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

Robert Sparrow has recently raised the possibility that stem cell technology could in the future be used to create multiple generations of embryos in the laboratory before transferring one embryo to a woman’s womb to create a pregnancy. Sparrow argues that any children produced in this way would be genetic orphans—they would lack living genetic parents—and explores the possible moral implications of this. A number of other authors have raised objections to Sparrow’s moral claims, but his descriptive claim remains unchallenged. (...) In this chapter, we challenge it, arguing that Sparrow’s imagined technology could be performed in such a way that the children produced would have living genetic parents. (shrink)

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

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

In this paper, we will discuss the prospect of human reproduction achieved with gametes originating from only one person. According to statements by a minority of scientists working on the generation of gametes in vitro, it may become possible to create eggs from men’s non-reproductive cells and sperm from women’s. This would enable, at least in principle, the creation of an embryo from cells obtained from only one individual: ‘solo reproduction’. We will consider what might motivate people (...) to reproduce in this way, and the implications that solo reproduction might have for ethics and policy. We suggest that such an innovation is unlikely to revolutionise reproduction and parenting. Indeed, in some respects it is less revolutionary than in vitro fertilisation as a whole. Furthermore, we show that solo reproduction with in vitro created gametes is not necessarily any more ethically problematic than gamete donation—and probably less so. Where appropriate, we draw parallels with the debate surrounding reproductive cloning. We note that solo reproduction may serve to perpetuate reductive geneticised accounts of reproduction, and that this may indeed be ethically questionable. However, in this it is not unique among other technologies of assisted reproduction, many of which focus on genetic transmission. It is for this reason that a ban on solo reproduction might be inconsistent with continuing to permit other kinds of reproduction that also bear the potential to strengthen attachment to a geneticised account of reproduction. Our claim is that there are at least as good reasons to pursue research towards enabling solo reproduction, and eventually to introduce solo reproduction as an option for fertility treatment, as there are to do so for other infertility related purposes. (shrink)

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

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

In vitro gametogenesis (IVG) might offer numerous research and clinical benefits. Some potential clinical applications of IVG, such as allowing opposite‐sex couples experiencing infertility to have genetically related children, have attracted support. Others, such as enabling same‐sex reproduction and solo reproduction, have attracted significantly more criticism. In this paper, we examine how different ethical principles might help us to draw lines and distinguish between ethically desirable and undesirable uses of IVG. We discuss the alleged distinction between therapeutic (...) and non‐therapeutic uses of assisted reproduction in the context of IVG, and show how it is both problematic to apply in practice and theoretically dubious. We then discuss how the ethical principles of reproductive justice and beneficence apply to IVG for opposite‐sex reproduction, same‐sex reproduction, and solo reproduction. We suggest that these principles generate strong reasons for the use of IVG for opposite‐sex and same‐sex reproduction, but not for solo reproduction. (shrink)

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

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)

New technology in human reproduction has provoked wide ranging arguments about the desirability and moral justifiability of many of these efforts. Authors of biomedical ethics have ventured into the field to offer the insight of moral theory to these complex moral problems of contemporary life. I believe, however, that the moral theories most widely endorsed today are problematic and that a new approach to ethics is necessary if we are to address the concerns and perspectives identified by feminist theorists (...) in our considerations of such topics. Hence, I propose to look at one particular technique in the growing repertoire of new reproductive technologies, in vitro fertilization, in order to consider the insight which the mainstream approaches to moral theory have offered to this debate, and to see the difference made by a feminist approach to ethics. (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)

New technology in human reproduction has provoked wide ranging arguments about the desirability and moral justifiability of many of these efforts. Authors of biomedical ethics have ventured into the field to offer the insight of moral theory to these complex moral problems of contemporary life. I believe, however, that the moral theories most widely endorsed today are problematic and that a new approach to ethics is necessary if we are to address the concerns and perspectives identified by feminist theorists (...) in our considerations of such topics. Hence, I propose to look at one particular technique in the growing repertoire of new reproductive technologies, in vitro fertilization, in order to consider the insight which the mainstream approaches to moral theory have offered to this debate, and to see the difference made by a feminist approach to ethics. (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)

