代理孕母最大的倫理爭議的產生主要在於其將傳統的生、育、養合而為一的母親身分，轉成可以各自獨立的情況。然而「代孕」對代理孕母和委託夫妻都不會是一個輕鬆的過程，代孕必然是不孕夫妻最後的希望，代孕合法化是讓處於生育弱勢的不孕夫妻得到補天道不足的機會。本文嘗試由倫理分析「代孕」並不違反人性尊嚴，在尊重代理孕母的自律、代理孕母應擁有優先的親子權利，並保護代孕所生子女、保障委託夫妻權利的前提之下，完善規範的代孕機制具可行性。 本文認為完善的代孕機制，主要是尊重代理孕母的自律權，這需要確定其確實得到足夠時間的深思熟慮後自願代孕，即充分的詢詢同意原則的運用，因此代孕仲介組織將扮演重要的角色。而本文主張代孕除必要的醫療、檢查等費用，代孕應有酬，除肯定代理孕母的辛勞，也明確化其權利義務，藉由「代孕人工生殖法」的規範與代孕仲介組織的連繫溝通之下，代理孕母與委託夫妻簽訂代孕契約，代孕可以是最低風險、最小傷害的機制。以英美兩個代孕合法化的國家為例，代孕不成功的案例約為1%，我們應該努力的是將這1%降至最低，而不是否定99%的成功率。即使一般的自然生殖，也存在母親生產困難、胎兒畸型等風險，我們並不因此而禁止自然生殖，而是致力於將傷害的可能性減至最低。本文的研究除對代孕機制予以倫理分析，並建議代孕仲介組織應提供的服務，最後依生命倫理學在代孕議題上的多方衡量，試擬一份代孕契約，期為代理孕母的開放，提出一較圓融的可行方式。 The root of the controversy of surrogate motherhood comes from the shivering of the traditional motherhood into three separate process: conceiving, gestating and raising the child. However, surrogacy is no easy matter for the infertile couple and the surrogate mother. Surrogacy is usually the last hope of the infertile couple to have their own child. This dissertation argues that surrogacy has no infringement on human dignity. With due respect to surrogate mother’s autonomy, her priority to keep custody of her child, due protection of the legal status of the child born, and ensuring the right of the infertile couple, I believe that a morally acceptable surrogacy arrangement is enforceable. Respect of the autonomy of the surrogate mother is tantamount to the success of surrogacy. The surrogate mother must be given sufficient time to deliberate about carrying a child for the infertile couple. It is proscribed by the principle of informed consent and in this respect, the agency of surrogacy plays a very important part. This dissertation advocates that the infertile couple should pay for the service of surrogacy and the expense must include reward beside necessary medical fees, in order to recognize the painstaking labor of surrogate mother and define her right and obligation clearly. By means of the “Surrogacy Arrangement” and the agency for surrogacy in proper coordination between surrogate mother and infertile couple, the surrogate contract could be an arrangement of least risk and least harm to all party. The failure rate of surrogacy is about 1% in United Kingdom and United States, what we should strive for is to reduce the failure rate, but not to deny the successful rate of 99%. Although natural reproduction still has risk of difficulty in delivery, in giving birth to deformed babies, we do not forbid natural reproduction, but make more effort to reduce the harm resulted. After an in-depth analysis of surrogacy, I suggest that the service of surrogacy should provide and built upon bioethical consideration of surrogacy. I give a draft of a surrogacy contract. I hope this essay will provide a satisfactory and enforceable method and policy for surrogacy.
