Although use of assisted reproduction techniques was examined by an ad hoc act in 2004 in Italy, there are many opposing views about ethical and economic implications of the technologies dealing with infertility and sterility problems. In this paper, the authors examine a recent judge's decision that ordered the removal and subsequent adoption of a 1-year-old child because her parents were considered too old to be parents. The couple had had recourse to heterologous artificial insemination abroad and decided to (...) give birth in Italy. The judgement deals with and discusses the complex issue of the right to procreate in order to balance the opportunities offered by scientific progress with the unborn child's condition. (shrink)

The posthumous retrieval and use of gametes is socially, ethically, and legally controversial. In the countries that do not prohibit the practice, posthumous assisted reproduction is usually permitted only at the request of the surviving spouse and only when the deceased left written consent. This paper presents the recommendations of an ethics committee established by the Israeli Fertility Association. In its discussions, the committee addressed the ethical considerations of posthumous use of sperm—even in the absence of written consent from (...) the deceased—at the request of either the spouse or the deceased’s parents who wish to become the offspring’s parents or grandparents. It is concluded that under certain conditions, a request by the deceased’s parents to posthumously use the deceased’s sperm is justified and should be granted. (shrink)

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those (...) older women who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

The last quarter of the twentieth century has given rise to reproductive technologies and arrangements that in the earlier part of the century could only be dreamed of by the authors of science fiction. We stand in the middle of this reproductive revolution, trying to cope with the developments that have already occurred but with an uneasy sense that the future may be even more complicated ethically than the past and the present. In this brief essay, I will (...) survey recent ethical and public-policy discussions of two reproductive techniques (assisted insemination and in vitro fertilization) and one reproductive arrangement (surrogate motherhood). After distinguishing three phases in the normative debate, I will briefly comment on some of the characteristics of, and continuing ambiguities in, the ethical debate of the past 25 years. At the conclusion of the essay, I will attempt to anticipate three future issues in ethics and reproduction. (shrink)

Recent developments in Western bioethics and biomedicine have called for the need to be culture-sensitive in handling certain bioethical issues. As a result of this anthropological turn in bioethics and biomedicine, there are cultural differences in moral attitudes such as disclosure of terminal illnesses, reproductive technologies, stem cell research, prenatal screening, genetic screening, therapeutic cloning, organ transplant, brain death, physician assisted suicide and so on.This paper offers an examination of the socio-culturally framed ways of dealing with Western and (...) African bioethics particularly as it relates to assisted reproductive technology. It focuses on the ethical issues surrounding assisted reproductive technology from an African perspective making special reference to their religious beliefs by drawing on the Christian and Islamic culture. Effort is made to distinguish between Western and African approaches to assisted reproduction stressing the fact of cultural diversity in issues relating to these reproductive techniques. It argues for the need to take social and cultural meanings embedded in various bioethical issues into consideration in arriving at different conclusions about issues in assisted reproduction in order to give room for adequate understanding.The paper concludes by emphasizing the need to acknowledge cultural diversity in bioethics giving reasons why this diversity is crucial and suggesting ways of handling this diversity. (shrink)

This paper critically discusses an argument that is sometimes pressed into service in the ethical debate about the use of assisted reproduction. The argument runs roughly as follows: we should prevent women from using assisted reproduction techniques, because women who want to use the technology have been socially coerced into desiring children - and indeed have thereby been harmed by the patriarchal society in which they live. I call this the argument from coercion. Having clarified this argument, I (...) conclude that although it addresses important issues, it is highly problematic for the following reasons. First, if women are being coerced to desire to use AR, we should eradicate the coercive elements in pro-natalist ideology, not access to AR. Second, the argument seems to have the absurd implication that we should prevent all woman, whether fertile or not, to try to have children. Third, it seems probable that women's welfare will be greater if we let well informed and decision-competent women decide for themselves whether they want to use AR. (shrink)

Along with the rapid growth that the field of assisted reproduction has experienced over the last few years, numerous ethical issues have arisen and need to be discussed thoroughly. One of them is the limitation of access to assisted reproduction techniques. Because no one should be discriminated against, it is essential to substantiate every single refusal of access carefully. The criterion of welfare of the child is used most frequently. In this paper, we propose a thought experiment aiming (...) at contributing to the discussion by demonstrating that this criterion, even in its strictest form, can easily allow access to assisted reproduction for legal persons as well. (shrink)

