally deficient in some other way--and explores the moral weight of taking unfair advantage. Among the first political philosophers to examine this important topic from (...) a non-Marxist perspective, Wertheimer writes about ordinary experience in an accessible yet philosophically penetrating way. He considers whether it is seriously wrong for a party to exploit another if the transaction is consensual and mutually advantageous, whether society can justifiably prohibit people from entering into such a transaction, and whether it is wrong to allow oneself to be exploited.Wertheimer first considers several contexts commonly characterized as exploitive, including surrogate motherhood, unconscionable contracts, the exploitation of student athletes, and sexual exploitation in psychotherapy. In a section outlining his theory of exploitation, he sets forth the criteria for a fair transaction and the point at which we can properly say that a party has consented. Whereas many discussions of exploitation have dealt primarily with cases in which one party harms or coerces another, Wertheimer's book focuses on what makes a mutually advantageous and consensual transaction exploitive and analyzes the moral and legal implications of such exploitation. (shrink)

This chapter contains sections titled: Moral Arguments against and for Surrogate Motherhood Legal Remedies for Surrogate Motherhood Perspectives of Health‐care Practitioners on Surrogate Motherhood Perspectives of Society on Surrogate Motherhood Conclusion.

The possibility of achieving ectogenesis, or the growing of a human fetus to term in an artificial womb, is approaching reality as a result of advances in treatment of premature newborns and in in vitro fertilization techniques. In their 1984 book, The Reproductive Revolution, issued in North America as Making Babies, Peter Singer and Deane Wells offered several arguments for ectogenesis. James examines their arguments and rejects two of them, that ectogenesis offers a less problematic alternative to surrogate motherhood, (...) and that ectogenesis could make it possible to reconcile fetal rights with the right to abortion on demand. He grants Singer and Wells' argument that the childless have a claim to state support of their desire to nurture, but contends that government-supported ectogenesis should still be rejected because the adoption of unwanted children is a preferable alternative to the use of an exotic, expensive, and still unproven technology. (shrink)

The questions and dilemmas of bioethics touch everyone. Should people who refuse to be vaccinated be treated for COVID-19, even if that displaces vaccinated patients with other serious conditions? What restrictions on abortion should there be, if any? Should women be paid to donate eggs? Bioethics: What Everyone Needs to Know ® discusses these and other similar questions facing the public today--as well as providing a way for thinking deeply about them. Steinbock and Menzel first examine major moral theories and (...) how they can be used to analyze bioethical issues. They then provide historical background to the birth of bioethics and explain how it shifted from a paternalistic doctor knows best approach to respect for autonomy, a fundamental value in contemporary bioethics. Subsequent chapters cover advance directives, experimentation on human subjects, the definition of death, physician-assisted dying, abortion, disability, just healthcare systems, the allocation of scarce resources, pharmaceutical drug pricing, assisted reproductive technology, egg donation, surrogate motherhood, sex selection, and the genetic modification of humans. Race and gender are considered throughout, as are the ethical issues raised by pandemics. Steinbock and Menzel consider the controversial questions that surface in the public sphere, explaining the facts, and then evaluating different approaches to resolving them. (shrink)

This book examines, through a multi-disciplinary lens, the possibilities offered by relationships and family forms that challenge the nuclear family ideal, and some of the arguments that recommend or disqualify these as legitimate units in our societies. That children should be conceived naturally, born to and raised by their two young, heterosexual, married to each other, genetic parents; that this relationship between parents is also the ideal relationship between romantic or sexual partners; and that romance and sexual intimacy ought (...) to be at the core of our closest personal relationships - all these elements converge towards the ideal of the nuclear family. The authors consider a range of relationship and family structures that depart from this ideal: polyamory and polygamy, single and polyparenting, parenting by gay and lesbian couples, as well as families created through current and prospective modes of assisted human reproduction such as surrogate motherhood, donor insemination, and reproductive cloning. (shrink)

One effect of late capitalism – the commodification of practically everything – is to knock down the Chinese walls between the natural and productive realms, to use a Marxist framework. Women's labour in egg extraction and ‘surrogate’ motherhood might then be seen as what it is, labour which produces something of value. But this does not necessarily mean that women will benefit from the commodification of practically everything, in either North or South. In the newly developing biotechnologies involving stem (...) cells, the reverse is more likely, particular given the shortage in the North of the egg donors who will be increasingly necessary to therapeutic cloning.Although most of the ethical debate has focused on the status of the embryo, this is to define ethics with no reference to global or gender justice. There has been little or no debate about possible exploitation of women, particularly of ovum donors from the South. Countries of the South without national ethics committees or guidelines may be particularly vulnerable: although there is increasing awareness of the susceptibility of poorer countries to abuses in research ethics, very little has been written about how they might be affected by the enormously profitable new technologies exploiting human tissue. Even in the UK, although the new Medical Research Council guidelines make a good deal of the ‘gift relationship’, what they are actually about is commodification. If donors believe they are demonstrating altruism, but biotechnology firms and researchers use the discourse of commodity and profit, we have not ‘incomplete commodification’ but complete commodification with a plausibly human face. (shrink)

