Many critics have suggested that international paid surrogacy is exploitative. Taking such concerns as its starting point, this article asks: how defensible is the claim that international paid surrogacy is exploitative and what could be done to make it less exploitative? In the light of the answer to, how strong is the case for prohibiting it? Exploitation could in principle be dealt with by improving surrogates' pay and conditions. However, doing so may exacerbate problems with consent. Foremost amongst these is (...) the argument that surrogates from economically disadvantaged countries cannot validly consent because their background circumstances are coercive. Several versions of this argument are examined and I conclude that at least one has some merit. The article's overall conclusion is that while ethically there is something to be concerned about, paid surrogacy is in no worse a position than many other exploitative commercial transactions which take place against a backdrop of global inequality and constrained options, such as poorly-paid and dangerous construction work. Hence, there is little reason to single surrogacy out for special condemnation. On a policy level, the case for prohibiting international commercial surrogacy is weak, despite legitimate concerns about consent and background poverty. (shrink)

Feminist scholars have done much to identify oppressive forces within transnational commercial contract pregnancy and its social context that may coerce women into becoming gestational laborers. Feminists have also been careful not to depict gestational laborers as merely passive victims of oppression, though there is disagreement about the degree to which contract pregnancy offers opportunities for agency. In this article I consider how women who sell gestational labor may be agents against their oppression. I make explicit connections between resistance and (...) judgment, which I will take to be a critically considered, intersubjective evaluative claim. Drawing on work by Jennifer Nedelsky and Hannah Arendt, my main argument will be that individual judgments can better enable oppressed persons to resist some aspects of their oppression, and that judgment helps to develop agential capacities, in particular, the capacity for a person to be self-constituting, to see herself as giving reasons for her own actions. I use Indian contract pregnancy as a case study to think through connections between resistance and judgment. (shrink)

Journal of Global Ethics, Volume 9, Issue 3, Page 329-343, December 2013.

When it comes to discourses around women's labor in global contexts, we need feminist philosophical frameworks that take the intersections of gender, race, and global capitalism seriously in order to arrive at a comprehensive understanding of women's lives within global processes. Women of color feminist philosophy can bring much to the table in such discussions. In this essay, I theorize about a concrete instance of global women's labor: transnational commercial gestational surrogacy. By introducing a “racialized gender” analysis into the philosophical (...) debate on this issue, I argue that women's reproductive labor is becoming increasingly stratified within the global economy along racial and other lines. This paves the way for a “transnational reproductive caste system,” which ends up reifying various social hierarchies and sustaining existing global inequities. I aim to expose the kind of violence that surrogates experience due to such stratification as women of color in a transnational space. I discuss how discourses of race and existing racial hierarchies play out in international surrogacy and ways in which these, and indeed, the very category of “woman of color” get complicated in international contexts when they intermingle with other localized social forms and global inequities. For the purposes of my argument, I engage several insights from feminist of color Dorothy Roberts's work on race and reproductive technologies in the US. (shrink)

Marx is generally reckoned to have had too little to say about what has come to be defined as ‘social reproduction’, largely as a consequence of too narrow a focus on industrial production, and a relative disregard for issues of gender. This paper argues in contrast that the approach he developed with Engels and in Capital, Volume 1, provides a powerful framework for its analysis. After an introductory discussion of recent literature on social reproduction the second section sets out Marx’s (...) approach to the ‘production of life, both of one’s own in labour and of fresh life in procreation’. The third addresses his account of reproduction in Capital, Volume 1, Chapter 23. The fourth and fifth compare the relationship of the family to industry and exchange as depicted in Capital and in the present day respectively. The conclusion suggests some implications for theories of social reproduction. (shrink)

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in vitro (...) fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

The 2004 Canadian Assisted Human Reproduction Act bans commercial contract pregnancy and egg provision, but Canadians undertake cross-border reproductive travel to access these services. Feminist bioethicists have argued that the ethical justification for enforcing the ban domestically, namely exploitation, grounds its extraterritorial enforcement. I raise an additional problem when Global Southern or low-income countries are destinations for travel: neocolonialism. Further, I argue that a ban on commercialized reproduction is problematic. Although well-suited to address neocolonial forces of exploitation and commodification, a (...) ban reinforces neocolonialism by paying insufficient attention to the agency of gestational laborers and egg providers. (shrink)