Potential applications of genome editing in assisted reproductive technology (ART) raise a vast array of strong opinions, emotional reactions and divergent perceptions. Acknowledging the need for caution and respecting such reactions, we observe that at least some are based on either a misunderstanding of the science or misconceptions about the content and flexibility of the existing legal frameworks. Combining medical, legal and ethical expertise, we present and discuss regulatory responses at the national, European and international levels. The discussion (...) has an EU starting point and is meant as a contribution to the general international regulatory debate. Overall, this paper concludes that gene editing technologies should not be regulated autonomously. Rather, potential uses should be regulated under general, existing frameworks and where applicable by reference to sufficiently equivalent technologies and techniques already subject to specific regulation. To be clear, we do not argue for the hasty introduction of gene editing as a reproductive treatment option in the immediate future. We call for caution with regard to overreaching moratoria and prohibitions that will also affect basic research. We recommend flexible regulations that allow for further responsible research into the potential development of the technology. We call for an open and inclusive debate and argue that scientific communication should claim a more prominent role to counter the danger of widespread misinformation. A high level of transparency and accuracy should guide scientific communication while simultaneously global‐scale responsibility and governance should be fostered by promoting cross‐disciplinary thinking and multi‐level stakeholder involvement in legal and regulatory processes. (shrink)

Embryo litigation -- Access to ART treatment : insurance and discrimination -- General professional liability litigation -- Paternity and donor insemination -- Maternity and egg donation -- Traditional and gestational surrogacy arrangements -- Posthumous reproduction : access and parentage -- Same-sex parentage and ART -- Genetics (PGD) and ART -- ART-related embryonic stem cell legal developments -- ART-related adoption litigation -- ART-related fetal litigation and abortion-related litigation.

Since its inception, donor conception practices have been a reproductive choice for the infertile. Past and current practices have the potential to cause significant and lifelong harm to the offspring through loss of kinship, heritage, identity, and family health history, and possibly through introducing physical problems. Legislation and regulation in Australia that specifies that the welfare of the child born as a consequence of donor conception is paramount may therefore be in conflict with the outcomes. Altering the paradigm to (...) a child-centric model, however, impinges on reproductive choice and rights of adults involved in the process. With some lobby groups pushing for increased reproductive choice while others emphasise offspring rights there is a dichotomy of interests that society and legislators need to address. Concepts pertaining to a shift toward a child-centric paradigm are discussed. (shrink)

The purpose of this article is to ascertain and appraise the ethical issues inherent to the utilisation of preimplantation genetic diagnosis for gender selection in infertile patients anticipating undergoing a medically indicated assisted reproductive technique procedure. Performance of preimplantation genetic diagnosis per request specifically for gender selection by an infertile couple undergoing medically indicated assisted reproductive technique may not breach the principles of ethics, and is unlikely to alter the population balance of sexes.

Procreative obligations are often discussed by evaluating only the consequences of reproductive actions or omissions; less attention is paid to the moral role of intentions and attitudes. In this paper, I assess whether intentions and attitudes can contribute to defining our moral obligations with regard to assisted reproductive technologies already available, such as preimplantation genetic diagnosis (PGD), and those that may be available in future, such as reproductive genome editing and ectogenesis, in a way compatible with (...) person‐affecting constraints. I propose the parent–child relationship argument, which is based on the moral distinction between creating and parenting a child. Hence, I first argue that intentions and attitudes can play a role in defining our moral obligations in reproductive decisions involving PGD. Second, I maintain that if we accept this and recognize reproductive genome editing and ectogenesis as person‐affecting procedures, we should be committed to arguing that prospective parents may have moral reasons to prefer reproduction via such techniques than via sexual intercourse. In both cases, I observe an extension of our procreative responsibility beyond what is proposed by the consequentialist person‐affecting morality. (shrink)

Potential applications of genome editing in assisted reproductive technology (ART) raise a vast array of strong opinions, emotional reactions and divergent perceptions. Acknowledging the need for caution and respecting such reactions, we observe that at least some are based on either a misunderstanding of the science or misconceptions about the content and flexibility of the existing legal frameworks. Combining medical, legal and ethical expertise, we present and discuss regulatory responses at the national, European and international levels. The discussion (...) has an EU starting point and is meant as a contribution to the general international regulatory debate. Overall, this paper concludes that gene editing technologies should not be regulated autonomously. Rather, potential uses should be regulated under general, existing frameworks and where applicable by reference to sufficiently equivalent technologies and techniques already subject to specific regulation. To be clear, we do not argue for the hasty introduction of gene editing as a reproductive treatment option in the immediate future. We call for caution with regard to overreaching moratoria and prohibitions that will also affect basic research. We recommend flexible regulations that allow for further responsible research into the potential development of the technology. We call for an open and inclusive debate and argue that scientific communication should claim a more prominent role to counter the danger of widespread misinformation. A high level of transparency and accuracy should guide scientific communication while simultaneously global‐scale responsibility and governance should be fostered by promoting cross‐disciplinary thinking and multi‐level stakeholder involvement in legal and regulatory processes. (shrink)

