Below is the text of my presentation for today’s annual SMF Research Symposium hosted by the Sexuality, Marriage, and Family Studies department at St. Jerome’s University/University of Waterloo. I post it here to facilitate better accessibility.
Territorial acknowledgement
I am a philosopher who primarily works in women’s and gender studies. Much of the content of my research in reproductive ethics has to do with access: Who has access to fertility? To what treatments and technologies? To whose bodies? What barriers or privileges facilitate access? As a settler scholar, I am trying to expand my circle of awareness beyond my research bubble and to more aware about access and privilege in relation to the physical spaces that house my work. Therefore, before turning to my topic, empathy and altruism in surrogacy, I’d like to acknowledge that the University of Waterloo, where I do my academic labour and where we share ideas with each other today, is on the Haldiman Tract, which is land promised to the Six Nations. We are on the traditional lands of the Haudenosaunee, the Neutral, and the Anishnawbe peoples.
A beginning
This presentation marks an initial exploration into what a philosophical account of empathy might contribute to the Canadian discourse around surrogacy. As a philosopher, I’m interested in how concepts help us understand the world, and when concepts muddle issues more than they help. In Canada, there is much talk about “altruism” in surrogacy, partially because the only legal option for surrogacy is unpaid. Payments to surrogates and gamete donors was criminalized by the 2004 Assisted Human Reproduction Act.
I begin with the claim that “altruism” has too much conceptual baggage to clarify ethical and political issues in surrogacy. In the first part of my presentation, I will outline ways in which “altruism” is ambiguously deployed. Then, I’ll sketch out why I think a philosophical account of empathy might help, especially with respect to the emotional labour that surrogates perform when gestating an embryo for someone else. I turn to the phenomenological accounts of Hannah Arendt and Edith Stein, as these philosophers offer tools for appreciating structural injustice and embodied empathy.
The ambiguity of altruism
Perhaps you’ve noticed the ambiguity around surrogacy in recent media attention. Member of Parliament Anthony Housefeather announced that he will be introducing a private member’s bill that aims to decriminalize payments for surrogacy. In support of this initiative, Anita Vandenbeld, who chairs the Liberal Party’s women’s caucus, remarks, “Assisted human reproduction is the one area in law where we are still criminalizing women’s bodies.” As feminist bioethicist Françoise Baylis notes, to say that Canadian law criminalizes bodies is misleading. Surrogacy is legal; paying for it isn’t.
This exchange exemplifies ambiguities with how “altruism” appears in surrogacy debates. Altruism is often contrasted with commercialization as a descriptor for a type of regulatory framework. For example, Canada and the UK legislate an altruistic system, whereas California supports a commercial system.
In addition to distinguishing between whether surrogacy is paid or not, “altruism” carries a normative charge. Within the principles of the Act, commercialization is equated with exploitation. “Altruism” becomes an indirect way to indicate that this mode of surrogacy avoids exploitation. Empirical research, however, has not supported the claim that commercialization is necessarily exploitative (see Bromfield 2016). Indeed, proponents of commercialization may worry that not paying surrogates exploits them or that pressures to be altruistic contribute to oppressive gender norms around the significance of motherhood and reproduction.
Moreover, “altruism” is ambiguously used to describe motivations to become a surrogate. Altruism is considered to be an acceptable reason to become a surrogate in a place like Canada or the US, whereas financial motivations tend to be viewed with suspicion. Consider what one Canadian surrogate said of her own experience: “My initial idea for the surrogacy is completely altruistic. [. . .] Money changes it from this altruistic expectation to one where you are commoditizing your progeny. [. . .] It literally is priceless.” Like with exploitation, a strong dichotomy between altruistic and financial motivations is unsupported by empirical research. Surrogates report that their motivations include altruism, financial need, enjoying pregnancy, and wanting to “do something ‘special’” (Bromfield 2016, 198-199).
The only thing that seems clear to me about “altruism” is that this concept distracts us from pressing political problems that may occur in both unpaid and paid forms of surrogacy. Altruism is appealed to, across ethical perspectives, to signify one end of a polarized spectrum. For some, altruistic surrogacy avoids exploitation, whereas for others altruistic surrogacy is exploitative. (My own view: exploitation can occur in both). For some, altruism is the only acceptable reason to become a surrogate. For others, altruism is one among many reasons to become a surrogate, and it may not be possible to cite one motivation as more meaningful than others.
