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)

What role should legislation or policy play in avoiding the complications of in-vitro fertilization? In this article, we focus on single versus double embryo transfer, and assess three arguments in favour of mandatory single embryo transfer: risks to the mother, risks to resultant children, and costs to society. We highlight significant ethical concerns about each of these. Reproductive autonomy and non-paternalism are strong enough to outweigh the health concerns for the woman. Complications due to non-identity cast (...) doubt on the extent to which children are harmed. Twinning may offer an overall benefit rather than burden to society. Finally, including the future health costs for children in reproductive policy is inconsistent with other decisions. We conclude that mandatory single embryo transfer is not justified and that a number of countries should reconsider their current embryo transfer policy. (shrink)

This article offers a detailed response to a recent article in this Journal by Charles Robertson titled “A Thomistic Analysis of Embryo Adoption.” A careful review of important terminology that is used in both Donum vitae and Dignitas personae was undertaken, and a summary is included to help define frequently misleading and even mistaken concepts and terms that can often lead to erroneous conclusions. This article focuses on Donum vitae I.3 and n. 2275 of the Catechism of the Catholic (...) Church, which provide strong magiste­rial support for the liceity of embryo transfer and, ultimately, for the morality of embryo adoption as the only moral solution for “orphaned” embryos. The conclusion offers a faithful interpretation and resolution of the difficult passages in Donum vitae I.5 and Dignitas personae n. 19 regarding the magisterial liceity of both embryo transfer and embryo adoption. (shrink)

Difficulties in the moral assessment of embryo transfer and adoption include distinguishing it from illicit procedures like IVF and cryopreservation, determining the moral status of the human embryo, and reconciling embryo transfer and adoption with the procreative and unitive aspects of marriage. Many scholars who support embryo transfer and adoption limit their discussion to heterologous embryo transfer, the transfer of a genetically unrelated embryo into the uterus of a married (...) woman. In this paper, the author focuses on homologous embryo transfer, the transfer of a genetically related embryo, as a viable option for married couples. It is the responsibility of the genetic mother to implant her embryos regardless of how they were created. When this option is not feasible, heterologous embryo transfer is possible in limited circumstances. (shrink)

I argue that proponents of heterologous embryo transfer are faced with the practical decision of whether would-be parents should adopt a prenatal child or a postnatal child (e.g., a child from the foster system). I argue that, all things considered, there is a good reason to favor postnatal adoption in every case in which a postnatal child is available for adoption. Since, unfortunately, there will always be postnatal children to adopt, there is little practical impetus for prenatal adoption.

In many countries where human embryo commercialization is banned, and no profit is allowed to be made directly from the transaction of frozen embryos between donor and recipient, there is still considerable opportunity for profiteering in medical fees arising from laboratory and clinical services rendered to the recipient. It is easy to disguise the 'sale' of altruistically donated human embryos through substantially increased medical fees, particularly in a private practice setting. The pertinent question that arises is what would constitute (...) a fair and honest profit margin for the medical professional and health institution in question? A suitable benchmark would obviously be the level of medical fees normally charged to patients for a self-freeze/thaw embryo transfer cycle, after initial failure at their first attempt in ART. This is because the level of medical expertise, clinical and laboratory services required for a donor- and self-freeze/thaw embryo transfer cycle should, in theory, be about the same, although slight variation in treatment can be expected owing to patients' respective medical histories, which results in varying predisposition to medical complications. In any case, the health authority should ensure that there is no gross disparity in the medical fees for both donor- and self-freeze/thaw embryo transfer cycle, as this could mask opportunistic profiteering by medical professionals and, in fact, be a covert form of embryo commercialization. (shrink)

In vitro fertilisation (IVF) daily practice reveals that couples are willing to take greater risks than doctors if there is a higher chance of pregnancy. Arising from this is a frequently addressed issue regarding the embryo transfer strategy: single or double embryo transfer? The dilemma is faced by patients, as well as physicians, who are caught between the possibility of no pregnancies at all and facing the prospect of iatrogenic twin gestation. How could the couple's preferences (...) concerning how many children they would like be taken into account in determining the number of embryos transferred? How should the physician exercise his medical responsibility towards his patients and the unborn child? An effective approach could be to enhance a couple’s autonomy by advocating a medical beneficence that incorporates patients’ values. This can be achieved through a case-by-case approach in a deliberative process of decision-making which includes real patient-centred communication. (shrink)

Please note that a commentary recently published in this journal (Heng; Philosophy, Ethics, and Humanities in Medicine 2007, 2:3) includes substantial duplication of Letters to the Editor published in Developing World Bioethics (Heng; Developing World Bioethics 2007, 7:49) and Human Fertility (Heng; Human Fertility 2007, 10: 129-130).

