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Surrogacy

Surrogacy. Rels 300 / Nurs 330 29 January 2014. 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

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Surrogacy

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  1. Surrogacy Rels 300 / Nurs330 29 January 2014 300/330 - appleby

  2. 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 300/330 - appleby

  3. Terms of the Contract: 3 parties • Richard Whitehead (husband of Mary Beth Whitehead) • gave consent for Mary Beth to be inseminated with sperm of William Stern • agreed to terminate his parental rights and surrender custody of infant upon birth • Mary Beth Whitehead • agreed to artificial insemination and to form no “parent-child relationship” with fetus/infant • agreed to assume all risks of pregnancy and childbirth • at birth, to surrender her parental rights to William Stern 300/330 - appleby

  4. Terms of the Contract: 3 parties • William Stern • agreed to pay $10,000 to Mary Beth W. upon surrender of live child • if miscarriage prior to 5th month, no payment • if miscarriage after 5th month, $1,000 • if stillborn, $1,000 • agreed to pay lawyer Noel Keane $10,000 for arranging contract • Elizabeth Stern – no part in contract; after birth, she would adopt baby • Elizabeth Stern was not infertile 300/330 - appleby

  5. 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. In the Matter of Baby M: 1988Plaintiffs: William and Elizabeth SternDefendant: Mary Beth Whitehead 300/330 - appleby

  6. What went wrong?Mary Beth changed her mind Mary Beth HAD bonded with the fetus/newborn • after conceiving, gestating and giving birth to Baby M, she felt like the baby’s mother • she refused the $10,000 and refused to terminate her maternal rights New Jersey Supreme Court overturned lower court’s ruling: • surrogacy contract was invalidated; adoption was annulled; Mary Beth’s parental rights were restored • William Stern awarded custody; Mary Beth had significant visitation rights 300/330 - appleby

  7. 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? 300/330 - appleby

  8. More complex forms of surrogacy GESTATIONAL SURROGACY: 1 Gestational mother has no genetic link to child • using ova and sperm of contracting couple • cycles of 2 women are synchronized using hormones • ova fertilized using IVF technology • embryo(s) transferred to surrogate 300/330 - appleby

  9. 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 300/330 - appleby

  10. 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 300/330 - appleby

  11. GESTATIONAL SURROGACY: 4 donor egg, donor sperm genetic concerns for both contractors desire for no biological / genetic link with offspring advanced parental age IVF; ET; surrogate gestation 300/330 - appleby

  12. 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 - $20,000 300/330 - appleby

  13. 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 300/330 - appleby

  14. MomService Egg Donor Catalogue http://surrogate-donation.com/egg_catalog.shtml Ekaterina, 25 http://surrogate-donation.com/surrogates_s6.shtml 300/330 - appleby

  15. 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 - $250 300/330 - appleby

  16. 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 $120,000 300/330 - appleby

  17. 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: 300/330 - appleby

  18. 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 300/330 - appleby

  19. 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 300/330 - appleby

  20. 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 $80,000 300/330 - appleby

  21. 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 300/330 - appleby

  22. 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? 300/330 - appleby

  23. SURROGACY & DISABILITY When 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? • The contract should be enforced so that the contracting parents assume parenting responsibilities. • The contract should be written in a way that assigns parenting responsibilities to the surrogate. • The pregnancy should be closely monitored so that a handicapped fetus can be identified and aborted. • The contract should stipulate that parental responsibilities may be refused in the case of a handicapped infant. • We think that . . . 300/330 - appleby

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