Bioethics.net » Reproductive Medicine http://www.bioethics.net Where the World Finds Bioethics Fri, 29 Apr 2016 12:00:27 +0000 en-US hourly 1 http://wordpress.org/?v=4.2.2 Taking Sperm From the Dead http://www.bioethics.net/news/taking-sperm-from-the-dead/ http://www.bioethics.net/news/taking-sperm-from-the-dead/#comments Thu, 28 Apr 2016 13:53:22 +0000 http://www.bioethics.net/?post_type=news&p=58953 http://www.bioethics.net/news/taking-sperm-from-the-dead/feed/ 0 The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic http://www.bioethics.net/2016/04/the-paradigm-of-the-paradox-women-pregnant-women-and-the-unequal-burdens-of-the-zika-virus-pandemic/ http://www.bioethics.net/2016/04/the-paradigm-of-the-paradox-women-pregnant-women-and-the-unequal-burdens-of-the-zika-virus-pandemic/#comments Wed, 27 Apr 2016 22:18:04 +0000 http://www.bioethics.net/?p=58950 by Lisa H. Harris, Neil S. Silverman, and Mary Faith Marshall

The inequalities of outcome are, by and large, biological reflections of social fault lines (Paul Farmer)

Three paradoxes characterize the Zika virus pandemic and clinical and policy responses to it:

  1. Zika virus has been shown to cause severe developmental anomalies in the fetuses of infected women. As a result, both women and men in endemic areas are asked to avoid or delay pregnancy. However, access to effective contraception and safe pregnancy termination is either not available (especially for those living below the poverty line) or a crime for many women in Zika-endemic regions.
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BioEthicsTV: A night of consent issues on ChicagoMed http://www.bioethics.net/2016/04/bioethicstv-a-night-of-consent-issues-on-chicagomed/ http://www.bioethics.net/2016/04/bioethicstv-a-night-of-consent-issues-on-chicagomed/#comments Wed, 27 Apr 2016 03:40:58 +0000 http://www.bioethics.net/?p=58919 by Craig Klugman, Ph.D.

On this week’s episode of ChicagoMed (Season 1; Episode 15) issues of consent was the main focus. The first major storyline concerned a 16-year-old in abdominal pain who enters the ED with her father, a heroin addict. Although in pain and in need of a diagnostic endoscopy, the patient refuses any and all medications: She fears that even one dose will turn her into the addict that her father has been for her entire life. The doctors try the endoscopy without anesthetic or pain medications and they are unable to get through the procedure.…

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The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic http://www.bioethics.net/articles/the-paradigm-of-the-paradox-women-pregnant-women-and-the-unequal-burdens-of-the-zika-virus-pandemic/ http://www.bioethics.net/articles/the-paradigm-of-the-paradox-women-pregnant-women-and-the-unequal-burdens-of-the-zika-virus-pandemic/#comments Tue, 26 Apr 2016 19:54:21 +0000 http://www.bioethics.net/?post_type=articles&p=58913 http://www.bioethics.net/articles/the-paradigm-of-the-paradox-women-pregnant-women-and-the-unequal-burdens-of-the-zika-virus-pandemic/feed/ 0 Paternalists at the Gate: Those With Privilege Fight to Keep It http://www.bioethics.net/2016/04/paternalists-at-the-gate-those-with-privilege-fight-back/ http://www.bioethics.net/2016/04/paternalists-at-the-gate-those-with-privilege-fight-back/#comments Wed, 06 Apr 2016 18:08:45 +0000 http://www.bioethics.net/?p=58607 by Craig Klugman, Ph.D.

One of the main concepts that most medical ethics instructors teach to their students is that of autonomy—self governance. I usually explain that this evolved in response to the age of paternalistic medicine. During the civil rights movement, where voiceless groups were demanding a voice, patients were among those who received a voice through autonomy. However, recent legislation suggests that the age of paternalism has returned anew, but this time medical authority is wielded by legislators and not physicians trying to ensure their continued privilege in society.…

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BIOETHICSTV: Chicago Med-BIID, post mortem egg retrieval, scope of practice and forgiveness http://www.bioethics.net/2016/04/bioethicstv-chicago-med-biid-post-mortem-egg-retrieval-scope-of-practice-and-forgiveness/ http://www.bioethics.net/2016/04/bioethicstv-chicago-med-biid-post-mortem-egg-retrieval-scope-of-practice-and-forgiveness/#comments Wed, 06 Apr 2016 06:29:15 +0000 http://www.bioethics.net/?p=58599 by Craig Klugman, Ph.D.

This week on Chicago Med brought 3 new ethical issues as well as the unsatisfying resolution to a story arc.

