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Accoe D, Pennings G. Navigating conflicts of reproductive rights: Unbundling parenthood and balancing competing interests. Bioethics 2024; 38:425-430. [PMID: 38518191 DOI: 10.1111/bioe.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 01/16/2024] [Accepted: 02/16/2024] [Indexed: 03/24/2024]
Abstract
Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights-the right (not) to be a gestational, genetic, and social parent-are negative rights that do not entail a right to assistance. Since terminating or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, "prior assistance" does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent.
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Affiliation(s)
- Dorian Accoe
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Ghent, Belgium
| | - Guido Pennings
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Ghent, Belgium
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2
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Farid MS. Ethical Issues in Sperm, Egg and Embryo Donation: Islamic Shia Perspectives. HEC Forum 2024; 36:167-185. [PMID: 36371516 DOI: 10.1007/s10730-022-09498-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
Abstract
Assisted Reproductive Technologies (ARTs) have been practiced in Islamic societies within married couples since their introduction. However, there are divergent views over the issue of third-party donation among Sunni and Shia scholars. This paper illustrates the different perspectives of Shia Muslims surrounding, sperm, egg, and embryo donation and ethical aspects thereof. The study reveals that there are different views regarding sperm, egg, and embryo donation among the Shia religious leaders around the world. Many Shia religious scholars, including the Iranian supreme religious leader Ali Hussein Khamenei allow sperm, egg, and embryo donation with certain conditions. However, the conditions stipulated by Shia religious scholars contradict the ethical and legal practices of sperm, egg, and embryo donation. Regarding sperm and egg donation, they declared that the donor child would inherit from a third-party donor and the commissioning parents would be adoptive parents. Thus, according to them, donor anonymity is impossible. Moreover, the Iranian act on embryo donation did not stipulate the right and responsibilities of the donor child and recipient couples and did not clarify the nature and number of embryos that can be donated and implanted. The paper argues that the lack of laws and guidelines on sperm, egg, and embryo donation raises many ethical problems. Based only on religious rulings, third-party donation has been practiced without foreseeing the well-being and safety of donor children, donors, and recipient couples.
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Affiliation(s)
- Md Shaikh Farid
- World Religions and Culture, University of Dhaka, Dhaka, Bangladesh.
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3
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Kandlbinder AE. A critical view on using "life not worth living" in the bioethics of assisted reproduction. Med Health Care Philos 2024; 27:189-203. [PMID: 38363499 PMCID: PMC11076207 DOI: 10.1007/s11019-023-10191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 02/17/2024]
Abstract
This paper critically engages with how life not worth living (LNWL) and cognate concepts are used in the field of beginning-of-life bioethics as the basis of arguments for morally requiring the application of preimplantation genetic diagnosis (PGD) and/or germline genome editing (GGE). It is argued that an objective conceptualization of LNWL is largely too unreliable in beginning-of-life cases for deriving decisive normative reasons that would constitute a moral duty on the part of intending parents. Subjective frameworks are found to be more suitable to determine LNWL, but they are not accessible in beginning-of-life cases because there is no subject yet. Conceptual and sociopolitical problems are additionally pointed out regarding the common usage of clear case exemplars. The paper concludes that a moral requirement for the usage of PGD and GGE cannot be derived from the conceptual base of LNWL, as strong reasons that can be reliably determined are required to limit reproductive freedom on moral grounds. Educated predictions on prospective well-being might still be useful regarding the determination of moral permissibility of PGD and/or GGE. It is suggested that due to the high significance of subjective experience in the normativity of beginning-of-life bioethics, the discipline is called to more actively realize the inclusion of people with disabilities. This regards for instance research design, citation practices, and language choices to increase the accessibility of societal debates on the reproductive ethics of genetic technologies.
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Affiliation(s)
- Agnes Elisabeth Kandlbinder
- PhD Researcher, URPP Human Reproduction Reloaded, High-Risk Sub-Project 4, Department of Philosophy, University of Zurich, Zollikerstrasse 115, 8008, Zurich, Switzerland.
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4
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Ethics Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org. Financial ''risk-sharing'' or refund programs in assisted reproduction: an Ethics Committee opinion. Fertil Steril 2024; 121:783-6. [PMID: 38276940 DOI: 10.1016/j.fertnstert.2023.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024]
Abstract
Financial "risk-sharing" fee structures in assisted reproduction programs charge patients a higher initial fee that includes multiple cycles but offers a partial or complete refund if treatment fails. This opinion of the American Society for Reproductive Medicine Ethics Committee analyzes the ethical issues raised by these fee structures, including patient selection criteria, conflicts of interest, success rate transparency, and patient-informed consent. This document replaces the document of the same name, last published in 2016.
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Allen JW, Gyngell C, Koplin JJ, Vears DF. The Parliamentary Inquiry into Mitochondrial Donation Law Reform (Maeve's Law) Bill 2021 in Australia: A Qualitative Analysis. J Bioeth Inq 2024; 21:67-80. [PMID: 37530962 PMCID: PMC11052762 DOI: 10.1007/s11673-023-10257-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 04/03/2023] [Indexed: 08/03/2023]
Abstract
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.
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Affiliation(s)
| | - Christopher Gyngell
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Julian J Koplin
- Monash University, Wellington Rd, Clayton, Australia
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Melbourne Law School, University of Melbourne, Parkville, Australia
| | - Danya F Vears
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Parkville, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
- Melbourne Law School, University of Melbourne, Parkville, Australia.
- Department of Public Health and Primary Care, Center for Biomedical Ethics and Law, Leuven, Belgium.
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Hall GA. Reconceiving Reproduction: Removing "Rearing" From the Definition-and What This Means for ART. J Bioeth Inq 2024; 21:117-129. [PMID: 37831289 PMCID: PMC11052855 DOI: 10.1007/s11673-023-10281-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/31/2023] [Indexed: 10/14/2023]
Abstract
The predominant position in the reproductive rights literature argues that access to assisted reproductive technologies (ART) forms part of an individual's right to reproduce. On this reasoning, refusal of treatment by clinicians (via provision) violates a hopeful parent's reproductive right and discriminates against the infertile. I reject these views and suggest they wrongly contort what reproductive freedom entitles individuals to do and demand of others. I suggest these views find their origin, at least in part, in the way we define "reproduction" itself. This paper critically analyses two widely accepted definitions of human reproduction and demonstrates that both are fundamentally flawed. While the process of reproduction includes the biological acts of begetting and bearing a child, I argue that it does not extend to include rearing. This reworked definition has little impact in the realm of sexual reproduction. However, it has significant ethical implications for the formulation and assignment of reproductive rights and responsibilities in the non-sexual realm in two important ways. First, a claim to access ART where one has an intention to rear a child (but does not beget or bear) cannot be grounded in reproductive rights. Second, lacking an intention to rear does not extinguish the reproductive rights and responsibilities for those who collaborate in the process. I conclude that clinicians collaborate in non-sexual reproduction at the point of triggering conception (begetting) and therefore have the right to refuse to be involved in non-sexual reproduction, in some instances, as do all reproductive collaborators.
