Comparative study of the knowledge of IVF in medical students of universities with different ethical and humanistic valuesEstudo comparativo do conhecimento das técnicas de reprodução assistida em estudantes de Medicina de universidades com diferentes ideários éticos e humanísticosIn vitro fertilization continues to be presented as a relatively simple solution to produce a pregnancy without exposing the medical and ethical problems that this represents. This project consisted of conducting a survey to medical students from three medical schools in Mexico City (...) with different ethical and humanistic ideas with the aim of evaluating knowledge about IVF techniques and their ethical implications. The survey was applied to 404 medical students. Students in schools with personalistic ethics had a greater recognition of the bioethical principles involved in the use of these techniques. Knowledge of the technique and ethical issues involved in assisted reproduction could improve the sensitivity of medical students to ethical dilemmas that arise in their professional practice.Para citar este artículo / To reference this article / Para citar este artigoCantú-Quintanilla G, Vidal-Sentíes C, Marcó-Bach FJ, Camargo-Prieto F, Aguiñaga-Chiñas N, Contreras-Estrada D. Estudio comparativo del conocimiento de las técnicas de reproducción asistida en estudiantes de medicina de universidades con diferentes idearios éticos y humanísticos. Pers Bioet. 2020;24:166-176. DOI: https://doi.org/10.5294/pebi.2020.24.2.4Recibido: 04/09/2019Aceptado: 05/08/2020Publicado: 27/11/2020. (shrink)

Despite its potential for radically reducing the harm inflicted on nonhuman animals in the pursuit of food, there are a number of objections grounded in animal ethics to the development of in vitro meat. In this paper, I defend the possibility against three such concerns. I suggest that worries about reinforcing ideas of flesh as food and worries about the use of nonhuman animals in the production of in vitro meat can be overcome through appropriate safeguards and a (...) fuller understanding of the interests that nonhuman animals actually possess. Worries about the technology reifying speciesist hierarchies of value are more troublesome, however. In response to this final challenge, I suggest that we should be open not just to the production of in vitro nonhuman flesh, but also in vitro human flesh. This leads to a consideration of the ethics of cannibalism. The paper ultimately defends the position that cannibalism simpliciter is not morally problematic, though a great many practices typically associated with it are. The consumption of in vitro human flesh, however, is able to avoid these problematic practices, and so should be considered permissible. I conclude that animal ethicists and vegans should be willing to cautiously embrace the production of in vitro flesh. (shrink)

This book considers the arguments for and against the implementation of in vitro meat technology. Rachel Robison-Greene argues that in light of emerging technology, we should rethink the ethical dimensions of what makes something “edible.”.

In vitro gametogenesis (IVG) is believed to be the next big breakthrough in reproductive medicine. The prima facie acceptance of this possible future technology is notable when compared to the general prohibition on human reproductive cloning. After all, if safety is the main reason for not allowing reproductive cloning, one might expect a similar conclusion for the reproductive application of IVG, since both technologies hold considerable and comparable risks. However, safety concerns may be overcome, and are presumably not the (...) sole reason why cloning is being condemned. We therefore assess the non‐safety arguments against reproductive cloning, yet most of these can also be held against IVG. The few arguments that cannot be used against IVG are defective. We conclude from this that it will be hard to defend a ban on reproductive cloning while accepting the reproductive use of IVG. (shrink)

A series of recent scientific results suggest that, in the not-too-distant future, it will be possible to create viable human gametes from human stem cells. This paper discusses the potential of this technology to make possible what I call ‘in vitro eugenics’: the deliberate breeding of human beings in vitro by fusing sperm and egg derived from different stem-cell lines to create an embryo and then deriving new gametes from stem cells derived from that embryo. Repeated iterations of (...) this process would allow scientists to proceed through multiple human generations in the laboratory. In vitro eugenics might be used to study the heredity of genetic disorders and to produce cell lines of a desired character for medical applications. More controversially, it might also function as a powerful technology of ‘human enhancement’ by allowing researchers to use all the techniques of selective breeding to produce individuals with a desired genotype. (shrink)

In vitro embryology not only makes possible the growing of human tissue to remedy infertility but also for many other experimental purposes. This paper examines the ethical issues involved in such work and outlines the circumstances in which such work is morally permissible and those in which it is not.