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

In this paper we look at the implications of an emerging technology for the case in favor of, or against, postmenopausal motherhood. Technologies such as in vitro derived gametes have the potential to influence the ways in which reproductive medicine is practiced, and are already bringing new dimensions to debates in this area. We explain what in vitro derived gametes are and how their development may impact on the case of postmenopausal motherhood. We briefly review some of the (...) concerns that postmenopausal motherhood has raised—and the implications that the successful development, and use in reproduction, of artificial gametes might have for such concerns. The concerns addressed include arguments from nature, risks and efficacy, reduced energy of the mother, and maternal life expectancy. We also consider whether the use of in vitro derived gametes to facilitate postmenopausal motherhood would contribute to reinforcing a narrow, geneticized account of reproduction and a pro-reproductive culture that encourages women to produce genetically related offspring at all costs. (shrink)

Background: Today in vitro fertilisation is a widespread and important technique of reproductive medicine. When the technique was first used, it was considered ethically controversial. This is the first study conducted of adult IVF-offspring in order to learn about their ethical opinions and personal attitudes towards this medical technology.Methods: We recruited the participants from the first cases of in vitro fertilisation in Germany at the Gynaecological Clinic of the University Hospital Erlangen. Our qualitative interview study consisted of in-depth, (...) face-to-face interviews with 16 adults who had been conceived by IVF. Our data was analysed with methods of Grounded Theory.Results: For these adults, the most important factor influencing their personal attitudes towards IVF was the knowledge that they were deeply wanted children. The artificiality of their conception seemed irrelevant for their ethical opinion. All participants mentioned that it was important for them to be informed about the circumstances of their conception by their parents.Conclusions: IVF seems to be a medical technique which, although it affects intimate aspects of human existence, can be integrated into the lives of the affected persons without any great difficulties. The findings suggest that parents should inform their children about their fertilisation at an early age and as part of a process over time, not only on a single occasion. Physicians should advise IVF-parents accordingly. (shrink)

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

ZusammenfassungEines der medizinischen Felder, in dem die ethische Diskussion um die „wunscherfüllende Medizin“ am intensivsten geführt wird, ist die Reproduktionsmedizin, die die Erfüllung des „Kinderwunsches“ verspricht. Strittig ist besonders, ob Sterilität als Krankheit definiert wird, die eine medizinische Intervention rechtfertigt, ob sich aus der Sterilität oder Infertilität lediglich ein Abwehr- oder auch ein positives Anspruchsrecht auf medizinische Ressourcen ergibt, ob legitime Fortpflanzungsmedizin Grenzen hat. Nach einer Übersicht über Eckpunkte der nationalen und internationalen Debatte beschreiben wir im zweiten Teil Ansichten zum (...) Status ungewollter Kinderlosigkeit, zum Recht auf Fortpflanzungsmedizin und zur möglichen Legitimität ihrer Begrenzung anhand der Ergebnisse unserer vom Bundesministerium für Bildung und Forschung (BMBF) geförderten Studien. Während der letzten fünf Jahre haben wir u. a. Paare mit und ohne Sterilitätsproblematik sowie verschiedene Expertengruppen qualitativ und standardisiert befragt. Die stark divergierenden Auffassungen konfrontieren wir im dritten Abschnitt mit internationalen Standards, zum anderen mit dem „Capability-Ansatz“ und dem freiheitsfunktionalen Liberalismus von Sen und Pauer-Studer. Dies ergibt, dass die Bereitstellung verschiedener Möglichkeiten der In-vitro-Fertilisations-(IVF-)Behandlung nicht lediglich einen Wunsch auf Elternschaft erfüllt sondern als die gesollte Erfüllung eines normativen Bedürfnissanspruchs begriffen werden muss. (shrink)

In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines (...) in ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines. (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)

Infertility is recognized as a major problem of modern society. Assisted Reproductive Technology is the one of many available treatment options to cure infertility. However, the efficiency of the ART treatment is still inadequate. Therefore, the procedure’s quality is constantly improving and there is a need to determine statistical predictors as well as contributing factors to the successful treatment. There is a concern over the application of adequate statistical analysis to clinical data: should classic statistical methods be used or would (...) it be more appropriate to apply advanced data mining technologies? By comparing two statistical models, Multivariable Logistic Regression analysis and Artificial Neural Network it has been demonstrated that Multivariable Logistic Regression analysis is more suitable for theoretical interest but the Artificial Neural Network method is more useful in clinical prediction. (shrink)

