This chapter contains sections titled: Reproductive Liberty Strong Libertarianism Reproductive Liberty in the Balance Conclusion.

Dana S. Belu combines Heidegger's phenomenology of technology with feminist phenomenology in order to make sense of the increased technicization of women's reproductive bodies during conception, pregnancy, and birth.

Reproductive medical technology has revolutionized the natural order of human procreation. Accordingly, some have celebrated its advent as a new and liberating determinant of kinship at the global level and advocate it as a right to reproductive health while others have frowned upon it as a vehicle for “guiltless exchange of sexual fluid” and commodification of human gametes. Religious voices from both Christianity and Islam range from unthinking adoption to restrictive use. While utilizing this technology to (...) enable the married couple to have children through the use of their own sexual material is welcome, the use of third party, surrogacy, and reproductive cloning are not in keeping with the sacrosanct principles of kinship, procreation through licit sexual intercourse, and social cohesiveness for building a cohesive family as uphold by both Christianity and Islam. To examine such larger issues emanating from these new ways of human procreation, beyond the question of legality, is a point which legal scholars in both Christianity and Islam, when issuing religious decrees, have not anticipated sufficiently. The article proposes to be an attempt to that end through a qualitative critical content analysis of selected literature written on the subject. (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)

Are there any ethical concerns about reproductive technologies that are specific or unique to developing countries? Three ethical concerns often mentioned specifically in regard to developing countries are , the “overpopulation argument”; the limited resources argument; and the ethical problem of poorly trained practitioners offering their services to unsuspecting and uninformed infertile individuals or couples. Each argument is explored in some detail, with the conclusion that ethical problems do, in fact, exist but are not unique to developing countries. Nevertheless, (...) the difficulties relating to reproductive technologies are likely to be greater in developing countries than in developed ones because of limited resources and a larger number of poor people residing there. (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)

This article examines the construction of parenthood, drawing on Brazilian cisgender, heterosexual, and homosexual couples' experiences in using assisted reproduction technologies (ART), particularly the surrogacy. For that purpose, we interviewed: 1) a lesbian woman who had her daughter through her partner's pregnancy, using ART with anonymous donor semen; 2) a gay man who, together with his partner, used a surrogacy service under contract via a specialised offshore agency; 3) a woman who was a surrogate, in Brazil, for her sister-in-law and (...) brother who lived abroad and, from abroad, sent an embryo fertilised for surrogacy; 4) a woman who resorted to her sister-in-law in order to be a mother by surrogacy, with ovules from the woman herself fertilised with semen from her husband; and 5) the sister-in-law mentioned in 4), who acted as surrogate for her brother and his wife. These interviews made it possible to think about the discursive construction of the legitimacy of such parenthoods, as it is produced by access to, and manipulation and circulation of, reproductive technologies and persons. This biomedical management of bodies sets up a material and discursive circuit that, in turn, produces a complex web of personal, normative, legal, professional and market relationships, particularly with a view to construction of a parenthood anchored in a notion of biologically-constituted origin. In this respect, biological, affective and social bonds merge to produce a precise placement of who is the father and/or who is the mother, as well as who are the important others and how they are linked to the child in a broader web of parenthood. (shrink)

It might come as a surprise to many that Spain, a country with a strong Catholic tradition that officially banned contraceptive technologies until 1978, has some of the most liberal regulations in assisted reproduction in the world. Law No. 35/1988 was one of the first and most detailed acts of legislation undertaken on the subject of assisted-conception procedures. Indeed, not only did the law permit research on nonviable embryos, it made assisted reproductive technologies available to any woman, whether married (...) or not, through the national healthcare system. (shrink)

In this paper I will discuss three areas in which advances in human reproductive technology could occur, their uses and abuses, and their effects on society. First is the potential to drastically increase the success rate and availability of in vitro fertilization and embryo freezing. Second is the ability to perform biopsies on embryos prior to the onset of pregnancy. Finally, I will consider the adding or altering of genes in embryos, commonly referred to as genetic engineering.As new (...) reproductive technologies pass from experimental models into the potential for medical utilization, I believe that it will be important for lawmakers everywhere to avoid the impulse to outlaw procedures that a society believes to be unnatural at a first glance. Rather, I would hope that they can respond thoughtfully with legislation that serves two purposes — to protect the rights of couples to overcome infertility or to reduce the risk of genetic disease in their children-to-be, and more importantly, to protect children-to-be from the abuses that could result from some of the practices that I will discuss. (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.

