The mission of Issues in Perspective is to provide thoughtful, historical and biblically-centered perspectives on current ethical and cultural issues.

One of my favorite novels is Fyodor Dostoevsky’s The Brothers Karamazov.  In one of the central chapters of the book, one of the brothers, Ivan Karamazov, argues, “If God does not exist, everything is permitted.”  The permissiveness of modern American society can scarcely be exaggerated, but it can be traced directly to the fact that modern men and women act as if God does not exist or is powerless to accomplish His will.  Furthermore, the church no longer represents the central core of Western civilization.  For the most part, the church has been displaced by the reign of secularist, postmodern autonomy.

There are some who argue that raw, political power is the answer.  Power will restore the moral center of our culture.  But, if one is intellectually honest, little progress toward the establishment of a moral center of gravity can be detected.  Instead, American culture has moved swiftly toward a more complete abandonment of all moral conviction.  Integrity, honesty, truthfulness are not championed in American culture in 2025.  The pursuit of power and treating those who disagree as mortal enemies that need to be not only silenced but destroyed governs the thinking of many today.

The church must stand not for political power but for the authoritative Word of God, which reveals the wisdom of God and His commands.  As theologian Albert Mohler argues, “The church is to be a community of character.  The character produced by a people who stand under the authority of the sovereign God of the universe will inevitably be at odds with a culture of unbelief.”

In this Perspective, I seek to illustrate the abandonment of a moral center rooted in God’s Word by focusing on “international surrogacy” using the gestational surrogacy procedure.

The growth of “international surrogacy” has supplanted adoption. What explains this growing preference for surrogacy?  In the mid-1980s in-vitro-fertilization allowed “gestational” surrogacy, whereby a woman could carry a child who was not related to her. Before then, childless couples who wanted families would generally have had no alternative but to apply to adopt. Yet demand has long outstripped supply. According to one study published in 2006, there were around 1 million parents in America who wanted to adopt a child, yet only 51,000 children were placed with agencies for adoption each year.  Therefore, many couples looked abroad. In 2004 international adoptions peaked at 45,000, mainly from poor or war-torn countries. Yet a series of scandals involving child-trafficking, kidnapping and baby-farming prompted tighter regulation and/or outright bans. The result has been a collapse in cross-border adoptions—in 2022 there were just 3,700 worldwide—stranding hundreds of thousands of children in orphanages. “It is a decline that will not be reversed, says Peter Selman, a professor at Newcastle University and an authority in this area.”

Two other developments add to this complicated situation:

• Domestic adoptions have fallen over recent decades in a number of rich countries, partly because of the introduction of needlessly stringent rules on the suitability of parents. In parts of Britain, for example, local authorities insist that each child must have their own bedroom. Moreover, the amount of time children spend in care before being placed with a family has gone from months to years, leaving many traumatized and institutionalized.
• As rich-world adoption has plummeted, demand for surrogacy has grown. It has also been fueled by rising infertility, an increase in the acceptability of singles and gay couples choosing to have children, and the spread of information on the internet.

The Economist reports that “There are no reliable worldwide statistics. Sam Everingham, who founded Growing Families, a non-profit organization in Australia that helps people navigate international surrogacy, estimates around 30,000 babies a year are born from international surrogacy. Other estimates are higher. Global Market Insights, a data firm, reckons this market was worth more than $14bn in 2022 and forecasts its value will rise to $129bn in 2032.  This rapid growth is bringing to the fore legal and moral quandaries that are similar to those that plagued, and then largely destroyed, international adoption: the potential for abuse when high demand in rich countries finds supply in poorer, unregulated one; whether it is ethical to pay for children; and how surrogacy, commercial or altruistic, affects women’s autonomy over their own bodies and the identity and well-being of the children they bear.  Some, such as Giorgia Meloni, Italy’s prime minister, are implacably opposed to the very idea of a woman carrying a baby for someone else under any circumstances. ‘Human life is priceless and is not a commodity,’ she tweeted after Italy declared surrogacy a universal crime.”

