Recommandations have been formulated in 1985 with reference to socialist morality and law and as a result of interdisciplinary discussion by the IAME (Interdisciplinary Working Party on Medical Ethics at the GDR Academy of Postgraduate Medical Education) for clinical application of in vitro fertilization and for the use of human oocytes and early embryonic stages.

The utilization of in-vitro fertilization (IVF) in assisted reproduction has undergone a notable surge since its inception in 1979. Consequently, the demand for well-trained IVF personnel has become crucial to address the expanding technical requirements of this field. However, acquiring specialized technical expertise remains a challenge in various regions and countries, particularly in the Arab Islamic region, frequently playing a pivotal role in the successful implementation of medical technology. Ensuring a proficient workforce of IVF experts requires the provision of (...) practical and comprehensive training opportunities. This work reveals the ethical considerations surrounding the utilization of actual human eggs in IVF training courses and examines potential alternative approaches to meet the training needs in a manner deemed ethically acceptable. We analyzed the bioethical issues of using human eggs in IVF training, considering ethical principles, benefits, and concerns to determine permissibility and contribute to discussions on reproductive technology ethics and the responsible use of human reproductive material. In addition, we shed light on perspectives from Islamic scholarship. In conclusion, utilizing immature eggs in practical IVF training, while ensuring informed consent, is widely deemed acceptable within the ethical framework. However, the crucial necessity of robust oversight, especially in the private sector, cannot be overstated. To address these critical considerations, the initial and fundamental step entails conducting a comprehensive regional survey. Using immature eggs in IVF training seems acceptable, but it is crucial to establish an oversight practice. Organizing a collaborative workshop with stakeholders from both the public and private sectors is a crucial first step in developing this controlled practice. (shrink)

New technology in human reproduction has provoked wide ranging arguments about the desirability and moral justifiability of many of these efforts. Authors of biomedical ethics have ventured into the field to offer the insight of moral theory to these complex moral problems of contemporary life. I believe, however, that the moral theories most widely endorsed today are problematic and that a new approach to ethics is necessary if we are to address the concerns and perspectives identified by feminist theorists (...) in our considerations of such topics. Hence, I propose to look at one particular technique in the growing repertoire of new reproductive technologies, in vitro fertilization, in order to consider the insight which the mainstream approaches to moral theory have offered to this debate, and to see the difference made by a feminist approach to ethics. (shrink)

For the sake of consistency with settled principles from other theological and ethical questions, there is a need for a Christian reexamination of in vitro fertilization (IVF). Both Old and New Testaments demonstrate that human personal life begins at conception or fertilization. Additionally, the Bible teaches that human beings are persons in the image of God from the very beginning of their existence. Thus, it can be concluded that the embryos created via IVF are persons in (...) God’s image. Applying this to the destruction and freezing of embryos, several limitations or restrictions present themselves—embryos should not be purposefully destroyed or wasted, all embryos ought to be implanted, and embryos should not be frozen. Ultimately, however, due to the immense quantity of embryo wastage, it is concluded that Christians should avoid this form of assisted reproductive technology and consider it a pro-life issue. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns (...) have emerged. One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)

After the typical theological and bioethical questions about in vitro fertilization (IVF) are vetted, there remains a three-dimensional understanding of responsibility that is not typically considered in Christian bioethics. This paper will explore responsibility to the spouses’ loving union, their bodies, and society in order to ascertain the morality of IVF. In a marriage partnership, the spouses’ primary responsibility is to each other. Although in matrimony physical union is essential to marriage, children are not. The second dimension of responsibility (...) focuses on the body—“the temple of God”—and on our responsibility to care for it. This concerns the woman, her husband, and even the newborn. Finally, the third understanding of responsibility leads us to address social concerns, with an emphasis on social dynamics, especially the cost of IVF procedures and how they siphon medical resources away from more urgent human needs in health care and within society. (shrink)

In the medical-technological practice of in vitro fertilization, it is increasingly the couple, rather than an individual patient, that is considered the unit of treatment. This article traces some mechanisms involved in the construction of medical interventions on female bodies as appropriate and effective therapeutic solutions to problems and diagnoses pertaining to male bodies. It traces the transformation of male infertility through shifts in localization and definition of the problem, concomitant reconceptualizations of the techniques involved, redistributions of properties, and (...) specific ways of constructing "success. " It is argued that both the notion of the couple as the patient in cases of male infertility and the claim that IVF techniques are appropriate solutions to this couple's problem simultaneously presuppose and legitimize medical interventions on women's bodies. This double movement is produced by leaving exactly the required material work of physical interventions—and, consequently, the uneven distribution of costs between the sexes—out of scientific accounts of these practices. (shrink)

The question of the morality ofin vitro fertilization is examined. One of the central questions to be answered is whether the zygote loss that seems inseparable from the process is morally justified. Even when embryo transfer occurs, many zygotes which have been intentionally created are intentionally destroyed; they are used as means to the alleged benefits that others will attain.

