Medicine, Health Care and Philosophy 23 (4):621-630 (2020)

Abstract
It is unclear what proper remuneration for surrogacy is, since countries disagree and both commercial and altruistic surrogacy have ethical drawbacks. In the presence of cross-border surrogacy, these ethical drawbacks are exacerbated. In this article, we explore what would be ethical remuneration for surrogacy, and suggest regulations for how to ensure this in the international context. A normative ethical analysis of commercial surrogacy is conducted. Various arguments against commercial surrogacy are explored, such as exploitation and commodification of surrogates, reproductive capacities, and the child. We argue that, although commodification and exploitation can occur, these problems are not specific to surrogacy but should be understood in the broader context of an unequal world. Moreover, at least some of these arguments are based on symbolic rhetoric or they lack knowledge of real-world experiences. In line with this critique we argue that commercial surrogacy can be justified, but how and under what circumstances depends on the context. Surrogates should be paid a sufficient amount and regulations should be in order. In this article, the Netherlands and India are case examples of contexts that differ in many respects. In both contexts, surrogacy can be seen as a legitimate form of work, which requires the same wage and safety standards as other forms of labor. Payments for surrogacy need to be high enough to avoid exploitation by underpayment, which can be established by the mechanisms of either minimum wage, or Fair-Trade guidelines. An international treaty governing commercial surrogacy should be in place, and local professional bodies to protect the interests of surrogates should be required. Commercial surrogacy should be permitted across the globe, which would also reduce the need for intended parents to seek surrogacy services abroad.
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DOI 10.1007/s11019-020-09976-x
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References found in this work BETA

Is Women's Labor a Commodity?Elizabeth S. Anderson - 1990 - Philosophy and Public Affairs 19 (1):71-92.
Reproductive Biocrossings: Indian Egg Donors and Surrogates in the Globalized Fertility Market.Jyotsna Agnihotri Gupta - 2012 - International Journal of Feminist Approaches to Bioethics 5 (1):25-51.
Fair Trade International Surrogacy.Casey Humbyrd - 2009 - Developing World Bioethics 9 (3):111-118.

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