"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Monday, December 30, 2013

Surrogacy And The Free Market

Dr. Nayna Patel is the Director of the Akanksha Infertility Clinic in India, an institution which sponsors surrogacy.  She selects Indian women to act as surrogate mothers for Western infertile couples.

The surrogate mothers are extremely well paid ($10,000) for bringing a baby to term plus room, board, medical supervision and attention, medicine and supplements, and social care.  The stipend is three times what a woman would make in Bihar and almost double that in more prosperous states.  In an extensive interview with the BBC (Hard Talk 12.30.13), Dr. Patel explained the procedures put in place at her clinic to assure legal protection for both parties, state-of-the art medical services, and a comfortable, open, and accommodating home environment for the surrogate mother.

Dr. Patel spoke of the surrogacy in terms of a business model.  Surrogate mothers ‘work’ for their pay just as any other Indian would, and compensation has been determined by an assessment of supply and demand, comparative values of labor, attendant costs, reasonable profit, and market prices.  Her costs are very low compared to surrogacy services in the United States which at current prices is approximately $100,000.  Western couples can be assured that their baby (and the surrogate mother) will receive top-quality, international-standard OB/GYN care since India has raised its medical standards high enough to become an international center for elective surgical procedures.

In short, says Dr. Patel, everyone is happy.  The surrogate mother has received a generous stipend which can be used to provide for her family, giving her children the opportunity for an education and the chance to rise far above their current socio-economic status; to be used as seed money for small business; or, at the least, to provide a level of comfort and security they have never enjoyed.

The Western couple is happy because they finally can have a child, and know that with the clinic’s rigorous screening, they can be as assured as anyone of a normal, healthy, baby.

Dr. Patel is satisfied because she has created a successful business and at the same time provided invaluable rewards to both ‘genetic parents’ and surrogate mothers.

So why should there be any debate?  Stephen Sackur, the BBC Hard Talk interviewer, suggested that Dr. Patel was being disingenuous at best and misleading at worst because she was dressing an exploitative practice in pretty clothes. Women who become surrogate mothers have no freedom of choice in the matter and cannot refuse this staggeringly lucrative opportunity. Furthermore, they are illiterate peasants who cannot understand the nature of the contract.

This is, of course, nonsense. Freedom of choice means exactly that. No woman is forced to become a surrogate mother, and if the choice is made perfectly clear – that is, if the woman understands exactly what she will be contracted to do – then there is no question of unethical coercion. No one has suggested that the Akanksha Clinic has done otherwise. Although some religious critics might share the sentiment that motherhood is sacred, and that God’s intentions should never be ignored or his laws violated, most economists would agree that children have economic value and that surrogacy is but one expression of this valuation.

Children have always been first and foremost economic units. Children have provided the additional labor required to sustain the family, to provide for the welfare of aged parents, to add status and privilege. 

Only in today’s modern developed societies have the costs of raising children exceeded the benefits.  There is no logical reason why families should continue to have children. The countries of Western Europe, faced with severe drops in fertility rates among native-born citizens, have offered bonuses and other benefits for each additional child.  In other words, they have acknowledged the economic nature of children and have intervened in the market by way of subsidy.

A negative expression of this valuation of children is the high abortion rates in the developing world, especially for girls. When the number of children exceeds their economic value, women abort; and in male-centered cultures, abortion becomes gender-specific.  Abortion is no less common in industrialized countries where well-off women abort because a child would interfere with their professional careers and increasing income.

Unless one is mystical, religious or both, procreation is essentially an economic matter. While the value of each individual child may vary, their fungibility does not – every child is a commodity to be managed for the greatest return.  The value of a surrogate child in India is $10,000.  In the US it is $100,000. The incremental value of an additional child decreases as family income rises. White children have more value than black ones on the adoption market. The eggs donated by Harvard students have more value than those from West Appalachia Community College.

In other words, without the supernatural overlay, surrogacy is a perfectly legitimate and logical human activity and should be encouraged.

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