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MCH-013: Surrogate Parenting

Surrogate Parenting: The Wisconsin Medical Society believes that physicians who participate in surrogate motherhood arrangements or provide fertility, obstetric or counseling services for a surrogate, should carefully examine all relevant issues, including legal, psychological, societal, medical and ethical aspects. Simple clear conclusions cannot be anticipated. Significant ethical concerns exist even in the most uncomplicated situation involving an infertile couple and no financial transactions. Additional concerns that result from the payment of fees and from special circumstances such as surrogate use for convenience or single parenting magnify the ethical complications. Thus, while the decision to participate or not in the surrogate motherhood alternative is an individual one for each physician to make, the Society has significant reservations about this approach to parenthood and offers the following recommendations for the guidance of physicians:

  1. Initiation of Surrogate Arrangements
    1. When approached by a patient interested in surrogate motherhood, the physician should, as in all other aspects of medical care, be certain there is a full discussion of ethical and medical risks, benefits and alternatives.
    2. A physician may justifiably decline to participate in surrogate motherhood arrangements.
    3. If a physician decides to become involved in a surrogate motherhood arrangement, he or she should follow these guidelines:
      1. The physician should be assured that appropriate procedures are utilized to screen the contracting person or persons and surrogate. Such screening may include appropriate fertility studies and genetic screening.
      2. The physician should receive only the usual compensation for obstetric and gynecologic services. Referral fees and other arrangements for financial gain beyond the usual fees for medical services are inappropriate.
      3. The physician should not participate in a surrogate program where the financial arrangements are likely to exploit any of the parties.
  2. Care of Pregnant Surrogates
    1. When a woman seeks medical care for an established pregnancy, regardless of the method, of conception, she should be cared for as any other obstetric patient or referred to a qualified physician who will provide that care. The surrogate mother should be considered the source of consent with respect to clinical interventions and management of the pregnancy. Confidentiality between the physician and patient should be maintained. If other parties, such as the adoptive parents, are to play a role in decision making, the parameters should be clearly delineated, with the agreement of the patient. (HOD, 0411)*

*Currently under five-year policy review.