¶ … ethical dilemmas surround surrogacy and the donation of egg and/or sperm? Because surrogates are paid, is this a practice that exploits the poor, such as surrogate mothers in India? Why or Why not?
Egg donation and surrogacy raises ethical dilemmas on all four basic principles of medical ethics: autonomy, justice, beneficence, and non-maleficence.
Autonomy -- .
Consent has to be given freely and with full volition of the surrogate mother. Yet, most times, intense pressure is involved aside from the fact that poor women in India may capitulate to the need for money and be taken in by the huge sums offered. The emotional and medical pressures are immense, but these women are often grossly misinformed about the situation that they are bound to undergo. Their poverty hampers them from making the clear, informed decisions that they would otherwise need to in order to undergo the procedure. Whilst most egg donors in the U.S. receive around $4,000 as compensation, advertisements can range to as high as $100,000 for surrogate mothers with "desirable characteristics. Many of these individuals are young females who could have spent their time more productively and healthily other than carrying a fetus to term. In fact, studies have shown that women who are compelled to offer themselves out of financial reasons often suffer more emotional damage than those who do it altruistically.
Secondly, Artificial Reproductive Technology has become such a complex field that surrogates are unable to understand all the risks and possible treatments involved without a substantial background in biology. Individuals are, therefore, lacking in the required autonomy necessary for full informed consent.
Justice
Because of the shortage of egg donors, it is those who are wealthy who are pandered to and addressed rather than those who may need it more but come from lower socio-economic brackets.
Injustice is also existent in a second sphere: the medical profession must do all it can to help infertile people who wish to have children reproduce. What, however, occurs if the infertile couple is still unable to produce? Should doctors encourage them to seek donors, if by so doing doctors inadvertently violate the element of ethical autonomy mentioned above? This problem become aggravated when one considers that pressure may be placed on young, and disadvantaged females to bear children when these females may have been better served pursuing their career and/or going in for an education. Aside for which, these females will be pressurized to undergo medical risks, most of which will remain unknown to them. The ethical factor of injustice, therefore, applies.
Beneficence and non-maleficence.
The medical profession must constantly ensure that its practice is towards providing benefit to the patient and preventing injury form occurring. However, donors do not receive much, if any benefit at all from the invasive surgical procedure that not only provides them with no clinical benefit but may also harm them. Doctors and legislative bodies have to decide whether it is ethically justifiable to place a young, healthy female donor at risk of harm for the benefit of an older, infertile patient.
This issue is particularly problematic since there is growing concern over the side effects of ovulation enhancing drugs on donors. An increasing frequency of studies finds ovulation enhancing drugs to be linked with occurrence of ovarian cancer. Longitudinal studies still have to be conducted to arrive at definite conclusions according to the American...
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