Hot Topics: Reproductive Medicine

Blog Posts (56)

July 27, 2015

Investigating Two Claims Against Planned Parenthood: Center of Medical Progress’s Secret Videos

by Craig Klugman, Ph.D.

Before you being reading, I have a disclaimer: Growing up, my mother worked for Planned Parenthood. As a nurse, she practiced in their clinics offering well women services, counseling, and contraception.…

July 23, 2015

Planned Parenthood and fetal tissue donation

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Planned Parenthood recently made national news because an anti-abortion group released an <a href="http://wnyt.com/article/stories/S3854083.shtml?cat=10114">undercover video</a> showing two people posing as fetal tissue recruiters interviewing Dr. Deborah Nucatola, the senior director of medical services of Planned Parenthood. The interview was cropped down into an eight minute clip in which Dr. Nucatola seems to be suggesting that Planned Parenthood sells fetal tissue for profit. Planned Parenthood has responded to the video saying that it is heavily edited and that they do not sell fetal tissue. They do, however, donate fetal tissue with women’s explicit consent and they sometimes receive a small amount of money – in the video Dr. Nucatola says it is typically between $30-100 – that covers transportation of the fetal tissue.</p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">This story made national news because the idea of selling fetal tissue for profit without women’s consent is horrifying. Yet, once we uncover the facts here, this story is much less troubling than it originally seems. One concern the undercover video raises is of selling fetal tissue. It is illegal in the US to sell human and fetal organs and tissue. However, it is not only legal, but also laudable to altruistically donate organs and tissue. Because there is such a strong need for organs and tissue for patients waiting for transportation and for scientific research, there are various campaigns to get people to sign up to be cadaveric organ donors, to donate blood, and to be live kidney donors.  In the US, organ donation is opt-in only, meaning it is completely voluntary and people are under no ethical obligation to donate. Likewise, women who have abortions are under no ethical obligation to donate fetal tissue and typically the fetal tissue is discarded. Women who choose to donate fetal tissue for scientific research are acting altruistically because there are choosing to further scientific research, which could help others in the future.</span></p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
July 16, 2015

Planned Parenthood, Tissue Donation, and American Politics: A Call to Separate the Debate in the Media

by Macey L. Henderson, JD and Brianna L. Doby

The controversy over Planned Parenthood seems to be as old as time in American politics, but now the public perception of donated tissue for medical research might be at stake.…

June 29, 2015

iPhone App Will Track Sexual Activity and Reproduction

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Apple recently announced that they will update their health app, HealthKit, to include reproductive health. Many were critical of the original app because although it can track a wide range of health indicators, such as BMI, sleep, sodium intake, number of falls, etc., it neglected reproductive health. Specifically, <a href="http://fusion.net/story/100781/apple-ios-update-new-version-of-healthkit-still-doesnt-track-periods/">it is problematic</a> that the app includes some obscure health indicators, like selenium intake, but not menstrual cycle, which affects half of the population. While there are other apps that are specifically geared toward women's reproductive health, it is troubling that an iPhone app that comes standard with the phone would exclude something so central to women's health as menstruation. Some believe that the omission of reproductive health from HealthKit is due to the fact that the tech world, including Apple, is dominated by men.  </div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The new the updated app is a huge improvement because it includes a variety of reproductive health indicators like menstruation, basal body temperature, and spotting. The broad range of reproductive health indicators helps women keep track of their reproductive health in general and specifically for women looking to prevent pregnancy and for women looking to achieve pregnancy. This is an important addition because too often reproductive health is overlooked or not considered part of "real" healthcare. The addition of the reproductive health category in HealthKit technology not only acknowledges the reproductive health issues specific to many women, but also normalizes them.</div> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
June 22, 2015

Reflections on Father’s Day from a “Single” Mother

by Nanette Elster, JD, MPH

Today on Father’s Day, as I miss my own father who has been gone for 17 years now, I am reflecting on my decision to intentionally become a single mother.…

May 19, 2015

Should someone who does not want biological children be diagnosed as infertile?

