Ought parents, in general, to value being biologically tied to their children? Is it important, in particular, that both parents be biologically tied to their children? I will address these fundamental questions by looking at a fairly new practice within IVF treatments, so-called IVF-with-ROPA ( Reception of Oocytes from Partner ), which allows lesbian couples to „share motherhood‟ with one partner providing the eggs while the other becomes pregnant. I believe that IVF-with-ROPA is, just like other IVF treatments, morally permissible; (...) but here I argue that the increased biological ties which IVF-with-ROPA allows for do not have any particular value beside the satisfaction of a legitimate wish, because there is no intrinsic value in a biological tie between parents and children; further, I argue that equality within parental projects cannot be achieved by redistributing biological ties. (shrink)

The Alabama Supreme Court recently held that embryos are children for purposes of the state's Wrongful Death of a Minor Act, causing in vitro fertilization (IVF) clinics to halt operations. While an emergency measure was passed to allow fertility services to resume, the governor made clear that it was a temporary fix and that regulations could follow. Indeed, some argue that IVF would have to be outlawed given the risk of loss of embryonic life inherent therein. But lawmakers could use (...) the doctrine of double effect to justify IVF as a means of assisting people to have children notwithstanding a foreseen but unintended risk of loss of embryonic life. Even still, if governments intend to take embryonic personhood seriously, legislatures will have to make difficult decisions about whether certain activities such as cryopreservation, preimplantation genetic screening, and multiembryo transfers ought to be restricted to mitigate the risk of embryonic loss. (shrink)

Singer and Dawson point out that two arguments against abortion, that the embryo is entitled to protection because from fertilization it is (1) a human being or (2) a potential human being, are also used by opponents of embryo experimentation. They focus on the second argument, evaluating the notion of potentiality as it applies to gametes, to the unimplanted embryo, to the implanted developing embryo, and to the embryo created by in vitro fertilization (IVF). They argue that there is a (...) crucial distinction between natural reproduction, in which all that is needed for the embryo to have a prospect of reaching its potential is for those involved to refrain from stopping it, and IVF, in which the embryo cannot develop into a person without a deliberate human act. Reproductive techniques necessitate our rethinking of established views about potentiality, and how it should be applied to the embryo in a laboratory. (KIE abstract). (shrink)

IVF as lottery or investment: contesting metaphors in discourses of infertilityThis paper reports an aspect of a poststructural feminist study in which I explored the discursive formations within which women for whom in vitro fertilisation (IVF) was unsuccessful constitute themselves. In my exploration I draw on data from interviews with women who discontinued infertility treatment, print media material and infertility self‐help books. Specifically, I highlight a metaphor of lottery in discourses of infertility, arguing that it is hegemonic and showing how (...) when women are situated as gamblers, the metaphor is instrumental in polarising them into ‘winners’ or ‘losers’ in relation to the subjectivity of motherhood. I further deconstruct these subjectivities, showing how ‘winners’ are valorised and ‘losers’ are pathologised. But importantly, I show how infertile women who are not mothers resisted locating themselves as ‘losers’ in a metaphor of lottery and instead situated themselves in a contesting metaphor of investment as diligent ‘workers’ and as active agents in choosing the best employment of their bodily and monetary resources. This paper therefore amplifies the marginalised perspective of infertile women who are not mothers. (shrink)

A n IVF mixup has resulted in a white couple giving birth to black twins. Prior to DNA testing, no one can be sure whether the white woman’s eggs were fertilised with the black man’s sperm, or the black couple’s embryo was mistakenly implanted in the white woman. It is believed that Mr and Mrs A, the white couple, want to keep the babies and there is conjecture about Mr and Mrs B, the black couple, wanting them too.1 Under the (...) Human Fertilisation and Embryology Act 1990, a woman who has a child born through IVF, even if it is not genetically hers, is the “legal mother”. Paternity, however, is “open to legal interpretation”.1–3News of the mixup has elicited a range of reactions. It is thought …. (shrink)

