Contracts, Care Planning, and Clinical Decision-Making: Catholic Health Care’s Mandate to Honor the Maternal Relationality and Dignity of Surrogate Mother
Annemarie Starr, Saint Louis University

Surrogacy contracts are routinely used as pseudo-care planning documents, specifying clinical care in advance to forestall conflict between surrogate mothers and intended parents over medical decisions. Catholic hospitals are bound to oppose all forms of artificial reproductive technology (including surrogacy), but they may still find themselves in the position of providing care to surrogate mothers and the children they bear during pregnancy, labor, and delivery. I argue that Catholic hospitals are obliged to disregard all surrogacy agreements which unjustly prioritize the preferences of intended parents over the wishes of the surrogate mother and the good of the child (or children) in clinical decision-making. While this inquiry raises a host of interesting, related ethical questions, I draw from the Catholic theological tradition to answer a narrowly focused clinical ethics question about honoring preexisting surrogacy contracts which stoke conflict between the patient and the intended parents. During the prenatal and antenatal/antepartum periods, the dignity of the surrogate mother in her unique maternal relationship to the child is best respected when clinicians solicit her wishes and her involvement in care for the child. These cases, while difficult, may prove an opportunity to prophetically witness to the intrinsic, relational dignity of the surrogate mother.