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71 - Ethical Dilemmas in ART: Current Issues

from PART IV - ETHICAL DILEMMAS IN FERTILITY AND ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

Most treatments in assisted reproduction raise ethical issues, and it is difficult to be exhaustive and detailed. Nevertheless, the aim of this chapter was to highlight the main ethical concerns that have been discussed since the inception of the complex, although now routine, technique of IVF. That the human embryo could be observed outside the body captured the world's imagination, in a different way than, for instance, the less technically taxing but older techniques of sperm donation. This had also led to many debates, and so do eternal themes, which return only because of the use of more modern technology like social sex selection. This chapter will cover gametes donation for reproduction and research, including embryo research and the newer issues around stem cell research, a subject of major current interest, rekindled by the therapeutic hopes from the possible use of embryonic stem cells, with or without somatic cell nuclear transfer technology (SCNT). Furthermore, the complex choices to be made in the use of preimplantation genetic diagnosis (1) are also the matter for ethical debate, and finally, one should not avoid the international concerns about sex selection for social reasons, an issue that has implications far outside the specialist field of ART. Other more specialized issues, from the cryopreservation of reproductive tissues (2) to the use of posthumous gametes (3), have been included in previous publications.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2008

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References

Wert, G, Geraedts, J. Preimplantation genetic diagnosis for hereditary disorders which do not show a simple Mendelian pattern: an ethical exploration. In: Shenfield, F, Sureau, C, eds. Contemporary Ethical Dilemmas in Assisted Reproduction. UK: Informa Healthcare, 2006; 85–98.Google Scholar
Shenfield, F, Davies, MC, Spoudeas, H. Attempts to preserve the reproductive capacity of minors with cancer: who should give consent? In: Shenfield, , Sureau, , eds. Ethical Dilemmas in Human Reproduction. Parthenon, 2002; 21–34.Google Scholar
Bahadur, G. Till death do us part: to be or not to be a parent after one's death. In: Shenfield, F, Sureau, C, eds. Contemporary Ethical Dilemmas in Assisted Reproduction. UK: Informa Healthcare, 2006;29–42.Google Scholar
The European IVF monitoring (EIM) for ESHRE. Assisted reproductive technology in Europe, 2002. Results generated from European registers by ESHRE. Hum Reprod 2006; 21(7): 1680–97.
Shenfield, F. Justice and access to fertility treatments. In: Shenfield, F, Sureau, C, eds. Ethical Dilemmas in Assisted Reproduction. Carnforth, UK: Parthenon Publishing, 1997;7–14.Google ScholarPubMed
Shenfield, F. Too late for change, too early to judge, but an oxymoron will not solve the problem. Reprod Biomed Online 2005; 10(4): 433–5.Google Scholar
Shenfield, F, Steele, SJ. A gift is a gift is a gift, or why gametes donors should not be paid. Hum Reprod 1995; 10(2): 253–5.CrossRefGoogle Scholar
HFE Act 1990. www.opsi.gov.uk/acts
Titmuss, R. The Gift Relationship: From Human Blood to Social Policy. London: Allen and Unwin, 1971.Google Scholar
Rodrigez del Pozo, P. Paying donors and the ethics of blood supply. J Med Ethics 1994; 20: 31–5.CrossRefGoogle Scholar
Human Fertilisation and Embryology. 6th Code of Practice, HFEA. 2005. www.gov.hfea.uk
FIGO Ethical guidelines on the sale of gametes and embryos, (1997). In: Ethical Issues in Obstetrics and Gynaecology by the Figo Committee for the Study of Ethical Aspects of Human Reproduction and Women's Health. FIGO house, 2006. www.FIGO.org
Pennings, G, Devroey, P. Subsidized in-vitro fertilization treatment and the effect on the number of egg sharers. Reprod Biomed Online 2006; 13(1): 8–10.CrossRefGoogle ScholarPubMed
Human Fertilisation and Embryology Authority (Disclosure of donor information) Regulations 2004 no 1511.
Gollancz, D. Donor insemination: a question of rights. Hum Fertil 2001; 4: 164–7.CrossRefGoogle ScholarPubMed
Golombock, S, Breaways, A, Cook, R, Giavazzi, MT, Guerra, D, Mantovani, A, Hall E Crossignani, PG, Dexeus, S. The European study of assisted reproduction families: family functioning and child development. Hum Reprod 1996; 11: 2324–31.CrossRefGoogle Scholar
ESHRE taskforce on law and ethics 3. Gametes and embryo donation. Hum Reprod 2002; 17(5).
