Reproductive Technology and Surrogacy

An Introduction to the Issues

by

©Lawrence M. Hinman

Many of the moral problems we face today-such as euthanasia, punishment, hunger, and discrimination-have been perennial issues for humanity. In the past few decades, however, we have been faced with a new range of moral problems, problems arising out of the advance of medical technology. Perhaps nowhere are these more pressing and more complex than in the area of reproductive technology. The last two decades of scientific advances have now turned fiction to fact. Indeed, so-called “test-tube babies”-more precisely, babies conceived in a petrie dish from human sperm and eggs and then implanted in a woman’s uterus-used to be the stuff of science fiction. Now the question is more likely to be whether the cost of such procedures should be covered by health insurance.

In this chapter, we will be looking at a number of the moral issues raised by this and other advances in reproductive technology. Some of these relate directly to the moral status of what is variously called the embryo, the pre-embryo, or the conceptus. To a large extent, the issues here repeat those explored in our discussion of abortion. However, some completely new issues arise as well. For example, there have been several cases in which divorcing couples have gone to court to settle disagreements about the disposition of frozen embryos from their own eggs and sperm.

A quite different set of issues arises in those situations where a surrogate mother carries the embryo to term, and these issues center primarily on the relationship among three parties: (a) the couple-or, occasionally, the single individual-who wants to have the child, (b) the surrogate mother who carries the baby to term, and (c) the baby that the surrogate mother bears.

A third set of issues arises through the intersection of reproductive technologies and genetic manipulation. We are only on the verge of confronting such issues, but they are sure to become more pressing as medical science becomes increasingly skilled at genetic manipulation and as the Human Genome Project maps out the genetic code with increasing precision. The questions are primarily hypothetical at present. What if we can decide whether a given embryo develops as a male or a female? What if we can select physical characteristics? personality traits? sexual orientation? The spectre of “designer babies” looms, if not in the immediate future, at least in the not-too-distant future. How should such choices be made, if at all?

Let’s consider each of these three areas in more detail.

In Vitro Fertilization

Current estimates suggest that one in twelve American couples who want to have a child experience signficant medical barriers to fertility. For such couples, once the nature of the medical problem(s) has been diagnosed, there are often initial therapeutic techniques, such as hormone therapy or surgery, that can allow the couple to have children without further medical assistance. However, this is not possible for all. For some couples, it is still impossible to conceive. In those cases, it is necessary to turn to more radical means. If conception cannot take place in the woman, then the next step is to try to bring about conception outside the woman-in a glass laboratory dish, in vitro. The man’s sperm and the woman’s egg are combined in a glass dish (in vitro just means “in glass” in Latin) in a way that allows the sperm to fertilize the egg, producing the embryo. This creates a double separation. First, the act of creating a human life is separated from sexual intercourse. Second, and even more importantly, the embryo itself is separate (if only for a short period of time) from the mother. At this point, the embryo is implanted, either in the woman herself or in another woman who will bear the baby.

The Vocabulary of the New Parenthood

We can begin to see the myriad of possibilities in this arrangement and how our traditional vocabulary fails us. To help describe the various possibilities, we can distinguish among the:
Intentional mother the woman who wants to have the child
Intentional father the man who wants to have the child
Genetic mother the woman who supplies the egg for the embryo
Genetic father the man who supplies the sperm for the embryo
Gestational mother the woman who carries the embryo to term and gives birth to it
Nurturing mother the woman who raises and nurtures the child from infancy as her own
Nurturing father the man who raises and nurtures the child from infancy as his own

In the simplest case, both sperm and egg may come from the couple wanting to have the child, and then the embryo may be implanted back in the woman. In this case, we may say that the intentional parents are also the genetic parents, the birth parents, and the nurturing parents. However, it is not uncommon for either the sperm or the egg-sometimes, even both-to come from a donor. (The male’s sperm count may be too low or too abnormal or unable to penetrate the egg, or the female may be unable to produce eggs that can be fertilized.) In those cases, the genetic mother or father is different from the birth mother and the nurturing parents. The simplest of these cases does not even require in vitro fertilization; it can simply be achieved through artificial insemination by a donor (AID). Compared with in vitro procedures, AID is comparatively cheap and effective. However, it is only helpful in cases of male infertility. The corresponding procedure for women, which involves donor eggs instead of donor sperm, is much more complicated and expensive and generally requires in vitro techniques.

