Surrogacy needs to be regulated, not prohibited
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj-2024-079542 (Published 05 August 2024) Cite this as: BMJ 2024;386:e079542- Lavanya R Fischer, solicitor,
- Natalie Gamble, solicitor2,
- Kirsty Horsey, professor of law3,
- Emily Jackson, professor of law4,
- Denise E Seidelman, partner5,
- Richard Vaughn, founder6
- 1Regunathan Fischer Advocates, Delhi, India
- 2NGA Law, London, UK
- 3Kent Law School, Canterbury, UK
- 4LSE Law School, London, UK
- 5Rumbold and Seidelman, New York, USA
- 6International Fertility Law Group, New York, USA
- Correspondence to: E Jackson e.jackson{at}lse.ac.uk
Criticism of surrogacy—in which a woman carries a child for parents who cannot do so themselves—has become increasingly vocal and fierce in recent years. In response to the Law Commissions’ recent consultation, opponents described surrogacy as an “exploitation of women and commodification of their bodies” and a “fragmentation of motherhood.”1 In March 2023, 100 lawyers, doctors, and psychologists signed the Declaration of Casablanca demanding the universal abolition of surrogacy,2 and in 2024 the Italian prime minister proposed legislation to make it a universal crime on a par with genocide and child trafficking.3
It is true that some surrogacy arrangements fail to adequately protect surrogates’ rights,4 and some intermediaries have operated unethically by trafficking women,5 engaging in unsafe practices such as multiple embryo transfer,6 or brokering surrogacy in war zones.7 However, empirical evidence does not support the claim that surrogacy is inherently harmful. Rather, it suggests that well regulated surrogacy can be positive for all involved.
As a group of lawyers from the UK, US, and India (all countries in which surrogacy is—or has been—practised) we have substantial experience of dealing with surrogacy agreements. Our legal perspective is that whether surrogacy is good or bad depends on how it is conducted. Healthy, safe, ethical surrogacy is both achievable and most likely when surrogacy is practised openly and regulated by laws designed to minimise risks and avoid harms. Laws which seek to restrict or prohibit surrogacy tend to produce the opposite outcome.
Evidence on surrogacy outcomes
Research into surrogacy outcomes does not support the claim that acting as a surrogate necessarily has a negative effect on women. A longitudinal study of 34 women from the …
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