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Affiliation(s)
- Georgina Antonia Hall
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Children's Bioethics Centre, The Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia.
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Zhang H, Wang J, Qin Y, Zhang C, Wang B, Wang Y. Anticipatory Governance of Noninvasive Prenatal Testing for "Non-Medical" Traits: Lessons from Regulation of Medically Assisted Reproduction. Am J Bioeth 2023; 23:45-47. [PMID: 36919543 DOI: 10.1080/15265161.2023.2169398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Hui Zhang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Jing Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Yan Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Chuanfeng Zhang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
| | - Bingwei Wang
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital
| | - Yuming Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics
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Affiliation(s)
- Alexander M Quaas
- Division of Reproductive Endocrinology and Infertility, University of California, San Diego, CA, USA.
- Reproductive Partners San Diego, 9850 Genesee Avenue, Suite # 800, La Jolla, San Diego, CA, 92037, USA.
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Albertini DF. How genetics human ART style is making dreams come true: the stairway to eugenics. J Assist Reprod Genet 2021; 38:261-263. [PMID: 33564934 DOI: 10.1007/s10815-021-02096-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 11/26/2022] Open
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Piersanti V, Consalvo F, Signore F, Del Rio A, Zaami S. Surrogacy and "Procreative Tourism". What Does the Future Hold from the Ethical and Legal Perspectives? Medicina (Kaunas) 2021; 57:47. [PMID: 33429930 PMCID: PMC7827900 DOI: 10.3390/medicina57010047] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/17/2020] [Accepted: 01/05/2021] [Indexed: 01/22/2023]
Abstract
Background and objectives: To explore the ethical and legal complexities arising from the controversial issue of surrogacy, particularly in terms of how they affect fundamental rights of children and parents. Surrogacy is a form of medically-assisted procreation (MAP) in which a woman "lends" her uterus to carry out a pregnancy on behalf of a third party. There are pathological conditions, such as uterine agenesis or hysterectomy outcomes, that may prevent prospective mothers from becoming pregnant or carry a pregnancy to term; such patients may consider finding a surrogate mother. Many issues relating to surrogacy remain unresolved, with significant disagreements and controversy within the scientific community and public opinion. There are several factors called into play and multiple parties and stakeholders whose objectives and interests need to somehow be reconciled. First and foremost, the authors contend, it is essential to prioritize and uphold the rights of children born through surrogacy and heterologous MAP. Materials and methods: To draw a parallel between Italy and the rest of the world, the legislation in force in twelve European countries was analyzed, eleven of which are part of the European Union (France, Germany, Italy, Spain, Greece, Netherlands, Belgium, Denmark, Lithuania, Czech Republic and Portugal) and three non-members of the same (United Kingdom, Ukraine and Russia), as well as that of twelve non-European countries considered exemplary (United States, Canada, Australia, India, China, Thailand, Israel, Nigeria and South Africa); in particular, legislative sources and legal databases were drawn upon, in order to draw a comparison with the Italian legislation currently in force and map out the evolution of the Italian case law on the basis of the judgments issued by Italian courts, including the Constitutional and Supreme Courts and the European Court of Human Rights (ECHR); search engines such as PubMed and Google Scholar were also used, by entering the keywords "surrogacy" and "surrogate motherhood", to find scientific articles concerning assisted reproduction techniques with a close focus on surrogacy. Results: SM is a prohibited and sanctioned practice in Italy; on the other hand, it is allowed in other countries of the world, which leads Italian couples, or couples from other countries where it is banned, to often contact foreign centers in order to undertake a MAP pathway which includes surrogacy; in addition, challenges may arise from the legal status of children born through surrogacy abroad: to date, in most countries, there is no specific legislation aimed at regulating their legal registration and parental status. Conclusion: With reference to the Italian context, despite the scientific and legal evolution on the subject, a legislative intervention aimed at filling the regulatory gaps in terms of heterologous MAP and surrogacy has not yet come to fruition. Considering the possibility of "fertility tourism", i.e., traveling to countries where the practice is legal, as indeed already happens in a relatively significant number of cases, the current legislation, although integrated by the legal interpretation, does not appear to be effective in avoiding the phenomenon of procreative tourism. Moreover, to overcome some contradictions currently present between law 40 and law 194, it would be appropriate to outline an organic and exhaustive framework of rules, which should take into account the multiplicity of interests at stake, in keeping with a fair and sustainable balance when regulating such practices.
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Affiliation(s)
- Valeria Piersanti
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, 00198 Rome, Italy; (V.P.); (F.C.); (S.Z.)
| | - Francesca Consalvo
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, 00198 Rome, Italy; (V.P.); (F.C.); (S.Z.)
| | - Fabrizio Signore
- Obstetrics and Gynecology Department, Sant’Eugenio Hospital, 00144 Rome, Italy;
| | - Alessandro Del Rio
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, 00198 Rome, Italy; (V.P.); (F.C.); (S.Z.)
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, 00198 Rome, Italy; (V.P.); (F.C.); (S.Z.)
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11
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12
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Abstract
The field of assisted reproduction is advancing rapidly and is ripe for regulation and guidance. In 2018, over four thousand frozen eggs and embryos were lost to approximately one thousand patients at Ahuja University Hospital in Cleveland, Ohio, due to an accidental thaw of a cryopreservation tank. The precedent that will be set by the Ahuja class-action case is significant for both past events and future possibilities and is core to the discussion of policy involving the cryopreservation of gametes and embryos.
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13
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Abstract
The melding of human genetics with clinical assisted reproduction, now all but self-evident, gave flight to diagnostic and therapeutic approaches previously deemed infeasible. Preimplantation genetic diagnosis, mitochondrial replacement techniques, and remedial germline editing are particularly noteworthy. Here we explore the relevant disruption brought forth by coalescence of these mutually enabling disciplines with the regulatory and legal implications thereof.
