sex marriage the family & surrogacy

The Human Person:

Sexuality, Marriage, & the FamilyLiza Manalo, MD, MSc.

THE DIGNITY OF THE

HUMAN PERSON

• Being in the image of God, the human individual

possesses the dignity of a person, who is not just

something, but someone.

• He is capable of self-knowledge, of self-possession

and of freely giving himself and entering into

communion with other persons.

• And he is called by grace to a covenant with his

Creator, to offer him a response of faith and love that

no other creature can give in his stead.(CCC, 357 )

THE DIGNITY OF THE

HUMAN PERSON• God created everything for man, but man in turn was

created to serve and love God and to offer all

creation back to him:

– It is man that great and wonderful living creature, more

precious in the eyes of God than all other creatures! For

him the heavens and the earth, the sea and all the rest of

creation exist.

– God attached so much importance to his salvation that He

did not spare his own Son for the sake of man. Nor does

He ever cease to work, trying every possible means, until He

has raised man up to Himself and made him sit at His right

hand. (CCC, 358)

The Trinity and the

Divine Family

• “God in His deepest mystery, is not a solitude

but a family, since He has in Himself

fatherhood, sonship and the essence of the

family which is love (John Paul II, 1979).

1. God is family—not like a family

2. Highest mystery of faith: Trinity, the Divine

Family

3. Earthly families are like the Trinity

4. Reveals essence of family = love

First principle of sexual life

• Marriage is the only natural way willed by God

wherein sexual life may be exercised morally.

Self-giving & Life-giving

• Sexuality is the biological vehicle for self-giving

between man and woman. however, human love

involves everything---all the dimensions of

“being,” – including the affective and spiritual.

• The sexual instinct is ordained essentially to the

propagation of the species, to the transmission of

life.

• The unitive and procreative aspects of

sexual love must not be separated.

Symbolism of Marriage

• One of the most glorious revelations of Scripture is

that the husband-wife relationship is symbolic of the

relationship that exists between Christ and the

Church (Eph. 5:22-23).

Zac Poonen (1971)

Married love is a reflection of

God’s love

• If married love is a sacramental sign of God's love

for His people (as both Old & New Testaments of

the Bible testify), then the act itself must accurately

reflect that love.

• It must be faithful, monogamous, indissoluble,

and fruitful.

• This is the foundation of all traditional Christian

sexual morality, though it will surely come as a

surprise to many Christians today.

Married Love as a Sign of the

Trinity

• So when “two become one” in the covenant of

marriage, the “one” they become is so real that

nine months later they might have to give it a

name!

• The child embodies their covenant oneness.

• The two become one flesh, and soon they are

joined by a third; yet they remain one family.

– Kippley, Sex and the Marriage Covenant

Fruitfulness

• Fecundity is a gift, an end of marriage, for

conjugal love naturally tends to be fruitful.

(CCC 2366)

• By giving life, spouses participate in God's

fatherhood. (CCC 2398)

Responsibility in Procreation

• Everything directly related to the transmission

of life participates in the creative power of

God; consequently, it should be treated with

respect and responsibility.

Is Surrogate Motherhood Ethical?

Womb for Hire• The story almost reads like a fairy tale: no sooner

had the child been born than it was taken from its

mother and whisked to a land far, far away.

• Except that in this case, the infant was flown as

hand-carried baggage from Manila to Bangkok,

swaddled in the arms of a Danish man who had

bought and prepaid for the baby boy.

• Far from being a tale of enchantment, what took

place in October 2008 was the first ever

commercially transacted case of surrogacy in the

Philippines.

• It was arranged by a foreign company between a

Filipino married woman and a male gay couple from

Malaysia and Denmark.

Womb for Hire

• “The egg is actually her own,” Michael Ho, owner

of Singapore-based Asian Surrogates, told

Newsbreak.

• He said the woman, whom he declined to name,

became pregnant in a “pretty straight forward”

manner – through intrauterine insemination or IUI.