Chapter 19 of the Children’s Act No. 32 of 2005 regulates the practice of surrogate motherhood in South Africa and provides legal certainty regarding the rights of the children born as a result of surrogacy, including the rights of the different parties involved. Despite the clarity regarding the legal consequences of human reproduction by artificial fertilisation of women acting as surrogate mothers, some legal gaps and inconsistencies regarding certain medical and ethico-legal issues remain. The purpose of this article (...) is to critically examine selected provisions whose implementation is hampered by a lack of detail or clarity, compromising compliance by the different parties to the surrogate motherhood agreement. The article concludes with recommendations on how some of these issues may be addressed to provide for legal certainty and transparency. (shrink)

An examination of the relationship between law and morals, this wide-ranging book develops themes addressed by Hart and Devlin, relating them to issues and events of current interest. Lee covers such timely concerns as: the Moral Majority; embryo experiments and surrogate motherhood; contraception, children's rights, and parents' rights; informed medical consent; equality and discrimination; and freedom of expression and pornography. Stressing the relevance of these issues to the lives of all of us, Lee argues for broader participation in debate (...) on this topic. (shrink)

This article examines pregnancy as a dyadic body-project within surrogate motherhood arrangements. In gestational surrogacy arrangements, the surrogate mother agrees to have an embryo that has been created using IVF, with the genetic materials of the intended parents or of anonymous donors, surgically implanted in her womb. Based on anthropological fieldwork among Jewish-Israeli surrogates and intended mothers involved in these arrangements, this article focuses upon the interactive identity management practices that the women jointly undertake during the pregnancy. For (...) each side, creating an unambiguous definition of motherhood was central to their individual identity-work. For surrogates, the possible imputations of immorality required redefining pregnant embodiment as separate from maternal identity, while for intended mothers, the surrogate’s embodiment of the pregnancy represented competing claims to their own maternity. Through verbal communication and through practices of disembodiment and vicarious embodiment, the women construct a ‘shifting body’ which they use to designate the social label of pregnancy, identity-building processes associated with pregnant embodiment, and even the lived experience of pregnancy. This example of a dyadic body-project contributes to the existing scholarship on the role of the body in the management of identity. While previous works have examined projects of the body as individualistic pursuits, the shifting body exemplifies that body-projects can be collaborative, dual forms of identity-work and that pregnancy can be the site of these projects. (shrink)

Reproductive techniques and practices, ranging from ordinary birth-control measures and artificial insemination to embryo transfer and surrogate motherhood, have greatly enhanced our range of reproductive choices. As a consequence, they pose a number of difficult moral and legal questions with regard to the formation of a family and our conception of parenthood. A view that is becoming increasingly common is that parental rights and responsibilities should not be based on genetic relationships but should instead be seen as arising (...) from agreements or contracts between individuals. Accordingly, a man who consents to his wife's artificial insemination by donor (AID) and not the sperm donor, is the legal father of the child; in surrogacy agreements, the “intending mother,” and not the surrogate, has the right to raise the resulting child. While agreeing that biology should not form the basis for assigning legal parenthood, I argue that the theory of intentional parenthood, despite being put forward as a liberal theory, is geared toward or will have the function of protecting the nuclear family and inhibiting the formation of alternative family forms. (shrink)

ABSTRACT In the first part of this article I discuss some objections which assert that surrogacy is primarily—but not exclusively—harmful in a moral sense. After examination of mainly but not exclusively morality‐dependent harms (objections from similarity with prostitution, exploitation, etc.) and after the discussion of possible non‐morality‐dependent harms (baby, couple, surrogate mother, agency, etc.), I argue, in the second part, that no one reason supports the possible prohibition of surrogacy. In the last part I try to show why moral (...) reasons alone could not be sufficient to criminalize any kind of activity—including surrogacy—in a liberal order. (shrink)

This comprehensive book covers the research, theory, policy and practice context of unusual reproduction using third parties. Olga Van den Akker details the psychological adaptation required to continuing changes in public opinion, advances in technologies and new legislations in surrogate motherhood and discusses their impact at an individual, societal and global level. She describes the competing interests and interactions between legal, organisational, personal, social, psychological and cultural issues in relation to biological and genetic surrogate and commissioning parenthood. This (...) book is intended for professionals, practitioners, academics and students interested in the complexities of unusual reproduction using multidisciplinary perspectives. (shrink)

Book reviewed in this article: Recreating Motherhood: Ideology and Technology in Patriarchal Society. By Barbara Katz Rothman. Surrogate Motherhood: The Legal and Human Issues. By Martha A. Field.

