Tag: reproductive rights

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 Blogs

Sterilization for Prisoners Is Not New and Shows That Studying History is Essential

by Craig Klugman, Ph.D.

In 1927, Supreme Court Justice Oliver Wendell Holmes ruled that Carrie Buck and her baby could be sterilized because of a perception that they were “mental defectives.” In the 20th century, 32 states had federally funded programs that sterilized “undesirable” populations. Approximately 60,000 people in the U.S. were sterilized without their consent or even knowledge of the procedure. This history made an unexpected reappearance last week when a Tennessee judge offered to reduce the jail sentences of prisoners if they underwent sterilization.

The inmates were offered vasectomies (males) or contraceptive implants (females) in exchange for him shaving 30 days off of their prison sentences. The offer was popular as 70 inmates signed up (32 women and 38 men). The inmates were convicted of drug offenses and Judge Sam Benningfield said he was offering them “an opportunity to take personal responsibility and give them a chance, when they do get out, to not to be burdened with children…This gives them a chance to get on their feet and make something of themselves.”

The primary purpose in this was to try to reduce the number of children born drug dependent or suffering the consequence of in vitro drug exposure…the number of children who would eventually wind up in foster care,” the Judge said in a statement. He claims that the offer was “strictly voluntary…no one is forced to participate…it is no way a eugenic program.” Of course, the Judge presumes that inmates have true freedom of choice in this matter.

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

The Limits of Choice: Abortion and Assisted Dying

Michelle Oberman compares abortion and assisted dying and argues that focusing on the ‘right to choose’ risks ignoring the social and economic factors that shape and constrain our choices.

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I’ve watched the trend toward legalizing physician assistance in dying with a vague sense of alarm. My peers, healthy and wealthy, are puzzled by my response. How is this different from abortion, they ask? You’re pro-choice on abortion, so why wouldn’t you be for assisted dying?

Here’s my problem: As much as I support reproductive rights, I am weary of the rhetoric of ‘choice’ as it applies to great swaths of women who have abortions. I’ve spent the past six years studying abortion in the United States, and in countries like El Salvador where abortion is completely banned. The more I’ve learned about why many women have abortions, the less I see abortion as a choice. Abortion is often a coerced response to desperate circumstances.

When we focus on the question of choice – framing the issue as one of individual liberty – we ignore entirely the social and economic factors that shape and constrain choice. Such constraints lead many women to undergo abortions they might otherwise deeply prefer to avoid. The most common reason that women give for seeking an abortion is financial. It is expensive to have a baby, to pay for day care, to feed, clothe, and house a child. For marginally-employed women, having a baby necessarily means plunging themselves and their families deeper into poverty.

We’ve spent decades fighting over abortion, yet we have done little to offset the economic pressures that compel some women to have one.

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

An Assessment of Mitochondrial Replacement Therapy

By: Alexa Woodward

Last year, a baby boy was born from an embryo that underwent mitochondrial replacement therapy (MRT). MRT was used to prevent this child from inheriting a mitochondrial disease from his mother, specifically infantile subacute necrotizing encephalomyelopathy – a disease that affects the central nervous system and usually results in death within the first few years of life. While controversial, assisted reproductive technologies (ARTs) such as MRT provide prospective parents with additional options and have the potential to improve the quality of human life by preventing disease.

This story is of bioethical interest because this technique results in germline modification, which is the alteration of DNA in the reproductive cells of humans that will be passed on to their offspring. Implementing MRT in humans has consequentially garnered much criticism, from simple health-related implications (such as unknown harms to potential offspring and eugenics concerns) to the futuristic next logical step of scientific intervention; directly editing the nuclear genome.

With MRT, modifications affect the mitochondrial genome (mtDNA), not the nuclear genome. Researchers emphasize the lack of bearing that mtDNA has on personal characteristics and the overall maintenance of “genetic integrity,” especially when compared to using the whole donor egg with an “unrelated” nuclear genome.1 Even so, additional concerns arise regarding the long-term anthropological effects, blurring the distinction between therapy and enhancement, and issues of resource allocation.

Mutations and deletions  in the mitochondrial genome can result in mitochondrial diseases affecting the neurological, musculoskeletal, cardiac, gastrointestinal, renal, and other systems, all of which are incurable.  MRT uses the intended parents’ nuclear DNA in conjunction with a donor’s mitochondria.