• “The sperm is inserted into the womb of the

surrogate and she gets pregnant, (with) no

physical contact” with the male client, he assured.

Womb for Hire

• Because the client “donated” his own sperm, he is

the baby boy's legitimate father and therefore has

the legal right to take the infant out of the country, he

said.

• The mother's prior consent is part of the transaction,

he added.

• “The father took him back to Thailand because even

though he's Danish, he was working in Thailand,” he

said.

Womb for Hire

• He said the gay couple paid Asian Surrogates at

least 45,000.00 Singapore dollars or Php 1.4

million for the service.

• Of this amount, roughly Php 715,074.00 or

22,000.00 Singapore dollars went to the Filipina for

renting out her womb and providing her eggs.

• The sum would roughly take her 5.4 years to earn

on minimum wage.

• Eight other Filipino women are eagerly waiting in

line to provide a similar service, Ho said, expressing

his satisfaction.

Gestational Surrogacy

• Begins with

– (1) in vitro fertilization of the intending mother’s egg with

the intending father’s sperm and concludes, by

contractual agreement, with

– (2) the transfer of the IVF embryo to the surrogate

mother’s womb

– (3) so she can gestate the baby for nine months and then,

– (4) at birth, release the child to the intending or

sociological parents.

• Children born of gestational surrogacy share a

gestational link to their surrogate mother and a

genetic link to their sociological mother.

Dr. Vicki Belo and her beloved Dr. Hayden Kho are proud parents of Scarlet Snow Belo,

through gestational surrogacy shown (top right) at four months old and as cute endorser on the

billboard advertising Vicki’s baby products.

– Photos by RICKY LO/from Vicki and Hayden’s Instagrams

Traditional Surrogacy

• Involves a contractual arrangement between an adult

female of normal reproductive health and parents

intending to have a baby.

• For a set fee, the woman agrees

– (1) to be impregnated, via artificial insemination, with the

intending father’s sperm;

– (2) to act as the surrogate carrier who gestates the resulting

baby for nine months and,

– (3) at birth, to release the baby to the intending or

sociological parents so they can raise the child.

• Children born of traditional surrogacy, then, share

both a gestational and genetic link to their

surrogate, rather than their sociological, mother.

“Traditional surrogacy," the procedure used by Joel Cruz who wanted

one baby but got twins by a surrogate mother from Russia (“Who looks

like Julia Roberts,” said Joel). So satisfied was Joel that he did it with the

same woman and, again, got twins.

U.S. Data

• The Centers for Disease Control and the

Department of Health and Human Services report

in their 2007 Assisted Reproductive Technology

Success Report that 1,293 IVF cycles involved

gestational surrogates.

• The Society for Assisted Reproductive

Technology (SART) Report for 2008 estimates

that 2,502 IVF cycles were performed on

gestational surrogates resulting in 987 births and

1,395 babies.

The Injustices of the

Surrogacy Industry

Sister Renée Mirkes

• In Donum Vitae (1987) and again in Dignitas Personae (2008), the Congregation for the

Doctrine of the Faith adopts bold rights language

to defend the dignity of the conception of each

and every embryonic human being:

– The child has the right to be conceived, carried in the womb, brought into the world and brought

up within marriage.

Injustices against the surrogate child


• The Church succinctly defines the gestational

link—created in the conception-gestation-

birthing of a baby.

• The Church clarifies the important truth that

respect for this bio-psychic bond is so essential:

– to upholding the dignity of the human being,

– to promoting his continued welfare and normal human

development, that experience of it constitutes a child’s

natural human right and,

– by implication, the lack of experiencing the gestational

link results in the failure to satisfy one of the child’s

basic human needs.

Case in point:

Recent studies conducted by

Dr. Susan Golombok

• One of her (2013) research projects examined 30

surrogate families, 31 egg donation families, 35 donor

insemination families, and 53 natural conception families.

• Children’s adjustment levels were assessed at ages 3, 7,

and 10 using the Strengths and Difficulties Questionnaire

administered to the mother and to the child’s teacher.

