The Moral Status of the Embryo Flashcards

1
Q

Why Consider the Moral Status of the Embryo?

  1. Unresolved moral debates over the … and … of human embryos
  2. Views on this issue link in to views on other ethically contentious issues such as …
  3. These debates are … as well as personal, … as well and individual.
  4. Because this area of science and medicine is rapidly expanding there are new issues emerging all the time, such as …
A
  1. Unresolved moral debates over the significance and status of human embryos
  2. Views on this issue link in to views on other ethically contentious issues e.g. abortion, cloning, stem cell research
  3. These debates are political as well as personal, national as well and individual.
  4. Because this area of science and medicine is rapidly expanding there are new issues emerging all the time, e.g. Mitochondrial transplant, research, IVF…
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2
Q

Asking The Correct Question - Moral Status of Embryo

  • When does life …?
    • or
  • When does life … … …?
    • or
  • What … a life … …?
A
  • When does life begin?
    • or
  • When does life become morally significant?
    • or
  • What makes a life morally significant?​
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3
Q

History of Legislation - Moral Status of the Embryo

  • Report of the committee of Enquiry in to Human Fertilisation and Embryology 1984
    • https://www.bioeticacs.org/iceb/documentos/Warnock_Report_of_the_Committee_of_Inquiry_into_Human_Fertilisation_and_Embryology_1984.pdf
  • Human Fertilisation and Embryology Act 1990
    • https://www.legislation.gov.uk/ukpga/1990/37/contents
  • Human Fertilisation and Embryology Authority 1991
    • http://www.legislation.gov.uk/uksi/1991/1889/contents/made
  • House of Commons Science and Technology Committee Human Reproductive Technologies and the Law, 2004-5
    • http://www.publications.parliament.uk/pa/cm200405/cmselect/cmsctech/7/7i.pdf
  • Human Fertilisation and Embryology Act 2008 came into force October 2009
    • https://www.legislation.gov.uk/ukpga/2008/22/contents
  • To keep up to date check in to http://www.hfea.gov.uk/
  • The Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015
    • http://www.legislation.gov.uk/ukdsi/2015/9780111125816/contents
  • HFEA – Guidelines on Surrogacy: https://www.hfea.gov.uk/treatments/explore-all-treatments/surrogacy/
A
  • Report of the committee of Enquiry in to Human Fertilisation and Embryology 1984
    • https://www.bioeticacs.org/iceb/documentos/Warnock_Report_of_the_Committee_of_Inquiry_into_Human_Fertilisation_and_Embryology_1984.pdf
  • Human Fertilisation and Embryology Act 1990
    • https://www.legislation.gov.uk/ukpga/1990/37/contents
  • Human Fertilisation and Embryology Authority 1991
    • http://www.legislation.gov.uk/uksi/1991/1889/contents/made
  • House of Commons Science and Technology Committee Human Reproductive Technologies and the Law, 2004-5
    • http://www.publications.parliament.uk/pa/cm200405/cmselect/cmsctech/7/7i.pdf
  • Human Fertilisation and Embryology Act 2008 came into force October 2009
    • https://www.legislation.gov.uk/ukpga/2008/22/contents
  • To keep up to date check in to http://www.hfea.gov.uk/
  • The Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015
    • http://www.legislation.gov.uk/ukdsi/2015/9780111125816/contents
  • HFEA – Guidelines on Surrogacy: https://www.hfea.gov.uk/treatments/explore-all-treatments/surrogacy/
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4
Q

Abortion Act 1967

  • While it permits abortion, it also includes provision to enable medical staff or physicians to … … to participating in the provision of abortion and … … from a particular legal and professional duty to participate in it’s provision.
    • In this way - it is a response to the idea that there is a proportion of the population that see something … significant with …
A
  • While it permits abortion, it also includes provision to enable medical staff or physicians to conscientiously object to participating in the provision of abortion and exempt themselves from a particular legal and professional duty to participate in it’s provision.
    • In this way - it is a response to the idea that there is a proportion of the population that see something morally significant with embryos
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5
Q

Human Fertilisation and Embryology Act 1990

  • Similar provision to … Act … - suggests a proportion of population believe there is something morally significant with …
A
  • Similar provision to Abortion Act 1967 - suggests a proportion of population believe there is something morally significant with embryos
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6
Q

