Posted by: bridget | 5 January 2008

Medical Tourism & Open Thread

What do y’all think about this?  Judith Warner discusses surrogacy arrangements in foreign countries and states,

Because what’s going on in India – where surrogacy is estimated now to be a $445-million-a-year business — feels like a step toward the kind of insane dehumanization that filled the dystopic fantasies of Aldous Huxley’s “Brave New World” and Margaret Atwood’s “Handmaid’s Tale.” (One “medical tourism” website,, refers to the Indian surrogate mother as a mere “host.”) Images of pregnant women lying in rows, or sitting lined up, belly after belly, for medical exams look like industrial outsourcing pushed to a nightmarish extreme.

A few thoughts: there is a difference between selling your body via prostitution, which almost always involves illegality, exploitation, and violence, and selling it when both you and the buyer have a vested interest in your own health.

Ms. Warner makes short work of the idea that surrogates should be monitored; however, she completely ignores the fact that a surrogate who smokes, drinks, or acquires diseases is not just harming the couple who enlisted her help, but may cause permanent damage to a child. Is there really something wrong in protecting your child’s health before it is born?

The United States has some screwy laws, which prohibit the payment of a surrogate for her trouble beyond her medical expenses.  While this does ensure that no one will exploit herself for the money, it has other perverse results.  After handing over thousands of dollars for medical treatment, a couple may be left without a child and without their money: essentially, they gave another person money for having a child, without the charitable intention of giving money away.



  1. When something like that is so fraught with risks and issues it makes me wonder if the whole enterprise is just wrong. It isn’t like their aren’t plenty of kids available to adopt in India!

  2. Baby farms. Wrong, bad, heinous, twisted, sick.

    ‘Scuse me while I hurl. Boo!!!!

  3. Two quick comments:

    Here is a link to adoption costs.

    I take it both of you dislike the idea of surrogacy, but do not limit such dislike to surrogates in developing countries. (Some of what puzzled me about Ms. Warner’s article is the seeming dislike of surrogacy in other countries, without a general condemnation of the practice.)

  4. Look no further than the ridiculous laws concerning organ donation- i.e. the inability to sell your own organs.

  5. After death? Before death? Including your own blood? All of the above? #1 and #3?

  6. BTW if anyone is worried about adoption costs, when you adopt from any one of the 50 states foster systems, the state where you adopt usually reimburses almost all reasonable costs (up to about $6,000). ;-)

    So often the adoption itself doesn’t carry a large price tag.

  7. Potential problem: you are talking about foster systems, correct? Older children with possible psychological problems, instead of adopting infants? There is a reasonable distinction to be drawn there.

  8. “There is a reasonable distinction to be drawn there.”

    Yeah there is, and that is why the one is no-cost and the other is very expensive. ;-)

    And with regard to organ sales I mean at any point.

  9. Well, yes, you get what you pay for. :)

    As for organ sales – are you pro-organ sale, or is there some sarcasm that isn’t coming through here?

  10. “As for organ sales – are you pro-organ sale”

    I took a lot of heat arguing in favor of organ sale during law school. I was the only i a class of 54 law students to support such a concept.

  11. Do tell.

    (Not like I’m trying to provoke a showdown/smack down between you and the Queen of Swords, but I think it’s fascinating to hear what people have to say about organ sales. This is my version of reality TV.)

  12. I think I will reserve such for later since I just downed a foul tasting protein shake and as a result I am feeling quite ornery.

  13. TT, You know that I strongly discourage “ornery” on my blog.


  14. Ok, baby farms? Yes, that’s DAMN creepy. So much about this strikes me as just wrong.

    But the quirky thing of it is, if you go to a country with serious health problems, it seems a bit odd to expect healthy results.

    I think we need to take a closer look at the laws we have here for surrogates. There is this unmistakable whiff of colonialism is US couples going to India to have someone else carry their children to term.

    As for monitoring, to some degree that’s fine, for the very health reasons you cite. But perhaps France is actually right on something:

    “The human body is not lent out, is not rented out, is not sold,” France’s highest court ruled back in 1991, when it outlawed surrogate motherhood.

  15. “The human body is not lent out, is not rented out, is not sold,” France’s highest court ruled back in 1991, when it outlawed surrogate motherhood.”

