Block 5 VLE

Question 1

What does the Human fertilisation and Embryology Act (HFE Act) 1990 + 2008 amendments say?

Answer 1

1. It is unlawful to store or use gametes or embryos without a license granted by the HFEA (s3, 4)
2. Counselling requirements (s13(6))
3. Welfare of the child (s13(5))
4. Specification of who is legal mother and father (s27, 28)
5. Persons or embryos that are known to have a gene, chromosome or
   mitochondrion abnormality involving a significant risk that a person with the abnormality will have or develop a serious physical or mental disability, a serious illness, or any other serious medical condition, must not be preferred to those that are not known to have such an abnormality.
6. Embryos that are known to be of a particular sex and to carry a particular risk, compared with embryos of that sex in general, must not be preferred to those that are not known to carry such a risk

Question 2

When is embryo testing permitted according to the HFE Act?

Answer 2

1) To find anything that may reduce the chances of a live birth
2) To find anything serious that may cause the child to have a serious health condition or disability
3) To create a saviour sibling

Question 3

Is sex selection permitted?

Answer 3

Sex selection is permitted only when there is a risk of sex-related abnormalities that may result in serious disability or illness.

Question 4

What are some different perspectives about PIGD and IVF?

Answer 4

Value assigned to the quality of life of the future child

1. pre-implantation genetic diagnosis or prenatal testing used rather my child not suffer
2. no genetic testing, having the condition is not so bad – have a good life. No testing, there are things you cannot screen for.

Valuing reproductive responsibility

1. use prenatal testing/PIGD – there is quality of life but also a lot of problems – responsibility as a parent to give child the best start in life.
2. Playing God – responsibility to love the child regardless of any problems – duty to love unconditionally and take what you get in ife – do not be picky.

Question 5

What are some ethical principles about PIGD?

Answer 5

1. Maximising benefit/minimising harm
   a. Who are the beneficiaries?
   i. Future people – discount rate
   ii. Embryos
   iii. (Potential) parents
   iv. Existing children – which?

b. Different types of harm
i. Physical harm (to mother, baby, embryos by destroying
them) .
ii. Psychological harm (of not having a baby)?
iii. Can you be harmed by being brought into existence?
iv. Harm as negative messages about those with disabilities?

2. Fair use of resources (justice)
   a. Funding issues – who should get treatment
   b. Postcode lottery
   c. Criteria – previous parenthood, BMI, only medically in/subfertile
   vs same-sex couples and single people
3. Autonomy and rights
   a. Right to procreates – method/details of procreation and choose features of future child
   b. Demonstrating resect for life (embryos)

Question 6

Describe the legal framework governing consent to treatment of legal minors

Answer 6

Statute
1. Mental Capacity Act (2005)
- applies to 16+  assumed to have capacity
- under 16Gillick
2. Children Act - welfare of the child should be the paramount concern
3. Sexual Offences Act (2003)
- (a) protecting the child from sexually transmitted infection,
- (b) protecting the physical safety of the child,
- (c) preventing the child from becoming pregnant, or
- (d) promoting the child’s emotional well-being by the giving of
advice

Common law
1. Gillick competence - Gillick v West Norfolk and Wisbech Health
Authority
2. Fraser guidelines
3. The Queen On The Application Of Sue Axon v The Secretary Of State
For Health, 2006
- A Medical professional is entitled to provide advice and treatment
on sexual matters without parental knowledge or consent provided that he or she follows Fraser guidelines.

Question 7

What are the requirements for GIlick competence of young children and young people under 16 years of age?

Answer 7

• sufficient understanding and intelligence to understand fully what is proposed
• capable of understanding what is proposed, and of expressing his or her own wishes
• maturity and understanding and the nature of the consent required.

Other info about Gillick:
• No fixed age: depends on degree of maturity and understanding, and the nature of the decision to be made – i.e. it is decision-specific
• Fully understand nature, purpose and implications
• Can consent to treatment – no need for parental consent
• Applies to (precedent for) all medical treatment and not just
contraception

Note that:
• the threshold ‘fully understand’ is greater than that required for adult capacity
• Treatment is in the patient’s interests.

Question 8

Describe the Fraser guidelines

Answer 8

For sexual health

1. Understands advice
2. Cannot be persuaded to inform parents
3. Very like to continue sexual intercourse
4. If doesn’t receive treatmentphysical/mental health likely to suffer
5. Best interests of child to be given contraception