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

Bu çalışma, İran İslam Cumhuriyeti ve Kuzey Kıbrıs Türk Cumhuriyeti’nde faaliyet gösteren tüp bebek (IVF) merkezlerinden bir kısmının web sitelerinden elde edilen veriler üzerinden, “tedavi” kapsamında sunulan bazı uygulamaların meşru sınırlarla ilişkisini fıkhi açıdan incelemektedir. Evli çiftlerin kendi üreme hücreleri ile oluşturulan embriyonun anne adayının rahmine yerleştirilmesiyle gerçekleştirilen in vitro fertilizasyon günümüz Sünnî İslam hukukçularının büyük çoğunluğu tarafından caiz görülürken, tüp bebekte gamet ve embriyo donasyonu ile taşıyıcı annelik gibi üçüncü kişilerin katkısına dayalı uygulamalar ise nesep karışıklığına ve çarpık aile (...) ilişkilerinin oluşmasına yol açması gibi nedenlerle gayri meşru kabul edilmektedir. Buna karşılık Ayetullah Hamaneî’in konuya dair fetvası doğrultusunda, Şiî alimler arasında belirgin kanaat gamet ve embriyo bağışı, taşıyıcı annelik gibi yöntemlerin caiz olduğu yönündedir.Söz konusu yöntemler İran’da yasal zeminde uygulanmaktadır. Konuyla ilgili liberal mevzuata sahip Kuzey Kıbrıs’ta da üreme hücreleri ve embriyo donasyonu ile taşıyıcı anneliğin serbest olduğu, ülkenin uluslararası üreme turizminin merkez noktalarından biri haline geldiği görülmektedir. Çalışmamızın amacı, söz konusu uygulamaların sadece tıbbi bir tedavi meselesi olmadığını, bunun yanı sıra fıkhi boyuttan nesil emniyetinin ihlal edilmesi, aile kurumunun zedelenme ihtimali, çocuk hak ve yararının gözetilmemesi, insan bedeninin saygınlığına zarar vermesi gibi çok yönlü sonuçlar doğurduğunu ortaya koymaktır. Doküman inceleme ve veri analizi tekniği kullanılarak gerçekleştirilen çalışmada sonuç olarak çocuk sahibi olma anlaşılır ve meşru bir istek olmakla birlikte buna ulaşmak için kullanılan araçların da meşru olmasına dikkat edilmesi gerektiği, üçüncü taraflara ait gamet, embriyo ya da rahim kullanımının tedavi kavramının istismarı anlamına geldiği vurgulanmaktadır. (shrink)

An article by Mark Repenshek and a letter by Edward Delaquil published recently in The National Catholic Bioethics Quarterly underscore the urgent need for further moral and magisterial clarification regarding a number of highly complex and difficult bioethical issues. These involve ex utero therapeutic genomic interventions, the practice of in vitro fertilization and embryo transfer, and the ongoing debate over the morality of embryo adoption to help resolve the “absurd” fate of countless, cryopreserved human embryos. This essay critiques and argues (...) against the use of therapeutic IVF, helps clarify why embryo transfer and embryo adoption do not violate the sacred bond of marriage, and uses key magisterial passages from both Donum vitae and the Catechism of the Catholic Church to defend the practice of embryo transfer. National Catholic Bioethics Quarterly 14.2 : 227–234. (shrink)

In vitro fertilization (IVF) and the risk of birth and developmental defects - facts and fictions Poland is being swept by a wave of discussions on various aspects of IVF application. Scientists of various disciplines are getting involved in these discussions as opponents to this form of procreation. Referring to research carried out all over the world, they demonstrate that children born thanks to the in vitro procedure are significantly more susceptible to all sorts of disease. The author, surveying available (...) research data, shows that, in reality, the worse health of in vitro-conceived children deals with a narrow number of well-identified disorders and in most cases is of correlative, not causative nature. The main reason for the weaker health of these children is often connected with the advanced age of the parents who choose IVF and their health condition (mothers' in particular), as compared to those who become parents in a natural way. (shrink)

Access to state-funded fertility treatments is age-restricted in many countries based on epidemiological evidence showing age-associated fertility decline and aimed at administering scarce resources. In this article, we consider whether age-related restrictions can be considered ageist and what this entails for a normative appraisal of access criteria. We use the UK as a case study due to the state-funded and centrally regulated nature of in vitro fertilization provision. We begin by reviewing concepts of ageism and age discrimination in gerontological scholarship (...) and contend that it is analytically useful to differentiate between them when considering age-restricted health services. We then argue that criteria to access IVF could be considered indirectly ageist so far as they rely on an age-related evidence base that manifests ageist categorizations of persons. Lastly, we examine whether there could be more normatively desirable alternatives to devise criteria to access fertility treatment, considering “lifestyle” as a potential candidate. We conclude, however, that lifestyle-based discrimination is problematic because, unlike age-based discrimination, it risks exacerbating existing socioeconomic and ethnic inequalities. (shrink)