Recommandations have been formulated in 1985 with reference to socialist morality and law and as a result of interdisciplinary discussion by the IAME (Interdisciplinary Working Party on Medical Ethics at the GDR Academy of Postgraduate Medical Education) for clinical application of in vitro fertilization and for the use of human oocytes and early embryonic stages.

Harvesting human embryonic stem (hES) cells is a highly controversial field of research because it rests on the destruction of human embryos. Altering the procedure of nuclear transfer (NT) is suggested to generate hES cell lines without ethical obstacles by claiming that no embryo would be involved. While discussing the nature of an embryo and related central questions concerning their moral status and the respect they deserve, this paper argues that the entity created by somatic cell nuclear (...) transfer (SCNT) or altered nuclear transfer (ANT) is an embryo and has the same moral status as a natural embryo. Respect for the embryo is expressed by the ethical principles of proportionality, probability and subsidiarity. This paper argues that the human embryo should only be taken for research with high ranking goals, which are proven in animal experimentation and for which there are no alternatives. This makes ANT obsolete and shows that SCNT to produce hES cells is premature at the present time. (shrink)

The screening of in vitro embryos resulting from in vitro fertilization treatment for chromosomal abnormalities has as a primary aim to help patients achieve a successful pregnancy. Most IVF centers will not transfer aneuploid embryos, as they have an enhanced risk of leading to implantation failure and miscarriage. However, some aneuploidies, such as trisomy-21, can lead to viable pregnancies and to children with a variable health prognosis, and some prospective parents may request transfer of such embryos. I present (...) two cases where the testing for and detection of trisomy-21 can lead to conflicts between IVF professionals and patients and argue that in most such cases respect for choices of patients should prevail. (shrink)

Is it permissible to use a human embryo in stem cell research, or in general as a means for benefit of others? Acknowledging each embryo as an object of moral concern, Louis M.Guenin argues that it is morally permissible to decline intrauterine transfer of an embryo formed outside the body, and that from this permission and the duty of beneficence, there follows a consensus justification for using donated embryos in service of humanitarian ends. He then proceeds (...) to show how this justification commands assent even within moral and religious views commonly thought to oppose embryo use. Beneath his moral reasoning lies a carefully constructed metaphysical foundation incorporating accounts of the ontology of development, embryos, and species. He also incisively discusses nonreprocloning, reprocloning, ectogenesis, and related scientific frontiers. This compelling philosophical study will interest all concerned to understand virtue and obligation in the relief of suffering. (shrink)

The development of in vitro fertilisation (IVF) as a treatment for human infertilty was among the most controversial medical achievements of the modern era. In Ireland, the fate and status of supranumary (non-transferred) embryos derived from IVF brings challenges both for clinical practice and public health policy because there is no judicial or legislative framework in place to address the medical, scientific, or ethical uncertainties. Complex legal issues exist regarding informed consent and ownership of embryos, particularly the use of non-transferred (...) embryos if a couple separates or divorces. But since case law is only beginning to emerge from outside Ireland and because legislation on IVF and human embryo status is entirely absent here, this matter is poised to raise contractual, constitutional and property law issues at the highest level. Our analysis examines this medico-legal challenge in an Irish context, and summarises key decisions on this issue rendered from other jurisdictions. The contractual issues raised by the Roche case regarding informed consent and the implications the initial judgment may have for future disputes over embryos are also discussed. Our research also considers a putative Constitutional 'right to procreate' and the implications EU law may have for an Irish case concerning the fate of frozen embryos. Since current Medical Council guidelines are insufficient to ensure appropriate regulation of the advanced reproductive technologies in Ireland, the report of the Commission on Assisted Human Reproduction is most likely to influence embryo custody disputes. Public policy requires the establishment and implementation of a more comprehensive legislative framework within which assisted reproductive medical services are offered. (shrink)

