The greatest indirect risk, as others have said, is that the surrogacy will destroy LW's marriage. On the other hand, no one seems to have noted that by effectively not permitting LW to act on her own conscience, her husband is threatening his own marriage. I would certainly resent my husband for a long time if I were in LW's position.

As for the health risks and all, I had a baby at age 45, no complications, easily the healthiest of my four pregnancies. There are many ways to minimize the health risks of a pregnancy, among them undergoing thorough medical assessment prior to agreeing to undertake the surrogacy (for instance, cardiac stress testing).

And for those advocating adoption, there are not thousands of available babies just waiting to be adopted. Adoption is, if anything, more expensive and intrusive than assisted reproduction. In the end, how one chooses to have a family, whether one chooses to have a family, are decisions that are too personal for second guessing. No one should be guilt tripped into adoption (or parenthood).

The Clinic's negligence is obviously beyond dispute, but I don't accede to the Does' innocence. No, they bear no fault for this mess, but there it is all the same, a fait accompli to which they can only react. That they bear no fault does not absolve them of reacting ethically and with empathy to those who, like them, also bear no fault. Their reaction appears to be indicative of how they plan to raise their child -- in complete denial of his or her origin through third party reproduction. To a point, I understand that revelation of their actions will cause all manner of potentially negative consequences due to the opprobrium their church and social peer group hold for third party reproduction (though they may be surprised at how many among their peer group also have similar secrets). Indeed it is an irony that ultimately drove me away from the church -- that an institution that promotes family life to the degree that it does would adopt such an unyielding and ultimately punitive position on the use of fertility services.

But the Does' loss of status among their chosen faith group is nothing compared to the complete and involuntary loss of control over one's offspring, and their desire for secrecy is an insufficient excuse to inflict such a great penalty on the biological father of their child. Indeed, I have trouble believing that they could not work out a reasonably discreet solution under the circumstances. Perhaps if the Does had not been so wedded to denial and secrecy they would have been more flexible, not that they would have agreed to the involvement of a "third parent," but possibly to an arrangement that is more like open adoption that would permit Hayes to have some assurance about the well-being of his biological child.

I agree that the world would be a better place if we were not so driven by the idea that biology is destiny, represented here by the notion that sharing genetic material is just as if not more important than the day to day devotion of someone who knowingly assumed the role of parent in spite of having no genetic connection to a child. Obviously, we could argue until the end of time about how much of a connection a shared gene pool contributes to the relationship between a parent and child, but one of the advantages of open adoption is that it allows the genetic parent and their adoptive children to realize in more concrete terms that shared genes are not necessarily the most important element of the parent child relationship. For this reason, in many if not most open adoptions, the biological parents move on with their lives without wishing to become a third parent in any way. On the other hand, the secrecy of Doe/Roe emphasizes their own complicity in a cultural view that disproportionately elevates genetic make-up even as it insists that it's not all that important (e.g., the glorification of adoption in all forms).

Clearly, getting an assistant to do the naughty pics of mom is a good compromise. But it's a little weird that the LW's main feelings of discomfort appear to stem from a sense of sexual competition with her mother in law, as in, LW isn't as sexy. This suggests either that LW is terribly insecure, or that mother in law sends subtle and not so subtle "signals" to LW and even LW's husband about her hold on LW's husband. Since she did have husband when she was young, it is possible that mother in law fostered a "you and me against the world" mentality. Whatever the source, there is an undercurrent of LW feeling like "three is a crowd" and LW definitely being the third one who doesn't belong -- and the whole exercise being a contest orchestrated by the mother in law to demonstrate that, even as she gets her own hsuband, mother in law is first in line for the loyalty of LW's husband. Of course her husband is probably too loyal to his mother to see this, and therein lies the problem. If at this late date LW has to ask her husband to choose between her and his mother, there's a good chance she won't be the winner of the contest.