This paper explores whether egg donation could still be ethically justified if in vitro gametogenesis (IVG) became reliable and safe. In order to do this, issues and concerns that might inform a patient’s reasoning in choosing to use donor eggs instead of IVG are explored and assessed. It is concluded that egg donation would only be ethically justified in a narrow range of special cases given the (hypothetical) availability of IVG treatment and, further, that egg donation could itself (...) be replaced by donation through IVG techniques. Two possible criticisms of this position are then considered: Ones based on respect for patient wishes, and on loss of donor benefit. It is concluded that whilst neither argument constitutes a strong enough reason to continue with programmes of egg donation, egg‐sharing programmes could still be permitted come the advent of IVG; these could then provide a morally acceptable source of “natural” donor eggs. (shrink)

In vitro gametogenesis (IVG) is believed to be the next big breakthrough in reproductive medicine. The prima facie acceptance of this possible future technology is notable when compared to the general prohibition on human reproductive cloning. After all, if safety is the main reason for not allowing reproductive cloning, one might expect a similar conclusion for the reproductive application of IVG, since both technologies hold considerable and comparable risks. However, safety concerns may be overcome, and are presumably not (...) the sole reason why cloning is being condemned. We therefore assess the non‐safety arguments against reproductive cloning, yet most of these can also be held against IVG. The few arguments that cannot be used against IVG are defective. We conclude from this that it will be hard to defend a ban on reproductive cloning while accepting the reproductive use of IVG. (shrink)

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. (shrink)

Abstract:Research into the development of stem cell-derived (SCD) gametes in humans, otherwise known asin vitrogametogenesis (IVG), is largely motivated by reproductive aims. Especially, the goal of establishing genetic parenthood by means of SCD-gametes is considered an important aim. However, like other applications in the field of assisted reproduction, this technology evokes worries about the possibility of creating so-called ‘designer babies.’ In this paper, we investigate various ways in which SCD-gametes could be used to create such preference-matched offspring, and what this (...) would mean for the acceptability of IVG, if it is premised that it is morally problematic to ‘design’ offspring. We argue that IVG might facilitate the creation of preference-matched offspring, but conclude that this should not undermine the moral acceptability of IVG altogether—even if one concedes the premise that creating ‘designer babies’ is morally problematic. In the light of this, we also point at a possible inconsistency for a position that condemns the creation of ‘designer offspring,’ while accepting the various endeavors to have genetically related offspring. (shrink)

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does not (...) dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

In vitro gametogenesis is the process of deriving gametes from embryonic stem cells or induced pluripotent stem cells. While not as well-known as in vitro fertilization, IVG could lead to more moral issues that would require corresponding responses from the Magisterium. Because IVG remains at the experimental stage, mainly using mice, the Magisterium has not issued any such responses in a document along the lines of Donum vitae and Dignitas personae. This essay situates IVG within Catholic moral (...) teachings for those who are unfamiliar with the teachings of the Church but who are interested in forming their consciences and those of others on what is undoubtedly a peculiar medical technique with many moral ramifications. (shrink)

An exciting development in the field of assisted reproductive technologies is In Vitro Gametogenesis (IVG) that enables production of functional gametes from stem cells in the laboratory. Currently, development of this technology is still at an early stage and has demonstrated to work only in rodents. Upon critically examining the ethical dimensions of various possible IVG applications in human fertility treatment from a Sunni Islamic perspective, together with benefit-harm (maslahah-mafsadah) assessment; it is concluded that utilization of IVG, once (...) its efficacy and safety are guaranteed, could be permissible by strictly adhering to Islamic ethical principles related to marriage, biological/genetic relatedness, sexual intercourse, and moral status of the embryo/fetus versus that of the gamete. As a result, IVG will be acceptable for treating primary infertility, age-related infertility, and preventing genetic diseases. However, it will be unacceptable for application in posthumous reproduction, donor gametes, genetic enhancement, and procreation in same-sex couples. (shrink)

In this work I have tried to fill the gap left by the bioethical discussion on in vitro gametogenesis with regard to the contextual factors of the development of this technology. Starting from the understanding of IVG within the sociotechnical system of assisted reproductive technologies, I tray to explain, from a co-production point of view, the role played by agents and contextual factors in the configuration of the IVG. To do this, I use semi-structured interviews with specialist in (...) embryology, as well as scientific and philosophical bibliographic sources on IVG. Finally, I examine the disruptive capacity of IVG withn this context. (shrink)