The author applies the definitions of surrogacy offered by Donum vitae to the question of embryo adoption and shows that embryo adoption does not in fact constitute an act of surrogacy. The author shows that neither Donum vitae nor Dignitas personae condemns heterologous embryo transfer or embryo adoption per se but only when these acts also involve illicit forms of artificial fertilization or surrogacy. The author suggests that the apparent reason for a lack of endorsement (...) of embryo adoption by Donum vitae and Dignitas personae is pastoral caution, concern for scandal, and the connection between embryo adoption and IVF; it is not because embryo adoption is intrinsically illicit. National Catholic Bioethics Quarterly 11.2 (Summer 2011): 249–256. (shrink)

DNA methylation can be considered a component of epigenetic memory with a critical role during embryo development, and which undergoes dramatic reprogramming after fertilization. Though it has been a focus of research for many years, the reprogramming mechanism is still not fully understood. Recent results suggest that absence of maintenance at DNA replication is a major factor, and that there is an unexpected role for TET3-mediated oxidation of 5mC to 5hmC in guarding against de novo methylation. Base-resolution and genome-wide (...) profiling methods are enabling more comprehensive assessments of the extent to which ART might impair DNA methylation reprogramming, and which sequence elements are most vulnerable. Indeed, as we also review here, studies showing the effect of culture media, ovarian stimulation or embryo transfer on the methylation pattern of embryos emphasize the need to face ART-associated defects and search for strategies to mitigate adverse effects on the health of ART-derived children. DNA methylation, critical for embryo development, suffers significant changes after fertilization, including demethylation, remethylation and TET3-mediated oxidation of 5 mC to 5 hmC. In addition to infertility and environmental insults, ART could impact DNA methylation and ART related consequences in the offspring have been reported. (shrink)

Some stem cell researchers believe that it is easier to derive human embryonic stem cells from fresh rather than frozen embryos and they have had in vitro fertilization (IVF) clinicians invite their infertility patients to donate their fresh embryos for research use. These embryos include those that are deemed 'suitable for transfer' (i.e. to the woman's uterus) and those deemed unsuitable in this regard. This paper focuses on fresh embryos deemed suitable for transfer - hereafter 'fresh embryos'- which (...) IVF patients have good reason not to donate. We explain why donating them to research is not in the self-interests specifically of female IVF patients. Next, we consider the other-regarding interests of these patients and conclude that while fresh embryo donation may serve those interests, it does so at unnecessary cost to patients' self-interests. Lastly, we review some of the potential barriers to the autonomous donation of fresh embryos to research and highlight the risk that female IVF patients invited to donate these embryos will misunderstand key aspects of the donation decision, be coerced to donate, or be exploited in the consent process. On the basis of our analysis, we conclude that patients should not be asked to donate their fresh embryos to stem cell research. (shrink)

Although two documents from the Congregation for the Doctrine of the Faith have given instruction on the moral problems of artificial reproductive technologies and the importance of respecting the lives of cryopreserved embryos, no definitive judgment has been made regarding the possibility of rescuing those embryos by means of embryo transfer into the uterus of a willing woman. This essay offers an analysis of the morality of embryo transfer in light of the ethical principles of St. (...) Thomas Aquinas and argues that the proper use of our generative potential is only safeguarded by being restricted to marital intercourse. The arguments of those who favor the adoption model are considered and rejected in light of a Thomistic analysis of the categories of paternity, maternity, and filiation. National Catholic Bioethics Quarterly 14.4 : 673–695. (shrink)

Under current UK law, an embryo cannot be transferred to a woman's uterus without the consent of both of its genetic parents, that is both of the people from whose gametes the embryo was created. This consent can be withdrawn at any time before the embryo transfer procedure. Withdrawal of consent by one genetic parent can result in the other genetic parent losing the opportunity to have their own genetic children. We argue that offering couples only (...) one type of consent agreement, as happens at present, is too restrictive. An alternative form of agreement, in which one genetic parent agrees to forego the right to future withdrawal of consent, should be available alongside the current form of agreement. Giving couples such a choice will better enable them to store embryos under a consent agreement that is appropriate for their circumstances. Allowing such a choice, with robust procedures in place to ensure the validity of consent, is the best way to respect patient autonomy. (shrink)