Story 1 begins with a patient brought into the ED after trying to saw off his arm in the hardware store. The doctors are able to save it but the patient is upset. Dr. Charles, the psychiatrist, realizes the patient suffers from Body Integrity Identity Disorder (BIID) which is characterized by people feeling a part of their body is not theirs.…

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The ethics of Indiana HB 1337: Outlawing abortion based on race, sex, and disability http://www.amc.edu/BioethicsBlog/post.cfm/the-ethics-of-indiana-hb-1337-outlawing-abortion-based-on-race-sex-and-disability http://www.amc.edu/BioethicsBlog/post.cfm/the-ethics-of-indiana-hb-1337-outlawing-abortion-based-on-race-sex-and-disability#comments Fri, 01 Apr 2016 16:06:01 +0000 http://www.amc.edu/BioethicsBlog/post.cfm/the-ethics-of-indiana-hb-1337-outlawing-abortion-based-on-race-sex-and-disability

In March, the Indiana legislature passed and the Indiana governor signed into law HB 1337, a bill that bans abortions for women seeking them based solely on certain characteristics of the fetus, such as race, sex, and disability. Specifically, the bill:

 “Prohibits a person from performing an abortion if the person knows that the pregnant woman is seeking the abortion solely because of: (1) the race, color, national origin, ancestry, or sex of the fetus; or (2) a diagnosis or potential diagnosis of the fetus having Down syndrome or any other disability. Provides for disciplinary sanctions and civil liability for wrongful death if a person knowingly or intentionally performs a sex selective abortion or an abortion conducted because of a diagnosis or potential diagnosis of Down syndrome or any other disability.”

As I have discussed in a previous blog, sex selection is a frequent occurrence in certain countries, such as India and China, where there is a strong preference for sons. Yet, there is little to no evidence that sex selection abortion is commonplace in the US. Abortion based on the race of the fetus is similarly rare in the US. While the purpose of any law is to prohibit actions it deems unethical or contrary to social norms, regardless of their frequency, due to limited time and resources, it makes sense to focus on bills that address common occurrences or things that are so morally repugnant that the state must take a stand. The main motivating factor for this bill does not seem to be avoiding discrimination based on sex and race, but rather trying to undermine legal access to abortion. Indiana is one of only five states that does not have a hate crime law and it recently rejected another attempt to pass hate crime legislation. It seems odd, and even contradictory, that Indiana is so worried about discrimination against fetuses, but not against legal persons.

The provision outlawing abortion due to disability is also troubling. Women and their families are often faced with very difficult decisions if they find out a fetus they are carrying has a disability and they should have the autonomous right to make decisions that are best for themselves and their families. This bill does allow women carrying fetuses with lethal abnormalities to abort, but they first have to receive materials about perinatal hospice care and complete documentation stating that they received such materials. The knowledge that the fetus has a lethal abnormality is devastating to many women and the idea of carrying the pregnancy to term is often psychologically distressing for them. Requiring them to be counseled about perinatal hospice care seems unnecessary and insensitive. Good physicians already ensure that their patients are adequately informed about their options and this seems to be a form of directive, morally laden counseling that will just make women feel guilty, rather than expanding their choices.

Another aspect of this bill that is quite problematic is that it “Provides that a miscarried or aborted fetus must be interred or cremated by a facility having possession of the remains.” For most abortions, the fetal remains are disposed of with other medical waste. This law, however, requires that the fetal remains are buried or cremated. This is clearly an attempt to elevate the status of the fetus and give it equal rights to legal persons.

This law means that Indiana now has some of the most restrictive abortion laws in the country. While many antiabortion supporters are in favor of this law, it is worth noting that some antiabortion legislators think this bill goes too far. They are concerned that this bill lacks compassion and demeans women. I agree with these concerns and am troubled by the passage of this law for the reasons I have outlined here.

 

 

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 website. 

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WHO sees scientific consensus on Zika as cause for disorders http://www.bioethics.net/news/who-sees-scientific-consensus-on-zika-as-cause-for-disorders/ http://www.bioethics.net/news/who-sees-scientific-consensus-on-zika-as-cause-for-disorders/#comments Fri, 01 Apr 2016 15:41:24 +0000 http://www.bioethics.net/?post_type=news&p=58539 http://www.bioethics.net/news/who-sees-scientific-consensus-on-zika-as-cause-for-disorders/feed/ 0 F.D.A. Eases Requirements on Abortion Pill Label http://www.bioethics.net/news/f-d-a-eases-requirements-on-abortion-pill-label/ http://www.bioethics.net/news/f-d-a-eases-requirements-on-abortion-pill-label/#comments Thu, 31 Mar 2016 12:37:58 +0000 http://www.bioethics.net/?post_type=news&p=58516 http://www.bioethics.net/news/f-d-a-eases-requirements-on-abortion-pill-label/feed/ 0 A Few Thoughts On Abortion and Valuing Human Life http://www.amc.edu/BioethicsBlog/post.cfm/a-few-thoughts-on-abortion-and-valuing-human-life http://www.amc.edu/BioethicsBlog/post.cfm/a-few-thoughts-on-abortion-and-valuing-human-life#comments Thu, 24 Mar 2016 16:19:27 +0000 http://www.amc.edu/BioethicsBlog/post.cfm/a-few-thoughts-on-abortion-and-valuing-human-life

Who could be against life? Ancient natural law theory in the Catholic tradition tells us that human beings desire to live, and that life is good, therefore humans have an obligation to live and not kill other human beings. This ancient wisdom has been instilled into western ways of moral thinking. So, who could not be prolife in terms of how we place value on all individual human life?

Who could be against human freedom? Individual human beings should be free to live peacefully in accordance with their own values and life goals. This is a basic tenet of democracy that has shaped moral and political thinking in the West for the past four centuries. So, who could not be against the exercise of free choice, especially about something so basic as having control over our bodies?