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

Public opinion on legalizing surrogacy in China?

Yegang Su comments on the Chinese government’s apparent interest in public opinion on legalizing surrogacy in China.

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Recently, a news report on surrogacy in China was tweeted by the WeChat public account of Liaowang Institute. The Institute is a high-level, Chinese think tank established by the Central Government’s official news agency, Xinhua. I read the original news report published in China Newsweek, and was surprised to learn about the scale and sophistication of the surrogacy industry in China. (A partial English translation of this news story is available through South China Morning Post.)

The China Newsweek article provides a description of a complex business ecosystem that includes: entrepreneurs, doctors, seekers and bearers of surrogacy services, salespersons and care workers. The news report also uses ‘contract’ language. For example, those providing surrogacy services are hired as “reproductive labourers,” they are paid a monthly wage and their pay fluctuates with the stages of pregnancy. The work involved is explained to the recruited women surrogates as “renting their wombs.” These women are described as between 24 and 32 years of age and married, and they must have previously given birth. Most of the women are reported as being from rural areas and motivated for financial reasons.

Internet Backbone (representation of principal internet data routes)

I forwarded the China Newsweek article to some bioethicists and scientists working on ethical, legal, and social issues related to assisted reproductive technologies in China. The one person who replied, also expressed surprise at how little was known about the practice of surrogacy in China.

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

Contraception and Reproductive Ethics: Constitutional Right vs. Right for the Country

Sophia Yin won the Reproductive Ethics category for our 2016 Bioethics Essay contest.  Our panel of judges thought Sophia’s essay presented a rigorous and clarifying analysis of a contentious and ongoing debate about reproductive rights.  We are pleased to publish Sophia’s essay, below. — The Editors

by Sophia Yin

Though the male condom seems almost ubiquitous in current American society, female contraceptive methods constantly seem to be the subject of controversy. While debates in the twentieth century centered on the legalization of contraception, the discussion now is over who should be required to pay for contraception. This question of funding may seem less pressing than the question of legality, however, ability to pay is directly tied to access: women who cannot afford contraception cannot freely use it. Though many supporters frame their case in terms of an infringement of women’s rights, this argument is inherently weak. Women should have open access to contraception regardless of whether they have the right to it. The issue of women’s access to contraception is most often viewed through a legal lens, but it should be discussed in terms of its benefits to public health.

Supporters of access to contraception argue that women have a right to contraception. This argument is based upon the rulings of Griswold v. Connecticut, in which the Supreme Court ruled that states cannot outlaw the use of contraception by married couples because of “the zone of privacy created by several fundamental constitutional guarantees.” Though the ruling did not directly state that women had a right to contraception, it did create a right to privacy in reproductive matters for married couples, which allowed them the freedom to decide, without state interference, whether they would like to use contraception.

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

Health Law at AALS 2017

Next week, in San Francisco, there is a plethora of health law related programming at the 111th Annual Meeting of the Association of American Law Schools.



THURSDAY, JAN 5


Health Law and Health Equity
8:30 am – 10:15 am
Continental Ballroom 5, Ballroom Level, Hilton
Moderator and Speaker: Elizabeth Pendo, Saint Louis University School of Law
Speakers:
Daniel Dawes, Executive Director, Government Relations, Policy & External Affairs, Morehouse School of Medicine
Dayna B. Matthew, University of Colorado Law School
Courtney Anderson, Georgia State University College of Law 
Medha D. Makhlouf, The Pennsylvania State University – Dickinson Law


Health Insurance and Access to Healthcare After the Affordable Care Act
10:30 am – 12:15 pm
Continental Ballroom 5, Ballroom Level, Hilton
Moderator: Allison K. Hoffman, University of California, Los Angeles School of Law
Speakers:
Brietta R. Clark, Loyola Law School, Los Angeles 
Mark A. Hall, Wake Forest University School of Law


The Affordable Care Act has significantly reshaped the landscape of private and public health insurance coverage and content. This panel will examine these changes and the effect on access to health care.


