Term Paper: In Vitro Fertilization

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[. . .] Human Embryo Research

The dilemma becomes even more grotesque and complicated when examples such as that of the Geron Corp. In Menlo Park, California are considered. These laboratories obtain donated human embryos from IVF clinics. [NBAC 1999, Author not available. 2003] They are allowed to develop from a few cells to about a 100 cells for about 12 days and then the human embryonic stem cells that will form the various types of tissue, are harvested to be grown into specific types. These are used for advanced medical research and transplantations. It is justifiable and indeed laudable if we could be sure that all we were dealing with were human cells not the being itself. [NBAC 1999]

Arguments for the continuation of this process are the fact that these abandoned embryos would be destroyed anyways, and they could be put to important use helping promote technology that could assist in medical advancement. Pluripotent stem cells can however be extracted from the placentas left over from healthy live births, cord blood, adult bone marrow, and even fat thus human embryos need not be an exclusively pursued avenue of medical discovery. [Author not available. 2003]

There is some evidence that stem cells derived from adults may in fact be a better source than live human embryos. Therapies derived from the patient's own stem cells have little probability of rejection. It has been found that only adult stem cells have the ability to create insulin-secreting cells that have potential for normalizing blood glucose in diabetics. Embryonic stem cells seem to lack that capability. [Author not available. 2003]

Genetic Screening

Another controversial issue associated with IVF is the ability to screen and interfere with the implantation process after genetic screening of the embryo. Usually if any defects are observed then the 'pre-embryo' is not transferred to the uterus and thus several chronic and irreversible conditions such as cystic fibrosis and Duchenne muscular dystrophy are avoided without the painful necessity of abortion. However this has created such ethical dilemmas as considering the rights of the embryo. Depending on what we consider the status of the embryo to be genetic testing is accused of interfering with the natural course of development and the right to life. Questions arise on which genetic conditions justify termination of pregnancy. Sometimes genotype is not the only determining factor in a disease and so to base such a crucial decision as continuance of pregnancy, on mere genetics is akin to playing God. [Shanner and Nisker 2001]

Eugenics

This ability to screen genetically has another aspect. That of producing children with pre-determined and desired characteristics. This has both a beneficial and sinister facet to its implementation.

In the future we may be able to correct any genetic faults through gene therapy avoiding termination of pregnancy, but this could raise expectations of parents and the terms 'healthy baby' may be replaced with 'genetically perfect.' This is when the more sinister angle of eugenics comes to mind, and man's wish to manipulate. Sex selection is still banned in most countries using IVF but babies have been produced with selected qualities for specific reasons. Adam Nash was born after genetically screening 10 embryos so that he could help donate stem cells to replace his sister Molly's bone marrow. She had Fanconi's anemia. The short-term achievement is no-doubt commendable but the long-term implications are the mechanization and dehumanization of reproduction and the human race. [Singer and Dawson 1988, Sweeney 2002]

Commercializing reproduction

There is a fear that the availability of gametes and embryos will commercialize reproduction. [Shanner and Nisker 2001] Individuals from lower socioeconomic levels tend to be the donors while the better off are usually recipients. Commercialization also occurs by agreeing to pay for IVF treatment by donating embryos. Such sharing programs also undermine informed consent taking advantage of the parents wish to have children with their inability to pay with cash instead of their own embryos. [Shanner and Nisker 2001]

Multiple Births

Not only are multiple embryos produced but also often multiple pregnancies result. Sometimes the number can be dangerous to the mother's health, or not viable. "Pregnancy reduction" is then recommended. This means that the physician will strategically abort a few of the growing babies in order to increase the woman's chances of carrying any to term. Again ethics becomes an issue. The question of abortion is still unresolved, but here we are not only producing conditions that we know will lead to multiple pregnancy, but also determining consciously which babies to abort, perhaps through genetic screening. The power wielded by humans over life seems almost extreme. True that multiple births are less likely to be viable and have more social and economic costs but if the desire to produce human life leads to the application of IVF then responsibility of that life must also be assumed. [Shanner and Nisker 2001]

Surrogacy recent addition to the list of issues associated with IVF that need to be analyzed is surrogacy. Natural surrogacy has been an accepted form of treating infertility for years and in the UK IVF surrogacy is now also an option. [Brinsden 2000] The process however raises many ethical and moral issues. As the surrogate is human and the process of pregnancy and birth are highly personal and life changing events often the birth mother may decide that she wishes to keep the child. This will undoubtedly cause pain to the infertile couple who have set such store in this method but legally The Human Fertilisation and Embryology Act 1990 has declared that no pre-pregnancy contracts are enforceable by the law, and that the birth mother is the legal parent.

An abnormal child may be rejected by both parents and then the responsibility and future of the child would be in limbo. Long-term effects on children is still unknown as are the psychological effects on either parents. Most surrogates feel fulfilled and recipients grateful, but the emotional separation between birth mother and child must leave emotional scars that need to be investigated. [Brinsden 2000]

The Surrogacy Arrangements Act 1985 prohibits commercial surrogacy agencies and outlaws advertising for or about surrogacy. Only the commissioning couples and the host surrogate may initiate, negotiate, or compile information to make a surrogacy arrangement. The act does not prohibit payments to surrogate mothers, but the question of whether producing a child and then giving it up should be financially rewarded is a dilemma. It commercializes the reproductive process and materializes the act of motherhood. [Brinsden 2000]

Religion

Most religions are against almost all aspects of IVF and any other form of assisted reproduction. The Roman Catholic Church uses natural law as the basis for its argument that God has laid down certain rules that human beings should obey. [Dyson 1995]. The feature of "external" fertilization in IVF and the use of masturbation by the husband or donor to provide the sperm are both points of focus of this argument. [Dyson 1995] Another viewpoint of this argument is taken up by Fletcher, in which he considers that the "nature" to be respected is not the reproductive process but "what is worthy of a human being"-freedom, planning, control of physical nature to serve human nature! [Daar 1999, Sweeney 2002]

All major religions attach special meaning to embryos, although significant disagreement exists about the details of embryo status. The Vatican considers embryos to be persons from conception and rejects IVF because it separates sex and reproduction. Conservative and Orthodox Judaism both attach greater but varying significance to embryos after the 40th day of conception, while both the Sunni and Shia branches of Islam believe that ensoulment occurs around the fourth month.

The Child

Children are the most vulnerable party in the whole IVF procedure. As many as 5 adults can play parental roles in a child's creation ranging from gamete donors, surrogate mothers to recipients. If not delicately handled the situation could confuse and traumatize the child. Other family variations, such as women who bear their own genetic grandchildren, postmenopausal pregnancies and reproduction by members of same-sex couples, challenge social, legal and historical norms. These new possibilities often leave family members without social or legal support. [Shanner and Nisker 2001]

Donor anonymity is an issue that might protect the donor and recipient but fails to realize the vulnerabilities and sensitivities of the child regarding their genetic medical history and ancestral heritage. [Shanner and Nisker 2001]

Conclusion

The ethical and moral questions raised by IVF and other assisted reproductive techniques grow more varied and complex as the technology becomes more accessible and advanced. ART procedures now account for one to three percent of all births in Australia and New Zealand each year so this has become an issue for a significant portion of populations in developed countries. [Monash… [END OF PREVIEW]

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