The notion of the human embryo is not immutable. Various scientific and technological breakthroughs in reproductive biology have compelled us to revisit the definition of the human embryo during the past 2 decades. Somatic cell nuclear transfer, oocyte haploidisation and, more recently, human stem cell-derived embryo models have challenged this scientific term, which has both ethical and legal repercussions. Here, we offer a legal perspective to identify a universally accepted definition of ‘embryo’ which could help (...) to ease and unify the regulation of such entities in different countries. (shrink)

A remarkable event occurred at the December 3, 2004, meeting of the U. S. President’s Council on Bioethics. Council member William Hurlbut, a physician and Consulting Professor in the Program in Human Biology at Stanford University, formally unveiled a proposal that he claimed would solve the ethical problems surrounding the extraction of stem cells from human embryos. The proposal would involve the creation of genetically defective embryos that “never rise to the level of integrated organismal existence essential to be designated (...) human life with potential,” and therefore could be used as morally acceptable sources of stem cells for research and therapy. The aim of this essay is to show that Hurlbut’s proposal does not solve the ethical problems associated with human embryonic stem cell research. Two major reasons are presented. First, the proposal, which involves modification of a somatic cell nucleus, suffers from an ethical problem that is common to all types of human genetic engineering: since the procedure is not foolproof, there will be failures. In the case of the procedure Hurlbut proposes, some normal (albeit cloned) embryos will be produced. Second, the embryo engineered in the manner described is, at least in the early stages of its development, fully human despite its genetic defect. This essay also will show how a reasonable person might mistakenly view the proposal as legitimate if he or she makes the error of conflating genetic determinism with Aristotelian teleology. Finally, it will argue that ethical clarity can be achieved by seeing the embryo as a holistic entity possessing emergent properties that cannot simply be spelled out by genes. (shrink)

Recent arguments on the ethics of stem cell research have taken a novel approach to the question of the moral status of the embryo. One influential argument focuses on a property that the embryo is said to possess—namely, the property of being an entity with a rational nature or, less controversially, an entity that has the potential to acquire a rational nature—and claims that this property is also possessed by a somatic cell. Since nobody seriously thinks that we (...) have a duty to preserve the countless such cells we wash off our body every day in the shower, the argument is intended as a reductio ad absurdum of the claim that the embryo should be afforded the same moral status as a fully developed human being. This article argues that this argument is not successful and that it consequently plays into the hands of those who oppose embryonic stem cell research. It is therefore better to abandon this argument and focus instead on the different argument that potentiality, as such, is not a sufficient ground for the creation of moral obligations towards the embryo. (shrink)

Mitochondrial/nuclear transfer (M/NT) to avoid the transmission of serious mitochondrial disease raises complex and challenging ethical, legal and social issues (ELSI). In February 2015, the United Kingdom became the first country in the world to legalize M/NT, making the heated debate surrounding this technology even more relevant. This critical interpretive review identified 95 relevant papers discussing the ELSI of M/NT, including original research articles, government-commissioned reports, editorials, letters to editors and research news. The review presents and synthesizes the arguments (...) present in the literature in relation to the most commonly raised themes: terminology; identity, relationships and parenthood; potential harm; reproductive autonomy; available alternatives; consent; impact on specific interest groups; resources; “slippery slope”; creation, use and destruction of human embryos; and beneficence. The review concludes by identifying those ELSI that are specific to M/NT and by calling for follow-up longitudinal clinical and psychosocial research in order to equip future ELSI debate with empirical evidence. (shrink)

ABSTRACT Recent developments allow for the creation of human stem cells without the creation of human embryos, a process called alternate nuclear transfer (‘ANT’). Pursuing this method of stem cell research makes sense for pro‐lifers if arguments for the sanctity of the human embryo do not apply to ANT. However, the technology that makes ANT possible undermines the erstwhile technical barrier between human embryos and somatic cell DNA. These advances bring home the force of hypothetical arguments about the (...) potential of the DNA in somatic cells, showing that there is not a morally relevant difference between the potential of an embryo and the potential of the DNA in a somatic cell. Therefore, the supposed distinction between entities that are potential human life and entities that are human life does not give any support to arguments for the sanctity of the human embryo because those arguments extend value to too many entities. (shrink)

A review of S. M. Liao's "Rescuing human embryonic stem cell research: The blastocyst transfer method," American Journal of Bioethics 5(6), 2005: 8:16.

