Commercial surrogacy: how provisions of monetary remuneration and powers of international law can prevent exploitation of gestational surrogates

J Med Ethics. 2013 Jun;39(6):397-402. doi: 10.1136/medethics-2012-100527. Epub 2013 Feb 26.


Increasing globalisation and advances in artificial reproductive techniques have opened up a whole new range of possibilities for infertile couples across the globe. Inter-country gestational surrogacy with monetary remuneration is one of the products of medical tourism meeting in vitro fertilisation embryo transfer. Filled with potential, it has also been a hot topic of discussion in legal and bioethics spheres. Fears of exploitation and breach of autonomy have sprung from the current situation, where there is no international regulation of surrogacy agreements--only a web of conflicting national laws that generates loopholes and removes safeguards for both the surrogate and commissioning couple. This article argues the need for evidence-based international laws and regulations as the only way to resolve both the ethical and legal issues around commercial surrogacy. In addition, a Hague Convention on inter-country surrogacy agreements is proposed to resolve the muddled state of affairs and enable commercial surrogacy to demonstrate its full potential.

Keywords: Artificial Insemination and Surrogacy; Autonomy; Coercion; Legal Aspects; Moral and Religious Aspects.

MeSH terms

  • Asia, Southeastern
  • Coercion
  • Commerce / ethics*
  • Commerce / legislation & jurisprudence*
  • Female
  • Humans
  • Income
  • International Cooperation* / legislation & jurisprudence
  • Internationality / legislation & jurisprudence
  • Legislation, Medical / trends*
  • Medical Tourism / ethics
  • Medical Tourism / legislation & jurisprudence
  • Personal Autonomy
  • Poverty*
  • Pregnancy / psychology*
  • Remuneration*
  • Reproductive Techniques, Assisted / legislation & jurisprudence
  • Self-Help Groups
  • Social Justice
  • Surrogate Mothers / legislation & jurisprudence*
  • United Kingdom
  • United States
  • Vulnerable Populations*