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Affiliation(s)
- Eli Y. Adashi
- Warren Alpert Medical School, Brown University, Providence, RI 02906, USA
- Corresponding author
| | - I. Glenn Cohen
- Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Harvard University, Cambridge, MA, USA
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Ott MA, Bernard C, Wilkinson TA, Edmonds BT. Clinician Perspectives on Ethics and COVID-19: Minding the Gap in Sexual and Reproductive Health. Perspect Sex Reprod Health 2020; 52:145-149. [PMID: 32945616 PMCID: PMC7537032 DOI: 10.1363/psrh.12156] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/30/2020] [Accepted: 06/10/2020] [Indexed: 05/07/2023]
Affiliation(s)
- Mary A. Ott
- Indiana University School of MedicineIndianapolis
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15
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Selter JH, Spurlin EE, Brady PC. Gender inequality in leadership and academic rank in academic reproductive endocrinology programs. J Assist Reprod Genet 2020; 37:1959-1962. [PMID: 32564240 DOI: 10.1007/s10815-020-01866-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To identify gender differences in leadership and academic rank within academic reproductive endocrinology (REI) programs with fellowships in the USA. METHODS Official institutional websites of the 2017-2018 American Board of Obstetrics and Gynecology (ABOG)-accredited reproductive endocrinology fellowship programs were reviewed, and gender representation at each leadership position and academic rank (Division and Fellowship Director and Full, Associate, and Assistant Professor) was recorded. Univariate comparisons were performed using Chi-square tests, with significance at p < 0.05. RESULTS Among 49 ABOG-accredited reproductive endocrinology programs, 263 faculty were identified, 129 (49.0%) male and 134 (51.0%) female. Division directors were 69.3% male and 30.7% female (p = 0.006). Similarly, fellowship directors were 65.3% male and 34.6% female (p = 0.03). Full professors (n = 101) were more frequently male (70.3% vs. 29.7%, p < 0.001). There was no difference in gender among associate professors (n = 60, 51.7% male vs. 48.3% female, p = 0.79), while significantly more assistant professors were female than male (n = 102, 73.6% vs. 26.4%, p < 0.001). CONCLUSION While a majority of residents in obstetrics and gynecology and half of reproductive endocrinology academic faculty are female, women are still underrepresented among leadership positions and full professors in academic reproductive endocrinology programs with fellowship programs.
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Affiliation(s)
- Jessica H Selter
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA.
| | - Emily E Spurlin
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Paula C Brady
- Department of Obstetrics and Gynecology, Columbia University Fertility Center, Columbia University Irving Medical Center, 5 Columbus Circle, Penthouse, New York, NY, 10019, USA
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16
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Abstract
The use of reproductive techniques and the eventual reproductive negligence from the provider of reproductive services gave rise to situations in which the intended parents are deprived of raising a child genetically connected to them. Courts have been dealing with cases of those for years, but have systemically denied claimants (the prospective parents) compensation, failing to recognise as damage the loss of genetic connection. In 2017, for the first time, the Singapore High Court provided compensation for that damage, labelled "loss of genetic affinity" (ACB v Thomson Medical Pte Ltd and Others [2017] SGCA 20). This paper will argue that the damage in question is the loss of genetic connection (wrongful genetic connection) and results from a violation of reproductive rights (and eventually also the right to found a family) because a key element of reproductive rights is to have children with whom we keep a genetic bond and raise them. The paper will explain why the arguments classically argued against such compensation are unfounded and it will argue for a compensation covering both patrimonial and non-patrimonial damages.
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Affiliation(s)
- Vera Lúcia Raposo
- Faculty of Law, University of Macau, Room 2043, E32, Avenida da Universidade, Taipa, Macao, China.
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17
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Gilbar R, Ram-Tiktin E. It Takes a Village to Raise a Child: Solidarity in the Courts-Judicial Justification for Posthumous Use of Sperm by Bereaved Parents. Med Law Rev 2020; 28:317-341. [PMID: 31638702 DOI: 10.1093/medlaw/fwz033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The practice of posthumous use of sperm raises social, ethical, and legal questions. We examine the issue of who should be allowed to use the sperm-only the deceased's spouse or the deceased's parents as well-from the perspective of solidarity and relational autonomy. Following a theoretical discussion of various accounts of solidarity and relational autonomy, the legal status of posthumous assisted reproduction is examined in three jurisdictions-the USA, Australia, and Israel-in which most applications to the courts were submitted by the deceased's parents. In Israel, we found fifteen court rulings on requests for posthumous use of sperm and fourteen in Australia. A smaller number were found in the case of the USA. The analysis reveals that Israeli and Australian courts employ solidarity-based arguments to justify their decisions to allow posthumous use of sperm, particularly when the deceased's true wishes are unknown. We thus conclude that the posthumous use of sperm can be legally extended to include the deceased's parents based on solidarity and relational autonomy arguments.
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Affiliation(s)
- Roy Gilbar
- School of Law, Netanya Academic College, Netanya 4223587, Israel
| | - Efrat Ram-Tiktin
- Department of Philosophy, Bar-Ilan University, Ramat Gan 5290002, Israel
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18
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Abstract
It is frequently claimed that artificial wombs (AWs) could alleviate the burdens placed exclusively on women in reproduction. In this article, I demonstrate how AWs used for the partial gestation of preterm neonates could introduce new choices for women by changing perceptions of tolerable risks in gestation. In light of advancing medical technology, it is necessary to consider whether the current legal framework in England and Wales would support increased choice for women about alternative forms of gestation. I examine the ill-defined offence of 'unlawfully procuring miscarriage' in the Offences Against the Person Act 1861 and demonstrate that different conclusions about the legal significance of ending a pregnancy are evident, depending on the analytical lens adopted in interpreting ambiguities. Furthermore, I demonstrate that the defences available to pregnancy termination under the Abortion Act 1967 are too narrow to support choices about alternative forms of gestation, even if they become physically and medically possible. Therefore, we should decriminalise termination of pregnancy, or, if it is assumed that gestation is the business of the criminal law, specific reforms to the legal framework are necessary. The offence of unlawfully procuring miscarriage is too uncertain and broad, and the defences available are too restrictive.
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Affiliation(s)
- Elizabeth Chloe Romanis
- Department of Law, Centre for Social Ethics and Policy, School of Social Sciences, University of Manchester, Manchester, UK
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Kimberly LL, Sutter ME, Quinn GP. Equitable access to ectogenesis for sexual and gender minorities. Bioethics 2020; 34:338-345. [PMID: 32050295 DOI: 10.1111/bioe.12723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/16/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual- or gender-minority groups who likewise seek to pursue parenthood. We examine the history of access to current family-building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual- or gender-minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice.
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Affiliation(s)
- Laura L Kimberly
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York
- Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, New York
| | - Megan E Sutter
- Department of Population Health, New York University School of Medicine, New York, New York
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York
| | - Gwendolyn P Quinn
- Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, New York
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York
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20
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Abstract
Biomedicine has opened up new possibilities for parenthood. Once resigned to remaining childless or pursuing adoption, infertile couples can now pursue options such as gamete donation, in-vitro fertilization, and uterine transplantation, as well as surrogacy. Muslim thinkers have viewed these strategies with both promise and caution given new types of kinship and parenthood result. By drawing upon leading medical fiqh academy resolutions this paper critically analyses Islamic normative views on the production of parenthood. We start with an overview of the Sunni rulings on gamete donation, gestational surrogacy and uterus transplantation, and the rationale and scriptural sources that undergird these moral assessments. Next, we discuss the contested relational bonds in light of larger discussions on genetics and the preservation of lineage. Finally, we comment on how scientific data, social imaginaries, and empirical gaps impact Islamic normativity regarding the production of parenthood so as to inform more holistic Islamic bioethical assessments.