The Committee of Inquiry into Human Fertilisation and Embryology

  • Convened in July 1982, chaired by Dame Mary Warnock
    • “to examine the …, … and … implications of recent, and potential developments in the field of human assisted …”
  • Published The … Report in 1984
    • Explored the ethical considerations behind a range of issues in embryology, including;
      • The ethical status of emerging … … (… first successful in 1978)
      • D.., f…, and use of e.., e.., s…
      • S…
      • R…
  • Recommended the current … day limit on research on embryos
  • Led to the 1990 … … … Act (HFEA)
A
  • Convened in July 1982, chaired by Dame Mary Warnock
    • “to examine the social, ethical and legal implications of recent, and potential developments in the field of human assisted reproduction
  • Published The Warnock Report in 1984
    • Explored the ethical considerations behind a range of issues in embryology, including;
      • The ethical status of emerging reproductive technologies (IVF first successful in 1978)
      • Donation, freezing, and use of eggs, embryos, sperm
      • Surrogacy
      • Research
  • Recommended the current 14 day limit on research on embryos
  • Led to the 1990 Human Fertilisation and Embryology Act (HFEA)
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7
Q

What is the 14 day limit on research on embryos? and why is it recommended?

A
  • It stipulates that human embryos, for whatever purpose, should not be grown in vitro for longer than 14 days after the point of fertilisation
  • 14 day limit is very important – before possibility of twinning (Fourteen days was the point at which an embryo could no longer split into two identical twins, requiring two souls and not just one soul between them)
    • Justification is that prior to this stage, the embryo isn’t part of a continuum for an identifiable future person.
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8
Q

“The Warnock Committee”: Objective

  • To establish​ how we should … the human …
    • Combination of … and … questions about this - can be interpreted differently by different people - therefore must be resolved / regulated through …
A
  • To establish​ how we should treat the human embryo
    • Combination of factual and moral questions about this - can be interpreted differently by different people - therefore must be resolved / regulated through policy
      • “Although the questions of when life or personhood begin to appear to be questions of fact susceptible of straightforward answers, we hold that the answers to such questions in fact are complex amalgams of factual and moral judgements. Instead of answering these questions directly we have gone straight to the question of how it is right to treat the human embryo.”

Warnock 11.9 pg 60

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9
Q

What is Moral Status?

  • “An entity has moral status if and only if it or its interests morally matter to some degree for the entity’s … sake.”
    • … view: Having moral status means that one’s interests (extent, duration of pleasures/pains etc) must be factored into the utility calculations of other people/society as a whole.
    • … view: Having moral status means that there are reasons, independent of the consequences, for treating an entity with respect, and acting
A
  • “An entity has moral status if and only if it or its interests morally matter to some degree for the entity’s own sake.”
    • Utilitarian: Having moral status means that one’s interests (extent, duration of pleasures/pains etc) must be factored into the utility calculations of other people/society as a whole.
    • Non-Utilitarian: Having moral status means that there are reasons, independent of the consequences, for treating an entity with respect, and acting
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10
Q

Warnock’s Position - Moral Status of Embryo

  • “there is no particular part of the developmental process that is more important than another; all are part of a continuous process, and unless each stage takes place normally, at the correct time, and in the correct sequence, further development will cease. Thus biologically there is no one single identifiable stage in the development of the embryo beyond which the in vitro embryo should not be kept alive.”
    • This acknowledges the fact that embryonic development is a … - diffificult to … the biologically significant … … of moral status - need some kind of moral … of when we can … status.
A
  • “there is no particular part of the developmental process that is more important than another; all are part of a continuous process, and unless each stage takes place normally, at the correct time, and in the correct sequence, further development will cease. Thus biologically there is no one single identifiable stage in the development of the embryo beyond which the in vitro embryo should not be kept alive.”
    • This acknowledges the fact that embryonic development is a continuum - diffificult to differentiate the biologically significant starting point of moral status - need some kind of moral justification of when we can assign status.
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11
Q

