Schenker Ethical Dilemmas in Assisted Reproductive Technologies
1. Auflage 2011
ISBN: 978-3-11-024021-4
Verlag: De Gruyter
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)
E-Book, Englisch, 412 Seiten
ISBN: 978-3-11-024021-4
Verlag: De Gruyter
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)
Zielgruppe
Obstetricians and Gynaecologists, Neonatalogists
Autoren/Hrsg.
Fachgebiete
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Klinische und Innere Medizin Pädiatrie, Neonatologie
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Vorklinische Medizin: Grundlagenfächer Reproduktionsmedizin
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Klinische und Innere Medizin Gynäkologie, Geburtshilfe
- Geisteswissenschaften Philosophie Angewandte Ethik & Soziale Verantwortung Medizinische Ethik
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Medizinische Ethik
Weitere Infos & Material
1;Contents;6
2;Preface;18
3;Author index;22
4;1 The foundations and application of medical ethics;26
4.1;1.1 Introduction;26
4.2;1.2 Historical background;26
4.3;1.3 General ethical theories and principles;27
4.4;1.4 Modern medical ethics;33
4.5;1.5 Conclusion;38
5;2 Legislation for assisted reproductive technologies;40
5.1;2.1 Introduction;40
5.2;2.2 Legislation and regulations;41
5.3;2.3 Legislative motivations;43
5.4;2.4 Evidence-based legal policy;45
5.5;2.5 The focus of legislation;47
5.6;2.6 Human rights;50
6;3 Reproductive rights as an integral part of women’s rights;54
6.1;3.1 Introduction;54
6.2;3.2 Granting women equal rights: the origin of discrimination;55
6.2.1;3.2.1 Cornerstones of women’s rights;57
6.2.1.1;3.2.1.1 Dignity, body integrity, and freedom from violence;57
6.2.1.2;3.2.1.2 Equality and empowerment;59
6.2.1.3;3.2.1.3 Full, unconditional access to health care services;60
6.2.2;3.2.2 A right to treat infertility;61
7;4 Right to reproduce;68
7.1;4.1 Socioeconomic issues;68
7.2;4.2 Religious issues;70
7.3;4.3 Legal and historical aspects;70
7.4;4.4 Moral aspects;73
7.5;4.5 ART-related aspects;74
8;5 Informed consent for treatment of fertility;78
8.1;5.1 Introduction;78
8.2;5.2 The right to experience parenthood and its standing;79
8.3;5.3 The informed-consent doctrine;80
8.3.1;5.3.1 The doctrine and its nature;80
8.3.2;5.3.2 Application of the doctrine to fertility treatments;80
8.4;5.4 Mutual consent of spouses;81
8.4.1;5.4.1 Joint process;81
8.4.2;5.4.2 The good of the child and consideration of parental capability;82
8.5;5.5 Validity of the consent;83
8.5.1;5.5.1 Effect of the initial consent;83
8.5.2;5.5.2 Withdrawal of patient consent;84
8.5.3;5.5.3 Physician’s withdrawal of consent;84
8.5.4;5.5.4 Consent after death;85
8.6;5.5 Conclusion;85
9;6 Specific ethical and legal aspects of ART practice in eastern European countries;88
9.1;6.1 Introduction;88
9.2;6.2 Situation in eastern European countries;88
9.2.1;6.2.1 Number of centers;88
9.2.2;6.2.2 Legal regulation of ART;89
9.2.3;6.2.3 Coverage or reimbursement of ART;90
9.2.4;6.2.4 Marital status in ART;91
9.2.5;6.2.5 The number of transferred embryos in ART;92
9.2.6;6.2.6 Cryopreservation;93
9.2.7;6.2.7 Posthumous ART;95
9.2.8;6.2.8 Gamete donation;96
9.2.9;6.2.9 Anonymity;97