This paper explores some of the ethical implications of artificial insemination and in vitro fertilization. In both cases the emphasis is on the interests of the potential child. It concludes that in neither case is great optimism or great pessimism appropriate. About AID, much of the legal and ethical concern has been other than child-centered, and has focused mainly on the interests of parents and donors. Three aspects expecially remain troubling: donor selection, record-keeping and disclosure and the testing of (...) frozen semen. About further IVF research, approval appears justified, as long as remaining concerns about risk/safety and need are satisfied. (shrink)

Judaism has understood procreation as representing a partnership between God and humans, calling for both human reverence and action. The development of in vitro fertilization raises questions about the implications of this partnership and applications of this technology. A holistic approach to Jewish ethics, drawing on traditional sources, suggests that it can be appropriate for an infertile couple to utilize IVF using their own sperm and egg to have a child. The use of donated sperm, eggs, and embryos (...) raises significant challenges that the couple must consider and address, but these procedures would be acceptable in appropriate cases. Additional issues, including preimplantation genetic testing and freezing embryos, must be considered in light of traditional precedents, ethical values, biomedical developments, and experience with the procedures. (shrink)

Human population growth must end, and the sooner the better, for both nature and a humanity that pursues boundlessly increasing affluence. Poisoning of organisms and massive extinctions result, exacerbated by population momentum. Infliction of pain and death largely for trivial reasons constitutes the ignoble dénouement of our history. Reducing human numbers would be only one fitting response to recognition of this situation. Reliance on voluntary socio-economic reforms, including even the empowennent of women, appears unlikely to lead to below-replacement-level (...) fertility, since families on average still elect to have more than two children. Discussed are three reasons for thinking that coercive measures could help to engender a decreasing human population without negating preferable voluntary efforts to the same end. Hence some coercion to reduce fertility is justifiable. (shrink)

Several philosophers have recently argued that policies aimed at reducing human fertility are a practical and morally justifiable way to mitigate the risk of dangerous climate change. There is a powerful objection to such “population engineering” proposals: even if drastic fertility reductions are needed to prevent dangerous climate change, implementing those reductions would wreak havoc on the global economy, which would seriously undermine international antipoverty efforts. In this article, we articulate this economic objection to population engineering and show how (...) it fails. We argue, first, that the economic objection paints an inaccurate picture of the complicated relationship between demographic change and economic growth, and second, that any untoward economic effects of fertility reduction can be mitigated with additional policies. Specifically, we argue that supplementing fertility reduction with policies that facilitate the emigration of younger people from developing nations to developed nations could allow for both global reductions in GHG emissions and continued economic stability. Further, we show that moral arguments against such unprecedented increases in immigration are unsuccessful. We conclude that population engineering is a practical and morally justifiable tool for addressing the twin evils of climate change and global poverty. (shrink)

In discussing the effects of grandparents on child survival in natural fertility populations, Coall & Hertwig (C&H) rely extensively on the review by Sear and Mace (2008). We conducted a more detailed summary of the same literature and found that the evidence in favor of beneficial associations between grandparenting and child survival is generally weak or absent. The present state of the data on human alloparenting supports a more restricted use of the term Human stem family situations with (...) celibate helpers-at-the-nest can be described as cooperatively breeding, but the term is a poor fit to many human family systems. (shrink)

Our objective is to test an optimality model of human fertility that specifies the behavioral requirements for fitness maximization in order (a) to determine whether current behavior does maximize fitness and, if not, (b) to use the specific nature of the behavioral deviations from fitness maximization towards the development of models of evolved proximate mechanisms that may have maximized fitness in the past but lead to deviations under present conditions. To test the model we use data from a representative (...) sample of 7,107 men living in Albuquerque, New Mexico, between 1990 and 1993. The model we test proposes that low fertility in modern settings maximizes number of grandchildren as a result of a trade-off between parental fertility and next generation fertility. Results do not show the optimization, although the data do reveal a trade-off between parental fertility and offspring education and income.We propose that two characteristics of modern economies have led to a period of sustained fertility reduction and to a corresponding lack of association between income and fertility. The first is the direct link between costs of investment and wage rates due to the forces of supply and demand for labor in competitive economies. The second is the increasing emphasis on cumulative knowledge, skills, and technologies in the production of resources. Together they produce historically novel conditions. These two features of modern economies may interact with evolved psychological and physiological mechanisms governing fertility and parental investment to produce behavior that maximizes the economic productivity of lineages at the expense of fitness. If cognitive processes evolved to track diminishing returns to parental investment and if physiological processes evolved to regulate fertility in response to nutritional state and patterns of breast feeding, we might expect non-adaptive responses when returns from parental investment do not diminish until extremely high levels are reached. With high economic payoffs from parental investment, people have begun to exercise cognitive regulation of fertility through contraception and family planning practices. Those cognitive processes maynot have evolved to handle fitness trade-offs between fertility and parental investment. (shrink)

