Tag: reproductive rights

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Canadian reproductive rights pioneer in disgrace over IVF mix-up

Dr Norman Barwin after a disciplinary hearing in 2013   

An Ottawa fertility specialist secretly used his own sperm to impregnate clients in the late 1980s, a lawsuit alleges. Two families claim that Dr Norman Barwin, who used to run the Broadview Fertility Clinic, negligently inseminated his patients with the wrong sperm, and it may have been his own. Since a law firm announced that it was commencing a class action, dozens of other couples have contacted it about their children.

Dr Barwin is not an obscure rural physician. He is a past president of the Canadian Fertility Society, a past president of the Planned Parenthood Federation of Canada and the founder of Canadians for Choice. He was given the Order of Canada in 1997 for making  “profound impact on both the biological and psycho-social aspects of women’s reproductive health.” He was a strong advocate for sex education, abortion rights and IVF for lesbians and single women.

His reputation took a nose dive in 2013 after he admitted that he mixed up the sperm of other clients. His registration to practice medicine was suspended for two months and he resigned from the Order of Canada.

However, Dr Barwin never admitted that he might have used his own sperm to help his patients have children. The father of one of the families initiating the class action, Dan Dixon, told freelance documentary maker Alison Motluk that he had spent years swatting away comments that his daughter did not look like him. Only when his daughter Rebecca was in her 20s did they discover that she was not his biological daughter.

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.

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Is voting for The Donald unethical?

Is it ethical for bioethicists to support Donald Trump? Without actually naming him, Wayne Shelton, of the Alden March Bioethics Institute at Albany Medical Center, suggests that it is not.

Shelton’s reason is interesting. Bioethics, he argues, is a way of finding practical solutions in a society with fractured moral perspectives. This can only succeed in a healthy democracy where differences are settled peacefully.  

Donald Trump and his angry, frustrated fans threaten this amicable way of settling disputes. It is time for bioethicists to speak out to protect democracy:

Bombast and lack of substance have always been part of American political rhetoric. Normally I would see the role of bioethicists to advocate for policy positions within the political process, but try to remain relatively neutral in attacking or supporting particular political candidates and speaking out so candidly about issues. But in my judgment, this election cycle is an exception. Now is the time for all thoughtful people who value democracy and, in particular, bioethicists should speak out strongly. We are not in a position to take our political order and indeed the framework for moral decision making for granted.

Some of the anger amongst voters stems from a changing economy. “Tragically, their despair, as expressed currently in political terms, approaches nihilism. For them the message is clear, the American way of life no longer provides them meaning and purpose.

But some is values-driven: “Another part of the explanation also involves evolving cultural and religious norms over the past few decades governing same sex marriage, women’s roles and their reproductive rights, along with greater ethnic and religious inclusion and tolerance—changes that we liberals celebrate as progress and essential to a growing democracy—that are anathema to many on the political and cultural right. “

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.

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A Concerning Time For America: No Time To Be Politically Silent

Bioethics as a field emerged in post WWII America during an era of American political stability and international economic and military dominance. Those of us working in the field of bioethics for past few decades, as beneficiaries of this setting, take for granted the American democratic political system and its traditions as the natural context and moral framework for scientific discovery and ethical decision-making. Though we might invoke normative ethical approaches at times on particular issues, from both various philosophical and religious traditions, generally speaking most major ethical dilemmas both at the broader policy level and in particular settings of individual patient care and research issues, must proceed according to well-established procedural rules and standards. The goal of ethical resolution in our democratic context is not to arrive at the ultimate, final, or “the” canonical ethical answer, but to reach a consensus between opposing moral perspectives that preserves a plurality of moral values based on well-established moral and legal democratic principles and values. Thus, bioethics as a field that deals with living, practical ethical conflicts depends on a stable, democratic political system in which people with diverse values and beliefs can find non-violent, indeed peaceful means of finding resolutions to their moral differences. It is in this light that bioethicists should find very concerning what is happening in our presidential election cycle.

Bombast and lack of substance have always been part of American political rhetoric. Normally I would see the role of bioethicists to advocate for policy positions within the political process, but try to remain relatively neutral in attacking or supporting particular political candidates and speaking out so candidly about issues.

