11 May 2016 'Chicago Med' Gives Surrogacy a Bad Rap

A recent episode of NBC medical drama Chicago Med, (Season 1 Episode 15, “Inheritance”) set in the emergency room of Gaffney Chicago Medical Center, portrayed a scenario that was both completely unrealistic and showed assisted reproductive technology and surrogacy in an extremely negative light.

In a nutshell, the plot line has a pregnant woman showing up in the ER with symptoms of pre-eclampsia, a life-threatening condition that, if left untreated, can lead to organ damage. The doctor wants to induce delivery early, at 32 weeks, in order to protect the woman’s health. She resists, explaining that she is a surrogate, and that under the terms of the surrogacy agreement she will not receive her bonus payment unless she carries the baby to term. The loss of that payment, she explains, means she and her two existing sons will wind up back in the homeless shelter. She is finally persuaded to deliver the baby early rather than risk orphaning her sons.

As it turns out, the four-pound infant is healthy despite the premature birth. But the intended parents still refuse to accept parental responsibility for the newborn. It’s a melodramatic plot twist, complete with evil villains exploiting innocent victims, and that makes for great TV.

In real life… never happen!

First of all, in any surrogacy arranged via an agency, intended parents, surrogate and even the surrogate’s spouse or significant other are scrupulously vetted. Terms of the surrogacy agreement are carefully negotiated so that all parties understand their rights and obligations.

In addition to a physical health exam, the surrogate in this scenario would have been required to undergo psychological and mental health screenings. Her living and financial situation would have been investigated—a woman living with her two children in a homeless shelter receiving government assistance or whose household income fell below the federal poverty line would never have been approved—for the very reason this episode attempts to convey!

Nothing evokes public passion like the abuse or abandonment of an innocent child, particularly a frail one. The garish headlines that pop up every so often about Western intended parents who pay poor women in places like Mexico or Thailand to be surrogates, only to later shirk their responsibilities for one reason or another, trigger public outrage. A brisk “surrogacy tourism” business has developed, in part due to high costs or overly restrictive laws that force intended parents to seek foreign surrogates, a sometimes risky proposition. (Recently it appears this trend may be in decline, since authorities have been cracking down or banning surrogacy in some more suspect or high-risk environments).

But surrogacy in the United States is a much different environment: Although surrogates and their families may benefit financially, agencies take care to screen out women who seek to become surrogates out of any semblance of financial desperation.

On very rare occasions, intended parents do abandon their children born via surrogacy, just as parents by any means sometimes abandon their children. Truth is, bad people sometimes become parents, and sometimes they abandon their babies. Our court system is full of cases of parents who neglect, abuse or abandon their children. My personal experience tells me that parents via surrogacy are far less likely to abandon their babies, because the arduous process of creating a family via surrogacy naturally weeds out those who are unwilling or unprepared to become parents. To have a child via assisted reproductive technology requires determination, perseverance and a significant financial commitment; most ART children are long hoped for and much wanted.

But when a parent via surrogacy abandons a child, that case is much more likely to make the headlines than all the other cases of child abuse and neglect that clog our court system. Unfortunately that casts surrogacy in a negative light. In the rare event such a case arises out of surrogacy, there is a governmental system of child protection and rescue and termination of parental rights. Both kinds of cases should be dealt with the same way via the same system, after the child is born, and only if and when the parents behave badly. 

It’s just a TV show, right? Sure, but scenarios like that depicted on Chicago Med reach millions of people with a message that surrogacy is exploitative, intended parents behave selfishly and irresponsibly, and agencies are unethical, profit-taking machines. The “Inheritance” episode plays right into the organized political and religiously based opposition to surrogacy and other forms of ART. As we wrote earlier, that organized opposition works hand-in-hand with those opposed to a woman’s right to choose and other social conservatives.

The true story is that most intended parents engaging in surrogacy are deeply caring individuals who want to become biological parents badly enough to invest large sums of time, money and emotion into the effort. The true story is that most surrogates agree to carry someone’s child in order to give the gift of parenthood to someone who otherwise might never experience that joy. The true story is that most agencies are ethical and stringent about prescreening of surrogates and donors and meticulous in matching surrogates and IPs. Chicago Med, in its scurrilous depiction of a surrogate driven by desperation and uncaring biological parents, is an insult to all of them and represents a step backward as society grows in its understanding and acceptance of the life-giving miracle of ART.