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 work sought to carry out a comparative analysis of in vitro fertilization (IVF) vis-à-vis St. Thomas Aquinas’ Natural Law Theory. Both of them emanated from problem of infertility. IVF makes use of artificial insemination for fertilization which is quite contrary to the natural process of sexual reproduction. This work makes use of analytic method to analyse comparatively in vitro fertilization and St. Thomas Aquinas’ Natural Law Theory. Thus, this work conceives that IVF is one (...) of the assisted reproductive technologies in the scientific exploration of genetic engineering and bio-technology which emanated to tackle the problem of genetic inheritance outside marriage. It contravenes the coital or natural reproduction which conforms to St. Thomas Aquinas’ second precept of natural law. Again, IVF is artificial as such it is pruned to many complications. There is no adequate information given by the medical practitioners or providers of this service on the health hazards or risks involve in IVF. In addition, in vitro fertilization makes provision for donor gamete and surrogate motherhood which may have many negative implications both for the couples, off-spring, gestation mother, and society at large. (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)

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)

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)

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)

The views on in vitro fertilization within Russian Orthodox Christian society are diverse. One reason for that variation is the ambiguity found in “The Basis of the Social Concept,” the document issued in 2000 by the Russian Orthodox Church and considered to be the primary guidelines for determining the Church’s stance on bioethics. This essay explores how the treatment of infertility reconciles with the Orthodox Christian faith and what methods of medical assistance for infertility may be appropriate for (...) Orthodox Christians. The focus here is on IVF because it is among the most widely used methods to overcome childlessness, and the permissibility of IVF is the object of disagreement among Orthodox. The article defines criteria that can help to discern what is absolutely wrong and must be avoided from what only falls short of the mark, but not very far, for Orthodox Christians. If treatment of the underlying causes of infertility has failed or promises no hope and a husband and a wife do not feel able to carry the Cross of infertility, then from pastoral dispensation they might be blessed to use ethically acceptable variants of IVF. IVF has many variants that are different in their spiritual influence on a person. Orthodox Christians pursuing IVF should seek spiritual guidance and a blessing to pursue IVF. They must not form more embryos than will be transferred in the same cycle. Freezing, discarding, or reduction of embryos is forbidden. Infertile couples ought to use only their reproductive cells. The use of donor gametes is unacceptable. Any embryo formed ought to be transferred into the wife’s womb, and the use of surrogates is impermissible. Only a husband and wife who are able to maintain their marital union and where the wife is still of childbearing age should be blessed to use IVF. (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)

After the typical theological and bioethical questions about in vitro fertilization (IVF) are vetted, there remains a three-dimensional understanding of responsibility that is not typically considered in Christian bioethics. This paper will explore responsibility to the spouses’ loving union, their bodies, and society in order to ascertain the morality of IVF. In a marriage partnership, the spouses’ primary responsibility is to each other. Although in matrimony physical union is essential to marriage, children are not. The second dimension of (...) responsibility focuses on the body—“the temple of God”—and on our responsibility to care for it. This concerns the woman, her husband, and even the newborn. Finally, the third understanding of responsibility leads us to address social concerns, with an emphasis on social dynamics, especially the cost of IVF procedures and how they siphon medical resources away from more urgent human needs in health care and within society. (shrink)

In the medical-technological practice of in vitro fertilization, it is increasingly the couple, rather than an individual patient, that is considered the unit of treatment. This article traces some mechanisms involved in the construction of medical interventions on female bodies as appropriate and effective therapeutic solutions to problems and diagnoses pertaining to male bodies. It traces the transformation of male infertility through shifts in localization and definition of the problem, concomitant reconceptualizations of the techniques involved, redistributions of properties, (...) and specific ways of constructing "success. " It is argued that both the notion of the couple as the patient in cases of male infertility and the claim that IVF techniques are appropriate solutions to this couple's problem simultaneously presuppose and legitimize medical interventions on women's bodies. This double movement is produced by leaving exactly the required material work of physical interventions—and, consequently, the uneven distribution of costs between the sexes—out of scientific accounts of these practices. (shrink)

In the 2008 Instruction Dignitas personae (The Dignity of the Person), the Congregation for the Doctrine of the Faith presented once again the teaching of the Church on in vitro fertilization. Much of this teaching was contained in the earlier Instruction Donum vitae (The Gift of Life, 1987), but the new document brings the teaching of the Church up to date. Because the teaching is not accepted in the secular scientific community and is often unknown in the Catholic (...) community, this article explores the process of IVF, the view of the Church concerning it, and the fundamental principles underlying the Church’s teaching. National Catholic Bioethics Quarterly 10.4 (Winter 2010): 709–722. (shrink)