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.

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Peru continues to debate legacy of forced sterilizations

Most of the victims of the sterilization campaign were poor indigenous women / BBC  

“A nurse put me on a stretcher and tied my hands and feet,” said Sabina Huillca. “I asked them to bring me my little baby girl but instead they anesthetized me. When I woke up, the doctor was stitching my stomach. I started screaming, I knew I had been sterilized.”

In Peru, during the presidency of Alberto Fujimori, 272,000 women and 22,004 men were sterilized between 1996 and 2000 as part of the National Reproductive Health and Family Planning Program. Most of the men and women were indigenous, poor, and living in rural areas. The program’s alleged aim was to eradicate poverty through lower birth rates, but evidence has emerged over the years that it was coercive and blatantly violated reproductive rights.

Over 2,000 women have testified that medical practitioners performed the procedures against their will. In many cases, the women did not speak enough Spanish to understand what they were consenting to and in some cases, providers did not even go through the motions of obtaining informed consent. Some women have shared stories of providers offering them money to have the procedure or intimidating them with threats or violence.   Some women died due to complications and other women still suffer serious health complications today.

Last month, Public Prosecutor Marcelita Gutiérrez decided not to pursue charges of crimes against humanity against former President Fujimori and several staff members of the Ministry of Health. Gutiérrez stated that instances of forced sterilizations of indigenous women were not conclusive evidence that the practice was state policy and were, rather, isolated 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.

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Disability Rights and Reproductive Rights Don’t Have to Be in Conflict

September 2, 2016

(Los Angeles Times) – Many people who reprove the notion of abortions based on sex (or if prenatal testing technology were more advanced, sexual orientation, or eye color) make an exception for abortions due to disability. They seem to believe that disabled people will be so unhappy, or make their parents so unhappy, that it would be better if they were not born. Such a distinction points to the inherent ableism within American society. We must do better; we must find a way to fairly and consistently handle the ethical complexities of widely accessible, and ever more precise, prenatal diagnostic technology.

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.

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A Private Right of Procreation in the U.S. Supreme Court

By Dov Fox The landmark abortion decision in Whole Woman’s Health v. Hellerstedt eclipsed quieter reproductive rights news out of the Supreme Court at the end of its term. It involves a couple’s claim that the Tennessee Supreme Court violated their equal protection rights … Continue reading

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.

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The plague at our doorstep: ethical issues presented by the Zika virus outbreak

By Ryan Purcell
Image courtesy of Flickr user Day Donaldson
“Never before in history has there been a situation when a bite from a mosquito can result in such a devastating scenario.” So says Tom Frieden, director of the US Centers for Disease Control and Prevention (CDC). The Zika virus has captured headlines since late 2015, when word spread north from Brazil that a virus, new to the Americas, may be silently causing alarming neurodevelopmental disorders in newborns. Now, the southern United States is preparing to confront the mosquito-borne illness, which “may become the first great plague of the 21st century.” As public health officials continue to work to mitigate the impact of what the World Health Organization has declared a “Global Health Emergency”, there are several important ethical issues that must be considered. These include a women’s reproductive rights, disability rights concerning those most affected, and the growing realization that poverty-stricken regions and neighborhoods will bear a disproportional burden from this disease. Each of these concerns deserves much more attention than could be provided here. My current aim is merely to point out key issues to stimulate discussion.

In a letter to the editor published in February in The Lancet, Monica Roa of American University made a compelling argument for increased attention to women’s reproductive rights in Latin America in response to the Zika virus outbreak. According to Roa, the recommendation by Columbia, Ecuador, El Salvador, and Jamaica for women to delay pregnancy is woefully out of step with the unfortunate realities of life for many women in these countries.

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.

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The Politics of Fetal Pain: Why This Is Not A Legislative Issue


I read with interest the recent
blog
by my colleagues Paul Burcher and Claire Horner entitled “The Politics
of Fetal Pain”. In their blog they discuss the recent
fetal
pain bill
passed in Utah, which “requires the use of general anesthesia on women seeking
abortions at 20 weeks gestation or later.” At stake is the concern that fetuses
may be capable of experiencing pain by 20 weeks, which has prompted 12 states
to restrict or prohibit abortions from that point on, instead of 24 weeks,
which is the current standard.


