Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

Volume 20, Issue 3, March 2020, Page 88-90.

This article presents the case of a mother who is planning a home birth with a midwife with the shared knowledge that the fetus would have congenital anomalies of unknown severity. We discuss the right of women to choose home birth, the caregivers’ duty to the infant, and the careproviders’ dilemma about how to respond to this request. The ethical duties of concerned careproviders are explored and reframed as professional obligations to the mother, infant, and their profession at large. Recommendations (...) are offered based on this case in order to clarify the considerations surrounding not only home birth of a fetus with anticipated anomalies, but also to address the ethical obligations of caregivers who must navigate the unique tension between respecting the mother’s wishes and the duty of the careproviders to deliver optimal care. (shrink)

In a recent article in the American Journal of Obstetrics and Gynecology, Frank Chervenak et al. argue that home birth is less safe than hospital birth, and that physicians have a dual duty to avoid any collaboration with home birth midwives and to make hospital birth more psychologically and socially supportive to accommodate women who want more choices during labor. The assertion that home birth is significantly less safe than hospital birth has been responded to by Howard Minkoff and Jeffrey (...) Ecker and by a recent large observational study of home birth outcomes in America. Minkoff and Ecker argue that the evidence supports, at most, a minimal increased.. (shrink)

Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.

This book is the second collection of essays on reproductive ethics from Drs. Campo-Engelstein and Burcher. This volume is unique in that it is both timely and includes several essays on new technologies, while also being a comprehensive review of most of the major questions in the field, from racial disparities in reproductive healthcare to gene editing and the possibility of the creation of a transhuman species. The scholars writing these essays are pre-eminent in their fields, and their backgrounds are (...) quite varied, including philosophers, anthropologists, physicians, and professors of law. Reproductive ethics remains an underdeveloped area of bioethics despite the recent technological breakthroughs that carry both great promise and potential threats. Building on the first volume of work from a conference held just over one year ago, this new collection of essays from a conference held April 2017 continues this discussion as well as provides ethical insights and reviews of these emerging technologies. The ethical questions swirling around human reproduction are both old and new, but the conference presentations, and the essays derived from them, focus on new ways of appreciating old arguments such as the ethics of abortion, as well as new ways of seeing new technologies such as CRISPR and mitochondrial transfer. (shrink)

Until quite recently human reproduction was considered an entirely natural process, and the ethics of reproduction were governed more by cultural mores and religious strictures than by any serious philosophical or empirical inquiry. However, more recently reproductive ethics has exploded as a field for several reasons. At a cultural level, many things taken for granted a generation ago, including the increasing medicalization of birth and the heteronormative two-parent nuclear family, have been challenged, and new possibilities have arisen from these now (...) contested ideas. It is important to remember that the explosion of reproductive ethics is as much from new thinking as it is from new technologies, and, at least in regard to reproductive possibilities for the LGBTQ community, it may well be fair to say that it is our new thinking that then led to new technological explorations. (shrink)

This book summarizes the contributions at an April 2016 conference held at Albany Medical College, Reproductive Ethics: New Challenges and Conversations. Reproductive ethics does not suffer from a lack of challenging issues, yet a few "hot button" issues such as abortion and surrogacy seem to attract most of the attention, while other issues and dilemmas remain relatively underdeveloped in bioethics literature. The goal of this book is to explore and expand the range of topics addressed in reproductive ethics. This is (...) a multi-disciplinary book bringing together philosophers, clinicians, sociologists, anthropologists, and other scholars whose research or clinical interests touch reproductive issues. The results of this compilation are a comprehensive and unique discussion of the evolving issues in the rapidly changing field. The majority of the popular reproductive ethics anthologies were published at least 10 years ago. The field of reproductive ethics would benefit from a new anthology that addresses some of the perennial dilemmas in reproductive ethics (e.g. abortion, sex selection) from updated perspectives and that also covers new technologies that have emerged only in the last few years, such as social egg freezing. (shrink)