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Affiliation(s)
- Aasim I Padela
- Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA
| | - Katherine Klima
- Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA
| | - Rosie Duivenbode
- Initiative on Islam and Medicine, The University of Chicago, Chicago, IL, USA
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21
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Ranisch R. Germline genome editing versus preimplantation genetic diagnosis: Is there a case in favour of germline interventions? Bioethics 2020; 34:60-69. [PMID: 31448423 PMCID: PMC6973094 DOI: 10.1111/bioe.12635] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 06/05/2023]
Abstract
CRISPR is widely considered to be a disruptive technology. However, when it comes to the most controversial topic, germline genome editing (GGE), there is no consensus on whether this technology has any substantial advantages over existing procedures such as embryo selection after in vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD). Answering this question, however, is crucial for evaluating whether the pursuit of further research and development on GGE is justified. This paper explores the question from both a clinical and a moral viewpoint, namely whether GGE has any advantages over existing technologies of selective reproduction and whether GGE could complement or even replace them. In a first step, I review an argument of extended applicability. The paper confirms that there are some scenarios in which only germline intervention allows couples to have (biologically related) healthy offspring, because selection will not avoid disease. In a second step, I examine possible moral arguments in favour of genetic modification, namely that GGE could save some embryos and that GGE would provide certain benefits for a future person that PGD does not. Both arguments for GGE have limitations. With regard to the extended applicability of GGE, however, a weak case in favour of GGE should still be made.
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Affiliation(s)
- Robert Ranisch
- Institute of Ethics and History of Medicine, University of TübingenGermany
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22
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Abstract
The ability to make direct genetic changes to the DNA of future children poses profound challenges for governance. Over the last several years, efforts to establish frameworks of ethical deliberation and governance for human genome editing have focused largely on technical criteria for proceeding with research and rules and mechanisms for regulating it. Less attention has been given to the question of who decides, and on the basis of what authority. The power to decide is exercised not only in giving answers to ethical questions or suppling policy advice, but in designating what questions should (and should not) be asked in the first place. The ways problems are framed and terms of collective debate are set is a crucial element of governance. This essay examines how certain framings that have dominated in influential arenas of deliberation about human germline genome editing underwrite (false) imperatives of governance. These imperatives have shaped not only ethical deliberation and governance agendas, but the trajectory of science itself. The essay focuses in particular upon the case of He Jiankui, arguing that his project is not an aberration, but, rather, an expression of ideas about science, ethics, and progress that are widely shared within the scientific community.
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Nordberg A, Minssen T, Feeney O, de Miguel Beriain I, Galvagni L, Wartiovaara K. Regulating germline editing in assisted reproductive technology: An EU cross-disciplinary perspective. Bioethics 2020; 34:16-32. [PMID: 31877579 DOI: 10.1111/bioe.12705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 11/01/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
| | - Timo Minssen
- Centre for Advanced Studies in Biomedical Innovation Law (CeBIL), University of Copenhagen, Copenhagen, Denmark
| | - Oliver Feeney
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
- UNESCO Bioethics Ireland, Centre of Bioethical Research and Analysis, National University of Ireland (Galway), Galway, Ireland
| | - Iñigo de Miguel Beriain
- University of the Basque Country, Spain
- Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Lucia Galvagni
- Center for Religious Studies, Bruno Kessler Foundation, Trento, Italy
| | - Kirmo Wartiovaara
- University Hospital of Helsinki, University of Helsinki, Helsinki, Finland
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24
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Abstract
In the current agon between those promoting and opposing the development of human reproductive applications of genome editing techniques, the bone of contention is often whether the prospective reproductive technologies answer an "unmet medical need." Proponents often point to highly unusual cases of inherited genetic conditions as exhibiting that need. This essay argues that we ought to admit that the opponents are correct: human reproductive genome editing cannot be justified on medical grounds. Taking a deliberately provocative line, the essay suggests how inscribing such practices within a conventional model of biomedical research fails to take proper account of the interrelated interests in play, including those of the wider society and its future members. It also obscures important questions about how the public significance and value of human genome editing are produced through the dynamic encounter between science, technology, and social morality. This has certain discomfiting implications that will require both courage and humility to confront and-finally, perhaps-to embrace.
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25
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Abstract
This article considers the existential and eugenic risks of gene editing with CRISPR-Cas9. It brings forward epistemological and phenomenological questions concerning what CRISPR technology suggests about the limits of being human. By illuminating the paradoxical relationship between our "then self" and "now self," it considers the fragility of our individual and collective future-making endeavors. To do this, the article offers an overview of the existential dilemmas facing modern subjects, a history of eugenics and the ideology of health, a meditation on the limits of human knowledge, and an explication of the cultural work of metaphor. It argues for the benefits of human variation for individuals and communities and concludes by calling for an attitude of humility and restraint to guide the development and implementation of humane technologies rather than genetic manipulation technologies that aim to control future outcomes through present actions.
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26
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Notini L, Gyngell C, Savulescu J. Drawing the line on in vitro gametogenesis. Bioethics 2020; 34:123-134. [PMID: 31617217 PMCID: PMC6973109 DOI: 10.1111/bioe.12679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 06/24/2019] [Accepted: 08/12/2019] [Indexed: 05/06/2023]
Abstract
In vitro gametogenesis (IVG) might offer numerous research and clinical benefits. Some potential clinical applications of IVG, such as allowing opposite-sex couples experiencing infertility to have genetically related children, have attracted support. Others, such as enabling same-sex reproduction and solo reproduction, have attracted significantly more criticism. In this paper, we examine how different ethical principles might help us to draw lines and distinguish between ethically desirable and undesirable uses of IVG. We discuss the alleged distinction between therapeutic and non-therapeutic uses of assisted reproduction in the context of IVG, and show how it is both problematic to apply in practice and theoretically dubious. We then discuss how the ethical principles of reproductive justice and beneficence apply to IVG for opposite-sex reproduction, same-sex reproduction, and solo reproduction. We suggest that these principles generate strong reasons for the use of IVG for opposite-sex and same-sex reproduction, but not for solo reproduction.