    A skilled craftsman has a body which allows him to perform certain tasks, knowlege alone is not enough to perform those tasks. If he is not self-employed, is he not renting out his body.

    A lawyer has a certain combination of intelligence and communication skills without which she would not be successful. Is the lawyer renting out her body when he works for her client.

    I think that arguement has some problems.

  16. SST,

    I was going to make a similar argument, if anyone picked up on it.

    IMHO, it is more applicable to things like construction work, housekeeping, moving, or security details. We acknowledge that many people (especially men) have jobs that involve some degree of physical labour, and, as the result of the toll it takes on their bodies, we compensate them more. (Many people who claim that there is no gender wage gap cite this rationale.)

    Now, I do think there is a line at which point there is NO intellectual work involved (such as with prostitution), and the work affects the soul. Just as someone cannot contract to be enslaved, he cannot contract (or should not contract) to have his very soul destroyed.


    I agree with a reexamination of our surrogacy laws. Unfortunately, they are predicated upon the notion that women can’t contract for pregnancy, and, therefore, if a woman chooses to be a surrogate, she does so out of the desire to help someone else or because she likes being pregnant.

    Those rationales both apply to the reasons why people work. I love the law and I think it would be fantastic to use my law degree to help people, but I still want to be paid for it. There is a strange idea that we can morally not pay someone to do something they like, and, in fact, it is more moral to not pay them. B.S., IMHO.

  17. SST,
    There is a marked qualitative difference in offering one’s body and offering one’s services. You wouldn’t claim using muscles to move your arms to fix a leaky sink is equivalent to offering your body sexually for pay, would you? In the same way, offering your body as a host for a pregnancy is incredibly intimate, and wholly different than offering say, oh, cleaning services.

    I agree with the ridiculousness of assuming that a person’s passion for a job somehow invites lower (or no) pay. You see this with firefighters, teachers, and other public servants all the time. It is BS.

    The question regarding being a surrogate is a tough one. I think the French court’s opinion reflects the writer (of the linked article)’s opinion that there is more to offering to give birth than providing a service.

  18. You are both right of course. There is a lot more to it than that. That is just what struck me about that quote.

    We struggled with infertility for several years and never considered surrogacy an option.

    However it seems odd that a society that allows mothers to kill unwanted babies, also won’t allow a mother to carry a wanted baby for someone else for pay.

    I just don’t see where this is the business of the government. It seems more of a moral and emotional issue among the parties involved.

  19. […] is a fair assumption that these women were not necessarily willing parties to the transaction.  (Query whether one can voluntarily contract for those services.)  To HaP readers who are of a liberal bent: don’t blame us when we break out in mottled […]

  20. Now, I do think there is a line at which point there is NO intellectual work involved (such as with prostitution), and the work affects the soul. Just as someone cannot contract to be enslaved, he cannot contract (or should not contract) to have his very soul destroyed.

    I don’t think that is a very useful standard for determining which occupations should be legal or illegal. Prostitution may be soul-killing, yes. But so is an unfullfilling, dead-end retail job or an anonymous corporate job. If “soul-killingness” becomes one of the standards by which we judge the legality of a profession, then most of the jobs available in the United States would be immediately outlawed.

    As far as prostitution is concerned, I think legalizing prostitution is probably the best solution. There is nothing reasonable you can do to “end” prostitution (it is the oldest human profession for a reason) and it’s unclear as to whether the violence surrounding the practice is intrinsic or a product of its current illegality. If the violence is intrinsic, then I think we should outlaw prostitution, since the cost is too high.

    If (and I think this is the case) the violence is a product of the illegality of prostitution, and if regulations and monitoring can serve to reduce exploitation…then I think legalizing prostitution is something we should at least consider.

  21. Jamelle,

    Please do not equate retail work with prostitution. That is one of the most sickening things I have heard in a long, long time.

    Retail work may be boring and unfulfilling, but it does not bring the psychological ruin upon people that does prostitution.

    I can’t respond to this. Someone else want to step in and explain?