One Consideration on Warnock - Moral Status of the Embryo

  • “producing watertight philosophical reasoning and dispensing moral expertise was not the committee’s self-stated mission. Instead, as Warnock herself argued, the aim was to facilitate a dialogue and process by which the plurality of dissenting moral views could somehow forge a workable policy decision.”
  • “Thus, as Nelson comments, the choice of the 14-day cut-off “…did not reflect an overwhelming national feeling that individuation is an essential property of a member of the human species. On the contrary, utilitarian considerations concerning potential research benefits played an explicit role in the Committee’s judgment about this matter.” (1)
    • Chan S. A bioethics for all seasons. J Med Ethics. 2015 Jan 1;41(1):17–21.
  • What does this mean?
  • 14 day cut off - helps how?
A
  • Means that there needs to be a compromise here for everyone to be more or less happy or at least satisfied that something better could not be achieved
    • 14 day cut off - doesnt suggest it is the precise moment that status occurs but recognition that there is value to research and that this is important to be allowed and some scope or space whereby research can be permitted.
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12
Q

Life as a Continuum

  • Pictures show a … day old embryo vs formation of the primitive streak (…) at day…-…
A

Pictures show a 5 day old embryo vs formation of the primitive streak (gastrulation) at day 14-15 - research on embryo no longer permitted

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13
Q

Visibility of Life

  • Pictures show embryo at … weeks and a … at …-… weeks
A

Pictures show embryo at 4 weeks and a foetus at 10-12 weeks

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14
Q

Boundaries

  • Pictures show a … week old foetus and a … newborn
A

Pictures show a 22 week old foetus and a premature newborn

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15
Q

Rejecting …

  • “Human embryos deserve the … … as all other human beings”, Pope Benedict XVI told an audience of scholars on February 27 2006.
  • “The love of God does … … between the newly-conceived infant still in its mother’s womb, the baby, the youth, the grown adult or the elderly, because in each of them He sees the sign of His own image and likeness,”
A

Rejecting Gradualism

  • “Human embryos deserve the same protection as all other human beings”, Pope Benedict XVI told an audience of scholars on February 27 2006.
  • “The love of God does not distinguish between the newly-conceived infant still in its mother’s womb, the baby, the youth, the grown adult or the elderly, because in each of them He sees the sign of His own image and likeness,”
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16
Q

Account One: Biological Humanity - Moral Status

  • We have moral status because we are …
  • Advantage – Clear, simple statement of which entities have …, and which … …
  • But…
  • What … as a human life, and …?
    • Not just Human … – every individual cell in our bodies would qualify.
    • “moment of …”? – that “moment” is lengthy and complex
    • Warnock’s “twinning argument” – Justification for … day limit on research
A
  • We have moral status because we are HUMAN
  • Advantage – Clear, simple statement of which entities have status, and which do not.
  • But…
  • What counts as a human life, and when does it start?
    • Not just Human DNA – every individual cell in our bodies would qualify.
    • “moment of conception”? – that “moment” is lengthy and complex
    • Warnock’s “twinning argument” – Justification for 14 day limit on research
17
Q

Account Two: Personhood - Moral Status

  • Mary Elizabeth Warren - Persons have;
    • S…
    • R…
    • C.. for moral agency
    • L…
    • … lack these features
  • Problem with this?
    • Could …
A
  • Mary Elizabeth Warren - Persons have;
    • Sentience
    • Rationality
    • Capacity for moral agency
    • Language
    • Embryos lack these features
  • Problem:
    • Could exclude many we might want to say have membership of the moral community – quite a high standard for moral status
18
Q

Account Three: Interests - Moral Status

  • Joel Feinberg
    • “… Principle”: Rights are intended to protect interests – rights holders must therefore be capable of having interests of their own.
      • Interests = having “… in things”
    • To have interests an entity must be … = “the capacity for having experiences of any kind”
      • Not plants, rocks, inanimate objects.
      • …? Jeremy Bentham thought so
      • An … cannot be … – no nervous system, thus no … or experience
  • Is there a difference between taking an interest, and something being in something’s interest?
A
  • Joel Feinberg
    • Interest Principle”: Rights are intended to protect interests – rights holders must therefore be capable of having interests of their own.
      • Interests = having “stakes in things”
    • To have interests an entity must be sentient = “the capacity for having experiences of any kind”
      • Not plants, rocks, inanimate objects.
      • Animals? Jeremy Bentham thought so
      • An embryo cannot be sentient – no nervous system, thus no awareness or experience
  • Is there a difference between taking an interest, and something being in something’s interest?
19
Q

