Group 6

Ethics at the Beginning of Life, Part 2

Reproductive technology is a field of medical procedures designed to alleviate infertility, such as

intrauterine insemination, in vitro fertilization, and surrogate motherhood. These technologies enable
infertile couples to have a child to whom at least one of the parents is genetically related, but they can
raise moral and legal questions.

Overview of Technologies

Primary reproductive technologies are available to infertile couples, with detailed information on
success rates and costs.

1. Intrauterine insemination (IUI) is a relatively simple procedure in which sperm from the
woman’s husband is inserted into the woman’s uterus artificially rather than through sexual
intercourse.
2. donor insemination (DI) Here the insemination is performed using a donor’s sperm when the
man’s sperm is incapable of facilitating conception.
3. egg donation This is analogous to sperm donation but is more technologically difficult and
expensive. The donor woman is given hormonal stimulation so that she can donate multiple
eggs.
4. in vitro fertilization (C-IVF) the woman receives strong fertility medication in order to stimulate
and release as many eggs as possible in a single cycle. The husband’s sperm are obtained
through masturbation and placed in a petri dish with the eggs in the infertility clinic’s lab in the
hope that most, if not all, of the eggs will be successfully fertilized.
5. Surrogate motherhood arrangements, though not particularly new, are both technologically
and legally sophisticated reproductive technologies. What is most different about surrogacy
agreements is the presence of brokers, contracts, and lawyers in the process of procreation.

Genetic or traditional surrogacy occurs when the surrogate is inseminated with the sperm of
the husband of the couple who contracts her. She conceives, carries, and gives birth to the child
and turns over her rights to the child to the contracting couple.
6. Gestational surrogacy occurs when the surrogate has no such genetic relationship to the child.
She provides the womb but not the egg. The infertile couple has eggs removed, sperm obtained,
and IVF performed (though donor sperm and eggs could also be used if necessary).
7. commercial surrogacy is a type of surrogacy can be done for a substantial fee, which is the
normal practice.
altruistic surrogacy is an arrangement without a fee.
8. Intracytoplasmic sperm injection (ICSI) is a more expensive and more reliable way to achieve
pregnancy. The procedure essentially involves injecting a single sperm into an egg, using highly
specialized instruments.
Biblical/Theological Parameters for Reproductive Technologies

The Roman Catholic Church prohibits virtually all technological assistance, while others have more
moderate restrictions such as limiting the use of technologies to those that use the genetic materials of
husband and wife. Technological options can be used to stop on a train route or on the technological
train, with some refusing to do so.

The use of technology in creating families has changed the language used to describe children and
childbearing, from procreation to reproduction. This shift is a more product-oriented view of children
and families, with traits and gender specifications of the parents met by using various technologies.

First fence is that the Roman Catholic Church emphasizes the continuity between normal sexual
relations in marriage, procreation, and parenthood, believing that every sexual encounter has the
potential for conception and childbirth.

Second fence is that procreation should occur in a stable, heterosexual, permanent, monogamous
marriage, with continuity between procreation and parenthood.

Third fence the moral status of the unborn must be protected in any infertility procedure, which raises
moral issues about grading embryos for IVF and freezing embryos for future use.

Lastly adoption is a legitimate rescue operation, fulfilling the biblical virtue of compassion for the most
vulnerable, and any view of procreation that downplays it would fall outside the biblical parameters.

Moral Questions about IUI and IVF

Intrauterine insemination (IUI) using the husband's sperm is a controversial topic in Catholic teaching,
but it is increasingly being done in conjunction with multiple-ovulation drugs used with IVF, which
increases the risk of pregnant women becoming pregnant with major multiples. IUI can control the
number of embryos in the womb, but not with powerful fertility drugs, so couples who put themselves
in this situation risk very difficult decisions and should be performed to avoid such a scenario.

In vitro fertilization is a procedure that uses harvested eggs to fertilize embryos in the lab. Usually,
between one and three embryos are implanted in the woman's uterus. If more than one embryo
successfully implants, the couple may end up with more children than they originally intended. It is
possible to view embryo donation as an analogous to adoption. The most important details in this text
are that all embryos created in the lab deserve an opportunity to be implanted, and that the grading and
selection of embryos in IVF raises ethical issues.

Freezing embryos also raises ethical issues, as there is attrition in the number of embryos that are
successfully thawed. This suggests that methods of IVF that minimize embryos in storage, such as
natural IVF, minimal stimulation IVF, or egg freezing, are ethically preferable.

Some critics of IVF argue that freezing embryos is intrinsically morally problematic.