In his discussion of in vitrogametogenesis, Rob Sparrow claims that an ethical barrier to development of this technology is that many jurisdictions currently prohibit the practice of creating embryos solely for the purpose of research. However, he suggests that this ethical barrier will soon be eroded, in view of the fact that in vitro gametogenesis could serve as a powerful new technology to overcome infertility. In this commentary, I argue that Sparrow is being overly optimistic in his analysis (...) here. I claim that the debate over so-called compromise positions in the human embryonic stem cell debate suggests that the purpose of the research for which a research embryo is created is unlikely to be considered as having any significant bearing on the moral permissibility of the practice for those who oppose it. Even though in vitro gametogenesis could serve as a powerful new technology to overcome infertility, I argue that opponents of the practice of creating embryos solely for research purposes would still view the creation of research embryos that the development of in vitro gametogenesis would require, as being incompatible with affording the embryo proper moral respect. I conclude by suggesting that Sparrow's analysis of the potential benefits of in vitro gametogenesis provides us with further reasons to scrutinise the unconvincing arguments that are often cited in favour of prohibiting the practice of creating embryos solely for research purposes. (shrink)

ABSTRACT Recent developments in generating gametes via in vitro gametogenesis (IVG) from induced pluripotent stem cells (iPSCs) and their successful use for reproductive purposes in animals strongly suggest that soon these methods could also be used in human reproduction. At least two questions emerge in this context: (a) if a legislator should permit their use and (b) if ethical claims emerge that support their provision, e.g., by public health care systems. This urges an ethical reflection of the new (...) reproductive options this technique might offer. Since the concept of reproductive freedom is a key aspect for the ethical evaluation of artificial reproductive technologies (ARTs), it is necessary to analyze if the new possibilities emerging from IVG fall within the scope of this concept. The results may constitute a morally relevant difference between different imaginable applications of IVG and potentially justify differences in claims to access this technology. (shrink)

Recent research with human embryos, in different parts of the world, has sparked a new debate on the ethics of genetic human enhancement. This debate, however, has mainly focused on gene-editing technologies, especially CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats). Less attention has been given to the prospect of pursuing genetic human enhancement by means of IVF (In Vitro Fertilisation) in conjunction with in vitro gametogenesis, genome-wide association studies, and embryo selection. This article examines the different ethical (...) implications of the quest for cognitive enhancement by means of gene-editing on the one hand, and embryo selection on the other. The article focuses on the ethics of cognitive enhancement by means of embryo selection, as this technology is more likely to become commercially available before cognitive enhancement by means of gene-editing. This article argues that the philosophical debate on the ethics of enhancement should take into consideration public attitudes to research on human genomics and human enhancement technologies. The article discusses, then, some of the recent findings of the SIENNA Project, which in 2019 conducted a survey on public attitudes to human genomics and human enhancement technologies in 11 countries (France, Germany, Greece, the Netherlands, Poland, Spain, Sweden, Brazil, South Africa, South Korea, and United States). (shrink)

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

In vitro embryology not only makes possible the growing of human tissue to remedy infertility but also for many other experimental purposes. This paper examines the ethical issues involved in such work and outlines the circumstances in which such work is morally permissible and those in which it is not.

A series of recent scientific results suggest that, in the not-too-distant future, it will be possible to create viable human gametes from human stem cells. This paper discusses the potential of this technology to make possible what I call ‘in vitro eugenics’: the deliberate breeding of human beings in vitro by fusing sperm and egg derived from different stem-cell lines to create an embryo and then deriving new gametes from stem cells derived from that embryo. Repeated iterations of (...) this process would allow scientists to proceed through multiple human generations in the laboratory. In vitro eugenics might be used to study the heredity of genetic disorders and to produce cell lines of a desired character for medical applications. More controversially, it might also function as a powerful technology of ‘human enhancement’ by allowing researchers to use all the techniques of selective breeding to produce individuals with a desired genotype. (shrink)

In vitro fertilization 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, as compared to those who become parents in a natural way. (shrink)

This chapter focuses on a novel class of models used in frontier research in the bioengineering sciences – in vitro simulation models – that provide the basis for biological experimentation. These bioengineered models are hybrid constructions, composed of living tissues or cells and engineered materials. Specifically, it discusses the processes through which in vitro models were built, experimented with, and justified in a tissue engineering lab. It examines processes of design, construction, experimentation, evaluation, and redesign of in (...) class='Hi'>vitro simulation models, in general, as instances of building the source analogy (as distinguished from retrieving an analogy), which figures prominently in creative frontier scientific research. Building the analogical source is a bootstrapping process, which furthers the articulation, as well as the solution of the problem. -/- . (shrink)