Over the last two decades, social scientists across disciplines have been researching how value is extracted and governed in the reproductive bioeconomy, which broadly refers to the various ways reproductive tissues, bodies, services, customers, workers, and data are inserted into capitalist modes of accumulation. While many of these studies are empirically grounded in single country–based analyses, this paper proposes an integrative political economy framework, structured around the concept of “global fertility chains.” The latter articulates the reproductive bioeconomy as a nexus (...) of intraconnected practices, operations, and transactions between enterprises, states, and households across the globe, through which reproductive services and commodities are produced, distributed, and consumed. Employing a diffractive reading of the literature on commodity chains and care chains, this unified approach scrutinizes the coproduction of value, biology, and technoscience and their governance mechanisms in the accumulation of capital by taking into account the unevenly developed geographies of global fertility chains, their reliance on women’s waged and unwaged reproductive labor, and the networked role of multiple actors at multiple scales without losing sight of the constitutive role of national states in creating demand, organizing supply, and accommodating the distribution of surplus value. We empirically ground this integrative political economy approach of the reproductive bioeconomy through collaborative, multisited fieldwork on transnational reproduction networks in Israel/palestine, Romania, Georgia, and Spain. (shrink)

NICE, the draft fertility guideline and dodging the big question: should fertility treatment be provided by the NHS?In August of this year the National Institute for Clinical Excellence made its draft guideline on fertility treatment available for consultation.1 As has been widely reported in the media the draft guideline recommends that the National Health Service should provide publicly funded fertility treatment in a consistent way across England and Wales. The guideline recommends that three cycles of IVF should be available when (...) “The woman is within the optimal range for in vitro fertilisation and there is an appropriately diagnosed cause of infertility of any duration, or unexplained infertility of at least three years’ duration .Those who need fertility treatment will celebrate the guideline, as will many fertility clinics. The guideline does not, however, address key questions that will be obvious to many. Is fertility treatment the kind of thing that ought to be available on the NHS? Will the inevitable increase in demand mean that resources are directed away from other services? Is fertility treatment really the same kind of intervention as heart or hip replacement surgery?My view is that there are good reasons for doing what we can to help people access fertility services. Most of us will start a family and for those of us who do it is probably the most important of all of our life projects. Given that social status and wealth can be significant obstacles to many of the things that people would like to do with their lives, the fact that most of us are able to pursue this important life project is good from an egalitarian …. (shrink)

Male provisioning ability may have evolved as a “good dad” indicator through sexual selection, whereas male creativity may have evolved partly as a “good genes” indicator. If so, women near peak fertility (midcycle) should prefer creativity over wealth, especially in short-term mating. Forty-one normally cycling women read vignettes describing creative but poor men vs. uncreative but rich men. Women’s estimated fertility predicted their short-term (but not long-term) preference for creativity over wealth, in both their desirability ratings of individual men (r=.40, (...) p<.01) and their forced-choice decisions between men (r=.46, p<.01). These preliminary results are consistent with the view that creativity evolved at least partly as a good genes indicator through mate choice. (shrink)

Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Aging is the fourth path-breaking monography in the flourishing literature on egg freezing in just a few years. In April 2019, The Oocyte Economy: The Changing Meaning of Human Eggs by the renowned Australian social scientist Catherine Waldby, was published, the first book to examine the emergence of a global market for eggs through biomedical innovation. In September 2019, sociologist Kylie Baldwin of De Montfort University published Egg Freezing, Fertility and (...) Reproductive Choice: Negotiating Responsibility, Hope and Modern Motherhood, in which she explores the experiences of some pioneering women who are having eggs frozen in the United... (shrink)

During the last 100 years, several interpretations of the Thesmophoria have been advanced. Following the typology of H.S. Versnel, we can classify these interpretations as substantive, functionalist and cosmological. The three approaches can be seen as comple­mentary, but in practice they are hardly ever pursued simultaneously. This article examines how they fit together. In particular, it re-examines the subject of fertility, asking how it fits in with the wider social and ideological issues to which Detienne and others have drawn attention (...) and which, to our mind, have little connection with agriculture or human repro­duction. As a response this paper offers a synthetic interpretation that places fertility in a wider cosmological context and shows it as interconnected with all the other levels of the festival.Plusieurs interprétations des Thesmophories ont été proposées depuis un siècle. En suivant la typologie d’H.S. Versnel, on peut les qualifier de substantives, de fonctionnalistes et de cosmologiques. Les trois approches peuvent être complémentaires, mais, en pratique, elles sont difficilement assumées en même temps. L’article examine la manière dont elles fonctionnent ensemble. Il reprend en particulier le thème de la fertilité, en posant la question de savoir comment il s’insère dans les thèmes sociologiques et idéologiques plus larges sur lesquels Detienne et d’autres ont attiré l’attention et qui, dans notre esprit, ont peu de rapport avec l’agriculture et la reproduction humaine. En réponse à ce problème, on offre une interprétation synthétique qui situe la fertilité dans un contexte cosmologique plus vaste et en montre les relations avec les autres niveaux de la fête. (shrink)

Who owns frozen human embryos? Are "surrogate motherhood" arrangements dangerous for women? Should access to in vitro fertilization be limited or increased? With the development of complex reproductive technologies and the ensuing controversies in reproductive ethics, there is an urgent need for more careful examination of moral principles, current practices, and social policies pertaining to reproduction. The issues examined in this collection of nine papers focusing of the Canadian experience include abortion, the cryopreservation of embryos, the selective termination (...) of fetuses within multiple pregnancies, social policy for gestational "surrogacy," and the regulation of in vitro fertilization. Adopting a feminist perspective, the book places reproductive autonomy at the center of debates about the control of reproduction. (shrink)

