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The Moral Status of the Early Embryo

Bioethical assessment of attitudes to pregnancy . Fundamentals of Biotic assessment of the moral status of fetus and early life . Surrogacy. The Moral Status of the Early Embryo.

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The Moral Status of the Early Embryo

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  1. Bioethicalassessmentofattitudestopregnancy. Fundamentals ofBioticassessmentofthemoralstatusoffetusandearlylife. Surrogacy.

  2. The Moral Status of the Early Embryo • The zygote or fertilized egg not only contains the plan or blueprint for a new human being, but it has the potential within itself to develop into that human being. Based on these facts, many would argue that the zygote is a full human being from the moment it comes into existence. This view would preclude any research that might be harmful or destructive to an embryo, unless intended to be therapeutic for that embryo or to improve its chances for implantation.

  3. Fertilization of egg • It is possible to hold this position while acknowledging that fertilization is a process rather than an instantaneous event, and hence that the new human life begins only when the process of fertilization is completed. At least two possible candidates marking the completion of fertilization have been suggested. • The first is the time of syngamy, when the chromosomes from the male and female gametes unite to form the genotype of the embryo. Since syngamy is not completed until about twenty-four hours after the sperm penetrates the egg, this view would allow some study of the early development of the embryo.

  4. Six- to eight-cell stage • The embryo does not begin its life as a new human being until the regulation of its development switches from oocyte genes to embryonic genes. In 1988 Peter Braude and colleagues showed that this occurs at the six- to eight-cell stage, approximately two days after penetration of egg by sperm. • Arguably the embryo begins its own life distinct from that of the oocyte at the time that its own internal regulatory mechanism begins to function. This interpretation would allow investigation of questions such as why a large proportion of embryos are arrested in their development during the earliest cell divisions

  5. Moral status • The human body occupies a unique and somewhat ambiguous moral status. Although material, and therefore a source of temptation, the body is nevertheless sacrosanct because it is indispensable to human life. • God is thought to have a divine plan for humanity, and any attempt to subvert this plan by tinkering with the human body is regarded as at least prima facie wrong.

  6. Surrogate motherhood • Among the many applications of the new reproductive technologies (including artificial insemination by donor—AID, in vitro fertilization—IVF, embryo transfer, and embryofreezing) surrogate motherhood has such far-reaching consequences that it raises a multitude of ethical and legal questions. • There are several reasons why a couple might choose to have a child through a surrogate. Infertility is a common reason. With approximately 15 to 20 per cent of all couples infertile and a decrease in adoptable babies, many argue that surrogate motherhood provides a unique opportunity for certain couples to have a child biologically related to the husband. Other reasons range from the desire to avoid passing on a genetic defect to convenience.

  7. Motivation • What is the motivation for choosing to enter a surrogate arrangement? There are several reasons why a couple might choose to have a child through a surrogate. Infertility is a common reason. With approximately 15 to 20 per cent of all couples infertile and a decrease in adoptable babies, many argue that surrogate motherhood provides a unique opportunity for certain couples to have a child biologically related to the husband. • Other reasons range from the desire to avoid passing on a genetic defect to convenience. Many ethical analyses draw a sharp distinction between these motivations.

  8. The degree of stress • What is the degree of stress on the couple and especially on the surrogate mother? Can true informed consent ever be given by the surrogate, and can anyone predict the emotions associated with relinquishing a child? What are the possible adverse psychological effects on the child? What identity crisis might ensue, and will there be a desire on the part of the child to know his/her gestational mother? • Will surrogate arrangements be used not only by infertile couples but also for the sake of convenience, or by single men or women? Should the surrogate be paid? Would this lead to commercialization of surrogacy and expose the surrogate mother to possible exploitation?

  9. Ethical considerations of the new reproductive technologies • The American Fertility Society issued a report, Ethical Considerations of the New Reproductive Technologies, setting forth the then-held ethical position of the Society on the various new reproductive technologies. In 1987, the Congregation for the Doctrine of the Faith issued the Instruction on the Respect for Human Life and Its Origin and on the Dignity of Procreation. • While both documents state that very similar moral criteria were used to derive ethical positions with respect to various reproductive procedures, the conclusions as to the ethical acceptability of the various procedures differ sharply in the two documents.

  10. Catholic statements • While the difference in conclusion from similar premises may be troubling to society, it can be especially paralyzing to four groups: • (1) those who face problems that might be solved by one or another of the new reproductive technologies; • (2) those who are involved in applying them; • (3) those who are responsible for institutional policies where such techniques may be applied; and • (4) those who are in a position to influence public policy in a legislative or regulatory way. Because of the conflicting conclusions of the two documents, the present Ethics Committee (1986-87) of The American Fertility Society was convened and considered these guidelines in the light of the Instruction.

  11. Assisted reproductive technologies in Ukraine • Ukraine is one of a few countries in the world where appliance of majority of assisted reproductive technologies, especially surrogacy, is absolutely legal. In this sphere Ukrainian legislators have proven to be more progressive than the main part of their European colleagues.