The two value perspectives contained in the prior two paragraphs, all things equal, are eminently reasonable and most ethically unproblematic. These two value positions represent two fundamental principles of ethics—the intrinsic value of all individual human lives and the right of free individuals to govern their own lives and bodies—that guide us in living an ethical life and making ethical decisions. It is when these fundamental principles come into direct conflict that a serious, a near irresolvable, ethical conflict arises. There is no greater direct conflict of these two ethical principles than right of women to have an abortion. It is commonly assumed that one is either on one side of this moral abyss or the other and the twain shall never meet. It seems to me one of the central tasks of ethical reflection on this issue is to find as much meaningful middle ground as possible. In this brief blog I’ll offer a few ideas in this regard, which advocates on either extreme will likely find unsatisfactory.

 

Once a fetus reaches full term and emerges at birth into the world as a separate human being, there is no question about its full moral standing—from my perspective this would include babies with the most serious birth defects, including anencephaly. Some bioethicists believe that a being must have interests to have full moral standing. Since babies with anencephaly, if they survive a short time after birth, have no brain, no capacity to experience pain or pleasure, and no future life, they have no interests. The latter may be true descriptions of babies with this disorder, but they are unequivocally individual human beings. And there is no reason, as the law currently supports, to justify killing or euthanizing the lives of these babies in my view. So can’t the same be said of a fetus from the moment of conception?

It is true that a human embryo is a biologically a distinct form of individual human life and because of that fact has moral worth and deserves respect. But there is a basic aspect of fetal life even after viability and prior to birth that is inescapable: the fetus is dependent on the mother for its life and is part of the woman’s body. There is no protecting the fetus prior to birth without controlling the bodies of pregnant women. At the same time, at the very least, abortion as I am defining my terms is morally concerning and even problematic. I realize many of my pro-choice friends will find that conclusion concerning, but it is simply a consequence of recognizing the moral humanity of fetal life. So the key question then becomes who should make this moral or ethical decision and how should abortion services be regulated under the law?

A moderate position that seeks to preserve as many values as possible in this conflict, it seems to me, will recognize elective abortion as a moral issue but will reject the notion that it should be restricted as a service under the law. For if the law seeks to protect fetal life by restricting abortions, ipso facto, it also seeks to restrict the liberty of the woman to control her body as she so desires. The idea of requiring a woman to keep an unwanted pregnancy is an assault to her dignity as free human being. We cannot pretend to live in a free society where men and women have equal moral worth if we do not extend full moral autonomy to both men and women equally.

I conclude abortion is a moral issue and like many moral issues they are decisions that individual free human people should make and should not be the business of government to regulate. But it is not trivial to recognize abortion as a moral issue. We should not only talk, but also act, like all human life as value. We can provide adequate healthcare to all people, which should include family planning, prenatal, and birth control services for woman. We should provide more day care for parents, particularly single parents and other support services to make having children easier.

In short we can be a society that acts like it values all human life, of which fetal life is a part. But the ethical position of valuing all human life in terms of ascribing full moral standing to individual human beings cannot extend individual fetal life if we are to full value women as autonomous human beings.

 

 

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 website.

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Should providers offer oncofertility to patients with a poor prognosis? http://www.amc.edu/BioethicsBlog/post.cfm/should-providers-offer-oncofertility-to-patients-with-a-poor-prognosis http://www.amc.edu/BioethicsBlog/post.cfm/should-providers-offer-oncofertility-to-patients-with-a-poor-prognosis#comments Tue, 15 Mar 2016 15:08:45 +0000 http://www.amc.edu/BioethicsBlog/post.cfm/should-providers-offer-oncofertility-to-patients-with-a-poor-prognosis

Whereas quality of life issues for cancer patients used to minimized, and sometimes even ignored, today there is more of a focus on cancer patients’ quality of life post-cancer. One such quality of life issue is oncofertility, which is fertility preservation for cancer patients. In many places, oncofertility is, or is becoming, the standard of care for cancer patients. But should it be offered to all patients? What about patients who have a very bad prognosis?

 Fertility preservation for patients with a poor prognosis raises a host of ethical issues. Providers may worry that discussing fertility preservation will give patients false hope about their prognosis. In other words, these patients may feel their providers deceived them by mentioning fertility preservation, leading them to believe that their prognosis is not as bad as they originally thought.

Yet, at the same time, pursuing fertility preservation may be a source of hope and happiness for patients during difficult times. It may furnish them with mental and physical strength, making them even more motivated to survive for the sake of their potential future children. Additionally, these patients, and their families, may feel a degree of inner peace knowing that part of their lives will continue on in the reproductive material even if they are never used.

Nevertheless, some may argue that, despite any personal and emotional benefits they may experience, offering patients with a poor prognosis fertility preservation options is an unjust allocation of resources. From a utilitarian perspective, it does not make sense to devote resources to patients who will likely not benefit from them. Put differently, resources should be allocated to those who have a high probability of a positive outcome, which means individuals with a poor prognosis should be placed lower on the priority list for receiving fertility preservation resources than individuals with a good prognosis.

On the other hand, if we take a deontological (duty-based, individual rights) approach, providers have a duty to care for their patients. Not offering fertility preservation to all of their patients, including those with a poor prognosis, may be seen as diminishing patient autonomy. According to this view, providers should be more concerned with the needs and rights of their individual patients than with social justice (i.e., fair allocation of resources).

For more on this topic, see my book chapter “Addressing the Three Most Frequently Asked Questions of a Bioethicist in an Oncofertility Setting” in Oncofertility Medical Practice, edited by T.K. Woodruff and C. Gracia.

 

 

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 website.