Observing the practical situation of the techniques of assisted procreation in European societies, one is allowed to affirm that these techniques are largely in use in our societies, it did not find resistance among the secular groups of the society. It is not the case of the representatives of the Catholic church, hostile to each intervention on the reproductive mechanisms as being a violation against natural law, the most virulent opposition is linked to intervention on embryos or to (...) each way of reproduction outside of the canonic marriage, considering therefore artificial insemination as immoral and anti-juridical.The opposition between secular and the catholic groups is of unequal intensity in the different European countries, it did not stop the application and the use of these reproductive techniques although it made the adoption difficult of measures in some states, and even in the European Parliament. However, they could not oppose the scientific and medical corporation and their arguments of treatment of diseases and of sterility of men or women. This way to present these reproductive techniques in terms of lowering of suffering of couples not able to reproduce naturally received a full social acceptance and legitimation, acceptation because the origin of these techniques is incontestably scientific and legitimation because the goal is essentially medical. (shrink)

Since assisted reproductive technologies (ART) are becoming increasingly important in wildlife conservation breeding programs, we need to discuss their implications to ensure their responsible use regarding the environment, the animals, and the people involved. In this article, we seek to contribute to the ongoing ethical and philosophical debate on ART in conservation by discussing the current attempt to save the northern white rhino (Ceratotherium simum cottoni, NWR) from extinction. Only two female NWRs are known to the world, both (...) unable to carry a pregnancy, and the last chance to avoid sure extinction relies on pushing the boundaries of contemporary science through the use of advanced ART and stem cell-associated techniques. The attempt to save the NWR constitutes a valuable testbed for assessing the use of ART in conservation and an occasion for identifying possible critical issues. It touches upon several ethically relevant points—that we identify and organize in an Ethical Matrix—such as the need to guarantee animal welfare, and it provides the opportunity to discuss some significant questions related to conservation. For instance, how far is it legitimate to go in trying to save a taxon? Is using sophisticated technologies to remedy anthropogenic harm a part of the problem rather than the solution? (shrink)

Much work in contemporary bioethics defends a broadly liberal view of human reproduction. I shall take this view to comprise (but not to be exhausted by) the following four claims.1 First, it is permissible both to reproduce and not to reproduce, either by traditional means or by means of assisted reproductive techniques such as IVF and genetic screening. Second, it is permissible either to reproduce or to adopt or otherwise foster an existing child to which one is not (...) biologically related. Third, it is permissible either to bring into existence a child with the greatest chance of a life of maximum human flourishing or to bring into existence a child with a life worth living but with less than the greatest chance of a life of maximum human flourishing. Fourth, it is impermissible to bring into existence a child whose life is either certain or likely to fall below some baseline of a human life minimally worth living. (shrink)

Based on the "Guide to the Human Fertilisation and Embryology Act 1990", this volume reviews the regulation of assisted conception including complex moral issues such as abortion, embryo research and cloning.

There are no technologies at the present time that would allow parents to select the sexual orientation of their children. But what if there were? Some commentators believe that parents should be able to use those techniques so long as they are effective and safe. Others believe that these techniques are unethical because of the dangers they pose to homosexual men and women in general. Both sides point to motives and consequences when trying to analyse the ethics of this question. (...) These arguments are reviewed, and it is concluded that opponents of these technologies have not shown good reason why the law or policy should override parental choice in this matter. In general, therefore, if technologies become available to choose the sexual orientation of children, parents should be allowed to use them, provided they are safe and disrupt no interest of the child. This use will, at the very least, protect homosexual children from parents who do not want them, but it will also allow parents who want homosexual children to make that choice as well. (shrink)

Artificial gametes, derived from stem cells, have the potential to enable in vitro fertilization of embryos. Currently, artificial gametes are only being generated in laboratory animals; however, considerable efforts are underway to develop artificial gametes using human cell sources. These artificial gametes are being proposed as a means to address infertility through assisted reproductive technologies. Nonetheless, the availability of artificial gametes obtained from adult organisms can potentially expand the possibilities of reproduction. Various groups, such as same-sex couples, post-menopausal (...) women, and deceased donors, could potentially utilize artificial gametes to conceive genetically related offspring. The advent of artificial gametes raises significant bioethical questions. Should all these reproductive scenarios be accepted? How can we delineate the range of future reproductive choices? A normative bioethical framework may be necessary to establish a consensus regarding the use of human artificial gametes. This review aims to present the current state of research on the biological roadmap for generating artificial gametes, while also summarizing proposed approaches to establish a normative framework that delineates ethically acceptable paths for reproduction. (shrink)

