Thread by @hogotheforsaken

Report on ethics in surrogacy (inc use of unethical language):
dovepress.com/current-perspe…

This is about international surrogacy, but of course relevant also to national.
I've used capitals to highlight terminology used for *surrogate mother*.

I hope it's helpful for you Brandon.

https://twitter.com/BrandonAmbro/status/1150566348650635264

A word on language:
A number of shifts have occurred in public discourse, laws, and scholarly literature re the language used to describe ICS, pertinent because language does influence perceptions.
Views on these semantic shifts (include) concerns about manipulating perceptions.

“Mother” is often removed from “surrogate mother” allowing greater objectification, even though the surrogate MOTHER is the biological, and in most countries, the legal mother at birth regardless of genetic relatedness or contracts.

Ethical concerns about fundamental freedoms, autonomy, self-determination, privacy, confidentiality, and informed consent as they relate to surrogate MOTHERS can be explored by following their journey starting with recruitment.

WOMEN who sell their eggs and become surrogate MOTHERS in Asia, South America, Europe, and Africa* usually live in impoverished conditions. Existing research indicates that coercive practices whether by poverty or persons do exist.

*I would suggest also true within US.

Multiple reports exist of coercion by brokers, in-laws & husbands.
Agents are known to be hired by doctors, husbands, or relatives. In these situations, WOMEN experience no agency over decision to become a surrogate or the recruitment process.

WOMEN are evaluated for their suitability as surrogates, that is, their likelihood of handing over the child. Assessment is about ensuring the success of the commissioned surrogacy not about the interests or well-being of the WOMAN.

"Making her own choice" is cast as feminist act, which assumes empowerment. Choice theory is criticized for encouraging individualism/consumerism while ignoring impact of race, class, & socioeconomic status which exacerbates existing power imbalances rather than redressing them.

Business ethics, not medical ethics, apply and, as such, are insufficient to fully meet health obligations and ethical standards. The reality shows a vastly different standard of medical consent exists than is used in other health care settings.

Surrogate MOTHERS undergo multiple medical procedures including medication, multiple embryo transfers, fetal reductions, sex selection, abortions, & cesareans, without being provided with full explanations of the risks prior to each invasive and noninvasive procedure.

Multiple embryo implantation is purposeful and commonplace and is likely to occur without the surrogate MOTHER'S informed consent about how many embryos are implanted, health risks to herself, to the fetuses, or to the child or children born.

Risks to the WOMAN'S health such as hypertension, pre-eclampsia, cholestasis, hyperemesis gravidarum, venous thromboembolism, and short- and long-term complications from cesarean sections are also not explained.

Opportunities for surrogate MOTHERS to change their minds are anticipated &eliminated. Few WOMEN have the resources to challenge. Many WOMEN bond with their babies -few are offered opportunity to make informed decisions about relinquishment esp where power disparities are marked.

There is usually no short- or long-term counseling available to surrogate MOTHERS. Health care ceases after the completion of the transaction.

"There is no organ system of the fetus that is not anatomically, psychologically, &genetically affected by a gestational MOTHER'S endocrine system. Thus the resulting child is uniquely product of the gestational MOTHER regardless of who contributed genetic material to the child”.

Recognizing emotional and physical relationships is important to understand experience of SURROGATE MOTHERS and children. Practices need to be explored when the needs and rights of WOMEN and children and ethical practices are fully considered.

Many more commissioning parents abandon children than surrogate MOTHERS who change their minds. There is no preparation/screening of commissioning parents. Focus is always on evaluation of surrogate MOTHERS to ensure compliance.

Legal questions exist as to whether an ICS arrangement constitutes the sale of children, which violates children’s rights and whether enforcing contracts violates the human rights of surrogate MOTHERS who have lesser capacity to act on their rights even if bestowed.

Sources of conflict exist between the financial interests of professionals, agents, and other intermediaries and the psychological/health needs of surrogate WOMEN & children. The interests of surrogate MOTHERS and children can also compete with those of commissioning parents.

Conclusion:
These practices as they stand are ethically unsatisfactory. Governments, middlemen, and professionals who reap considerable financial benefit and people who desperately want a genetically related child can no longer be ignorant of the consequences.

@threadreaderapp please unroll.

"Brandon Ambrosino - a writer who has been criticized for peddling misinformation about LGBT people and acting as an apologist for anti-gay discrimination."

mediamatters.org/tags/brandon-a…

"All surrogacy is exploitation. The word should follow Sweden's ban:

amp.theguardian.com/commentisfree/…