This paper explores some of the ethical implications of artificial insemination and in vitro fertilization. In both cases the emphasis is on the interests of the potential child. It concludes that in neither case is great optimism or great pessimism appropriate. About AID, much of the legal and ethical concern has been other than child-centered, and has focused mainly on the interests of parents and donors. Three aspects expecially remain troubling: donor selection, record-keeping and disclosure and the testing (...) of frozen semen. About further IVF research, approval appears justified, as long as remaining concerns about risk/safety and need are satisfied. (shrink)

In‐vitro fertilization clinics across the world currently use the body mass index (BMI) to assess risk for and determine access to in‐vitro fertilization (IVF); however, clinics vary widely in both setting specific BMI limits for access to IVF and articulating the reasons for their policies. Given that scholars have begun to question the usefulness of BMI for individual health risk assessment, it is striking that ethicists have not yet systematically evaluated the reasons given for using BMI (...) in assessing individuals' risk in IVF treatments. In this paper, I provide the first systematic analysis of the chief arguments currently offered by IVF programs for using BMI as a criterion for risk assessment. Specifically, I articulate empirical concerns about the success of IVF in high‐BMI patients, practical concerns about the ability of high‐BMI patients to safely undergo procedures associated with IVF, and ethical concerns about the risk‐to‐reward ratio for high‐BMI patients and their potential children. I advance a series of objections to those arguments, using empirical data regarding IVF procedures and analogies with other high‐risk conditions including systemic lupus erythematosus, and science regarding the diagnosis of BMI‐correlated comorbidities such as high blood pressure or diabetes to argue that BMI alone is not a reasonable criterion for risk assessment in IVF; moreover, the usage of BMI may involve unacceptable violations of the bioethical principles of justice and respect for autonomy. Instead, I hold that IVF programs should rely on more precise laboratory and clinical measurements to evaluate risk in IVF. (shrink)

This paper explores the reasons why women who are themselves fertile might consent to undergo in vitro fertilization (IVF) with an infertile male partner. The reasons often given are desire to have that particular man's child, or altruism, giving a gift to the partner. Although ethically, the decision should be completely woman's prerogative, because IVF programs usually treat the couple as a unit, she may be offered few other options by the medical staff. In social terms, whether the (...) woman is or is not infertile may be immaterial because in either situation, if she wants to try to have a biological child and maintain the relationship, she may have to make a patriarchal bargain and undergo in vitro fertilization. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns (...) have emerged. One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns (...) have emerged. One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)

Judaism has understood procreation as representing a partnership between God and humans, calling for both human reverence and action. The development of in vitro fertilization raises questions about the implications of this partnership and applications of this technology. A holistic approach to Jewish ethics, drawing on traditional sources, suggests that it can be appropriate for an infertile couple to utilize IVF using their own sperm and egg to have a child. The use of donated sperm, eggs, and embryos (...) raises significant challenges that the couple must consider and address, but these procedures would be acceptable in appropriate cases. Additional issues, including preimplantation genetic testing and freezing embryos, must be considered in light of traditional precedents, ethical values, biomedical developments, and experience with the procedures. (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 (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 from incipient 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 research and pregnancy. 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)

Part of the normalization of assisted reproductive technologies is the premise that the children born from in vitro fertilization are no different from their counterparts conceived spontaneously. However, interest in peri-conception health and new epigenetic understandings of biological plasticity has led to some questioning the presumed irrelevance of conception in vitro, and when doing so, describing IVF children as “apparently healthy.” Taking “apparently” and “healthy” seriously, this article explores how modes of attention—ways of naming and framing embryo (...) potentiality—shape understandings of health and normality. I contend that understanding the politics of potentiality, and how they may emerge in a postgenomic age, requires an unpacking of various modes of attention and framing. Ethnographic findings from South Africa’s fertility clinics and emerging literature on epigenetic variation in IVF conception demonstrate how, under a genetic mode of attention, IVF clinics views “abnormality” as fated, unviable, and discardable. Exploring the possibility of answering the postgenomic questions to IVF reveals structural challenges to knowing long-term health implications. Incipient attempts within the fertility clinic at managing these questions shows various strategic techniques, such as leveraging epigenetics to marketable ends and shifts to individual responsibility. (shrink)

