Texas court orders hospitals to provide lifesaving care to baby at center of surrogacy dispute
A Texas district court ordered UT Southwestern Medical Center and Children’s Medical Center of Dallas to provide lifesaving care for Gabriel, a baby with hypoplastic left heart syndrome, due to be born to surrogate McKenna West. The baby’s intended parents, Nausheen Gilkar and Omar Ahmed, threatened to refuse consent to surgery and possibly move the child to California to withhold treatment. Attorney General Ken Paxton announced the court’s emergency order and emphasized the state’s commitment to protecting the life of baby Gabriel. Legal expert Anthony Sirven highlighted the case’s implications for surrogacy contracts and constitutional rights following the Dobbs decision.
about 2 months ago
A Texas district court issued an emergency order requiring two major Dallas hospitals to deliver life‑saving treatment to Gabriel, a baby diagnosed with hypoplastic left‑heart syndrome who is due to be born on Sept. 2 to surrogate mother McKenna West. The order bars the child’s removal from the hospitals or the state except for medical care, and it remains in effect until further notice. The case stems from an interstate surrogacy dispute in which the intended parents, Nausheen Gilkar and Omar Ahmed, indicated they might seek to withhold treatment or move the child to California to avoid life‑sustaining care. Texas Attorney General Ken Paxton announced the court’s decision, emphasizing the state’s commitment to protecting the baby’s life. 3
Catholic attorney Anthony Sirven warned that the case raises questions about enforcing surrogacy contracts under the U.S. 13th and 14th Amendments, which prohibit slavery and guarantee equal protection and due process. He noted that prior jurisprudence treated embryos as “a special kind of property” after Roe v. Wade, but the 2022 Dobbs decision, which overturned Roe, has unsettled that framework. 3
Stefano Gennarini of the Center for Family and Human Rights highlighted that international conventions, such as the Universal Declaration of Human Rights, protect mothers and children during pregnancy and after birth. He argued that allowing third‑party contracts to dictate a surrogate’s medical decisions undermines these protections and “deconstructs the natural family” recognized in international law. 4
Attorney General Paxton praised the ruling as “the right decision,” stating his office used every tool to protect Gabriel’s well‑being and that every child in Texas deserves care and protection. 3
Legal experts acknowledge that while the immediate order secures medical care for Gabriel, future disputes may arise over custody and the enforceability of surrogacy contracts, especially if the intended parents pursue legal avenues to limit treatment or claim parental rights. 3 4
Examine Catholic doctrine on medical consent in surrogacy
Catholic doctrine distinguishes consent to medical treatment from moral permission to participate in surrogacy. A woman may give valid consent to ordinary medical care affecting her own body, but consent—whether given by the gestational mother, intended parents, or a child’s representative—cannot make the surrogacy arrangement morally licit.
The Church affirms the importance of free and informed consent. The USCCB’s Ethical and Religious Directives for Catholic Health Care Services states:
“The free and informed consent of the person or the person’s surrogate is required for medical treatments and procedures,” except in an emergency when consent cannot be obtained and there is no indication that the patient would refuse treatment.
This principle has several implications:
The same requirement applies with particular force to experimentation. No person may be subjected to medical or genetic experimentation without prior free and informed consent. For nontherapeutic experimentation, a surrogate may consent only where there is no significant risk to the person’s well-being; heightened vulnerability demands stronger justification.
Catholic teaching does not treat bodily consent as unlimited authorization to do anything with the body. The USCCB teaches that patients, physicians, researchers, and others do not possess unlimited rights over the human body; the body has an inherent order and purpose that must be respected.
Accordingly, the reasoning is not:
“The woman consented, therefore the arrangement is morally permissible.”
Rather, the Church asks whether the proposed act respects:
Consent is morally important, but it cannot transform an intrinsically disordered arrangement into a good one. A person may freely consent to an act that remains objectively wrong because it violates the dignity of another person or the moral structure of human sexuality and procreation.
The USCCB directive is direct:
“Because of the dignity of the child and of marriage, and because of the uniqueness of the mother-child relationship, participation in contracts or arrangements for surrogate motherhood is not permitted.”
The directive concerns arrangements and contracts, not merely commercial transactions. Commercial payment is an additional injustice because it can exploit women, particularly those who are poor, but the prohibition is broader than opposition to payment alone. Even altruistic or unpaid surrogacy remains morally impermissible under this directive because the underlying arrangement conflicts with the dignity of the child, marriage, and motherhood.
