Bioethics of New Assisted Reproduction

Abstract

Infertility is widespread, and, given socialisation about the value of genetically related children, causes much suffering. Assisted reproduction (AR) can enable the infertile to reproduce. As a mostly private sector enterprise, it is delivered primarily as innovative therapy rather than the product of rigorously vetted research, putting women and children at risk of both some immediate harms and unknown long‐term ones. This state of affairs also means that it is difficult for treatment to proceed with genuinely meaningful informed consent. There is also much ethical controversy about the ever‐widening potential scope of AR, among which can be found IVF, ICSI, PGD, PGS, frozen sperm, embryos and eggs, assisted hatching, surrogacy, genetic screening and testing, mtDNA donation and artificial gametes. Regulation of the procedures ranges from minimal or non‐existent to quite stringent; however, the latter does not necessarily focus on harm prevention.

Key Concepts

  • Human societies socialise their members to seek genetically related children, even at great cost.

  • Infertility is widespread and causes much suffering.

  • Much infertility could be prevented, but AR focuses on helping infertile individuals reproduce after it has developed.

  • AR has, for the most part, developed as innovative treatment rather than as the product of rigorous research programmes, putting women and their children at risk of both immediate harm and unknown long‐term risks.

  • The context within which AR proceeds also makes truly informed decision‐making and informed consent difficult.

  • There is a much ethical controversy about AR.

  • AR needs more stringent regulation to protect women and children from harm.

Keywords: assisted reproduction; IVF; ICSI; genetics; ethics; informed consent; harm

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Purdy, Laura(Jan 2015) Bioethics of New Assisted Reproduction. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0003479.pub3]