MARKETS AND MORALS
                                     { SURROGATE PREGNANCY }
                                                     continuation


   Elizabeth Anderson, a contemporary moral philosopher, has applied her version of this argument to the surrogacy debate. She argues that surrogacy contracts degrade children and and women's labor by treating them as if they were commodities. By degradation, she means treating something "in accordance with a lower mode of valuation than is proper to it. We value things not just 'more' or 'less' , but in qualitatively higher and lower ways. To love or respect someone is to value her in a higher way than one would if one merely used her . . . Commercial surrogacy degrades children insofar as it treats them as commodities." It uses them as instruments of profit rather than cherishes them as persons worthy of love and care. 
   Commercial surrogacy also degrades women, Anderson argues, by treating their bodies as factories and by paying them not to bond with the children they bear. It replaces "the parental norms which usually govern the practice of gestating children with the economic norms which govern ordinary production." By requiring the surrogate mother "to repress whatever parental love she feels for the child," Anderson writes, surrogacy contracts "convert labor into a form of alienated labor." 

     In the surrogate contract, the mother agrees not to form or to attempt to form a parent-child relationship with her offspring. Her labor is alienated, because she must divert it from the end which the social practices of pregnancy rightly promote --- an emotional bond with her child. 

   Central to Anderson's argument is the idea that goods differ in kind ; it's therefore a mistake to value all goods in the same way, as instruments of profit or objects of use. If this idea is right, it explains why there are some things money shouldn't buy.
   It also poses a challenge to utilitarianism. If justice is simply a matter of maximizing the balance of pleasure over pain, we need a single, uniform way of weighing and valuing all goods and the pleasure or pain they give us. Bentham invented the concept of utility for precisely this purpose. But Anderson argues that valuing everything according to utility (money) degrades those goods and social practices --- including children, pregnancy, and parenting--- that are properly valued according to higher norms. 
   But what are those higher norms, and how can we know what modes of valuation are appropriate to what goods and social practices ? One approach to this question begins with the idea of freedom. Since human beings are capable of freedom, we shouldn't be used as if we were mere objects, but should be treated instead with dignity and respect. This approach emphasizes the distinction between persons (worthy of respect) and mere objects or things (open to use) as the fundamental distinction in morality. The greatest defender of this approach is Immanuel Kant, to whom we turn later. 
   Another approach to higher norms begins with the idea that the right way of valuing goods and social practices depends on the purposes and ends those practices serve. Recall that, in opposing surrogacy, Anderson argues that "the social practices of pregnancy rightly promote" a certain end, namely an emotional bond of a mother with her child. A contract that requires the mother not to form such a bond is degrading because it diverts her from this end. It replaces a "norm of parenthood" with a "norm of commercial production." The notion that we identify the norms appropriate to social practices by trying to grasp the characteristic end, or purpose, of those practices is at the heart of Aristotle's theory of justice. We have already discussed this approach. 

                                OUTSOURCING PREGNANCY 

   Melissa Stern, once known as Baby M, recently graduated from George Washington University, where she majored in religion. Over two decades have passed since her celebrated custody battle in New Jersey, but the debate over surrogate motherhood continues. Many European countries ban commercial surrogacy. In the United States, more than a dozen states have legalized the practice, about a dozen states prohibit it, while in other states its legal status is unclear. 
   New reproductive technologies have changed the economics of surrogacy in ways that sharpen the ethical quandary it presents. When Mary Beth Whitehead agreed to undertake pregnancy for pay, she provided both egg and womb. She was therefore the biological mother of the child she bore. But the advent of in vitro fertilization (IVF) makes it possible for one woman to provide the egg and another to gestate it. Deborah Spar, a professor of business administration at the Harvard Business School, has analyzed the commercial advantages of the new surrogacy. Traditionally, those who contracted surrogacy "essentially needed to purchase a single package of egg-bundled-with-womb." Now they can acquire "the egg from one source(including, in many cases, the intended mother) and the womb from another. 
   The "unbundling" of the supply chain, Spar explains, has prompted growth in the surrogate market. "By removing the traditional link between egg, womb, and mother, gestational surrogacy has reduced the legal and emotional risks that surrounded traditional surrogacy and allowed a new market to thrive." "Freed from the constraints of the egg-and-womb package," surrogacy brokers are now "more discriminating" in the surrogates they choose, "looking for eggs with particular genetic traits and wombs attached to a certain personality." Prospective parents no longer need worry about the genetic characteristics of the woman they hire to carry their child, "because they're acquiring those elsewhere."