In this paper, I argue that the development of an artificial womb is already well on its way. By putting together pieces of information arising from new scientific advances in different areas, (neo-natal care, gynecology, embryology, the human genome project and computer science), I delineate a distinctive picture, which clearly suggests that the artificial womb may become a reality sooner than we may think. Currently, there is a huge gap between the first stages of gestation (using in vitro fertilization) and (...) the 22nd week (inside the womb). At the present time this gap seems an insurmountable barrier for fully developing a fetus outside a natural womb – a notion better known as ectogenesis. The history of science however, suggests that impenetrable barriers are such only temporarily. It is just a matter of time (and due research) until someone – intentionally or by chance – accesses the right answer and finds a way to overcome existing obstacles. Despite misgivings that the case of the artificial womb presents too many barriers, it would be naïve to suppose things would happen any differently. I observe in this paper, that it is time to acknowledge the consequences of new developments in different areas of scientific research which are leading to the advent of an artificial womb; and I modestly suggest that we might initiate a discussion on this topic now, while we have still enough time to decide what we may want and why. (shrink)

Reproductive technologies do not allow us to choose future people, but they do change who will exist. Confusion arises because of the different senses in which ”identity’ is used in ethical debate. I distinguish qualitative, cultural, and numerical identity. Reproductive choices do impact the qualitative features of children in ways that affect wellbeing, both directly and indirectly via cultural identification. I explain how the nonidentity problem makes it difficult to say what, if anything, is wrong with risky (...) class='Hi'>reproductive choices, and I outline four strategies or responding to the non-identity problem. (shrink)

This paper reflects on the social consequences of biotechnological control of population for values and ethics of care within the family household in rural north India. Based on long-term ethnographic research, it illustrates the manner in which social practices intermingle with reproductive choices and new reproductive technologies, leading to a systematic elimination of female foetuses, and thus, imbalanced sex ratios. This technological fashioning of populations, the paper argues, has far-reaching consequences for the institutions of family, marriage and kinship (...) in north India particularly in relation to care circulation within the family-household leading to a shifting local ethics of care. (shrink)

Giulia Cavaliere disagrees with claims that ectogenesis will increase equality and freedom for women, arguing that they often ignore social context and consequently fail to recognise that ectogenesis may not benefit women or it may only benefit a small subset of already privileged women. In this commentary, I will contextualise her argument within the broader cultural milieu to highlight the pattern of reproductive advancements and technologies, such as egg freezing and birth control, being presented as the panacea for women’s (...) inequality. While these advancements and technologies can benefit women, I argue medicine is not the best tool to ‘cure’ social problems and should not be co-opted as an agent of social change. Systemic social changes, not just technomedical approaches, are needed to address the root of gender inequality, which is social in nature, not medical. (shrink)

New reproductive technology permits a distinction between two different aspects of abortion: (1) the (premature) emptying of the uterus (the expulsion of the fetus) and (2) causing the death of the fetus. The paper argues that the fetus has not right to occupancy of its mother's (or any other woman's) uterus, And that the mother (or anyone else) has not right to kill the fetus. Some implications of these claims are discussed.

In Australia and other countries, certain groups of women have traditionally been denied access to assisted reproductive technologies . These typically are single heterosexual women, lesbians, poor women, and those whose ability to rear children is questioned, particularly women with certain disabilities or who are older. The arguments used to justify selection of women for ARTs are most often based on issues such as scarcity of resources, and absence of infertility , or on social concerns: that it “goes against (...) nature”; particular women might not make good mothers; unconventional families are not socially acceptable; or that children of older mothers might be orphaned at an early age. The social, medical, legal, and ethical reasoning that has traditionally promoted this lack of equity in access to ARTs, and whether the criteria used for client deselection are ethically appropriate in any particular case, are explored by this review. In addition, the issues of distribution and just “gatekeeping” practices associated with these sensitive medical services are examined. (shrink)

Howard W. Jones, Jr.'s Personhood Revisited chronicles reproductive technology's debate-evoking history meanwhile exploring the ongoing moral dilemmas of the twenty-first century, including: personhood, in vitro fertilization, conjugal love, eugenics, cloning, stem cell research, and more. Balanced readings on each reproductive topic represent conflicting viewpoints from legal, religious, and scientific perspectives. And Jones' personal experiences, such as meetings with the Vatican, add a unique look into the highly political yet benevolent world of reproductive medicine. Author Howard W. (...) Jones, Jr., alongside Robert Edwards (winner of the Nobel Prize for Medicine 2010), fertilized the first human eggs in vitro. Jones and his wife, Georgeanna Seegar Jones, established the first in vitro fertilization program in the United States, which went on to develop America's first test tube baby in 1981. Book jacket. (shrink)