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Affiliation(s)
- Lauren Notini
- Melbourne Law SchoolUniversity of MelbourneCarltonVictoriaAustralia
- Biomedical Ethics Research GroupMurdoch Children’s Research InstituteParkvilleVictoriaAustralia
| | - Christopher Gyngell
- Biomedical Ethics Research GroupMurdoch Children’s Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneCarltonVictoriaAustralia
| | - Julian Savulescu
- Biomedical Ethics Research GroupMurdoch Children’s Research InstituteParkvilleVictoriaAustralia
- The Oxford Uehiro Centre for Practical EthicsUniversity of OxfordOxfordUnited Kingdom of Great Britain and Northern Ireland
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27
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Abstract
Providers specializing in reproductive medicine are treating increasing numbers of women pursuing parenthood in their 40s, 50s, and beyond. The rise in later-life parenting can be linked to factors ranging from the advent of assisted reproductive technologies and donor oocytes to the highly publicized pregnancies of older celebrities. We explore the medical and psychosocial implications of this trend for both older parents and their children. We also discuss ethical arguments regarding older parents' access to fertility care, existing professional guidelines, and both public and provider opinions about setting age limits for fertility treatment. Finally, we share preliminary considerations of whether age policies should be established, applied to men as well as women, and standardized or considered on a case-by-case basis.
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Affiliation(s)
- Julianne E Zweifel
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 2365 Deming Way, Middleton, WI, 53562, USA.
| | - Julia T Woodward
- Department of Psychiatry & Behavioral Sciences, Department of Obstetrics & Gynecology, Duke University Health System, Durham, USA
| | - Robert W Rebar
- Department of Obstetrics and Gynecology, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI, USA
| | - Mark V Sauer
- Department of Obstetrics, Gynecology & Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
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Wilkinson J, Malpas P, Hammarberg K, Mahoney Tsigdinos P, Lensen S, Jackson E, Harper J, Mol BW. Do à la carte menus serve infertility patients? The ethics and regulation of in vitro fertility add-ons. Fertil Steril 2019; 112:973-977. [PMID: 31703942 DOI: 10.1016/j.fertnstert.2019.09.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 01/08/2023]
Abstract
Add-on treatments are the new black. They are provided (most frequently, sold) to patients undergoing in vitro fertilization on the premise that they will improve the chances of having a baby. However, the regulation of add-ons is consistently minimal, meaning that they are introduced into routine practice before they have been shown to improve the live birth rate. Debate on the adequacy of this light-touch approach rages. Defenders argue that demands for a rigorous approval process are paternalistic, as this would delay access to promising treatments. Critics respond that promising treatments may turn out to have adverse effects on patients and their offspring, contradicting the clinician's responsibility to do no harm. Some add-ons, including earlier versions of preimplantation genetic testing for aneuploidy, might even reduce the live birth rate, raising the prospect of desperate patients paying more to worsen their chances. Informed consent represents a solution in principle, but in practice there is a clear tension between impartial information and direct-to-consumer advertising. Because the effects of a treatment cannot be known until it has been robustly evaluated, we argue that strong evidence should be required before add-ons are introduced to the clinic. In the meantime, there is an imperative to identify methods for communicating the associated risks and uncertainties of add-ons to prospective patients.
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Affiliation(s)
- Jack Wilkinson
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
| | - Phillipa Malpas
- Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | | | - Sarah Lensen
- Cochrane Gynecology and Fertility Group, University of Auckland, Auckland, New Zealand
| | - Emily Jackson
- Law Department, London School of Economics and Political Science, London, United Kingdom
| | - Joyce Harper
- Department of Reproductive Health, Institute for Women's Health, University College London, London, United Kingdom
| | - Ben W Mol
- Evidence-based Women's Health Care Research Group, Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
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29
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Abstract
The ethical issues associated with germline gene modification and embryo research are some of the most contentious in current international science policy debates. In this paper, we argue that new genetic techniques, such as CRISPR, demonstrate that there is an urgent need for China to develop its own regulatory and ethical framework governing new developments in genetic and embryo research. While China has in place a regulatory framework, it needs to be strengthened to include better compliance oversight and explicit criteria for how different types of research should be reviewed by regulatory authorities. We also document a variety of opinions about the new technologies among the public, scholars, and policy makers. China needs to develop its own regulations in coordination with other countries; but it is unlikely that an international consensus will be achieved in this area, given the existing differences in regulations between countries. We should aim at harmonization, not necessarily complete consensus, and the perspective from China is vital when international norms are developed and harmonized. Chinese policy makers and researchers need to be aware of the international discussions, at the same time as the international community is aware of, and accommodates, Chinese positions on important policy options.
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Affiliation(s)
- Di Zhang
- Department of Social Sciences and Humanities/Center for Bioethics, Chinese Academy of Medical Sciences & Peking Union Medical College, Dong Dan San Tiao #5, Dongcheng District, Beijing, 100730, China
| | - Reidar K Lie
- Department of Philosophy, University of Bergen, Sydnesplassen 12-13, 5020, Bergen, Norway.
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30
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Liu JJ, Sheng LB, Liu XH, Tao GZ, Fan YY, Lei LJ, Liu S, Yang HJ. [Assisted reproductive technology for male patients with end-stage renal disease: A case-based discussion on strategies and ethical issues]. Zhonghua Nan Ke Xue 2019; 25:1011-1014. [PMID: 32233236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore normalized and reasonable strategies of assisted reproductive technology (ART) for patients with end-stage renal disease (ESRD) under ethical supervision based on the experience with a case of ART for an ESRD male. METHODS A male patient with ESRD successfully fathered a child through in vitro intracytoplasmic sperm injection (ICSI) in our center. We performed an epidemiological analysis, reviewed the relevant literature and explored the feasibility, ethical issues and strategies of ART for male patients with ESRD. RESULTS ESRD affected the reproductive hormone levels, sperm quality and erectile function of the patient. Considering the contradictions between the reproductive right and the uncertainty of disease prognosis of the patient and the health of the offspring and his wife, we comprehensively evaluated the physical and mental conditions of the patient, obtained the informed consent, submitted the case to the Ethics Committee of Reproductive Medicine. CONCLUSIONS With respect to ART for ESRD patients, importance should be attached to their rights of reproduction and choice of reproductive technology. In the process of ART, the physical conditions of the patient ought to be evaluated comprehensively and rigorously, and the related ethical principles followed strictly.
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Affiliation(s)
- Jiao-Jing Liu
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
| | - Lian-Bing Sheng
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
| | - Xiao-Hui Liu
- Department of Urology, Huantai People's Hospital, Zibo, Shandong 256400, China
| | - Guo-Zhen Tao
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
| | - Yuan-Yuan Fan
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
| | - Li-Jun Lei
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
| | - Song Liu
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
| | - Hui-Jun Yang
- Center of Reproductive Medicine / Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China / Key Laboratory of Eugenic Technology of Shandong Province, Maternity and Child Healthcare Hospital of Shandong Province, Jinan, Shandong 250021, China
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31
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Keromnès G. [MAR: current and future practices with the review of the law on bioethics]. Soins Pediatr Pueric 2019; 40:12-17. [PMID: 31757269 DOI: 10.1016/j.spp.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Medically assisted reproduction techniques are aimed at heterosexual couples, when both members are living, of reproductive age, consenting to acts of insemination or the transfer of embryos and presenting medically diagnosed infertility. The review of the law on bioethics could offer new perspectives for reproduction notably by allowing access to medically assisted reproduction (MAR) to all women, elective egg freezing, the lifting of gamete donor anonymity and the authorisation of post-mortem MAR.