In some cases the embryo may be implanted in a surrogate, who then bears the child. She is then the birth mother, but she may not be the genetic mother. Nor, if things go according to the plan of the intentional parents, will she be the nurturing mother. The whole point of the process for them is for the surrogate to bear their child for them. As we shall see in our readings, the issue of surrogacy is a thorny one, especially in those cases where a surrogate changes her mind and wants to raise the baby herself.

We can easily see the complex possibilities that present themselves. It is possible for a child to have three mothers: a genetic mother (i.e., the one who supplies the egg); a birth mother (i.e., the woman who carries the child and gives birth to it); and a nurturing mother (i.e., the woman who raises the child as her child). (Presumably the intentional mother and the nurturing mother are the same, although in unusual circumstances they could be two different women.) Similarly, a child can have at least two fathers: the genetic father (i.e., the one who supplies the sperm) and the nurturing father (i.e., the one who raises the child as his own).

Who, then, are the real parents? Our initial answers often reveal a lot about our most fundamental beliefs about what counts as “real.” Some see biology as constituting what is most real, and for them the “real” parents are either the genetic parents or, in some cases, the birth mother. Some see relationships and love as being the most “real,” and for them the “real” parents are often the nurturing parents. But there is no simple and unchallenged answer to this question, and little is to be gained by pursuing it too far. Rather, the answer-as Ruth Macklin indicates in “Artificial Means of Reproduction and Our Understanding of the Family”-is to be found in making the various senses of “real” more precise and then specifying the ways in which a given person meets, or fails to meet, that more specific sense.

The Moral Status of the Pre-embryo

We have already discussed many of the arguments about the moral status of the fetus in the introduction to the chpater on abortion. However, when we are dealing with in vitro fertilization, we are dealing with what is sometimes called a “pre-embryo,” which arguably has a different moral status than an embryo.

What is a “pre-embryo?” Some have argued that it is simply an embryo at its earliest stage of development, and that the attempt to call it a pre-embryo is simply an attempt to make anythig relating to it appear morally unobjectionable. Yet giving something a new name does not change its moral status. We will follow common usage and employ the term “pre-embryo,” but note that this does not entail any judgment about its moral status.

At least two points are relevant here to the moral status of the pre-embryo. First, at this early stage, the pre-embryo is microscopic, smaller than the period at the end of this sentence. Usually, it is implanted or frozen when it has reached eight cells. There is nothing visually resembling a human being, although the pre-embryo certainly contains the coded genetic information for a full human being. Second, in contrast to its situation when it is in utero, the pre-embryo in a petrie dish will not develop into a human being unless someone takes positive steps to implant it. This is very different from the situation of abortion, where someone has to intervene to prevent the pre-embryo from developing. Of course, the positive steps necessary when the pre-embryo is ex utero are only necessary because the woman’s eggs have been artifically removed and fertilized.

One of the principal moral issues here is that it is standard procedure during in vitro fertilization to harvest a number of eggs, to fertilize them outside of the uterus, and then to implant the pre-embryo most likely to thrive. What happens to the remaining pre-embryos? In some instances, they may be frozen in order to be used later by the couple if this attempt is unsuccessful or if they want additional children. Otherwise they are usually destroyed. Some people are opposed to in vitro fertilization primarily because it produces pre-embryos that are then discarded.

Access to in vitro Fertilization

Unusual cases often find their way into the newspaper headlines, and unusual cases involving in vitro fertilization are no exception. In 1995 in Italy, a woman in her early sixties gave birth to a healthy baby boy, with the help of donor eggs and her husband’s sperm. She decided to try IVF after the death of their seventeen year old son and after they were told that they were too old to adopt. Such a case inevitably raises questions. Should there be age limits on couples seeking IVF? Moreover, should there be any restrictions about motivation? In the Italian case, the woman gave her new baby the same name as her previously deceased son. In another case in 1995, a black woman in Italy with a husband of mixed race obtained in vitro fertilization using the eggs of a white woman. One of the reasons she gave was her belief that a light-skinned child would have an easier time in life than a dark-skinned one, given the existence of racism. Again, questions about motivation immediately arise.

What interest, if any, does the state have in regulating such IVF? While we might raise questions about the motives of the women mentioned in the preceding paragraph, we could certainly raise questions about the motives of many parents, and yet that is not sufficient grounds for state intervention. The situation changes significantly if public money is used to finance such procedures; but as long as they are done with private funds, it seems that the state has little basis for questioning the motivation of the couples involved.