Fertility treatment enables involuntary childless people to have genetically related children, something that, for many, is a valuable life project. In this paper, I respond to two sets of objections that have been raised against expanding state-funded fertility treatment provision for existing treatments, such as in vitro fertilisation (IVF), and against funding new treatments, such as uterine transplantation (UTx). Following McTernan, I refer to the first set of objections as the ‘one good among many’ objection. It purports that it (...) is unjustifiable for the state to prioritise the funding of the life project of becoming a parent through fertility treatment provision over the funding of other life projects that people might have. Following Lotz, I refer to the second set of objections as the ‘norm-legitimation’ objection. It maintains that the provision of costly forms of fertility treatment, such as UTx, would legitimise problematic social norms concerning genetic relatedness, reproduction and parenting, and that states should not engage in such a legitimation. In response to these objections, I defend the view that (reproductive) preferences ought to be taken more seriously when discussing fertility treatment provision and parental projects, and that not doing so can be costly, especially for women. The approach defended in this paper seeks to avoid disregarding and policing preferences and to reconcile their fulfilment with political projects aimed at improving the material and social conditions of sub-fertile people: people who, for social or biological reasons (or an intersection of the two), are unable to reproduce unassisted. (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)

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)

In vitro fertilization technology has been in use in Poland for over 25 years with success and social approval, but it is still not regulated under Polish law. The current debate over different non-medical aspects of reproductive technologies in Poland is extremely heated and highly politicized. Politicians on the right, Catholic clergy and some journalists use very radical language and criticize IVF as a technique that plays with the lives and deaths of thousands and thousands of children. The (...) aim of this article is to follow the Polish debate on IVF in the context of Poland’s transition, which is marked primarily by two events: the collapse of communism in 1989 and access to the European Union in 2004. The article shows that the IVF debate concerns not only moral choices or legal regulation, but also citizenship, nation, state, and the role of the Catholic Church within. Moreover, it creates new citizens: frozen embryos, which being independent persons, have the right to life, ‘dignity’ and care. The history of IVF in Poland reveals the different tensions in the Polish transition to liberal democracy and it can be used to view a ‘big’ history of the Polish transition. It is one of the micro-histories which make this big story about Poland after 1989. Analyses of both the abortion debate and the IVF debate in Poland show that the process of democratization is very much connected with limiting women’s reproductive rights, including the right to choose infertility treatment. (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)

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in (...) class='Hi'>vitro fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (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)

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)

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)

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)

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)

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)

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)

Fertility treatments, which are part of "assisted reproductive technologies" (ART), mainly undertaken through in vitro fertilization (IVF), offer the opportunity to infertile couples to conceive. IVF treatments are undertaken in Israel in significantly higher numbers than in the rest of the world. As such, Israel provides an important case-in-point for examining the validity of the actual claims used to justify the more generous public funding of IVF treatments at the policy level. In this article, we utilize an analytical (...) philosophy approach to conduct this examination. First, we highlight two fundamental concepts that were used at the Israeli public policy level in order to justify the generous public funding of IVF treatments. These concepts are “emotional vulnerability” and the “worthlessness of the childless,” where the latter emphasizes the infinite value of children. Then, by applying the perspective of the European model of Bioethical Principlism, and focusing the attention to these two concepts we show that these justifications are invalid. Specifically, it is suggested that these concepts are on the one hand both relying on and expressing the principles of vulnerability, dignity, and integrity; yet on the other hand, these concepts are also undermining the very principles of bioethics they are supposed to express and rely on. Based on this suggested criticism, we offer two “take home” messages informed by our analysis of the Israeli case, but reaching beyond it. (shrink)

The central importance of reproduction in all human cultures has given rise to many methods and techniques of assisting reproduction or overcoming infertility. Such methods and techniques have achieved spectacular successes in the Western world, where processes like in vitro fertilization (IVF) constitute a remarkable breakthrough. In this paper, the author attempts to reflect critically on assisted reproduction technologies (ART) from the background and perspective of African culture, a culture within which human reproduction is given the highest priority (...) but which also exhibits a highly ambivalent attitude to modern technology-assisted methods of reproduction. The author considers the ethical crux of reproductive technologies to be linked to the issue of the moral status of the human embryo and argues that a morally significant line of demarcation cannot be drawn between embryos and other categories of humans. (shrink)

