Ethical dilemmas in assisted reproductive technologies

Transcription

1 Ethical dilemmas in assisted reproductive technologies Bearbeitet von Joseph G. Schenker 1. Auflage Buch. XXIII, 387 S. Hardcover ISBN Format (B x L): 17 x 24 cm Gewicht: 836 g Weitere Fachgebiete > Medizin > Klinische und Innere Medizin > Gynäkologie, Geburtshilfe, Materno-Fetal, Hebammen schnell und portofrei erhältlich bei Die Online-Fachbuchhandlung beck-shop.de ist spezialisiert auf Fachbücher, insbesondere Recht, Steuern und Wirtschaft. Im Sortiment finden Sie alle Medien (Bücher, Zeitschriften, CDs, ebooks, etc.) aller Verlage. Ergänzt wird das Programm durch Services wie Neuerscheinungsdienst oder Zusammenstellungen von Büchern zu Sonderpreisen. Der Shop führt mehr als 8 Millionen Produkte.

2 Contents Preface Author index xvii xxi 1 The foundations and application of medical ethics... 1 Avraham Steinberg 1.1 Introduction Historical background General ethical theories and principles Modern medical ethics Conclusion Legislation for assisted reproductive technologies Bernard M. Dickens 2.1 Introduction Legislation and regulations Legislative motivations Evidence-based legal policy The focus of legislation Human rights Reproductive rights as an integral part of women s rights Giuseppe Benagiano, Sabina Carrara, and Valentina Filippi 3.1 Introduction Granting women equal rights: the origin of discrimination Cornerstones of women s rights Dignity, body integrity, and freedom from violence Equality and empowerment Full, unconditional access to health care services A right to treat infertility Right to reproduce Harpreet Kaur and Kamini A. Rao 4.1 Socioeconomic issues Religious issues Legal and historical aspects Moral aspects ART-related aspects... 49

3 vi Contents 5 Informed consent for treatment of fertility Yosi Green 5.1 Introduction The right to experience parenthood and its standing The informed-consent doctrine The doctrine and its nature Application of the doctrine to fertility treatments Mutual consent of spouses Joint process The good of the child and consideration of parental capability Validity of the consent Effect of the initial consent Withdrawal of patient consent Physician s withdrawal of consent Consent after death Conclusion Specific ethical and legal aspects of ART practice in eastern European countries Jiri Dostál 6.1 Introduction Situation in eastern European countries Number of centers Legal regulation of ART Coverage or reimbursement of ART Marital status in ART The number of transferred embryos in ART Cryopreservation Posthumous ART Gamete donation Anonymity Micromanipulation In vitro maturation of oocytes Welfare of the child Multifetal-pregnancy reduction Preimplantation genetic diagnosis Surrogacy Research on the embryo Gamete intrafallopian transfer The moral status of the embryo Conclusions... 82

4 Contents vii 7 Sperm donation and sperm-bank management Dan Gong and Zheng Li 7.1 Introduction Limiting the number of donor offspring United States United Kingdom Minimizing the risk of infection and genetic complications from sperm donors Age requirements for sperm donors Anonymity versus nonanonymity of sperm donors Anonymous sperm donation Nonanonymous sperm donation Sperm-donor compensation Informed consent and counseling Conclusions Oocyte donation: medical and legal perspectives Sarit Avraham and Daniel S. Seidman 8.1 Introduction: Indications for egg donation Preparation of donor and recipient Outcome determining factors Obstetric and perinatal outcomes Ethical aspects Legislation The new Israeli legislation Summary Egg donation: ethical considerations and regulatory context Anna C. Mastroianni and Luigi Mastroianni Jr. 9.1 Introduction The regulatory context Donating eggs Informed consent Meeting demand: remuneration and other programs Financial compensation Egg-sharing programs Other obligations Use of donated eggs Informed consent Nontraditional patients and access to donated eggs Age Donor identity and disclosure Conclusions

