Reproductive ethics Flashcards
New reproductive
technologies
Human embryonic stem cells
Somatic nuclear transfer
patient-specific embryonic stem cells
human-animals hybrid embryos
Eugenics
“Good genes” or “good birth”
The use of genetics to improve the health of a
population
Negative selection: Don’t allow “bad genes” to
be reproduced
Forced sterilization or abortion
Marriage restrictions
“Euthanasia”
Definitions
Embryo
-> human organism during first 56 days of its development following fertilization/creation,excluding time during which its development has been suspended
Foetus
-> human organism from 57th day following fertilization/creation until birth
Human reproductive material
->sperm, ovum or other human cell or human gene, and includes a part of any of them
Rights Based Ethics
*What becomes of the idea that everyone is created equal if you
start designing children?
*Loss of autonomy because of a necessity to be competitive in
society
*Inherently discriminatory; makes assumptions about quality of life
“Most people with disabilities rate their quality of life as much
higher than other people think. People make the decision [to
reject embryos] based on a prejudice that having a disability
means having a low quality of life.“ (Zitner 2002)
Utilitarianism
The greatest good for the greatest number suggests that…
The alleviation of suffering for many is important.
IVF helps many infertile couples achieve a life-long dream of having a child.
PGD helps those same couples reach their goal of a disease free child.
Is a disease free society is preferable for all members
of society?
Peter Singer (Preference
Utilitarian)
We already allow this kind of treatment. It has
benefited many people.
Individuals should be free to make their own
choices on this issue as it is a private matter
harming no-one else.
Many children have been born as a result of this
technology. It hasn’t harmed any of them or
society so we should conclude that it is
acceptable.
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Pre-implantation Genetic Diagnosis (PGD)
Genetic analysis of a single cell from an eight-cell
embryo done in conjunction with in vitro
fertilization (IVF) to improve the chances of a
“normal” pregnancy
Why consider PGD in addition to IVF?
1.recurrent miscarriages
2.one child already affected with a genetic disease
3.family history of inherited disease
4.maternal age older than 38
5.prior failure with IVF
6.family “balancing” for sex
The Methods of Preimplantation Genetic
Diagnosis
- Remove a single cell from the 6-8-cell embryo
using a fine glass needle to puncture the zona pellucida and aspirate the cell
- In skilled hands, this generally does not harm the developing embryo.
- Each cell is called a blastomere.
- Prepare a metaphase spread of chromosomes to assess karyotype (number and integrity of each chromosome)
- Two types of assessment techniques are common:
a. chromosome “painting” (or FISH) using fluorescent
probes specific for each chromosome. These allow
number and size of each chromosome to be checked.
* useful for identifying aneuploidies (incorrect
chromosome numbers) and translocations
- procedure destroys the tested cell
- limited number of chromosomes can be checked
simultaneously; some abnormalites undetectable
- Two types of assessment techniques are common:
a. chromosome “painting” (or FISH)
b. genetic testing for specific disease loci (PCR or gene
chips)
Polymerase chain reaction (PCR)
- amplification of DNA specific to a gene of interest (family
history guides choice of genes)
Risks of IVF to the mother/couple:
- Multiple pregnancies (20-30%)
- Ectopic pregnancy
- Cancellation (over- or under-response to ovarian induction)
- Ovarian hyperstimulation syndrome (fluid build-up in pelvic
cavity due to ovarian enlargement; clotting problems) - Mechanical injury to bowel, bladder, ureters, or blood vessels during egg retrieval
- Greater risk of premature delivery and delivery by Caesarean section
Risks to the child conceived via IVF/PGD:
- Low birth weight; premature birth
- Developmental delays
- Cognitive problems (ADHD)
- Urogenital problems
- Cerebral palsy
- Certain cancers (e.g., Beckwith-Weidemann syndrome, which
may be related to ICSI)
(Note: The vast majority of children born of IVF appear normal. Low birth weight, cognitive delays, and cerebral palsy are more common for any multiple-birth situation. Very few controlled, longitudinal studies have compare IVF to natural.)
Proposed AHR Act –
Prohibited Activities
The proposed legislation would ban:
creating a human clone for any purpose (i.e.
reproductive or therapeutic);
creating an in vitro embryo for any purpose other
than creating a human being, or improving
assisted reproduction procedures;
creating an embryo from an embryo or fetus for
the purpose of reproduction;
maintaining an embryo outside a woman’s body
beyond the 14th day of its development;
Germ-Line Alteration?
The act forbids altering “the genome of a cell of
a human being or in vitro embryo such that the
alteration is capable of being transmitted to
descendants;”
But why not, e.g., allow permanent removal of
the gene for sickle-cell anemia from a particular
family line?
distinguish 2 kinds
negative = correcting or avoiding ‘defects‘
positive = making ‘improvements‘
Strongest arguments are for negative genetic
engineering
Objection 1: Playing
God / Unnaturalness
‘To engage in germ-line alteration is playing
God.’
Ethically a need to explore how this instance is different than other apparently morally OK
“acting unnaturally”
Uncertainty about Effects
Our knowledge of what exactly the alteration will do is incomplete.
This objection’s force will decrease with time.
We should be careful of identifying particular
traits as definitively problematic, e.g., in some
contexts, the gene for sickle-cell anemia
confers an advantage (i.e., protection from
malaria)