This paper explores whether egg donation could still be ethically justified if in vitro gametogenesis (IVG) became reliable and safe. In order to do this, issues and concerns that might inform a patient’s reasoning in choosing to use donor eggs instead of IVG are explored and assessed. It is concluded that egg donation would only be ethically justified in a narrow range of special cases given the (hypothetical) availability of IVG treatment and, further, that egg donation could itself be (...) replaced by donation through IVG techniques. Two possible criticisms of this position are then considered: Ones based on respect for patient wishes, and on loss of donor benefit. It is concluded that whilst neither argument constitutes a strong enough reason to continue with programmes of egg donation, egg‐sharing programmes could still be permitted come the advent of IVG; these could then provide a morally acceptable source of “natural” donor eggs. (shrink)

Abstract:Research into the development of stem cell-derived (SCD) gametes in humans, otherwise known asin vitrogametogenesis (IVG), is largely motivated by reproductive aims. Especially, the goal of establishing genetic parenthood by means of SCD-gametes is considered an important aim. However, like other applications in the field of assisted reproduction, this technology evokes worries about the possibility of creating so-called ‘designer babies.’ In this paper, we investigate various ways in which SCD-gametes could be used to create such preference-matched offspring, and what this (...) would mean for the acceptability of IVG, if it is premised that it is morally problematic to ‘design’ offspring. We argue that IVG might facilitate the creation of preference-matched offspring, but conclude that this should not undermine the moral acceptability of IVG altogether—even if one concedes the premise that creating ‘designer babies’ is morally problematic. In the light of this, we also point at a possible inconsistency for a position that condemns the creation of ‘designer offspring,’ while accepting the various endeavors to have genetically related offspring. (shrink)

This chapter focuses on a novel class of models used in frontier research in the bioengineering sciences – in vitro simulation models – that provide the basis for biological experimentation. These bioengineered models are hybrid constructions, composed of living tissues or cells and engineered materials. Specifically, it discusses the processes through which in vitro models were built, experimented with, and justified in a tissue engineering lab. It examines processes of design, construction, experimentation, evaluation, and redesign of in (...) class='Hi'>vitro simulation models, in general, as instances of building the source analogy (as distinguished from retrieving an analogy), which figures prominently in creative frontier scientific research. Building the analogical source is a bootstrapping process, which furthers the articulation, as well as the solution of the problem. -/- . (shrink)

In vitro fertilisation is now an established technique for treating some forms of infertility, yet it remains ethically controversial. New developments, such as embryo donation and embryo freezing, have led to further discussion. We briefly discuss the ethical aspects of IVF, focusing on the issues of resource allocation, the 'unnaturalness' of the procedure, the moral status of the embryo, surrogate motherhood, and restrictions on access to IVF. We argue that, on the whole, IVF is an ethically justifiable method of (...) assisting infertile couples. (shrink)

The prospect of consumable meat produced in a laboratory setting without the need to raise and slaughter animals is both realistic and exciting. Not only could such in vitro meat become popular due to potential cost savings, but it also avoids many of the ethical and environmental problems with traditional meat productions. However, as with any new technology, in vitro meat is likely to face some detractors. We examine in detail three potential objections: 1) in vitro meat (...) is disrespectful, either to nature or to animals; 2) it will reduce the number of happy animals in the world; and 3) it will open the door to cannibalism. While each objection has some attraction, we ultimately find that all can be overcome. The upshot is that in vitro meat production is generally permissible and, especially for ethical vegetarians, worth promoting. (shrink)

Technological advances in genetic testing have enabled prospective parents to learn about their risk of passing a genetic condition to their future children. One option for those who want to ensure that their biological children do not inherit a genetic condition is to create embryos through in vitro fertilisation and use a technique called preimplantation genetic testing to screen embryos for genetic abnormalities before implantation. Unfortunately, due to its high cost, IVF-with-PGT is out of reach for the vast majority (...) of Americans. This article addresses an issue that has been underexplored in the medical ethics literature: the lack of insurance coverage for IVF-with-PGT.Within the US system, a key concept in insurance is that of medically necessary care, which broadly consists of diagnostic services and treatment services. In this article, I argue that IVF-with-PGT could be classified as either a diagnostic service or as a treatment service. To make this case, I show that IVF-with-PGT is similar to other types of services that are often covered by US insurance providers. In light of these similarities, I argue that the current system is inconsistent with respect to what is—and is not—covered by insurance. To promote consistency and fairness in coverage, like cases should be treated alike—starting with greater coverage for IVF-with-PGT. (shrink)