Rapid development in the area of assisted reproductive technology, has benefited mankind by addressing reproductive problems. However, the emergence of new technologies and techniques raises various issues and discussions among physicians and the masses, especially on issues related to bioethics. Apart from solutions provided using conventional bioethics framework, solutions can also be derived via a complementary framework of bioethics based on the Higher Objectives of the Divine Law in tackling these problems. This approach in the Islamic World (...) has been applied and localised in the Malaysian context. Thus, this paper highlights a conceptual theoretical framework for solving current bioethical issues, with a special focus on ART in the Malaysian context, and compares this theory with conventional theories of bioethics. (shrink)

A short article examining the problems of the fertility industry, commodifying human life and allowing unaccountable third parties to create children in ways that undermine their identity by way of donor conception, human cloning and artificial reproductive techniques.

Recent results from studies on animals suggest that functional germ cells may be generated from human pluripotent stem cells, giving rise to three possibilities: research with these so‐called artificial gametes, including fertilization experiments in vitro; their use in vivo for therapy for the treatment of human infertility; and their use in assisted reproductive technologies in vitro. While the legal, philosophical, and ethical questions associated with these possibilities have been already discussed intensively in other countries, the debate in Germany (...) is still at its beginning. A systematic and detailed analysis of the legal framework in Germany is provided with regard to the three possibilities, including the applicable statutory laws as well as the constitutional law. The question emerges as to whether the statutory laws as well as the constitution justify a distinction to be made between embryos of artificial and natural origin. This question is subject to philosophical analysis, discussing the distinction between person and thing, dignity and price, personality and property, and nature and technique. As a result, the criterion of naturalness alone may not be sufficient to differentiate between embryos of natural and artificial origin, and other criteria need to be identified. (shrink)

Abstract Background The first live birth following the use of a new reproductive technique, maternal spindle transfer (MST), which is a mitochondrial replacement technique (MRT), was accomplished by dividing the execution of the MST procedure between two countries, the USA and Mexico. This was done in order to avoid US legal restrictions on this technique. -/- Sources of data Academic articles, news articles, documents obtained through freedom of information requests, laws, regulations and national reports. -/- Areas of agreement MRTs (...) are new reproductive techniques that present novel ethical and legal challenges, since genetic material from three people is employed to create a child. -/- Areas of controversy Could the first MST procedure that culminated in a live birth negatively impact reproductive medicine in Mexico? -/- Growing points The USA and Mexico need specific and clear legislation on MRTs, in order for such techniques not to be governed by prior existing legislation on assisted reproduction that is inadequate for dealing with the new challenges that these techniques present. -/- Areas timely for developing research There is a pressing need for work to be done on the international governance of new reproductive techniques. (shrink)

The central importance of reproduction in all human cultures has given rise to many methods and techniques of assisting reproduction or overcoming infertility. Such methods and techniques have achieved spectacular successes in the Western world, where processes like in vitro fertilization (IVF) constitute a remarkable breakthrough. In this paper, the author attempts to reflect critically on assisted reproduction technologies (ART) from the background and perspective of African culture, a culture within which human reproduction is given the highest priority but (...) which also exhibits a highly ambivalent attitude to modern technology-assisted methods of reproduction. The author considers the ethical crux of reproductive technologies to be linked to the issue of the moral status of the human embryo and argues that a morally significant line of demarcation cannot be drawn between embryos and other categories of humans. (shrink)

Although most studies investigated the impact of infertility and its treatment on the couple, a small body of evidence suggested that infertility care providers may experience different sources of stress related for instance to excessive workload, the complexity of the technique, and relational difficulties with patients. The current study aimed at providing further insight into the understanding of the subjective experience of infertility care providers by highlighting their feelings and emotions, personal meanings, challenges, and opportunities. Following the methodological guidelines of (...) Interpretative Phenomenological Analysis, we conducted individual semi-structured interviews with 23 members of two different fertility units. Interviews were audiotaped and transcribed verbatim. Textual analysis was then conducted to identify emerging dominant themes and subthemes. Three main themes were extracted: dealing with infertile patients and their specificities, performing assisted reproductive technology, being part of a team. These themes related to participants experiencing: difficulties in establishing an empathic connection and communicating with couples, such that women were sometimes perceived as “particular patients” and men as poorly involved in the process; difficulties in dealing with a complex procedure in which errors are not allowed, with a growing number of women aged > 40 seeking assisted reproduction, despite the risks for their health; being part of a team as a resource, although the huge amount of time spent together can involve conflicts and organizational problems. These findings suggested that patients’ overpersistence represents an important source of stress for infertility care providers. At the same time, the concept of particular or difficult patient derives from the combination of multiple factors, including providers’ own history and subjective experience. The presence of mental health professionals in fertility units is essential to help providers improve the quality of doctor-patient communication and relieve the stress related to organizational issues and conflicts. (shrink)