In Re D is the most recent in a line of cases to raise problems with the determination of legal fatherhood under s.28(3) of the Human Fertilisation and Embryology Act 1990. The judgments in In Re D are interesting in particular because they demonstrate the growing currency of the idea that a child has a right to ‘genetic truth’. They also further evidence the ‘fragmentation of fatherhood’. This case is best understood as part of a complex and ongoing negotiation of (...) men’s role in the family in the light of shifting family forms. (shrink)

Over the last few decades an increasingly pressing social demand for access to assisted reproductive technologies (ART) has emerged. Alongside the use of reproductive technologies, relevant bioethical and biolegal issues arise, such as the claim of a “right” to have a child, the so-called “reproductive rights”, of the prospective parents and the rights of children. This paper explores these and further challenges, both old and new, calling for a transformation of parenthood and filiation, from the perspective of (...) the different theories of the contemporary pluralistic debate, with a descriptive and critical analysis of the recent Report on ART of the Unesco International Bioethics Committee, the first global document on these topics. (shrink)

This paper presents a direction for narrative ethics based on ethical ideas found in the works of Michel Foucault. Narrative ethics is understood here at the meta-level of cultural discourse to see how the moral subject is constituted by the discursive practices that structure the contemporary debate on reproductive technologies. At this level it becomes meta-narrative-ethics. After a theoretical discussion, this paper uses two literary narratives representing the polarized views in the debate to show how the moral subject may (...) be compelled to relate to its self. Ethics is redefined as Foucauldian rapport à soi, and ethical analysis, at this meta-level, shows how the moral self is intimately connected to cultural discourse. (shrink)

The article critically examines the Assisted Reproductive Technology (Regulation) Act 2021, its development process spanning 15 years, and its potential shortcomings in addressing the needs of India’s 27 million infertile couples. By scrutinizing the recommendations presented in the Parliamentary Standing Committee on Health and Family Welfare’s 129th report, the critique argues that the Act may not effectively cater to the diverse reproductive rights of the population. The article claims that most of its suggestions are in opposition to (...) redefining families and accepting inclusive family structures other than heterosexual marriages. The study posits that the Act, with its inherent limitations, perpetuates the reinforcement of patriarchal family structures that medical science intends to disrupt. In order to foster inclusivity and comprehensibility, the article advocates for necessary amendments that align with the interest of the general populace. (shrink)

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

Que sont les droits de l’homme? Existent-ils? Je me propose de répondre à ces questions en proposant un compte-rendu contractuel des droits de l’homme. Je me concentre sur le droit de fonder une famille et d’avoir des enfants. Je montre également comment l’approche contractuelle des droits de l’homme peut expliquer la pertinence actuelle des droits reproductifs dans le discours sur les droits de l’homme, et comment l’émergence des TRA (technologies de reproduction assistée) a contribué à ce changement. Le compte rendu (...) contractuel des droits de l’homme pose, en premier lieu, la question suivante : quels besoins et désirs fondamentaux peuvent être attribués à tout être humain indépendamment de son sexe, de sa nationalité, de son orientation sexuelle, de son âge, de son appartenance ethnique, etc. Le fait d’avoir un intérêt, par exemple, à préserver sa propre intégrité corporelle, sa liberté et sa propriété privée est considéré comme un besoin fondamental ou un désir fondamental de l’être humain. Mais un besoin ou un désir humain fondamental ne constitue pas en soi un droit de l’homme. Deuxièmement, le compte rendu contractuel des droits de l’homme demande donc quels besoins ou désirs fondamentaux de l’homme les individus et les représentants des États considéreraient comme si importants qu’ils accepteraient de créer des cadres institutionnels, tant au niveau national qu’international, de manière à permettre aux individus de poursuivre la satisfaction de leurs besoins ou désirs fondamentaux sans interférence de l’État. Les droits de l’homme existent et ne peuvent être revendiqués que dans le contexte de ces cadres normatifs. (shrink)