  22. theobromophile,

    I’m not equating retail work with prostitution. I recognize that being a prostitute really sucks. I’m only nothing that using “soul-killingness” as a method of determining whether we should outlaw prostitution is probably not a good idea, since there are a lot of soul-killing occupations. It would probably be better to use other measures that more accurately show the unique crappiness of prostitution.

  23. To add a bit more:

    When it comes to “soul-killingness” the difference between being a prostitute and say, working in a slaughterhouse, is a matter of degree. Unless you can demonstrate that working as a prostitute is uniquely soul-killing then it really is more useful (for your argument) to find another measure of suckiness.

  24. “I can’t respond to this. Someone else want to step in and explain?”

    You suck at your own opinions, so how can you hope to pass judgment [on] others’?

  25. *on others’. I grammar good.

  26. “You suck at your own opinions, so how can you hope to pass judgment [on] others’?”

    Yes, and your one sentence reply goes a long way toward painting a vivid picture of your mental superiority. Perhaps next time you could treat us to a whole two sentences?

    Ah, what a lovely internet world this is. It serves to emphasize Dennis Prager’s point (well worth the read)….

  27. Jamelle,

    Then, instead of equating retail work with prostitution in terms of soul-killingness, then say that you are not doing that, why not actually propose other measures that, in your opinion, better describe the problem of prostitution (and, by implication, surrogacy, as this is neither a thread about retail work nor sex work)?

    I disagree with the slaughterhouse example. I think it a fundamentally different issue – one of kind, not of degree. When I said “soul-killing,” I was not exaggerating. Prostitutes have described their profession as consent to be raped; rape has been described as “unfinished murder.” Perhaps I respond differently, being a female and therefore suspectible to rape, but I simply cannot see how you fail to draw this distinction.


    You have issues. Serious issues. Let me know where you live, and I’ll send you some info so you can get the help you need. Rational, mentally healthy and happy people do not go around doing the things you do. That is one crappy way to live your life.

  28. theobromophile,

    I will again repeat, I am not equating retail work and prostitution.

    Prostitution = soul-killing
    Retail work = also soul-killing

    Conclusion: Even though one profession has more soul-killing than the other, they are still both soul-killing professions, as such soul killing is a bad criteria because it leads to plainly ridiculous outcomes, such as outlawing retail work.

    Again, the only solution to this problem is to either find a different criteria, or argue why prostitution is uniquely soul-killing (or why rape* is uniquely soul-killing). I happen to think that there are other professions that rival prostitution when it comes to degree of “soul-killingness,” American slaughterhouse workers have described their profession as horrific and desensitizing. They suffer awful injuries, serious emotional distress and among a significant minority, develop sadistic tendencies. It is also soul-killing.

    Now, since I don’t think prostitution should be outlawed, it’s not my obligation to find another criteria, it is yours, since (it seems) you want to take legalizing prostitution off of the table.

    * I’m not diminishing the horror of rape, I’m only making the point that there may be other crimes that are worse than rape, and it links back to the argument that it is necessary to find something uniquely terrible about the soul-killing that results from prostitution in order to make your argument.

  29. Jamelle,

    Retail is NOT “soul-killing.” You only state as much with the exaggeration of a teenager, for whom everything is a deprivation on par with the most inhumane treatment imaginable.

    Let me state this again: retail work does not damage the soul. Being bored and being raped are two very, very different things – the latter destroys a part of the soul, while the former merely does little to stimulate the mind.

    Jamelle, please understand that retail is not soul-killing. It is boring, frustrating, but it does not do permanent damage to the psyche. Last time I checked, 13% of retail associates do not attempt suicide. Clear?

    So what if there are worse crimes than rape? We are getting back to your initial problem of refusing to see something as bad if there is anything that might be worse. Under that criteria, there is but one thing in the world that is bad, and everything else, acceptable.

  30. FYI: prostitutes attempt suicide at a rate of between 20 and 40%:

    I do not use “soul-killing” as a melodramatic, teenage term, the way you are so doing. Until you get that through your head, we can’t have a discussion.

    One other fundamental part to a discussion is for you to do more than knock my views; you must present your own. So, Jamelle, if you want to continue this debate, please follow my comment policy. Saying, “I think you are wrong” is insufficient; it is incumbent upon you to find a system that works better than the one you reject.

