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Basic Bioethics: What Christians should know about surrogacy

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November 16, 2017

Editor’s note: This is the seventh article in a monthly series on what Christians should know about bioethics.

Because of celebrities like Kim Kardashian and Kanye West and the popular TV series The Handmaid’s Tale, the issue of surrogacy has become a popular topic in 2017. While the methods may be new, the use of pregnancy surrogates has been around for almost all of human history. Indeed, it could be argued that surrogacy is one of the first examples of a “reproductive technology.”

Yet despite its ancient origin and current topicality, it’s an issue few Christians have thought about from a biblical perspective. What is surrogacy? Is it moral for believers to use surrogates?

Here is what you should know about surrogacy and how it relates to the ethics of “making life.”

What is surrogacy?

Is it moral for Christians to use pregnancy surrogates?

Surrogacy is the practice by which a woman (called a surrogate mother) becomes pregnant and gives birth to a baby in order to give it to someone who cannot (or will not) bear children of their own. A surrogate mother is a woman who carries and gives birth to the child of another woman, who is usually infertile, by way of a pre-arranged legal contract.

There are two main types of surrogacy, gestational surrogacy and traditional surrogacy.

Additionally, if the surrogate mother receives compensation beyond the reimbursement of medical and other reasonable expenses, the arrangement is called commercial surrogacy; otherwise, it is referred to as altruistic surrogacy.

What is traditional surrogacy?

In traditional surrogacy, the surrogate mother is impregnated naturally or artificially, but the resulting child is genetically related to the surrogate mother. A traditional surrogate is the baby’s biological mother since the child was conceived from the union of her egg and the father’s sperm.

What is gestational surrogacy?

In gestational surrogacy, the pregnancy results from the transfer of an embryo created by in-vitro fertilization (IVF), in a manner so the resulting child is genetically unrelated to the surrogate.

Gestational surrogate mothers are also referred to as gestational carriers.

Is surrogacy legal?

The laws forbidding or allowing both altruistic and commercial surrogacy vary from country to country and, within the U.S., from state-to-state. The law also varies based on whether the surrogacy is commercial or altruistic.

Is surrogacy ethical?

Almost all Christian bioethicists agree that most forms of surrogacy are theologically and morally problematic. The moral qualms generally concern the exploitation of women (e.g., “womb-renting”), the selling of children, the violation of the marital covenant, and the use of embryo-destructive reproductive technology.

Concerns about exploitation of women

In a commercial surrogacy arrangement in the U.S., the surrogate mother is typically paid $20,000 to $25,000, which averages to approximately $3.00 per hour for each hour she is pregnant, based on a pregnancy of 266 days or 6,384 hours. Few women who have the financial means are willing to undergo the pain, trauma, and grief of surrogacy for such low wages. Women who have low-income or a lack of financial resources are typically recruited to be surrogates.

In addition to being exploited for their wages, such women are rarely fully informed about the potential health risks associated with surrogacy (e.g., hormone injections) or with the emotional damage that can come from giving up a child. Many are unaware, for example, that during pregnancy, the female body is biologically, hormonally, and emotionally programmed to bond with the child.

Selling of children

Children are a gift from God (Psalm 127:3) and not a commodity that can be bought and sold. Traditional surrogacy is always immoral if the mother gives up her child for payment. Likewise, gestational surrogacy is always immoral when the embryos or games used in the surrogacy are “purchased” for the purpose of implantation.

Many, if not most, Christian bioethicists and legal scholars would agree that commercial surrogacy is morally and legally problematic since it constitutes the sale of a child. Some even claim it is a form of human trafficking. The general consensus is that such arrangements violate the human dignity of the child and the gestational mother.

Violation of the marital covenant

As Scott B. Rae and Paul M. Cox explain, surrogacy violates the creation norm for marriage, family, and procreation, by introducing a third-party contributor, either in the form of a womb donor or a womb and an egg donor.

For instance, the use of donor gametes is an act that includes a third party in an event that was meant to remain strictly within the marriage covenant. It also prevents infertility from being a burden shared by both spouses. As Dawn McColley explains,

Because of the special union in marriage, problems such as infertility are shared by both spouses and should be borne by both. Our traditional marriage vows say, ‘for better for worse, … in sickness and in health.’ By using the gametes of a donor, the fertile spouse refuses to share the burden.

This refusal to share burdens is not a Biblical response to God’s will, nor is it the way Christian spouses ought to treat each other. Children are not the sole, sacred purpose of marriage. If God has chosen to withhold that blessing from one spouse, He necessarily chose to withhold it from the other.

General concerns about embryo-destructive reproductive technology

On average, only about 25 percent of embryos that are created by the use of IVF and transferred to the womb develop until birth. Because of this high failure rate, surrogacy often involves creating more embryos than will be implanted in the womb. The embryos are usually kept in a state of suspended animation (i.e., cryogenically frozen) until their death (which usually occurs in less than 10 years).

Several passages in the Bible strongly suggest that human life begins at conception

(Job 31:13-15; Psalms 51:5; 139:13-16; Matthew 1:20). The Bible is also clear about the taking of innocent life (Exodus 20:13; Deuteronomy. 5:17). For these reasons, Christians should not support any reproductive techniques that create embryos that will not be implanted in a womb.

Doesn’t the Bible mention surrogacy?

There are two cases of surrogacy mentioned in the Bible. In Genesis 16, Sarai tells Abram, “The Lord has kept me from having children. Go, sleep with my slave; perhaps I can build a family through her” (Genesis 16:2). In Genesis 30 very much the same scenario occurs but this time it was Rachel who said to her husband Jacob, “Here is Bilhah, my servant. Sleep with her so that she can bear children for me and I too can build a family through her” (Genesis 30: 3).

Neither of these accounts provides an example for Christians should act. Both cases illustrate the distortion of family relationships and society that result from breaking the marital bond in order to overcome infertility.

Are there any forms of surrogacy that are ethical?

One surrogacy arrangement that many Christian bioethicists believe may at times be morally acceptable is “rescue surrogacy.” In this situation, a surrogate mother volunteers her womb to save an IVF-created embryo that has been frozen and is destined for destruction. While concerns such as the violation of the marital bond are still applicable and should be taken into account, the rescue of an innocent child may be a morally justifiable overriding consideration.

Joe Carter

Joe Carter is the author of The Life and Faith Field Guide for Parents, the editor of the NIV Lifehacks Bible, and the co-author of How to Argue Like Jesus: Learning Persuasion from History’s Greatest Communicator. He also serves as an executive pastor at the McLean Bible Church Arlington location in Arlington, Virginia. Read More

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24