In the modern world, technology has enabled us to understand the connections between the menstrual cycle and female fertility and to observe the reproductive process even from conception. Unable to see inside the living body, however, eighteenth-century people imagined reproduction and fertility holistically. Their understanding of fertility was inseparable from the way in which they imagined the inner-workings of the humoral body. Although menstruation was understood to be connected to reproduction, it was considered unreliable, a peripheral indicator of fertility. Above (...) all, the best marker of a woman’s fecundity was good overall health. (shrink)

A preimplantation genetic test to discriminate between severe and mild autism spectrum disorder might be developed in the foreseeable future. Recently, the philosophers Julian Savulescu and Guy Kahane claimed that there are strong reasons for prospective parents to make use of such a test to prevent the birth of children who are disposed to autism or Asperger’s disorder. In this paper we will criticize this claim. We will discuss the morality of selection for mild autism in embryo selection in a (...) hypothetical in vitro fertilization (IVF) situation where preimplantation genetic diagnosis is performed and compare this with a similar selection for congenital deafness. To do this we first discuss relevant human differences. We then introduce the principle of human capabilities (PC) and compare this principle with the principle of procreative beneficence (PB) introduced by Savulescu and Kahane. We apply the two principles to selection for mild autism and selection for congenital deafness. We argue that PC allows for the selection for mild autism but rules out selection for congenital deafness. PB will not give clear answers; the ruling of PB depends to a large extent on expected social, cultural and political developments. We will argue that PC is preferable to PB. We will discuss arguments for the value of mild autism for individuals who have this condition and argue that they are able to lead a life with human dignity provided autism-friendly social circumstances are present. Neither PC nor PB yields strong reasons for prospective parents to seek to prevent the birth of children who are disposed to mild autism spectrum disorder. (shrink)

Many medical‐ethics advisory boards have concluded that human embryonic stem cell research can be conducted in an ethical manner. Yet, almost all the recommendations of the ethics advisory boards have included a rather obscure requirement: the embryos that are to be destroyed for stem cell research must be treated with profound respect. In none of these recommendations, however, do we see an adequate explanation of what proper respect for human embryos actually entails. In this essay I argue that (...) showing proper respect for human embryos, on the one hand, and simultaneously destroying them for stem cell research, on the other hand, are not mutually exclusive. In addition, I maintain that given current U.S. in vitro fertilization practices, which deliberately produce more embryos than will be implanted, proper respect for surplus embryos requires their use in embryonic stem cell research. (shrink)

On the morning of December 2, 1994, after a preceding afternoon of discussion, the Advisory Committee to the Director of the National Institutes of Health unanimously voted to approve the recommendations of the Report of the Human Embryo Research Panel. Panel members like myself who were present were elated. The vote marked the culmination of nearly a year of work. Approval of the report also represented a decisive step forward in bringing an end to a 15-year long moratorium on (...) federally funded research on the preimplantation human embryo and techniques of in vitro fertilization. (shrink)

New prospects for technologically aided human reproduction require the development of a public policy concerning the setting of limits to reproductive autonomy and to research on human embryos. Previous American efforts to clarify policy on such matters have been ignored by the executive branch; there is a need for Congressional action to initiate the requisite processes of debate and policy formation. Keywords: human reproduction, public policy, persons, in vitro fertilization, embryo transfer, reproductive autonomy CiteULike Connotea Del.icio.us (...) What's this? (shrink)

Contemporary medicine offers more and more possibilities as far as procreation is concerned. They are available, first of all, to infertile couples (IVF – In Vitro Fertilization). However, the advanced reproductive technology is also used by people who are biologically capable of having children. These people are ready to resign voluntarily from pregnancy and childbirth difficulties. The surrogate motherhood appears as a phenomenon known already from biblical times but existing nowadays in a different context. At the same time, some (...) issues are emerging – questions concerning social, ethical, moral and legal consequences. This paper presents the issue of surrogate motherhood in the context of social changes, which could lead to a development of such practices as well as the reasons of parents and surrogate mothers. Can this phenomenon be perceived as a service for people who want to fulfill their desires for having children? Would surrogate motherhood become a socially approved practice? What are the ethical, religious and legal norms concerning this phenomenon? The religious norms are connected, first of all, with an attitude of the Catholic Church which recognizes surrogacy as unacceptable and states that “it offends the dignity and the right of a child to be conceived, carried in the womb, delivered to the world and brought up by their own parents”. The ethical norms refer to the biotechnological issues and include matters of creating and implanting human embryos as well as the problem of the surrogate mother – child – biological parents relationship. As far as legal norms are concerned, the case is still open hence Polish law does not take into consideration in vitro fertilization or the admissibility of surrogate motherhood. (shrink)