  12. TheFamilycodeofUkraine • Item 1. Ifthewifeisfertilizedbyartificialprocreationtechniquesuponwrittenconsentofherhusband, thelatterisregisteredasthefatherofthechildbornbyhiswife. • Item 2. Ifanovumconceivedbythespouses (manandwoman) isimplantedtoanotherwoman, thespousesshallbetheparentsofthechild. • Item 3. Wheneveranovumconceivedbythehusbandwithanotherwomanisimplantedtohiswife, thechildisconsideredtobeaffiliatedtothespouses.

  13. BasisoflegislationofUkraineabouthealthcare • Artificial fertilization and embryo implantation are performed according to conditions and order, prescribed by the Ministry of Health Care of Ukraine, for medical grounds of women of age, which undergoes this procedure upon written consent of spouses, anonymity of donor and medical secrecy.

  14. RulesofcivilregistrationinUkraine • OrderofchildregistrationisregulatedbytheDecreeoftheMinistryofJusticeofUkraineNo. 140/5fromNovember 18, 2003 “AboutamendmentsandadditionstoRulesofcivilregistrationinUkraine: • Item 2.2. Incaseofchildbirthbythewomanwhowasimplantedbyfetus, conceivedbythespouses, thechildisregistereduponthedeclarationofspouses, whogavetheirconsentforimplantation. Inthiscasetogetherwiththedocument, confirmingthefactofchildbirth, thewomanhastoprovidenotarizedwrittenconsentforregistrationspouseaslegalparentsofthechild. Thereby, thereis a certainnoteincolumn “Fornotes”: “Thecitizen (surname, name, patronymic) isthemotherofthechildaccordingtomedicalbirthcertificateof 103/о-95(z0266-95) form.”

  15. CivilCodeofUkraine • Civil Code of Ukraine (as amended from January 21, 2010 No. 1822-VI) regulates who has the right to participate in assisted reproductive programme: • Article 281. Women or men of full age are entitled to have been cured with assisted reproductive technologies in accordance with their medical indications in order, prescribed by the law.

  16. ApprovalofordermanualofapplianceofassistedreproductivetechnologiesApprovalofordermanualofapplianceofassistedreproductivetechnologies • Subparagraph 3 of item1. Certified medical institutions are entitled to perform artificial fertilization. • Subparagraph.4 of item 1. Patients are entitled to freely choose a medical institution for ART treatment. • Subparagraph 6 of item 1. ART are applied according to medical indications upon written free consent of patients and Statement of a patient/patients of ART appliance.

  17. ApprovalofordermanualofapplianceofassistedreproductivetechnologiesApprovalofordermanualofapplianceofassistedreproductivetechnologies • Subraragraph 7 ofitem. 1. Womanand/ormanoffullageupontheirmedicalindicationsareentitledtoapplyto ART treatmentaccordingtoarticle 281 ofCivilCodeofUkraine. • Subparagraph 5.1. Donationofgametesis a procedure, duringwhich, accordingtowrittenvoluntaryconsent, donorsgranttheirgerminalcells – gametes (sperm, oocytes), orembryosforuseininfertilitytreatmentbyotherpersons. • Subparagraph5.2. Donorsofgametescannotundertakeparentalrightstowards a futurechild.

  18. Oocytedonors • Subparagraph 5.5. Oocyte donors can be: • female acquaintances and relatives; • anonymous voluntary donors; • patients of ART programmes, who according to written voluntary consent give part of their oocytes to recipient.

  19. Requirementsforoocytedonors • Subparagraph 5.6. Requirementsforoocytedonors: • woman in age from 20 to 32; • presence of a born healthy child; • absence of negative phenotypic manifestations; • satisfactorysomatichealth; • absence of medical contra-indications for oocyte donation; • absenceofhereditarydiseases; • absence of harmful habits: drug addiction, alcoholism, toxic substances abuse.

  20. Listofnecessarydocumentsforoocytedonation • Subparagraph 5.10. Listofnecessarydocumentsforoocytedonation: • agreement with the oocyte donor, voluntary written informed consent for participation in donation, controlled stimulation of ovulation and oocyte retrieval; • statement of a written consent of husband. • Subparagraph 7.4. A healthywomanoffullage, whogavebirthto a healthychilduponherwrittenfreeconsentandabsenceofmedical contra-indications, isentitledtoperformsurrogacy.

  21. Achildbornby a Surrogateareforeigncitizens • Subparagraph 7.10. Ifparentsof a childbornby a Surrogateareforeigncitizenstheyshallinformtheaddressoftheirresidencebeforeprocessingofdocumentsanddeparturefromcountryforpatronageby specialists-pediatrics andforsupervision. • Subparagraph 7.11. Registrationof a childbornthrough ART bymeansofsurrogacyisconductedaccordingtotheordersetbythecurrentlegislationofUkraineatthepresenceof a certificateofgeneticrelationshipofparents (motherorfather) with a child.

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