As one of the most effective medical technologies for the infertile patients, in vitro fertilization has been more and more widely developed in recent years. However, prolonged waiting for IVF procedures has become a problem of great concern, since this technology is only mastered by the large general hospitals. To deal with the insufficiency of IVF service capacity, this paper studies an IVF queuing network in an integrated cloud healthcare system, where the two key medical services, that is, (...) egg retrieval and transplantation, are assigned to accomplish in the general hospital, while the routine medical tests are assigned into the community hospital. Based on continuous-time Markov procedure, a dynamic large-scale server scheduling problem in this complicated service network is modeled with consideration of different arrival rates of multiple type of patients and different service capacities of multiple servers that can be defined as doctors of the general hospital. To solve this model, a reinforcement learning algorithm is proposed, where the reward functions are designed for four conflicting subcosts: setup cost, patient waiting cost, penalty cost for unsatisfied patient personal preferences, and medical cost of patient. The experimental results show that the optimal service rule of each server’s queue obtained by the RL method is significantly superior to the traditional service rule. (shrink)

Insights from Confucianism and Daoism disrupt the usual conversation in productive ways. While they ultimately come down for or against abortion and other related issues, they do so for reasons other than those usually put forward in conventional American debates. There is much about birth in Daoism, but nothing about a definitive determination of the beginning of life. Confucianism and Daoism maintain a certain consistency between their attitudes on abortion and in vitro fertilization (IVF). Ethical questions regarding stem (...) cell research are related to those involved with abortion and IVF. Daoism is a fluid enough philosophy to allow for an alternative interpretation. Stem cell research might be seen as a simpler process of working at things before they've begun, and that could open the way for Daoist acceptance. (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)

argues that, by failing to respect the connection between the conjugal act and procreation, in vitro fertilization – even in the homologous or "simple case", where both gametes come from a married couple and the resulting embryo is transferred to the wife – shows itself to be morally unacceptable. On the other hand, the document refers approvingly to other technological interventions which "facilitate" or "assist" the conjugal act in achieving its objective. Although none of the latter interventions are (...) mentioned by name, the recently developed gamete intrafallopian transfer (GIFT) and certain associated techniques have found favor with many orthodox Roman Catholic thinkers, as well with some church authorities. The present article explores this situation in the Catholic moral tradition, and offers reasons for believing that, given relevantly similar conditions, if GIFT is morally acceptable so also is homologous IVF-ET. Keywords: Roman Catholic ethics, reproductive technologies, in vitro fertilization (IVF-ET), gamete intrafallopian transfer (GIFT) CiteULike Connotea Del.icio.us What's this? (shrink)

This research used the embodied approach to analyse the pain experiences of 25 heterosexually married Israeli-Jewish women undergoing in vitro fertilization (IVF) treatments for a first pregnancy. Semi-structured interviews were conducted to allow the women to openly discuss issues concerning their perceptions of pain. Research findings show that the women’s pain perceptions dictated two distinct categories of discourse. The first category of discourse surfaced in the accounts of 14 of the interviewees. Women belonging to this category expressed their (...) willingness to “do everything for a child”. These women insisted on silencing pain and considered it to be irrelevant. They refused to locate bodily pains at the centre of their experience, fearing that this would delay their goal of reproducing. The second discourse of pain emerged from the accounts of 11 interviewees. This discourse was associated with women’s motivation to maintain an active dialogue with painful experiences. They obstinately sought to direct internal attentiveness to what was happening inside their bodies. This approach enabled them to define body boundaries and form an active negotiation with the authority treating their bodies. The research findings suggest that women who share the same socio- cultural environment (Israeli pronatalism) and physical circumstances (the inability to conceive) have varied and wideranging interpretations of pain. It seems that medical authorities can benefit the understanding of pain by providing new support resources to women undergoing IVF treatments. (shrink)

Nowadays, novel techniques such as Reciprocal effortless in vitro fertilization (ReIVF) enable two individuals to “carry the same pregnancy,” that is to “carry” the same embryo in both their bodies. However, even though these techniques are likely to be increasingly requested, little is known about their safety and efficacy, and much less about their bioethical legitimacy and issues. Considering their uniqueness, this study assesses the compatibility of ReIVF as well as of another similar technique with the classical principles (...) of medical ethics: autonomy, beneficence, nonmaleficence, and justice. The aim is twofold: (i) to start investigating whether these techniques and their underlying reasons are, or could ever be, bioethically justifiable and (ii) to make clinicians and any other potentially interested persons such as researchers, lawmakers and prospective parents themselves are more aware of the health and social implications of using these techniques. Hence, after a brief overview of the technical aspects of the procedures that allow two persons to carry the same pregnancy, this study offers a general moral framework that can be useful for starting to address some relevant aspects of these procedures, such as their benefits and harms on the health of the individuals involved, the reasons behind their use, and the possibility that they might be covered by states in the future. Finally, this study provides a bioethical overview on ReIVF as well as on similar techniques considering different perspectives, while also suggesting some questions and recommendations for further research. (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)