  31. theobromophile,

    You have yet to address my argument. You tip toe your way there, when you cite the suicide rates of prostitutes (pointing to something uniquely terrible about prostitution), but you have yet to run straight into the argument.

    Instead, you’ve focused the discussion on something largely tangential to the actual argument, attacked me as melodramatic and prone to teenage exaggeration (both of which are false, since I’m far from melodramatic and not a teenager) and tried to shut down the discussion by invoking an entirely arbitrary rule. Ed: My blog, my rules. Don’t like it? Find another blog upon which to troll. Civility is not arbitrary. Which as an aside, isn’t even relevant in my case, since I’ve stated twice that I think the violence and exploitation surrounding prostitution can be mitigated if not eliminated by legalizing and regulating the trade. Ed. Statistics, please. You can’t speculate out of your rear end and then tell me that I’m wrong. You have your own blog for that. Prostitution is legal in some European nations as well as parts of Nevada. The research is there. Cite it. Your claim, not mine, so the duty is upon you to mosey over to google and make a case for yourself. I’ve made my positive case.

    My argument, restated in full, is this:

    Your standard for determining the illegality of an occupation is “soul-killingness.” Soul-killing professions should be illegal in your view. If we define soul-killing as extreme emotional and psychological distress, then it is certainly true that prostitution is a “soul-killing” occupation. It is also true though that prostitution isn’t the only soul-killing occupation. Now, this doesn’t mean that prostitution isn’t bad (something I never said by the way); but it does mean that one can imagine other occupations that are similarly soul-crushing but are not illegal.

    Since there exists mulitiple legal, soul-crushing occupations, then per your argument, we must outlaw these occupations (examples: executioners, industrial slaughterhouse workers). But that is ridiculous, since some of these occupations are integral to the functioning of a society. The fact that prostitution is illegal, means that it can’t be solely because it’s soul-crushing; there must be something else other than soul-killingness for an occupation to be illegal.

    Or in short, the quality of “soul-crushingness” may be necessary, but isn’t sufficient to declare something illegal. Your argument would be better served if you either: made it sufficient, or found a criteria less generic than “soul-killingness.”

  32. Well, that’s a radical change from your comparisons to the retail industry.

    (Rolls eyes)

    Re-read what I wrote, and congrats on turning 20. As an undergraduate, though, you’re still close enough for a teenager so as to not win on the melodramatic teenager issue. Besides, there are these things called analogies, remember?

  33. I’m trolling your blog?

    If by trolling you mean offering up decently thought out arguments with an honest attempt to engage, sure. That makes sense.

    What is your definition of civility again, because every time you write “civility” I read, “my policy of only tolerating agreement.” Because if you were actually civil, you wouldn’t consistently revert to name-calling and condescension whenever someone sustained a disagreement. You do it here, you did it at my blog, and I’ve seen it at various other blogs.

    I fully expect you to edit this comment with snarky remarks, and comments about how I must have issues or am just too “emotional.” Fine, whatever. Hopefully one day you’ll come down from your perch on Mt. Arrogant and actually engage what someone is saying.

  34. Fine, whatever. Hopefully one day you’ll come down from your perch on Mt. Arrogant and actually engage what someone is saying.

    My bad. You’re obviously a sweetie pie.

    My comment policy is very clear. It is the price one pays for posting on this blog. If one finds that price to high, and the benefit not worthwhile, he may (as in all free markets) decline the good. My comment policy is fairly standard among blogs that have them. Dawn Eden once used the Harris Protocol, which is similar. The rules are not arbitrary; they are meant to provoke thoughtful debate and avoid the type of argumentation whereby people merely say, “You’re wrong! You’re wrong! Ha, ha, ha!” After all, if I wanted that, I would post on Feministe.

    Let me see. You said that retail industry is “soul-killing” in the same way as prostitution, yet you get your tighty-whities in a twist over comparisions of deprivations of human life via abortion and via slavery. Right. You refuse to do your own research, instead citing non-statistics that you make up (“Legalising prostitution would change all that!”), although the research is out there to be found. When I ask you to start acting like an adult, you say that I’m arrogant.

    Want to try again?

  35. […] recently tried to start a discussion on prostitution with this blogger, but after some difficulties in getting my point across (and a few misunderstandings) I kind of […]

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