Lesbian, gay, bisexual, and queer family-making has exploded in many western nations in the past few decades in the midst of growing social acceptance and legal recognition of queer families, as well as increasing options for same-sex reproduction.1 Philosophers and bioethicists have perhaps been late in taking up these issues compared to scholars in other fields concerned with politics, justice, and cultural criticism. And where philosophers and bioethics have taken up these topics, often the moral issues at stake are framed (...) in a manner that implicitly or explicitly holds heterosexual reproduction through intercourse in a committed relationship to be the normal, natural, and morally unquestioned... (shrink)

(2001). How Should IVF Programs Handle Initial Disclosure of Information to Prospective Ovum Donors? The American Journal of Bioethics: Vol. 1, No. 4, pp. 23-25.

Nonfeminist accounts of post-menopausal IVF reject the practice on four main grounds: I) scarcity of resources; 2) fairness; 3) the “inappropriateness” of post-menopausal motherhood; and 4) concerns for orphaned children. I argue that these grounds are insufficient for denying post-menopausal women IVF access. I then suggest that a feminist evaluation of the practice is more compelling; ultimately, however, we have no strong grounds for a policy denying post-menopausal women access to this technology.

There is great diversity in in vitro fertilization (IVF) funding and reimbursement policies and practice throughout Europe and the rest of the world. While many existing reimbursement and regulatory frameworks address safety and legal concerns, economic factors also assume a central role. However, there are several problems with the evidence that is available on the economics of IVF. This suggests there is a need for more robust cost-effectiveness studies. It also indicates the need for alternative rationales to justify the reimbursement (...) of IVF, which might more fully account for the social, political, ethical, and philosophical considerations embedded in notions of infertility and technology-driven reproductive treatments. The merits and limitations of five alternative rationales are discussed. The review suggests that while no existing single rationale provides a complete framework with which to support funding decisions, taken together they provide guideposts which signal important issues for consideration and highlight where further research, action, and debate are needed. (shrink)

Recently, several claims have been made that free provision of in vitro fertilisation will boost our economy. This is premised on the assumption that people provide more in terms of tax and insurance than they consume in resources, leaving an overall gain. Even where these ‘replacement’ people are created by means of IVF, it is argued that the costs involved are easily offset by the financial contribution we can expect IVF-conceived adults to make to our economy. However, although it may (...) be true that the creation of a new person constitutes an overall financial gain to the state, I question the degree to which the arithmetic involved is as simple as the reports suggest.Research presented by a group of scientists at the annual conference of the European Society of Human Reproduction and Embryology in Prague, which has been widely reported in the media, has suggested that it is in our society’s economic interests to fund access to in vitro fertilisation treatments.1,2 The team, led by Professor William Ledger from the University of Sheffield, claims that for each IVF baby born, the economy makes a net gain. But can this possibly be true? IVF is an expensive procedure, which by its very nature creates more claimants on state funds and National Health Service resources. IVF also takes a financial and physical toll on all those involved: the women, their partners, and the children born as a result. It might be assumed that state funding of IVF would be a drain on public resources, rather than boosting them. However, the researchers have suggested otherwise. Their claim is that the average £13 000 that it costs to create a baby using IVF is far exceeded by the average of £160 000 in taxes and insurance that will …. (shrink)

Joshua Shaw argues that one common belief among abortion opponents—that embryos possess full moral status—is inconsistent with their support for ‘parent-friendly’ in vitro fertilisation (IVF) policies, that allow the production of surplus embryos (which are then stored indefinitely or destroyed). These abortion opponents, Shaw argues, should conclude that it is morally objectionable to destroy, discard, or freeze embryos indefinitely. Thus, they should reject current IVF practices and should consider the millions of frozen embryos that currently exist to be an urgent (...) moral crisis. Yet, Shaw notes, many abortion opponents support ‘parent-friendly’ IVF. This raises doubts over their commitment to the claim that embryos possess full moral status. Shaw continues that, contrary to some scholars’ suggestions, artificial-gestation technologies—which could, theoretically, be used to “rescue” surplus embryos—are unlikely to resolve this tension. In fact, they seem likely to increase the number of surplus embryos, worsening existing problems. We agree with Shaw that if embryos possess full moral status, then current ‘parent-friendly’ IVF practices are morally objectionable. We also agree that artificial womb technology cannot change this fact. What those technologies could do, however, is (eventually) rescue frozen embryos that currently exist. Thus, we argue abortion opponents should do two things. First, advocate to alter current ‘parent-friendly’ IVF practices in more ‘embryo-friendly’ ways. Second, advocate to keep existing surplus embryos frozen until they may be rescued. (shrink)