9.2.10;6.2.10 Micromanipulation;98
9.2.11;6.2.11 In vitro maturation of oocytes;99
9.2.12;6.2.12 Welfare of the child;100
9.2.13;6.2.13 Multifetal-pregnancy reduction;101
9.2.14;6.2.14 Preimplantation genetic diagnosis;102
9.2.15;6.2.15 Surrogacy;103
9.2.16;6.2.16 Research on the embryo;104
9.2.17;6.2.18 Gamete intrafallopian transfer;106
9.2.18;6.2.19 The moral status of the embryo;106
9.3;6.3 Conclusions;107
10;7 Sperm donation and sperm-bank management;112
10.1;7.1 Introduction;112
10.2;7.2 Limiting the number of donor offspring;113
10.2.1;7.2.1 United States;113
10.2.2;7.2.2 United Kingdom;113
10.3;7.3 Minimizing the risk of infection and genetic complications from sperm donors;114
10.4;7.4 Age requirements for sperm donors;114
10.5;7.5 Anonymity versus nonanonymity of sperm donors;115
10.5.1;7.5.1 Anonymous sperm donation;115
10.5.2;7.5.2 Nonanonymous sperm donation;116
10.6;7.6 Sperm-donor compensation;117
10.7;7.7 Informed consent and counseling;118
10.8;7.8 Conclusions;118
11;8 Oocyte donation: medical and legal perspectives;120
11.1;8.1 Introduction: Indications for egg donation;120
11.2;8.2 Preparation of donor and recipient;121
11.3;8.3 Outcome determining factors;123
11.4;8.4 Obstetric and perinatal outcomes;123
11.5;8.5 Ethical aspects;124
11.6;8.6 Legislation;126
11.6.1;8.6.1 The new Israeli legislation;129
11.7;8.7 Summary;132
12;9 Egg donation: ethical considerations and regulatory context;136
12.1;9.1 Introduction;136
12.2;9.2 The regulatory context;136
12.3;9.3 Donating eggs;137
12.3.1;9.3.1 Informed consent;137
12.3.2;9.3.2 Meeting demand: remuneration and other programs;138
12.3.2.1;9.3.2.1 Financial compensation;138
12.3.2.2;9.3.2.2 Egg-sharing programs;139
12.3.3;9.3.3 Other obligations;140
12.4;9.4 Use of donated eggs;140
12.4.1;9.4.1 Informed consent;140
12.4.2;9.4.2 Nontraditional patients and access to donated eggs;140
12.4.3;9.4.3 Age;141
12.5;9.5 Donor identity and disclosure;141
12.6;9.6 Conclusions;143
13;10 Medical, ethical, and legal aspects of fetal reduction;146
13.1;10.1 History;146
13.2;10.2 Ethical issues;148
13.2.1;10.2.1 Moral compromise;152
13.3;10.3 Legal issues;153
13.3.1;10.3.1 Recommendations;153
13.4;10.4 Summary;154
13.5;10.5 Acknowledgments;154
14;11 Fertility treatments in human immunodeficiency virus (HIV) infected patients;156
14.1;11.1 Introduction;156
14.2;11.2 HIV and the male genital tract;157
14.3;11.3 HIV and the female genital tract;158
14.4;11.4 Assisted reproductive technologies in HIV-positive patients;158
14.5;11.5 Semen processing;159
14.6;11.6 Viral testing of spermatozoa;160
14.7;11.7 Success rates;160
14.8;11.8 Summary;160
15;12 Pregnancies in perimenopause and beyond;164
15.1;12.1 Medical aspects and considerations;164
15.1.1;12.1.1 Fertility fecundity and abortions;164
15.1.2;12.1.2 Pregnancy-associated physiological changes;165
15.1.3;12.1.3 Obstetrical and intrapartum complications;165
15.1.4;12.1.4 Maternal mortality;166
15.1.5;12.1.5 Neonatal outcome;166
15.2;12.2 Oocyte-donation programs;166
15.3;12.3 Ethical aspects;167
15.3.1;12.3.1 The issue of choice;167
15.3.2;12.3.2 The welfare of the child;168
15.4;12.4 Coping with the medical risks;168
15.5;12.5 Legislation, regulation, and religion aspects;169
