Supreme Court fall-out


The Supreme Court has handed down a landmark ruling on same-sex marriage which effectively legalises it throughout the United States. President Obama welcomed the decision. “Today,” he declared, “we can say, in no uncertain terms, that we have made our union a little more perfect.” A rainbow light show was projected onto the White House as a sign of the Administration’s joy.

Although it’s a bit churlish of me to open the door of the party and let in the cold air, are there any bioethical challenges which follow in the wake of Obergefell v. Hodges? I can think of three.

First, most married couples want children. Where are the children of gay and lesbian couples going to come from? An adult outside of the relationship has to supply gametes to create the child. This has already led to a tangled web of relationships with multiple parents for a single child. This trend will accelerate. In due course, it may be possible to “manufacture” sperm and eggs from stem cells. This could provoke another stem cell debate.

Second, many gay couples will need surrogate mothers. Much of the demand for surrogate mothers in developing countries is generated by this consumer group. A couple of years ago BioEdge surveyed Indian IVF clinics. Most of them were expected a surge in demand if same-sex marriage was legalised. Surrogacy is dangerous work and only poor and desperate women take it on – which is why so few surrogate mothers live in New York’s Park Avenue. Surrogacy is a kind of exploitation which raises important ethical questions.

Third, conscience rights will be tested. In his dissent Justice Alito said, “the majority attempts, toward the end of its opinion, to reassure those who oppose same-sex marriage that their rights of conscience will be protected … We will soon see whether this proves to be true. I assume that those who cling to old beliefs will be able to whisper their thoughts in the recesses of their homes, but if they repeat those views in public, they will risk being labeled as bigots and treated as such by governments, employers, and schools.” Conscientious objection is already a big topic in bioethics journals. It will grow bigger.

I am sure that there are others. Any ideas? 




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