Surrogacy Rels 300 / Nurs January /330 - appleby1

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 - appleby2

Terms of the Contract: 3 parties 1. Richard Whitehead (husband of Mary Beth Whitehead) o gave consent for Mary Beth to be inseminated with sperm of William Stern o agreed to terminate his parental rights and surrender custody of infant upon birth 2. Mary Beth Whitehead o agreed to artificial insemination and to form no parent-child relationship with fetus/infant o agreed to assume all risks of pregnancy and childbirth o at birth, to surrender her parental rights to William Stern 300/330 - appleby3

Terms of the Contract: 3 parties 3. William Stern o agreed to pay $10,000 to Mary Beth W. upon surrender of live child o if miscarriage prior to 5 th month, no payment o if miscarriage after 5 th month, $1,000 o if stillborn, $1,000 o agreed to pay lawyer Noel Keane $10,000 for arranging contract Elizabeth Stern – no part in contract; after birth, she would adopt baby o Elizabeth Stern was not infertile 300/330 - appleby4

In the Matter of Baby M: 1988 Plaintiffs: William and Elizabeth Stern Defendant: Mary Beth Whitehead 300/330 - appleby5 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.

What went wrong? Mary Beth changed her mind Mary Beth HAD bonded with the fetus/newborn o after conceiving, gestating and giving birth to Baby M, she felt like the babys mother o she refused the $10,000 and refused to terminate her maternal rights New Jersey Supreme Court overturned lower courts ruling: o surrogacy contract was invalidated; adoption was annulled; Mary Beths parental rights were restored o William Stern awarded custody; Mary Beth had significant visitation rights 300/330 - appleby6

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 - appleby7

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 - appleby8

GESTATIONAL SURROGACY: 2 donor egg, fathers sperm intended mother has no ova; or advanced maternal age no female partner maternal genetic concerns use IVF technology embryo transfer 300/330 - appleby9

GESTATIONAL SURROGACY: 3 contracting womans egg, donor sperm poor sperm motility or mobility; male infertility paternal genetic concerns IVF technology embryo transfer surrogate gestation 300/330 - appleby10

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 - appleby11

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, /330 - appleby12

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. compensation.phphttp:// compensation.php; donor/BecominganEggDonor.phphttp:// donor/BecominganEggDonor.php 300/330 - appleby13

MomService Egg Donor Catalogue donation.com/eg g_catalog.shtml Ekaterina, 25 donation.com/su rrogates_s6.sht ml donation.com/su rrogates_s6.sht ml 300/330 - appleby14

Typical Fees Paid to Surrogates and 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 - $ /330 - appleby15

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, /330 - appleby16

Would YOU engage in Surrogacy? I would consider being a gestational surrogate if: I would never be a gestational surrogate because: 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: I would consider using a gestational surrogate if: I would never use a gestational surrogate because: 300/330 - appleby17

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 - appleby18

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 - appleby19

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 dont 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, /330 - appleby20

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 - appleby21

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 - appleby22

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? 1.The contract should be enforced so that the contracting parents assume parenting responsibilities. 2.The contract should be written in a way that assigns parenting responsibilities to the surrogate. 3.The pregnancy should be closely monitored so that a handicapped fetus can be identified and aborted. 4.The contract should stipulate that parental responsibilities may be refused in the case of a handicapped infant. 5.We think that /330 - appleby23