5 viii Contents 10 Medical, ethical, and legal aspects of fetal reduction Mark I. Evans and David W. Britt 10.1 History Ethical issues Moral compromise Legal issues Recommendations Summary Acknowledgments Fertility treatments in human immunodeficiency virus (HIV) infected patients Karen Olshtain-Pops and Shlomo Maayan 11.1 Introduction HIV and the male genital tract HIV and the female genital tract Assisted reproductive technologies in HIV-positive patients Semen processing Viral testing of spermatozoa Success rates Summary Pregnancies in perimenopause and beyond Yoel Shufaro and Joseph G. Schenker 12.1 Medical aspects and considerations Fertility fecundity and abortions Pregnancy-associated physiological changes Obstetrical and intrapartum complications Maternal mortality Neonatal outcome Oocyte-donation programs Ethical aspects The issue of choice The welfare of the child Coping with the medical risks Legislation, regulation, and religion aspects Summary Legal control of surrogacy international perspectives K. Svitnev 13.1 Introduction Surrogacy definition

6 Contents ix 13.3 Surrogacy history Legal control of surrogacy international perspectives Prohibition of Surrogacy by legislation Counties surrogacy no prohibited by law Surrogacy in China Non commercial surrogacy Greece Law South Africa Commercial surrogacy Former Countries of the Soviet Union India Surrogacy in USA Surrogacy in Russia Russian Public Opinion Surrogacy in Islamic Countries Cross-border Surrogacy Conclusions Preimplantation genetic diagnosis in assisted reproduction: medical, ethical, and legal aspects Anver Kuliev 14.1 Introduction Biopsy methods for preimplantation genetic diagnosis Polar-body biopsy Embryo biopsy Chromosomal aneuploidies in preimplantation development Chromosomal rearrangements Impact of PGD on IVF outcome Conclusion Preimplantation genetic diagnosis of late-onset diseases Zoltán Papp, Tibor Várkonyi, and Valéria Váradi 15.1 Introduction Embryo selection Huntington s disease Cardiovascular disorders Alzheimer s disease Genetic testing for cancer Breast cancer Genetic counseling Conclusion

7 x Contents 16 Bioethics of human embryonic stem cells and cloning for stem cells: an Israeli perspective Michel Revel 16.1 The scientific and medical aspects Ethical issues related to human embryo stem cells Pluralism of moral views on the preimplantation embryo Potentiality of human preimplantation embryo Personal status of the embryo Therapeutic aims of human ES cells Pluralism of decisions on human ES cell production and research in various countries A case study: ethical regulations on human ES cell research in Israel Ethical views on cloning to obtain autologous ES cells Bioethical arguments National and international resolutions Case study: regulations in Israel regarding cloning for ES cells The future of human embryonic stem cell research: medical, legal, and ethical perspectives Outi Hovatta and Kenny A. Rodriguez-Wallberg 17.1 Introduction: Human embryonic stem cell research The first possible clinical applications of cells differentiated from hesc Challenges in clinical treatment using hesc-derived cells Microbial contamination GMP and EU tissues and cells directive Immunogenicity Tumorigenicity ips cells versus hesc Legal and ethical aspects of hesc research Conclusions Preservation of fertility in children with cancer: medical, ethical, and legal aspects Ginny Ryan 18.1 Introduction Population at risk Medical and surgical options for fertility preservation The ethical propriety of fertility-preservation options Autonomy, justice, and treating pediatric patients Ethical and legal issues with unused tissue and gametes

8 Contents xi 18.7 Posthumous reproduction Conclusion Fertility preservation for cancer patients: a review of current options and their advantages and disadvantages Shauna Reinblatt, Barnis Ata, Einat Shalom-Paz, Seang Lin Tan, and Hananel Holzer 19.1 Introduction Cancer and fertility preservation Current options for fertility preservation Medical options: GnRH agonists Surgical options: ovarian transposition and cryopreservation of ovarian cortical tissue Ovarian transposition Cryopreservation of ovarian cortical tissue ART: in vitro fertilization and in vitro maturation Embryo and oocyte cryopreservation after ovarian stimulation Embryo cryopreservation Oocyte cryopreservation Embryo and oocyte cryopreservation without prior ovarian Stimulation IVM embryo cryopreservation IVM-oocyte vitrifi cation Fertility preservation: the McGill experience Conclusion Sexual orientation and use of assisted reproductive technology: social and psychological issues Rachel G. Riskind 20.1 Introduction A note about terminology Routes to parenthood among nonheterosexual adults Legal issues surrounding sexual orientation and family formation Sexual orientation and incidence of parenthood Sexual orientation and plans for parenthood Studies of sexual orientation and plans for parenthood Outcomes for children of lesbians and gay men Relationships with peers Child behavior problems Gender development Conclusions and future directions Assisted reproduction among nonheterosexual adults Barriers to ART use by nonheterosexual adults