In vitro fertilisation is now an established technique for treating some forms of infertility, yet it remains ethically controversial. New developments, such as embryo donation and embryo freezing, have led to further discussion. We briefly discuss the ethical aspects of IVF, focusing on the issues of resource allocation, the 'unnaturalness' of the procedure, the moral status of the embryo, surrogate motherhood, and restrictions on access to IVF. We argue that, on the whole, IVF is an ethically justifiable method of (...) assisting infertile couples. (shrink)

The prospect of consumable meat produced in a laboratory setting without the need to raise and slaughter animals is both realistic and exciting. Not only could such in vitro meat become popular due to potential cost savings, but it also avoids many of the ethical and environmental problems with traditional meat productions. However, as with any new technology, in vitro meat is likely to face some detractors. We examine in detail three potential objections: 1) in vitro meat (...) is disrespectful, either to nature or to animals; 2) it will reduce the number of happy animals in the world; and 3) it will open the door to cannibalism. While each objection has some attraction, we ultimately find that all can be overcome. The upshot is that in vitro meat production is generally permissible and, especially for ethical vegetarians, worth promoting. (shrink)

Technological advances in genetic testing have enabled prospective parents to learn about their risk of passing a genetic condition to their future children. One option for those who want to ensure that their biological children do not inherit a genetic condition is to create embryos through in vitro fertilisation and use a technique called preimplantation genetic testing to screen embryos for genetic abnormalities before implantation. Unfortunately, due to its high cost, IVF-with-PGT is out of reach for the vast majority (...) of Americans. This article addresses an issue that has been underexplored in the medical ethics literature: the lack of insurance coverage for IVF-with-PGT.Within the US system, a key concept in insurance is that of medically necessary care, which broadly consists of diagnostic services and treatment services. In this article, I argue that IVF-with-PGT could be classified as either a diagnostic service or as a treatment service. To make this case, I show that IVF-with-PGT is similar to other types of services that are often covered by US insurance providers. In light of these similarities, I argue that the current system is inconsistent with respect to what is—and is not—covered by insurance. To promote consistency and fairness in coverage, like cases should be treated alike—starting with greater coverage for IVF-with-PGT. (shrink)

ABSTRACT This article deals with a cluster of moral problems raised by the new techniques of human fertilisation. It is concerned primarily with the putative rights of embryos brought into being as a by‐product of the practice of in vitro fertilisation. In this connection it investigates the basis for the ascription of rights to entities and asserts the view that consciousness is a pre‐requisite for the possession of rights. It draws attention to the speciesism implicit in attitudes of some (...) of those who have contributed to the debate. It also examines other issues briefly, raising, for example, the question whether children by AID (or by in vitro fertilisation by donor) must be denied access to information about their genetic fathers; and looking at objections to the new techniques based on the so‐called unnaturalness of the procedures involved. (shrink)

Recent advances in stem cell research suggest that in the future it may be possible to create eggs and sperm from human stem cells through a process that we term in vitro gametogenesis (IVG). IVG would allow treatment of some currently untreatable forms of infertility. It may also allow same-sex couples to have genetically-related children. For example, cells taken from one man could potentially be used to create an egg, which could then be fertilised using naturally produced sperm (...) from another man to create a genetically-related child with half of its DNA from each of the men. In this chapter, we consider whether this technology could justifiably be denied to same-sex couples if it were made available as a fertility treatment to different-sex couples. We argue that it could not. (shrink)

In Germany — as probably worldwide — in vitro fertilization has provoked disapproval, fears, and dread, but it also raises hope and gives feelings of pride and satisfaction in a new scientific achievement. Critics look for convincing argu- ments that could ban IVF completely or at least restrict it considerably. Some of the most important arguments are outlined below.The main aspect of IVF that was new to society was that conception could take place outside the female body. Although this (...) fact has made a deep impression on us, no ethical relevance has been attributed to it. One must look further for arguments against IVF. (shrink)