Religion has a considerable influence over the public’s attitudes towards science and technologies. The objective of the paper is to understand the ethical and religious problems concerning the use of embryo for research in assisting conception for infertile couples from the perspective of Catholic Christians. This paper seeks to explain our preliminary reflections on how religious communities particularly the Catholic Christian communities respond to and assess the ethics of reproductive technologies and embryo research. Christianity as a whole lacks a (...) unified and definitive statement on when an embryo becomes a person, although fundamentalist Christians tend to be opposed to embryo experimentation. Roman Catholics tend to believe that the embryo should be treated as human life from the moment of conception or fertilisation. As opposed to this preconception I have tried to point out that a foetus is a clump of cells and lacks individuality as a conscientious human being and thus can be used for research for therapeutic reason. The paper concluded that the Church accepts techniques on embryo that respect their life. So they would allow procedures that are akin with healing and improvement of life without involving undue risks. The Church feels children should arise out of act of love between man and his wife in co-operation with God. In this regard, it may be pointed out though the creation of a child through a conjugal act in a wed lock is the preferred method since it is the most natural, least expensive one. But that does not mean, it should be the only acceptable means to conception. To state a child born using ARTs would be less perfect compared to a child born through conjugal act of husband and wife is absurd one to be mentioned. (shrink)

Since the decade of the 1970s, and particularly since the first successful test-tube baby in 1978, the development and use of assisted reproductive technologies have grown exponentially. Would-be parents—including those in so-called traditional male-female marriages, unmarried adults, postmenopausal women, and same-sex partnerships—who just over 20 years ago had no recourse for their fertility issues can now pursue their desires to have children with at least a partial, if not, total, genetic and/or biological relationship. Ovulation-stimulating medications, artificial insemination using (...) the sperm of a husband or unrelated donor, in vitro fertilization with embryo transfer, intracytoplasmic sperm injection, and gamete and zygote intrafallopian transfers are but a few of a host of treatment options ranging in complexity, invasiveness, and expense. And on the horizon are genetic techniques such as cloning—which was once considered “pure” science fiction but in 1997 became what some call an inevitability, with the development of mammalian cloning in the form of the now-famous Dolly the sheep. (shrink)

What responsibilities, if any, do we have towards our genetic offspring, before or after birth and perhaps even before creation, merely by virtue of the genetic link? What claims, if any, arise from the mere genetic parental relation? Should society through its legal arrangements allow 'fatherless' or 'motherless' children to be born, as the current law on medically assisted reproduction involving gamete donation in some legal systems does? Does the possibility of establishing genetic parentage with practical certainty necessitate reform (...) of current legal regimes of parenthood? And what limits, if any, should we set on parental procreative choices in the interests of future children, particularly with regard to genetic engineering and related techniques? These are the questions explored in this book by some of the foremost legal, bioethical and biomedical thinkers. Assembled with a view to assisting the reader to reflect critically on the ongoing social experiment which medically assisted reproduction is today, the essays in this collection highlight what are - and what else might in the nearby future become - possible reproductive options and respond to the difficulties we encounter in assessing these practices and possibilities from our traditional ethical vantage points. Contributions by: Andrew Bainham, Thomas Baldwin, Lisa Bortolotti, John Harris, Martin H. Johnson, Judith Masson, Martin Richards, Alison Shaw, Sally Sheldon, Bonnie Steinbock and Mary Warnock. (shrink)

On Oct. 24, 2019, French philosopher Sylviane Agacinski was scheduled to speak at the Université de Bordeaux-Montaigne on « l’être humain à l’époque de sa reproductibilité technique » [the human being in the era of its technological reproducibility]. Amidst “violent threats” and their purported inability to assure the safety of Agacinski, the organizers cancelled the event. Agacinski and other French intellectuals lament what they perceive to be part of a “drifting liberticide”, a form of censorship that forbids the exchange of (...) ideas and forecloses open space for debate. The story goes that Agacinski, notable for her staunch opposition to surrogacy and extending assisted reproductive technologies (ARTs) to non- heterosexual couples, as well as her anthropological claim that the fabric of our social order relies on the heteronormative structure of sexual difference, has been silenced. In a communiqué to the university, student organizations such as Riposte Trans and Mauvais Genre-s pleaded “no platform”, indicating that Agacinski’s reactionary homophobic and transphobic positions run contrary to the university’s mission of safeguarding against discrimination. What to do when an incitement to (epistemic) violence masks itself as free speech? Bring Sara Ahmed’s hammer to France. (shrink)