This essay develops an ecofeminist, environmental justice perspective on the shortcomings of “choice” rhetoric in the politics of women’s reproductive self-determination, specifically around fertility-enhancing technologies. These new reproductive technologies (NRTs) medicalize and thus depoliticize the contemporary phenomenon of decreased fertility in first-world industrialized societies, personalizing and privatizing both the problem and the solution when the root of this phenomenon may be more usefully addressed as a problem of PCBs, POPs, and other toxic by-products of industrialized culture that are (...) degrading our personal and environmental health. The NRTs’ rhetoric of choice is implicitly antifeminist: it blames the victim by attributing rising infertility rates to middle-class women who delay childbearing while struggling to launch careers; it conceals information about adverse health effects and solicits egg donation and gestation services from women disadvantaged by economic status, nation, and age; and it offers no choice at all for the millions of female animals—chicks, cows, turkeys, pigs, and others—whose fertility is regularly manipulated and whose offspring are commodified as products for industrialized animal food production. An intersectional analysis shifts the discourse away from reproductive choice to a framework of ecological, feminist, and reproductive justice. (shrink)

This article analyzes U.S. court cases involving reproductive technologies in terms of their implications for reproductive choice, mothers' versus fathers' rights, definitions and evaluations of parenting, and the nuclear family structure. The analysis reveals that the courts have tended not to recognize how social conditions shape women's reproductive choices, to promote fathers' rights more than mothers' rights, to ignore the social relationships that constitute childbearing and child rearing and value men's over women's biological contribution to these processes, (...) to reflect certain assumptions about the proper roles of mothers and fathers, and to privilege the nuclear family. The implications of developing reproductive technology policy for an understanding of the relationships among gender, reproductive technologies, and the state are considered, and recommendations for the equitable regulation of these technologies are offered. (shrink)

In Saks v. Franklin Covey Co., the Court of Appeals for the Second Circuit held that the American with Disabilities Act, Title VII of Civil Rights Act of 1964, the Pregnancy Discrimination Act, and New York state law do not proscribe an employer's self-insured employee health plan from excluding surgical impregnation procedures from its coverage. Although the court found that infertility qualifies as a disability under the ADA, it restricted required coverage of certain infedty treatments.Title I of the ADA prohibits (...) an employer from discriminating on the basis of disability “in regard to … fringe benefits available by virtue of employment, whether or not administered by the covered entity.” The ADA defines “disability” as “a physical or mental impairment that substantially limits one or more major life activities.” In Bragdon v. Abbott, the U.S. Supreme Court found that reproduction was a major life activity under the ADA. (shrink)

IVF/PGS procedures require that all embryos produced for potential implantation be screened for genetic abnormalities: only embryos free of genetic defects may be implanted or cryogenically preserved for future implantation. In this paper, I argue that the standard practice of the reproductive technology clinic, according to which all abnormal embryos must be discarded, unjustly imposes certain biases and discriminatory social values upon persons for whom it may not be a significant concern that their offspring would be disabled. The (...) “standard” practice both reflects a bias against disability and imposes this bias upon those who seek reproductive assistance from RTCs. I argue, therefore, that insofar as consenting to the destruction of any abnormal embryos as a condition of IVF treatment, RTCs threaten the autonomy of women seeking medical assistance to overcome infertility. Finally, I examine recent empirical findings which suggest that genetic screening and destruction of abnormal embryos does not actually aid the overall objective of IVF, which is live birth, and may actually hinder it. (shrink)

This book takes a phenomenological approach to feminist issues in medical ethics: AIDS and reproductive technology.

The impact of culture and religion on sexual and reproductive health and behavior has been a developing area of study in contemporary time. Therefore, it is crucial for people using reproductive procedures to understand the religious and theological perspectives on issues relating to reproductive health. This paper compares different perspectives of three Abrahamic faiths, i.e., Judaism, Christianity, and Islam on ARTs. Procreation, family formation, and childbirth within the context of marriage have all been advocated by these three (...) major religions of the world. Judaism permits the use of all assisted reproductive technologies when the oocyte and sperm come from the husband and wife, respectively. The different denominations of Christianity have diverse views on reproductive practices. Although the Vatican does not approve of assisted reproduction, Protestant, Anglican, and other religious groups are free to use it. ARTs are acceptable in Sunni Islam, although they can only be carried out if the couples are married. Shia Islam, however, permits third-party donations to married couples under specific restrictions. This comparison reveals that while the three major world religions utilize assisted reproduction in distinct ways, there are also many comparable aspects of each religion. (shrink)

