Tag: gametes

Bioethics Blogs

Françoise Baylis and Carolyn McLeod (eds), Family-Making: Contemporary Ethical Challenges, Oxford University Press, 2014

This fascinating anthology focuses on the question of how we make families, and how bionormative assumptions shape or distort our collective thinking about parenting, children’s welfare, and state obligations to parents and children. The editors are primarily interested in the question of whether parents’ moral responsibilities toward children differ for children produced through assistive reproductive technologies (ART) compared to children brought into the family via adoption. As the editors point out, in the realm of ART, most of the philosophical literature has been focused on parental autonomy and rights to assistance in reproducing, while the adoption literature is almost entirely focused on the protection of children. The anthology does an excellent job of exploring this disconnect, and probing assumptions about moral responsibilities within family-making. Taken as a whole, the chapters explore “whether people should rely on others’ reproductive labour in having children, whether they should ensure that they will have a genetic tie to their children or that their children will have some connection to genetic relatives, whether they should bring a new child into the world at all, whether they should agree to what the government would require of them for an adoption, where they should live if the family they make is multi-racial, at what age they should forgo having children, and the list goes on” (6).

The first section of the book sets the stage with two excellent chapters on the goods of parenting (Harry Brighouse and Adam Swift) and the goods of childhood (Samantha Brennan). The goods of parenting are distinguished from other related goodsintimacy with another adult or friend, friendship with a child, being an uncle, having a pet, etc.

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

Reproducing the Speculative: Reproductive Technology, Education, and Science Fiction by Kaitlyn Sherman

Walter, a Synthetic, quietly makes his rounds in the brightly lit, pristine interior of the Covenant, a Weyland Corporation Spaceship. Fingers pressed to the translucent, impermeable glass, he checks the status of each crew member as they rest in their cryochambers, suspended in chemically-induced comas until they reach their destined planet in seven years and four months’ time. The ship’s artificial intelligence system, Mother, chimes, “Seven bells and all is well.” Reassured of their security, Walter moves on to the next zone, where another 2,000 cryochambers contain sleeping colonists from Earth. This zone also features a panel of drawers, each housing dozens of embryos—over 1,100 second-generation colonists. They are packed individually into river-stone sized ovoids; clear, solid, egg-like. Amid the rows, an embryo has died, and its artificial uterine-sack is clouded and dark. Observing it briefly, Walter takes it from its socket with a set of tongs and places it into a biohazard bin. The Covenant is on a mission to colonize a habitable, distant planet. Their ship contains everything that could be useful in setting up a new colony: terraforming vehicles, construction materials, and human life itself. Even though these frozen embryos aren’t yet actively developing, they reflect a technology that allows for such a feat, while ensuring a population boom that is not dependent upon the limited space of mature female colonists’ wombs.

This scene is part of the opening sequence of the latest film in Ridley Scott’s Alien franchise. Alien: Covenant (2017) is the most recent science fiction film to illustrate advances in reproductive technologies, especially that of ectogenesis, or external gestation and birth.

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

Germ line genome editing. Current tendency is to accept it, with the ethical difficulties that it entails

In December 2015, an international summit took place in Washington D.C., convened by the United States National Academy of Sciences and the National Academy of Medicine, at which scientists, doctors, bioethicists and specialists in legal matters met to reach a consensus on the application of genome editing (see HERE) in humans, at both laboratory and clinical level.

As a result of this summit, a report was drawn up (see HERE) and has recently been published. The report tackles questions on the application of gene editing in humans, including the balance between the potential benefits and unintended harms, how to govern the use of genome editing, the incorporation of societal values into clinical applications and policy decisions, and respect for the differences across nations and cultures that will determine whether these new technologies will be used and how. One of the most relevant aspects of this report, however, is that it favors the use of genome editing techniques on the germ line, i.e. gametes and early embryos, although restricting their use only to the prevention of serious diseases and providing that there is no other alternative.

The risks of germ line genome editing are unpredictable, aggravated by the fact that the changes produced will be transmitted to offspring. An added concern is that their application to disease prevention could open the door to human enhancement or the production of designer children (see HERE), which would mean modifying our genome to make us stronger, taller, thinner, more intelligent, etc., which is known as transhumanism.

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

Transferring Embryos with Genetic Anomalies

Jackie Leach Scully argues that respect for equality and diversity, and not just respect for the parental autonomy and the welfare of the future child, should inform policies governing the use of preimplantation genetic diagnosis.

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The Ethics Committee of the American Society for Reproductive Medicine recently published an Opinion on “Transferring embryos with genetic anomalies detected in preimplantation testing.” The Opinion aims to help providers deal with the rare but ethically difficult situation when prospective parents want to transfer embryos with a known genetic anomaly that is linked to a serious health-affecting disorder.