Since the birth of the first test-tube baby, Louise Brown, in 1977, we have seen truly remarkable advances in biotechnology. We can now screen the fetus for Down Syndrome, Spina Bifida, and a wide range of genetic disorders. We can rearrange genes in DNA chains and redirect the evolution of species. We can record an individual's genetic fingerprint. And we can potentially insert genes into human DNA that will produce physical warning signs of cancer, allowing early detection. In fact, (...) biotechnology has progressed to such a point that virtually any kind of genetic manipulation, if not already possible, is just around the corner. But these breakthroughs also raise serious ethical and moral dilemmas that we are only now beginning to confront. In Wonderwoman and Superman, noted medical ethicist John Harris offers the first thorough analysis of the moral dilemmas created by the revolution in molecular biology. Covering a wide array of recent innovations, Harris discusses, for example, the moral decisions involved and the consequences of creating egg and embryo banks. Who should be allowed to use such resources? Should recipients be screened? Should such banks be open for public or private use? And does it cheapen life to make embryos available for sale? In another chapter, Harris examines the question of conceiving children chiefly for organ donation, focusing on the recent case of a woman who wanted to have a second child to provide a bone marrow donor for her first child sick with leukemia (she intended to abort the fetus if its bone marrow did not genetically match that of her living child). In this case, the medical staff had to decide whether they should perform in-vitro fertilization, knowing that the mother did not satisfy the clinic's criteria (there was no father), and also knowing the potential for abortion. Discussing the ethics of the mother's choice and the clinic's choice, Harris asks whether it is morally correct to create a child as an organ donor, whether the future child would suffer, whether it is worth any suffering to be born, and who has the right to weigh the various factors (both moral and physiological) involved in making these decisions. Delving into a multitude of issues such as when life begins, when suffering is needless, and whether we should play God, Wonderwoman and Superman provides not only a thought-provoking inquiry into the potential and actual ethical dilemmas created by the many advances in biotechnology, but challenges us to learn to choose responsibly and to face the moral implications of the choices that confront us. (shrink)

Many geoengineering projects have been proposed to address climate change, including both solar radiation management and carbon removal techniques. Some of these methods would introduce additional compounds into the atmosphere or the ocean. This poses a difficult conundrum: Is it permissible to remediate one pollutant by introducing a second pollutant into a system that has already been damaged, threatened, or altered? We frame this conundrum as the ‘‘Problem of Permissible Pollution.’’ In this paper, we explore this problem by taking up (...) ocean fertilization and advancing an argument that rests on three moral claims. We first observe that pollution is, in many respects, a context-dependent matter. This observation leads us to argue for a ‘‘justifiability criterion.’’ Second, we suggest that remediating actions must take into account the antecedent conditions that have given rise to their consideration. We call this second observation the ‘‘antecedent conditions criterion.’’ Finally, we observe that ocean fertilization, and other related geoengineering technologies, propose not strictly to clean up carbon emissions, but actually to move the universe to some future, unknown state. Given the introduced criteria, we impose a ‘‘future-state constraint’’. We conclude that ocean fertilization is not an acceptable solution for mitigating climate change. In attempting to shift the universe to a future state geoengineering sidelines consideration of the antecedent conditions that have given rise to it —conditions, we note, that in many cases involve unjustified carbon emissions —and it must appeal to an impossibly large set of affected parties. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 551 Human Embryo Research: Yes or No?. By CIBA FOUNDATION. London: Tavistock: 1987. Pp. xv + 232. $39.95 (cloth). In 1984 a governmental commission formed under the directorship of Dame Mary Warnock studied proposed legislation for experimentation on human embryos for research purposes. It concluded that such experimentation should not be permitted ·after the fourteenth day of gestation. This book records a symposium conducted under (...) the sponsorship of the CIBA foundation, an international scientific and educational organization which promotes research into biomedical and chemical research. The purpose of the symposium was to determine whether the guidelines set forth by the Warnock commission were legitimate and whether new criteria for allowing embryo r.esearch should be established. The book consists of eleven papers presented at a symposium on the ethics of embryo research along with panel discussions about the papers. Technically, embryo research only concerns experimentation with human products of conception after the fourteenth gestational day. The first seven papers describe contemporary embryo research dealing with the diagnosis and mechanisms of infertility, its ti;eatment by in vitro fertilization, the diagnosis of genetic disease, the causes and avoidance of congenital malformations, and the improvement of contraception. The final four papers deal with the issues of the status of the human embryo in d:ffierent world religions, the moral arguments against human embryo research, and public attitudes on human embryo research. The scientific papers are quite detailed, and they provided a good deal of information about the contemporary state of embryo research. But the papers on the ethics of human embryo research are rather partisan, and they do not adequately approach the difficult human and ethical issues involved in embryo research. One gains the impression from this book that the conference was heavily weighted in favor of those who sought virtually unqualified and unrestricted moral and legal permission for human.embryo research. The scientific papers seemed to go out of their way to argue that there was an unbreakable continuum in the process of transmitting life such that it could not be determined when human life began. For example, Professor Teresa Iglesias's suggestion that a new and distinct human life began when the process of fertilization began, and when the newly formed genetic material came to govern the development of the organism, rceeived little acknowledgment. No papers were presented rejecting nontherapeutic research on human embryos, and.the papers presented by J. W. Bowker and by Bernard Williams argued in behalf of the moral licitness of unspecified forms of embryo research. Bowker claimed that there was no consensus to be found 55~ BOOK REVIEWS among the various world religions on the moral status of the human embryo. He surveyed various religions such as Buddhism and concluded that the arguments in favor of the humanity or personhood of the embryo were not strong or persuasive. His point should not be accepted without caution, however, for he did not consider the claims made by western traditions such as Catholicism in behalf of the personhood of the embryo. 'F:or the claims of an oriental religion such as Buddhism are not as persuasive with Western, rationalist, liberal minds as they are with orientals. Bowker argues that religious claims about the personhood of the unborn ';are weak since we do not claim that larvae are full grown fish or that acorns are oak trees. This is true, but on the other hand, we do not say that horse embryos are vegteables or pigs. Implied in Bowker's claim that the embryo is not a human being or a human person is the assumption that at some point in the gestation process the embryo undergoes a "species-transfer" or "class-transfer" from the biological category of non-human or non-personal to human and personal. This is difficult to accept as there is no precedent in other mammals for such a species or class transfer. Equine, bovine, and canine embryos are not considered to be anything than other than of the species of horse, pig, or dog, and there is no reason to believe that they engage in some sort of species transfer. And he does not explain why the human case alone exhibits this... (shrink)