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Zika: An opportunity to improve pre-conception care. http://www.bioethics.net/2016/03/zika-an-opportunity-to-improve-pre-conception-care/ http://www.bioethics.net/2016/03/zika-an-opportunity-to-improve-pre-conception-care/#comments Tue, 08 Mar 2016 21:20:58 +0000 http://www.bioethics.net/?p=58284 by Andrea L. Kalfoglou, Ph.D.

The Zika virus is spreading rapidly throughout parts of South and Central America. Public health officials are concerned because there is a correlation between the emergence of the Zika virus and a dramatic increase in number of babies born in Brazil with a severe birth defect called microcephaly.

The CDC has warned women from the U.S. who are pregnant or thinking about becoming pregnant not to travel to certain areas in Central and South America. Additionally, infectious disease specialists are concerned that Zika may adapt to transmission by a type of mosquito common in 32 states in the U.S.…

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Zika Kills Cells Key to Fetal Brain Development, Study Says http://www.bioethics.net/news/zika-kills-cells-key-to-fetal-brain-development-study-says/ http://www.bioethics.net/news/zika-kills-cells-key-to-fetal-brain-development-study-says/#comments Fri, 04 Mar 2016 18:31:23 +0000 http://www.bioethics.net/?post_type=news&p=58239 http://www.bioethics.net/news/zika-kills-cells-key-to-fetal-brain-development-study-says/feed/ 0 First Uterus Transplant in the US Gives 26-year-old Woman Chance at Pregnancy http://www.bioethics.net/news/first-uterus-transplant-in-the-us-gives-26-year-old-woman-chance-at-pregnancy/ http://www.bioethics.net/news/first-uterus-transplant-in-the-us-gives-26-year-old-woman-chance-at-pregnancy/#comments Wed, 02 Mar 2016 17:34:06 +0000 http://www.bioethics.net/?post_type=news&p=58200 http://www.bioethics.net/news/first-uterus-transplant-in-the-us-gives-26-year-old-woman-chance-at-pregnancy/feed/ 0 All Surrogacy is Exploitation – The World Should Follow Sweden’s Ban http://www.bioethics.net/news/all-surrogacy-is-exploitation-the-world-should-follow-swedens-ban/ http://www.bioethics.net/news/all-surrogacy-is-exploitation-the-world-should-follow-swedens-ban/#comments Tue, 01 Mar 2016 19:48:56 +0000 http://www.bioethics.net/?post_type=news&p=58189 http://www.bioethics.net/news/all-surrogacy-is-exploitation-the-world-should-follow-swedens-ban/feed/ 0 Cleveland Clinic Performs First U.S. Uterus Transplant http://www.bioethics.net/2016/02/cleveland-clinic-performs-first-u-s-uterus-transplant/ http://www.bioethics.net/2016/02/cleveland-clinic-performs-first-u-s-uterus-transplant/#comments Fri, 26 Feb 2016 00:52:52 +0000 http://www.bioethics.net/?p=58144 by Craig Klugman, Ph.D.

Almost like Aphrodite herself, surgeons at the Cleveland Clinic this week may have given fertility to a 26-year-old woman through a 9-hour uterus transplant operation. The transplanted uterus was from a deceased woman. This was the first such surgery in the United States, though it has been performed previously in Sweden and Turkey. Of the 9 women in Sweden who had the procedure, 4 have given birth.

The American patient had uterine factor infertility, which result from fibroids, scarification, genetics, or not having developed a uterus.…

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Pope suggests women threatened by Zika virus could use contraception http://www.bioethics.net/news/pope-suggests-women-threatened-by-zika-virus-could-use-contraception/ http://www.bioethics.net/news/pope-suggests-women-threatened-by-zika-virus-could-use-contraception/#comments Thu, 18 Feb 2016 18:38:33 +0000 http://www.bioethics.net/?post_type=news&p=58075 http://www.bioethics.net/news/pope-suggests-women-threatened-by-zika-virus-could-use-contraception/feed/ 0 Catholic group urges pope to allow contraception to fight Zika http://www.bioethics.net/news/catholic-group-urges-pope-to-allow-contraception-to-fight-zika/ http://www.bioethics.net/news/catholic-group-urges-pope-to-allow-contraception-to-fight-zika/#comments Wed, 10 Feb 2016 22:54:43 +0000 http://www.bioethics.net/?post_type=news&p=58015 http://www.bioethics.net/news/catholic-group-urges-pope-to-allow-contraception-to-fight-zika/feed/ 0 Oh, baby! Woman’s Fitbit reveals she is pregnant http://www.bioethics.net/news/oh-baby-womans-fitbit-reveals-she-is-pregnant/ http://www.bioethics.net/news/oh-baby-womans-fitbit-reveals-she-is-pregnant/#comments Wed, 10 Feb 2016 21:34:05 +0000 http://www.bioethics.net/?post_type=news&p=58012 http://www.bioethics.net/news/oh-baby-womans-fitbit-reveals-she-is-pregnant/feed/ 0 Penis Transplants Coming to America http://www.amc.edu/BioethicsBlog/post.cfm/penis-transplants-coming-to-america http://www.amc.edu/BioethicsBlog/post.cfm/penis-transplants-coming-to-america#comments Wed, 10 Feb 2016 14:31:59 +0000 http://www.amc.edu/BioethicsBlog/post.cfm/penis-transplants-coming-to-america The New York Times recently reported that physicians will soon undertake the first penis transplants in the U.S. The goal of this procedure is to restore everyday functionality as well as sexual functioning for men with genitourinary injuries, which are injuries involving loss of part of all of the penis and/or testicles. The donated penis will come from a deceased donor, with that donor’s permission. Penis transplants have only taken place in China in 2006, where the procedure failed due to the recipient psychologically rejecting the transplant, and in South Africa in 2014, where the procedure was successful. 