Conflicting Claims: The Embryos of Divorcing Couples

One of the more perplexing issues arising out of the fact that embryos can-at least temporarily-exist outside the mother’s womb is that couples, when in the process of divorcing, make competing claims for custody of the embryos. Usually such embryos are frozen, and this allows such battles to be protracted. Several issues are intertwined here.

The first of these issues is the moral status of the pre-embryo, which we have already considered above. If they have the moral status of persons, then they have a right to life. If one member of the couple wants the embryos destroyed, this would not be morally permissible if they have a right to life. If, on the other hand, they do not yet have this moral status, then destructing embryos would be morally permissible.

Second, what kind of rights and responsibilities do the genetic parents have toward the embryo as parents? Is it a relationship of ownership? of parenthood? In the case of one divorcing couple, the woman wanted possession of the embryos in order to have them implanted in herself and to bring them to term. The divorcing husband did not want to be the (genetic) father, with its accompanying responsibilities, when he and his wife were getting a divorce. Does the wife have the right to go ahead and have the embryos emplanted? Does the husband have the right to have the embryos destroyed, since he no longer wants to be their father? What role should the courts play in settling such disputes?

Conservative Objections to in vitro fertilization

Some critics of the current rise in in vitro fertilization recognize that it may be effective in achieving its goal, but that it ought not to be used anyway. Several motives come into play in such criticisms.

Religiously-based Critiques of Assisted Reproduction. Many religious traditions are profoundly opposed to the development of reproductive technologies. At its deepest level, just as we have seen in our discussion of abortion, this view questions the technological society’s presumption that we can control our destiny. Instead, it believes that our fates are ultimately in divine hands, and that intrusive technological procedures are hubris.

The second principal concern within religious traditions is that reproductive technologies almost always involve manipulating and destroying embryos. Embryos, many religous thinkers maintain, are persons and thus are not the proper objects of manipulation. Certainly, it is immoral to destroy them. Since in vitro fertilization almost inevitably involves such destruction of embryos, many religious thinkers believe it should be condemned.

Anti-Technology Critiques of Assisted Reproduction. Not all critics of assisted reproduction are motivated solely by religious concerns. Many are concerned with the way in which technology distorts the reproductive process, as our selection from Paul Lauritzen, “What Price Parenthood?”, indicates. Ideally-and almost everyone would admit that the actual case often falls short of the ideal-conception is part of a larger process, one with both human and natural elements. Technological intervention breaks both the natural and the human cycle. Ideally, human intercourse is motivated by love and is open to the possibility that this love will result in children.

Surrogacy

From Donors to Surrogates

Many of these situations become more complicated with the introduction of a surrogate who is the birth mother. The role that the birth mother plays in this process is different from the role played by donors. In the case of sperm donors, their contributions may be made in a way that does not personally involve them in the process at all. Their sperm is frozen, and those in need of donor sperm cnosult lists of available donors which give information such as physical characteristics, interests, etc. Moreover, donor sperm may be mixed with the husband’s sperm in some cases, thus making its contribution less prominent and less certain. Donor eggs are a different matter, since they are much more difficult to harvest-currently, this requires laproscopic surgery-and often the harvesting must be coordinated with the cycle of the gestational mother. Whereas sperm is donated to a general sperm bank, eggs are usually donated with a specific recipient in mind. However, the interests of the sperm or egg donors do not come close to rivaling the interests of the hopeful couple, and there would be scant basis for such donors to claim the child as their own.

The case of surrogate mothers is much different from that of donors. Surrogate mothers have a nine month relationship with the child they are carrying and which they eventually bear. This is an intimate and emotionally-charged relationship, and it is understandable if unanticipated feelings of attachment develop during it. Moreover, there is often a relationship between the surrogate mother and the couple desiring the child. A surrogate carries the baby for a particular couple, with whom in some cases she has personal contact. The interests of the surrogate, in other word, have a kind of standing that we would not accord to the interests of either sperm or even egg donors.

The Case of Baby M.