The last quarter of the twentieth century has given rise to reproductive technologies and arrangements that in the earlier part of the century could only be dreamed of by the authors of science fiction. We stand in the middle of this reproductive revolution, trying to cope with the developments that have already occurred but with an uneasy sense that the future may be even more complicated ethically than the past and the present. In this brief essay, I will survey recent (...) ethical and public-policy discussions of two reproductive techniques (assisted insemination and in vitro fertilization) and one reproductive arrangement (surrogate motherhood). After distinguishing three phases in the normative debate, I will briefly comment on some of the characteristics of, and continuing ambiguities in, the ethical debate of the past 25 years. At the conclusion of the essay, I will attempt to anticipate three future issues in ethics and reproduction. (shrink)

On occasion, British in vitro fertilization practitioners look over the ocean to the practice of IVF and embryo research in the United States, wonder why these areas are subject to less regulation than in the United Kingdom, and ask how much less risky and more progressive IVF and embryo research might be if subject to additional federal, or at least state, regulation. To an American audience, imbued with the centuries‐old spirit of independence, regulation and autonomy can seem in tension. (...) From a British perspective, there is no necessary conflict. There is no dissent in the United Kingdom from the proposition that individual activities, services, and industries can be regulated and, at the same time, retain and exercise such autonomy as is their right within a safe sphere. From 1994 to 2002, I was the chair of the United Kingdom's Human Fertilisation and Embryology Authority, which regulates the practice of IVF and embryo research. The existence of the HFEA assures patients that safety and aspects of the practice of assisted reproduction are monitored, leaving them free to choose without worrying about danger, in the same way that the public may take only those drugs that have passed health and safety tests. I would propose that anxious and vulnerable patients do not have more autonomy in a less regulated, market‐driven field. (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)

Although conventionally tracked in the "overdeveloped world" , assistive reproductive technologies are now available in many parts of the globe. This review essay reports on qualitative social science research on techniques such as In Vitro Fertilization, egg purchase, gestational surrogacy, and sex selection across national boundaries. It highlights the disruptions and recuperations of gender and generational relations; religious and legislative regulation; and the opportunities as well as oppressions that the commercialization of the reproductive body entail.

Ron Harris captured the popular imagination in October 1999 with a website where he auctioned off the ova of fashion models to the highest bidder. This article treats the controversy surrounding Harris’ site within a dual frame of critical theory’s approach to reproduction and a folkloristic approach to discourse. The website fuses traditional narrative motifs and structures with the logic of advertising, seventies television, family-values rhetoric, and the fertility industry. I argue that the great attraction of ronsangels.com is that (...) it put into relief the intervention of mechanical reproduction in human fertility together with the state of genetics at the turn of the 21st century. The result is not only a disconcerting aestheticization and commodification of biological reproduction, but also the biological reproduction of a particular aesthetic and moral code—a generation of reality by model. (shrink)

Infertility is an unpredictable but widespread condition. While high‐income countries grapple with when, or how to cover the costs of assisted reproductive technology (ART), such as in‐vitro fertilisation (IVF), these services are generally only available to wealthy persons at private facilities in low‐ and middle‐income countries (LMICs). Although the principle of non‐interference with normal individual reproductive rights is robust, whether it is also the responsibility of collective society to provide the means (when ART applies) to achieve pregnancy, is controversial. (...) Recently, a low‐cost model was developed at a South African public institution. The target population for this model was “helpless and marginalised, childless couples”, but a new threat has arisen, namely, infertile couples who could conceivably afford private care. In the allocation of this scarce resource, we argue for a prioritarian response that first addresses the worst‐off, in order to even out unequal access imposed by sharp differences in income. (shrink)

In this paper I will discuss three areas in which advances in human reproductive technology could occur, their uses and abuses, and their effects on society. First is the potential to drastically increase the success rate and availability of in vitro fertilization and embryo freezing. Second is the ability to perform biopsies on embryos prior to the onset of pregnancy. Finally, I will consider the adding or altering of genes in embryos, commonly referred to as genetic engineering.As new reproductive (...) technologies pass from experimental models into the potential for medical utilization, I believe that it will be important for lawmakers everywhere to avoid the impulse to outlaw procedures that a society believes to be unnatural at a first glance. Rather, I would hope that they can respond thoughtfully with legislation that serves two purposes — to protect the rights of couples to overcome infertility or to reduce the risk of genetic disease in their children-to-be, and more importantly, to protect children-to-be from the abuses that could result from some of the practices that I will discuss. (shrink)

The paper discusses the practice of genetic counseling and elective abortion in the German Democratic Republic. Keywords: elective abortion, embryo transfer, in vitro fertilization, protection of human life, reproductive ethics, German Democratic Republic, bioethics CiteULike Connotea Del.icio.us What's this?