In 2015 the United Kingdom (UK) became the first nation to legalize egg and zygotic nuclear transfer procedures using mitochondrial replacement techniques (MRTs) to prevent the maternal transmission of serious mitochondrial DNA diseases to offspring. These techniques are a form of human germline genetic modification and can happen intentionally if female embryos are selected during the MRT clinical process, either through sperm selection or preimplantation genetic diagnosis (PGD). In the same year, an MRT was performed by a United States (U.S.)-based (...) physician team. This experiment involved a cross-border effort: the MRT procedure per se was carried out in the US, and the embryo transfer in Mexico. The authors examine the ethics of MRTs from the standpoint of genetic relatedness and gender implications, in places that lack adequate laws and regulation regarding assisted reproduction. Then, we briefly examine whether MRTs can be justified as a reproductive option in the US and Mexico, after reassessing their legalization in the UK. We contend that morally inadequate and ineffective regulations regarding egg donation, PGD, and germline genetic modifications jeopardize the ethical acceptability of the implementation of MRTs, suggesting that MRTs are currently difficult to justify in the US and Mexico. In addition to relevant regulation, the initiation and appropriate use of MRTs in a country require a child-centered follow-up policy and more evidence for its safety. (shrink)

Nowadays, novel techniques such as Reciprocal effortless in vitro fertilization (ReIVF) enable two individuals to “carry the same pregnancy,” that is to “carry” the same embryo in both their bodies. However, even though these techniques are likely to be increasingly requested, little is known about their safety and efficacy, and much less about their bioethical legitimacy and issues. Considering their uniqueness, this study assesses the compatibility of ReIVF as well as of another similar technique with the classical principles of medical (...) ethics: autonomy, beneficence, nonmaleficence, and justice. The aim is twofold: (i) to start investigating whether these techniques and their underlying reasons are, or could ever be, bioethically justifiable and (ii) to make clinicians and any other potentially interested persons such as researchers, lawmakers and prospective parents themselves are more aware of the health and social implications of using these techniques. Hence, after a brief overview of the technical aspects of the procedures that allow two persons to carry the same pregnancy, this study offers a general moral framework that can be useful for starting to address some relevant aspects of these procedures, such as their benefits and harms on the health of the individuals involved, the reasons behind their use, and the possibility that they might be covered by states in the future. Finally, this study provides a bioethical overview on ReIVF as well as on similar techniques considering different perspectives, while also suggesting some questions and recommendations for further research. (shrink)

This book provides a clear, simple account of techniques involved in assisted reproduction and embryo research. It thoughtfully and provocatively explores controversies raised by developments in reproductive technology since the first IVF baby in 1978, such as 'saviour siblings', designer babies, reproductive cloning and embryo research.

Assisted Reproductive Technologies, as a solution to the issues of human infertility, have been developed since the mid-twentieth century. The development of these techniques, their progress and results have occurred simultaneously with two events related to ART: the establishment of new rights that have contributed to their endorsement, and the birth of bioethics that have allowed the recognition of their limits. The cultural change due to the coming of ART is characterized by three topics that are discussed in (...) this article and which are all included in the so-called gender ideology: the concept of woman and the control of her body, kinship and parentage, and the idea of autonomy. Some considerations on these topics are presented as well as some alternatives to ART, which include learning to redirect their work based on criteria pointed out by bioethical reflection. Such criteria reveal the profound meaning of preserving the dignity of every single person within a true human framework. (shrink)

Susan Kahn rend compte dans cet ouvrage d’une recherche ethnographique menée en Israël sur l’usage des nouvelles techniques de reproduction et sur les interrogations qu’elles soulèvent concernant la parenté, la paternité, la maternité et la fabrique de citoyens juifs. Son travail s’appuie sur des entretiens avec des Israéliennes non mariées qui ont eu recours à une insémination artificielle, des rabbins et des juifs orthodoxes, ainsi que sur une observation participante dans une clinique de...