It is becoming increasingly apparent that human embryo research has the very real potential to generate significant humanitarian benefits. Equally, it is clear that the destruction of embryos that such research inevitably involves is highly controversial within societies such as ours, where many hold either that from the moment of conception the embryo is morally considerable or that as a member of the human species it should not be treated as a mere means. How might we balance the (...) potential humanitarian benefits of embryo research against the various strongly felt moral objections to such use?In this rich and highly sophisticated work, Guenin argues for the experimental use of a bounded range of embryos, namely those which were intentionally produced for research ex utero and for which the progenitor has explicitly banned any intrauterine transfer. He argues that since they are not possible persons, it is morally permissible to perform experiments on this set of embryos .1 Indeed, he suggests that given the suffering that such research might relieve, it would be uncaring for us not to undertake it .As one might expect, the focus of the book is primarily on stem cell research. The ‘pluripotent’ stem cells one finds in …. (shrink)

More and more areas of medicine involve subjects donating tissues to another — blood, organs, bone marrow, sperm, ova and embryos can all be transferred from one person to another. Within the technical frameworks of biomedicine, such fragments are generally treated as detachable things, severed from social identity once they are removed from a particular body. However an abundant anthropological and sociological literature has found that, for donors and patients, human tissues are not impersonal. They retain some of the values (...) of personhood and identity, and their incorporation often has complex effects on embodied identity. This article draws on feminist philosophy of the body to think through the implications of some of these practices. Specifically, it draws on the idea of intercorporeality, wherein the body image is always the effect of embodied social relations. While this approach is highly productive for considering the stakes involved in tissue transfer, it is argued that the concept of body image has been too preoccupied with the register of the visual at the expense of introceptive data and health/illness events. Empirical data around organ transplant and sperm donation are used to demonstrate that the transfer of biological fragments involves a profound kind of intercorporeality, producing identifications and disidentifications between donors and recipients that play out simultaneously at the immunological, psychic and social levels. (shrink)

This paper stems from an ethnographic, multidisciplinary study that explored the views and experiences of practitioners and scientists on social, ethical and clinical dilemmas encountered when working in the area of pre-implantation genetic diagnosis for serious genetic disorders. We focus here on staff perceptions and experiences of working with embryos and helping women/couples to make choices that will result in selecting embryos for transfer and disposal of 'affected' embryos, compared to the termination of affected pregnancies following prenatal diagnosis. Analysis (...) and discussion of our data led us to consider the possible advantages of pre-implantation genetic diagnosis and whether a gradualist account of the embryo's and fetus's moral status can account for all of these, particularly since a gradualist account concentrates on the significance of time (developmental stage) and makes no comment as to the significance of place (in vitro, in utero). (shrink)