The purpose of the Instruction Dignitas personae, issued by the Congregation for the Doctrine of the Faith, is not only to reaffirm the validity of the teaching laid out in Donum vitae (1987), with regard to both the principles on which it is based and the moral evaluations which it expresses, but to add needed clarification on reproductive technologies in the light of more recent developments. In addition to the reproductive technologies discussed in Dignitas personae, namely, homologous and heterologous artificial (...) insemination, in vitro fertilization, and intracytoplasmic sperm injection, the author also discusses other reproductive technologies, not covered by the Instruction, such as gamete intrafallopian transfer, zygote intrafallopian transfer, tubal embryo transfer, and pronuclear-stage embryo transfer. After analyzing each of these the author offers a general ethical evaluation. National Catholic Bioethics Quarterly 10.1 (Spring 2010): 51–59. (shrink)

Since the decade of the 1970s, and particularly since the first successful test-tube baby in 1978, the development and use of assisted reproductive technologies have grown exponentially. Would-be parents—including those in so-called traditional male-female marriages, unmarried adults, postmenopausal women, and same-sex partnerships—who just over 20 years ago had no recourse for their fertility issues can now pursue their desires to have children with at least a partial, if not, total, genetic and/or biological relationship. Ovulation-stimulating medications, artificial insemination using the sperm (...) of a husband or unrelated donor, in vitro fertilization with embryo transfer, intracytoplasmic sperm injection, and gamete and zygote intrafallopian transfers are but a few of a host of treatment options ranging in complexity, invasiveness, and expense. And on the horizon are genetic techniques such as cloning—which was once considered “pure” science fiction but in 1997 became what some call an inevitability, with the development of mammalian cloning in the form of the now-famous Dolly the sheep. (shrink)

The Canadian province of Quebec recently amended its Health Insurance Act to cover the costs of In Vitro Fertilization . The province of Ontario recently de-insured IVF. Both provinces cited cost-effectiveness as their grounds, but the question as to whether a public health insurance system ought to cover IVF raises the deeper question of how we should understand reproduction at the social level, and whether its costs should be a matter of individual or collective responsibility. In this article (...) I examine three strategies for justifying collective provisions in a liberal society and assess whether public reproductive assistance can be defended on any of these accounts. I begin by considering, and rejecting, rights-based and needs-based approaches. I go on to argue that instead we ought to address assisted reproduction from the perspective of the contractarian insurance-based model for public health coverage, according to which we select items for inclusion based on their unpredictability in nature and cost. I argue that infertility qualifies as an unpredictable incident against which rational agents would choose to insure under ideal conditions and that assisted reproduction is thereby a matter of collective responsibility, but only in cases of medical necessity or inability to pay. The policy I endorse by appeal to this approach is a means-tested system of coverage resembling neither Ontario nor Quebec's, and I conclude that it constitutes a promising alternative worthy of serious consideration by bioethicists, political philosophers, and policy-makers alike. (shrink)

In a well known story Derek Parfit describes a disconnection between two entities that normally (in real life) travel together through space and time, namely your personal identity consisting of both mind and body. Realising the possibility of separation, even if it might never happen in real life, new questions arise that cast doubt on old solutions. In human reproduction, in real life, at present the fetus spends approximately nine months inside the pregnant woman. But, we might envisage other (...) possibilities. Historically, the first era is the normal conception inside the woman, the growth of the fetus in the womb and then, after nine months, birth and the appearance of a new individual. The second era is In Vitro Fertilisation (IVF). The fetus starts outside the woman as a fertilised egg, moves to the body of the woman and spends nine month there, where the body of the woman and the fetus travel together in space-time to separate at birth. In the third era of reproductive ectogenesis, the two never travel together. The fetus spends its gestational time entirely outside the woman’s body. We have two entities separated in space-time the whole time. The intimate connection consisting in the fetus being a part of the woman’s body is gone. (shrink)

