Tag: artificial insemination

Bioethics Blogs

Jewish Guide to Practical Medical Decision Making

Check out
this new 368-page
book
 from Rabbi Jason Weiner: Jewish Guide to Practical
Medical Decision Making.


Due to rapid advances in the medical field, existing books on Jewish medical
ethics are quickly becoming outdated. 
Jewish
Guide to Practical Medical Decision Making
 seeks to remedy that by
presenting the most contemporary medical information and rabbinic rulings in an
accessible, user-friendly manner. 


Rabbi Weiner addresses a broad range of medical circumstances such as surrogacy
and egg donation, assisted suicide, and end-of-life decision making. Based on
his extensive training and practical familiarity inside a major hospital, Rabbi
Weiner provides clear and concise guidance to facilitate complex
decision-making for the most common medical dilemmas that arise in contemporary
society.


1. Facilitating Shared Decision-Making 

A. Understanding Terminology: Key Concepts to Facilitate
Collaborative Decision-Making

B. Truth-Telling: When Painful Medical Information Should
and Should Not Be Revealed 

C. Mental Illness: Determining Capacity and Proper Treatment
in Accordance with Jewish Law  


2. How Much Treatment? 

A. Risk and Self-Endangerment: Determining the
Appropriateness of Attempting Various Levels of Dangerous Medical Procedures

B. Making Decisions on Behalf of an Incapacitated Patient

C. Pediatrics: Jewish Law and Determining a Child’s Consent
and Treatment 

D. Palliative Care and Hospice in Jewish Law and Thought


3. Prayer  

A. Is Prayer Ever Futile? On the Efficacy of Prayer for
the Terminally Ill 

B. Viduy: Confessional Prayers Prior to Death


4.  At the End of Life

A. Advance Directives and POLST Forms  

B. End-of-Life Decision-Making: DNR, Comfort Measures,
Nutrition/Hydration, and Defining “Terminal” in accordance with Jewish Law

C. Withholding vs. Withdrawing: Deactivating a
Ventilator and Cessation of Dialysis and Cardiac Defibrillators at the End of
Life

D. Case

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Reining in the SHEEFs

Consider the human embryo… Ordinarily, it arises from the union of a sperm and egg to form a zygote, which is totipotent, that is, able to develop into a full individual.  In our time, fertilization can happen artificially, as with artificial insemination or in vitro fertilization, or naturally through the process that is accessible even to educated fleas.  But the zygote develops into a multicellular… // Read More »

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Incidence of ectopic embryos doubles in assisted reproduction

Ectopic embryos doubles is an added risk for assisted reproduction. Remains to know if the clinics inform it to their clients

Ectopic pregnancies are a serious obstetric complication, also occurring after assisted reproduction. Several articles report that the incidence of ectopic pregnancies (ectopic embryos) after using assisted reproduction techniques is higher (double) than that of natural pregnancies (4.5% versus 2.2%). Several of these have described the possible causes of ectopic pregnancies in assisted reproduction. Now, an article has been published in Fertility and Sterility (see HERE) in which some of these causes are analysed, after assessing 18,432 pregnancies resulting from assisted procreation techniques. It seems that one of the causes is ovarian stimulation and also the type of sperm used in the case of artificial insemination.

Click here about the risks and possible treatment

La entrada Incidence of ectopic embryos doubles in assisted reproduction aparece primero en Observatorio de Bioética, UCV.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Incidence of ectopic embryos doubles in assisted reproduction

Ectopic embryos doubles is an added risk for assisted reproduction. Remains to know if the clinics inform it to their clients

Ectopic pregnancies are a serious obstetric complication, also occurring after assisted reproduction. Several articles report that the incidence of ectopic pregnancies (ectopic embryos) after using assisted reproduction techniques is higher (double) than that of natural pregnancies (4.5% versus 2.2%). Several of these have described the possible causes of ectopic pregnancies in assisted reproduction. Now, an article has been published in Fertility and Sterility (see HERE) in which some of these causes are analysed, after assessing 18,432 pregnancies resulting from assisted procreation techniques. It seems that one of the causes is ovarian stimulation and also the type of sperm used in the case of artificial insemination.