For the time being, this procedure will be limited in the U.S. to men who lost their penis in military service. In the last 15 years, over 1300 men have suffered genitourinary injuries in Afghanistan or Iraq, mainly due to homemade bombs. Almost all of these men are under 35 years old.

One objection to penis transplantation is that it is not life-saving. While it is true that penis transplants are not life-saving, much of modern medicine focuses on improving quality of life (e.g. glasses for poor vision, over the counter medication for the common cold, physical therapy for back pain, assisted reproductive technologies for infertility, etc.). While a genitourinary injury may not be visible to others, the effect on the individual can be devastating. For many men, the penis is a symbol of his masculinity and not having “normal” genitals can impair his gendered and sexual identity. As I have discussed in my published research,

“the male genitals are generally central to a man’s coherent sexual identity, and are associated with stereotypical masculine traits like “strength” and “courage.” Because of the personal, as well as social, significance of the male genitals, having “misfunctioning” (e.g. impotent, prematurely ejaculating, infertile) genitals or genitals that look “abnormal” (e.g. small penis, missing a testicle) can diminish men’s sense of masculinity.”

Given the significance of the male genitals to men, it is not surprising that many male patients find a genitourinary injury to be the worst type of injury possible. According to Scott E. Skiles, the polytrauma social work supervisor at the Veterans Affairs Palo Alto Health Care System who is quoted in the New York Times article on penis transplants, “Our young male patients would rather lose both legs and an arm than have a urogenital injury.”

The psychological suffering caused by genitourinary injuries should not be underestimated. The objection that a penis transplant is merely “elective” and not medically necessary overlooks the profound effect a genitourinary injury can have on a man’s mental health. While there are still concerns about penis transplants, namely the fact that they are still experimental, they should not be equated with other types of surgeries that purely or mostly cosmetic.   

 

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 website.

 

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Ethicists approve “3 parent” embryos to stop diseases, but congressional ban remains http://www.bioethics.net/news/ethicists-approve-3-parent-embryos-to-stop-diseases-but-congressional-ban-remains/ http://www.bioethics.net/news/ethicists-approve-3-parent-embryos-to-stop-diseases-but-congressional-ban-remains/#comments Wed, 03 Feb 2016 23:19:59 +0000 http://www.bioethics.net/?post_type=news&p=57920 http://www.bioethics.net/news/ethicists-approve-3-parent-embryos-to-stop-diseases-but-congressional-ban-remains/feed/ 0 Restricting Choices of Childbearing Women http://www.bioethics.net/2016/02/restricting-choices-of-childbearing-women/ http://www.bioethics.net/2016/02/restricting-choices-of-childbearing-women/#comments Wed, 03 Feb 2016 21:56:12 +0000 http://www.bioethics.net/?p=57914 by Bela Fishbeyn, M.S.

In this month’s issue of AJOB, Howard Minkoff and Mary Faith Marshall argue that we ought to acknowledge the inherent complexity and personal nature of risks involved in childbirth, and thus defer, when possible, to the decisions made by autonomous mothers-to-be. They place this in opposition to the claim that, “women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk,” and discourage deference to the evaluations of clinicians and judges.…

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Fetal Risks, Relative Risks, and Relatives’ Risks http://www.bioethics.net/articles/fetal-risks-relative-risks-and-relatives-risks/ http://www.bioethics.net/articles/fetal-risks-relative-risks-and-relatives-risks/#comments Mon, 01 Feb 2016 21:30:14 +0000 http://www.bioethics.net/?post_type=articles&p=57928 http://www.bioethics.net/articles/fetal-risks-relative-risks-and-relatives-risks/feed/ 0 Restricting Choices of Childbearing Women http://www.bioethics.net/articles/restricting-choices-of-childbearing-women/ http://www.bioethics.net/articles/restricting-choices-of-childbearing-women/#comments Mon, 01 Feb 2016 21:27:07 +0000 http://www.bioethics.net/?post_type=articles&p=57927 http://www.bioethics.net/articles/restricting-choices-of-childbearing-women/feed/ 0 My Child, Your Womb http://www.amc.edu/BioethicsBlog/post.cfm/my-child-your-womb http://www.amc.edu/BioethicsBlog/post.cfm/my-child-your-womb#comments Thu, 28 Jan 2016 17:31:48 +0000 http://www.amc.edu/BioethicsBlog/post.cfm/my-child-your-womb Gestational surrogacy contracts have been in the news again recently as a gestational surrogate reports that the intended father, having discovered that she is expecting triplets, is demanding that she undergo selective reduction to abort one of the fetuses.  Situations such as these, while often not reported, are not necessarily uncommon.  In 2013, a gestational carrier was offered $10,000 to abort when a second trimester ultrasound discovered congenital heart and brain abnormalities.  Despite a well-established Constitutional right to privacy that includes a pregnant woman’s right to procure – or refuse – an abortion, surrogacy contracts routinely include provisions that not only prohibit a surrogate from having an abortion unless there is a medical need, but also give the intended parents sole discretion to determine whether the surrogate should abort where there is evidence of a physical abnormality or other issue.  Such provisions have not been tested in court, but would almost certainly be unenforceable based on the surrogate’s Constitutionally-protected right to reproductive autonomy.