     They don't care what she looks like, and they are less worried that she will claim the child at birth or that courts would be inclined to find in her favor. All they really need is a healthy woman, willing to adhere to certain standards of behavior --- no drinking, no smoking, no drugs---during its course.

   Although gestational surrogacy has increased the supply of prospective surrogates, demand has increased as well. Surrogates now receive about $20,000 --- $25,000 per pregnancy. The total cost of the arrangement (including medical bills and legal fees) is typically $75,000 to $80,000. 
   With prices this steep, it's not surprising to find that prospective parents have begun to seek less expensive alternatives. As with other products and services in a global economy, paid pregnancy is now outsourced to low-cost providers. In 2002, India legalized commercial surrogacy in hopes of attracting foreign customers.
   The western city of Arnand may soon be to paid pregnancy what Bangalore is to call centers. In 2008, more than fifty women in the city were carrying pregnancies for couples in the United States, Taiwan, Britain, and elsewhere. One clinic there provides group housing, complete with maids, cooks, and doctors, for fifteen pregnant women serving as surrogates for clients around the world. The money the women earn, from $4,500 to $7,500, is often more than they would otherwise make in fifteen years, and enables them to buy a house or to finance their own children's education. For the prospective parents who go to Anand, the arrangement is a bargain. At around $25,000 (including medical costs, the surrogate's payment, round-trip airfare, and hotel expenses for two trips), the total cost is about a third of what it would be for gestational surrogacy in the United States.
   Some suggest that commercial surrogacy as practiced today is less troubling than the arrangement that led to the Baby M case. Since the surrogate does not provide the egg, only the womb and the labor of pregnancy, it is argued, the child id not genetically hers. According to this view, no baby is being sold, and the claim to the child is less likely to be contested.
   But gestational pregnancy does not resolve the moral quandary. It may be true that gestational surrogates will be less attached to the children they bear than surrogates who also provide the egg.  But dividing the role of the mother three ways (adopting parent, egg donor, and gestational surrogate) rather than two does little to settle the question of who has the superior claim to the child. 
   If anything, the outsourcing of pregnancy that has occurred due in part to IVF has cast the moral issues in sharper relief. The substantial cost savings for prospective parents, and the enormous economic benefits, relative to local wages, that Indian surrogates derive from the practice, make it undeniable that commercial surrogacy can increase the general welfare. So, from a utilitarian point of view, it's hard to argue with the rise of paid pregnancy as a global industry.
   But the global outsourcing of pregnancy also dramatizes the moral qualms. Suman Dodia, a twenty-six-year-old Indian who was a gestational surrogate for a British couple, had previously earned $25 per month working as a maid. For her, the prospect of earning $4,500 for nine months' work must have been almost too compelling to resist. Te fact that she had delivered her own three children at home and never visited a doctor adds poignancy to her role as a surrogate. Referring to her paid pregnancy, she said, "I'm being more careful now than I was with my own pregnancies." Although the economic benefits of her choice to become a surrogate are clear, it's not obvious that we should call it free. Moreover, the creation of a paid pregnancy industry on global scale --- as a deliberate policy in poor countries, no less --- heightens the sense that surrogacy degrades women by instrumentalizing their bodies and reproductive capacities. 


It's hard to imagine two human activities more dissimilar than bearing children and fighting wars. But the pregnant surrogates in India and the soldier Andrew Carnegie hired to take his place in the Civil War have something in common. Thinking through the rights and wrongs of their situations brings us face to face with two of the questions that divide competing conceptions of justice : How free are the choices we make in the free market ? And are there certain virtues and higher goods that markets do not honor and money cannot buy ?