Emotional labour
The ambiguity around altruism is important to attend to because it poses a barrier to addressing exploitation and other ethical and political problems that may arise in surrogacy. I will focus on one particular problem here: Accounting for surrogates’ emotional labour. This broad category captures the emotional dimensions of care that surrogates may direct towards the embryo they gestate or to nurturing the parental aspirations of the intended parents who commission the surrogacy. Emotional labour is rarely acknowledged, and in commercial systems, difficult to quantify and describe for the purposes of payment (Crozier et al 2014).
The issue of emotional labour has come up in public consultations that Health Canada has conducted in their process of clarifying Section 12 of the Act on which expenses are legally eligible for reimbursment. Perhaps unsurprisingly, the difficulty around acknowledging and quantifying emotional labour tends to lead to discussions about, and controversies around, payments for surrogates. Indeed, the report indicates that financial transactions in surrogacy remain contentious among some Canadians. (See my previous post about Health Canada’s public consultations here).
If regulation is going to meaningfully provide ethical protections (see section 2 of the Act), then we need better conceptual tools for thinking about emotional labour and power dynamics in surrogacy. Because of its ambiguity, invoking altruism—either to argue for or against unpaid surrogacy—is not the best strategy.
The “we” here is broad. Re-thinking altruism is not only a policy issue, but about reframing important dimensions of the surrogate-intended parent relationship to help us deliberate about the ethics and politics of surrogacy. Emotional labour is a part of the surrogacy experience that surrogates report is underappreciated by intended parents (Bromfield 2016). Although we might understand altruism as a motivating drive, a surrogate does much more than help someone have a child. Acknowledging the surrogate’s emotional labour may be threatening for intended parents because it may, from their perspective, threaten their status as the parents of the child. And that’s just one example of complexity in surrogacy.
Instead of altruism, I want to explore whether an account of empathy might provide a more helpful way to theorize about emotional labour and capture ways in which surrogates may be vulnerable in their relationships with intended parents.
Empathy
Rather than define empathy, I want to approach this concept via two twentieth-century philosophers, Hannah Arendt and Edith Stein. Stein was a German Jew who converted to Catholicism and became a nun. She was killed at Auschwitz in 1942. Fifteen years her junior, Arendt was a German Jew who left Germany in 1933 and came to the United States in 1941. I will begin with Arendt.
Arendt’s critique of empathy
Arendt, in her own words, did not find empathy to be a helpful concept (see Arendt 1968 and 1992 particularly). Nevertheless, it is useful to think both with and against Arendt to move us towards a philosophical account of empathy. Arendt’s theory of judgment, which depends on something like empathy (Gatta 2014), has the resources to be attentive to power dynamics in surrogacy.
For Arendt, judgment is a normative evaluation that requires a person to imaginatively consider a question or issue from multiple perspectives. Judgment aims at intersubjectivity, thus it requires distance from one’s own subjective position. Arendt describes the adoption of other perspectives as “visiting.” At this juncture, she distinguishes visiting from relating to someone through empathy. For example, she (1992) says “The trick of critical thinking [i.e., judgment] does not consist in an enormously enlarged empathy through which one can know what actually goes on in the mind of all others” (43). Whereas visiting requires reflective, critical thinking, empathy for Arendt involves unreflectively adopting another person’s perspective. Rather than promote intersubjectivity, empathy entails a collapse of one’s own subjective position to another person’s subjective position (Gatta 2014, 998).
If you are thinking, “Wow, this is an idiosyncratic and narrow way to think about empathy,” you’re not wrong. Hang on to that thought. Before turning to problems with Arendt’s description of empathy, let me say what I find helpful about it. In rejecting empathy, what Arendt rejects is merely taking someone’s feelings as the total representation of their position. Contra empathy, for Arendt, visiting the standpoint of the other is about finding objectivity. This objectivity is grounded in contextual features of a person’s situation. Visiting requires attention to the particular structure in which another’s standpoint is embedded. Insofar as ethical problems within surrogacy are structural, then examining objective conditions of the other’s standpoint seems relevant. After all, a surrogate may be subject to exploitation without feeling that she is exploited.
Now return to that thought you had, that Arendt’s account of empathy seems strange. I’ve just said that a strength of Arendt’s account is that she focuses on objective conditions of a person’s situation. But aren’t a person’s feelings, their unique subjectivity, relevant at all? According to Giunia Gatta (2014), there is a middle ground between unreflectively adopting a person’s feelings (this is empathy, which Arendt rejects), and visiting their perspective in the way that Arendt advocates. In other words, Gatta suggests, there seems to be something like relating to someone through empathy that supports the ability to imaginatively visit their perspective. If we accept visiting as an important tool to consider another’s situation, then empathy seems necessarily involved, though not as Arendt described. What we need is an explicit account of empathetic visiting.
