A surrogate's secrets are(n't) safe with me: patient confidentiality in the care of a gestational surrogate

J Med Ethics. 2018 Jun 13:medethics-2017-104518. doi: 10.1136/medethics-2017-104518. Online ahead of print.


Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate's rights and the physician's ethical and professional duties. A surrogate's confidentiality must be maintained as it is an essential element of the physician-patient relationship.

Keywords: artificial insemination and surrogacy; confidentiality/privacy; ethics; obstetrics and gynaecology.