Future Like Ours - Moral Status

  • Don Marquis
    • According to Marquis, the … view fails because it cannot explain why killing a person in a temporary coma is wrong
    • They lack …, so apparently lack interests. But we don’t think killing them is moral.
    • While an embryo or foetus cannot take an interest in anything, it does have an interest in …
    • … is wrong because it deprives the victim of their future – the same is true, according to Marquis, for an embryo or a foetus (maybe even eggs and sperm).
  • BUT
    • Unlike an embryo, we can have interests which should be respected even if we aren’t … … of them – the interest view does not require permanent, … … of our interests
A
  • Don Marquis7
    • According to Marquis, the interest view fails because it cannot explain why killing a person in a temporary coma is wrong
    • They lack sentience, so apparently lack interests. But we don’t think killing them is moral.
    • While an embryo or foetus cannot take an interest in anything, it does have an interest in living out its future
    • Murder is wrong because it deprives the victim of their future – the same is true, according to Marquis, for an embryo or a foetus (maybe even eggs and sperm).
  • BUT
    • Unlike an embryo, we can have interests which should be respected even if we aren’t fully conscious of them – the interest view does not require permanent, conscious awareness of our interests
20
Q

Does an embryo have moral status?

  1. Human Biology – …
  2. Personhood – …
  3. Interests – …
  4. Future Like Ours - …
A
  1. Human Biology – Yes
  2. Personhood – No
  3. Interests – No
  4. Future Like Ours - Questionable
21
Q

Mitochondrial Donation: A Case Study​

  • What is mitochondrial donation used for?
A
  • Mitochondrial donation is a way to address different diseases which can lead to very severe and life limiting/shortening conditions - premature death of children
    • Donation will help to avoid these disabilities
    • Different perspectives on this
22
Q

Perspectives on Mitochondrial Donation

  • … Generations – mitochondrial transplant will affect …
  • … babies?
  • … opposition due to destruction of “donor” embryos
  • Concern over “…” vote:
  • C…t – is there a right to be pregnant/have genetically related children?
A
  • Future Generations – mitochondrial transplant will affect the children of the babies born as a result of the donation.
  • Designer babies?
  • Religious opposition due to destruction of “donor” embryos
  • Concern over “rushed” vote:
  • Cost – is there a right to be pregnant/have genetically related children?
23
Q

One Argument in Favour of … …: Robert Winston

  • “Transfusing mitochondria is not unlike transfusing red blood cells in a case of severe anaemia - the main difference being that the mitochondrial treatments last into … …
    • “As an Orthodox Jew, my religious tradition sees no objection to using science in this way. If mitochondrial treatments could prevent disease, this is to be celebrated as we are using the God-given intelligence afforded us.
    • “We are not altering a child’s characteristics, nor enhancing humans in any way. The scientists are merely trying to ensure that a crippling and sometimes fatal disease is prevented and that future generations will not suffer this horrific sadness.”
A

One Argument in Favour of Mitochondrial Donation: Robert Winston

  • “Transfusing mitochondria is not unlike transfusing red blood cells in a case of severe anaemia - the main difference being that the mitochondrial treatments last into future generations
    • “As an Orthodox Jew, my religious tradition sees no objection to using science in this way. If mitochondrial treatments could prevent disease, this is to be celebrated as we are using the God-given intelligence afforded us.
    • “We are not altering a child’s characteristics, nor enhancing humans in any way. The scientists are merely trying to ensure that a crippling and sometimes fatal disease is prevented and that future generations will not suffer this horrific sadness.”

http://www.telegraph.co.uk/news/science/science-news/11383004/Three-parent-baby-technique-no-more-sinister-than-blood-transfusion-says-Robert-Winston.html

24
Q

Thinking About Your Practise - Moral Status of the Embryo

  • You have a right to … … to … in many legal, medical services relating to fertility – Abortion Act, HFEA.
    • BUT, you must be able to … your decision to do so, if you choose to … …
  • However, you cannot “…” your patient – you must … them to an …
  • You need to be aware of the …, so you can … your patients ….
  • Your colleagues may not …, how will you manage your relationships with them?
  • How will you manage your relationships with your patients?
A
  • You have a right to conscientiously object to participating in many legal, medical services relating to fertility – Abortion Act, HFEA.
    • BUT, you must be able to justify your decision to do so, if you choose to conscientiously object
  • However, you cannot “abandon” your patient – you must refer them to an alternative provider
  • You need to be aware of the law, so you can advise your patients appropriately.
  • Your colleagues may not share your position, how will you manage your relationships with them?
  • How will you manage your relationships with your patients?