The following paper aims at discussing the major ethical issues faced by the fertility industry. Even though it helps childless couples, it posses many ethical questions which need to be addressed urgently. Assisted Reproductive Technology is gaining momentum, giving a chance to overcome infertility issues. Due to lack of governmental guidelines there are many serious ethical issues that remain unsolved. The paper is an attempt to classify these problems.
Assisted Reproduction
Introduction
The various procedures and methods used to induce pregnancy using artificial or partially artificial means is known as Assisted Reproductive Technology (ART). This technology is mainly used for infertility treatments. Many fertile couples also seek out ART for genetic reasons or due to communicable diseases such as AIDS are discordant. The various techniques included in ART are; in-vitro fertilization (IVF), intrauterine insemination (IUI), gamete intrafallopian tube transfer (GIFT), intracytoplasmic sperm injection (ICSI) etc.
Ethical issues surrounding surrogacy
Even though the reproductive technologies present many benefits, it is also a cause of many ethical as well as legal issues. The major difference of surrogacy is not the technology but the apparent nature of this procedure whereby one woman carries the child of another woman. The arrangement requires the surrogate mother to sign a contract with the couple in which many clauses are stated. Upon signing the stated contract, the surrogate agrees to be artificially inseminated with the sperm of the husband, to bear the child until its full term, give birth to the child and to handover the child to the couple. Although the contracts are different in nature, depending upon the couple and the surrogate, one of the main aspects of the contract states that the surrogate must give up all the custodial rights as well as parental rights of the unborn child.
The relationship between a child and mother is considered as one of the purest form of love. According to research¹, these bonds are developed right in the foetal stage. Oxytocin, a hormone, is believed to be responsible for the maternal instincts. This hormone is released during interaction between the mother and the newborn by activities such as skin-to-skin contact, breast feeding and eye contact. This release of hormone is responsible for many physiological processes that benefit the baby as well as the mother to develop and recover.
Apart from biological benefits, research indicates that important cognitive attachments are formed with the gestational mother due to interactions, right after the birth². Therefore a child does not live in ambivalence as thought, but instead are attuned with their surroundings.
Therefore rupturing this mother-child bond can have severe effects on the well being of the child, as well as emotional stress on the surrogate mother.
Selective abortion
Choosing to abort a fetus, especially during a multi-fetal pregnancy is termed as selective abortion or reduction. In order to achieve high success rate, often multiple embryos are transferred into the uterine cavity of the woman, thus increasing the chances of pregnancy. But often parents opt to abort the remaining embryos and carry forward with only one pregnancy. Ethical issues have been raised on this practice as it is termed as killing of a human life, according to the convenience of the parents. It is also unethical on the part of the doctors to transfer multiple embryos, merely to increase their fertility success rate.
In case the parents do not opt for selective abortion, it results in multiple pregnancies. But this has subsequent effects on the health of the mother as well as the fetuses evolving within the womb. It increases the chances of birth defects, miscarriages, premature births and physical or mental disabilities. The mother may face complications such as premature delivery, pregnancy induced high blood pressure, vaginal or uterine hemorrhage³ etc. Therefore this practice raises many ethical issues.
Premature births
Even though medical advances have been made in recent years, the medical world yet faces many ethical paradigms concerning premature and still births. Often healthcare professionals and neonatal care specialists while performing resuscitation to stabilize the health of the child are faced with many ethical questions which do not have a direct answer. It is observed that the health of a premature does not merely lie in the hands of the medical professionals but is also in the hands of the parents. It is their responsibility to identify their problems and make ethical decisions. When an extremely premature baby is born, it is not merely in the hands of the parents to make decisions, but along with the neonatal specialist conclusions are drawn. Conclusions are made only through discussion between the doctor and the parents. It is ultimately the parents who are the sole decision makers in case of premature babies.
An extremely premature baby faces many challenges such as continuous intervention, needle pricks, tubes passing through throat and many times brain surgery. Exposing little babies seems to be much more painful not merely for the child but also for its parents. Constant suffering and pain suffered by the child seems unethical and hence many parents as well as health professionals choose to let the baby die than face than face the agony, maybe for many years to come. Consequently the decision rests on the parents. Therefore even though it is an ethical question, addressing it and coming up with a possible answer lies in the hands of the parents and doctors involved.
Conclusion
Every medical aspect has its pros and cons, identifying them and addressing them is the need for the hour. In order to achieve higher pregnancy rate, doctors may use unethical resource, similarly to insure safe and enhanced pregnancy, parents might resort to unethical attempts, but these issues need to be addressed by the federal government and the government must come up with guidelines.
The fertility industry has proved to be extremely beneficial for those parents suffering from the solitude of living without kids. But like every beneficial procedures, it involves many determinant aspects. Addressing them and solving ethical issues seem difficult due to many political as well as practical barriers. Infertility is a serious problem affecting many people which has led to the emergence of many scientific techniques and procedures, but these technological advances are seen colliding with values and addressing them in a transparent and responsive manner is the need of the hour.
References:
1. A. Meinke S.(2009). Surrogate Motherhood: Ethical and Legal Issues. 9 April 2009. Retrieved from web. http://bioethics.georgetown.edu/publications/scopenotes/sn6.pdf
2. The National Academies Press (2007). Introduction. 17 March 2009. Retrieved from web. http://www.nap.edu/openbook.php?record_id=11622&page=31
3. Tieu M. (2007). The problem of surrogacy. 11 March 2007. Retrieved from web. http://www.bioethics.org.au/