15.6;12.6 Summary;170
16;13 Legal control of surrogacy – international perspectives;174
16.1;13.1 Introduction;174
16.2;13.2 Surrogacy – definition;174
16.3;13.3 Surrogacy – history;174
16.4;13.4 Legal control of surrogacy – international perspectives;175
16.4.1;13.4.1 Prohibition of Surrogacy by legislation;175
16.4.2;13.4.2 Counties – surrogacy no prohibited by law;176
16.4.3;13.4.3 Surrogacy in China;177
16.4.4;13.4.4 Non commercial surrogacy;177
16.4.5;13.4.5 Greece Law;177
16.4.6;13.4.6 South Africa;178
16.5;13.5 Commercial surrogacy;178
16.5.1;13.5.1 Former Countries of the Soviet Union;178
16.5.2;13.5.2 India;179
16.5.3;13.5.3 Surrogacy in USA;179
16.5.4;13.5.4 Surrogacy in Russia;180
16.6;13.6 Russian Public Opinion;183
16.7;13.7 Surrogacy in Islamic Countries;183
16.8;13.8 Cross-border Surrogacy;184
16.9;13.9 Conclusions;186
17;14 Preimplantation genetic diagnosis in assisted reproduction: medical, ethical, and legal aspects;190
17.1;14.1 Introduction;190
17.2;14.2 Biopsy methods for preimplantation genetic diagnosis;191
17.2.1;14.2.1 Polar-body biopsy;191
17.2.2;14.2.2 Embryo biopsy;192
17.3;14.3 Chromosomal aneuploidies in preimplantation development;192
17.4;14.4 Chromosomal rearrangements;194
17.5;14.5 Impact of PGD on IVF outcome;195
17.6;14.6 Conclusion;197
18;15 Preimplantation genetic diagnosis of late-onset diseases;200
18.1;15.1 Introduction;200
18.2;15.2 Embryo selection;202
18.3;15.3 Huntington’s disease;203
18.4;15.4 Cardiovascular disorders;205
18.5;15.5 Alzheimer’s disease;206
18.6;15.6 Genetic testing for cancer;206
18.7;15.7 Breast cancer;207
18.8;15.8 Genetic counseling;210
18.9;15.9 Conclusion;210
19;16 Bioethics of human embryonic stem cells and cloning for stem cells: an Israeli perspective;214
19.1;16.1 The scientific and medical aspects;214
19.2;16.2 Ethical issues related to human embryo stem cells;215
19.2.1;16.2.1 Pluralism of moral views on the preimplantation embryo;215
19.2.2;16.2.2 Potentiality of human preimplantation embryo;216
19.2.3;16.2.3 Personal status of the embryo;216
19.2.4;16.2.4 Therapeutic aims of human ES cells;217
19.2.5;16.2.5 Pluralism of decisions on human ES cell production and research in various countries;217
19.2.6;16.2.6 A case study: ethical regulations on human ES cell research in Israel;219
19.3;16.3 Ethical views on cloning to obtain autologous ES cells;220
19.3.1;16.3.1 Bioethical arguments;220
19.3.2;16.3.2 National and international resolutions;221
19.3.3;16.3.3 Case study: regulations in Israel regarding cloning for ES cells;222
20;17 The future of human embryonic stem cell research: medical, legal, and ethical perspectives;226
20.1;17.1 Introduction: Human embryonic stem cell research;226
20.2;17.2 The first possible clinical applications of cells differentiated from hESC;226
20.3;17.3 Challenges in clinical treatment using hESC-derived cells;227
20.3.1;17.3.1 Microbial contamination;227
20.3.2;17.3.2 GMP and EU tissues and cells directive;227
20.3.3;17.3.3 Immunogenicity;228
20.3.4;17.3.4 Tumorigenicity;228
20.4;17.4 iPS cells versus hESC;229
20.5;17.5 Legal and ethical aspects of hESC research;229
20.6;17.6 Conclusions;231
21;18 Preservation of fertility in children with cancer: medical, ethical, and legal aspects;234