Specific studies of the “situated ethics” of international surrogacy that address the structural conditions and local moral economies that sustain the trade are needed. In this essay, I describe the intimate industry of surrogacy in Thailand, exploring the local moral economy in which surrogacy is described as a form of Buddhist merit making and an opportunity to provide for one’s own children. This offers a further example of how other ethical values beyond the strictly economic are negotiated in commercial surrogacy (...) relationships. Situated ethics allow us to locate and understand the tensions, competing logics, and contradictions within ethical practices. (shrink)

The emerging area of philosophy of birth is invaluable, first, to diagnose fallacious assumptions about the relation between the womb and reason, and, ultimately, to challenge potentially damaging narratives with major impact on birth care. With its analysis of eighteenth-century epistemic and medical discussions about the role of the uterus in women's reasoning, this article supports two arguments: first, that women's “flawed thinking” was a premise drawn by many modern intellectual men, one that was presented as based upon empirical evidence; (...) and second, that the pervasive construction of the uterus as an element that renders women wild, uncontrollable, and irrational continues to influence contemporary obstetrics, even as today's medicine and science consider themselves to be free of any such prejudices.This article shows the role that Giacomo Casanova played in debunking these prejudices and presents his short manuscript on the issue as an important contribution to the literature of the Enlightenment, with its argument against women's supposed “natural” inferiority and for the idea that differences in education were to blame for women's subordinate position in society.Detailed analysis of the “thinking uterus” debate illuminates the different ways in which various arguments from/by the “anti-uterine” lobby were used to justify the subordination of women: sometimes emphasizing the connection between the uterus and thought and sometimes negating it, but always concluding that women's inferiority is to be found in some known or yet-to-be-discovered anatomical, and mainly sexual, deficiency or problem. (shrink)

Critics of transnational commercial surrogacy frequently call our attention to the race, class, and cultural background of surrogates in the global South. Consider the following sampling from the critics: "the women having babies for rich Westerners have been pimped by their husbands and are powerless to resist" (Bindel 2011); our "rules of decency seem to differ when the women in question are living in abject poverty half a world away" (Warner 2008); and we should worry that "women of color are (...) easier to commodify" (Smerdon 2008, 51-52). Critics suggest—rightly, in my view—that the race, class, and culture of Southern surrogates matter to the moral acceptability of transnational surrogacy. But how, precisely, do .. (shrink)

It is unclear what proper remuneration for surrogacy is, since countries disagree and both commercial and altruistic surrogacy have ethical drawbacks. In the presence of cross-border surrogacy, these ethical drawbacks are exacerbated. In this article, we explore what would be ethical remuneration for surrogacy, and suggest regulations for how to ensure this in the international context. A normative ethical analysis of commercial surrogacy is conducted. Various arguments against commercial surrogacy are explored, such as exploitation and commodification of surrogates, reproductive capacities, (...) and the child. We argue that, although commodification and exploitation can occur, these problems are not specific to surrogacy but should be understood in the broader context of an unequal world. Moreover, at least some of these arguments are based on symbolic rhetoric or they lack knowledge of real-world experiences. In line with this critique we argue that commercial surrogacy can be justified, but how and under what circumstances depends on the context. Surrogates should be paid a sufficient amount and regulations should be in order. In this article, the Netherlands and India are case examples of contexts that differ in many respects. In both contexts, surrogacy can be seen as a legitimate form of work, which requires the same wage and safety standards as other forms of labor. Payments for surrogacy need to be high enough to avoid exploitation by underpayment, which can be established by the mechanisms of either minimum wage, or Fair-Trade guidelines. An international treaty governing commercial surrogacy should be in place, and local professional bodies to protect the interests of surrogates should be required. Commercial surrogacy should be permitted across the globe, which would also reduce the need for intended parents to seek surrogacy services abroad. (shrink)

