Some time in the middle of March I wrote a post defining the terms I planned to use in the discussion of surrogacy. I wanted to be clear about the differences between gestational (or host) surrogacy and regular (or straight) surrogacy. I also wanted to distinguish between the surrogacy system in use in the UK and the system in use here in the US. (In the UK, surrogacy is legal as long as no money is paid to the surrogate beyond reasonable expenses.) I referred to the system in the UK as “compassionate” or “altruistic” surrogacy. I used those terms because I had seen them bandied about. And I referred to the US system as “commercial surrogacy” because, at the time, it seemed to me a critical and distinguishing feature of the system here.
Now that was some time ago and the discussion in this blog have proceeded quite a bit. The distinction between what I’ve been calling “altruistic surrogacy” and what I’ve been calling “commercial surrogacy” has become increasingly importance to my thinking. (You can see that here, for example.) Alas, it has also become clear that those were not the best chosen terms to use. I’ve touched on some of the reasons the terms aren’t well chosen before. But let me draw them together here.
First off, many (if not most) surrogates in the US (that is, in a commercial surrogacy system) act at least in part out of altruism. That’s clear from reading the recent Newsweek story or many of the other accounts in the popular press. Whether they are directly paid or not, most women who are willing to bear a child for another person do so at least in part out of a desire to be helpful. (It might be tempting to say that you cannot really pay another person enough so that surrogacy is worth it purely in monetary terms. There has to be some altruistic reward as well. But I’m afraid some of the worst of the outsourcing stories may be proof of the falsity of that statement. For women in desperate poverty, surrogacy may indeed be a matter of simple economic survival.)
Second, surrogates in what I’ve called altruistic surrogacy do get paid money. And, it appears, they can get just about the same amount of money as a surrogate in a commercial surrogacy system. (Though in the UK can you can only pay a surrogate “reasonable expenses” it seems these expenses can be fairly substantial.) That, too, seems perfectly reasonable to me. It seems rare indeed that a woman would become a surrogate for purely altruistic reasons.
So calling one form of surrogacy “altruistic” and the other form “commercial” does a disservice to the women serving as surrogates in commercial surrogacy. Many of them do, indeed, act (at least in in part) out of altruism. And it equally misrepresents the surrogates in an altruistic system, who must often take the financial benefit into account.
Surely it would be better to use language that relates to the real differences between the two systems that are of importance to me? Now I’ve actually written about what the critical distinction is for me. In what I’ve been calling “altruistic surrogacy” the surrogate is recognized in law as the mother of the child and thus has the right to change her mind. (Which is not by any means to say that she should change her mind, by the way.) In “commercial surrogacy” the surrogate is not a mother, cannot change her mind, and can be compelled to carry through on her agreement and surrender the child.
So the question is, what do I call the two systems now? I’m tempted to replace “commercial surrogacy” with “bound surrogacy”, to highlight the critical feature noted above. But it’s hard to see what to do with “altruistic surrogacy” that parallels that. I suppose one could call them “legally-enforced” and “morally-enforced” (which might reflect my personal inclination to say that one is morally bound to follow through on these sorts of agreements. I’m sure there are other possibilities. I’ll settle on something tomorrow. Having erred in the choice of language once, I figure it’s worth taking my time here.