The Human Fertilisation and Embryology Act 2008: a missed opportunity?Amel AlghraniCorrespondence to Dr Amel Alghrani, Institute for Science, Ethics and Innovation, Centre for Social Ethics and Policy, School of Law, University of Manchester, Oxford Road, Manchester, M13 9PL; amel.alghrani@manchester.ac.ukReceived 16 September 2009 Accepted 24 September 2009 Regulating reproduction is no easy feat. In the past three decades we have witnessed a reproductive revolution and great strides have been made to alleviate the effects of infertility. Reproductive advances such as in-vitro (...) fertilisation , sex selection, reproductive cloning and embryo selection for the purpose of creating “saviour siblings” have all emerged as part of a rapid and ever-changing branch of medicine, each promising to upset the status quo and transform human reproduction.Following much activity in this area, the lengthy process of updating the legislation is now complete. The Human Fertilisation and Embryology Act 2008 received Royal Assent on 13 November 2008. The majority of the HFE Act 2008’s amendments will come into force in October of this year, with the exception of the provisions pertaining to parenthood, which commenced in April 2009. Welcoming Royal Assent, Professor Lisa Jardine, Chair of the Human Fertilisation and Embryology Authority, stated:“This is a momentous day for the HFEA and for those with fertility problems. The regulatory system that has served us so well has been renewed. Parliament has provided a clear framework for the future and a solid base on which to regulate 21st century practice within 21st century law.”1However, as scientific endeavours into developments such as artificial gametes, womb transplantation and ectogenesis continue apace, it could be argued that Jardine was perhaps overly optimistic about the achievements of the new legislation. The HFE Act 2008 is an amending statute, and as Jackson 2 notes “much of the regulatory architecture” in the 1990 legislation “remains intact”. In retaining the architecture of the 1990 legislation, and merely amending or adding certain provisions, has the government missed an ideal opportunity to consider how to equip the regulatory framework for the next phase/era of assisted reproduction?The next …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Human Gene TherapyMary Carrington Coutts (bio)On September 14, 1990, researchers at the U.S. National Institutes of Health (NIH) performed the first approved gene therapy procedure on a four-year-old girl named Ashanti DeSilva. Born with a rare genetic disease, severe combined immune deficiency (SCID), Ashanti lacked a healthy immune system and was extremely vulnerable to infection. Children with SCID usually develop overwhelming infections and rarely survive to adulthood; even (...) a common childhood illness like chicken pox is life-threatening. Ashanti led a cloistered existence, avoiding contact with people outside her family, remaining in the sterile environment of her home, and battling frequent illnesses with massive amounts of antibiotics.In Ashanti's gene therapy procedure, her own white blood cells were genetically modified and then infused back into her bloodstream. Laboratory tests show that the therapy has strengthened Ashanti's immune system. She no longer has recurrent colds, has been allowed to attend school, and has been immunized against whooping cough. This gene therapy procedure is not a cure, however. The genetically-treated white blood cells only survive for a few months and must then be replaced, but Ashanti's future is much brighter because of the new therapy (VI, Thompson [The First] 1993).Although this simplified description of Ashanti's gene therapy procedure sounds like a happy ending, it is little more than an optimistic chapter in a long story. The road to the first approved gene therapy procedure was rocky and fraught with controversy. The biology of human gene therapy is very complex, and there are still many techniques that need to be developed and diseases that need to be understood more fully before gene therapy is well established. The public policy debate surrounding the possible use of genetically engineered material in human subjects is equally complex. Major participants in the debate come from the fields of biology, government, law, medicine, philosophy, politics, and religion, each bringing different views to the discussion.In studying the ethics of gene therapy, one should draw a distinction between [End Page 63] therapy on somatic (non-reproductive) cells and germ (reproductive) cells. Only the germ cells carry the genes that will be passed on to the next generation. Reactions to gene therapy have varied widely. Some commentators on gene therapy object to any form of genetic manipulation, no matter how well-intentioned (VI, Rifkin 1983). Another reaction is to allow the use of somatic-cell therapy, but not to approve the use of germ-line therapy, which could have unforeseeable effects on future generations. A different stance is that, with proper regulation and safeguards, germ-line gene therapy is a logical extension of the progress made to date and that it is an ethically acceptable procedure.TechniquesTo date, 43 research protocols have been approved for somatic-cell gene therapy in the United States. The techniques employed in each protocol vary, but in general a virus is used as a "vector" to insert the desired gene into the DNA of the patient's cells, in order to compensate for a defective gene. For Ashanti's gene therapy, this technique involved obtaining white blood cells and introducing properly functioning genes into as many of the cells as possible. The normal genes were delivered through the use of a specially-engineered virus.Although similar techniques are used in germ-line gene therapy, the procedure is more difficult. There are two basic ways to perform germ-line gene therapy: (1) to treat a preimplantation embryo that carries a serious genetic defect before its implantation in the mother, which necessitates the use of in vitro fertilization techniques; or (2) to treat the germ cells (sperm or egg cells) of afflicted adults so that the genetic defects would not be passed on to their offspring, which requires the technical expertise to delete the defective gene and insert a properly functioning replacement. Because of the complexity of the procedures involved and the attendant ethical controversy, germ-line therapy is not currently performed.Candidate Diseases for Gene TherapyAt present, gene therapy is likely to be most successful in treating diseases that are caused by single-gene defects and has been approved for treating diseases such... (shrink)