Radical feminists have argued for both the radical potential of assisted reproductive technology (ART) and its oppressive and damaging effects for women. This paper will address the question of what constitutes a radical feminist position on ART; I will argue that the very debate over whether ART liberates or oppresses women is misguided, and that instead the issue should be understood dialectically. Reproductive technologies are neither inherently liberating nor entirely oppressive: we can only understand the potential and effects by considering (...) how they are actually taken up within a culture. The internal contradictions, tensions, and inconsistencies within ART and the way it is addressed within the law points to a dialectic that resists a simple reductivist understanding. (shrink)

The majority of embryos created in natural reproduction die spontaneously within a few weeks of conception. Some have argued that, therefore, if one believes the embryo is a person (in the normative sense) one should find ‘natural’ reproduction morally problematic. An extension of this argument holds that, if one accepts embryo deaths in natural reproduction, consistency requires that one also accepts embryo deaths that occur in (i) assisted reproduction via in vitro fertilisation (IVF) and (ii) (...) embryo research. In a recent paper in this journal, Timothy Murphy criticises both the initial argument and its extension. Murphy argues that double-effect reasoning can justify embryo deaths both in natural reproduction and IVF, but not in embryo research. Thus, according to Murphy, one can, without being inconsistent, (1) believe the embryo is a person and accept natural reproduction and IVF, and (2) accept natural reproduction and IVF, while rejecting embryo research on the ground that it involves embryo deaths. I show that Murphy's argument is problematic because double effect cannot justify embryo deaths in standard IVF practices. The problem is that the proportionality criterion of double effect is not met by such practices. Thus, Murphy's argument fails to support (1) and (2). An implication of his argument failing to support (2) is that it does not defeat the position I have defended in the past—that if one accepts standard IVF practices one should also accept embryo research, including research with embryos created solely for that purpose. (shrink)

Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add‐on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever‐increasing array of add‐ons are marketed to ART patients, even when evidence to support them is equivocal. A defining feature of ART is hope—hope that a cycle will lead to a baby or that another (...) test or intervention will make a difference. Yet such hope also leaves ART patients vulnerable in a variety of ways. This article argues that previous attempts to safeguard ART patients have neglected how the use of add‐ons in commercial ART can exploit patients’ hopes. Commercial providers of ART should provide add‐ons only free of charge, under a suitable research protocol. (shrink)

Infertility Accepted treatment is replete with bioethical dilemmas regarding the limits of available medical therapies. Poland has no legal acts regulating the ethical problems associated with infertility treatment and work on such legislation has been in progress for a long time, arousing very intense emotions in Polish society. The purpose of the present study was to find out what Polish women undergoing infertility treatment think about the most disputable and controversial bioethical problems of assisted reproduction. An Attitudes towards Bioethical (...) Problems of Infertility Scale was constructed specifically for this study. Items were taken from the Bioethics Bills currently under discussion in Polish Parliament (Seym). 312 women were enrolled in the study. Women experiencing infertility favoured more liberal legislation. Participants disagreed, for example, with the following regulations: prohibition of embryo freezing, prohibition of preimplantation genetic diagnosis of embryos, age limits for women using in vitro fertilisation and prohibition of in vitro fertilisation for single women. The opinions of patients undergoing infertility treatment are an important voice in the Polish debate on the Bioethics Bills. (shrink)

Reproductive technologies, such as self-arranged donor conception, clinical donor insemination and in vitro fertilization, now have an established place in lesbian reproductive practices, providing a route to conception which separates reproduction from heterosexual intercourse. This article explores how lesbian reproduction figures within feminist studies of reproductive technologies. It critically engages with representations of reproduction and structures of sexuality in early and more recent feminist studies of reproductive technologies. Specifically, the article investigates constructions of reproduction, technology (...) and sexuality in key ethnographic studies by Sarah Franklin, Charis Thompson and Rayna Rapp. The findings suggest that heterosexuality is foundational to, and yet invisible within, this feminist research into reproductive technologies. Endorsing Chrys Ingraham's concept of a `heterosexual imaginary', I argue that this research reproduces a heterosexual imaginary of procreation, continuously representing conception as heterosexual despite the separation of conception and heterosexual sex realizable through reproductive technology. It effectively renders lesbian reproduction inconceivable. (shrink)

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