Since the 1980’s, surrogacy has become a popular reproductive alternative for individuals experiencing infertility. The ethical and legal analyses of surrogacy have been rich and varied. Some bioethicists have charged the commercial surrogacy industry with the exploitation of global southern women or with the impermissible commodification of children and women’s reproductive capacities. Others have praised the potential for economic empowerment and bodily autonomy that surrogacy may accord to women. However, throughout these explorations of the ethics of surrogacy, comparatively little attention (...) has been paid to the moral status of a crucial actor: the fertility doctor. Without doctors willing to provide prenatal and postnatal care to surrogates and make use of assisted reproductive technologies (ARTs), commercial surrogacy would not take place. Yet, doctors’ involvement in surrogacy is far from morally neutral. In my thesis, I aim to explore what duties doctors have in the context of commercial surrogacy. To do so, I take up the framework of fiduciary obligation. I argue that doctors have fiduciary obligations to surrogates, and that these obligations shape if and when doctors can ethically facilitate surrogacy. My thesis is divided into four chapters. The first defends the view that the doctor-patient relationship is fiduciary in nature. The second chapter extends this view to the realm of commercial surrogacy, arguing that doctors also owe the surrogates they treat fiduciary obligations. The third chapter addresses a challenge posed by my view, namely that surrogacy seems to place doctors in positions where they constantly face conflicts of interest, and are therefore unable to uphold their fiduciary duty of loyalty to surrogates. I address this concern by arguing that conflicts of interest are not inherent in surrogacy, but that surrogacy arrangements must be substantially rethought in order to safeguard the doctor-surrogate fiduciary relationship. The final chapter considers the obligations doctors have to the children they help create through surrogacy and through assisted reproduction more generally. (shrink)

ABSTRACTGlobal demand for human ova in in vitro fertilization has led to its expansion in countries with falling average incomes and rising female unemployment. Paid egg donation in the context of national, regional, and global inequalities has the potential to exploit women who are socioeconomically vulnerable, and indeed there is ample evidence that it does. Structural injustices that render women in middle-income countries – and even some high-income countries – economically vulnerable contribute to a context of ‘omissive coercion’ that is (...) morally troubling. When egg brokers or fertility clinics take advantage of these background structural injustices and prospective ova providers’ vulnerability in order to pay them less than they need to meet their livelihood needs, they engage in exploitation. Analyzing paid egg donation as a form of reproductive labor, however, can direct our attention to reforms that would reduce exploitative instances of this practice. In contrast to those who see... (shrink)

Transnational reproductive travel is symptomatic of insufficient supplies of reproductive resources, including donor gametes and gestational surrogacy services, and inequities in access to these within domestic health-care jurisdictions. Here, we argue that an innovative approach to domestic policy making using the framework of the National Self-Sufficiency paradigm represents the best solution to domestic challenges and the ethical hazards of the global marketplace in reproductive resources.

This article critically assesses the different ways of theoretically connecting feminism, capitalism, and ecology. I take the existing tradition of socialist ecofeminism as my starting point and outline two different ways that the connections among capitalism, the subordination of women, and the destruction of the environment have been made in this literature: materialist ecofeminism and Marxist ecofeminism. I will demonstrate the political and theoretical advantages of these positions in comparison to some of the earlier forms of theorizing the relationship between (...) women and nature, but I will also submit them to philosophical critique. I will show how the Marxist ecofeminist position needs to be both updated and revised in order to account for the different, sometimes contradictory mechanisms for the capitalization of nature that have become prominent today. I will underscore two developments in particular: the dominance of neoliberalism and the development of biotechnology. I will conclude by summing up the theoretical grounds on which a contemporary political alliance between feminist and ecological struggles against capitalism can be built. (shrink)

Drawing on conceptual tools from philosophical bioethics, economics, and materialist feminism, we advocate viewing transnational commercial surrogacy as labor and consider what it means to compensate women for this work. We find two distinct but interrelated concerns emerge in our discussion of wages for surrogates: how to value and compensate for social reproduction, and how to establish a fair wage for surrogates. We explore limitations of minimum wage policy in addressing the undervaluation of biological and emotional labor in the transnational (...) commercial surrogacy industry. We argue that subsidization is a superior method of addressing at least one cause of undervaluation. (shrink)

With advances in assisted reproductive technologies, globalization, and the ease of contact via the internet, the use of gestational surrogates as a family building option has grown significantly over the past decade. In a gestational surrogacy arrangement, unlike a traditional surrogacy arrangement, the surrogate is not the genetic mother of the child she carries; the genetic mother is either an egg donor or the commissioning parent. There are only a handful of countries in which commercial surrogacy is permitted, with the (...) United States and India prominent among them. More surrogacy arrangements are carried out in the United States than in any other nation, and the number of gestational.. (shrink)