In vitro fertilization (IVF) and surrogacy have enabled many to achieve their dreams of parenthood. With a turnover of $500 million, reproductive tourism in India has helped transform the country into a “global baby factory.” However, as the surrogacy industry grew, so did concerns of women’s exploitation, commodification of motherhood, and human rights violations. In an effort to prevent women from being exploited, the Indian government had taken successive administrative measures to regulate surrogacy. The Surrogacy (Regulation) Bill, 2016 (...) and Assisted Reproductive Technologies Bill 2008 were introduced in the Parliament to regulate various aspects of surrogacy arrangements. Yet, it was not until 25 January 2022, that the Surrogacy (Regulation) Act, 2021 went into effect. The Act does, however, leave certain important points unaddressed. The article claims that the legislation’s purposeful exclusion of the LGBTQ population and emphasis on “familial altruism” stinks of inequity and moral conservatism. It also delineates the mechanics of altruistic surrogacy by examining documents that illustrate how the connections between money and morality are framed via the framing of altruism. The article therefore demands that a comprehensive dialogue must be held considering the socio-economic realities of Indian society, or else India risks enacting yet another law that cannot be implemented or that society dislikes. (shrink)

The introduction of in vitro fertilization (IVF) results in a separation of sex and reproduction which has generated enormous ethical debate (Lauritzen 1993). Surrogacy makes this situation more complicated by bringing a surrogate mother into reproduction. A surrogacy case may involve five individuals (in addition to the surrogate child). These are the commissioning couple, the gamete donors, and the surrogate mother. Hence, a surrogate child may have up to five parents, including biological parents, commissioning parents, and a gestational (...) parent. The question is which of these people should undertake parental duty? In terms of the acquisition of parental duty, there are three accounts. They are the biological connection account, the causal account, and the consent account. In this article, I try to argue that only the commissioning parents should undertake the parental duty for the surrogate child based on the latter two accounts. I do not apply the biological connection account because the biological connection account fails to explain one’s parental duty, which I will show in the following sections. (shrink)

Sarah Franklin’s Biological relatives: IVF, stem cells, and the future of kinship and Charis Thompson’s Good science: the ethical choreography of stem cell research, examine recently normalized biotechnologies. Franklin’s monograph extends her previous work on in vitro fertilization , deconstructing the success of a technology that, she argues, has grown “curiouser and curiouser” while taking hold in scientific and social life. IVF in its diverse aspects becomes a lens for scrutinizing our ambivalence about new technology, which Franklin articulates (...) by putting disparate literatures into conversation: feminist science studies, political economy, fine art, and more. Thompson’s Good science focuses more concretely on the first decade of human pluripotent stem cell research, tracing the field from the innovation of cultured human embryonic stem cells through Bush-era policy debates, to current acceptance of stem cell research as a part of the scientific and policy landscape. Th .. (shrink)

Stem cell research is very promising. The use of human embryos has been confronted with objections based on ethical and religious positions. The recent production of reprogrammed adult (induced pluripotent) cells does not – in the opinion of scientists – reduce the need to continue human embryonic stem cell research. So the debate continues.Islam always encouraged scientific research, particularly research directed toward finding cures for human disease. Based on the expectation of potential benefits, Islamic teachings permit and support human embryonic (...) stem cell research. The majority of Muslim scholars also support therapeutic cloning. This permissibility is conditional on the use of supernumerary early pre-embryos which are obtained during infertility treatment in vitro fertilization (IVF) clinics. The early pre-embryos are considered in Islamic jurisprudence as worthy of respect but do not have the full sanctity offered to the embryo after implantation in the uterus and especially after ensoulment.In this paper the Islamic positions regarding human embryonic stem cell research and therapeutic cloning are reviewed in some detail, whereas positions in other religious traditions are mentioned only briefly.The status of human embryonic stem cell research and therapeutic cloning in different countries, including the USA and especially in Muslim countries, is discussed. (shrink)