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Affiliation(s)
- Gwénola Keromnès
- Centre de fertilité, Groupe hospitalier Diaconesses Croix-Saint-Simon, 18 rue du sergent Bauchat, 75012 Paris, France.
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32
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Nau JY. [Not Available]. Rev Med Suisse 2019; 15:1728-1729. [PMID: 31553542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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33
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Segers S, Pennings G, Mertes H. Getting what you desire: the normative significance of genetic relatedness in parent-child relationships. Med Health Care Philos 2019; 22:487-495. [PMID: 30758798 DOI: 10.1007/s11019-019-09889-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according to which the satisfaction of this desire is regarded as a way to meet one's presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people's lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns.
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Affiliation(s)
- Seppe Segers
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium.
| | - Guido Pennings
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
| | - Heidi Mertes
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
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34
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Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M. Maqasid al-Shariah Based Islamic Bioethics: A Comprehensive Approach. J Bioeth Inq 2019; 16:333-345. [PMID: 30715660 DOI: 10.1007/s11673-019-09902-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
Maqasid al-Shariah based Islamic bioethics is an Islamic bioethics concept which uses the objectives of the Shariah (maqasid al-Shariah) as its approach in analysing and assessing bioethical issues. Analysis based on maqasid al-Shariah based Islamic bioethics will examine any bioethical issues from three main aspects namely intention, method, and output or final goal of the studied issues. Then, the evaluation will be analysed from human interest hierarchy, inclusivity, and degree of certainty. The Islamic bioethics concept is a manifestation of dynamic Islamic jurisprudence which can overcome new complex and complicated bioethical issues such as tri-parent baby technology issues. Therefore, this article will introduce and explain the concept of maqasid al-Shariah based Islamic bioethics and outline a general guidance of maqasid al-Shariah based Islamic bioethics to determine a maqṣad (objective) based on standards of human good or well-being (maslahah) and harm (mafsadah).
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Affiliation(s)
- Abdul Halim Ibrahim
- Programme of Applied Science with Islamic Studies, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Noor Naemah Abdul Rahman
- Department of Fiqh and Usul, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shaikh Mohd Saifuddeen
- Centre for Science and Environment Studies, Institute of Islamic Understanding Malaysia, 2 Langgak Tunku Off Jalan Tuanku Abdul Halim, 50480, Kuala Lumpur, Malaysia
| | - Madiha Baharuddin
- Programme of Applied Science with Islamic Studies, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia
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35
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Shaw MK. Doctors as moral pioneers: Negotiated boundaries of assisted conception in Colombia. Sociol Health Illn 2019; 41:1323-1337. [PMID: 31328286 PMCID: PMC6851546 DOI: 10.1111/1467-9566.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
New biotechnologies such as assisted conception are socially embedded artefacts that raise context-specific ethical, moral and social anxieties. In contexts where the regulations of these profitable developments are limited or ambiguous, and competition between private facilities is high, individual doctors become morally and socially responsible for determining the parameters of administering such therapies. Ethnographic research at two private fertility centres in Colombia reveals that doctors do not determine boundaries based on monetary gain but rather personal morals, social norms and professional obligations. Medical professionals hold diverse perceptions of assisted conception, and often struggle to make decisions regarding who should access such therapies, who are ideal gamete donors and the fate of extra embryos. The complexity of these perceptions applied in a context of limited regulation and the competition of private medicine impacts the praxis of assisted conception. As doctors determine the boundaries of their practice they not only create variation between clinical practices, but also make moral decisions regarding who should be parents, how families should be formed and the significance of embryos. Thus, in navigating their everyday practices, doctors also shape the social world.
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Affiliation(s)
- Malissa Kay Shaw
- The Graduate Institute of Humanities in MedicineTaipei Medical UniversityTaipeiTaiwan
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36
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Gyngell C, Bowman-Smart H, Savulescu J. Moral reasons to edit the human genome: picking up from the Nuffield report. J Med Ethics 2019; 45:514-523. [PMID: 30679191 PMCID: PMC6820147 DOI: 10.1136/medethics-2018-105084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 05/12/2023]
Abstract
In July 2018, the Nuffield Council of Bioethics released its long-awaited report on heritable genome editing (HGE). The Nuffield report was notable for finding that HGE could be morally permissible, even in cases of human enhancement. In this paper, we summarise the findings of the Nuffield Council report, critically examine the guiding principles they endorse and suggest ways in which the guiding principles could be strengthened. While we support the approach taken by the Nuffield Council, we argue that detailed consideration of the moral implications of genome editing yields much stronger conclusions than they draw. Rather than being merely 'morally permissible', many instances of genome editing will be moral imperatives.
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Affiliation(s)
- Christopher Gyngell
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | | | - Julian Savulescu
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Faculty of Philosophy, Oxford Uehiro Centre for Practical Ethics, Oxford, UK
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37
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Abstract
Australian medical professionals whose patients undertake assisted reproductive treatment abroad face a conflict: to try to provide optimal and on-going care for their patient at the same time as ensuring compliance with Australian legal, ethical, and professional rules which proscribe as unsafe or unethical key aspects of such treatment. A major suggestion from literature on medical travel is that risks to the patient can be mitigated through the involvement of the local professional. However, the force of legal regulation and ethical guidance in Australia strenuously directs clinicians away from involvement in overseas reproductive treatment. This article reports on 37 interviews with Australians travelling abroad for surrogacy, egg donation, and embryo donation, reflecting on patients' experiences with Australian medical professionals both before and after they travelled. Patient reports demonstrate a fragmented and bewildering medical landscape in Australia, in which the ability to access domestic care and expertise varied markedly depending upon the kind of treatment patients were seeking abroad, and the mode of practice of the Australian doctor. Doctors practicing within licensed IVF clinics were notably more constrained than those outside such a setting. Patients seeking egg donation were offered information and received a wide range of diagnostic and preparatory treatments, while those seeking surrogacy were shunned, chided and offered limited (and sometimes covert) assistance. While recent changes to national ethical guidance improve clarity on information giving, the ethical and legal propriety of Australian medical professionals providing diagnostic or preparatory treatment for cross border reproduction remains uncertain.
