Sex Marriage the Family & Surrogacy

The Human Person:
Sexuality, Marriage, & the Family
Liza 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

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.

surrogate child
• 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.”

surrogate child
• 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.

surrogate child
• 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.

surrogate child
• 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.

surrogate child
• 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.”

surrogate child
• 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.

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 parents
Donum 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 specific
characteristics by virtue of the personal dignity of
the parents and of the children,” it is a moral
enterprise “whereby the man and the woman
collaborate with the power of the Creator” and are
assured that their children, begotten within their
loving acts of sex, will be “the fruit and the sign of
the mutual self-giving of the spouses, of their love
and of their fidelity.”
• Everything directly related to the transmission
of life participates in the creative power of
God; consequently, it should be treated with
respect and responsibility.
- Donum Vitae, 1987

Sex Marriage the Family & Surrogacy

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