Non‐invasive microanalytical methods have been devised to study the energy metabolism of single human preimplantation embryos. Psyruvate, which is added routinely to all media used to culture human embryos, is consumed throughout the preimplantation period, with glucose assuming an increasing role at embryo compaction and blastocyst formation. All of the glucose consumed may be accounted for by the appearance of lactate in the incubation medium. The enzyme hexokinase my be involved in regulating this aerobic glycolysis. There is cosiderable indirect (...) evidence for the utilisation of endogenous as opposed to exogenous energy substrates, the most likely candidate being protein. Information on early human embryo metabolismis likely to find application in a number of areas: these include the improvement of techniques for assisted human conception, notably in the selection of embryos for transfer following In Vitro Fertilisation; the diagnosis of gentic defects at the preimplantation stage; increased undersding of the causes of implantation failure and miscarriage, and the development of novel post‐coital contraceptives. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NABER on Embryo SplittingMichael B. BurkeMadam:In its interesting Report on Human Cloning through Embryo Splitting: An Amber Light (KIEJ, September 1994), NABER (the National Advisory Board on Ethics in Reproduction) discusses ten potential clinical uses of embryo splitting. With one member dissenting, NABER finds two of the uses to be acceptable in principle: (1) “to improve the chances of initiating pregnancy in those individuals undergoing IVF (...) who produce only a limited number of embryos for transfer and implantation” (p. 267) and (2) “to minimize the number of egg retrieval procedures for those undergoing IVF by providing embryos for cryopreservation and future transfer” (p. 268).However, some members of NABER limit their support for these uses to cases in which none of the embryos into which the originals are split are intentionally destroyed (see pp. 266–68). I find their position puzzling. They consider it “ethically unacceptable to discard cryopreserved embryos” (p. 268). In general, they object to intentional destruction of embryos resulting from embryo splitting. Yet they accept intentional destruction of the original embryos.Does the splitting of an embryo truly destroy it? Yes, it does, at least if the embryo is split into two equal parts—or into more than two parts, none of which contains a majority of the cells contained by the original. Suppose, for instance, that a two-cell embryo has been split into two one-cell embryos. Then the original embryo, although it may not have “died” and although its cells have both survived, has nonetheless ceased to exist. Even though the resulting one-cell embryos are identical genetically to the original embryo, neither of them is that embryo. (There is nothing to confer this honor on one of them rather than the other.) The original embryo has undergone what I will call “destructive splitting.”Now it is possible, even likely, that some splittings are not destructive splittings. Suppose that a four-cell embryo is spilt into a three-cell embryo and a one-cell embryo. At least from my perspective as an identity theorist, there is nothing to stop us from identifying the three-cell embryo with the four-cell original: we could say that the original embryo, although diminished, still exists. In any case, there is no indication that any members of NABER intended to limit their acceptance of embryo splitting to cases in which the original embryo survives.How are we to understand the apparent indifference of conservative members of NABER to the embryo that is split, given their concern for the embryos that result from the split? Perhaps the explanation is found in the following passage:NABER members represent a broad spectrum of views on the moral status of the embryo, and yet virtually all of them find embryo splitting per se ethically permissible if the resulting embryos are not damaged or destroyed in the process. These members maintain that there is nothing inherently wrong with creating several embryos [End Page 210] from a single embryo, providing all the embryos involved [except the original!] remain intact at the conclusion of the procedure. Embryo splitting parallels the spontaneous production of identical twins or triplets at this stage of embryo development, an occurrence that is accepted in our society with equanimity. The fact that embryo splitting is deliberately used to produce multiple embryos does not make it inherently wrong to employ the procedure.(Report, pp. 266–67)This argument appears to rely on the following principle: if something is properly viewed with equanimity when it happens spontaneously, then it is not inherently wrong to bring it about deliberately. At least in its full generality, this is a principle generally and rightly viewed with suspicion (by moral conservatives above all). Although it is proper to view with equanimity, even with relief, the natural deaths of terminally ill patients in great pain, many hold that active euthanasia is inherently wrong.When NABER has occasion to revisit the issue of embryo splitting, those members who object to destruction of embryos resulting from embryo splitting should make clear whether they accept the destructive splitting of embryos. If they do, they should clarify their reasons for accepting it.Michael B. BurkeDepartment of Philosophy Indiana... (shrink)

Embryo adoption is a topic of considerable debate in the Church. Well over a million human embryos are currently being kept in cryogenic containers with little prospect of survival. The desire to rescue these vulnerable human beings is natural. However, the processes required to do so raise serious questions regarding the ethics of embryo adoptions. The violation of the unitive and procreative aspects of human intercourse and its ramifications on the moral status of heterologous embryo transfer (...) are key to understanding the reasoning behind some objections to human embryo adoption. (shrink)