This article analyzes the main reasons offered by the literature in relation to the question of whether pre-implantation genetic diagnosis and selection should be allowed in the context of assisted reproduction techniques to avoid the birth of children with disabilities. The bioethical literature faces a challenge from the disability discourse. When the oppressive social dimension of disability is taken into account, it results in a series of questions that could challenge the most settled conclusions of the bioethical debate. However, (...) the social model has not been without criticism and one of them, the underestimation of the importance of biological traits origin against a disability of social origin, resonates particularly in the debate on preimplantation genetic selection. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range (...) of bioethical and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

The ethical and legal challenges posed by assisted reproduction techniques are both profound and breathtaking, with most societies unable to fully comprehend one technique before another one, even more daring, emerges. The wrongful implantation of embryos in two women undergoing in vitro fertilisation treatments at two separate clinics in the UK seriously vitiates the traditional concept of who is a parent. In one case, a patient’s embryos were wrongly implanted into another woman seeking similar treatment, and in the second, (...) a woman’s eggs were fertilised using sperm from a man other than her husband.In the first mix-up, neither member of the recipient couple was the genetic parent of the child, while in the second case, the recipient mother was the genetic mother and her husband was not the genetic father. The mix-ups resulted in litigation to determine who the rightful parents were. First, I will show in this paper that, although the outcome of the application of English law in both cases was in agreement with the outcome prescribed by basic principles of Islamic law and bioethics, that agreement is based on different reasoning in the two traditions. Next, I will show that the profound ethical implications of reproductive technologies begs for a more pluralistic bioethical discourse than the one-dimensional analysis applied by secular Western societies that currently dominates the enquiry, particularly as most Western societies are more or less multicultural and multireligious. (shrink)

The ever-growing acceptance and use of assisted human reproduction techniques has caused demand for “donated” sperm and eggs to outstrip supply. Medical professionals and others argue that monetary reward is the only way to recruit sufficient numbers of “donors”. Is this a clash between pragmatics and policy/ethics? Where monetary payments are the norm, alternative recruitment strategies used successfully elsewhere may not have been considered, nor the negative consequences of commercialism on all participants thought through. Considerations leading some countries to (...) ban the buying and selling of sperm, eggs and embryos are outlined and a case made that the collective welfare of all involved parties be the primary consideration in this, at times heated, debate. (shrink)

The ethical and legal challenges posed by assisted reproduction techniques are both profound and breathtaking, with most societies unable to fully comprehend one technique before another one, even more daring, emerges. The wrongful implantation of embryos in two women undergoing in vitro fertilisation treatments at two separate clinics in the UK seriously vitiates the traditional concept of who is a parent. In one case, a patient’s embryos were wrongly implanted into another woman seeking similar treatment, and in the second, (...) a woman’s eggs were fertilised using sperm from a man other than her husband.In the first mix-up, neither member of the recipient couple was the genetic parent of the child, while in the second case, the recipient mother was the genetic mother and her husband was not the genetic father. The mix-ups resulted in litigation to determine who the rightful parents were. First, I will show in this paper that, although the outcome of the application of English law in both cases was in agreement with the outcome prescribed by basic principles of Islamic law and bioethics, that agreement is based on different reasoning in the two traditions. Next, I will show that the profound ethical implications of reproductive technologies begs for a more pluralistic bioethical discourse than the one-dimensional analysis applied by secular Western societies that currently dominates the enquiry, particularly as most Western societies are more or less multicultural and multireligious. (shrink)

Khalafzai, Rida Usman The legalization of egg donation for medical research has resulted in the use of assisted reproductive techniques for the creation of embryos for research. This carries significant risks for the women undergoing these procedures and has brought humankind to a major ethical and moral crossroads.

An effectiveness assessment on access criteria for advance fertility treatment funded by the National Health Service, UK, in people who need help to procreate identified serious ethical issues associated with these criteria. The new draft National Institute for Health and Clinical Excellence guidelines on fertility treatment that aims to expand the eligible group of patients is deemed inadequate on the basis that the right to found a family should be accorded to all. Assisted reproductive techniques aim to satisfy (...) a basic human need and therefore should be routine part of the National Health Service. (shrink)