21.1;18.1 Introduction;234
21.2;18.2 Population at risk;235
21.3;18.3 Medical and surgical options for fertility preservation;236
21.4;18.4 The ethical propriety of fertility-preservation options;237
21.5;18.5 Autonomy, justice, and treating pediatric patients;239
21.6;18.6 Ethical and legal issues with unused tissue and gametes;239
21.7;18.7 Posthumous reproduction;240
21.8;18.8 Conclusion;241
22;19 Fertility preservation for cancer patients: a review of current options and their advantages and disadvantages;244
22.1;19.1 Introduction;244
22.2;19.2 Cancer and fertility preservation;244
22.3;19.3 Current options for fertility preservation;245
22.4;19.4 Medical options: GnRH agonists;245
22.5;19.5 Surgical options: ovarian transposition and cryopreservation of ovarian cortical tissue;246
22.5.1;19.5.1 Ovarian transposition;246
22.5.2;19.5.2 Cryopreservation of ovarian cortical tissue;247
22.6;19.6 ART: in vitro fertilization and in vitro maturation;248
22.6.1;19.6.1 Embryo and oocyte cryopreservation after ovarian stimulation;248
22.6.1.1;19.6.1.1 Embryo cryopreservation;248
22.6.1.2;19.6.1.2 Oocyte cryopreservation;249
22.6.2;19.6.2 Embryo and oocyte cryopreservation without prior ovarian Stimulation;250
22.6.3;19.6.3 IVM embryo cryopreservation;251
22.6.4;19.6.4 IVM-oocyte vitrification;251
22.6.5;19.6.5 Fertility preservation: the McGill experience;252
22.7;19.7 Conclusion;252
23;20 Sexual orientation and use of assisted reproductive technology: social and psychological issues;258
23.1;20.1 Introduction;258
23.2;20.2 A note about terminology;258
23.3;20.3 Routes to parenthood among nonheterosexual adults;259
23.4;20.4 Legal issues surrounding sexual orientation and family formation;259
23.5;20.5 Sexual orientation and incidence of parenthood;260
23.6;20.6 Sexual orientation and plans for parenthood;260
23.7;20.7 Studies of sexual orientation and plans for parenthood;261
23.8;20.8 Outcomes for children of lesbians and gay men;262
23.9;20.9 Relationships with peers;262
23.10;20.10 Child behavior problems;263
23.11;20.11 Gender development;263
23.12;20.12 Conclusions and future directions;264
23.13;20.13 Assisted reproduction among nonheterosexual adults;264
23.14;20.14 Barriers to ART use by nonheterosexual adults;264
23.15;20.15 Donor-insemination decisions;266
23.16;20.16 Recommendations for clinical practice;267
23.17;20.17 Conclusion;268
24;21 Access to fertility treatment by lesbian couples;270
24.1;21.1 Introduction;270
24.2;21.2 Legal changes;271
24.3;21.3 Assisted reproduction;274
24.4;21.4 Being a lesbian and a mother;275
24.5;21.5 Donor anonymity;275
24.6;21.6 Ethical assessment;277
24.7;21.7 A Child with two mothers;279
25;22 ART practice and tourism;282
25.1;22.1 Introduction;282
25.2;22.2 Background and methods;283
25.3;22.3 Major findings;284
25.3.1;22.3.1 The United Arab Emirates;286
25.3.1.1;22.3.1.1 Reproductive travel to the UAE;286
25.3.1.2;22.3.1.2 Reproductive travel from the UAE;287
25.3.1.3;22.3.1.3 Reproductive travel to and from the UAE;288
25.3.2;22.3.2 The East Coast of the United States;288
25.4;22.4 Conclusion;290
26;23 A savior child conceived by PGD/HLA: medical and ethical aspects;294