Debate has raged in Canada recently over whether in vitro fertilization should be funded through public health insurance. Such a move would require that the provinces classify IVF as a medically necessary service. In this paper, I defend the position I have taken publicly—especially in Ontario, my own province—that IVF is not medically necessary. I contend that, by funding IVF on grounds of medical necessity, governments like Ontario's violate their commitments to equality and fairness, and cause harm. They do (...) the last by suggesting that the lives of people who forgo procreation, and perhaps have children in other ways, will be stunted. (shrink)

In vitro fertilization and the risk of birth and developmental defects - facts and fictions Poland is being swept by a wave of discussions on various aspects of IVF application. Scientists of various disciplines are getting involved in these discussions as opponents to this form of procreation. Referring to research carried out all over the world, they demonstrate that children born thanks to the in vitro procedure are significantly more susceptible to all sorts of disease. The author, surveying (...) available research data, shows that, in reality, the worse health of in vitro-conceived children deals with a narrow number of well-identified disorders and in most cases is of correlative, not causative nature. The main reason for the weaker health of these children is often connected with the advanced age of the parents who choose IVF and their health condition, as compared to those who become parents in a natural way. (shrink)

In vitro gametogenesis (IVG) might offer numerous research and clinical benefits. Some potential clinical applications of IVG, such as allowing opposite‐sex couples experiencing infertility to have genetically related children, have attracted support. Others, such as enabling same‐sex reproduction and solo reproduction, have attracted significantly more criticism. In this paper, we examine how different ethical principles might help us to draw lines and distinguish between ethically desirable and undesirable uses of IVG. We discuss the alleged distinction between therapeutic and non‐therapeutic (...) uses of assisted reproduction in the context of IVG, and show how it is both problematic to apply in practice and theoretically dubious. We then discuss how the ethical principles of reproductive justice and beneficence apply to IVG for opposite‐sex reproduction, same‐sex reproduction, and solo reproduction. We suggest that these principles generate strong reasons for the use of IVG for opposite‐sex and same‐sex reproduction, but not for solo reproduction. (shrink)

Fertility treatments raise a range of social and ethical issues regarding self-identity for family, sexual intimacy, and the interests and welfare of potential children. Eggs and sperm are combined to produce fertilized eggs. These eggs are then implanted as embryos and grow into viable fetuses, which are carried by the original mother or a surrogate mother. This artificial form of conception can challenge religious values and family structures. In-vitro fertilization can be considered either as a medical miracle or playing (...) with divinity. What obligation do medical professionals have to infertile women and to what extent? The bioethical dilemma of IVF use encompasses different moral issues for all involved in the process. Ethical issues address respect for personal autonomy, access and care, and the duty of the health care provider to be compassionate to persons whose actions and moral values may be different from their own. Health care providers need to impart empathy, understanding and sensitivity towards this unique type of patient population. The conflict for those treating patients who are trying to conceive by IVF includes respect for personal autonomy, nonmaleficence, justice, utility and the ethics of care. As a registered nurse in a postpartum hospital unit, I have seen antepartum and postpartum women involved with this new technology. I have worked with mothers and their partners as they experience different levels of anxiety and hope for the future. There is an underlying psychosocial connection with patients who undergo IVF treatments. The purpose of this article is to explore the ethical use of IVF on older women. Is this type of biotechnolgy being applied for the right reasons and for the best patient population? (shrink)