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38
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Kleiderman E, Ravitsky V, Knoppers BM. The 'serious' factor in germline modification. J Med Ethics 2019; 45:508-513. [PMID: 31326898 PMCID: PMC6820154 DOI: 10.1136/medethics-2019-105436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/12/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
Current advances in assisted reproductive technologies aim to promote the health and well-being of future children. They offer the possibility to select embryos with the greatest potential of being born healthy (eg, preimplantation genetic testing) and may someday correct faulty genes responsible for heritable diseases in the embryo (eg, human germline genome modification (HGGM)). Most laws and policy statements surrounding HGGM refer to the notion of 'serious' as a core criterion in determining what genetic diseases should be targeted by these technologies. Yet, this notion remains vague and poorly defined, rendering its application challenging and decision making subjective and arbitrary. By way of background, we begin by briefly presenting two conceptual approaches to 'health' and 'disease': objectivism (ie, based on biological facts) and constructivism (ie, based on human values). The basic challenge under both is sorting out whether and to what extent social and environmental factors have a role in helping to define what qualifies as a 'serious' disease beyond the medical criteria. We then focus on how a human rights framework (eg, right to science and right to the highest attainable health) could integrate the concepts of objectivism and constructivism so as to provide guidance for a more actionable consideration of 'serious'. Ultimately, it could be argued that a human rights framework, by way of its legally binding nature and its globally accepted norms and values, provides a more universal foundation for discussions of the ethical, legal and social implications of emerging or disruptive technologies.
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Affiliation(s)
- Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Vardit Ravitsky
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
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Lewis MS. The American Democratic Deficit in Assisted Reproductive Technology Innovation. Am J Law Med 2019; 45:130-170. [PMID: 31722626 DOI: 10.1177/0098858819860610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In many areas of innovation, the United States is a leader, but this characterization does not apply to the United States' position in assisted reproductive technology innovation and clinical use. This article uses a political science concept, the idea of the "democratic deficit" to examine the lack of American public discourse on innovations in ART. In doing so, the article focuses on America's missing public consultation in health care innovation. This missing discourse is significant, as political and ethical considerations may impact regulatory decisions. Thus, to the extent that these considerations are influencing the decisions of federal agency employees, namely those who work within the U.S. Food and Drug Administration, the public is unable to participate in the decision-making process. This lack of a public discourse undermines the goals of the administrative state, which include democratic participation, transparency, and accountability. The United Kingdom, on the other hand, has had a markedly divergent experience with assisted reproductive technology innovation. Instead of ignoring the various ethical, social, and legal issues surrounding assisted reproductive technology innovation, the United Kingdom engaged in a five-strand public consultation on the topic of mitochondrial transfer, a form of assisted reproductive technology that uses genetic modification in order to prevent disease transmission. This article argues that after a multi-decade standstill in terms of the public discourse related to ethical issues associated with assisted reproductive technology and germline modification, it is time for the United States to institute a more democratic inquiry into the scientific, ethical, and social implications of new forms of assisted reproductive technology and ultimately, forthcoming medical innovations that involve genetic modification.
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Affiliation(s)
- Myrisha S Lewis
- Assistant Professor, William & Mary Law School; J.D., Columbia Law School; A.B., Harvard College
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Zemyarska MS. Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it? J Med Ethics 2019; 45:346-350. [PMID: 30745435 DOI: 10.1136/medethics-2018-104983] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/25/2018] [Accepted: 01/10/2019] [Indexed: 06/09/2023]
Abstract
In vitro fertilisation (IVF) 'add-ons' are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical-namely, morally good and righteous, the question was considered in relation to three key values of medical ethics-autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.
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Taneja A, Das S, Hussain SA, Madadin M, Lobo SW, Fatima H, Menezes RG. Uterine Transplant: A Risk to Life or a Chance for Life? Sci Eng Ethics 2019; 25:635-642. [PMID: 29423621 DOI: 10.1007/s11948-018-0018-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 01/09/2018] [Indexed: 06/08/2023]
Abstract
Being inherently different from any other lifesaving organ transplant, uterine transplantation does not aim at saving lives but supporting the possibility to generate life. Unlike the kidneys or the liver, the uterus is not specifically a vital organ. Given the non-lifesaving nature of this procedure, questions have been raised about its feasibility. The ethical dilemma revolves around whether it is worth placing two lives at risk related to surgery and immunosuppression, amongst others, to enable a woman with absolute uterine factor infertility to experience the presence of an organ enabling childbirth. In the year 2000, the first uterine transplantation, albeit unsuccessful, was performed in Saudi Arabia from where it has spread to the rest of the world including Sweden, the United States and now recently India. The procedure is, however, still in the preclinical stages and several ethical, legal, social and religious concerns are yet to be addressed before it can be integrated into the clinical setting as standard of care for women with absolute uterine factor infertility.
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Affiliation(s)
| | - Siddhartha Das
- Department of Forensic Medicine and Toxicology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Syed Ather Hussain
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohammed Madadin
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Huda Fatima
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Ritesh G Menezes
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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Kudina O. Accounting for the Moral Significance of Technology: Revisiting the Case of Non-Medical Sex Selection. J Bioeth Inq 2019; 16:75-85. [PMID: 30591987 PMCID: PMC6474848 DOI: 10.1007/s11673-018-9891-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 12/11/2018] [Indexed: 05/21/2023]
Abstract
This article explores the moral significance of technology, reviewing a microfluidic chip for sperm sorting and its use for non-medical sex selection. I explore how a specific material setting of this new iteration of pre-pregnancy sex selection technology-with a promised low cost, non-invasive nature and possibility to use at home-fosters new and exacerbates existing ethical concerns. I compare this new technology with the existing sex selection methods of sperm sorting and Prenatal Genetic Diagnosis. Current ethical and political debates on emerging technologies predominantly focus on the quantifiable risk-and-benefit logic that invites an unequivocal "either-or" decision on their future and misses the contextual ethical impact of technology. The article aims to deepen the discussion on sex selection and supplement it with the analysis of the new technology's ethical potential to alter human practices, perceptions and the evaluative concepts with which we approach it. I suggest that the technological mediation approach (Verbeek, 2005, 2011) can be useful to ethically contextualize technologies and highlight the value of such considerations for the informed deliberation regarding their use, design and governance.
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Affiliation(s)
- Olya Kudina
- Philosophy Department, University of Twente, Cubicus C315, Drienerlolaan 5, 7500AE, Enschede, The Netherlands.
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Smajdor A. An alternative to sexual reproduction: artificial gametes and their implications for society. Br Med Bull 2019; 129:5-11. [PMID: 30753441 DOI: 10.1093/bmb/ldz001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 01/02/2019] [Accepted: 01/22/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Artificial gametes (AGs) are cells that have been 'reprogrammed' to function as sperm or eggs. Such cells may in the future enable people who cannot produce gametes, to have genetically-related offspring. In this paper, I consider the prospect of AGs in the context of declining birthrates and postponed parenthood across the Western world. SOURCES OF DATA The data quoted in this paper is gathered from a range of sources, encompassing both scientific, demographic and philosophical work. AREAS OF AGREEMENT Fertility decline in Western democracies is a widely recognised phenomenon, and postponement of parenthood is regarded as a significant contributing factor in this phenomenon. AREAS OF CONTROVERSY It is not clear at what point, if ever, AGs might come into clinical use. There is dispute as to what is the best approach to declining fertility rates in developed countries. GROWING POINTS Technologically-assisted reproduction is becoming a more common phenomenon as fertility rates fall and maternal age increases. AGs could offer new ways in which to prolong fertility. AREAS TIMELY FOR DEVELOPING RESEARCH More research into the development of AGs is required. There is a need for close analysis of the possible causes of declining fertility and the ways in which societies might respond to these challenges.