Infertility is a serious social problem. Very often the only treatment possibility are IVF methods. This study explores the possibility of outcome prediction in the early stages of treatment. The data, collected from the previous treatment cycles, were divided into four subsets, which corresponded to the selected stages of treatment. On each such subset, sophisticated data mining analysis was carried out, with appropriate imputations and classification procedures. The obtained results indicate that there is a possibility of predicting the final outcome (...) at the beginning of treatment. (shrink)

Bioethical debates on the use of human embryos and oocytes for stem cell research have often been criticized for the lack of empirical insights into the perceptions and experiences of the women and couples who are asked to donate these tissues in the IVF clinic. Empirical studies that have investigated the attitudes of IVF patients and citizens on the donation of their embryos and oocytes have been scarce and have focused predominantly on the situation in Europe and Australia. This article (...) examines the viewpoints on the donation of embryos for stem cell research among IVF patients and students in China. Research into the perceptions of patients is based on in-depth interviews with IVF patients and IVF clinicians. Research into the attitudes of students is based on a quantitative survey study. The empirical findings in this paper indicate that perceptions of the donation of human embryos for stem cell research in China are far more diverse and complex than has commonly been suggested. Claims that ethical concerns regarding the donation and use of embryos and oocytes for stem cell research are typical for Western societies but absent in China cannot be upheld. The article shows that research into the situated perceptions and cultural specificities of human tissue donation can play a crucial role in the deconstruction of politicized bioethical argumentation and the assumptions about “others” that underlie socio-ethical debates on the moral dilemmas of technology developments in the life sciences. (shrink)

The Chairman of the Australian Law Reform Commission summarizes the discussion of in vitro fertilization (IVF) at the 1983 Mogul International Management Consultants Ltd. Conference on "Bioethics and Law of Human Conception in Vitro." Participants included IVF pioneers Patrick Steptoe and Robert Edwards, as well as other British physicians, scientists, sociologists, and moral philosophers. They raised questions about multiple embryo implantations, the risks and benefits of IVF, the ethical responsibilities of investigators, public policy and social control of IVF, threats to (...) the family and to genetic integrity, and the implications of IVF for determining criteria of personhood and the beginning of life. (shrink)

Some time ago an article was published in this journal relating the difficulties of legislating for InVitro Fertilization in a Catholic country and the issues and side issues which had to be faced. Since then one has approached closer to having a law which regulates this technology. However several issues continue to challenge the country. The main concern, other than IVF not being a natural method of having children is the status of the embryo. The normative values of the country (...) in fact induces politicians to discuss an ‘embryology act’ rather than a ‘reproductive medicine’ act. At the eleventh hour Bishops continue to launch concerns which raises queries on how the debate moved forward over the past two decades. This paper tackles these issues and other more recent concerns and suggestions and takes a look at how such processes can be improved through a more rigorous understanding and logistic of dialogue, as certainly such debates should have implications for bioethics in general. Although the Church’s document Donum Vitae’s instructions for politicians where legislation for this technology has to occur has been vindicated, I seems that whilst many disputes have been resolved, the main conflict—that of the value of the conjugal act—has not. (shrink)

This paper examines the metaphysical question of 'ensoulment' in relation to the theory, put forward in an earlier paper, that human life begins when the newly formed body organs and systems of the embryo begin to function as an organised whole, at which stage there is evidence of a change of nature. Although Roman Catholic theology teaches that a human being is a union of physical body and spiritual soul, it is incorrect to interpret this in a dualistic sense. The (...) meaning of 'soul' is considered and the conclusion reached that although both in the religious context and apart from it abortion is difficult to justify at any stage after conception, it does not follow that the use of 'spare' In Vitro Fertilisation (IVF) embryos should be rejected. If 'ensoulment' does not occur until the new organism functions as a whole then a decision not to make use of IVF embryos for medical purposes would be a heavy responsibility and not a 'safe' way out. (shrink)