Fertility treatments raise a range of social and ethical issues regarding self-identity for family, sexual intimacy, and the interests and welfare of potential children. Eggs and sperm are combined to produce fertilized eggs. These eggs are then implanted as embryos and grow into viable fetuses, which are carried by the original mother or a surrogate mother. This artificial form of conception can challenge religious values and family structures. In-vitro fertilization (IVF) can be considered either as a medical miracle or (...) playing with divinity. What obligation do medical professionals have to infertile women and to what extent? The bioethical dilemma of IVF use encompasses different moral issues for all involved in the process. Ethical issues address respect for personal autonomy, access and care, and the duty of the health care provider to be compassionate to persons whose actions and moral values may be different from their own. Health care providers need to impart empathy, understanding and sensitivity towards this unique type of patient population. The conflict for those treating patients who are trying to conceive by IVF includes respect for personal autonomy, nonmaleficence, justice, utility and the ethics of care. As a registered nurse in a postpartum hospital unit, I have seen antepartum and postpartum women involved with this new technology. I have worked with mothers and their partners as they experience different levels of anxiety and hope for the future. There is an underlying psychosocial connection with patients who undergo IVF treatments. The purpose of this article is to explore the ethical use of IVF on older women. Is this type of biotechnolgy being applied for the right reasons and for the best patient population? (shrink)

ABSTRACT This article deals with a cluster of moral problems raised by the new techniques of human fertilisation. It is concerned primarily with the putative rights of embryos brought into being as a by‐product of the practice of in vitro fertilisation. In this connection it investigates the basis for the ascription of rights to entities and asserts the view that consciousness is a pre‐requisite for the possession of rights. It draws attention to the speciesism implicit in attitudes of some (...) of those who have contributed to the debate. It also examines other issues briefly, raising, for example, the question whether children by AID (or by in vitro fertilisation by donor) must be denied access to information about their genetic fathers; and looking at objections to the new techniques based on the so‐called unnaturalness of the procedures involved. (shrink)

In Germany — as probably worldwide — in vitro fertilization has provoked disapproval, fears, and dread, but it also raises hope and gives feelings of pride and satisfaction in a new scientific achievement. Critics look for convincing argu- ments that could ban IVF completely or at least restrict it considerably. Some of the most important arguments are outlined below.The main aspect of IVF that was new to society was that conception could take place outside the female body. Although this (...) fact has made a deep impression on us, no ethical relevance has been attributed to it. One must look further for arguments against IVF. (shrink)

This study examines recent French bioethics laws governing the uses of new reproductive and genetic technologies (NRGTs)—including in-vitro fertilization, surrogate motherhood, prenatal diagnostics, sex selection, and cloning—in light of feminist claims to women's rights, especially a woman's right to reproductive freedom. To this end, the study explores two interrelated questions: First, to what extent have French feminists supported NRGT development and treatment? Second, to what extent do French national bioethics debates, laws, and policies reflect feminist reactions to NRGTs? The (...) investigation of these questions is informed by recent theories of state feminism that show how national policy debates are gendered by particular sets of feminist ideas, and how policy choices resulting from these debates turn some of these ideas into law (McBride Stetson and Mazur 1995). Some of the most pressing feminist concerns in this area include women's loss of control over their bodies and fertility, women's exploitation and commercialization of their bodies, and women's health risks from NRGTs. The analysis of pronouncements by French feminist writers, researchers, and policy-makers reveals a multiplicity of feminist stances on NRGTs, showing keenly how feminists contest what constitutes effective feminist public policies to illuminate the fact that these policies are subject to shifting political contestations, rather than the reflection of a fixed set of feminist ideas. While contemporary French feminists grapple with the potential merits and dangers of NRGTS, the study shows that feminists generally seem to support NRGTs, as long as French law protects women's reproductive autonomy. Seen in this light, France's strong sense of the right to procreate through facilitation of access to NRGTs is not a contradiction of France's strong social and legal support for women's reproductive freedom, but rather enables French lawmakers to regulate NRGTs more effectively. (shrink)