The interests of the surrogate have even greater standing if the surrogate is also the genetic mother. This was the situation in the case of Baby M, where the surrogate mother-Mary Beth Whitehead-was also the genetic mother of the baby she was carrying for William and Elizabeth Stern; William Stern was the genetic father through artifical insemination. Mr. Stern contracted with Mrs. Whitehead for her to be the surrogate mother for the Stern’s child; in return, they promised to pay her $10,000 and to pay her medical expenses. Several days after the birth, she asked the Sterns to allow her to take the baby back for a week, and the Sterns agreed. The next day, Mrs. Whitehead left the state to visit her mother. Shortly thereafter, Mrs. Whitehead told the Sterns that she wanted to keep the baby, and she eluded a subsequent court order requiring her to return the baby to the Sterns. She ran away with the baby for almost three months. After numerous press conferences, suits and countersuits, the court awarded custody of the baby to the Sterns but gives Mrs. Whitehead visitation rights. However, the court did not uphold the enforceability of the surrogacy contract itself; rather, it awards custody on the basis of what it considers to be “the best interests of the child.”

The public reaction to the case of Baby M was both deep and widespread. Many sympathized with Mrs. Whitehead, and decried the action of the court as taking a child from her “real” mother. Others sympathized with the Sterns, who had placed their trust and hopes for a family with Mrs. Whitehead. They saw Mrs. Whitehead’s promise to the Sterns as binding. Some sympathized with both sides, as well as with the baby, and denounced the situation itself; they often called for the banning of all surrogacy arrangements, precisely because they could lead to such Solomonic outcomes.

The case of Baby M was exceptional. Most surrogacy arrangments proceed without such difficulties. However, it focused attention on a number of moral issues about the practice of surrogacy that deserve attention. How should we deal with changes of heart on the part of surrogates? Is the relationship between the intending parents and the surrogate best understood in terms of family law or contract law? Does surrogacy involve buying and selling babies? Does surrogacy usually exploit women, especially poor women? Let’s turn to some of these questions.

Models for Understanding the Relationship between the Surrogate and the Intending Parents

There are several ways in which we might attempt to understand the relationship between the surrogate mother and the intentional parents. Our choice of a model affects both our moral evaluation of the situation and the ways in which we respond when something goes wrong in the arrangement.

The Contractual Model. Since there is often a contract between the surrogate mother and the intending parents, we are often inclined to understand their relationship primarily in terms of a contract. This can lead to either of two results. On the one hand, those who see this contractual model as appropriate to surrogacy will maintain that surrogate mothers as well as intending parents should be held to the terms of their contract. The contract, in their eyes, is the only morally salient aspect of the situation. On the other hand, some see surrogacy as a matter of contracts, but maintain contracts for carrying babies are inappropirate. Among the reasons for seeing such contracts as objectionable is that they involve “selling babies” or that they are exploitative of women, especially poor women. From this, they conclude that surrogacy itself is wrong.

The drawback of the contractual model is that it overlooks much in the process of surrogacy that is morally relevant but which is not part of the contract. Among the neglected factors are the best interests of the child and the feelings of natural bonding that the surrogate mother may experience.

The Adoption Model. Some have suggested that we understand the relationship between the intending parents the the surrogate in terms of pre-natal adoption. One of the advantages of such a model is that the adoption model usually has a specified period of time (up to six months) during which the birth mother can change her mind about her decision to allow the baby to be adopted. Moreover, birth mothers receive no payment for their baby, although their living expenses (including medical costs and counselling) may be paid by the intending parents.

Such a model seems to avoid the two principal drawback of the contractual model, but there are important differences between surrogacy and adoption. First, in adoption, the birth mother is not getting pregnant for the intending parents, and thus there is no direct connection with the intending parents as there is in surrogacy. In recent years, this has changed somewhat, since birth mothers may well have selected-and be emotionally quite close to-the couple that hopes to adopt. Second, there is no genetic connection in adoption between the intending parents and the birth mother, whereas in most cases of surrogacy there is a genetic contribution from at least one of the intending parents. Often the embryo will have no genetic links to the surrogate mother, but it always does in adoption.

The Cooperative Model. If we ask ourselves what is taking place in the ideal relationship between intending parents and surrogate, we can get a fuller picture of the moral aspects of this relationship and a better idea of what we want to strive for in this area. Let’s look at the two parties in the relationship, the intending parents and the surrogate.

First, the intending parents are presumably a couple that either is infertile (thus unable to have children on their own) or is at risk through pregnancy. These “at risk” factors are presumably on the intending mother’s side, and usually relate to the physical risks of pregnancy. For example, in the Baby M case, it was reported that the intending mother (Mrs. Stern) had a mild case of multiple sclerosis, which could have been greatly exacerbated by pregnancy. Presumably, we would look with much greater suspicion at intending parents who wanted to hire a surrogate for reasons of convenience, career, and the like.