Pennings, G. The double track policy for donor anonymity. Hum Reprod 1997; 12: 2839–44.CrossRefGoogle ScholarPubMed
Testard, J, Sele, B. Towards an efficient medical eugenics: is the desirable always the feasible?Hum Reprod 1995; 11: 3086–90.CrossRefGoogle Scholar
Milliez, J, Sureau, C. PGD and the eugenic debate: our responsibility to future generations. In: Shenfield, , Sureau, eds. Ethical Dilemmas in Assisted Reproduction. Parthenon, 1997;51–6.Google Scholar
ESHRE taskforce 5; Shenfield F, Pennings G, Devroey P, Sureau C, Tarlatzis B, Cohen J. ESHRE Ethics Task Force: Preimplantation genetic diagnosis. Hum Reprod 2003; 18(3): 649–51.CrossRef
ESHRE taskforce 9; Shenfield F, Pennings G, Cohen J, Devroey P, Tarlatzis B. The application of preimplantation genetic diagnosis for human leukocyte antigen typing of embryos. Hum Reprod 2005; 20(4): 845–7.
Pennings, G, Liebaers, I. Creating a child to save another: HLA matching of siblings by means of preimplantation diagnosis. In: Shenfield, , Sureau, , eds. Ethical Dilemmas in Human Reproduction. Parthenon, 2002;51–66.Google Scholar
CCNE, Reponse au President de la Republique au sujet du clonage reproductif, cahiers du CCNE, Paris, 1997.
The Human Reproductive Cloning Act 2001. www.legislation. Hmso.gov.uk/acts 20010023.
ESHRE Taskforce for Ethics and Law 1; Shenfield F, Pennings G, Sureau C, Cohen J, Devroey P, Tarlatzis B. European Society of Human Reproduction and Embryology Task Force on Ethics and Law. I. The moral status of the pre-implantation embryo. Hum Reprod 2001; 16(5): 1046–8.CrossRef
Council of Europe Strasbourg. Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine, 1997. www.coe.int
Check, E. Special report ethicists and biologists ponder the price of eggs. Nature 2006; 442: 606–7.CrossRefGoogle Scholar
Luk, et al. Evaluation of compliance and range of fees by ASRM-listed egg donor and surrogacy agencies (Oral Presentation). ASRM, 2006; P–156.Google Scholar
FIGO Ethical guidelines on embryo research (2005). In: Ethical Issues in Obstetrics and Gynaecology by the FIGO Committee for the Study of Ethical Aspects of Human reproduction and Women's Health. FIGO house, 2006. www.FIGO.org
ESHRE Taskforce for Law and Ethics 12. Oocyte donation for non reproductive purpose. Hum Reprod 2007; 22(5): 1210–13.CrossRef
Edwards, RG. Cloning and cheating. Reprod Biomed Online 2006; 12(2): 141.CrossRefGoogle ScholarPubMed
Sen, A. More than 100 million women are missing. In: New York Review of Books. 1990.Google Scholar
Sen, A. Missing women-revisited. Br Med J; 327: 1297–8.CrossRef
Strathern, M. British Medical Association debate on sex selection. 1993.Google Scholar
Wu, Z et al. Perinatal mortality in rural China: retrospective cohort study. Br Med J 2003; 327: 1319–22.CrossRefGoogle ScholarPubMed
Prabath, J et al. Low male to female sex ratio of children born in India: national survey of 1.1 million households. Lancet 2006; 367: 211–8.Google Scholar
Sheth, S. Missing female births in India. Lancet 2006; 367(9506): 185–6.CrossRefGoogle ScholarPubMed
Ganapar, M. Doctors in India prosecuted for sex determination, but few selected. Br Med J 2006; 332: 257.Google Scholar
Nisker, J, Jones, M. The ethics of sex selection. In: Shenfield, , Sureau, eds. Ethical Dilemmas in Assisted Reproduction. Parthenon, 1997.Google Scholar
HFEA. Sex selection: options for regulation. Choice and responsibility in human reproduction. 2004. www.hfea.gov.uk
Ethics committee of ASRM. Preconception gender selection for non medical reasons. Fertil Steril 2001; 75: 861–4.CrossRef
Robertson, J. Sex selection: final word from the ASRM Ethics Committee on the use of PGD. Hastings Cent Rep 2002; 32(2): 6.Google ScholarPubMed
Pennings, G. Ethics of sex selection for family balancing: family balancing as a morally acceptable application of sex selection. Hum Reprod 1996; 11: 2339–43.CrossRefGoogle ScholarPubMed
Dahl, E. No country is an island. Comment on the House of Commons Report. RBM Online 2005; 11: 10–11.Google ScholarPubMed
Shenfield F. Procreative liberty, or collective responsibility? A comment on the select committee on the Commons' Science and technology 5th report “Human reproductive technology and the law”, and on Dahl's response. RBM.
Shenfield, F. Sex selection, why not. Hum Reprod 1994; 9: 142.Google Scholar
Dickens, B. Interfaces of assisted reproduction, ethics and law. In: Shenfield, F, Sureau, C, eds. Ethical Dilemmas in Assisted reproduction. Parthenon, 1997; 77–82.Google Scholar

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