Click here about the risks and possible treatment

La entrada Incidence of ectopic embryos doubles in assisted reproduction aparece primero en Observatorio de Bioética, UCV.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Just What We Need: Slicker Infertility Marketing

The most unsettling line in the recent Forbes article on the ambitious infertility startup Prelude comes about halfway through. “The IVF industry in the United States,” writes Miguel Helft, “has everything private equity likes—scale (about $2 billion annually) and growth (more than 10% a year), along with being fragmented and having outdated marketing.” 

In an era with precious few opportunities for double digit returns, why not turn the reproductive health sector into the next big thing by furthering its consolidation and selling services using lifestyle content?  “Hey,” Prelude’s hipster-chic splash page calls out, “how’s your fertility doing?” 

If that piques your interest, scrolling down takes you on a kind of virtual stroll through the streets of Williamsburg, Wicker Park, or the Mission District, where you encounter edgily coifed, tatted, and bespectacled folk who presumably are spending as much time thinking about their reproductive fitness as they do their next Americano or Kimchi taco.  But you’ll find scant information about financial, psychological, or medical risks of egg retrieval (unless you count the presumed donor pictured alongside the quotation “I was worried about the discomfort, but seriously, it was no worse than a bikini wax—and for a much higher purpose”) or about failure rates after eggs are thawed and implanted.  Everything is upbeat and empowering, geared toward the “millennial mindset of health, wellness, and control.”

Prelude is targeting 20 to 30 year olds and the main product it’s selling them is their own eggs and sperm on ice.  The site proclaims, “If you are in your 20s or early 30s, there is no better time than now to bank your eggs and sperm.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Hidden from View: Canadian Surrogacy

Pamela M. White questions why we know so little about Canadian surrogacy practices and outcomes.

__________________________________________

Canadian researchers, ethicists, and lawyers often lament the fact that there exists very little empirical data about Canadian surrogacy practices and outcomes. As a former Statistics Canada Director and data analyst (now teaching medical law and ethics at the Kent Law School, Canterbury, United Kingdom) this data deficit has long intrigued me.

Both traditional surrogacy (where the woman is genetically related to the child she gives birth to) and gestational surrogacy (where the woman is not genetically related to the child she gives birth to) are legally permitted in Canada. In both cases, the arrangements must be altruistic, since commercial surrogacy is not permitted.

Though altruistic surrogacy is legal in Canada, attempts to find information about the kind of women who choose to be surrogates, the type of surrogacy that is commonly practiced, and how many children are born to Canadian surrogates, have been challenging.

I have not been able to obtain statistics on the incidence of traditional surrogacy. Whether artificial insemination of a surrogate occurs in a fertility clinic or at home without the involvement of a medical practitioner, surrogacy procedures are not currently recorded in any existing assisted human reproduction data system.

I have been able to gather some information about gestational surrogacy, even so the findings are limited. In theory, data from gestational surrogacy could be more easily tracked than data about traditional surrogacy because it requires IVF, which must be performed in a fertility clinic. However, Canada, unlike the United States or the United Kingdom, does not require fertility clinics to transmit IVF treatment data to a public health authority. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Some data on assisted reproduction in Europe do not agree with those given in the brochures of assisted reproduction clinics

IVF LIVE BIRTH RATE. After one stimulation cycle varies around 20% of births and after three between 30% and 40%

The European Society of Human Reproduction and Embryology (ESHRE) has published a new report, the latest, on the outcomes of assisted reproduction in Europe, corresponding to the year 2011 (SEE our previous report).

It includes data from 33 countries, two more than in 2010, from 1064 clinics, which total 609,973 ovarian stimulation cycles. Of these, 138,592 correspond to in-vitro fertilisation (IVF) and 298,918 to intracytoplasmic sperm injections (ICSI). Frozen embryos were used on 129,693 occasions, and donor eggs on 30,198. Preimplantation genetic diagnosis to select the best embryos was used 6,824 times. Artificial insemination using the husband or partner’s semen was performed on 174,390 occasions, and using donor semen on 41,151.

The most interesting thing about this report, however, is undoubtedly the outcomes obtained. The pregnancy rate in the first IVF cycle per aspiration and per embryo transfer was 29.1% and 33.2 %, respectively, while these rates were 27.9% and 31.8% when ICSI was used.