9 xii Contents Donor-insemination decisions Recommendations for clinical practice Conclusion Access to fertility treatment by lesbian couples Simón Marina, Fernando Marina, and David Marina 21.1 Introduction Legal changes Assisted reproduction Being a lesbian and a mother Donor anonymity Ethical assessment A Child with two mothers ART practice and tourism Marcia C. Inhorn and Pasquale Patrizio 22.1 Introduction Background and methods Major findings The United Arab Emirates Reproductive travel to the UAE Reproductive travel from the UAE Reproductive travel to and from the UAE The East Coast of the United States Conclusion A savior child conceived by PGD/HLA: medical and ethical aspects Edwin C. Hui 23.1 Introduction Medical indications and social acceptance of PGD Chromosomal abnormalities Monogenic diseases Adult-onset diseases and cancer-predisposing genes Creating a savior child Other possible applications of PGD: savior embryos, gender selection, and designer babies Savior embryos Gender selection Designer babies Legislation and professional guidelines for the uses of PGD/HLA Ethical considerations

10 Contents xiii Embryo wastage Moral status of the human embryo Harm of embryo biopsy The condition of absolute medical necessity PGD SC and family ethics Well-being of the savior child PGD, parental interests and public access Posthumous reproduction: ethical and legal perspectives Bethany Spielman 24.1 Introduction The source What counts as consent? Coercion Minors as sources Requesters of retrieval Reproductive partners Children Summary Human reproductive cloning: ethical perspectives David A. Jensen 25.1 Introduction The potential value of HRC Ethical concerns with HRC HRC and the value of our unique genetic make-up Conclusion ART practice religious views Joseph G. Schenker 26.1 Introduction The Jewish law Torah The Mishnah The Talmud Post-Talmudic codes Responsa Orthodox Judaism Reform Judaism Conservative Christian denominations Roman Catholic Church Anglican Church

11 xiv Contents The Protestant Church Eastern Orthodox Church Hinduism Buddhism A Catholic ethical perspective on human reproductive technology Norman Ford 27.1 Catholic position on respect for the human embryo Biblical perspective Christian tradition Embryo defined Catholic Christian teaching A person from conception Ethics and destructive research on human embryos Morality and personalized natural law Secular ethics and the human embryo Challenge to find ethical alternatives Catholic ethics, marriage, and reproductive technology Catholic Christian position on children of the marriage union Assisted insemination Rights of children and natural parents Donor gametes Surrogacy Access to ART by single women and lesbians Human reproductive cloning Conclusion Islamic laws and reproduction Gamal I. Serour 28.1 Islamic laws Reproduction in Islam ART and Islam Islam and various ART practices Surrogacy Multifetal pregnancy reduction Pregnancy in postmenopause Sex selection Cryopreservation Embryo implantation following husband s death Embryo research Gene therapy

12 Contents xv Cloning ART practices in different Muslim countries Jewish law (halakha) and reproduction Joseph G. Schenker 29.1 Introduction Homosexuality Lesbianism Evaluation of the infertile couple The laws of niddah Infertility treatment The beginning of human life Artificial insemination by husband Artificial insemination by donor Oocyte donation Surrogacy Legalizing surrogacy in Israel The state-appointed permission committee Guidelines set by the committee for surrogacy Expenses Legal status of the newborn Surrogate mother s withdrawal from the agreement Legal rights of the surrogate mother Enforcement of the law Right to privacy Illegal financing Legal adoption Fetal reduction Gender preselection Cryopreservation Posthumous reproduction Cloning Preembryo research Commercialized assisted reproduction Filip Krěpelka 30.1 Position of reproductive treatment in the economy Commercialization of assisted reproduction Divergent national policies toward reproductive treatment International economic integration and assisted reproduction Absence of effective restrictions on reproductive tourism

13 xvi Contents 30.6 Natural barriers to reproductive tourism Intellectual property and assisted reproduction Doing business in the reproductive industry Assisted reproduction in united Europe Case study: German patients in Czech centers The intersection between economic and ethical aspects of ART Georgina M. Chambers 31.1 Introduction A framework for economic and ethical aspects of ART Distributive justice and funding of ART International differences in funding Provision of ART in developing countries Morally challenging funding decisions The cost of ART treatment Treatment costs The costs of multiple births Valuing ART treatment from an economic perspective The affordability of ART treatment and its implications Affordability and utilization Affordability and clinical practice It makes economic as well as clinical sense to reduce multiple-births Conclusion