26.1;23.1 Introduction;294
26.2;23.2 Medical indications and social acceptance of PGD;294
26.2.1;23.2.1 Chromosomal abnormalities;294
26.2.2;23.2.2 Monogenic diseases;295
26.2.3;23.2.3 Adult-onset diseases and cancer-predisposing genes;295
26.2.4;23.2.4 Creating a “savior child”;296
26.3;23.3 Other possible applications of PGD: savior embryos, gender selection, and designer babies;297
26.3.1;23.3.1 Savior embryos;297
26.3.2;23.3.2 Gender selection;298
26.3.3;23.3.3 Designer babies;298
26.4;23.4 Legislation and professional guidelines for the uses of PGD/HLA;299
26.5;23.5 Ethical considerations;299
26.5.1;23.5.1 Embryo wastage;300
26.5.2;23.5.2 Moral status of the human embryo;300
26.5.3;23.5.3 Harm of embryo biopsy;302
26.5.4;23.5.4 The condition of absolute medical necessity;302
26.5.5;23.5.5 PGD SC and family ethics;304
26.5.6;23.5.6 Well-being of the savior child;306
26.5.7;23.5.7 PGD, parental interests and public access;308
27;24 Posthumous reproduction: ethical and legal perspectives;314
27.1;24.1 Introduction;314
27.2;24.2 The source;315
27.2.1;24.2.1 What counts as consent?;315
27.2.2;24.2.2 Coercion;316
27.2.3;24.2.3 Minors as sources;317
27.3;24.3 Requesters of retrieval;318
27.4;24.4 Reproductive partners;319
27.5;24.5 Children;320
27.6;24.6 Summary;320
28;25 Human reproductive cloning: ethical perspectives;322
28.1;25.1 Introduction;322
28.2;25.2 The potential value of HRC;322
28.3;25.3 Ethical concerns with HRC;326
28.4;25.4 HRC and the value of our unique genetic make-up;331
28.5;25.5 Conclusion;332
29;26 ART practice – religious views;334
29.1;26.1 Introduction;334
29.2;26.2 The Jewish law;335
29.2.1;26.2.1 Torah;335
29.2.2;26.2.2 The Mishnah;336
29.2.3;26.2.3 The Talmud;336
29.2.4;26.2.4 Post-Talmudic codes;336
29.2.5;26.2.5 Responsa;336
29.2.6;26.2.6 Orthodox Judaism;337
29.2.7;26.2.7 Reform Judaism;337
29.2.8;26.2.8 Conservative;338
29.3;26.3 Christian denominations;339
29.3.1;26.3.1 Roman Catholic Church;339
29.3.2;26.3.2 Anglican Church;340
29.3.3;26.3.3 The Protestant Church;341
29.3.4;26.3.4 Eastern Orthodox Church;341
29.4;26.4 Hinduism;342
29.5;26.5 Buddhism;343
30;27 A Catholic ethical perspective on human reproductive technology;346
30.1;27.1 Catholic position on respect for the human embryo;346
30.1.1;27.1.1 Biblical perspective;346
30.1.2;27.1.2 Christian tradition;346
30.1.3;27.1.3 Embryo defined;347
30.1.4;27.1.4 Catholic Christian teaching;347
30.1.5;27.1.5 A person from conception;349
30.1.6;27.1.6 Ethics and destructive research on human embryos;349
30.1.7;27.1.7 Morality and personalized natural law;350
30.1.8;27.1.8 Secular ethics and the human embryo;351
30.1.9;27.1.9 Challenge to find ethical alternatives;352
30.2;27.2 Catholic ethics, marriage, and reproductive technology;352
30.2.1;27.2.1 Catholic Christian position on children of the marriage union;352
30.2.2;27.2.2 Assisted insemination;353
30.2.3;27.2.3 Rights of children and natural parents;354
30.2.4;27.2.4 Donor gametes;354
30.2.5;27.2.5 Surrogacy;354
30.2.6;27.2.6 Access to ART by single women and lesbians;355
30.2.7;27.2.7 Human reproductive cloning;355
30.3;27.3 Conclusion;355
31;28 Islamic laws and reproduction;358
31.1;28.1 Islamic laws;358
31.2;28.2 Reproduction in Islam;358