IVF LIVE BIRTH RATE LOWER THAN IN PREVIUOS YEARS

The live birth rate — the main figure to take into account since it reflects the number of women who had a child after one stimulation cycle — was 19.2%, lower than in previous years, since this was 20.6% in 2010; 20.2% in 2009; 21.7% in 2008; 22.3% in 2007 and 20.8% in 2006.

IVFOne possibly more interesting fact is to know the percentage of women who had a child after several IVF attempts, since this is ultimately the real success rate.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Thom van Dooren’s Flight Ways: Life and Loss at the End of Extinction by Eva Giraud

Flight Ways: Life and Loss at the End of Extinction

by Thom van Dooren

Columbia University Press, 2014. 208 pages.

Flight Ways begins with a question: at what moment should a species be categorized as extinct? The extinction of Passenger Pigeons, for instance, could – in the most technical terms – be marked with the passing of the final bird, Martha. Little connection seems to exist, however, between the pigeons as they moved ‘through the sky in flocks of hundreds of millions of birds that blocked out the sun’ (11) and Martha’s isolated death in 1914. This prolonged period, between endangerment and the death of the last member of a species, is described by van Dooren as the ‘dull edge of extinction’: a period of time that sees, even as individual life forms exist, a break-down in the distinct form of life  that characterises what it meant to be a particular species (11). Flight Ways engages in an ‘ethics of storytelling’ (9) which seeks to make the lives of five species of bird who currently live on this ‘dull edge’ visible: Albatrosses in the North Pacific, Vultures in India, a pocket of Little Penguins inhabiting Sydney harbour, Whooping Cranes in a U.S. breeding programme and, finally, Hawaiian Crows.

What needs to be emphasised is that this book has resonance far beyond its subject matter and – though it will clearly be of interest to those working within the Environmental Humanities or Animal Studies – Flight Ways is an important book that deserves a far wider audience. At the same time as presenting the stories of its birds in an evocative and politically urgent way, van Dooren manages to strike a delicate balance between theoretical innovation and accessibility.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Forgotten Stories of the Eugenic Age #5: Creating Super-People

The Birth of Venus by Sandro Botticelli, 1480s

[Forgotten Stories of the Eugenic Age is a blog series exploring the lesser-known ways that eugenics affected and engaged American lives during the first half of the twentieth century.]

“Can science produce a superman?” science writer Waldemar Kaempffert wondered in the New York Times in 1928. “What kind of a superman do we want? And who shall dictate his specifications?”

In the early twentieth century, new genetic discoveries prompted supporters of eugenics to ponder the potential creation and characteristics of a superior human race. Many believed that encouraging the eugenically “fit” to mate and isolating or sterilizing the eugenically “unfit” would yield over time a superior population. They argued that breeding a better race represented the next step in human evolution. After all, careful husbandry had improved crops and livestock. Surely the production of “human thoroughbreds” could not be much different.

“Scientific” Creation
With new scientific knowledge and technologies, eugenists believed that they at last had the tools to create improved people. They were particularly interested in developing technologies for assisted reproduction, including the human application of animal husbandry techniques like artificial insemination. Dr. Julian Huxley, grandson of champion of the theory of evolution T. H. Huxley, predicted that such techniques would allow eugenically fit men and women to marry whomever they chose, but—regardless of their partners’ fertility—have children with third parties who had been specially selected for their genetic qualities. (Those who might object to this cold calculation were merely exhibiting “outworn sentimentalism,” said Huxley.)

Exhibiting similar thinking, Dr.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

The Shocking Story of the First Artificial Insemination

By Maria Coluccio
Assisted reproductive technologies (ART) have provided millions of individuals with the opportunity to have biological children who otherwise would have never been able to do so. In 2013, around 68,000 babies were born using ART in nearly 500 clinics across the U.S. As prominent as these technologies are today, ART had some ethically troublesome beginnings. In an article about the first artificial insemination procedure, Elizabeth Yuko describes how …

The post The Shocking Story of the First Artificial Insemination appeared first on Global Bioethics Initiative.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.