A Texas court has transformed a private surrogacy dispute into a test of who controls medical decisions for a critically ill newborn—and whether the state can override the wishes of a child’s intended parents.

The baby, Gabriel, was born in Texas with hypoplastic left heart syndrome, a rare condition requiring multiple surgeries. According to the liberal-leaning account, the intended parents, California residents Nausheen Gilkar and Omar Ahmed, asked surrogate McKenna West to terminate the pregnancy after the diagnosis. West refused, traveled to Texas and sought care near specialists. An Alaska court had previously ruled that she could make her own medical decisions. West said it was “scary to think that something might be wrong, and that I may be the one that's not able to make a decision about the treatment.”¹

The court’s order requires lifesaving care and gives the intended parents—not West—responsibility for medical decisions within the order’s limits. It also bars West from contacting the child after birth, while allowing her to continue seeking custody. The intended parents have not publicly commented, and their attorney did not respond to a request for comment. The surrogacy agency said the dispute should have gone to mediation, with the child’s interests placed ahead of “lawyers and litigation.”¹

The conservative account presents the case primarily as a disability-rights and pro-life victory. Texas Attorney General Ken Paxton and the Trump administration’s Health and Human Services civil-rights office warned that hospitals cannot deny treatment because of disability. HHS urged an infant-care committee review if doctors consider withholding treatment, with care continuing during that process. Paxton said, “Baby Gabriel deserves a chance at life, and I will not allow anyone to unlawfully deny him medically necessary care.”³

Both accounts agree the court has ordered treatment. Their emphasis differs: one foregrounds the unresolved custody and consent conflict; the other casts the intervention as protection against disability-based medical neglect. The surgery may settle the immediate question of care, but not who ultimately speaks for Gabriel—or what obligations surrogacy contracts impose after birth.