 


Burcher and Horner remind us that the issue of fetal pain has
been a source of contention for
some
time,
which has led to “several states restricting or
prohibiting abortions
 20 weeks or later on the basis of potential fetal pain.” The
authors are very much aware of the possibility that anti-abortion advocates may
be using this issue as a convenient means by which to place additional limits
on abortion rights of women. Which is to say, anti-abortion advocates
supporting these restrictions on women’s reproductive rights may be using the
fetal pain issue as a means to restrict abortion rights. Even if they do have a
bias in creating this law, Burcher and Horner still believe that the law itself
is justified.


 


Though I would
share a concern about the possibility of fetal pain, if I had reason to believe
there were evidence to support it, I disagree that the appropriate next move
ethically is to join forces with a legislative agenda of politicians whose
interests go far beyond the issue of fetal pain.

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.

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Unheard Publics in the Human Genome Editing Policy Debate

Though the CRISPR-Cas9 genome editing platform is only three years old, universities and industry are racing forward with a range of research projects, including in human embryos. Given the speed of uptake, and the recent approval of non-clinical experiments with embryos in a number of countries, many are wary of this kind of CRISPR research because it could so easily pave the path to high-tech fertility clinics vending eugenic upgrades.

A vast diversity of publics, communities, and stakeholders are deeply concerned about this prospect of heritable human genetic modification. Yet, a  recent comment in JAMA Forum by Eli Adashi seeks to funnel this textured landscape of opinion into a tale of two cities in an international biomedical arms race in which the American research establishment is falling behind.

Adashi frames this battle royale as “Divergent US vs UK Human Embryo Research Policies in light of the HFEA’s decision to license Kathy Niakan’s CRISPR research with viable human embryos. (Her research program has yet to begin. It recently received a second round of ethical approval to use surplus embryos from IVF clinics, but those may take months to secure.)

On one side, Dr. Adashi places a mostly British cohort of pioneers, including two groups of research charities and stem cell researchers that have separately gone on record advocating for clinical research into genetically modifying embryos for human reproduction, once certain thresholds are met. He writes:

Many UK scientists quoted in the lay and professional media welcomed the HFEA decision. Professor Sir Robert Lechler, MB, ChB, PhD, President of the UK Academy of Medical Sciences, offered that “studies such as [that proposed by Dr Niakan], that focus on asking basic questions about human-embryo development, are needed to help answer the many scientific and ethical questions remaining in this field.”

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.

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Survival Needs and Growth Attenuation Therapy: Do They Signal a Need for a “Dependency Ethics”?

By John Banja, PhD

In 2006, the world learned about a child born with profound and life-long cognitive and physical disabilities who had undergone growth attenuation therapy (GAT) four years previously [1]. Called “Ashley” in media reports, she not only received the GAT—which consisted of administering high doses of estrogen over the span of a few years so as to staunch her physical growth—but she additionally had a hysterectomy, removal of her breast buds and an appendectomy. In response to international outrage that the child suffered these “mutilations” because she was disabled, her parents argued that these interventions would enable them to take better care of her, especially as she aged.
Image courtesy of Pixabay
GAT is back in the news with a New York Times magazine article [2] appearing March 22nd and an empirical study on parental perspectives recently published in the Cambridge Quarterly of Healthcare Ethics [3]. Children who receive GAT have an intellectual capacity that will likely never exceed that of a 1 year old, and they require 24 hour a day care throughout their lives. GAT typically consists in their receiving daily doses of estrogen between ages 3 and 6. The estrogen stimulates the premature closing of the growth plates or cartilaginous structures occurring at the ends of the long bones in their legs and arms, resulting in some reduction in height. About 75 percent of parents who choose GAT for their children do so because they are the child’s primary caregivers, and they justify their treatment decision in light of its facilitating both their and their child’s quality of life [2].

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.