Introduction to Reproductive Ethics

James J. Hughes Ph.D.Executive Director,

Institute for Ethics and Emerging Technologies

Reproductive Rights?

Bodily autonomy Women’s rights Rights to what? Balancing mother’s

interests with father’s, child’s, family’s, society’s interests

Rights from, rights to

Contraceptive Freedom Uncoupling sex and reproduction Comstock laws (1873) banning

distributing of contraceptives or contraceptive information

U.S. Supreme Court case Griswold v. Connecticut (1965) struck down Comstock laws in CT & MA for married couples.

Eisenstadt v. Baird (1972) extended to unmarried persons as well.

Rights to What?

Not be raped Choose to reproduce or not To contraception To abortion, selective or

other reason To fertility assistance To genetic choice To public financing of

choices

Prenatal Diagnosis

Prenatal Counseling Pre-implantation Genetic Diagnosis Chorionic Villus Sampling (CVS) Ultrasound Amnioscentesis Sperm sorting Home tests

Risks of amnio False negatives and false positives Disability rights/eugenics complaints

Abortion Rights

1973 – Row v Wade Trimesters and viability

Hyde Amendment (1976) bans public financing

Do reasons matter? Health, rape, incest

What is legitimate regulation of safety? What is legitimate informed consent?

Pre-abortion counseling, trans-vaginal ultrasound Access for minors

Abortion Milestones

Catholic Doctrine

A child has rights from conception

A child has the right to be conceived in a sex act, nurtured in the womb, born, and raised by male and female married parents.

Forbids contraception, abortion, in-vitro fertilization and all ARTs, all interventions in reproduction

Who Has Interests?

Legal persons Future persons Potential persons? Personhood

Psychological vs. biological

Embryo Fetus Preemie Newborn

Does Body Autonomy Trump?

Waking up attached to a VIP

Baby K: Anencephaly

Born in 1992 with anencephaly and placed on a ventilator.

Hospital personnel urged a DNR order and to discontinue ventilator treatment for Baby K.

Mother refused to permit either. The hospital filed suit to get permission to refuse

treatment. The court sided with mother, and denied hospital

right to determine that treatment was futile or inhumane

Using Embryos in Research

Using human embryos in research

Embryonic stem cells Leftover embryos from IVF Embryo tissue from

abortions (Financial incentives for

abortions?) Risks from purchased

eggs

In Vitro Fertilization Artificial insemination by husband or donor In virtro fertilization (IVF) Egg or embryo donation

Sperm Banks and Egg Sales Should individuals be allowed

to profit from the sale of sperm, ova or embryos?

Many countries ban sperm and egg sales

Austria and Italy ban all egg and sperm donations for IVF.

Germany and Norway ban donating eggs, but not sperm.

Mandating disclosure of identity

Fertility Clinics

Risks of ovulation induction Informed consent about success

rates What should be done with

gametes/embryos that are no longer required by the donor couple for their own joint reproductive purposes? Who should control their use?

Lesbian and Single Women

France and Italy forbid IVF and artificial insemination for lesbians and single women

Switzerland requires couples to be married

Sweden requires a one year stable relationship

Surrogate Motherhood

Commercial surrogacy banned in Europe and Canada

Developing world surrogates Mary Beth Whitehead (1986)

and Baby M Genetic claim Birth mother claim Contract claim Best interest of child claim

NICUs, Artificial Uteri

Neonatal intensive care units (NICUs)

Medical futility vs. Baby Doe protections

Moving line of viability Artificial uteri

Designer Babies

Rights of parents to genomic choice

Parents trusted with best interests of child

Ensuring best fit of parents and child

Burdened expectations

Procreative Beneficence

If you have a reproductive choice you are obliged to choose the child with the best possible chance of fulfilling the widest range of life’s possibilities

Also “procreative altruism” – an obligation to have the best child for the community

Julian Savulescu

Sex Selection Sperm sorting Prenatal diagnosis and

selection Family balancing versus

patriarchy Rights of “missing girls”

versus their reluctant mothers

Infanticide versus abortion Alternative solutions:

women’s education

Eugenics Selective breeding applied to humans,

with the aim of improving the species. Popular in US &

Europe in early decades of the 20th century

Now associated Nazi Germany.

States with Eugenic Laws

Reproductive Cloning

Methods Natural twinning Induced twinning Nuclear transfer

Arguments Safety to mother(s) and child Right to uniqueness Instrumental parenting

Germline Therapy

Are we obliged to protect human genomic diversity?

Isn’t it better to pass a better genome to your children?

With syn-bio no sequence is ever really “lost.”

Mitochondrial transfer: nuclear transfer to embryo with healthy mitochondria

Genetic Enhancement

Transfer of desirable existing traits from other human genomes

…from animals …from novel sequences

To enhance Health, beauty and longevity Physical and mental abilities

Review

Expanding frame of reproductive rights to include positive claims to technological enablement

Contraceptives Prenatal Diagnosis Abortion rights, fetal personhood debate In-vitro fertilization Sperm banks and egg sales Fertility clinics Lesbian and single women access Surrogate motherhood

Review

NICUs and artificial uteri Designer babies Procreative beneficence Sex selection Eugenics Reproductive cloning Germline therapy & mitochondrial transfer Genetic enhancement

For more information

Institute for Ethics and Emerging Technologiesieet.org

These slides: http://ieet.org/archive/20140402ReproEthics.ppt

Me: james.hughes@trincoll.edu