Second, the surrogate mother usually has special characteristics as well. Although they often welcome the payment ($10,000 is currently the usual amount), their motives are usually much more than monetary. (There are often other, easier, and less intrusive ways of making money; and some surrogates, especially family members, do not accept money.) They are usually not desperately poor women, but rather middle-class women who use the money for things like college tuition for her other children, a new car, or home improvements. They understand, often through the experiences of a close friend or family member, how painful it can be for a couple to want to have children but be unable to. Moreover, they usually have children themselves, and they value parenthood highly. Interestingly, some even enjoy the experience of being pregnant, despite its obvious discomforts and the pain of childbirth. They often become surrogates in order to help a couple who otherwise would be unable to have children. And it is this which makes surrogacy unique. Surrogates become pregnant, not in order to have children of their own, but in order to help others to have children of their own. Indeed, often the babies they have are not genetically their own at all; rather, they are carrying a baby for someone else.

The issue, then, is how to structure the surrogacy arrangement so that it most often approximates this ideal. Here it seems that the first step is screening to insure, as much as possible, that both parties comes as close as possible to this ideal. Intending parents should not be people who simply want to avoid the inconveniences of pregnancy or the career interruptions it can cause. Similarly, surrogates should not be women who have ambivalent feelings about carrying another couple’s child for them or about giving up the child once it is born. The more thoroughly those who facilitate surrogacy arrangments can do this, the more smoothly the process will proceed.

This does not mean that contracts have no place in surrogacy arrangments, but it does mean that the relationship is not primarily about contracts. Consider the difference between getting married and buying a car. Both may involve contracts of types, but marriage in not primarily about a contract. Buying a car, on the other hand, is mainly a matter of contract, and any personal relationship between buyer and seller is incidental. Marriage, on the other hand, is mainly about a certain kind of relationship between two people. What is morally salient here is, first and foremost, the relationship; only secondarily, the contract. Similarly, with surrogacy. The relationship is primarily about one woman bearing a child for another couple.

Remaining Moral Issues.

Many issues obviously remain to be resolved in this area. Who does the screening? What standards are legitimate in such screening? What interest does the state have in regulating this process? Most difficult of all, what should happen in those cases where a surrogate changes her mind about turning over the child? Here it is important to distinguish three types of cases: (1) those in which the surrogate is also the genetic mother; (2) those in which the intending parents are also the genetic parents; and (3) those in which the genetic parents are neither the surrogate nor the intending parents. The interests of the surrogate seem strongeest in the first case. The interests of the intending parents certainly seem strongest in the second case. In the third case, both the surrogate and the intending parents have strong, although quite different, interests. The surrogate may well have strong feelings of bonding which she had not, in all good faith, anticipated; the intending parents certainly have invested deeply, emotionally as well as financially, in this process. When neither side can claim genetic lineage to tip the scales, there seems to be no clear and easy basis for deciding whose interests are stronger.

Genetic Manipulation and Parenthood

Two areas of development have recently combined to open possibilities that were previously thought to be only in the realm of science fiction. First, in just the past few years, scientists have developed the ability to manipulate the genes of an embryo or fetus. Although such techniques are still in their infancy, as it were, there is little reason to doubt that they will develop further, probably fairly rapidly. Second, in the late 1980’s, the United States government and others lauched the Human Genome Project, which is intended eventually to provide a complete map of the human genome. A hugh understanding, this project is gradually uncovering the genetic markers for numerous diseases as well as for a number of human conditions that are not diseases. The combination of the technology to manipulate genes and the knowledge of the human genetic code is a powerful and awesome prospect.

From Abortion to Genetic Manipulation

The moral terrain opened up by advances in genetic manipulation is still largely uncharted. One of the first things we notice is that, with the advent of genetic manipulation, abortion is no longer the only option when tests reveal an unwanted condition in the embryo or fetus. This makes the situation morally much more complex, because it is no longer a question-as it was in the case of abortion-of depriving the fetus of a future through terminating it. Instead, the issue is now one of giving it a different future, one that results from conscious human choice rather than genetics.