• Two of this study’s findings are germane to the discussion:

• First, at age 7, surrogate children in the study exhibited

higher levels of adjustment difficulties than same-aged

children who were conceived by gamete donation (and

lacked a genetic link to their sociological parent/s).

• This outcome suggests that absence of a

gestational connection may place surrogate

children at greater psychological risk than their

non-surrogate counterparts.

• Golombok and her colleagues noted that the

increased adjustment difficulties they witnessed

could well have been exacerbated by the

extenuating circumstances of some surrogate

families.

• The surrogate child is not only born to a third

“parent,” but the surrogate mother, particularly if

she is also the child’s genetic mother, may remain

in contact with the family, thus undermining

family relationships as the surrogate child

matures.


• Second, this study showed that, if the sociological

mother exhibited maternal distress when the

surrogate child was 3 years old (particularly over

whether to tell the child about his surrogate

birth), this distress was predictive of adjustment

problems for the 7-year-olds who, after being told

of their surrogate birth, “conceivably…felt less

secure when faced with their mother’s emotional

problems.”


• Another Golombok study (2011) revealed that the

absence of a 7-year-old child’s genetic or

gestational link to his sociological mother caused

the mother’s interaction with her surrogate child

(and vice versa) to be less warm and less mutually

responsive and cooperative.


• Studies like these are just beginning to uncover

the psychosomatic upset that OB/GYN researchers

frequently discuss when a surrogate child is cut

off from an important component of the

gestational link: the oxytocin-bonding hormone of

his gestational mother.


• Oxytocin’s hormonal bond, firmly established between the mother and her preborn during gestation, is meant to be reinforced after birth by mother-to-baby physical interactions—skin-to-skin contact, eye gazing, and breast-feeding.

• This oxytocin link not only facilitates key physiological processes in the baby’s development, but also helps the mother to recover after delivery.

• It promotes bonding patterns between the mother and neonate and creates desire for further contact.


• In fact, the powerful imprinting for mother and

baby from the oxytocin release during

breastfeeding occurs chiefly “so that mother and

baby will be able to find and recognize each other

in the hours and days after birth.”

• Most importantly, studies show “the resulting high

or low level of oxytocin will control the permanent

organization of the stress-handling portion of the

baby’s brain—promoting lasting ‘securely

attached’ or ‘insecure’ characteristics in the

adolescent and the adult.”


• All of this essential maternal-child melding and

mother-to-baby recognition is proactively

disrupted when the surrogate mother hands her

baby over to its sociological parents.

• We can only guess how long the resulting love-

vacuum is felt, consciously by the surrogate

mother and subconsciously by the baby.

• Nor can we know when failure to experience this

gestational link might morph into a panoply of

insecure behavior on the part of the surrogate

child/adolescent/adult: anti-socialism, aggression,

difficulty forming lasting bonds with a mate,

mental illness, and poor handling of stress.

Injustices against the

surrogate mother

• Donum Vitae declares that surrogate motherhood

represents:

– an objective failure on the part of the surrogate ‘’to meet

the obligations of maternal love, of conjugal fidelity and of

responsible motherhood;

– it offends the dignity and the right of the child to be

conceived, carried in the womb, brought into the world and

brought up by his own parents;

– it sets up, to the detriment of families, a division between

the physical, psychological and moral elements which

constitute those families.”

The Church insists that the woman’s

choice of surrogacy serves neither

her own good nor the good of

others.

• And, in saying that, isn’t the Church implying the

decision and choice to gestate another couple’s

child is not only a self-inflicted injustice—a

failure of the surrogate to give due respect to

her own personal integrity, freedom, and

dignity—but also a society-inflicted injustice, a

failure by the intending couple and the

reproductive medical community at-large to

treat the surrogate justly?

The depth of the injustices

befalling a surrogate mother:

• First, her health risks.

• Researchers can extrapolate from the potential risks

associated with artificial insemination, IVF, and

pregnancy generally.

