Ethical Considerations of Commercial Gestational Surrogacy

Sarah Cross – Yale School of Medicine

Abstract: Commercial gestational surrogacy involves the practice in which a gestational carrier (GC) undergoes transfer of a genetically unrelated embryo and carries a pregnancy on behalf of another individual(s) who is(are) the intended parent(s). In many cases, the GC receives financial compensation. Opponents of commercial surrogacy argue that the practice commodifies the female body or even individual characteristics, and that it poses a risk of financial coercion and exploitation. Despite these concerns over commodification and coercion associated with this practice, the American Society for Reproductive Medicine (ASRM) endorses the ethical permissibility of financial compensation for GCs, likening such compensation to that received for participation in medical research. In this discussion, we will explore ethical considerations related to financial compensation for gestational surrogacy. We ask whether commercial surrogacy is ethically permissible in its current practice and whether medical research is the correct analogy justifying its ethical permissibility. Further, we will compare and contrast this practice with other ethically complex practices such as paid organ donation and sex work which, in contrast to gestational surrogacy, are largely illegal in the United States. By examining these practices, we aim to contribute to a nuanced understanding of the ethical complexities surrounding commercial gestational surrogacy and its place within the broader landscape of reproductive rights and bodily autonomy.

Keywords: Gestational surrogacy, Commercial surrogacy, Reproductive rights