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings , is exploitative of surrogate women. Arising out of consideration of (...) the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative. (shrink)

The United States has become an ideal marketplace for those seeking selective technologies that are illegal, inaccessible, or unavailable in their own countries. Specifically, technologies such as commercial egg donation, preimplantation genetic diagnosis, and sex selection are prohibited or highly regulated in many nations, but remain legal and largely unregulated in the United States. Based on in-depth interviews with US fertility industry providers, including physicians and egg donor and surrogate brokers, this article analyzes how the ideologies of genetic determinism and (...) consumer choice are embedded in the industry. These are transformed into competitive advantages that may appeal to foreign nationals unable to acquire the technologies, services, and reproductive materials to which they feel entitled. Regardless of providers’ particular attitudes regarding the uses of selective technologies, their overall practice reinforces intended parents’ desires to have some control over their potential children’s appearance, temperament, abilities, and behavior. Despite other nations’ laws and policies, ideologies supportive of the use of selective technologies do not, obviously, end at the US borders, and the globalization of communications, media, and transportation technologies enable their spread. (shrink)

Travel for reproductive health care has become a widespread global phenomenon. Within the field, the decision to travel to seek third parties to assist with reproduction is widely assumed to be autonomous. However there has been scant research exploring the application of the principle of autonomy to the experience of the cross-border traveller. Seeking to contribute to the growing, but still small, body of sociological bioethics research, this paper maps the application of the ethical principle of autonomy to the lived (...) experience of infertile individuals who cross borders for reproductive care. It examines their choices as patient, consumer and traveller. It suggests that their experience evidences a contradictory autonomy, which offers them both choice and no choice in their final decision to travel. The paper argues that this lack of meaningful autonomy is enabled by a medicalised framework of infertility which prioritises technology as the cure to infertility. This both shapes expectations of infertile individuals and limits their options of family creation. Ultimately, the paper suggests that sociological bioethics research shows that the liberatory credentials of technology should be questioned, and identifies that this field demands greater scholarly attention. (shrink)

Tässä artikkelissa tarkastelen feministisen bioetiikan näkökulmia sijaissynnyttämiseen. Keskityn erityisesti sijaissynnytykseen konstruoimiseen työksi, äitiyden käsitteeseen sekä kaupallisuuden ja sen määrittelemisen pohdintaan. Kysyn, onko sijaissynnyttäjälle maksettava palkkio riittävä tai välttämättä edes moraalisesti keskeisin eettisesti kestämättömän kaupallisuuden määrittäjä. Esitän, että sijaissynnyttämisen mieltäminen työksi voisi auttaa laatimaan eettisesti kestävää säätelyä, jota Suomessa ei tällä hetkellä ole. Sijaissynnyttämisen täyskielto Suomen kaltaisissa korkean reproduktioterveyden, globaalisti verraten pienten tuloerojen maissa ruokkii kolonialistista reproduktioturismia. Katson, että äitiyden käsitteellistä paikkaa sijaissynnytyskonstruktioissa ja sen vaikutuksia sijaissynnytyskäytenteisiin tulisi tarkastella kriittisesti. Nähdäkseni sijaissynnytystä (...) tulisi myös tarkastella suhteessa ammattikasvattamisen ja -hoivaamisen etiikkaan. (shrink)

As a method of family formation, cross-border surrogacy is controversial and beset by risks of exploitation. This article extends the literature on surrogacy by examining the way Australian surrogacy promotion and information events represent cross-border surrogacy. It examines the emerging phenomenon of surrogacy events held by a not-for-profit surrogacy organization to promote cross-border surrogacy in Australia—a country that prohibits commercial surrogacy. The article draws on observations from a series of surrogacy events in Australia and online during the 2019–21 time period. (...) It examines the presentations given at these events by surrogacy facilitators, surrogate mothers, and intended parents. We observed four themes: (1) Intended parents are positioned as consumers, (2) the benefits of cross-border commercial surrogacy are highlighted relative to other methods of family formation, (3) the positive side of cross-border surrogacy is accentuated, and (4) reproductive rights are emphasized. These representations run counter to feminist framings of cross-border surrogacy as exploitative and risky. This paper understands that the framing of surrogacy that occurs at these promotion events to be neoliberal in nature. The conceptualization helps explain their consumerist peppiness and commodifying subjectivity. (shrink)