Bioethics L2 Reproductive ethics

• Procreative liberty is the ability of individuals to make reproductive choices
• Methods to promote procreative liberty carry ethical considerations

Methods Supporting Procreative Liberty & Ethical Considerations

• Contraception: Allows control over conception timing, but raises religious and cultural debates
• Sterilization: Permanent method, controversial if performed without informed consent or under societal pressure
• Termination of pregnancy: Deeply debated, involves fetal rights, women's autonomy, and when life begins
• Artificial Insemination and In Vitro Fertilization (IVF): Enables conception via medical intervention, but raises concerns about commodification and unused embryos
• Preimplantation Genetic Diagnosis (PGD): Genetic selection to avoid hereditary diseases, but raises eugenics concerns and pressure to create "designer babies"
• Surrogacy: Option for those unable to carry a pregnancy, but raises ethical debates on exploitation and commercialization

Perspectives Shaping Procreative Choice & Ethical Tensions

• Procreative Autonomy: Emphasizes individual rights to decide on reproduction, but societal and familial pressures can complicate autonomy
• Procreative Beneficence: Suggests parents should aim for the "best" child, raising debates on genetic selection, disability rights, and societal expectations of normality
• Interests of the Future Child: Focuses on ensuring the child's well-being and raises questions about the ethics of certain reproductive choices (e.g., selecting embryos with disabilities)
• Interests of the State: Governments may regulate reproduction for public health or genetic screening, which may conflict with personal freedoms
• Preserving Life: Argues all human life has moral worth from conception, often in opposition to abortion and embryo selection

Ethical Views on the Moral Status of the Embryo & Their Limitations

• Identity as a Human Organism: An embryo is considered a human being from conception;Critics argue biological existence does not necessarily grant personhood
• Potential to Be a Person: Embryo has moral status due to its potential to become fully human, but potentiality does not equate to actual personhood
• Identity as a Person: Personhood is granted based on traits like consciousness and self-awareness, but this is debated because newborns/disabled individuals might not meet these criteria
• Conferred Status: Moral status is assigned by society/individuals, making it flexible but potentially inconsistent

Social Values Promoting Assisted Reproduction & Shaping Public Opinion

• Pronatalism: Emphasizes childbearing as a life goal, influencing attitudes toward fertility treatments
• Biological Relationships: The desire for genetic connection drives demand for IVF and surrogacy
• Medical Advancements: Technological progress has increased effectiveness of assisted reproduction, leading to greater acceptance
• Social Acceptance: Changing attitudes toward non-traditional families increased support for assisted reproduction

Ethical Objections to Assisted Reproduction

• Separation of Sex and Reproduction: Argues reproduction should remain natural due to religious/philosophical beliefs
• Alteration of Traditional Relationships: Challenges conventional family structures, leading to moral and legal debates
• Exploitation of Women: Demand for egg donors/surrogates may lead to exploitation of economically disadvantaged women
• Moral Status of Embryos: Creation and potential destruction of embryos in IVF raises moral questions
• Eugenics Concerns: Technologies like PGD could lead to selective breeding

Ethical Concerns Associated with Artificial Insemination by Donor (AID)

• Screening: Concerns over adequate screening of sperm donors for genetic/infectious diseases
• Anonymity: Debates whether donor-conceived individuals have right to know biological origins
• Family Relationships: Donor sperm use can create complex emotional and legal issues in defining parenthood
• Exploitation: Commercialization of sperm donation raises concerns about commodifying reproduction

Ethical Challenges Associated with In Vitro Fertilization (IVF)

• Moral Status of Embryos: Creating and discarding embryos raises ethical concerns
• Health Risks: Risks for mothers (e.g., ovarian hyperstimulation) and children due to IVF
• Cost and Access: IVF is expensive, creating disparities and justice-related concerns
• Multiple Pregnancies: IVF often results in twins/triplets, leading to medical complications

Ethical Concerns with Surrogacy

• Exploitation: Coercion of women, particularly the financially needy, to become surrogates
• Commodification: Surrogacy turns childbirth into a commercial transaction
• Legal Issues: Disputes over parental rights if the surrogate changes her mind
• Psychological Impact: Consequences for the surrogate, child, and intended parents

Ethical Dilemmas Raised by Pre-Birth Testing

• Discrimination: Selecting against embryos with disabilities raises concerns about societal attitudes toward disability
• False Positives/Negatives: Inaccurate test results can lead to emotional distress or misguided decisions
• Burden on Women: Significant emotional and medical pressures related to testing
• Eugenics: Potential for selecting desirable traits raises genetic engineering fears

Technologies Used for Sex Selection & Ethical Objections

• Sperm Sorting: Pre-conception method to influence the sex of a child
• Selective Abortion: Terminating fetuses based on sex
• Ethical objections - Sexism: Reinforces gender biases, especially cultures favoring male children
• Imbalanced Sex Ratios: Can lead to long-term demographic challenges
• Moral Concerns: Raises broader issues about selecting traits in children