This study examines recent French bioethics laws governing the uses of new reproductive and genetic technologies —including in-vitro fertilization, surrogate motherhood, prenatal diagnostics, sex selection, and cloning—in light of feminist claims to women’s rights, especially a woman’s right to reproductive freedom. To this end, the study explores two interrelated questions: First, to what extent have French feminists supported NRGT development and treatment? Second, to what extent do French national bioethics debates, laws, and policies reflect feminist reactions to NRGTs? The (...) investigation of these questions is informed by recent theories of state feminism that show how national policy debates are gendered by particular sets of feminist ideas, and how policy choices resulting from these debates turn some of these ideas into law. Some of the most pressing feminist concerns in this area include women’s loss of control over their bodies and fertility, women’s exploitation and commercialization of their bodies, and women’s health risks from NRGTs. The analysis of pronouncements by French feminist writers, researchers, and policy-makers reveals a multiplicity of feminist stances on NRGTs, showing keenly how feminists contest what constitutes effective feminist public policies to illuminate the fact that these policies are subject to shifting political contestations, rather than the reflection of a fixed set of feminist ideas. While contemporary French feminists grapple with the potential merits and dangers of NRGTS, the study shows that feminists generally seem to support NRGTs, as long as French law protects women’s reproductive autonomy. Seen in this light, France’s strong sense of the right to procreate through facilitation of access to NRGTs is not a contradiction of France’s strong social and legal support for women’s reproductive freedom, but rather enables French lawmakers to regulate NRGTs more effectively. (shrink)

There is a modern movement to grow artificial meat in laboratories in order to counter the ills of industrial animal agriculture. This article investigates whether lab-grown meat constitutes animal liberation by critically examining its proposed ethical superiority over traditional meat. These considerations are balanced with reflections on the ethical unknowns and shortcomings of the use of technology to solve human-caused problems. We examine a range of meanings attributed to “animal liberation” and consider how various forms of violence are potentially left (...) unchallenged, with a particular focus on gender relations. (shrink)

In-vitro fertilization is becoming a pressing issue in contemporary societies. The article considers it starting form the Polish debate but takes up its broader anthropological an ethical aspects. Dealing with the latter, it also employs some acute remarks from Dignitas Personae. Finally it considers an approach to in vitro against the background of European Convention on Bioethics. In its conclusion the paper offers a balanced pro-life stance, albeit critical of in vitro.

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does not (...) dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

The views on in vitro fertilization within Russian Orthodox Christian society are diverse. One reason for that variation is the ambiguity found in “The Basis of the Social Concept,” the document issued in 2000 by the Russian Orthodox Church and considered to be the primary guidelines for determining the Church’s stance on bioethics. This essay explores how the treatment of infertility reconciles with the Orthodox Christian faith and what methods of medical assistance for infertility may be appropriate for Orthodox (...) Christians. The focus here is on IVF because it is among the most widely used methods to overcome childlessness, and the permissibility of IVF is the object of disagreement among Orthodox. The article defines criteria that can help to discern what is absolutely wrong and must be avoided from what only falls short of the mark, but not very far, for Orthodox Christians. If treatment of the underlying causes of infertility has failed or promises no hope and a husband and a wife do not feel able to carry the Cross of infertility, then from pastoral dispensation they might be blessed to use ethically acceptable variants of IVF. IVF has many variants that are different in their spiritual influence on a person. Orthodox Christians pursuing IVF should seek spiritual guidance and a blessing to pursue IVF. They must not form more embryos than will be transferred in the same cycle. Freezing, discarding, or reduction of embryos is forbidden. Infertile couples ought to use only their reproductive cells. The use of donor gametes is unacceptable. Any embryo formed ought to be transferred into the wife’s womb, and the use of surrogates is impermissible. Only a husband and wife who are able to maintain their marital union and where the wife is still of childbearing age should be blessed to use IVF. (shrink)

In vitro experimental approaches are of central importance to contemporary molecular and cellular biology and toxicology. However, the scientific value or impact of in vitro results depends on their relevance in vivo. In vitro effect studies address inobservable in vivo phenomena through experiments on analogous in vitro phenomena. We present a theoretical basis developed to evaluate the in vivo relevance of in vitro effect studies. As a case study, the procedure for measuring specific gene transcription (...) in isolated cell nuclei (nuclear run-off method) is analyzed It is concluded that current evidence fails to justify in vivo interpretations of nuclear run-off experiments within the framework of theoretical models of transcription, implying that quantitative in vivo interpretations are unwarranted. Qualitative interpretations of nuclear run-off experiments may be justified by inferring the best explanation, especially when significant in vitro effects follow in vivo perturbations.Elements of a general theory are proposed. It is concluded that quantitative in vivo interpretations are warranted primarily in biochemical quantitation of biomolecules, while studies on biological function should be interpreted qualitatively in terms of causal explanations. Inferences to the best explanations are strengthened through additional evidence and the creation of experimental differences (effects). (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. (...) Contradicting Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)