Women who suffer from fertility issues often use in vitro fertilization (IVF) to realize their wish to have children. However, IVF has its own set of strict administration rules that leave the women physically and emotionally exhausted. Feeling alienated and frustrated, many IVF users turn to internet IVF-centered forums to share their stories and to find information and support. Based on the observation of Dutch and Greek IVF forums and a selection of 109 questionnaires from Dutch and Greek IVF forum (...) users, we investigate the reasons why users of IVF participate in online communities centered on IVF, their need for emotional expression and support, and how they experience and use the information and support they receive through their participation in the online community. We argue that the emotional concerns expressed in such forums should be taken into account by health care ethics committees for IVF-related matters in order to promote more patient-oriented care and support for women going through IVF. (shrink)

In vitro fertilization with reception of oocytes from partners allows lesbian mothers to share biological motherhood. The gestational mother receives an egg from her partner who becomes the genetic mother. This article examines the ethics of IVF with ROPA with a focus on the welfare of the woman and the resulting child, on whether ROPA qualifies as a “legitimate” medical therapy that falls within the goals of medicine, and on the meaning and value attributed to a biologically shared bond between (...) parents and child. We also contrast IVF with ROPA with egg donor IVF for heterosexual couples and intrafamilial live uterus transplantation with IVF, and show how Swedish legislation makes certain ways of sharing biological bonds out of place. In Sweden, IVF with ROPA is illegal, egg donor IVF for heterosexual couples is allowed and practiced as is sperm donor IVF for lesbians, and live uterus transplantation is performed within a research project. But is ROPA really ethically more problematic than these other cases? The article argues that IVF with ROPA gives rise to fewer ethical questions than does live uterus transplantation with IVF and, in some cases, egg donor IVF. (shrink)

During the process of in vitro fertilization (IVF), hormonal drugs are used to stimulate the woman's ovaries to produce multiple eggs. The injecting of the drugs is often performed by the women themselves outside of the clinical context, constituting a gendered burden of work that is rendered invisible by the dominant representations of treatment as undergone by couples and performed by doctors. Based on a series of interviews with women and couples who have undergone IVF unsuccessfully and who have ended (...) treatment at least two years previously, this paper focuses on two aspects of the self-injection of hormonal drugs that emerged from the participants accounts: firstly, the gendered ways in which the drug regimen was experienced as compromising privacy and secondly, the strategic use of images of both illicit and medical drug use in the accounts. The paper argues that in spite of the dominant representation of IVF as a couples’ technology, the IVF process is profoundly gendered, both in terms of bodily intervention and in the distribution of labour in the implementation of treatment; that the invisibility of the drug regimens from dominant representations of IVF can leave those undergoing treatment unprepared for some of the problems that the self-administration of the drugs can raise, particularly in terms of maintaining privacy; and finally, that images of the drug injection are mobilized strategically in the accounts to locate themselves within normative social reproductive standards. This highlights the extent to which the enduring ideological construction of proper womanhood as defined by motherhood continues to pose a dilemma for those who are involuntarily childless. (shrink)

Malta traditionally enjoys a Roman Catholic Society, with the official religion of the country being cited in the second article of the constitution. Recently the government proposed to legislate to regulate human reproductive technology, in particular In Vitro Fertilization, which has been practiced for over two decades without controlling legislation. A Parliamentary Committee for social affairs was set up to study the situation inviting most stakeholders. The arguments gravitated mostly on issues of the status of the embryo and the media (...) played a considerable role. At the end of the discussion the Archbishop made a statement which pointed out that IVF involves destruction of embryos and the process stopped. This article examines what caused the deterioration of the process and points favourably towards a way forward within the context of a Catholic Country. (shrink)

In recent years, the genetic testing and selection of IVF embryos, known as preimplantation genetic testing (PGT), has gained much traction in clinical assisted reproduction for preventing transmission of genetic defects. However, a more recent ethically and morally controversial development in PGT is its possible use in selecting IVF embryos for optimal intelligence quotient (IQ) and other non–disease-related socially desirable traits, such as tallness, fair complexion, athletic ability, and eye and hair colour, based on polygenic risk scores (PRS), in what (...) is referred to as PGT-P. Artificial intelligence (AI) and machine learning–based analysis of big data sets collated from genome sequencing of specific human ethnic populations can be used to estimate an individual embryo’s likelihood of developing such multifactorial traits by analysing the combination of specific genetic variants within its genome. Superficially, this technique appears compliant with Islamic principles and ethics. Because there is no modification of the human genome, there is no tampering with Allah’s creation (taghyīr khalq Allah). Nevertheless, a more critical analysis based on the five maxims of Islamic jurisprudence (qawa'id fiqhiyyah) that are often utilized in discourses on Islamic bioethics, namely qaṣd (intention), yaqın̄ (certainty), ḍarar (injury), ḍarūra (necessity), and `urf (custom), would instead reveal some major ethical and moral flaws of this new medical technology in the selection of non–disease-related socially desirable traits, and its non-compliance with the spirit and essence of Islamic law (shariah). Muslim scholars, jurists, doctors, and biomedical scientists should debate this further and issue a fatwa on this new medical technology platform. (shrink)

