Ethics of ART Flashcards
2 key acts regulating ART
Human Fertilisation and Embryology Act 1990 (as amended 2008)
The Human Fertilisation and Embryology (Quality and Safety) Regulations 2007 - see EC Directive
HFE Act 1990 (2008) says…
The Act is designed to regulate embryo/gamete research and most forms of treatment
The Act prohibits certain kinds of research and treatment entirely and prohibits certain kinds of research / treatment unless the research or treatment is licenced by the HFEA
Consent is placed at the heart of the HFE Act both in terms of research and treatment
what is banned under the HFE Act
Banned: human cloning, placing a non-human embryo in a woman’s uterus etc.
the HFE Act says that patient consent is needed for… (5)
Investigations/Treatment (e.g. IVF procedure)
Disclosure of information
Storage and use of sperm, oocytes & embryos
Use of data held on HFEA database for research
Patients can withdraw/change consent as long as sperm/oocytes/embryos have not already been used in treatment/research/training
key amendments of the HFE Act in 2008
A ban on selecting the sex for social reasons
Requiring clinics to take account of ‘the welfare of the child’ when providing fertility treatment
Provisions clarifying the scope of legitimate embryo research activities, including regulation of ‘human admixed embryos’
Enabling people in same sex relationships to apply for an order allowing them to be treated as the parents of a child born using a surrogate
Allowing for the recognition of both partners in a same-sex relationship as legal parents of children conceived through the use of donated s,o,e
Removing the previous requirement that clinics take account of the child’s ‘need for a father’
purpose of the HFEA (6)
Licensing & monitoring fertility clinics
Licensing & monitoring research on human embryos
Maintaining register of licences held by clinics, research establishments & storage centres
Regulating storage of gametes & embryos
Keeping confidential register of information about donors, patients & treatments
Providing impartial & authoritative information to the public & patients about ART & embryo research
what info does the HFEA collect from donors?
physical description year and country of birth ethnicity whether they had children- how many and gender marital status medical history goodwill message to any potential children if provided by donor identifying info
when can babies from donors find out info about their donor?
Donor-conceived people conceived after 1 April 2005, when they reach 18 years old are able to apply to the HFEA to find the information their donor provided, including identifying information. They can find out donors name, DOB, appearance and short statement about the donor. Donor-conceived people 18 years or older are entitled to find out identifying information about any donor-conceived genetic siblings - if both sides consent.
important articles of the HRA 1998
Article 8 (right to private and family life) Article 12 (right to found a family) Articles 14 (right not to be discriminated against)
How does parentage in ART work?
The legal mother is the mother who gave birth to the child (even if she a surrogate or used donor oocyte)
Donors of oocytes/sperm have no legal rights over the children they help to conceive and they are not the legal mothers/fathers of these children*
Husband who is “receiving treatment services together with a woman” and consented to this will become the legal father even if the woman receives donated sperm/embryo.
Where the woman giving birth is not married, the legal father or second parent of the child will be the person who is named on the ‘consent to parenthood’ forms. Both the named person, and the woman giving birth, must consent to that man being recognised as the legal father or that woman being the second parent of the child. Where the woman giving birth is in a civil partnership with another woman, the legal second parent will be her civil partner, unless it can be shown that the female partner did not consent to the embryo being placed in the woman giving birth. A female second parent is not the legal mother of the child; the law does not allow a child to have two legal mothers.
Note: A child may end up without a legal father (e.g. single woman using donated sperm), but a child cannot have multiple legal mothers or fathers – but can have a “legal second parent”.
limitations to access to fertility resources
Limited Resources “The welfare of the child” & the “welfare of other existing children” Age Genetic Diseases Ill-health
NICE Guidelines for ART
Fertility treatment on the NHS should:
- Be offered to women aged before 40
- In whom there is a 2y+ history of infertility
- 3 cycles of IVF should be funded
Fertility treatment should be offered to women aged 40 to 42 finding it difficult to get pregnant who:
2 years history of infertility
Have never had IVF before
Tests show that their ovaries would respond normally to fertility drugs/no evidence of low ovarian reserve
Have discussed the risks of IVF and becoming pregnant at this age with their doctor
Eligible for 1 cycle (1-2 eggs) of IVF
how has covid impacted ART
Donor shortage increased
Demand for fertility treatment increased
NHS provision decreased
Extending limit for storage of gametes by 2 years to reflect disruption in provision