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Affiliation(s)
- Anna Smajdor
- Department of Philosophy, Classics, History of Art and Ideas, Faculty of Humanities, University of Oslo, Norway
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Maung HH. Ethical problems with ethnic matching in gamete donation. J Med Ethics 2019; 45:112-116. [PMID: 30530762 PMCID: PMC6388904 DOI: 10.1136/medethics-2018-104894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/28/2018] [Accepted: 10/27/2018] [Indexed: 05/31/2023]
Abstract
Assisted reproduction using donor gametes is a procedure that allows those who are unable to produce their own gametes to achieve gestational parenthood. Where conception is achieved using donor sperm, the child lacks a genetic link to the intended father. Where it is achieved using a donor egg, the child lacks a genetic link to the intended mother. To address this lack of genetic kinship, some fertility clinics engage in the practice of matching the ethnicity of the gamete donor to that of the recipient parent. The intended result is for the child to have the phenotypic characteristics of the recipient parents. This paper examines the philosophical and ethical problems raised by the policy of ethnic matching in gamete donation. I consider arguments for the provision of ethnic matching based on maximising physical resemblance and fostering ethnic identity development. I then consider an argument against ethnic matching based on the charge of racialism. I conclude that while the practice of ethnic matching in gamete donation could promote positive ethnic identity development in donor-conceived children from historically subjugated ethnic minorities, it also risks endorsing the problematic societal attitudes and assumptions regarding ethnicity that enabled such subjugation in the first place.
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Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M. Tri-parent Baby Technology and Preservation of Lineage: An Analysis from the Perspective of Maqasid al-Shari'ah Based Islamic Bioethics. Sci Eng Ethics 2019; 25:129-142. [PMID: 29071572 DOI: 10.1007/s11948-017-9980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
Tri-parent baby technology is an assisted reproductive treatment which aims to minimize or eliminate maternal inheritance of mutated mitochondrial DNA (mtDNA). The technology became popular following the move by the United Kingdom in granting license to a group of researchers from the Newcastle Fertility Centre, Newcastle University to conduct research on the symptoms of defective mtDNA. This technology differs from other assisted reproductive technology because it involves the use of gamete components retrieved from three different individuals. Indirectly, it affects the preservation of lineage which is important from an Islamic point of view. This paper aims to analyze and discuss the implications of the tri-parent technology on preservation of lineage from the perspective of Maqasid al-Shari'ah based the Islamic bioethics. The analysis shows that there are a few violations of the preservation of lineage, hence the tri-parent baby technology should not be permitted.
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Affiliation(s)
- Abdul Halim Ibrahim
- Programme of Applied Science with Islamic Studies, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Noor Naemah Abdul Rahman
- Department of Fiqh and Usul, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shaikh Mohd Saifuddeen
- Programme of Applied Science with Islamic Studies, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Centre for Science and Environment Studies, Institute of Islamic Understanding Malaysia, 2 Langgak Tunku Off Jalan Tuanku Abdul Halim, 50480, Kuala Lumpur, Malaysia
| | - Madiha Baharuddin
- Programme of Applied Science with Islamic Studies, Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Wang C, Zhai X, Zhang X, Li L, Wang J, Liu DP. Gene-edited babies: Chinese Academy of Medical Sciences' response and action. Lancet 2019; 393:25-26. [PMID: 30522918 DOI: 10.1016/s0140-6736(18)33080-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Chen Wang
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiaomei Zhai
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xinqing Zhang
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Limin Li
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jianwei Wang
- Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - De-Pei Liu
- Chinese Academy of Medical Sciences, Beijing 100730, China
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Affiliation(s)
- Boli Zhang
- Chinese Academy of Engineering, Beijing 100088, China
| | - Zuoning Chen
- Chinese Academy of Engineering, Beijing 100088, China
| | - Jian Yi
- Chinese Academy of Engineering, Beijing 100088, China
| | - Haiying Tang
- Chinese Academy of Engineering, Beijing 100088, China
| | - Chen Wang
- Chinese Academy of Engineering, Beijing 100088, China.
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48
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Affiliation(s)
- Linqi Zhang
- Comprehensive AIDS Research Center, Global Health and Infectious Diseases, School of Medicine, Tsinghua University, Beijing, 100084, China.
| | - Ping Zhong
- Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China
| | - Xiaomei Zhai
- Center for Bioethics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shan Lu
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Abstract
We seek to develop a plausible conception of genetic parenthood, taking a recent discussion by Heidi Mertes as our point of departure. Mertes considers two conceptions of genetic parenthood-one invoking genetic resemblance and the other genetic inheritance-and presents counter-examples to both conceptions. We revise Mertes' second conception so as to avoid these and related counter-examples.
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Affiliation(s)
- Thomas Douglas
- Oxford Uehiro Centre for Practical EthicsOxfordUnited Kingdom
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50
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Blackshaw BP, Rodger D. Ectogenesis and the case against the right to the death of the foetus. Bioethics 2019; 33:76-81. [PMID: 30341923 DOI: 10.1111/bioe.12529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/20/2018] [Accepted: 08/14/2018] [Indexed: 06/08/2023]
Abstract
Ectogenesis, or the use of an artificial womb to allow a foetus to develop, will likely become a reality within a few decades, and could significantly affect the abortion debate. We first examine the implications for Judith Jarvis Thomson's violinist analogy, which argues for a woman's right to withdraw life support from the foetus and so terminate her pregnancy, even if the foetus is granted full moral status. We show that on Thomson's reasoning, there is no right to the death of the foetus, and abortion is not permissible if ectogenesis is available, provided it is safe and inexpensive. This raises the question of whether there are persuasive reasons for the right to the death of the foetus that could be exercised in the context of ectogenesis. Eric Mathison and Jeremy Davis have examined several arguments for this right, doubting that it exists, while Joona Räsänen has recently criticized their reasoning. We respond to Räsänen's analysis, concluding that his arguments are unsuccessful, and that there is no right to the death of the foetus in these circumstances.
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Affiliation(s)
- Bruce P Blackshaw
- Department of Philosophy, University of Birmingham, Birmingham, United Kingdom
| | - Daniel Rodger
- Allied Health Sciences, School of Health and Social Care, London South Bank University, London, United Kingdom
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