31.3;28.3 ART and Islam;359
31.4;28.4 Islam and various ART practices;360
31.5;28.5 Surrogacy;360
31.6;28.6 Multifetal pregnancy reduction;360
31.7;28.7 Pregnancy in postmenopause;360
31.8;28.8 Sex selection;361
31.9;28.9 Cryopreservation;362
31.10;28.10 Embryo implantation following husband’s death;362
31.11;28.11 Embryo research;363
31.12;28.12 Gene therapy;363
31.13;28.13 Cloning;364
31.14;28.14 ART practices in different Muslim countries;364
32;29 Jewish law (halakha) and reproduction;368
32.1;29.1 Introduction;368
32.2;29.2 Homosexuality;369
32.3;29.3 Lesbianism;369
32.4;29.4 Evaluation of the infertile couple;370
32.5;29.5 The laws of niddah;370
32.6;29.6 Infertility treatment;371
32.7;29.7 The beginning of human life;373
32.8;29.8 Artificial insemination by husband;375
32.9;29.9 Artificial insemination by donor;375
32.10;29.10 Oocyte donation;376
32.11;29.11 Surrogacy;377
32.11.1;29.11.1 Legalizing surrogacy in Israel;378
32.11.2;29.11.2 The state-appointed permission committee;378
32.11.2.1;29.11.2.1 Guidelines set by the committee for surrogacy;378
32.11.2.2;29.11.2.2 Expenses;379
32.11.2.3;29.11.2.3 Legal status of the newborn;379
32.11.2.4;29.11.2.4 Surrogate mother’s withdrawal from the agreement;379
32.11.2.5;29.11.2.5 Legal rights of the surrogate mother;380
32.11.2.6;29.11.2.6 Enforcement of the law;380
32.11.2.7;29.11.2.7 Right to privacy;380
32.11.2.8;29.11.2.8 Illegal financing;380
32.11.2.9;29.11.2.9 Legal adoption;380
32.12;29.12 Fetal reduction;381
32.13;29.13 Gender preselection;382
32.14;29.14 Cryopreservation;382
32.15;29.15 Posthumous reproduction;383
32.16;29.16 Cloning;384
32.17;29.17 Preembryo research;385
33;30 Commercialized assisted reproduction;388
33.1;30.1 Position of reproductive treatment in the economy;388
33.2;30.2 Commercialization of assisted reproduction;388
33.3;30.3 Divergent national policies toward reproductive treatment;388
33.4;30.4 International economic integration and assisted reproduction;389
33.5;30.5 Absence of effective restrictions on reproductive tourism;390
33.6;30.6 Natural barriers to reproductive tourism;390
33.7;30.7 Intellectual property and assisted reproduction;391
33.8;30.8 Doing business in the reproductive industry;391
33.9;30.9 Assisted reproduction in united Europe;392
33.9.1;30.9.1 Case study: German patients in Czech centers;393
34;31 The intersection between economic and ethical aspects of ART;396
34.1;31.1 Introduction;396
34.2;31.2 A framework for economic and ethical aspects of ART;397
34.3;31.3 Distributive justice and funding of ART;398
34.3.1;31.3.1 International differences in funding;398
34.3.2;31.3.2 Provision of ART in developing countries;401
34.3.3;31.3.3 Morally challenging funding decisions;402
34.4;31.4 The cost of ART treatment;402
34.4.1;31.4.1 Treatment costs;402
34.4.2;31.4.2 The costs of multiple births;403
34.4.3;31.4.3 Valuing ART treatment from an economic perspective;405
34.5;31.5 The affordability of ART treatment and its implications;406
34.5.1;31.5.1 Affordability and utilization;406
34.5.2;31.5.2 Affordability and clinical practice;409
34.5.2.1;31.5.2.1 It makes economic as well as clinical sense to reduce multiple-births;410
34.6;31.6 Conclusion;411
