introduction to reproductive ethics james j. hughes ph.d. executive director, institute for ethics...
TRANSCRIPT
Introduction to Reproductive Ethics
James J. Hughes Ph.D.Executive Director,
Institute for Ethics and Emerging Technologies
Reproductive Rights?
Bodily autonomy Women’s rights Rights to what? Balancing mother’s
interests with father’s, child’s, family’s, society’s interests
Rights from, rights to
Contraceptive Freedom Uncoupling sex and reproduction Comstock laws (1873) banning
distributing of contraceptives or contraceptive information
U.S. Supreme Court case Griswold v. Connecticut (1965) struck down Comstock laws in CT & MA for married couples.
Eisenstadt v. Baird (1972) extended to unmarried persons as well.
Rights to What?
Not be raped Choose to reproduce or not To contraception To abortion, selective or
other reason To fertility assistance To genetic choice To public financing of
choices
Prenatal Diagnosis
Prenatal Counseling Pre-implantation Genetic Diagnosis Chorionic Villus Sampling (CVS) Ultrasound Amnioscentesis Sperm sorting Home tests
Risks of amnio False negatives and false positives Disability rights/eugenics complaints
Abortion Rights
1973 – Row v Wade Trimesters and viability
Hyde Amendment (1976) bans public financing
Do reasons matter? Health, rape, incest
What is legitimate regulation of safety? What is legitimate informed consent?
Pre-abortion counseling, trans-vaginal ultrasound Access for minors
Abortion Milestones
Catholic Doctrine
A child has rights from conception
A child has the right to be conceived in a sex act, nurtured in the womb, born, and raised by male and female married parents.
Forbids contraception, abortion, in-vitro fertilization and all ARTs, all interventions in reproduction
Who Has Interests?
Legal persons Future persons Potential persons? Personhood
Psychological vs. biological
Embryo Fetus Preemie Newborn
Does Body Autonomy Trump?
Waking up attached to a VIP
Baby K: Anencephaly
Born in 1992 with anencephaly and placed on a ventilator.
Hospital personnel urged a DNR order and to discontinue ventilator treatment for Baby K.
Mother refused to permit either. The hospital filed suit to get permission to refuse
treatment. The court sided with mother, and denied hospital
right to determine that treatment was futile or inhumane
Using Embryos in Research
Using human embryos in research
Embryonic stem cells Leftover embryos from IVF Embryo tissue from
abortions (Financial incentives for
abortions?) Risks from purchased
eggs
In Vitro Fertilization Artificial insemination by husband or donor In virtro fertilization (IVF) Egg or embryo donation
Sperm Banks and Egg Sales Should individuals be allowed
to profit from the sale of sperm, ova or embryos?
Many countries ban sperm and egg sales
Austria and Italy ban all egg and sperm donations for IVF.
Germany and Norway ban donating eggs, but not sperm.
Mandating disclosure of identity
Fertility Clinics
Risks of ovulation induction Informed consent about success
rates What should be done with
gametes/embryos that are no longer required by the donor couple for their own joint reproductive purposes? Who should control their use?
Lesbian and Single Women
France and Italy forbid IVF and artificial insemination for lesbians and single women
Switzerland requires couples to be married
Sweden requires a one year stable relationship
Surrogate Motherhood
Commercial surrogacy banned in Europe and Canada
Developing world surrogates Mary Beth Whitehead (1986)
and Baby M Genetic claim Birth mother claim Contract claim Best interest of child claim
NICUs, Artificial Uteri
Neonatal intensive care units (NICUs)
Medical futility vs. Baby Doe protections
Moving line of viability Artificial uteri
Designer Babies
Rights of parents to genomic choice
Parents trusted with best interests of child
Ensuring best fit of parents and child
Burdened expectations
Procreative Beneficence
If you have a reproductive choice you are obliged to choose the child with the best possible chance of fulfilling the widest range of life’s possibilities
Also “procreative altruism” – an obligation to have the best child for the community
Julian Savulescu
Sex Selection Sperm sorting Prenatal diagnosis and
selection Family balancing versus
patriarchy Rights of “missing girls”
versus their reluctant mothers
Infanticide versus abortion Alternative solutions:
women’s education
Eugenics Selective breeding applied to humans,
with the aim of improving the species. Popular in US &
Europe in early decades of the 20th century
Now associated Nazi Germany.
States with Eugenic Laws
Reproductive Cloning
Methods Natural twinning Induced twinning Nuclear transfer
Arguments Safety to mother(s) and child Right to uniqueness Instrumental parenting
Germline Therapy
Are we obliged to protect human genomic diversity?
Isn’t it better to pass a better genome to your children?
With syn-bio no sequence is ever really “lost.”
Mitochondrial transfer: nuclear transfer to embryo with healthy mitochondria
Genetic Enhancement
Transfer of desirable existing traits from other human genomes
…from animals …from novel sequences
To enhance Health, beauty and longevity Physical and mental abilities
Review
Expanding frame of reproductive rights to include positive claims to technological enablement
Contraceptives Prenatal Diagnosis Abortion rights, fetal personhood debate In-vitro fertilization Sperm banks and egg sales Fertility clinics Lesbian and single women access Surrogate motherhood
Review
NICUs and artificial uteri Designer babies Procreative beneficence Sex selection Eugenics Reproductive cloning Germline therapy & mitochondrial transfer Genetic enhancement
For more information
Institute for Ethics and Emerging Technologiesieet.org
These slides: http://ieet.org/archive/20140402ReproEthics.ppt