This essay responds to an article by Elizabeth Bothamley Rex titled “The Magisterial Liceity of Embryo Adoption”, specifically to Rex’s critique that his objections to the liceity of embryo transfer distort magisterial documents. He then draws out the implications of the differences between his view and Rex’s on the relation between maternity and pregnancy. The essay concludes by pointing out that, if they are to change their minds, opponents of embryo adoption need to be convinced that (...) it is morally licit to impregnate, or “introduce an order to birth,” in a woman by means other than the marriage act. (shrink)

Guidelines on embryo storage prioritise 'respect for the embryo' above the wishes of the women whose labour and tissue have gone into creating the embryo in the first place, effectively making women and the female body disappear. In this article I draw a parallel between this phenomenon relating to embryo storage and other instances of a similar phenomenon that I have called 'the lady vanishes', particularly in stem cell and 'mitochondrial transfer' research. I suggest that (...) a modified property regime could protect women's interests in embryo storage, making a parallel with the Yearworth case, in which it was recognised that men had limited but actionable interests in their stored sperm.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Future Directions for Human Cloning by Embryo Splitting:After the HullabalooCynthia B. Cohen (bio)In October 1993, a paper entitled, "Experimental Cloning of Human Polyploid Embryos Using an Artificial Zona Pellucida," was presented at a joint meeting of the American Fertility Society and the Canadian Fertility and Andrology Society. Although it was awarded a prize, its authors, who are affiliated with George Washington University, decided against calling a press conference (...) to announce their findings. Word of their experiment soon leaked out, however, and the New York Times blazoned on its front page that human embryo cloning had been achieved. The story was accompanied by a diagram of cloning by nuclear transplantation.Newspapers and television networks around the world picked up the story and embellished it. The idea of unlimited, xeroxed copies of human beings gripped the public imagination. Wild scenarios of hundreds of Hitlers plotting to take over the world and of clones giving birth to their own twins enlivened media reports. Only gradually did it become clear that the term "polyploid" in the title of the paper referred to abnormal embryos that could never develop into living human beings and that "cloning" referred to embryo splitting or twinning, not to nuclear transplantation or the transfer of a donor nucleus into an enucleated egg. Once this sank into public consciousness, the "hullabaloo," as Dr. Howard W Jones, Jr., called it, died down.It left in its wake unanswered questions about the ethics of splitting embryos. During the height of the publicity given to the George Washington experiment, newspaper and TV stories had not delved in any depth into the ethical issues it raised. Ethicists, given limited time to discuss the ethical questions at stake, had been quoted in quick, simplistic responses. Some had offered little analysis of the rights and wrongs of embryo splitting, but, revealing tremendous creative talent, had spun out [End Page 187] imaginary and frightening applications of the procedure. This was a story essentially about ethics in which ethics was never really discussed.The National Advisory Board on Ethics in Reproduction* (NABER), an independent, multidisciplinary group that addresses ethical issues in modern reproductive science, technology, and care, became concerned about the sparsity of reflective ethical debate about embryo splitting. NABER's chair, Albert Jonsen, observed that "reporters phoning ethicists for comment and ethicists appearing on talk shows do not a debate make. Debate requires face to face (or at least essay to essay) argument among persons sharing the same information. This has yet to take place." Consequently, NABER decided to convene a workshop on human cloning by embryo splitting at the National Academy of Sciences in February 1994. The board invited participants who would provide a broad range of opinion about the ethical and public policy issues entailed by human embryo splitting. Embryologists, ethicists, reproductive biologists, public policy experts, staff from the National Institutes of Health (NIH), legal scholars, journalists, and infertility specialists were among those who participated. The feature articles in this issue of the Kennedy Institute of Ethics Journal derive from that workshop. Their authors were given free rein to take whatever stance they deemed ethically supportable.The first article is designed to provide some understanding of the science of human cloning as a basis for exploring the ethical issues raised by this set of techniques. Jacques Cohen, a leading reproductive embryologist, and Giles Tomkin, a science writer, both of Cornell University Medical School, explain, in a way that is clear to laypersons and biologists alike, the meaning, nature, and function of cloning. They discuss recent: advances in this area and offer an assessment of feasible uses of human cloning procedures, hoping to dispel what they view as mistaken fears about its future applications. Dr. Howard W Jones, Jr., a pioneer infertility specialist, briefly comments on Cohen and Tomkin's paper, pointing out that embryo splitting may not improve pregnancy results if genetic heterogeneity is required for successful embryo transfer and implantation.In the next article, three major ethical arguments against human cloning by embryo splitting are analyzed and rejected by Ruth Macklin, an expert in reproductive ethics from Albert Einstein College of Medicine. She finds the first argument, that the worth of individuals... (shrink)