The use of preimplantation genetic diagnosis (PGD) has expanded both in number and scope over the past 2 decades. Initially carried out to avoid the birth of children with severe genetic disease, PGD is now used for a variety of medical and non-medical purposes. While some human studies have concluded that PGD is safe, animal studies and a recent human study suggest that the embryo biopsy procedure may result in neurological problems for the offspring. Given that the long-term (...) safety of PGD has not been clearly established in humans, this study sought to determine how PGD safety is presented to prospective patients by means of a detailed website analysis. The websites of 262 US fertility centres performing PGD were analysed and comments about safety and risk were catalogued. Results of the analysis demonstrated that 78.2% of centre websites did not mention safety or risk of PGD at all. Of the 21.8% of centres that did contain safety or risk information about PGD, 28.1% included statements highlighting the potential risks, 38.6% presented information touting the procedure as safe and 33.3% included statements highlighting potential risks and the overall safety of the procedure. Thus, 86.6% of PGD-performing centres state that PGD is safe and/or fail to disclose any risks on their websites despite the fact that the impact of the procedure on the long-term health of offspring is unproven. This lack of disclosure suggests that informed consent is inadequate; this study examines numerous factors that are likely to inhibit comprehensive discussions of safety. (shrink)

A sociologist examines contemporary engagements of queer bodies and identities with fertility biomedicine. Drawing on social science, media culture, and the author’s own empirical research, three questions frame the analysis: 1. In what ways have queers on the gendered margins moved into the center and become implicated or central users of biomedicine’s fertility offerings? 2. In what ways is Fertility Inc. transformed by its own incorporation of various gendered and queered bodies and identities? And 3. What are the biosocial and (...) bioethical implications of expanded queer engagements and possibilities with Fertility Inc.? The author argues that “patient” activism through web 2.0 coupled with a largely unregulated free-market of assisted reproduction has included various queer identities as “parents-in-waiting.” Such inclusions raise a set of ethical tensions regarding how to be accountable to the many people implicated in this supply and demand industry. (shrink)

BackgroundCurrent preimplantation genetic testing (PGT) technologies enable embryo genotyping across the whole genome. This has led to the development of polygenic risk scoring of human embryos (PGT-P). Recent implementation of PGT-P, including screening for intelligence, has been extensively covered by media reports, raising major controversy. Considering the increasing demand for assisted reproduction, we evaluated how information about PGT-P is communicated in press media and explored the diversity of ethical themes present in the public debate.MethodsLexisNexis Academic database and Google News (...) were searched to identify articles about polygenic embryo screening. This led to 535 news articles. 59 original articles met the inclusion criteria. Inductive content analysis was used to analyse these articles.Results8.8% of articles gave embryo polygenic scoring a positive portrayal, while 36.8% expressed a negative attitude. 54.4% were neutral, mostly highlighting limited practical value of the technology in in vitro fertilization settings. We identified five main ethical themes that are also present in academic literature and the broader debate on reproductive technologies: a slippery slope towards designer babies, well-being of the child and parents, impact on society, deliberate choice and societal readiness.ConclusionsImplementation of embryo polygenic profiling engenders a need for specific recommendations. Current media analysis discloses important ethical themes to consider when creating future guidelines for PGT-P. (shrink)

In addressing bioethical issues at the beginning of human life, such as abortion, in vitro fertilization, and embryonic stem cell research, one primary concern regards establishing when a developing human embryo or fetus can be considered a person. Thomas Aquinas argues that an embryo or fetus is not a human person until its body is informed by a rational soul. Aquinas's explicit account of human embryogenesis has been generally rejected by contemporary scholars due to its (...) dependence upon medieval biological data, which has been far surpassed by current scientific research. A number of scholars, however, have attempted to combine Aquinas's basic metaphysical account of human nature with current embryological data to develop a contemporary Thomistic account of a human person's beginning. In this article, I discuss two recent interpretations in which it is argued that a human person does not begin to exist until a fetus has developed a functioning cerebral cortex. (shrink)

Biohacking involves individuals determining, developing, and directing relevant activities to meet their personal biological goals. Biohacking fertility is a resilient method that trans and genderqueer people use to meet their reproductive and family-planning needs in the face of historic medical marginalization and oppression. In this study, nine participants were recruited from three different Facebook groups specific to queer and trans fertility, family planning, pregnancy, and parenting. Each participant’s posts and comments to their respective Facebook group(s) were analyzed, followed by interviews (...) with participants. A total of 1,155 Facebook posts were collected. Biohacking activity—understood as a web of activity including gathering information, applying knowledge to personal circumstances, and sharing personal experiences and knowledge—was found in each of the three groups. Participants identified these online groups as safer spaces to learn more about their own fertility and find community. Participants were active in these groups to biohack their fertility at home and to become empowered at the doctor's office or fertility clinic, ultimately achieving agency in their fertility and family planning. (shrink)

A practical guide for fellow lawyers to navigate international ART law.