The Vatican’s position on in vitro fertilization (IVG), found in the ’Instruction on Bioethics’ (1987), is that all IVF is immoral, for it violates the normative procreative act of married spouses. The dilemma created is, if all instances of IVF are immoral, then God’s act in the Incarnation (granting the traditional doctrine) must also have been immoral. Conversely, if God’s act in the Incarnation was not immoral, then at least some cases of human IVF are not immoral either. (...) A resolution is offered. Two diagrams are employed. (shrink)

For over four decades, feminist studies of assisted reproductive technologies have been interested in the ethical, political and personal implications of in vitro fertilization and other infertility treatments. Most work on the implications of ART for women has focused on the demanding cyclical process of trying to become pregnant by using the technology. However, less attention has been paid to the implications of experiencing IVF after the conception phase. This article tackles the under-researched topic of the aftermath of (...) IVF, and discusses the temporality of affective embodied experiences of infertility after one has stopped IVF. Drawing on an ethnographic study of peer support groups for the involuntarily childless in Finland, and on in-depth interviews with women suffering from infertility, this article juxtaposes two groups of women who have had IVF: those who have had children as a result of the procedure, and those who have not. The article proposes an exploration of experiences of childlessness after IVF as ‘lingering technological entanglements’ – that is, as affective and embodied experiences of the effects of IVF, including after the cessation of treatment. It argues that the lingering of these entanglements manifests itself in the enactment of childlessness in relation to the available technology. Furthermore, this results in parents identifying themselves as childless, even after they have gained temporal distance from IVF practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Morality in Flux: Medical Ethics Dilemmas in the People's Republic of ChinaRen-Zong Qiu (bio)IntroductionModern China is undergoing a fundamental change from a monolithic society to a rather pluralistic one. It is a long and winding road. Marxism is facing various challenges as the influence of Western culture increases. Confucianism is still deeply entrenched in the Chinese mind but various religions, including Buddhism, Islam, and Christianity are experiencing a revival. (...) Almost fifty minorities coexist in the country in addition to the majority Han people. Tension and conflict are inevitable as diverse—and sometimes incompatible—values come to the fore at this historic juncture. Many fields, including medicine, face new challenges, and in this environment the field of bioethics is flourishing.Like many countries, China is groping with the effects of new medical technology and skyrocketing health care costs. But in the context of the Chinese sociocultural environment, some unique—as well as more familiar—issues arise. None of the classic texts provide ready-made answers to these dilemmas; we must find the answers ourselves. The only reasonable way to resolve the conflicts between opposing values is through dialogue, consultation, and negotiation among the various social and cultural groups.The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia.Dilemmas Surrounding Reproductive TechnologyAccording to traditional Chinese belief, not having a child results from not having virtue. In fact, the most serious violation of the Confucian [End Page 16]principle of filial piety is to be without offspring. A Chinese man without a child experiences heavy psychological pressure, and the burden is especially onerous for women because infertility is always blamed on the wife. Wives who do not bear a child are stigmatized and mistreated—even abused—in families that stick to traditional values.In China today, this widely held belief is colliding with another reality: an apparent increase in infertility among newly-married couples. The rate may be about 5 percent. These couples turn to doctors for help.Artificial insemination by donor (AID) and by husband is now widely practiced. Eleven provinces have established sperm banks, and private doctors are performing AID for considerable fees. But procedures to address legal and ethical problems associated with the procedure have lagged behind. With the exception of a few centers in large cities, AID is undertaken without established procedures or policies relating to the selection of donors and recipients, records about those involved, or clarification of the status of the child. The legal status of the child remains unresolved.The status of the child within the community is also unresolved as traditional values clash with the application of modern technology to childbearing. The case of "The Child Who Did Not Belong" (see box), illustrates how an AID child is not accepted by the family that embraces traditional values because he is not the husband's biological child.In vitro fertilization (IVF) is another alternative. Two IVF centers are in operation, one in Beijing and the other in Changsha, and both have succeeded in producing live births. This technology has received considerable media attention and is generally accepted even among those with traditional views.But much of this medical technology is not widely accessible—especially in rural areas—and so some infertile couples resort to surrogate motherhood to ensure an heir. An infertile couple enters into a contract with a woman who has intercourse with the husband in order to bear a child for the couple. This practice is called "borrowing a wife." In some villages, the "borrowed wife" receives as much as 10,000 yuan (five times a professor's monthly salary or about $250) for a girl and double that for a boy.But the more common and thorny problems involved with the beginning of life relate to birth control, family planning, and the "one couple, one child" policy that the Chinese government instituted to curb overpopulation. The goal of that policy is to prevent China's population from exceeding 1.2 billion in the year 2000... (shrink)