In India, where there is an estimated $400 million surrogate tourism industry, women agree to be surrogates in exchange for $5,000-7,000, which is far more than they could make otherwise.  In many clinics, surrogates live in dormitories for the duration of the pregnancy and their food and medical care is provided by the clinic.  There are also reports that some clinics have policies against pregnancies of 3 or more fetuses – meaning that selective reduction may occur as a matter of course to reduce the number of fetuses to 2 or 1.  If this is in fact happening, are the surrogates (or even the intended parents) aware of what is happening?  Are they given a voice in the medical care and treatments they receive?  Or are the decisions made by the intended parents or the clinic, and simply imposed on the surrogate?


Surrogacy, as with other assisted reproductive techniques, has been promoted in the name of reproductive autonomy – the right and ability to have more options and exert more control over reproduction.  But in cases such as these, where surrogates are pressured legally, financially and socially to have an abortion, whose reproductive autonomy are we honoring?  While it may be the child of the intended parents, it is the uterus of the surrogate.  The intended parents have an interest in the healthy development and birth of their child, which can be affected by congenital abnormalities, surrogate behavior, or the presence of multiples.  The surrogate has an interest in her own bodily integrity, her own health, and the treatments or procedures performed on her, even in connection with the gestation of another’s child.  Where these interests conflict, whose rights are stronger: the intended parents of the child, or the woman carrying it? 


It seems unconscionable that a woman could be forced to undergo an abortion based on enforcement of a contract.  It is equally disturbing to think that an intended parent would be prevented from objecting to an abortion of his or her child because the surrogate was making the decision to abort.  While both of these decisions in the context of a commercial surrogacy arrangement may be considered a breach of contract, and therefore may have monetary damages, what is left in the aftermath?  A parent whose unborn child was aborted without the parent’s permission?  A surrogate who has been abandoned with a newborn she never intended to keep?  These consequences are far weightier than could be compensated for by money.

 

The problem with blending the rights of reproductive autonomy is trying to separate them again when there is a conflict.  A surrogate will always have the right to determine what happens to her body, which includes the right to have or refuse an abortion, even if the child belongs to someone else.  Is it possible, then, to simultaneously protect the reproductive rights of both the surrogate and the intended parents?  Or will there always be an inherent imbalance of reproductive rights and the potential for coercion in the enforcement of commercial surrogacy agreements?


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 website.

