Why sister-to-sister gestational surrogacy can be ethically acceptable: a reproductive bioethical perspective

We examine the ethical permissibility of sister-to-sister gestational surrogacy and assess whether such arrangements, often prohibited in many jurisdictions, can be ethically justified and beneficial when properly regulated. I employ normative ethical analysis grounded in the four core bioethical principles: autonomy, beneficence, non-maleficence, and justice. I find that, with appropriate safeguards such as independent counseling, legal clarity, and ongoing psychological support, sister-based gestational surrogacy can enhance informed consent, reduce psychological risks, and strengthen familial bonds. Altruistic surrogacy arrangements- those without financial compensation- further mitigate the risks of exploitation and commodification. Emotional trust and solidarity between sisters can support relational autonomy and ethical surrogacy practices. I conclude that sister-to-sister gestational surrogacy embedded within robust ethical and legal frameworks can be a morally permissible and even desirable reproductive option. The article challenges blanket prohibitions and advocates for nuanced, regulated pathways that uphold the dignity and well-being of both surrogate and intended mother.