Of Sherpas and Surrogates and The Role Of Compensation

I’m sure many of you have read about the tragic deaths of 16 Sherpas on Mt Everest.   This story, about the local response here in the Pacific Northwest, caught my attention this AM.  And oddly (or perhaps not so oddly, given my general interests in all things ART) it made me think about surrogacy and surrogates.

I actually think surrogates and Sherpas have more in common than you might think even though there are obvious differences.   Both undertake difficult and dangerous jobs.   Most surrogates do so for money and Sherpas are paid, too.   And both Sherpas and surrogates are doing work which really, when you get right down to it, doesn’t have to be done.  No one has to climb Mt. Everest.   No one has to use a surrogate to have a child or even has to have a child, come to that.   (This last point is the subject of some of the discussion of my most recent post about social surrogacy.)    

A least part of the point of the story from the Seattle Times (the one about Sherpas that I linked to) is that the amount paid is too low.   And it’s pretty hard for me to argue this point.   Here are some key quotes from the article:

Compensation is a sensitive subject in an industry where mandatory life-insurance payouts for high-altitude porters is a mere $11,000 (though the Nepalese government has said this week that it will increase that amount).

*****

The pay — which averages about $5,000 per season and is significantly higher than the country’s per capita household income — is good, but the compensation is not enough, says Morton, who believes that mandatory life-insurance payout for Sherpas should be raised to $22,000.

Now as you think about whether the Sherpas are paid enough maybe it is also important to consider how much the climbers are actually paying for these expeditions.   My understanding is that it is typically somewhere around $75,000 per person.   As I look at it, all this means there’s a lot of money changing hands but a relatively small amount of it is going to the Sherpas–again, an argument that they aren’t paid nearly enough.

Now one could also think this about surrogates–and perhaps the most obvious parallel would be think about surrogates in India, say, or Thailand.   Here too the women are paid a modest amount but way over the per capita income.  And here too lots of money is changing hands but only a small amount going to the person taking the risks.

What really striking to me, though, is where the conversation about surrogacy goes.   What you sometimes see is an argument like this:

Also, women may be offering their own bodies willingly to surrogacy, yet still the money that offers these women many benefits in the future, could be seen as a type of coercion.   There may be no actual frank coercion, but what the large amounts of money offered may be so valuable to these women that they may not have a choice but to take it.

(That’s from this website.)   Indeed, in general you see this concern about compensation being coercive where women are paid to participate in ART.   I’ve written about this in the past with regard to compensation for providing eggs.    Thus to the extent there is a conversation about the amount of conversation, it focusses on the idea that women are being paid too much.

So here we are.   Surrogates and Sherpas have a lot in common.  But for some reason we all seem to agree that the question with regard to the Sherpas is “are they paid enough, given the dangerous work they do?”   At the same time, the question for the surrogates would seem to be “are they paid too much, given the dangerous work they do?”

What explains this?   Here’s one thing that comes to mind, though I am sure there are other possible explanations:  We generally think that men will be taking risks and so generally accept that we need to compensate them properly for those risks.   This is what working men do.  But women?  Women ought not to be taking risks and all so we protect them by not tempting them to take risks.   (Of course, what this ends up meaning is that the poor women are underpaid to take risks.)

(Keep in mind I’m looking at a system that allows compensation but seems to focus concern on inverse questions–is the compensation too low/is the compensation too high.   You could also take the position that NO compensation should be allowed for surrogates–and that would raise different questions.)

 

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24 responses to “Of Sherpas and Surrogates and The Role Of Compensation

  1. I understood the argument you were making until you got to the part about whether the question for surrogates is “are they paid too much, given the dangerous work they do.” Could you elaborate on what you mean? Do you mean that because surrogates are paid enough to make it worth it to them to carry a child for another person, they should be paid less or nothing to keep money out of their decision making?

    The fee for our gestational carrier was our largest surrogacy expense (except maybe the drug company for the IVF drugs). Her compensation was average based on what we researched.

    I personally would not have been comfortable with an altruistic surrogacy – I chalk it up to an imbalance of power but possibly not in the way you think. I think people are inherently suspicious of getting something for “nothing.” I was happy to have a contract and able to exchange something for the gestation of our child. In a perfect world, that something would be other than sordid money, but I haven’t found it yet.

    • The concern about too much money amounting to coercion can be traced back to discussions among medical ethicists. Imagine you are conducting some sort of research and you need human subjects. You can pay them for their time/trouble, but ethicists will tell you that you cannot pay them too much. Doing that would amount to “coercion.” (This is the word I’ve seen used.) People would volunteer not to be helpful but for the money.