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Unintended second pregnancies could be avoided http://www.bioethics.net/news/unintended-second-pregnancies-could-be-avoided/ http://www.bioethics.net/news/unintended-second-pregnancies-could-be-avoided/#comments Wed, 13 Jan 2016 23:39:41 +0000 http://www.bioethics.net/?post_type=news&p=57709 http://www.bioethics.net/news/unintended-second-pregnancies-could-be-avoided/feed/ 0 CDC: Too few schools meet recommendations for sex education http://www.bioethics.net/news/cdc-too-few-schools-meet-recommendations-for-sex-education/ http://www.bioethics.net/news/cdc-too-few-schools-meet-recommendations-for-sex-education/#comments Fri, 11 Dec 2015 15:42:34 +0000 http://www.bioethics.net/?post_type=news&p=57442 http://www.bioethics.net/news/cdc-too-few-schools-meet-recommendations-for-sex-education/feed/ 0 No Planned Parenthood cut-off in Republicans’ spending draft: Pelosi http://www.bioethics.net/news/no-planned-parenthood-cut-off-in-republicans-spending-draft-pelosi/ http://www.bioethics.net/news/no-planned-parenthood-cut-off-in-republicans-spending-draft-pelosi/#comments Fri, 04 Dec 2015 15:48:08 +0000 http://www.bioethics.net/?post_type=news&p=57444 http://www.bioethics.net/news/no-planned-parenthood-cut-off-in-republicans-spending-draft-pelosi/feed/ 0 U.S. appeals court rules against Wisconsin abortion doctor law http://www.bioethics.net/news/u-s-appeals-court-rules-against-wisconsin-abortion-doctor-law/ http://www.bioethics.net/news/u-s-appeals-court-rules-against-wisconsin-abortion-doctor-law/#comments Tue, 24 Nov 2015 19:27:03 +0000 http://www.bioethics.net/?post_type=news&p=57287 http://www.bioethics.net/news/u-s-appeals-court-rules-against-wisconsin-abortion-doctor-law/feed/ 0 Woman Sues Hospital Over Traumatic Birth That ‘Turned Our Family Life Upside Down’ http://www.bioethics.net/news/woman-sues-hospital-over-traumatic-birth-that-turned-our-family-life-upside-down/ http://www.bioethics.net/news/woman-sues-hospital-over-traumatic-birth-that-turned-our-family-life-upside-down/#comments Fri, 20 Nov 2015 23:11:06 +0000 http://www.bioethics.net/?post_type=news&p=57258 http://www.bioethics.net/news/woman-sues-hospital-over-traumatic-birth-that-turned-our-family-life-upside-down/feed/ 0 S.F. woman who sought to have embryos preserved loses legal case http://www.bioethics.net/news/s-f-woman-who-sought-to-have-embryos-preserved-loses-legal-case/ http://www.bioethics.net/news/s-f-woman-who-sought-to-have-embryos-preserved-loses-legal-case/#comments Thu, 19 Nov 2015 21:52:23 +0000 http://www.bioethics.net/?post_type=news&p=57247 http://www.bioethics.net/news/s-f-woman-who-sought-to-have-embryos-preserved-loses-legal-case/feed/ 0 Can This Procedure Reverse an Abortion? http://www.bioethics.net/news/can-this-procedure-reverse-an-abortion-2/ http://www.bioethics.net/news/can-this-procedure-reverse-an-abortion-2/#comments Wed, 18 Nov 2015 23:12:35 +0000 http://www.bioethics.net/?post_type=news&p=57260 http://www.bioethics.net/news/can-this-procedure-reverse-an-abortion-2/feed/ 0 Can This Procedure Reverse an Abortion? http://www.bioethics.net/news/can-this-procedure-reverse-an-abortion/ http://www.bioethics.net/news/can-this-procedure-reverse-an-abortion/#comments Mon, 09 Nov 2015 21:45:54 +0000 http://www.bioethics.net/?post_type=news&p=57162 http://www.bioethics.net/news/can-this-procedure-reverse-an-abortion/feed/ 0 Sleepwalking Into Infertility: The Need for a Public Health Approach Toward Advanced Maternal Age http://www.bioethics.net/articles/sleepwalking-into-infertility-the-need-for-a-public-health-approach-toward-advanced-maternal-age/ http://www.bioethics.net/articles/sleepwalking-into-infertility-the-need-for-a-public-health-approach-toward-advanced-maternal-age/#comments Sun, 01 Nov 2015 22:48:18 +0000 http://www.bioethics.net/?post_type=articles&p=57257 http://www.bioethics.net/articles/sleepwalking-into-infertility-the-need-for-a-public-health-approach-toward-advanced-maternal-age/feed/ 0 Planned Parenthood revises reimbursement policy after video uproar http://www.bioethics.net/news/planned-parenthood-revises-reimbursement-policy-after-video-uproar/ http://www.bioethics.net/news/planned-parenthood-revises-reimbursement-policy-after-video-uproar/#comments Tue, 13 Oct 2015 21:54:38 +0000 http://www.bioethics.net/?post_type=news&p=56839 http://www.bioethics.net/news/planned-parenthood-revises-reimbursement-policy-after-video-uproar/feed/ 0 Elective or Life-Saving? Catholic Hospitals and the Ban on Tubal Ligation http://www.amc.edu/BioethicsBlog/post.cfm/elective-or-life-saving-catholic-hospitals-and-the-ban-on-tubal-ligation http://www.amc.edu/BioethicsBlog/post.cfm/elective-or-life-saving-catholic-hospitals-and-the-ban-on-tubal-ligation#comments Tue, 06 Oct 2015 01:10:53 +0000 http://www.bioethics.net/?guid=1d457f11b93c319b3cb124a8a4281dcc http://www.bioethics.net/2015/10/elective-or-life-saving-catholic-hospitals-and-the-ban-on-tubal-ligation/feed/ 0 Is it Ethical for Parents to Create a Savior Sibling? http://www.amc.edu/BioethicsBlog/post.cfm/is-it-ethical-for-parents-to-create-a-savior-sibling http://www.amc.edu/BioethicsBlog/post.cfm/is-it-ethical-for-parents-to-create-a-savior-sibling#comments Thu, 01 Oct 2015 10:10:53 +0000 http://www.bioethics.net/?guid=38fa6a6c5dae77b356282b64f7563c02 http://www.bioethics.net/2015/10/is-it-ethical-for-parents-to-create-a-savior-sibling/feed/ 0 Pregnant cancer patients shouldn’t terminate or delay treatment: study http://www.bioethics.net/news/pregnant-cancer-patients-shouldnt-terminate-or-delay-treatment-study/ http://www.bioethics.net/news/pregnant-cancer-patients-shouldnt-terminate-or-delay-treatment-study/#comments Tue, 29 Sep 2015 20:41:48 +0000 http://www.bioethics.net/?post_type=news&p=56673 http://www.bioethics.net/news/pregnant-cancer-patients-shouldnt-terminate-or-delay-treatment-study/feed/ 0 Researchers Apply For Permission To Alter DNA Of Human Embryos http://www.bioethics.net/news/researchers-apply-for-permission-to-alter-dna-of-human-embryos/ http://www.bioethics.net/news/researchers-apply-for-permission-to-alter-dna-of-human-embryos/#comments Fri, 18 Sep 2015 21:27:08 +0000 http://www.bioethics.net/?post_type=news&p=56528 http://www.bioethics.net/news/researchers-apply-for-permission-to-alter-dna-of-human-embryos/feed/ 0 Is Sex Selection Ethical? http://www.amc.edu/BioethicsBlog/post.cfm/is-sex-selection-ethical http://www.amc.edu/BioethicsBlog/post.cfm/is-sex-selection-ethical#comments Mon, 14 Sep 2015 04:09:02 +0000 http://www.bioethics.net/?guid=aff6152b57e570c00642b773f1fbac13 http://www.bioethics.net/2015/09/is-sex-selection-ethical/feed/ 0 Coerced sterilization of Canadian indigenous women in 70s widespread: researcher http://www.bioethics.net/news/coerced-sterilization-of-canadian-indigenous-women-in-70s-widespread-researcher/ http://www.bioethics.net/news/coerced-sterilization-of-canadian-indigenous-women-in-70s-widespread-researcher/#comments Tue, 01 Sep 2015 19:47:54 +0000 http://www.bioethics.net/?post_type=news&p=56332 http://www.bioethics.net/news/coerced-sterilization-of-canadian-indigenous-women-in-70s-widespread-researcher/feed/ 0 Legal case tests religious hospitals’ right to deny procedures http://www.bioethics.net/news/legal-case-tests-religious-hospitals-right-to-deny-procedures/ http://www.bioethics.net/news/legal-case-tests-religious-hospitals-right-to-deny-procedures/#comments Mon, 24 Aug 2015 17:33:58 +0000 http://www.bioethics.net/?post_type=news&p=56218 http://www.bioethics.net/news/legal-case-tests-religious-hospitals-right-to-deny-procedures/feed/ 0 In graphic detail, medical journal describes ‘heavy overtones’ of sexual assault in operating room http://www.bioethics.net/news/in-graphic-detail-medical-journal-describes-heavy-overtones-of-sexual-assault-in-operating-room/ http://www.bioethics.net/news/in-graphic-detail-medical-journal-describes-heavy-overtones-of-sexual-assault-in-operating-room/#comments Tue, 18 Aug 2015 18:02:29 +0000 http://www.bioethics.net/?post_type=news&p=56135 http://www.bioethics.net/news/in-graphic-detail-medical-journal-describes-heavy-overtones-of-sexual-assault-in-operating-room/feed/ 0 Investigating Two Claims Against Planned Parenthood: Center of Medical Progress’s Secret Videos http://www.bioethics.net/2015/07/investigating-two-claims-against-planned-parenthood-center-of-medical-progresss-secret-videos/ http://www.bioethics.net/2015/07/investigating-two-claims-against-planned-parenthood-center-of-medical-progresss-secret-videos/#comments Mon, 27 Jul 2015 22:00:39 +0000 http://www.bioethics.net/?p=55867 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. After many years, she went on to direct their clinic’s in vitro fertilization program. I also heard the word “Planned Parenthood” stated with a quick northeastern accent. Said that way, as a child, I thought the place was called “Plant Parenthood” and wondered what plants had to do with women’s health.…