Preimplantation genetic diagnosis (PGD) is typically used by couples to avoid transferring a genetic anomaly to their children. Using PGD to ensure the transfer of a genetic anomaly, rather than avoid it, seems deeply counter-intuitive. Yet, there are several scenarios where this might happen. For example, this might be a reasonable option when the only transferable embryos carry the genetic anomaly, or when the embryos carry a different, but potentially just as serious, genetic variation.

The most problematic cases, however, occur when prospective parents express an actual preference for children with ‘their’ genetic condition – an anomalous condition that others perceive in negative terms. It’s an uncommon situation, but despite its rarity steps have been taken to block attempts by prospective parents to ‘choose disability’, such as the UK’s legislation on reproductive medicine. The legislation prohibits the use of an embryo (or gamete, in the case of egg and sperm donation) that has a genetic anomaly “involving a significant risk” of “a serious physical or mental disability, serious illness, or a serious medical condition” unless there are no other unaffected embryos or gametes that could be used instead.

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

Editor-in-Chief Journal of Medical Ethics

The Institute of Medical Ethics and BMJ are looking for the next Editor-in-Chief who can continue to shape the Journal of Medical Ethics into a dynamic resource for a rapidly evolving field. Candidates should be active in the field, keen to facilitate international perspectives and maintain an awareness of trends and hot topics. The successful candidate will act as an ambassador for the journal supporting both pioneering authors and academics publishing their first papers. The candidate will also actively promote and strengthen the journal whilst upholding the highest ethical standards of professional practice. The editor will work with IME to promote research and scholarship in medical ethics and attend IME board meetings regularly.

International and joint applications are welcomed. Interviews will be held in December 2017. Term of office is five years; the role will take 12-15 hours a week. Contact Richard Sands (rsands@bmj.com) for more information and to apply with your CV and cover letter outlining your interest and your vision for the future development of the journal.

Application deadline: 31 October 2017; Interviews: December 2017

Start date: 1 June 2018 (handover from February 2018)

About Journal of Medical Ethics

Journal of Medical Ethics launched in 1975 and has since become a leading international journal that reflects the whole field of medical ethics. Publishing Original Research, Extended Essays, Current Controversies, Feature articles, Review articles and more, the journal is relevant to health care professionals, members of clinical ethics committees, medical ethics professionals, researchers and bioscientists, policy makers and patients.

The journal regularly publishes special collections on current hot topics and key conversations in the field including: Circumcision, DSM-5, Stem cell derived gametes and Withholding artificial nutrition & hydration.

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

IVF and respect for the dignity of human life

This past Thursday through Saturday I was at the CBHD summer conference which was focused on genetic and reproductive technologies. One of the sessions that I found most interesting was the final session on Saturday in which representatives of the Roman Catholic, Orthodox, and Protestant traditions of the Christian church discussed how their traditions view reproductive technology with a focus on in vitro fertilization. The Roman Catholic representative expressed some of the reasons why the Roman Catholic Church takes the position that all use of IVF is impermissible because it violates things that they see as essential in how God designed human beings to come into existence within a marriage relationship. The Orthodox representative said that while some Orthodox churches such as the Roman Orthodox Church have taken a specific position on IVF, most Orthodox churches see the decision about whether to use IVF in the treatment of infertility as a decision that should be made on a case-by-case basis with the infertile couple seeking the guidance of their bishop or spiritual mentor. The Protestant representative made it clear that there is not one Protestant position and identified himself as coming from an evangelical Protestant viewpoint. He said that most who have that point of view are primarily concerned about the moral problems of such things as the use of third-party gametes, surrogacy, and the destruction of excess embryos. He stated that IVF would generally be considered permissible as a treatment for infertility as long as those more problematic things were avoided.

During the question-and-answer time the Protestant representative was given a question about whether the fact that the destruction of human embryos was a necessary part of the development of the technique for IVF made the use of IVF today morally problematic.

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

Fertility preservation for transgender individuals

The field of oncofertility emerged to preserve the fertility
of cancer patients whose treatment might render them as infertile or sterile.
Today, the field of fertility preservation has expanded to other patient
populations whose medical treatment may affect their fertility. One such
population is transgender individuals undergoing gender affirming treatments.
Although research on transgender individuals is limited overall and in
particular regarding issues surrounding reproduction, transgender individuals
are interested in biological reproduction. Because various gender affirming
treatments will permanently affect their fertility, such as hormonal treatment
and surgical removal of the gonads, it is important for transgender individuals
to be offered fertility preservation before they start these treatments.

There are, however, some factors that may make fertility
preservation difficult or less attractive of an option for transgender
individuals. Healthcare professionals offering fertility preservation should be
aware of these factors so they can help mitigate them. Here I will discuss two
of them.