When we applied for the editorship of the JME 7 years ago, we said that we considered the JME to be the most important journal in medicine. The most profound questions that health professionals face are not scientific or technical, but ethical. Our enormous scientific and medical progress already outstrips our capability to provide treatment. Life can be prolonged at enormous cost, sometimes far beyond the point that the individual appears to be gaining a net benefit from that life. Science (...) can tell us how to achieve something, but it cannot tell us whether we should achieve that end—whether it is good. For that, we need ethics. Ethics grows in importance as our technology creates new possibilities. Where there are no options, there are no ethical questions. However, once there are options, there arise pressing questions about whether to pursue them. We require values and principles to decide how to use medicine and science. During the last 7 years, issues like the creation of brain organoids, human non-human chimeras, mitochondrial transfer, gene editing of embryos and in vitro gametogenesis have grown in prominence. These raise deep questions about moral status and how it should be determined, the limits of modification of humans, and what is good in life. As editors of the JME, we are proud of our small contribution to thinking about these challenges. We are grateful to the hard work of our associate editors and administrative staff, but there is still much more to do. During our term as editors, we have published papers from diverse perspectives, on a wide range of topics. We have seen vigorous debate within the pages of the journal and have often sought to deliberately encourage that debate …. (shrink)

Fertility treatments raise a range of social and ethical issues regarding self-identity for family, sexual intimacy, and the interests and welfare of potential children. Eggs and sperm are combined to produce fertilized eggs. These eggs are then implanted as embryos and grow into viable fetuses, which are carried by the original mother or a surrogate mother. This artificial form of conception can challenge religious values and family structures. In-vitro fertilization can be considered either as a medical miracle or playing (...) with divinity. What obligation do medical professionals have to infertile women and to what extent? The bioethical dilemma of IVF use encompasses different moral issues for all involved in the process. Ethical issues address respect for personal autonomy, access and care, and the duty of the health care provider to be compassionate to persons whose actions and moral values may be different from their own. Health care providers need to impart empathy, understanding and sensitivity towards this unique type of patient population. The conflict for those treating patients who are trying to conceive by IVF includes respect for personal autonomy, nonmaleficence, justice, utility and the ethics of care. As a registered nurse in a postpartum hospital unit, I have seen antepartum and postpartum women involved with this new technology. I have worked with mothers and their partners as they experience different levels of anxiety and hope for the future. There is an underlying psychosocial connection with patients who undergo IVF treatments. The purpose of this article is to explore the ethical use of IVF on older women. Is this type of biotechnolgy being applied for the right reasons and for the best patient population? (shrink)

Fertility treatments raise a range of social and ethical issues regarding self-identity for family, sexual intimacy, and the interests and welfare of potential children. Eggs and sperm are combined to produce fertilized eggs. These eggs are then implanted as embryos and grow into viable fetuses, which are carried by the original mother or a surrogate mother. This artificial form of conception can challenge religious values and family structures. In-vitro fertilization (IVF) can be considered either as a medical miracle or (...) playing with divinity. What obligation do medical professionals have to infertile women and to what extent? The bioethical dilemma of IVF use encompasses different moral issues for all involved in the process. Ethical issues address respect for personal autonomy, access and care, and the duty of the health care provider to be compassionate to persons whose actions and moral values may be different from their own. Health care providers need to impart empathy, understanding and sensitivity towards this unique type of patient population. The conflict for those treating patients who are trying to conceive by IVF includes respect for personal autonomy, nonmaleficence, justice, utility and the ethics of care. As a registered nurse in a postpartum hospital unit, I have seen antepartum and postpartum women involved with this new technology. I have worked with mothers and their partners as they experience different levels of anxiety and hope for the future. There is an underlying psychosocial connection with patients who undergo IVF treatments. The purpose of this article is to explore the ethical use of IVF on older women. Is this type of biotechnolgy being applied for the right reasons and for the best patient population? (shrink)

This study examines recent French bioethics laws governing the uses of new reproductive and genetic technologies (NRGTs)—including in-vitro fertilization, surrogate motherhood, prenatal diagnostics, sex selection, and cloning—in light of feminist claims to women's rights, especially a woman's right to reproductive freedom. To this end, the study explores two interrelated questions: First, to what extent have French feminists supported NRGT development and treatment? Second, to what extent do French national bioethics debates, laws, and policies reflect feminist reactions to NRGTs? The (...) investigation of these questions is informed by recent theories of state feminism that show how national policy debates are gendered by particular sets of feminist ideas, and how policy choices resulting from these debates turn some of these ideas into law (McBride Stetson and Mazur 1995). Some of the most pressing feminist concerns in this area include women's loss of control over their bodies and fertility, women's exploitation and commercialization of their bodies, and women's health risks from NRGTs. The analysis of pronouncements by French feminist writers, researchers, and policy-makers reveals a multiplicity of feminist stances on NRGTs, showing keenly how feminists contest what constitutes effective feminist public policies to illuminate the fact that these policies are subject to shifting political contestations, rather than the reflection of a fixed set of feminist ideas. While contemporary French feminists grapple with the potential merits and dangers of NRGTS, the study shows that feminists generally seem to support NRGTs, as long as French law protects women's reproductive autonomy. Seen in this light, France's strong sense of the right to procreate through facilitation of access to NRGTs is not a contradiction of France's strong social and legal support for women's reproductive freedom, but rather enables French lawmakers to regulate NRGTs more effectively. (shrink)

