Ber R
Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Theor Med Bioeth. 2000;21(2):153-69. doi: 10.1023/a:1009956218800.
The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing?
避孕技术的引入导致了性与生育的分离。新的生殖技术(主要是体外受精和胚胎移植)的引入不仅导致了生育与性的分离,还重新定义了母亲和家庭的概念。在本文中,我将区分以下几种情况:1. 基因母亲——卵子捐赠者;2. 妊娠母亲——孕育并生下婴儿的女性;3. 社会母亲——抚养孩子的女性。本文仅探讨妊娠代孕的形式,即基因父母有意成为社会父母,且代孕母亲与她所孕育和分娩的孩子没有基因关系。我将提出关于代孕的医学伦理问题以及医生对相关各方的义务。我将论证妊娠代孕者是“出租子宫”,妊娠商业代孕与器官移植交易有很大的相似性。此外,尽管声称有选择自由和自由交易,但我认为妊娠代孕是一种卖淫和奴役形式,是富裕者对贫困者和有需要者的剥削。成为父母的权利虽然没有写进宪法,但却是直观且根深蒂固的。然而,问题仍然是这项权利是否凌驾于所有其他权利之上,以及对相关各方来说要付出什么代价。我最后要向社会提出以下具有挑衅性的问题:在当今有限的技术与未来的体外妊娠技术(体外孕育)之间的过渡阶段,如果处于植物人状态的女性留下了书面许可,利用她们进行妊娠代孕在社会上是否可以接受/允许?