      Now in general I find this concept a difficult one. If you offered $100 I wouldn’t find it coercive because I have a good job, etc. But someone who was impoverished might.

      In any event you can see (if you follow some of the links) that this carries over into the compensation of women who provide eggs. The ASRM is opposed to paying them too much, lest they be coerced, in the sense used above. And it carries over for some to surrogates.

      Yet I don’t see it anywhere in the discussion of the Sherpas. That’s my point really. Why aren’t we concerned that paying them too much means they’ll be doing it for the money? That they are coerced?

      I think there is something deeply gendered going on here. Women’s wills is somehow overridden (and hence their conduct is no longer voluntary but rather is coerced) while men’s wills are not? In fact in both situations the circumstances might leave people little choice but to take the work in order to earn the money.

      I think the compensation of surrogates here in the US is a bit different, and perhaps I wasn’t clear enough about that. I wonder if it is always true about the greatest expense being the surrogate, though. In many instances the surrogate gets 20K but the surrogacy costs upwards of 100K. But of course, situations will vary.

      • Ah. I see what you mean now and agree that there is a gender divide going on in how we approach Sherpa vs surrogate.

        As far as cost, surrogacy approaches $100k typically only when an agency is involved and its fee is about $15-20k. We chose “DIY” surrogacy and proceeded without an agency to save costs. So for us and many who go it without an agency, the surrogate’s compensation is one of the costliest parts but one we are all happy to pay. I’d much rather pay our surrogate and spoil her than give that money to an agency

    • KeAnne –

      I think Julie was pointing out the different way we view two different risks and reward occupation/service. The who, the gender, the activity, and that it allows us to view it differently. To me Sherpa’s = high risk (male) occupation deserving of compensation, and if something goes wrong an insurance payout that isn’t high enough. Surrogacy = high risk (female) service that has the potential to be a forced coercive servitude that takes advantage of poverty stricken women in India, and that the higher the compensation/payment for harm – the higher the likelihood of more women being used in that way to their potential detriment.

      I view the two differently because of the power imbalance for females vs males especially in specific countries, and that in surrogacy your body is being used for a set period of time that you have no control over . I can be more secure that the Sherpa is willingly choosing that occupation, or at least goes in with his eyes wide open and could walk away if he chose to during the climb – than I could a poverty stricken woman providing a surrogacy service within the confines of both the society she lives in, how they view and treat women, and the employers requirements which can include residing in a home/residence – could she realistically walk away and get an abortion and be supported for it – hence the concern for coercion for me.

      Hopefully that made sense – sometimes I muddy it…

      • That helps a lot and even though we built our family via domestic gestational surrogacy, I have serious reservations about surrogacy in other countries.

      • What you say makes sense to me though I might not agree with all of it. I think you are right to focus on questions of power, which then tie to questions of autonomy.

        In the grand scheme of things what I don’t know how to deal with is this: In a poor country people will be (by my standards) poorly paid to do dangerous work. And they will take these dangerous jobs because they need the money and the amount of money is, relative to other options they have, high. On the one hand I can see these are choices and say they are voluntary. I don’t want to rob people of all agency. On the other hand, the circumstances in which people live are such that the idea that it is really a choice might look fanciful. They may in fact be desperately trying to survive and support those who depend on them and hence, I can see that the large amount of money is coercive–they cannot resist it.

        If is see the “choice” then I want the pay to be high so people are fairly compensated for the risk. If I see the coercion then I worry if they pay is high, because that is what makes it irresistible.

        This is a general problem. I actually think the Sherpas and surrogates, who just happen to be male and female, illustrate the two reactions.

        • I’ve lived for decades in an area highly populated by South Asians, worked with, been their neighbor, friend. I see some of the familial differences of their culture as practices we could, and should learn from, other areas not so much, that even subsequent generations born here still struggle with at times. Why I see the difference between the Sherpa and the Surrogate. I may not be able to change the world, but I can certainly choose where I spend my money and in that I respect, I do try to be a conscientious consumer. I will also note I still fail at times but then have always been a work in progress.