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Not all new mothers in U.S. get advice on breastfeeding, infant care: survey http://www.bioethics.net/news/not-all-new-mothers-in-u-s-get-advice-on-breastfeeding-infant-care-survey/ http://www.bioethics.net/news/not-all-new-mothers-in-u-s-get-advice-on-breastfeeding-infant-care-survey/#comments Mon, 27 Jul 2015 20:41:51 +0000 http://www.bioethics.net/?post_type=news&p=55953 http://www.bioethics.net/news/not-all-new-mothers-in-u-s-get-advice-on-breastfeeding-infant-care-survey/feed/ 0 India set to become world’s most populous country by 2022 – U.N. http://www.bioethics.net/news/india-set-to-become-worlds-most-populous-country-by-2022-u-n/ http://www.bioethics.net/news/india-set-to-become-worlds-most-populous-country-by-2022-u-n/#comments Mon, 27 Jul 2015 20:34:20 +0000 http://www.bioethics.net/?post_type=news&p=55951 http://www.bioethics.net/news/india-set-to-become-worlds-most-populous-country-by-2022-u-n/feed/ 0 Planned Parenthood and fetal tissue donation http://www.amc.edu/BioethicsBlog/post.cfm/planned-parenthood-and-fetal-tissue-donation http://www.amc.edu/BioethicsBlog/post.cfm/planned-parenthood-and-fetal-tissue-donation#comments Thu, 23 Jul 2015 07:07:30 +0000 http://www.bioethics.net/?guid=b3c24ba840af0181dd70c61ba4ac42df http://www.bioethics.net/2015/07/planned-parenthood-and-fetal-tissue-donation/feed/ 0 Video of Planned Parenthood executive discussing tissue, organ prices sparks abortion firestorm http://www.bioethics.net/news/video-of-planned-parenthood-executive-discussing-tissue-organ-prices-sparks-abortion-firestorm/ http://www.bioethics.net/news/video-of-planned-parenthood-executive-discussing-tissue-organ-prices-sparks-abortion-firestorm/#comments Fri, 17 Jul 2015 23:53:07 +0000 http://www.bioethics.net/?post_type=news&p=55807 http://www.bioethics.net/news/video-of-planned-parenthood-executive-discussing-tissue-organ-prices-sparks-abortion-firestorm/feed/ 0 Planned Parenthood, Tissue Donation, and American Politics: A Call to Separate the Debate in the Media http://www.bioethics.net/2015/07/planned-parenthood-tissue-donation-and-american-politics-a-call-to-separate-the-debate-in-the-media/ http://www.bioethics.net/2015/07/planned-parenthood-tissue-donation-and-american-politics-a-call-to-separate-the-debate-in-the-media/#comments Thu, 16 Jul 2015 18:52:25 +0000 http://www.bioethics.net/?p=55745 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. Most recently, a video surfaced alleging to show the Senior Director of Medical Services for Planned Parenthood engaging in what appears to be the buying and selling of tissue from fetuses to a start-up biotech firm. Let’s be clear: This is not the first attack on Planned Parenthood, nor will it be the last.…

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Battle over S.F. couple’s frozen embryos heads to court http://www.bioethics.net/news/battle-over-s-f-couples-frozen-embryos-heads-to-court/ http://www.bioethics.net/news/battle-over-s-f-couples-frozen-embryos-heads-to-court/#comments Mon, 13 Jul 2015 21:20:40 +0000 http://www.bioethics.net/?post_type=news&p=55747 http://www.bioethics.net/news/battle-over-s-f-couples-frozen-embryos-heads-to-court/feed/ 0