This paper will explore some moral and conceptual aspects of the practice of surrogate motherhood. Although I put forward a number of criticisms of existing ideas about this subject, I do not claim to offer a fully developed position. Instead what I have tried to do is to call into question what seem to be some generally accepted assumptions about surrogate motherhood, and to lend plausibility to my view that surrogate motherhood may be morally troubling for reasons (...) not always fully recognized by other writers on this issue. These reasons go beyond the fairly obvious consequentialist concerns about its effects on the persons - particularly the child — involved. A concern for the well being of a child produced by a surrogate is, I believe, entirely justified, but my focus in this paper will be upon the surrogate mother herself. (shrink)

Gestational surrogacy as a treatment for infertility is being practised in some well-known medical institutions in Tehran and some other cities in Iran. While the majority of Muslims in the world are Sunni, the majority of Iranians are Shiite. Most Sunni scholars do not permit surrogate motherhood, since it involves introducing the sperm of a man into the uterus of a woman to whom he is not married. Most Shiite scholars, however, have issued jurisprudential decrees (fatwas) that allow (...) class='Hi'>surrogate motherhood as a treatment for infertility, albeit only for legal couples. They regard this practice as transferring an embryo or fetus from one womb to another, which is not forbidden in Shiite jurisprudence. Nevertheless, there are some controversies concerning some issues such as kinship and inheritance. The main ethical concern of Iran’s experience with gestational surrogacy is the monetary relation between the intended couple and the surrogate mother. While monetary remuneration is practised in Iran and allowed by religious authorities, it seems to suffer from ethical problems. This article proposes that this kind of monetary relation should be modified and limited to reimbursement of normal costs. Such modification requires new legislation and religious decrees. (shrink)

Charles Darwin argued that human beings are what happen whenphysical laws act upon a planet with the characteristics that earthhad five billion years ago. Similarly, I have argued that theprimacy of individual will is what eventually happens when asociety allocates and limits coercion based upon rights. From timeto time particular visions of the good or the right dominate publicbehavior, but they are eventually enframed by rights — the authoritative claim of each person to respect.I have argued that the propositional structure (...) of American law—the laws themselves — can be seen to be a logically consistentsystem of propositions stemming from the axiom that the will ofeach person is worthy of respect. This is an explanatory, not anormative, proposition. The axiom was not put there by anyoneand the law derived from it, any more than the human brian wasput there and the theory of relativity derived from it. The axiomcame to be embodied in k because of a fact — the single universalcharacteristic of human beings that is relevant to the question ofarranging coercion is individual will — and a process — the right ofeach person to demand a justification for coercion used upon him.Since will is universal to human beings, this would suggest thatany rights-based legal system would evince a general structuresimilar to our own. Particularities of national culture, naturalresources, population density, and so on would produce a verydifferent liberty frontier from the one facing this country andhence, different laws. But the general structure of law — the relationship between principle and policy decision, the role of thebasic rights, and so on — should be similar. This similarity shouldprovide a common basis for cooperation between states, transcending particularities of economic structure, political structure and ideology. We have seen that a very broad range ofeconomic and political institutions may be justified. The essential difference between states lies not in the different ways that theyarrange institutions but in the different ways that they justifythem. Those that justify them to people as persons are similar.Those that justify them by conformity to a design are different.The theory set out here is not a design. It is an explanation. Onevirtue of explanations is that they draw forth other explanations.More importantly, they offer perspective — they tell us what weare “up to.” As the social relations which law must rationalizebecome ever more complex, perspective becomes ever more necessary. The simple laws have already been written. The connectionbetween the doctrine of consideration and the first principle isobvious. The connection between the “hard look” doctrine ofreviewing administrative agencies and the second principle isnowhere near so obvious (though it is a lovely example of thejudicial process enframing the realm of uncertainty). The morecomplex and artificial the institution, the poorer the guidance ofintuition and the more necessary are conscious guides to decision.Justification comes easy to printers. Most of them don't knowwhy a page of print that has straight margines left and right is“justified.” They don't need to know, for the idea has immediateintuitive appeal; it is easy to accept and to remember, and, onceremembered, it is an effective guide to behavior. It is easy to seethat this line of print is not justified and to do somethingabout it. It is not so easy to tell whether the “hard look” doctrine orthe enforcement of a surrogate motherhood contract sits fairly on itspage. Justification of law requires an understanding of thecriterion against which it is being done. There is an intuitive core— a “sense” — to any act of judgment, but that core can be illuminated and developed by an understanding of the framework withinwhich it operates. (shrink)

The arguments of Van Niekerk and Van Zyl that, on the grounds that it involves an inappropriate commodification and alienation of women's labour, commercial surrogate motherhood (CSM) is morally suspect are discussed and considered to be defective. In addition, doubt is cast on the notion that CSM should be illegal.