Surrogates and Other Mothers: The Debates over Assisted Reproduction

Developments in new reproductive technologies have confounded public policy and created legal and ethical quandaries for professionals and ordinary citizens alike. Drawing from the most current medical, psychiatric, legal, and bioethical literature, Ruth Macklin, noted author and philosopher, presents the arguments surrounding these advances through the voices of fictional characters. The episodes she narrates are based on real-life situations, both from her personal experience as a hospital ethicist and from the public arena, where such controversial court cases as that of Baby M have sparked a multitude of disparate opinions on surrogacy, in vitro fertilization, and egg and sperm donor program.

Macklin's hypoethical tale centers on Bonnie and Larry, an infertile couple longing for a child. As the couple's quest to become parents begins, they discover that Bonnie is physically incapable of carrying a pregnancy to term. Desperate to explore their options, Bonnie and Larry attempt adoption but are rejected by the agency without explanation. Finally, they contemplate surrogacy as their last chance to have a child. Seeking advice and answers, they consult health professionals, lawyers, pastoral counselors, and a bioethicist. In the course of this complicated and often painful decision-making process, they attend meetings of a government task force on reproduction where they hear both radical and liberal feminist positions.

Their experiences with friends, family members, two surrogates, hospital ethics committees, and special interest groups underscore the difficulty of coming to a consensus on such issues as AIDS, the right to privacy, premenstrual syndrome, the violation of surrogate contracts, and the responsibilities of therapists and physicians to their patients and to the community at large.