The 2024 declaration Dignitas Infinita develops this teaching in terms of human dignity. It states that surrogacy treats the child as an object and rejects the idea that a child can be the subject of a commercial contract. A child is a gift, not something to which another person has a purchasable “right.”
The declaration also teaches that surrogacy violates the dignity of the child because every child possesses inviolable dignity from conception onward. The desire to have a child, however understandable, cannot become a “right to a child” that overrides the child’s dignity and the proper meaning of human procreation.
The gestational mother’s consent is not ignored. In fact, Catholic doctrine is especially concerned that her apparent consent may be compromised by poverty, economic dependence, unequal bargaining power, or emotional pressure.
Dignitas Infinita makes an important distinction: surrogacy violates the woman’s dignity whether she is coerced or freely chooses it. The reason is that the arrangement separates her from the child she carries and makes her function as a means subordinated to the desires or interests of others.
Thus, even genuinely voluntary consent does not settle the moral question. If a woman is coerced, the injustice is aggravated. If she is not coerced, the Church still judges that the structure of surrogacy instrumentalizes her body and motherhood.
This does not mean that the woman loses her right to medical information or treatment. On the contrary, she remains a patient with her own dignity and medical rights. Intended parents, agencies, or physicians may not treat her as a mere reproductive instrument. Her consent is required for medical procedures performed on her, but her consent cannot validate the broader surrogacy contract.
The child is the most vulnerable person in the arrangement and cannot provide consent. Catholic reasoning therefore rejects the assumption that intended parents may consent on the child’s behalf to every reproductive or genetic intervention simply because they desire the child or will raise the child.
The 1987 CDF instruction states that surrogate motherhood is contrary to the unity of marriage and the dignity of procreation. It also says that it violates the child’s right to be conceived, carried in the womb, born, and raised by his or her own parents, and divides the physical, psychological, and moral elements of family life.
The issue is therefore not merely whether adults agreed to the arrangement. The child’s welfare and dignity impose objective limits on adult choice. Parents are ordinarily stewards of their children, not proprietors who may authorize any use of the child’s body, identity, or origins.
This principle is consistent with the Church’s wider teaching that an unborn child may never be treated as property. Pope Francis teaches that the child’s life is an end in itself and cannot be regarded as the property of another human being.
Surrogacy commonly involves artificial insemination, in vitro fertilization, embryo transfer, donor gametes, or genetic selection. Catholic teaching evaluates these procedures not simply by asking whether all adults consented, but whether procreation remains properly united to marriage and whether the child is respected as a person rather than produced as a technological project.
The CDF’s 1987 instruction teaches that assisted fertilization involving third-party gametes violates the unity of marriage, the dignity of the spouses, and the child’s right to be conceived within marriage and from the married couple. It also identifies the resulting separation between genetic parenthood, gestational parenthood, and responsibility for upbringing.
The instruction then applies this reasoning specifically to surrogate motherhood, judging it contrary to the unity of marriage and the dignity of human procreation.
Consent by the spouses, the donor, the surrogate, and the physician therefore cannot remove these moral defects. The problem concerns the nature of the act itself and the relationships it creates, not merely the presence or absence of permission.
A further distinction is necessary. Although the Church rejects entering into surrogacy arrangements, it does not follow that every medical treatment connected with an existing surrogacy pregnancy is automatically forbidden.
The medical treatment of the pregnant woman must still be governed by ordinary principles:
The sources provided do not offer a complete set of case-specific rules for every obstetrical emergency, such as selective reduction, termination of pregnancy, fetal surgery, or disputes between intended parents and the gestational mother. They do establish the governing principles: informed consent, respect for bodily integrity, protection of innocent human life, and rejection of treating the child or woman as property.
Consent by intended parents cannot override the pregnant woman’s bodily integrity. Conversely, the woman’s consent to a medical intervention cannot authorize the direct killing of the child, because the Church teaches that no alleged right over one’s own body justifies terminating the life of an innocent child.
Catholic doctrine can be summarized as follows:
The central Catholic principle is that consent protects personal freedom but does not create a right to use persons as means. In surrogacy, the Church judges that the contractual structure itself risks turning the woman into a reproductive instrument and the child into an object of acquisition; therefore, valid medical consent must still be respected in individual treatments, while participation in the surrogacy arrangement remains morally impermissible.