The social and institutional background of this research can be summarized as the relation between public and governmental policies on the one hand, and the experience of patients and IVF experts on the other. Namely, one third of all pregnancies achieved in state-funded in vitro fertilizations obscure some ethical and health issues, especially among patients who abandon the state-funded IVF programme in Serbia. The goal of the current research is to identify, describe and understand ethical and social issues that parents (...) encounter in attempts to fulfil their idea of a sovereign life through IVF. The method comprised a tri-level analysis based on semi-structured interviews with participants who exhibit personal experiences of basic ethical principles and social and health needs within IVF. The results obtained indicate that all three explored levels of patients' experience build a picture of Assisted Reproductive Technology as a means of a sovereign or good life. However, the cultural image of the fulfilment of expected parental social roles resulted in a denial of autonomy and led to self-abnegation through silent acceptance of unethical practices. There is an overlap of the margins of secular ideas and roles on the one hand, and religiosity on the other, making such consent socially acceptable and more easily explainable. Finally, the conclusion reached is that apparently a decrease in sovereignty of parental decisions causes a loss of trust in state clinics and medical procedures, reduces solidarity and establishes norms and patterns of social injustice and inequality. (shrink)

This article contributes to a more nuanced and contextual approach to women’s decision-making concerning their stored IVF (in vitro fertilisation) embryos through attempting to craft a space for the expression of the complex, and contradictory, emotions attached to these decisions, unhooked from any notion of abstract moral status inhering in the embryo itself. Women struggle to express the confounding nature of the relationship to the stored IVF embryo as something of-the-body but not within the body, neither self nor other, person (...) nor thing. In order to try to address this sense of the ineffable, I draw in this article upon a series of images by German-born American artist, Kiki Smith. The article explores three major themes, each alongside one of Smith’s artworks connecting to an experience of discomfort or confounding unease. (shrink)

In in vitro fertilisation (IVF) mix-ups and contested parenthood, Prince and colleagues argue that the familiar ‘genetic presumption’ in parenthood disputes should be treated as rebuttable in favour of the gestational relationship, and that custody and guardianship outcomes will typically be resolved under best-interests standards, with biological relatedness operating as one relevant factor among others. Their paper effectively re-centres moral attention on pregnancy, embodiment and gestation in a domain often organised around DNA and prior intention. This response agrees that gestation (...) generates morally weighty interests and that a purely genetic default can obscure how parental bonds are formed and sustained. However, IVF mix-ups are a structurally distinctive category: they arise within an ex ante consent-based system of embryo creation, allocation and implantation, where predictability and institutional accountability are central. To preserve these values without collapsing into rigid geneticism, I propose a time-sensitive hybrid model. On this approach, genetic–intentional parenthood supplies the default entitlement at the point of error identification, reflecting the consent architecture of assisted reproduction, while settled attachment and caregiving reliance modify the remedy when discovery occurs late. The model thereby protects relational stability while preserving identity interests and institutional accountability, offering a temporally staged allocation framework that better fits assisted reproduction’s underlying structure. (shrink)

Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)

In vitro fertilization (IVF) offers transformative opportunities for women facing infertility; however, it also presents significant challenges to their mental health. Clinical research has substantiated the need for adequate mental health support for women undergoing IVF. In this article, I argue that ethics consultation should be recognized as an important resource for providing this support. Drawing on the cognitive theory of emotion, which posits that emotions are or are caused by cognitive evaluations, I analyze the evaluative judgments and conflicts that (...) underlie women’s emotional responses to IVF. I contend that ethics consultation can offer a distinctive form of mental health support in resolving those evaluative conflicts. Unlike cognitive therapy, which often aims to modify or correct evaluative judgments, ethics consultation validates these judgments as meaningful reflections of patients’ values and facilitates deliberative prioritization among competing values. This paper offers a theoretical framework for understanding the role of ethics consultation in providing mental health support in IVF care. (shrink)