First, undergoing fertility preservation treatment can be
stressful for both transgender and cisgender people, but there are some unique
challenges for transgender individuals. Individuals with gender dysphoria may
find it particularly difficult to undergo procedures involving anatomy that is
discordant with their identity. For example, transgender women who are asked to
retrieve sperm via masturbation may find this request exacerbates their gender
dysphoria and may not be possible to do. Transgender men who are asked to
undergo vaginal ultrasounds may find this psychologically traumatic. In
recognizing how fertility preservation treatment can be particularly difficult
for transgender individuals, healthcare professionals should be prepared to
find ways to alleviate these difficulties, such as by offering surgical methods
of sperm retrieval for transgender women and sedating transgender men during
vaginal ultrasounds.

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

Fertility preservation for transgender individuals

The field of oncofertility emerged to preserve the fertility
of cancer patients whose treatment might render them as infertile or sterile.
Today, the field of fertility preservation has expanded to other patient
populations whose medical treatment may affect their fertility. One such
population is transgender individuals undergoing gender affirming treatments.
Although research on transgender individuals is limited overall and in
particular regarding issues surrounding reproduction, transgender individuals
are interested in biological reproduction. Because various gender affirming
treatments will permanently affect their fertility, such as hormonal treatment
and surgical removal of the gonads, it is important for transgender individuals
to be offered fertility preservation before they start these treatments.

There are, however, some factors that may make fertility
preservation difficult or less attractive of an option for transgender
individuals. Healthcare professionals offering fertility preservation should be
aware of these factors so they can help mitigate them. Here I will discuss two
of them.

First, undergoing fertility preservation treatment can be
stressful for both transgender and cisgender people, but there are some unique
challenges for transgender individuals. Individuals with gender dysphoria may
find it particularly difficult to undergo procedures involving anatomy that is
discordant with their identity. For example, transgender women who are asked to
retrieve sperm via masturbation may find this request exacerbates their gender
dysphoria and may not be possible to do. Transgender men who are asked to
undergo vaginal ultrasounds may find this psychologically traumatic. In
recognizing how fertility preservation treatment can be particularly difficult
for transgender individuals, healthcare professionals should be prepared to
find ways to alleviate these difficulties, such as by offering surgical methods
of sperm retrieval for transgender women and sedating transgender men during
vaginal ultrasounds.

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 biological status of the early human embryo. When does human life begins?

“Those who argue that that embryo can be destroyed with impunity will have to prove that this newly created life is not human. And no-one, to the best of our knowledge, has yet been able to do so.”

Introduction

In order to determine the nature of the human embryo, we need to know its biological, anthropological, philosophical, and even its legal reality. In our opinion, however, the anthropological, philosophical and legal reality of the embryo — the basis of its human rights — must be built upon its biological reality (see also HERE).

Consequently, one of the most widely debated topics in the field of bioethics is to determine when human life begins, and particularly to define the biological status of the human embryo, particularly the early embryo, i.e. from impregnation of the egg by the sperm until its implantation in the maternal endometrium.

Irrespective of this, though, this need to define when human life begins is also due to the fact that during the early stages of human life — approximately during its first 14 days — this young embryo is subject to extensive and diverse threats that, in many cases, lead to its destruction (see HERE).

These threats affect embryos created naturally, mainly through the use of drugs or technical procedures used in the control of human fertility that act via an anti-implantation mechanism, especially intrauterine devices (as DIU); this is also the case of drugs used in emergency contraception, such as levonorgestrel or ulipristal-based drugs (see HERE), because both act via an anti-implantation mechanism in 50% of cases.

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 biological status of the early human embryo. When does human life begins?

“Those who argue that that embryo can be destroyed with impunity will have to prove that this newly created life is not human. And no-one, to the best of our knowledge, has yet been able to do so.”

Introduction

In order to determine the nature of the human embryo, we need to know its biological, anthropological, philosophical, and even its legal reality. In our opinion, however, the anthropological, philosophical and legal reality of the embryo — the basis of its human rights — must be built upon its biological reality (see also HERE).

Consequently, one of the most widely debated topics in the field of bioethics is to determine when human life begins, and particularly to define the biological status of the human embryo, particularly the early embryo, i.e. from impregnation of the egg by the sperm until its implantation in the maternal endometrium.

Irrespective of this, though, this need to define when human life begins (see our article  is also due to the fact that during the early stages of human life — approximately during its first 14 days — this young embryo is subject to extensive and diverse threats that, in many cases, lead to its destruction (see HERE).

These threats affect embryos created naturally, mainly through the use of drugs or technical procedures used in the control of human fertility that act via an anti-implantation mechanism, especially intrauterine devices (as DIU); this is also the case of drugs used in emergency contraception, such as levonorgestrel or ulipristal-based drugs (see HERE), because both act via an anti-implantation mechanism in most of the time.

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.