A major obstacel to the study of mammalian development, and to the practical application of knowledge gained from it in the clinic during therapeutic in vitro fertilisation and embryo transfer (IVF‐ET), is the propensity of embryos to become retarded or arrested during their culture in vitro. The precise developmental cell cycle in which embryos arrest or delay is characteristic for the species and coincides with the earliest period of embryonic gene expression. Much evidence reviewed here implicates free oxygen (...) radicals (FORs) in the process of arrest. Thus, studies on the development of mouse preimplantation embryos in vitro have shown that (i) FORs are elevated in vitro, but not in vivo, at the time at which embryos become arrested or delayed, (ii) systems for removing reactive oxygen species to limit the formation of hydroxy radicals are present, although they have not yet been assessed quantitatively and may differ qualitatively from those in adult cells, (iii) metabolic and possibly genetic adaptations to oxidative damage are evident, (iv) published procedures for overcoming in vitro arrest are explicable in terms of FOR‐mediated damage or responses and (v) the arrest or delay of most embryos in vitro can be reduced or prevented experimentally by addition of metal chelators to limit hydroxy radical formation and lipid hydroperoxidation. (shrink)

It is becoming increasingly apparent that human embryo research has the very real potential to generate significant humanitarian benefits. Equally, it is clear that the destruction of embryos that such research inevitably involves is highly controversial within societies such as ours, where many hold either that from the moment of conception the embryo is morally considerable or that as a member of the human species it should not be treated as a mere means. How might we balance the (...) potential humanitarian benefits of embryo research against the various strongly felt moral objections to such use?In this rich and highly sophisticated work, Guenin argues for the experimental use of a bounded range of embryos, namely those which were intentionally produced for research ex utero and for which the progenitor has explicitly banned any intrauterine transfer. He argues that since they are not possible persons, it is morally permissible to perform experiments on this set of embryos.1 Indeed, he suggests that given the suffering that such research might relieve, it would be uncaring for us not to undertake it.As one might expect, the focus of the book is primarily on stem cell research. The ‘pluripotent’ stem cells one finds in …. (shrink)

This article discusses when it is ethically acceptable to withdraw consent for the storage and use of embryos and gametes. Currently, the law in the UK states that consent to use of a gamete or embryo can be withdrawn up to the point of the embryo's transfer to the recipient's uterus or when the gamete is used in providing treatment services; that is, the ‘point of no return’. In this article, we will consider other points of no (...) return and argue that having a single point of no return, a one size fits all form of consent can, in some cases, lead to restrictions on individuals’ autonomy and cause particular types of harm. Therefore, having different points of no return that fit different circumstances could extend autonomy and allow people to enter into agreements that are tailored more to their own particular needs and circumstances. (shrink)

This article is a response to McLeod and Baylis (2007) who speculate on the dangers of requesting fresh ‘spare’ embryos from IVF patients for human embryonic stem cell (hESC) research, particularly when those embryos are good enough to be transferred back to the woman. They argue that these embryos should be frozen instead. We explore what is meant by ‘spare’ embryos. We then provide empirical evidence, from a study of embryo donation and of embryo donors' views, to substantiate (...) some of their speculations about the problems associated with requesting fresh embryos. However, we also question whether such problems are resolved by embryo freezing, since further empirical evidence suggests that this raises other social and ethical problems for patients. There is little evidence that the request for embryos for research, in itself, causes patients distress. We suggest, however, that no requests for fresh embryos should be made in the first cycle of IVF treatment. Deferring the request to a later cycle ensures that potential donors are better informed (by experience and reflection) about the possible destinations of their embryos and about the definition of ‘spare embryos’. Both this article, and that by McLeod and Baylis, emphasize the need to consider the views and experiences of embryo donors when evaluating the ethics of embryo donation for hESC research. (shrink)