This study examines recent French bioethics laws governing the uses of new reproductive and genetic technologies —including in-vitro fertilization, surrogate motherhood, prenatal diagnostics, sex selection, and cloning—in light of feminist claims to women’s rights, especially a woman’s right to reproductive freedom. To this end, the study explores two interrelated questions: First, to what extent have French feminists supported NRGT development and treatment? Second, to what extent do French national bioethics debates, laws, and policies reflect feminist reactions to NRGTs? The (...) investigation of these questions is informed by recent theories of state feminism that show how national policy debates are gendered by particular sets of feminist ideas, and how policy choices resulting from these debates turn some of these ideas into law. Some of the most pressing feminist concerns in this area include women’s loss of control over their bodies and fertility, women’s exploitation and commercialization of their bodies, and women’s health risks from NRGTs. The analysis of pronouncements by French feminist writers, researchers, and policy-makers reveals a multiplicity of feminist stances on NRGTs, showing keenly how feminists contest what constitutes effective feminist public policies to illuminate the fact that these policies are subject to shifting political contestations, rather than the reflection of a fixed set of feminist ideas. While contemporary French feminists grapple with the potential merits and dangers of NRGTS, the study shows that feminists generally seem to support NRGTs, as long as French law protects women’s reproductive autonomy. Seen in this light, France’s strong sense of the right to procreate through facilitation of access to NRGTs is not a contradiction of France’s strong social and legal support for women’s reproductive freedom, but rather enables French lawmakers to regulate NRGTs more effectively. (shrink)

Debate has raged in Canada recently over whether in vitro fertilization should be funded through public health insurance. Such a move would require that the provinces classify IVF as a medically necessary service. In this paper, I defend the position I have taken publicly—especially in Ontario, my own province—that IVF is not medically necessary. I contend that, by funding IVF on grounds of medical necessity, governments like Ontario's violate their commitments to equality and fairness, and cause harm. They do (...) the last by suggesting that the lives of people who forgo procreation, and perhaps have children in other ways, will be stunted. (shrink)

There is a modern movement to grow artificial meat in laboratories in order to counter the ills of industrial animal agriculture. This article investigates whether lab-grown meat constitutes animal liberation by critically examining its proposed ethical superiority over traditional meat. These considerations are balanced with reflections on the ethical unknowns and shortcomings of the use of technology to solve human-caused problems. We examine a range of meanings attributed to “animal liberation” and consider how various forms of violence are potentially left (...) unchallenged, with a particular focus on gender relations. (shrink)

Advances in genomic technologies such as CRISPR‐Cas9, mitochondrial replacement techniques, and in vitro gametogenesis may soon give us more precise and efficient tools to have children with certain traits such as beauty, intelligence, and athleticism. In this paper, I propose a new approach to the ethics of reproductive genetic engineering, a human rights approach. This approach relies on two claims that have certain, independent plausibility: (a) human beings have equal moral status, and (b) human beings have human rights (...) to the fundamental conditions for pursuing a good life. I first argue that the human rights approach gives us a lower bound of when reproductive genetic engineering would be permissible. I then compare this approach with other approaches such as the libertarian, perfectionist, and life worth living approaches. Against these approaches, I argue that the human rights approach offers a novel, and more plausible, way of assessing the ethics of reproductive genetic engineering. (shrink)

For the sake of consistency with settled principles from other theological and ethical questions, there is a need for a Christian reexamination of in vitro fertilization (IVF). Both Old and New Testaments demonstrate that human personal life begins at conception or fertilization. Additionally, the Bible teaches that human beings are persons in the image of God from the very beginning of their existence. Thus, it can be concluded that the embryos created via IVF are persons in God’s image. Applying (...) this to the destruction and freezing of embryos, several limitations or restrictions present themselves—embryos should not be purposefully destroyed or wasted, all embryos ought to be implanted, and embryos should not be frozen. Ultimately, however, due to the immense quantity of embryo wastage, it is concluded that Christians should avoid this form of assisted reproductive technology and consider it a pro-life issue. (shrink)