Some alternative futures are clearly preferable to others, especially when we are dealing with disease. A child facing a future of Tay-Sachs disease or multiple sclorosis or other debilitating and eventually lethal ailements clearly has a bleaker future than a child who does not fact that. There seems to be little moral problem here. However, other cases are much more difficult. What do we say about dwarfism? gentically-based deafness? obesity? eye color? skin color? sex? sexual orientation? If it is possible do so so, do parents have the right to choose whatever characteristics they desire for their child?

Consider the following example. It is already possible to test to determine whether a fetus has the gene for acondroplegia, a form of dwarfism. If the fetus has that gene for both parents-a double dominant-then it can be expected to live only a few days after birth. If it has the gene just from one side, then it will be a drawf. If it does not have the gene from either side, its height will be normal. It is important to note that dwarfism is not a medical illness and that, although they encounter more problems with back pain and the like, dwarfs are not at medical risk. At present, the only option available to parents is to have the child or to abort it. Should a couple be allowed to abort a fetus because it will be a dwarf? Should a couple, both of whom are dwarfs, be allowed to abort a fetus if it is not a dwarf? Should genetic counselors (and genetic testing laboratories) provide prospective parents with such information? Let’s imagine, furthermore, that the choice did not involve abortion, but rather genetic manipulation. Should prospective parents be allowed to request genetic manipulation to insure that the child does not die shortly after birth? to insure that the child is not a dwarf? to insure that the child is not of normal height?

Individual Choices and Social Policy

Once we begin to raise questions about the limits of individual choice in these matters, we also have to distinguish betweeen the moral issues surrounding the individual decision and those that arise if large numbers of people make the same decision. This is not a major issue in regard to acondroplegia, which is a relatively rare condition (it affects one in every 20,000 to 30,000 births) and does not directly impact social policy. Consider two other areas that are more perplexing.

First, if it becomes possible genetically to manipulate the sex of an embryo, this could have far-reaching impact on society. If more couples have a preference for a male child than a female, and if an increasing number of couples have only one child, then such selection can seriously upset the balance of males and females in society. We do not know what consequences this may have, but a number of undesirable scenarios-especially undesirable for women-have been sketched out. Many of these involve women, because of their scarcity, being turned into breeding machines in a male-dominated society. If only a handful of parents were to engage in genetic sex selection for their developing embryos, then it may be unnecessary or unwise to legislate such practices. If, however, large numbers of parents do so, and if in doing so they affect the balance of males and females in our society, then there may be harful effects of the practice as a whole and reasons for intervening.

Second, imagine if it eventually becomes possible to determine sexual orientation. Some researchers feel that they are on the trail of a gene for “gayness.” Whether this will actually occur remains an open question, and to many it seems improbable that such a complex thing can be reduced to a single genetic marker. Nonetheless, it is certainly possible. Moreover, it is possible that, if such a genetic marker is found, it may become possible to change it. Several factors might discourage couples for having gay children, if the choice were up to them. First, the vast majority of couples having children are not gay. Second, in our society there is a significant amount of anti-gay sentiment. Some parents may be against having gay children; others may simply feel that a child will have an easier time in our society if he or she is not gay. It is not unimaginable that, given genetic manipulation, the percentage of persons who are gay might decrease.

Common Ground

When we are hiking in a new area, we often are particularly aware of possible dangers. These dangers often serve as landmarks, hazardous and to be avoided. Similarly, as we explore the new moral terrain opened up by recent reproductive technologies, there are several dangers which can serve as initial reference points as we begin to formulate our positions.

Unforseeable Consequences

Genetic manipulation opens up previously undreamed-of possibilities. It is all too easy, at least for some of us, to focus on the possible benefits of such developments rather than the possible-and, at least in some cases, largely unforseeable-negative effects. It is wise to tread carefully in such uncharted terrain.

Using Persons as Commodities

Many people, regrdless of political and ideological commitments, would agree that one of the principal dangers of contemporary capitalist, technological society is that it turns people into commodities. Persons, Kant once reminded us, are priceless, but mere things can always be bought and sold. We honor this admonition with our firm conviction that people-or even parts of people, their body parts-cannot be bought or sold. The danger we face with the development of reproductive technologies is that this tendency to turn everything into a commodity will only increase. We are moving at least dangerously close-some would say we have already crossed the line-to buying and selling sperm, eggs, and even the use of wombs.

 
Reproductive Technology and Surrogacy
An Introduction to the Issues

by

©Lawrence M. Hinman