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In Vitro Fertilization
This is a paper that outlines the morality issue behind in vitro fertilization. It has 12 sources.
As scientific progress advances more rapidly than the ability of mankind to assimilate and comprehend its influence on life concerns, fields such as Assisted Reproductive Technology (ART) are turning heretofore basic issues like procreation into complex ethical and moral dilemmas.
In 1978, with the birth of Louise Brown, the first child conceived through in vitro fertilization (IVF), man finally realized his power to create, not passively through instinctual processes but consciously and actively. [Daar 1999] The desire to have children is strong in the human heart and infertility is a serious and painful issue. There are however more aspects to having a child than mere desire and the means by which the child is created is amongst the most important. Over the past few decades science has allowed individuals biologically otherwise incapable of reproducing, to make or have children by artificial methods such as in vitro fertilization.
The natural act of procreation lessened in consequence with man's ability to use various techniques to achieve his goal. The steps involved in the reproductive process became insignificant, it was the ultimate end that became important, and that these were irrevocably interlinked was invalidated. Moral codes and values needed to be formatted to cope with this new circumstance of human existence, and law and government policies were not prepared. Bioethics is a recent field that studies the latest social and moral issues modern science produces but it still has a long way to go before it can define and regulate what still are the mysteries of life no matter how familiar; such as birth.
Infertility affects about 4.9 million couples in the United States, or one in every twelve. Approximately one-third of infertility is due to causes in the female. IVF was originally developed to help women whose fallopian tubes were blocked and for whom reconstructive surgery was impossible or had already been unsuccessful. The basic techniques aimed at optimizing conditions for fertilization of an ovum and sperm outside the female reproductive tract and the facilitating embedding of the fertilized egg in the uterus. [Monash 2001]
Medications are used initially to stimulate the ovaries to produce multiple follicles that will contain many eggs. In what is called a "fresh cycle," the eggs are retrieved and transferred to the laboratory. They are placed, along with sperm, in a special culture medium that encourages fertilization and growth of high-quality embryos in just a few hours. [Monash 2001]
Following fertilization, the oocyte becomes a zygote, and cell division commences. It is at the 6-to-8-cell stage that the embryo is transferred back into the uterus. As multiple embryos have been produced to increase chances of yield a limited number of high quality embryos are transferred, while the others are usually cryopreserved, or frozen, for future use in a "frozen embryo transfer" (FET). [Monash 2001]
Sometimes a "donor cycle, " is required when the woman is not able to produce her own eggs, or their quality will not support fertilization, implantation and pregnancy. Ova are then retrieved from a woman who has undergone ovarian stimulation and fertilized with sperm from the husband of the recipient couple or a donor. The resulting embryos are then transferred to the recipient female, whose body has been prepared for implantation and pregnancy. [Monash 2001] Nearly 0.2% of American and 1% of British babies are being born after IVF and there are now more than 300,000 IVF babies worldwide. [Monash 2001]
Assisted reproduction by IVF has many aspects and produces various complex ethical issues. The treatment itself has social, emotional and financial ramifications. It affects the parents and the child conceived, and is associated with risks such as medication side effects, multiple births or multifetal reduction to limit the number of pregnancies after successful embryo transfer. The outcome of the multiple embryos produced for the process but not necessarily used to fulfill their potential of creating a human being is an important issue. So are various social issues such as genetic screening, and 'designer babies' made to order. Religion also complicates a process that began with the best of intentions however naive.
Fate of the Embryo
The decision on how the many embryos produced during the IVF cycle are to be disposed of depends on whether one views them as a potential human beings or just a group of cells. Like abortion this issue has been the topic of much debate in the context of parental obligation and rights, and also human stem cell research.
The highly publicized the highly publicized divorce of Junior and Mary Sue Davis in 1992 [Daar 1999] focused national attention on this issue. It emphasized the fact that often conception and pregnancy could be separated by a significant amount of time due to cryopreservation. [Daar 1999] The question it raised was what rights did either parent have on an embryo that had not been implanted and should they be equal to those of ordinary individual able to reproduce without assistance?
Unlike in cases where the woman is reproductively normal, the law in the case of Davis vs. Davis gave the male progenitor an opportunity to override a woman's fundamental right to control her early embryo. Gender equality was given precedence and an inequality emphasized between the rights of a fertile and infertile woman. On the basis of the difference in location of the embryo men were allowed a say in whether a child is or is not born whereas with coital reproduction, once a man takes action that could result in a pregnancy, he waives his right to control the fate of his progeny. [Daar 1999] The reason given has been the lack of direct physical relationship between the woman and the cryopreserved embryos. [Daar 1999]
The court in Kass v. Kass, advocated an equal treatment approach, reflecting "from a propositional standpoint it matters little whether the ovum/sperm union takes place in the private darkness of a fallopian tube or the public glare of a petri dish. Fertilization is fertilization and fertilization of the ovum is the inception of the reproductive process." [Daar 1999]
This decision was however later reversed. Such a decision would have meant that Maureen Kass would have exclusive rights to determine the fate of her embryos and could delay implantation for many years, leaving her ex-husband in reproductive limbo. [Daar 1999] A man in a normal sexual relationship however would know if he is becoming a father within the limited period of 9 months whereas a male participating in an IVF procedure might have to wait for years. The Kass trial court thus directed that Maureen Kass exercise her right to implant the embryos "within a medically reasonably time," but this has still to be determined legally. [Daar 1999]
Due to the poor success rate of IVF, numerous human embryos are typically generated. It is estimated that there may be between 200,000 and a million human embryos frozen at sub-zero temperatures and stored at infertility clinics across America. According to the American Bioethics Advisory Commission human embryos created by IVF are human beings with the same rights as all human beings, which include the absolute right to life. Frozen human embryos are not merely "potential persons" but unique human beings at an early stage of development whose dignity has been assaulted by freezing them in liquid nitrogen, which exposes them to grave danger if not certain death. [American Bioethics Advisory Commission 2003]
This statement complicates the main way that human embryos are commonly disposed world over. In Victoria, Victorian State Legislation governs practices concerning ART and embryo storage limiting embryo storage to 5 years. Extensions to storage can be obtained by application to the ITA (Infertility Treatment Authority in Victoria). In Queensland the NH&MRC (National Health and Medical Research Committee) guidelines limit embryo storage to 10 years. [Monash 2001, Swan 1989]
Many couples due to religious or personal opinions do not want to destroy the extra human embryos, considering them to be babies, but are also unwilling to add them to the family. Instead they pay a monthly storage fee while postponing any sort of decision. If clinics are unable to contact the family for a year then these embryos may be disposed of, but some store them indefinitely unwilling to take this step while others either donate them to research labs or dispose them. [NBAC 1999, Author not available. 2003] third recent alternative that has emerged is placing these embryos created for IVF procedures with adoptive couples. Legal contracts are drawn up between the two families with both adoption and property transfer language for the protection of the families in the event that future laws change the status of human children living in the embryonic stages of development. Currently there are no laws in any state that regulate the adoption of human embryonic children. [NBAC 1999]
Cryoprecipitation is an important part of the IVF procedure so…[continue]
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