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. (shrink)

In vitro fertilization (IVF) involves making embryos outside of the human body, which has spurred debate about the status of the embryo, embryo research and donation. We explore couples’ perceptions about embryos and their thoughts and acceptability about various disposition decisions in Norway. Based on an ethnographic study including interviews and observations in an IVF clinic, we show that couples do not perceive their pre-implantation IVF embryos to be human lives; rather, they consider successful implantation the start of life. We (...) suggest that this response indicates a change in the perception of the human embryo or the fertilised egg fromincipient life—a viewpoint that was dominant in the discussions of embryo research in the 1980s and 1990s. We also show how this view of the pre-implantation embryo elucidates why donating embryos to research appears acceptable but donating to other infertile couples seems rather difficult. Before transfer to a woman’s uterus, the embryo exists in a liminality; it is not yet human life but a living cell with potential for both researchandpregnancy. When an embryo is implanted and pregnancy is confirmed, human life activates; the embryo becomes potential kin, influencing couples’ struggles with donating embryos to other couples. (shrink)

In recent years, preimplantation genetic testing (PGT) of IVF embryos have gained much traction in clinical assisted reproduction for preventing various genetic defects, including Down syndrome. However, such genetic tests inevitably reveal the sex of IVF embryos by identifying the sex (X and Y) chromosomes. In many countries with less stringent IVF regulations, information on the sex of embryos that are tested to be genetically normal is readily shared with patients. This would thus present Muslim patients with unintended opportunities for (...) sex selection based on personal or social biases without any pressing need or valid medical reason. Additionally, there are other patients who claim using PGT for preventing genetic defects as a pretext or “convenient excuse,” with a secret intention to do sex selection when it is banned in their home country. Currently, non-medical sex selection is a highly-controversial and hotly debated issue in Islam, because there is generally a strong preference for having sons over daughters due to widespread cultural norms of elderly parents depending on their sons for financial support, as well as the need for male heirs to continue the family lineage within the backdrop of local patriarchal cultures. There is a risk of gender imbalance and social disequilibrium occurring in Islamic societies due to prevalent sex selection. Hence, the question is whether opportunistic sex selection with PGT would contravene Islamic ethics and principles, which will thus be discussed here. (shrink)

In February 2016, the Institute of Medicine released a report, commissioned by the United States Food and Drug Administration, on the ethical and social‐policy implications of so‐called three‐parent in vitro fertilization. The IOM endorses commencement of clinical trials on three‐parent IVF, subject to some initial limitations. Also called mitochondrial replacement or transfer, three‐parent IVF is an intervention comprising two distinct procedures in which the genetic materials of three people—the DNA of the father and mother and the mitochondrial DNA of an (...) egg donor—can be used to create a child. Three‐parent IVF would enable a woman with mitochondrial disease to have a genetically related child without transmitting the disease to the child. The possibility for three‐parent children has prompted criticism from many corners. Critics have pointed to ethical issues including safety concerns and risks to children, genetic and germline engineering concerns, the potential exploitation of the third‐parent egg donor, donor anonymity and privacy, and objections to creating babies with three parents, which undermines natural and traditional conceptions of procreation. Additionally, developing the technology would involve experimenting on, manipulating, and disposing of embryos. Although the IOM report considers the ethical concerns about the value of the three‐parent IVF technology, the IOM failed to give due attention to an important objection to the development of this technology: three‐parent IVF lacks the social value necessary to make investment of public resources in it ethical.Unlike the other concerns, this objection is not based on conservativism about new reproductive technologies or default favoritism of the status quo. I argue that the technology does not meet a plausible social value standard to render public research investment into its development ethical. Proponents of three‐parent IVF make inaccurate and exaggerated claims that it will eradicate mitochondrial disease and save lives. Were these claims true, proponents would have a strong case for the social value of the technology. But three‐parent IVF alone will not eradicate mitochondrial disease, and it will not save lives. Rather, it can create healthy lives. As I discuss, the moral distinction is crucial. Most importantly, investment in three‐parent IVF comes at the opportunity cost of researching treatment for mitochondrial disease that would benefit actual, living disease sufferers. (shrink)