• The woman’s medical preparation for traditional

surrogacy involves

– submitting herself to the pre-pregnancy risks of artificial

insemination:

– sexually transmitted infection from the intending father’s

sperm;

– ovarian hyperstimulation that, in rare cases, can be severe

and life-threatening; and

– a variety of physical maladies including hot flashes,

abdominal pain, mood problems, and blurred vision.

- Council for Responsible Genetics, “Surrogacy in America”


surrogate mother

• Since gestational surrogacy necessarily involves

IVF,

– it carries with it all the in vitro adverse side effects

– a higher risk of multiple pregnancy,

– increased risk of miscarriage, anemia, urinary tract

infections, high blood pressure and organ damage,

hemorrhage, cesarean delivery, polyhydramnios, and

placental abnormalities.

• The risks associated with multiple embryo

implantation (routinely associated with IVF) are

greater when the individual bearing the risk is a

hired surrogate.

Council for Responsible Genetics, “Surrogacy in America”

• Typically, she lacks the knowledge and

bargaining power to reduce her health risks

by demanding reduction in the number of

embryos implanted.

• The superovulation process that

physiologically prepares the surrogate to

gestate can also be very dangerous, with the

possibility of ovarian rupture.

• And, then, there’s the risk for infections. Even

though clinics and matching agencies screen

reproductive cells for STDs and HIV, errors

can be made.

• And, finally, a gestational surrogate is at risk

from the intensive pre-pregnancy hormone

treatment aimed at matching her menstrual

cycle with that of the intending mother.


surrogate mother

• Both traditional and gestational surrogates risk

uterine cancer from the hormone estrogen and

bothersome physical side effects from the

hormone progesterone (bloating, irritability, and

breast tenderness).

• Gestational surrogates risk infections and serious

illnesses from antibiotics and/or anti-rejection

corticosteroids.


surrogate mother

• Second, surrogate mothers are at increased risk

for emotional trauma and psychological burden.

• The inability of some surrogate mothers to

relinquish their babies—to sever the gestational

link between them and their newborns—has

resulted in excruciating levels of anguish for the

surrogate and in high-profile lawsuits on the side

of the sociological parents.

The Baby-M case• A custody case that became the first American court ruling on the

validity of surrogacy.

• William Stern and his wife, Elizabeth Stern, entered into a surrogacy agreement with Mary Beth Whitehead, whom they found through a newspaper advertisement.

• According to the agreement, Mary Beth Whitehead would be inseminated with William Stern’s sperm (making her a traditional, as opposed to gestational, surrogate), bring the pregnancy to term, and relinquish her parental rights in favor of William’s wife, Elizabeth.

• After the birth, however, Mary Beth decided to keep the child.

• William and Elizabeth Stern then sued to be recognized as the child’s legal parent.

• The New Jersey court ruled that the surrogacy contract was invalid according to public policy, recognized Mary Beth Whitehead as the child’s legal mother, and ordered the Family Court to determine whether Whitehead, as mother, or Stern, as father, should have legal custody of the infant, using the conventional ‘best interests of the child’ analysis.

• Stern was awarded custody, with Whitehead having visitation rights.


surrogate mother• The presence of emotional loss, pain, and despair

for the surrogate mother—which might last a lifetime—could also lead to legal/moral deadlock and more spiritual suffering.

• What if neither the surrogate nor the commissioning parents want the child? Should there be penalties if the agreement is not honored?

• What happens to the surrogacy contract when there is a fetal diagnosis of disability or disease? Would it result in the commissioning couple reneging on their end of the bargain?

• Or what happens when the commissioning parents want the surrogate to abort her baby, but the surrogate has strong moral objections, or the reverse? - Matthew Tieu, 2007


surrogate mother

• Third, surrogate women are at risk for

exploitation.

• Reports cite that some surrogacy agencies have

chosen to locate near army bases, like San Diego’s

Camp Pendleton, and have advertised in military periodicals such as Military Times and Military Spouse.