In 2008 the Human Fertilisation and Embryology Act amendments made deliberately choosing to bring disability into the world, using assisted reproduction, a criminal offence. This paper considers whether the legal prohibition above, should influence other policy areas concerning the welfare of future children such as new possibilities presented by foetal surgery and in utero gene therapy. If we have legal duties to avoid disability in one context should this influence our avoidance of disability in this other context? This paper (...) investigates whether the State might have a stake in wider promotion of practices to reduce the degree of disability in foetuses that will come to exist. Not selecting for disability does not affect the welfare of any future individual, whereas treating in utero abnormalities can optimize the eventual child’s welfare; antenatal interventions stand to improve clinical outcomes and welfare should that specific child be born. I explore why the State may want to intervene in the antenatal setting and to what extent, if at all; the State should implement these technologies. I argue that if the State is justified in intervening to outlaw the choosing to create disabled lives using assisted reproductive techniques, it is also justified in putting pressure on prospective parents to accept therapies in utero to help their child be born less disabled. However, I qualify this with the argument that the State is not justified in using force or the criminal law in this situation during pregnancy. (shrink)

Objective: To analyse legislation and medical professionals’ position concerning the doctor’s role in assisted reproduction techniques in Italy, and to discuss the implications for physicians of preimplantation genetic diagnosis .Background: Until recently a strict interpretation of the assisted reproduction law and the guidelines subsequently issued, lead to denying infertile couples affected by genetic diseases the right to resort to PGD. In October 2006 the Constitutional Court ruled regarding the question of the constitutional legitimacy of the prohibition of PGD.Discussion: (...) The Constitutional Court declared the manifest inadmissibility of the question of the constitutional legitimacy of article 13 of law 40/2004. The debate has become very animated since the ruling. After the negative sentence of the Constitutional Court, three further sentences recognised the right of couples to obtain PGD, representing a hard blow to law 40/2004 and to the ministerial guidelines; a further confirmation of the untenability of a law that violates fundamental principles such as the right to healthcare for women and the unborn child, the right to responsible motherhood and to informed consent.Conclusion: It seems that in Italy the legislative inadequacy for medically assisted procreation is reprieved by the courageous decisions of the judges, which refer to the values of the Italian Constitution, in defence of the fundamental rights of the citizens. (shrink)

Introduction The present volume contains the proceedings of the First International Conference on Medical Ethics which took place in Nicosia, from the 24th ...

Are there universal ethical principles that should govern the conduct of medicine and research worldwide? -- Is it morally acceptable to buy and sell organs for human transplantation? -- Were it physically safe, would human reproductive cloning be acceptable? -- Is the deliberately induced abortion of a human pregnancy ethically justifiable? -- Is it ethical to patent or copyright genes, embryos, or their parts? -- Should minors have the right to refuse treatment, even when against the will of their (...) parents or guardians? -- Is physician-assisted suicide ever ethical? -- Should stem cell research utilizing embryonic tissue be conducted? -- Should we prohibit the use of chimpanzees and other great apes in biomedical research? -- Should the United States of America adopt universal health care? -- Is there a legitimate place for human genetic enhancement? -- Can there be agreement as to what constitutes human death? -- Is there ever a circumstance in which a doctor may withhold information? -- Should in vitro fertilization be an option for a woman? -- Are international clinical trials exploitative? (shrink)

The topics addressed in this work deal with the bioethical and legal conflicts in scenarios such as the termination of pregnancy, assisted reproductive technologies, technical developments in the genomic era, the reproductive cloning of human beings, divergences of sexual development and transsexualism, and a proposal for the analysis of ethical conflics in clinical practice. The joint work of students and professors has lead to identifying a set of issues that address both medical elements and cultural, moral, and (...) legal variables in relation to the proposed topics, in order to offer the necessary elements to deal with the complexity of each of these issues, in which cinema has been used as a didactic and mimetic resource that organizes the argumentative process of each case."--page 2 of cover. (shrink)

The Canadian province of Quebec recently amended its Health Insurance Act to cover the costs of In Vitro Fertilization . The province of Ontario recently de-insured IVF. Both provinces cited cost-effectiveness as their grounds, but the question as to whether a public health insurance system ought to cover IVF raises the deeper question of how we should understand reproduction at the social level, and whether its costs should be a matter of individual or collective responsibility. In this article I examine (...) three strategies for justifying collective provisions in a liberal society and assess whether public reproductive assistance can be defended on any of these accounts. I begin by considering, and rejecting, rights-based and needs-based approaches. I go on to argue that instead we ought to address assisted reproduction from the perspective of the contractarian insurance-based model for public health coverage, according to which we select items for inclusion based on their unpredictability in nature and cost. I argue that infertility qualifies as an unpredictable incident against which rational agents would choose to insure under ideal conditions and that assisted reproduction is thereby a matter of collective responsibility, but only in cases of medical necessity or inability to pay. The policy I endorse by appeal to this approach is a means-tested system of coverage resembling neither Ontario nor Quebec's, and I conclude that it constitutes a promising alternative worthy of serious consideration by bioethicists, political philosophers, and policy-makers alike. (shrink)