There has been considerable discussion about the impact artificial womb technology may have on debates in reproductive ethics. Much of it has focused on abortion. Some ethicists have also proposed, however, that artificial wombs will lead to more embryo adoption, and, in doing so, that they will eliminate an alleged moral tension between opposing most abortions based on a full moral status view of fetuses/embryos but not opposing the use of surplus embryos in fertility medicine. This article evaluates this argument, (...) what I will call the artificial womb argument. It defends two main claims. First, artificial womb technology is unlikely to lead to embryo adoption on the scale needed to resolve the moral tension between opposing abortion but tolerating the use of surplus embryos in what has been termed “parent-friendly” in vitro fertilization (IVF). Second, artificial womb technology is more likely to increase the use of surplus embryos. The artificial womb argument backfires, therefore, on abortion opponents. Far from mitigating the moral tensions between opposing abortion but tolerating parent-friendly IVF, artificial womb technology is more likely to exacerbate these tensions. (shrink)

The IVF ET method is a scientifically recognized infertility treat- ment method. The problem, however, is this method’s unsatisfactory efficiency. This calls for a more thorough analysis of the information available in the treat- ment process, in order to detect the factors that have an effect on the results, as well as to effectively predict result of treatment. Classical statistical methods have proven to be inadequate in this issue. Only the use of modern methods of data mining gives hope for (...) a more effective analysis of the collected data. This work provides an overview of the new methods used for the analysis of data on infertility treatment, and formulates a proposal for further directions for research into increasing the efficiency of the predicted result of the treatment process. (shrink)

Perspectives of IVF users on their spare embryos is a less explored subject in the Indian context despite the country’s population and abundance of IVF clinics. We conducted a qualitative study using in-depth interviews in a selected district of the Indian state of Karnataka. Seven individuals were recruited independently of any assistance from an IVF clinic. The interviews explored participants’ knowledge and perception of the spare embryos using a set of guiding questions exploring the theme of the informed consent process, (...) views on research, preferences for embryo donation, the role of family and the dynamics of decision-making, amongst other things. The interviews were qualitatively analysed using Corbin and Strauss’s grounded theory approach. Our findings reveal that the participants do not learn about the prospects of spare embryos from the very start of their IVF journeys, and they may not be informed about the various options available to decide the fate of the spare embryos. Irrespective of their views on research and moral perceptions of embryos, participants expressed a sense of responsibility and ownership towards their embryos and a general reluctance to donate them. Our findings have implications for guiding future inquiries on this subject, which can better the informed consent process and unravel the role of ownership in the ethics of spare embryos in the Indian context. (shrink)

This review critically appropriates Stephanie Gray Connors’ On IVF through a Lonerganian method of inquiry: beginning from attentive experience, moving through intelligent understanding, reasonable judgment, and culminating in responsible evaluation. Connors’ work is praised for its empathetic attention to the existential pain of infertility, its clear articulation of the moral structure distinguishing ends from means, and its systematic unfolding of the layers of harm intrinsic to in vitro fertilization. Ascending from the immediate drama of suffering to the broader metaphysical horizon, (...) Connors situates human procreation within a theology of giftedness rather than technological production. Her advocacy for Restorative Reproductive Medicine exemplifies an ethics that collaborates with natural finality rather than subverting it. Furthermore, her pastoral call to repentance and healing reveals an understanding of moral failure not as condemnation, but as an opportunity for conversion and renewed fidelity to the dignity of life. Connors' inquiry thus fulfills, in the domain of bioethics, the transcendental precepts of authentic moral reflection: be attentive, be intelligent, be reasonable, and be responsible. In doing so, On IVF emerges not merely as a critique of a contemporary practice, but as a summons to a more reverent participation in the mystery of human life. (shrink)

In 2014, the first child in the world was born after live uterus transplantation and IVF (UTx-IVF). Before and after this event, ethical aspects of UTx-IVF have been discussed in the medical and bioethical debate as well as, with varying intensity, in Swedish media and political fora. This article examines what comes to be identified as important ethical problems and solutions in the media debate of UTx-IVF in Sweden, showing specifically how problems, target groups, goals, benefits, risks and stakes are (...) delineated and positioned. It also demonstrates how specific assumptions, norms and values are expressed and used to underpin specific positions within this debate, and how certain subjects, desires and risks become shrouded or simply omitted from it. This approach—which we label the Ethics of the Societal Entrenchment-approach, inspired by Koch and Stemerding (1994)—allows us to discuss how the identification of something as the problem helps to shape what gets to be described as a solution, and how specific solutions provide frameworks within which problems can be stated and emphasised. We also offer a critical discussion of whether some of these articulations and formations should be seen as ethically troubling, and if so, why. (shrink)