• Anecdotal evidence shows that some military

wives, especially while their husbands are

deployed, seriously consider surrogacy as a

second source of income.

http://www.nydailynews.com/news/national/2008/03/31/2008-03-31_military_wives_cashing_in_surrogates

• Finally, all the potential psychosomatic harms that could befall a surrogate mother point to the basic injustice inherent in her situation.

• The medical and parental stakeholders are not loving, but using, the surrogate woman.

• The reproductive medical community and the commissioning parents know full well that for the surrogate carrier to contractually agree to transfer her maternal rights does not annul but only conceals the existing parental bonds between the gestational mother and her child.

• So, when the commissioning parents enter into such a contract, they reduce the surrogate mother and her child to a mere means to their end of getting a baby.

• When the medical community facilitates this contractual agreement, they reduce the surrogate mother to a mere object, a human incubator, who can be manipulated at will.

- Matthew Tieu, 2007


intending parentsDonum Vitae gives crucial advice to surrogacy-commissioning couples:

• On the part of the spouses, the desire for a child is natural: it expresses the vocation to fatherhood and motherhood inscribed in conjugal love.

• This desire can be even stronger if the couple is affected by sterility which appears incurable.

• Nevertheless, marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se ordered to procreation.

• A true and proper right to a child would be contrary to the child’s dignity and nature.

• The child is not an object to which one has a right,

nor can he be considered as an object of ownership:

rather, a child is a gift, “the supreme gift” and the

most gratuitous gift of marriage, and is a living

testimony of the mutual giving of his parents.

• For this reason, the child has the right to be the fruit

of the specific act of the conjugal love of his parents;

• And he also has the right to be respected as a person

from the moment of his conception.


intending parents

• Through their decision and choice to commission

a surrogate to gestate their child, the intending

parents act unjustly:

– toward their surrogate child and its gestational mother,

by suppressing some of their basic rights;

– toward society-at-large, by promoting the exploitative

practices of the surrogacy industry; and

– toward themselves, by allowing themselves to miss out

on the just rewards that come from being able to view

their child as the completion and confirmation of their

marital acts of reciprocal self-giving love.

Michael Scott Kline and Nick Scott with their

child Eliot, and surrogate mother Sarah Jones

Injustices against society

• “The inviolable right to life of every innocent

human individual and the rights of the family

and of the institution of marriage constitute

fundamental moral values, because they

concern the natural condition and integral

vocation of the human person; at the same time

they are constitutive elements of civil society

and its order.”

Donum Vitae, 1987

Injustices against society

• ”For this reason the new technological

possibilities which have opened up in the field

of biomedicine require the intervention of the

political authorities and of the legislator, since

an uncontrolled application of such techniques

could lead to unforeseeable and damaging

consequences for civil society.”

Donum Vitae, 1987

• To the extent that those who oversee the

reproductive medical community, especially

the Centers for Disease Control and the

Society for Assisted Reproductive

Technology, fail to adequately document, or

enforce documentation of, the surrogate

industry’s exploitation, unsafe practices,

abuse, and fraud carried out by its

spectrum of “baby-making” entrepreneurs

—hormone manufacturers, sperm and egg

harvesters, donor banks, foreign adoption

agencies, assisted reproductive

technology clinics, embryo banks, legal

experts, and surrogate matching

agencies; to that extent these medical

overseers heap an injustice against the

common good by contributing to the moral

attrition of society.

Human procreation is a

moral enterprise

• Because “human procreation has specificcharacteristics by virtue of the personal dignity ofthe parents and of the children,” it is a moralenterprise “whereby the man and the womancollaborate with the power of the Creator” and areassured that their children, begotten within theirloving acts of sex, will be “the fruit and the sign ofthe mutual self-giving of the spouses, of their loveand of their fidelity.”

• Everything directly related to the transmissionof life participates in the creative power ofGod; consequently, it should be treated withrespect and responsibility.

- Donum Vitae, 1987

sex marriage the family & surrogacy

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