  2. As I was saying earlier but kept being told was not relevant. There really should be no problem with setting the price at whatever the market will bear so long as the carrier is not agreeing to carry a child whose genetic mother won’t be around at birth to be named mother. Then the carrier is participating in something that will cost the child a tremendous amount. If the child will be delivered and then raised by the woman that produced the egg the child looses nothing in the process. As long as the activity won’t involve compromising anyone else’s freedom or rights we should not stop the practice, nor worry about the amount women are getting paid. The only difficulty I really see with surrogacy is the insurance issues. Medical insurance was not set up to accommodate people earning a living off of something that always requires high medical bills over the course of 10 months. I know it can be done with no prenatal care and an at home delivery but my guess is most who are willing to pay for surrogates want there to be regular doctor visits. I’m inclined to think many of these women are on welfare so that the government foots the bill for the prenatal and birth. I know that is a big no-no but I can’t see how it can be avoided really

    • Marilynn, most couples will not work with a surrogate who is in an unstable financial situation because it’s not a safe situation for all involved. Agencies will not take them on as clients either. I cannot say that there have been no surrogacy arrangements with surrogates who are on welfare, but it would absolutely not be the norm or encouraged.

      • If you know a bit I’ll pick your brain…without medical insurance the bills for having a baby I’m sure are astronomical. Of course the only really ethical way to do this would be to pay cash rather than have the cost be billed to insurance that the surrogate is already covered under. Obviously same reason as with Welfare, the insurance sort of operates on the idea people are not making money off the conditions they receive medical attention for. So they pay cash for the woman’s pregnancy and delivery? Who do they pay and I imagine they have to do it in advance. What if she has some kind of majorly expensive birth and life threatening surgery and the project goes over budget and they can’t pay the bill. She can’t like sue them for her medical bills can she? So complex.

    • My point here really is about what I think is a double standard and a gendered one at that.

      • I agree with you. Our society often reacts with shock and fear when a woman tries to make money, let alone in an “innovative” way like surrogacy.

        • Got a question for you. You paid your surrogate. How did you record that expense and how did she claim that income? Since you are not a company then was it called a gift? But if you had a contract with her it can’t rightly be called a gift. How did the insurance work? Did you take out a life insurance policy for her children to get in case she died? Was it your medical insurance or hers? What did the insurance company say? I feel like its got to be one or the other its a service you contract for or its altruistic and she gets nothing for it. I can’t see where the insurance company would agree to provide services if she was making money doing something that required medical care as opposed to doing something where there is a possibility the employee might get hurt. Their whole business is set up on the gamble people won’t get hurt that’s what actuaries do is calculate probability.

          • I’ll try to remember the specifics but it was 5 years ago, so forgive me if my memory is spotty. We offered to pay for a life insurance policy, but she didn’t want it. Her insurance did cover the pregnancy & when she called to confirm, she was told that “a pregnancy is a pregnancy” regardless of the intent and outcome. We paid her monthly & I honestly cannot remember how we accounted for it. It was not as an employee-employer for sure. As for her, I don’t know how her accountant coded the payments. We were prepared to call it a gift.

            Sorry. I’m sure my answers are unsatisfactory but they are what I remember.

            • No they are very satisfactory. There was no particular answer that I had in mind. Just wanted to know how it went down. The post on the topic of surrogacy and compensation is interesting. I’m confused as to how something could be a compensated duty to perform under the terms of a private contract and yet that the expense – a considerable one at that would be documented as a gift because what if there was a breach and you wanted to take her to court….you’d be ass out. If it’s a gift there is nothing she needs to do in return for it. Its like all jobs might be classified as gifts you know? Thanks for answering. It was a good answer

            • You have given awesome insight actually. You are not an employer. She was not an employee you did not pay her a wage you were not subject to federal labor laws. She was a big girl and she entered into a contract with you to provide services with her body same as if she contracted to type a manuscript for you. She had medical insurance. You very ethically offered her life insurance she very big girl declined. I don’t see the problem here other than potential tax evasion and frankly that’s for everyone to navigate for themselves. Big girl. It was a service contract. She had to claim that as income same as if she was remodeling your kitchen or something. I don’t see the problem with this. I don’t see her as exploited.

      • I agree completely. its galling that surrogacy regulatory bodies ostrnsibly to protect the surrogate, are actually lowering her pay,instead of raising it. if there was such a thing as a self run surrogacy union out to protect there own interests, you can bet theyd be working to improve their compensation, just like all other professional,unions. thats the difference between self advocacy and paternalistic agencies!

        • um lowering their pay? They are not employee’s they are independent contractors. It’s not a wage. They set their own rates. It’s a fee they charge. So charge more.

  3. Julie,

    I find it fascinating — the issues of this post and the issues you raise.