Edith Stein’s account of embodied empathy
Edith Stein’s philosophical work on empathy offers insights that help address limitations with Arendt’s account of visiting. For Stein, empathy requires an explicit comparison between one’s own subjective position and that of another. Her account of empathy enables her to both maintain her own subjective position and better understand the position of the other. Unlike Arendt’s emphasis on the cognitive, Stein argues that a person’s embodied expressions and their emotional life can be tools for intersubjective understanding. Not only does empathy enable a person to understand another’s perspective, the comparison with their own situation facilitates better self-understanding (Calcagno 2017).
Empathy, as Stein describes it, is able to avoid the worries Arendt had that empathy would obstruct intersubjective understanding. Instead, Stein’s account of empathy facilitates visiting multiple perspectives. Stein also makes room for embodied subjectivity to be relevant to the work that visiting does, thus addressing some of the concerns Gatta raised about empathy being implicit in Arendt’s account of visiting. We do need to take the other’s subjective perspective into account to help us understand their situation.
Reading Arendt and Stein together
There are challenges in bringing Arendt and Stein together, as well as differences in their philosophical approaches and commitments that I have completely ignored in this presentation. My goal has been modest: To sketch possibilities of constructing an account of empathy that might do some of the work altruism attempts to do in surrogacy debates, but in a way that enables us to better capture structural relationships of power.
Emotional labour is a source of vulnerability for surrogates and intended parents, but more worrisome for surrogates given their structural lack of power relative to intended parents. Empathy as visiting the embodied perspectives of others will not yield a perfect understanding of emotional labour, but may provide a way that enables an appreciation of the lived experiences of surrogates and of the objective conditions of surrogacy that may facilitate exploitation or other harms.
Empathy enables us to acknowledge the meaningfulness of the relational connection that altruism attempts to capture, but without ambiguities that arise in comparisons between altruism and commercialization. While using empathy to theorize about emotional labour will not resolve the debate between whether unpaid or paid surrogacy is preferable, it will offer tools for analyzing power dynamics that relate to emotional labour in surrogacy—dynamics that might be present whether surrogacy is paid or not.
In closing, I want to drop two teasers that I have not explored here. These are points I find interesting, and potentially challenging, for the initial sketch I have offered. First, Arendt often conceives of judgment through an analogy of midwifery (see Arendt 1992, 41 and Arendt 1971). Though Arendt did not find physical reproduction to be philosophically rich, her description of judgment as bringing new views into the world might be an intriguing metaphor to read alongside the particular context of surrogacy.
Second, Stein imbues motherhood with great philosophical and moral significance, arguing that women are more capable of empathy than men are. If separable from her essentialism, the uniqueness of mothering (perhaps as a contingent existential condition, and not a sexed essence) as grounds for empathetic and moral insight might prove interesting given that surrogacy is a site of relational entanglement that is organized, in many ways, around the ambiguities of motherhood.
Sources
Here is a list of academic sources. Other sources are hyperlinked in the above text and not listed here. There are a number of influential sources that inform the way I think about surrogacy–Iris Marion Young’s work on structural injustice, for example, is in the background of this presentation. Below are just the sources I cite directly (in addition to the hyperlinked articles in the post itself).
Arendt, Hannah. Between Past and Future. New York: Penguin, 1968.
Arendt, Hannah. Lectures on Kant’s Political Philosophy. Ed. Ronald Beiner. Chicago: The University of Chicago Press, 1992.
Arendt, Hannah. The Life of the Mind. San Diego: Harcourt, Inc., 1971.
Bromfield, Nicole F. “‘Surrogacy Has Been One of the Most Rewarding Experiences in My Life’: A Content Analysis of Blogs by US Commercial Gestational Surrogates.” IJFAB: International Journal of Feminist Approaches to Bioethics 9.1 (2016): 192-217.
Calcagno, Antonio. “Building a Meaningful Social World between Human and Companion Animals through Empathy.” In Pets and People. Ed. Christine Overall. pp. 35-48. New York: Oxford, 2017.
Calcagno, Antonio. The Philosophy of Edith Stein. Pittsburgh: Duquesne University Press, 2007.
Crozier, GKD, Jennifer L. Johnson, and Christopher Hajzler. “At the Intersections of Emotional and Biological Labor: Understanding Transnational Commercial Surrogacy as Social Reproduction.” IJFAB: International Journal of Feminist Approaches to Bioethics 7.2 (2014): 45-74.
Gatta, Giunia. “Visiting or House-Swapping? Arendt and Jaspers on Empathy, Enlarged Mentality and the Space Between.” Philosophy & Social Criticism 40.10 (2014): 997-1017.