Children As Decisionmakers: Legal, Social, and Scientific Perspectives
1:30 pm – 3:15 pm
Continental Parlor 1, Ballroom Level, Hilton
Moderator: Annette R. Appell, Washington University in St. Louis School of Law
Speakers:
Emily Buss, The University of Chicago, The Law School 
Jonathan Todres, Georgia State University 
College of Law 
Marina Tolou-Shams, Associate Professor, In Residence,University of California, San Francisco School of Medicine
Charisa Kiyô Smith, University of Wisconsin Law School


How should the law reflect and incorporate our evolving understanding of what it means to be a child?

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

Single Women’s Reproductive Rights in China

Qian Liu explains that single women in China who are contemplating pregnancy often care more about the attitudes of their parents towards single mothers, than about the laws on assisted reproduction.

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“I don’t care if the law does or doesn’t grant single women reproductive rights. I can get pregnant on my own and give birth if I really want to. But I don’t think I want to be a single mother by choice even if it is legal. What I care about most are the feelings of my parents and my relationship with them.” This is a version of the most common answer I got from 72 Chinese women when I asked them about the law in China which denies unmarried women the right to reproduce using reproductive technologies.

China, a country with a fertility rate of 1.05 children per woman, prohibits offering assisted reproductive technologies to single women. Also, women who choose to be single mothers by choice in China are penalized by the state. They have to pay a social upbringing fee for violating the country’s family planning policy. While lawyers and international media blame these laws for creating barriers to childbearing by single women in China, I argue that these laws are by no means the most significant factors keeping China’s single women from becoming single parents.

Last month, three Chinese NGOs involved in LGBT and gender issues released a report titled “Single Women’s Reproductive Rights – A Research Report on Policy and Lived Experience.” The report suggests that there is a close linkage between unmarried mothers’ miserable experiences and the law’s restrictions on childbearing out of wedlock.

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

Biopolitical News of 2016

The biggest surprise of the year was probably the birth, in Mexico, of a baby who was conceived following controversial mitochondrial manipulation (“3-parent IVF”). The location was chosen by a New York-based fertility doctor who noted that in Mexico “there are no rules.” Since 3-person IVF is technically a form of inheritable genetic modification, one big question is whether its increasing use and normalization will open the door to wider acceptance of gene editing for human reproduction.

The gene editing shockwaves of 2015 – when Crispr was first applied in human embryos, and controversy about the prospect of using it for human reproduction became explicit – developed into a somewhat more predictable flood of activity and comment in 2016. The big, and unfortunate, news here is perhaps the non-news: the absence of any significant efforts to encourage public participation in deliberations about whether powerful new genetic manipulation tools should be used in efforts to control the traits of future children and generations.

The most consequential news of the year for biopolitics as for so much else may well turn out to be the US presidential election result, but the consequences themselves remain somewhat unclear. Trump’s comments about having “the right genes” are ominous warning signs, which are perhaps getting worse, as partly described below.

Cross-border commercial surrogacy was in the news this year because of scandals, disputes, and changes in the laws of several nations where it had taken hold. Commercial pressures were particularly apparent in the slick marketing being used to promote egg freezing among young women with no fertility problems.

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

Will Donald Trump make bioethics great again?

Donald Trump was elected President of the United States this week on a platform of “change”, but it’s unlikely that bioethics figures prominently in his agenda. No remotely bioethical issues are listed in the 100-day plan Trump’s campaign released in October, “Donald Trump’s Contract With The American Voter.” We have to read the tea leaves, and like most tea cups, the future they tell is cloudy.

Most people working in the science, medicine and bioethics are probably unhappy with the prospect of President Trump. The American Physical Society (APS) was forced to retract a press release that urged President-elect Donald Trump to “Make America Great Again” by strengthening “scientific leadership.” One scientist tweeted “why not just go with ‘Physicists for fascism’ and be done with it?”

More measured responses came from Jonathan Moreno, of the University of Pennsylvania, and Art Caplan, of New York University’s Langone Medical Center, both scholars with enormous experience in the intersection of bioethics and politics.

Moreno points out that recent Presidents have appointed bioethics commissions to advise them on controversial issues. If Trump follows their lead, former Presidential hopeful Dr Ben Carson will probably play a role as he was a member of President George W. Bush’s commission. He is strongly pro-life, as is Vice-President-elect Mike Pence, who is in charge of the transition team. They might oppose developments in the rapidly evolving field of genetic engineering.

However, Trump is broadly opposed to government regulation, so his Administration might not want to ban research if it gave other countries a competitive edge.

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.