    The amount of attention and critique paid towards middle-class, first-world, married women who work as gestational surrogates is revealing. The press interest (and alarm) is fascinating, especially when compared to the lack of critique of first-world climbers who pay upwards of 50K to climb a mountain, placing the bodies of others at high risk. (What’s the death rate of those who successfully summit Everest?)

    There is something going on here that is deeply gendered, and, I think, connected to the widespread conception of females as dependents in need of protection — weak dependents who do not have the analytic capacity of men.

    Of course, the lack of capacity for economic choices within neo-liberal trans-national economies is a valid and important critique. But, what is targeted for critique is illuminating.

    Did we see many articles calling for the boycott of textile industries after the collapse of the building in Bangladesh? Are we seeing much criticism of the pursuit to climb Everest after the deaths of many workers?

    In contrast, how many “special interest” articles concerning surrogacy filled with alarm about the “aging of pregnancy” do we see in periodicals aimed at a middle-class female audience?

    Are journalists as attentive to farmworker’s movements? Why are these same audiences not alarmed about grape farmers and the exploitation of children? Why purchase certain brands of gym shoes without guilt? Where are the calls for alarm and articles that provoke people to pay attention to these industries? Why don’t stories about these types of bodily risk sell newspapers and magazines?

    Why do first-world journalists ignore these forms of bodily exploitation? Will first-world readers consume these stories?

    There is far less energy and attention paid to, say, the boycotts of textile industries, producers of gym shoes, grape farming — all industries where the bodily work of adults (and, appallingly, children) has been exploited.

    There’s a reason for the avid attention to certain types of bodily work, while there is a noticeable lack of attention towards other types of dangerous and, potentially exploitative, bodily work.

    • Tess I don’t think its possible for a person to combat every injustice in the world. It’s only natural for people to invest their emotions in some causes but not others; and to take greater interest in issues affecting their own societies first.

      another issue i have with your post is that it fails to differentiate between ones body and one’s work, which i think is an important differentiation.

      i agree that this too is a very gendered issue- since women are far far more likely to have their bodies exploited than men are.

      • I was thinking specifically of press attention, and public discourse, and not as much about the personal actions of individuals.

        Interestingly enough, press attention of surrogacy (even negative discussion) leads to its increase. The M-case is an example of this.

        In terms of, say, migrant farm labour, I would question if the “body,” and the exploitation of the body, can be separated from “labour/work.”

        I was thinking this is not only a gendered issue, but surrogacy does something else — it disrupts the pretended separation of the “private” sphere from the “public” sphere. Reproduction (gestation and the raising of children) is a critical aspect of the economy and public life. But an ideology of “separate spheres” pretends that reproduction, pregnancy and child care are irrelevant to the economy and it is not classified as “work.”

        Surrogacy reveals that false separation in a stark way. This may be why readers are intrigued/appalled/curious about surrogacy, and why newspaper articles about gestational surrogacy attract attention.

      • “Tess I don’t think its possible for a person to combat every injustice in the world. It’s only natural for people to invest their emotions in some causes but not others; and to take greater interest in issues affecting their own societies first.”

        I agree with this concept. We tend to get involved in issues that we have a passion for that have had some type of impact on our lives.

  4. ARGH you guys are mixing apples and oranges. First of all the world needs to make up its mind about this stuff because currently surrogacy and gamete donation have a publicity machine behind them billing these services as altruistic donations done out of the kindness of the people’s hearts and yet they do receive real income and have to claim it on their taxes as money earned for providing a service as an independent consultant. In the case of some surrogates they are providing the service of gestation only and others provide reproduction, gestation and abandonment of parental rights and their continued absence for no less than 18 years. Gamete donors provide reproduction, gestation and abandonment of parental rights and their continued absence for no less than 18 years. Are they paid enough? Too much? Should they be paid at all? Should they get hazard pay? Why are we worried about sherpas and not surrogates? How can you even draw the distinction when nobody would ever say that a sherpa was donating his services out of the goodness of his heart? How can you draw the distinction when being a sherpa only requires medical insurance pay out if they are hurt when surrogacy always requires medical insurance pay outs even when everything goes exactly perfect – like seeing a doctor is part of the services a surrogate provide. What is this bizarre comparison?

    If it is a service where they make money doing it, limit court enforcement only for the services offered prior to birth – don’t include relinquishment of the child or parental rights. Make it un-insurable or covered by some special surrogacy medical insurance just for women earning money off it. Include life insurance policies as part of the deal and let them set their own rates whatever the market will bear. If some company is going to have a staff of surrogates then they need to follow employment law. I really don’t understand this comparison. There is nothing whatsoever similar about the two activities.

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