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">In my </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="/BioethicsBlog/post.cfm/how-should-we-define-infertility-and-who-counts-as-infertile">last blog</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">, I discussed some of the problems with the definition of infertility, including that it is based mainly on women's bodies, which implies that men are less likely or not likely to be infertile, and it is based on heterosexual activity, which implies that single individuals and/or individuals in the LGBTQ community cannot experience infertility. I also distinguished between physiological infertility (i.e. infertility due to a biological condition such as low sperm count or blocked tubes) and social infertility (i.e. situational infertility, such as whether one has a partner and if so, if that partner is fertile and together one and one’s partner have the “right” parts to reproduce biologically). In this blog, I want to reflect more on that it means to be infertile and how the role social desire (i.e. the social desire to have biological children) plays in diagnosing this condition.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Imagine two women with the same exact circumstances: they are both 30 years old, in long term heterosexual relationships, and have been having unprotected sex regularly for the last 3 years. The only difference is that one woman, Jessica, wants to have biological children, while the other woman, Katie does not. Should they both be classified as infertile? How does their desire to have or not have biological children shape their medical diagnosis? Should their partners be labeled as infertile too? Does it matter whether Jessica and Katie are physiologically or socially infertile in classifying them as infertile? Does their partners’ interest in having biological children or lack thereof factor into determining if Jessica and Katie are infertile?</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"> </span><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif;"> </span></p>
April 20, 2015

How should we define infertility and who counts as infertile?

<div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The concept of infertility seems relatively straightforward, yet there are many myths, confusions, and disagreements regarding who counts as being infertile. According to the World Health Organization (WHO), <a href="http://www.who.int/reproductivehealth/topics/infertility/definitions/en/">infertility is</a> "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”Like many definitions of infertility, this one is based on a woman's body since she is the one who experiences pregnancy. However, this definition may make it more difficult to understand and recognize male factor infertility.Indeed, defining infertility based solely on a woman's ability to achieve pregnancy reinforces the myth that women are more likely to be infertile than men. In reality, women and men are equally likely to be infertile. The National Institutes of Health (NIH) <a href="http://www.nichd.nih.gov/health/topics/infertility/Pages/default.aspx">definition of infertility</a> is more inclusive: “the inability of a woman or man to conceive a child or the inability of a woman to carry a pregnancy to term.”</div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><br /></div> <div style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Another concerned with the WHO definition of infertility is that it is based on being in a heterosexual relationship.According to this definition and many others like it, people can only be considered infertile if they engage in "regular unprotected sexual intercourse." This definition does not explicitly state that this it is referring to heterosexual intercourse, which is problematic. Given the narrow scope of this definition, how then should we diagnose infertility in lesbian and gay couples and heterosexual individuals who are singleand not engaging in regular unprotected sexual intercourse.</div> <div><br /></div> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
April 1, 2015

Abortion Wars: Arizona Mandates Unscientific “Truths”

by Craig Klugman, Ph.D.

The Arizona legislature has apparently gone through medical school and graduated. They have passed a new law of the land.…

March 18, 2015

Frankenstein babies and designer babies? Ethical concerns raised by “3 person embryos”

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><a href="http://www.popsci.com/uk-one-step-closer-using-dna-3-people-make-babies">The story</a> about the UK passing a law to allowa reproductive technology called mitochondrial donation, what has been informally known as three person or three parent embryos, recently dominated the news.Part of the reason this story received so much attention is because the idea of a child with more than two biological parents sounds really scary, even Frankensteinish.While new medical technologies often raise ethical concerns, it is imperative to understand the science behind these technologies in order to accurately assess the likelihood and degree of potential harms caused by these technologies. In the case of three parent embryos, once we understand the science, this technology is not as threatening as it may initially appear.</p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">The UK will only allow mitochondrial donations in cases where women could pass along mitochondrial diseases to their children. There are various types of mitochondrial diseases, which affect approximately one in 8,500 people and can lead to serious and fatal conditions. The mitochondria are located in the cytoplasm of the cell and serve as the cell powerhouses. Mitochondria have their own set of DNA with the 37 genes and a mitochondrial disease occurs when there is a mutation in the mitochondrial DNA. Mitochondrial donation allows women who are at risk for passing along mitochondrial diseases to the children to avoid doing so by using the mitochondria of a donor. There are two ways this can be done. In the first way, known asmaternal spindle transfer technique, the nucleus from the donor egg is removed and replaced with the nucleus from the intended mother's egg. The resultant eggwill carry the nucleus with all the genetic information from the intended mother, but will also contain the healthy mitochondrial DNA from the donor egg.The second way, known as pronuclear transfer, removes the nucleus from a donor embryo and replaces it with the nucleus of an embryo that contains the genetic material from intended mother and father. Here again,the resultant embryo contains the genetic material from the intended parents, but avoids inheriting mitochondrial diseases because donor mitochondria is used. </span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
March 16, 2015

Ethics of Penile Transplants

by Craig Klugman, Ph.D.

This weekend, doctors in South Africa announced a new first—a successful penis transplant. The 9-hour operation took place in December 2014.…