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New Reproductive Options: New Ethical Questions. Dianne Bartels, RN, MA, PhD Center for Bioethics University of Minnesota. Objectives. To examine the individual and social consequences of new biological technologies by looking at reproductive options

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New reproductive options new ethical questions

New Reproductive Options: New Ethical Questions

Dianne Bartels, RN, MA, PhD

Center for Bioethics

University of Minnesota


Objectives
Objectives

  • To examine the individual and social consequences of new biological technologies by looking at reproductive options

  • To describe the range of current reproductive technologies

  • To identify ethical questions that arise in the context of offering new reproductive options


Reproductive options
Reproductive Options

  • prenatal testing

  • artificial insemination - by spouse or donor

  • egg donation

  • in vitro fertilization

  • pre-implantation genetic diagnosis (PGD)

  • surrogacy contract

  • embryo adoption

  • cloning?



Embryo adoption

Embryo adoption - proposed as an alternative after discussion of stem cell transplantation and cloning.

A response to a question about whether existing IVF embryos are really “spare” (unwanted) embryos.

Embryo Adoption


Embryo adoption1
Embryo Adoption discussion of stem cell transplantation and cloning.

  • Snowflake Embryo Adoption Program promises to help genetic parents find a suitable home for their “pre-born children” giving genetic parents “some control over their destiny”

    • abc news email 8/22/02


Genetic testing now offers the option to discussion of stem cell transplantation and cloning.

test for susceptibilities to diseases

like cystic fibrosis, breast cancer,

or Fanconi’s Anemia; genetics will

become the “new paradigm”

for health care.


Prenatal testing is often the first application of new tests.

So, what tests should be done/allowed?


One moral question is whether the end, (e.g. having a healthy child) justify the means

prenatal testing

offering the choices about whether to continue a pregnancy

selecting embryos


Alzheimer disease
Alzheimer Disease healthy child) justify the means

  • A 30 year old asymptomatic woman with a genetic mutation consistent with early onset Alzheimer disease was identified by predictive testing

  • She requested and received PGD which resulted in the birth a child free of inherited predisposition to early-onset AD


Boy conceived to be deaf at center of ethics uproar
Boy conceived to be deaf at center of ethics uproar healthy child) justify the means

  • “Taking the idea of genetic engineering to a whole new level [a couple] deliberately have conceived a deaf son because they think the inability to hear is a ‘cultural identity,’ not a disability.”

    • Chicago Sun Times 4/10/ 02


Does the child have a right to know

In fact a majority of couples who have used gamete donation to conceive their children do not intend to tell their children?

Does the child have a right to know?


Ethical challenges
Ethical Challenges to conceive their children do not intend to tell their children?

  • Destruction of Embryos

  • Status of embryos (personhood)

  • Right to reproduce

  • Best interest of the child

    • using a child as a means to another’s end

      • was Adam Nash “born to perform”

  • Commodification - product orientation

    • selecting traits of children


Egg donor needed
Egg Donor Needed to conceive their children do not intend to tell their children?

  • Large financial incentive

  • Intelligent, athletic egg donor needed/for loving family

  • You must be at least 5’ 10’’

  • Have a 1400+ SAT Score

  • Possess no family medical issues

  • $50,000

  • Free medical screening

  • All expenses paid


Ethical challenges1
Ethical Challenges to conceive their children do not intend to tell their children?

  • Family and community responsibility

    • to have a healthy child

    • to share genetic risk information

  • Eugenics - harm to society

    • discrimination against the disabled

  • Justice-resource allocation

    • 186,000,000 people in developing countries have little or no access to basic health care

    • 46 million people have little or no access to health care in the U.S.

    • cost is prohibitive, here and there


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