20 March 2015

The bioethics of transnational commercial pregnancy: reflections on the J Kenyon Mason Annual Lecture with Prof Francoise Baylis

By Agomoni Ganguli Mitra

It isn’t every day that you get to spend a winter evening huddled in a distinguished, old anatomy lecture theatre to listen to some of your favourite topics—social justice, women’s health, India and assisted reproduction—in a captivating talk, followed by a warm, informal exchange over a glass of wine. Yet, last Thursday, was one such evening for me, when the Mason Institute had the pleasure of hosting its J Kenyon Mason Annual Lecture with visiting speaker Professor Françoise Baylis, professor and Canada Research Chair in Bioethics and Philosophy at Dalhousie University. If the steep benches of the University’s Anatomical Museum were enough to give you a head rush, the implications of Prof Baylis’s talk soon grounded you to a rather sombre reality.

In ‘Baby-making: the harms of transnational commercial contract pregnancy’, Prof Baylis remained true to the principle of her personal mantra: ‘to make the powerful care’, by addressing some of the hardest questions associated with transnational contract pregnancy, namely: exploitation, harm, and identity formation. Using her book, Family-Making: Contemporary Ethical Challenges (co-authored with Carolyn McLeod), as anchor, Prof Baylis took us on a journey through the ethical dimensions of contract pregnancy in India, with particular attention to two broad moral issues: harm to women (those who act as surrogates) and harm to children (those who are born from contract pregnancies). 

Prof Baylis illustrated global justice concerns by juxtaposing the demand: couples from high-income countries eager to start a family; and its supply: women struggling to make a living in low-income economies and emerging markets, such as India. The charge of exploitation was explored in the face of existing socio-economic inequalities that provide the background to such schemes, coupled with the neoliberal zeal of a government somewhat blind to social inequalities and rather eager to open up its shores to foreign money.

Further concerns about harm are rooted in the specific features of these contracts, and Prof Baylis suggested, for example, that the wages paid for such services have not necessarily been commensurate with the burdens – both physical and psychological – associated with the practice. In Prof Baylis’ opinion, the transnational (global) features of such schemes, including the local and transaction-based unfairness, as well as the dubious validity of consent given in these conditions make such arrangements both harmful and exploitative to the women agreeing to undergo contract pregnancies. Her overarching contention was that by turning a blind eye to these transnational schemes, while such practices remain prohibited or restricted at home, the governments of high-income countries are essentially ‘exporting exploitation’.

Prof Baylis then turned her attention to the future well-being of those children born as a result of transnational contract pregnancies. Here, referring to the albeit limited empirical data, she suggested that the practice might lead to damages in the identity formation of such children, whose birth narrative would be deeply rooted in the (exploitative) contracts involving their biological mothers. 

Prof Baylis’s theses were controversial and compelling. Those who remained somewhat unconvinced raised their concerns and Prof Baylis engaged thoroughly with each question, thought and challenge. As we walked back in the rainy Edinburgh evening, I couldn’t help but feel that such exchanges are part of a crucial global conversation that needs to take place often, across a variety of disciplines, and across geographical, political and cultural boundaries. And once again, I was reminded of the great privilege and responsibility that comes with belonging to this enterprise we call bioethics.

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