What countries have the largest number of surrogate mothers?  America, Mexico, Colombia and Georgia are among the countries that have booming commercial-surrogacy industries. In America, where the rules are set by each state, this is a highly professional business with protection for mothers and the intended parents. California, a liberal surrogacy-friendly state, uses orders that establish the intended parents as legal parents before the birth. This makes it a popular destination, but also an expensive one, with costs of up to $200,000. This is increasing demand for cheaper—and often unregulated—destinations such as Mexico and Colombia, with costs of around $90,000 and $65,000 respectively.  “No regulation, poor young populations, and fertility clinics galore mean that African countries like Nigeria, Uganda and Kenya are also becoming popular hubs. Olaronke Thaddeus, the founder of Meet Surrogate Mothers, a clinic in Lagos, Nigeria, says when she opened in 2013 she had one couple visit that entire year. Now she welcomes 200-300 potential parents a year, most of whom come from America, Britain, Canada and continental Europe.”

Surrogacy has a short history, beginning over 30 years ago, gaining attention especially through the famous Baby M case in 1986.  In what is now called an example of traditional surrogacy, the surrogate, Mary Beth Whitehead, refused to give up the baby to the biological father and his wife.  With two families fighting over a child that both could actually claim, traditional surrogacy gave way to what is called gestational surrogacy:  An embryo is created in the laboratory (a Petrie dish), using eggs and sperm from the parents or from donors, and then implanted into the womb of a surrogate who has no genetic connection to the baby.  However, gestational surrogacy has not settled the controversial aspects of surrogacy; it has only created a whole new set of questions.  For example, is the surrogate paid extra money for a caesarian section, for multiple births or even for the loss of her uterus?  What if the intended parents die during the pregnancy?  Whose child is it then?  How long must the surrogate abstain from sex during the pregnancy?  Can the parents paying the surrogate mandate by contract such activity?  If extra bed rest is needed during the pregnancy, are the intended parents required to replace the lost wages of the surrogate because of the bed rest?   Should the intended parents also pay for child care for the surrogate’s existing children or even for such mundane expenses as housekeeping, laundry, etc.?  Finally, if the intended parents change their minds, can they require that the surrogate have an abortion because they no longer want the child?  All of these issues have led to elaborate and often complicated contracts negotiated by the surrogate and the intended parents.

Gestational surrogacy raises quite profound ethical issues:

1. Gestational surrogacy requires in vitro fertilization, which normally involves the production of multiple embryos.  Several embryos are implanted in the surrogate’s womb, but the other embryos are either destroyed or frozen.  Since life begins at conception (as the Bible stipulates in Psalm 139:16), the destruction of these embryos is the destruction of a life.  The primary ethical guideline for the frozen embryos must be to treat them in a manner where there is no harm to the embryo.  It is important to understand what happens to these embryos as a result of the gestational surrogacy process.
2. In studying the gestational surrogacy process summarized in this Perspective, one quickly comes to the conclusion that surrogacy is a procedure using technology and money to control and manipulate a process created by God to operate within the confines of family.  The enormous amounts of money affluent couples are spending for gestational surrogacy smacks of exploitation and manipulation.  There just seems to be something almost obscene about nearly $180,000 to produce a human life.  How can we as a civilization accept this?  Intuitively, amounts of money such as this raise important questions about the exploitation of women and the virtual selling of babies.  I find it amazing that many parts of the United States permit gestational surrogacy with no regulation and no significant legal boundaries.  European countries such as Great Britain and Germany, which are far more secular than the US, either prohibit gestational surrogacy or highly regulate it.
3. Gestational surrogacy falls under the stewardship responsibility of being God’s image bearers (Genesis 1:26ff).   Because God is sovereign and humans have dominion status, human accountability is a necessary corollary.  Gestational surrogacy gives humanity a degree of power and control never imagined in previous generations.  Given human depravity, it is difficult to be optimistic about the future developments concerning gestational surrogacy.

Gestational surrogacy is one of those procedures that raises deeply important questions:  Simply because science can pursue a particular medical, reproductive or even genetic procedure does not mandate that it must do so.  Gestational surrogacy is fraught with so many concerns, that perhaps it is wise that we do not do it.  I rather doubt that will ever occur, but I see little about gestational surrogacy that is positive or God-honoring.

See Albert Mohler in Tabletalk (August 2017), pp. 70-71; The Economist (1 February 2025), pp. 47-48; Tamar Lewis in the New York Times (6 July 2014) and James P. Eckman, Christian Ethics (2013), pp. 43-54.