Limited Governance of Non-Commercial Surrogacy in China: Action Pathways and Institutional Design

Surrogacy in contemporary China has triggered ongoing ethical, legal, and policy debates. Existing legislation adheres to a complete prohibition, but at the practical level, the demand and practice of non-commercial surrogacy have not vanished, and are exhibiting a growing trend driven by declining fertility rates, individual reproductive dilemmas, and the convenience of cross-border medical services. The tension between the complete prohibition and social demand has plunged surrogacy governance into a predicament of "cannot be eliminated, cannot be acknowledged, difficult to govern." This article proposes a "governability" shift under the analytical framework of public management and risk governance, transcending ethical impasses and singular negative stances, and discusses how to incorporate non-commercial surrogacy into governance under Chinese social conditions. The article unfolds across five dimensions: objectives, constraints, tools, capabilities, and outcomes, advocating for a limited, gradual, and highly constrained institutional design that addresses social concerns at the provincial level while controlling the diffusion of risks. Drawing on international experiences and local institutional logic, it proposes an intermediate path of governable but non-generalized non-commercial surrogacy, with provinces as the unit and a focus on medical needs.