CW long post (original content)

The Paradox of Altruistic Gamete Donation and Surrogacy

The various forms of artificial human reproduction are, all of them, problematic; not least because they present all sorts of complex moral and legal issues. And this blog touches on such issues but, before going into the complexity, let us first have a little simplicity.

Let us, therefore, consider what appears to many to be the least problematic forms of artificial human reproduction: altruistic gamete donation and altruistic surrogacy. They are called ‘altruistic’ because they are the freely given gifts of women who seek no profit; women who simply want to do good, and who are under no pressure to do so.

Such an altruistic woman is Anne, a healthy young woman who donates eggs so that an infertile couple can have children. Let's suppose that no monetary exchange is involved, not even in the form of compensation for expenses, which is still a subtle form of exchange. Anne, remember, expects nothing in return from the couple. This is altruism, not commerce. Some people would find her action morally acceptable, even laudable; and they would see no good reason why it should not be considered perfectly legal.

Another such altruistic woman is Marie. Like Anne, Marie is a healthy young woman and absolutely altruistic. Anne acts as a surrogate mother for a couple because the woman who wants to become a mother cannot carry a pregnancy. Again, let's suppose that no monetary exchange is involved, not even in the form of compensation for expenses. Marie allows the use of her womb for mere altruism and expects nothing in return from the couple. Some people would find her action, too, to be morally acceptable; even laudable. This, too, they believe, should be perfectly legal.

Certainly, appropriate forms of regulation would be necessary in the cases of both, Anne and Marie, to anticipate and avoid possible conflicts that just might arise between the parties involved. But, in general, there are not many people who would find the actions of either Anne or Marie to be, in any way, dreadfully, seriously, problematic.

Now, let us imagine another healthy, young, and exceptionally altruistic woman, whom we shall call, for obvious reasons, Annemarie. Annemarie, in this imaginary case, both donates her eggs to, and, acts as a surrogate mother for, a particular infertile couple, the woman of which cannot carry a pregnancy. Annemarie does the same, and is the same, as Anne and Marie. The same: but, different.

Yes, here is the paradox: while some people would approve of the actions of Anne, and of Marie, the actions of Annemarie seem to them to be very different. Because very few people would consider the practice of conceiving and gestating a child with the deliberate intention to give the child away to a commissioning couple, even for purely altruistic reasons, to be either morally or legally acceptable. So, with Anne and Marie: not problematic. Yet, with Annemarie: so problematic.

What is so wrong in the case of Annemarie that is not seemingly wrong in the cases of Anne or Marie? If two actions are individually good, why are they not good when combined together?

The paradox obviously does not arise for those who do not consider gamete donation – that is the donation of either eggs or sperm - or surrogacy, (or both,) to be in any way acceptable. For others, the paradox is there.

Ova are donated with a view to generating children; and if a surrogate mother is needed to complete the process why shouldn’t she be the very same woman who donates the eggs?

Similarly, if an altruistic surrogate mother is doing something good, isn’t she doing something even better if she is also the altruistic donor? Would it be different if Annemarie donates her ova to one couple and acts as a surrogate for a different couple?

We can easily imagine all sorts of permutations and combinations of roles, genders, relationships, number of people involved, etc., between the process of gamete donation and surrogacy. We can easily imagine just how complex and problematic the whole business can become.

In the reality of the world out there, cases are usually much more complicated that those presented here in such a simplified way. But, even as we discuss clear cut simplified cases, sooner or later some contradiction appears; and it points to something seriously wrong with splitting up the normal, and naturally composite, action of becoming the mother and the father of a child.

Those who would defend altruistic gamete donation and surrogacy should, if they are being logical, also defend the practice of generating children with the purpose of donating them to couples. For that is the logic of it all. Somehow, we feel that there is more to this than cold logic; this does not feel right and proper.

And those who have no problems with some form of compensation (be it a fee, or expenses, or whatever) for gamete donation and surrogacy, should have no problem with turning the bringing of a child into this world into a commercial business.

We demand to know: Since when has treating children as commodities to be given is progress?

The last paragraph should read "Since when has treating children as commodities to be given become progress?"

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@angelobottone I completely cannot see why what Annemarie is doing could be considered problematic, could you give me an intuition as to why you feel that way? You seem to be stating it as self evident, which makes the assertion all the more confusing to me.

@timorl Because genetic surrogacy commodifies babies, making them the object of a contractual transaction.

Let me know if I'm off track here.

I'm an advocate of adoption, when necessary (and not a fan when not necessary, and I'm a fan of helping it not be necessary). Sometimes a family will have an arrangement with a pregnant mother who is not able/willing to care for her baby, and they assisted with living and medical expenses during the pregnancy.

In this situation, the baby is already conceived, reproduction has already happened, and people are making decisions about what they believe is in the best interest of the child and other parties involved.

But in your scenarios, the decision isn't being made about already conceived babies, but about conceiving them. That seems to cross a different line that I'm...more hesitant about crossing.

Do you object to any/every ...other-than-natural means of conception and child bearing? Or is this specifically about this parties who choose/are chosen to be involved in these ways?

@SecondJon @timorl Adoption is noble and praiseworthy. It gives a family to children that found themselves in difficult circumstances. What I am discussing here, instead, is the opposite. Traditional surrogacy deliberately separates children from their mothers. I personally object every form of artificial reproduction but I think the law should permit ivf within the couple. I wouldn't use it but I don't see strong reason to ban it.
Instead, every other procedure that deliberately separates a child from their natural mother and also father should not be permitted by the law because it is not in the interest of the child.

@angelobottone @SecondJon I don't quite see how the child is worse off in this situation compared to a child that is part of its genetic family?

@angelobottone I don't quite see why this would be problematic. Even though the phrasing sounds bad to me, after thinking about it I cannot see what the problem with the situation itself is.

But this is irrelevant to my original (perhaps imperfectly phrased) question. What is the difference in what Annemarie is doing as opposed to what Anne and Marie are doing, that makes it so much different? I cannot think of anything that could be considered problematic in the Annemarie case that wouldn't be equally problematic in either the Anne or the Marie case, usually both. I think the "commodifying" issue is applicable just as much to all of them.

@SecondJon I have similar problems with your answer, it still doesn't differentiate the Anne&Marie from the Annemarie situation (and, once again, this might be the fault of my phrasing of the original question).

I do agree that adoption is a better solution than surrogacy to the problem of a couple wanting children, but @angelobottone seemed to imply that it is bad in general, in a vacuum, even when adoption is not an option.

I should probably point out that I see some problemes with surrogacy, but none of them make the act itself bad. They mostly make it harder to exacute in a way that does not hurt anyone. The problems I see are mostly related to emotional bonding that happens due to pregnancy and birth for most (I think?) women.

@timorl @SecondJon I agree with timorl, there is no difference between Annemarie and Anne&Marie but it seems that Annamarie is closer to baby selling than Anne&Marie. Is it because two fondamental moments of being a mother (conceiving and gestating) are separated that makes it appear less problematic? This is what I am trying to understand.

@angelobottone @SecondJon Actually this post answered my question! I did not see how one can have an intuition that what Annemarie is doing is more problematic, but if you frame this situation as "baby selling" then it makes some sense. It's much harder to say that either Anne or Marie are selling the baby, but you can conceivably say this about Annemarie.

But I also feel this shows that the framing itself is forced. I think of this kind of surrogacy rather as selling ones bodytime (mostly), and this framing works for all three of the women.

Obviously neither of the framings is a proper moral argument in itself, they are just attempts to get some intuition about the issue.

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