Biomedical Ethics: Assignment Week 2

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Chapter 4

The Ethical Challenge of the New Reproductive

Technology

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Ethically Evaluating Reproductive Technologies

• There is a need for moral consensus at infertility technologies increase.

• There are also legal and regulatory confusions about the “baby business”.

• Society is has conflicts over the morality of sex and reproduction.

• How can we ethically assess reproductive technologies?

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Inadequate Evaluation Approaches

• Act utility is not adequate because: • You should not separate lovemaking and baby

making. • Alternative technologies do not protect the

embryo. • Many current technologies could be seen as

immoral.

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Private Rights Argument

• Reproductive rights are private and part of autonomy.

• Competent adults must be free to exercise their reproductive rights including the use of technology.

• People who disagree must demonstrate that harm occurs.

• However, long-term affects remain unknown with developing technologies.

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Are these Arguments too Limited?

• Problems posed by the new technologies are more complex.

• Adults acts affect more than themselves. • Decisions have social consequences. • The technological imperative must not govern

reproductive practices and policy.

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Technology Cannot be Unrestricted

• Ecological and ethical disasters have occurred when technology is unrestricted.

• Side effects may outweigh advantages. • Technology is never neutral or value free. • It must be ethically assessed.

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The Basis for an Ethical Position

• It needs to be grounded in what benefits the children, their parents and families, and society.

• When there is a conflict, priority should be given to the child or potential child.

• Human communities have moral imperative to protect children.

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Need to Consider the Past

• There is a need to consider safeguard and norms from the past.

• The burden of proof should be on the innovator.

• The child cannot give informed consent, therefore society must be vigilant.

• Adults’ desires is not moral justification, but the concept of do no harm is moral justification.

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Adoption Practices as an Argument

• Children have been adopted and raised successfully.

• In adoption, the child already exists and needs care.

• But to create, make to order, or purchase a child for the parent’s desires is different ethically.

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Alternative Reproductive Technology

• Technology is ethical when: • It allows a socially adequate heterosexual

infertile couple to have a child. • It restores a normally expected function. • Technology must also not do harm to the

child, couple, or society.

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Distributive Justice

• Health care professionals have a moral duty to the community.

• Distributive justice issues exist about who gets expensive procedures.

• Other ethics issues are centered around profit versus benefits.

• Justice and the interest of the child should come first.

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Surrogates

• Surrogates are not ethically acceptable options.

• There are problems and risks for the surrogate, the families, and the child.

• How you got here does make a difference. • The child may have many issues concerning

his or her origins.

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The Family View

• Pair bonding produces greater resources for parenting.

• Commitment between heterosexual married couple who choose to have children can be strong.

• Extended families can support the parent couple.

• Genetic ties do matter.

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Parents and Spouses

• There are ethical and even legal issues when the genetic parents differ from the donor parents.

• Surrogacy can also result in many ethical and emotional problems.

• With genetic parents, the child is a sharing of their genes, but also unique.

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Parents and Spouses

• When technological assistance is used for reproduction by married couples, it can strengthen the marriage bonds.

• Each parent will be equally invested in the resulting child.

• Parents have to be prepared for disappointment and be open to adoption or childlessness as options.

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Parents and Spouses

• Children who are not related to one of their parents have the potential for many problems.

• Issues of parenting and bonding arise in blended families and divorce can be one result.

• Donors and surrogates do not disappear from family memory.

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Parents and Spouses

• There is a psychological tendency to want to know your birth origins.

• Openness of information responds to the child’s right to know and to seeking information.

• Secrecy and deception can cause issues for the child and for the family.

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The Child

• A child created by some reproductive technologies is part of a biosocial experiment without his/her consent.

• There is a psychological difference to the child between adoption and being created by technology.

• The created child may be seen more as a commodity.

• Parental fantasies make a difference.

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The Child

• Gourmet children may have to live up to higher expectations.

• Rejection of gourmet children who do not measure up is entirely possible.

• A child desired for the wrong reasons may face rejection if not perfect.

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The Child

• The child may also have real issues with his or her identity.

• Questions about self-identity arise and the need to know about other kin can become an issue.

• Now grown sperm-donor babies are using the Internet to support each other.

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Donors and the Cultural Ethos

• The baby business will continue to grow as a profitable entity.

• The ethics of the donor’s action has not been analyzed.

• Donors are actually selling their genetic heritage.

• Donors abdicate responsibility for their reproductive acts.

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Donors and the Cultural Ethos

• Should human eggs and sperm become commodities?

• Does this practice have the potential to exploit the poor?

• Does this practice change the nature of motherhood and families?

• Does this practice reduce people to means to an end?

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In Summary…

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