Since 1980, the number of twin births in the United States has increased 76 percent, and the number of triplets or higher‐order multiples has increased over 400 percent. These increases are due in part to increased maternal age, which is associated with spontaneous twinning. But the primary reason for these increases is that more and more people are undergoing fertility treatment. Despite an emerging (but not absolute) consensus in the medical literature that multiples, including twins, should be a far less (...) frequent outcome of fertility treatment, American clinicians currently practice fertility medicine in ways likely to result in twins and, occasionally, triplets—often, they tell us, at the request of their patients. At first blush, one might conclude that these practice patterns show that patients and their doctors have weighed the risks associated with twins against the benefits of swiftly completing their families and decided that the risks are worth taking. That is, their requests for twins must represent their free and informed choices. But there are reasons to be skeptical of this interpretation, including that the preferences of many patients seem to be very strongly shaped, if not sometimes completely constrained, by concerns about costs—costs that mainly result from the routine exclusion of in vitro fertilization from health insurance coverage. It is quite possible, we believe, that these cost concerns actually undermine the autonomy of fertility patients, pushing many of them to take risks with their health and the health of their hoped‐for future children. (shrink)

Oncofertility is one of the 9 NIH Roadmap Initiatives, federal grants intended to explore previously intractable questions, and it describes a new field that exists in the liminal space between cancer treatment and its sequelae, IVF clinics and their yearning, and basic research in cell growth, biomaterials, and reproductive science and its tempting promises. Cancer diagnoses, which were once thought universally fatal, now often entail management of a chronic disease. Yet the therapies are rigorous, must start immediately, and in many (...) cases result in premature failure of the body's reproductive ability. In women, this loss is especially poignant; unlike the routine storage of sperm, which is done in men and boys facing similar treatment decisions, freezing oocytes in anticipation of fertility loss is not possible in most cases, and creating an embryo within days of diagnosis raises significant moral, social and medical challenges. Oncofertility is the study of how to harvest ovarian tissue in women facing cancer to preserve their gametes for future use with IVF, thus allowing the decisions about childbearing to be deferred and reproductive choices to be preserved. The research endeavor uses the capacity of the ovarian follicle to produce eggs in vitro . Developing the human follicle to ovulate successfully outside the body is scientifically difficult and ethically challenging. Infertility is linked to long-standing religious and moral traditions, and is intertwined with deeply contentious social narratives about women, families, illness and birth. Is the research morally permissible? Perhaps imperative if understood as a repair from iatrogenic harms? How are considerations of justice central to the work? How will vulnerable subjects be protected? What are the moral implications of the work for women, children and families? What are the implications for society if women could store ovarian tissue as a way of stopping the biological clock? What are the moral possibilities and challenges if eggs can be produced in large quantities from a stored ovarian tissue? (shrink)

Since 1980, the number of twin births in the United States has increased 76 percent, and the number of triplets or higher-order multiples has increased over 400 percent. These increases are due in part to increased maternal age, which is associated with spontaneous twinning. But the primary reason for these increases is that more and more people are undergoing fertility treatment. Despite an emerging (but not absolute) consensus in the medical literature that multiples, including twins, should be a far less (...) frequent outcome of fertility treatment, American clinicians currently practice fertility medicine in ways likely to result in twins and, occasionally, triplets-often, they tell us, at the request of their patients. At first blush, one might conclude that these practice patterns show that patients and their doctors have weighed the risks associated with twins against the benefits of swiftly completing their families and decided that the risks are worth taking. That is, their requests for twins must represent their free and informed choices. But there are reasons to be skeptical of this interpretation, including that the preferences of many patients seem to be very strongly shaped, if not sometimes completely constrained, by concerns about costs-costs that mainly result from the routine exclusion of in vitro fertilization from health insurance coverage. It is quite possible, we believe, that these cost concerns actually undermine the autonomy of fertility patients, pushing many of them to take risks with their health and the health of their hoped-for future children. [ABSTRACT FROM AUTHOR]. (shrink)

Birth order has been examined over a wide variety of dimensions in the context of modern populations. A consistent message has been that it is better to be born first. The analysis of birth order in this paper is different in several ways from other investigations into birth order effects. First, we examine the effect of birth order in an egalitarian, small-scale, kin-based society, which has not been done before. Second, we use a different outcome measure, fertility, rather than outcome (...) measures of social, psychological, or economic success. We find, third, that being born late in an egalitarian, technologically simple society rather than being born early has a positive outcome on fertility, and fourth, that number of older siblings and sibling set size are even stronger predictors of fertility, especially for males. (shrink)