In this article, I will analyse the conduct of the Brazilian legislative process regarding new reproductive technologies, mainly the moral assumptions of three categories that are essential to the debate: the status of the child generated by these techniques; the number of embryos transferred in each cycle ; and the issue of women’s eligibility for such techniques. The analysis will be a sociological study of the Brazilian legislative debate, using feminist perspectives in ethics as the theoretical reference. The focus (...) will be the bills in progress in the Brazilian National Congress, the public and official declarations of legislators involved in the issue and the regulation of the medical class, which has influenced the legislative process. Aside from the analysis of the legislative process, I include a section on the justification of these bills, since that is where the legislator exposes what he/she believes is the moral support for the bill. (shrink)

In ‘in vitro eugenics’ (IVE), I outlined a theoretical use of a technology of artificial gametogenesis, wherein repeated iterations of the derivation of gametes from embryonic stem cells, followed by the fusion of gametes to create new embryos, from which new stem cells could be derived, would allow researchers to create multiple generations of human embryos in the laboratory and also to produce ‘enhanced’ human beings with desired traits. As a number of commentators observed, my purpose in publishing this (...) paper was to provoke ethical discussion of a largely unremarked upon technological possibility and surrounding issues. Even if this was, as Murphy observes archly, to aim ‘low’, discussion of IVE is valuable for three reasons. First, it may render us better prepared should IVE become practical. I noted of my original discussion that it was speculative and several of the respondents suggest that IVE is even less likely to come about than I allowed there. Nevertheless, second, discussion of IVE is valuable for what it reveals about the ethics of new reproductive technologies (NRTs) more generally and, third, about the ethics of genetic human enhancement in particular. The responses to my paper demonstrate this nicely by (a) illustrating the selective way in which arguments about risk are mobilised in debates about NRTs and (b) highlighting the tension between any obligation of ‘procreative beneficence’ and a concern for genetic relatedness. Even if IVE should never be pursued, then, discussion of this possibility may help us better understand the ethics of other NRTs and means of genetic human enhancement. (shrink)

When things go wrong with assisted reproduction we should look at what’s best for everyone in the particular circumstancesA RTBs, as we must now call them, are becoming more and more frequent. In the recent United Kingdom case Mr and Mrs A, a “white” couple, gave birth to twins described as “black”. The mix up apparently occurred because a Mr and Mrs B, a “black” couple, were being treated in the same clinic and Mrs A’s eggs were fertilised with Mr (...) B’s sperm. Mr and Mrs A love the twins and wish to keep them and the facts seem to be that Mrs A is the genetic mother of the twins but her partner is not the genetic father. Under English law, in assisted reproduction, the woman who gives birth to the child is the legal mother and this is true also in cases of surrogacy. I think there is no doubt in this case that English law has taken the right path and that it would be unconscionable to contemplate taking a child away from the woman who had undergone the risks and pains of pregnancy and childbirth and the bonding process that goes along with that when she wishes to keep the child particularly when there is no substantial and pressing evidence that she would be an unsafe parent. I argued this in my book The Value of Life4 and I think it is still true. So in this case justice, morality, and decency are served by confirming Mr and Mrs A as the parents of the children. Since in English law there is some ambiguity over paternity and how that is to be assigned and since Mr A is apparently not the genetic father, I think it is important …. (shrink)

If few authors have paid much attention to the feminine concerns in new reproductive technologies, actually it is mainly some feminist authors, who, to a great extent, have allowed these concerns to enter into public debate. On the other hand, the preoccupation about women's interests and points of view is a feature in common of all feminist approaches, independently of their other philosophical concepts. Nevertheless, another feature of feminist discourses is their plurality and heterogeneity. So, we have not find (...) back answers to the questions we have analysed in this paper, because there is not only one answer. This is not an inconvenience but an incentive to continue the democratic debate within the framework of plurality and tolerance. We must incorporate to this debate the, often forgotten, women's own interests, and a critical view of the underlying assumptions and biases. These two points of view are common to the majority of feminist approaches, and should be seriously considered as worthy to be incorporated to our discourses when debating the issues linked to the new reproductive technologies. (shrink)

The March 2002 symposium Human Dignity and Reproductive Technology brought together philosophers, theologians, scientists, lawyers, and scholars from across the United States. The essays of this book are the contributions of the symposium's participants.