Assisted Human Reproduction - Medical Ethics

Assisted Human Reproduction

·        3 types:

o   Couples using their own genetic material

o   Techniques using other people‟s genetic material

o   Techniques using another women‟s womb (surrogacy)

·        Current issues:

o   Surrogacy – non-commercial IVF

o   Posthumous use of sperm (creation of fatherless families) 

o   Should women have access to IVF if they already have children (eg following tube reversal) – is there a fair innings?

o   Intergenerational gamete donation (assisted incest!)

o   Pre-implantation genetic diagnosis (PGD)

·        To what extent should families be free to make their own choices

§  The significance of life

§  Does PGD devalue affected individuals

§  What is the meaning of disability

§  Who will have access to these diagnostic techniques

·        Ethical issues:

o  Human dignity, the value of life and what it is to be human

o  Autonomy

§  Procreative liberty vs the role of the state (reflecting the welfare of society)

§  Informed consent – eg pressure on surrogate mums

o  Beneficence:

§  Who benefits 

§  What are the best interested of the child not yet conceived. They should be an end in themselves, not a means to someone else‟s end

o  Non-maleficence (do no harm)

§  Commodification of children

§  Incrementalism – the „slippery slope‟ 

§  Unknown/possible harms – Intra-cytoplasmic sperm injection has become common without any long term trials looking for any effects on kids

o  Justice

§  Fair access to AHR procedures

§  Prioritisation of need and benefit 

§  Infertility vs social reasons (eg post vasectomy, freezing eggs till after you‟ve had a career, etc)