Further ethical issues arise when it comes to decisions to implant what are called “mosaic” embryos. In
IVF, a clinic usually makes available preimplantation genetic screening (PGS, sometimes referred to as
PGD, preimplantation genetic diagnosis). PGS involves something like an embryo biopsy, where cells are
removed from a three to five-day embryo and analyzed for abnormalities.

Additional ethical issues are raised by the ability to create “three-parent” embryos.

Moral Questions About Surrogate Motherhood

Surrogate motherhood is a controversial issue in the reproductive technologies, where the surrogate
bears the child for the contracting couple and willingly gives up the child she has borne to them. In some
cases, the couple views the surrogate with gratitude, as the surrogate has given a "gift of life" to a
previously infertile couple. The legal context of surrogacy in the 1980s was the legal context in which
reproduction occurred, with lawyers, detailed contracts, and legal representation for the yet-to-be-born
child being the new elements. The Old Testament records two incidents of surrogating, and it appears
that use of a surrogate to circumvent female infertility was an accepted practice in the ancient Near
East. However, in biblical times, surrogacy was not paid and it is doubtful that it was even consensual,
with the most service providers likely having little choice in the matter.

Defining Motherhood

Genetic surrogates are recognized legally as the mother of the children they bear, while gestational
surrogates are considered a "human incubator" or "prenatal babysitter" with no legal rights to the child
they are carrying. This legal difference makes genetic surrogacy rare and gestational surrogacy the norm.

Is Surrogacy Baby Selling?

Commercial surrogacy is a serious objection to adoption proceedings as it involves the purchase and sale
of children and reduces them to barter. The validity of the charge depends on the assignment of
motherhood and maternal rights to the child. In genetic surrogacy, the surrogate partners both
contribute the egg and give birth to one child. If the mother is the n mother, then any fee paid to her in
exchange for her child would constitute baby-selling, while in gestational surrogacy if the surrogate is
the father, then the charge of baby-selling would apply. However, if the contract is not between the
mother and the child, then she would only be providing "gestational services" to the contracting couple,
analogous to the way lawyers in adoption proceedings are paid for legal services rendered.

The charge of baby selling matters because it would violate the Thirteenth Amendment to the
Constitution, which outlawed slavery, and would further violate moral principles that safeguard human
rights and the dignity of human persons. If it is legitimate to pay surrogate child bearers for their time,
effort, and risk in pregnancy and delivery, her fee should be prorated over the number of months that
she performed a gestational service. The New Jersey Supreme Court has stated that some things that
money cannot buy, such as labor, love or life, are more important than granting wealth. Therefore,
other questions remain still needing to be resolved.
Are Surrogates Being Exploited?

Surrogacy can be exploited by desperate infertile couples, low-income surrogates, and surrogacy
brokers motivated by profit. The fee paid to surrogates is a market exchange of services for
compensation, and if the surrogates are in financial need, the fee provides them with resources they
wouldn't otherwise have.

Turning a Vice into a Virtue?

Surrogacy is controversial due to its ability to turn a vice, the ability to detach from the child in utero,
into a virtue. Proponents argue that surrogates can effectively and in some cases easily detach from the
children they are carrying without harming the child, and there is no evidence that children are harmed
by having their gestation in the womb of a stranger.

The Role of the Contract?

The standard surrogacy contract requires the surrogate to relinquish any parental rights to the child she
is carrying to the couple that contracted her services. However, the degree of informed consent varies
widely and some contracts are inherently null and void. Even if the surrogate has maternal rights, rights
must be shared with the genetic father, similar to a custody arrangement in a divorce proceeding. The
problem with allowing the surrogate to keep the child is that it increases the risk to the contracting
couple, as they may end up with shared custody of a child that they initially thought was to be all theirs.

Toward the Future of Reproductive Technologies

Artificial wombs and artificial sperm from women's eggs may become more popular in the future.
Artificial wombs could have a major impact on the abortion debate, but may not be in the best interests
of the child. Artificial sperm from women's eggs could also create an identical twin of the mother and be
seen as a form of human cloning. Technology is improving the prospects of posthumous procreation,
such as having children after one's death. Scientists are using artificial sperm and other cells to form
embryos, and IVF and preimplantation genetic testing are being used to make both sperm and eggs from
stem cells. Sperm can also be harvested after brain death and used in conjunction with IUI to
impregnate a woman.

Conclusion

People's desire to have genetically related children presents ethical dilemmas, leading to a brisk
business for reproductive medicine practitioners.