The Cultural Ethics and Artificial Insemination
In the early years, PGD was mainly used to enable parents to avoid having children with serious early-onset inherited disorders such as Tay-Sachs disease. Merely the individuals who hold that all human embryos have the moral status of a person will find it unacceptable. The mothers can take steps not to implant an embryo with the genetic basis for Tay-Sachs disease. Others will judge that it is morally unacceptable that mothers should be denied the opportunity to avoid having a child with Tay-Sachs disease. So with respect to these cases, the positions taken largely follow those already investigated. PGD has recently been extended to conditions such as bowel cancer and breast cancer.
This extension is not problematic.
Human welfare generally, as well as that of future children, is enhanced by relieving families of the anxiety. They might pass on a predisposition to these aggressive hereditary cancers. But as we look forward to further developments of this kind. Do we need to ask what are the limits to the use of PGD ?
One limit is set by genetics: once we are dealing with ailments the basis of which lies not in a single gene. In some complex multiple-gene interaction. The chances of finding an embryo with all the desired genes are much diminished. But further limits can be set by us. One issue arises from the fact that some genes dedicating had given rise to serious ailments are recessive.
Where this is the case, the individuals who’ carry’. A copy of the affected gene do not themselves suffer from the ailment in question but are liable to have children who do.
The question that arises is whether it is acceptable to use PGD to exclude not only embryos that are liable to a serious ailment. Also, those embryos that are carriers for the condition. Some argue that the disposal of embryos just because they are carriers places too low a value on the potential human life embodied in an embryo. However, once one appreciates that it is generally couples who are already utilizing PGD to avoid having a child with a serious ailment. Also, wish to avoid having children who are carriers of the ailment. It is difficult to see any good reason for not permitting them to rank the embryos that are to be implanted. Those which are not carriers at all as their preferred embryos .
So far I have discussed cases in which PGD is used to enable parents to avoid having a child with a serious genetic disorder.
This use is principally negative. What about positive uses, in which PGD is used to select a child of a specific kind? One kind of suit is the’ savior sibling’ type, where an embryo is selected as a human leukocyte antigen( HLA) match for a sibling. With a serious ailment that is best treated by a hematopoietic stem cell transfusion. This treatment requires an HLA-compatible source for the stem cells. Which are provided in the cord-blood available through the birth of the’ savior sibling. As the selection of the implanted embryo is guided by the medical needs of the affected child. It gives rise to the objection that the resulting child’s existence. It is being valued principally as a means to improve the welfare of its sibling, and not for its own sake.
The reply to this is that once one appreciates the situation of a family with an affected child. There is every reason to expect the’ savior sibling’ to be loved and valued for its own sake. Especially where its birth makes possible a treatment for its sibling. So although this use of PGD requires oversight, it is in principle acceptable .
We encounter positive eugenics proper where embryos are selected on the basis of genetic predilections that are wanted for their own sake.
Manifestly, this is a large topic, and I shall not try to address it fully here. It is, in fact, doubtful whether PGD is likely to be of much use for this purpose. The evidence suggests that insofar as significant abilities such as IQ have a genetic basis at all. They involve complex multiple gene-environment interactions. Still, one cannot rule out a priori some significant possibilities for the identification and selection of’ better embryos. Which turn out to be amenable to selection by PGD.
Most of us, I am sure, can think of valuable abilities that others seem to have been granted in the genetic lottery but that we ourselves lack. It strikes me that my life, for example, would have been better had I been more musical than I am.
So the question arises whether, if it were possible to select for this ability by PGD without losing other valuable abilities as a result, it would be acceptable to undertake this practice ?
In thinking about this, it is important not to imagine that the use of PGD here would have enabled one’s mothers. So to speak, to add musical ability to the genetic predispositions of the child they were going to have anyway( oneself ). Instead, they would be choosing which embryo to implant on the basis of the potential musical ability of the resulting child. Thereby choosing not to have different children with all sorts of other unknown abilities. Hence the use of PGD for positive selection of this kind is surrounded by uncertainty concerning the alternatives not selected. As a result, there could be no certainty that the embryo choice was potential’ the best-of that judgment makes any sense at all. For that reason, most people prefer to leave the determination of their children’s genome to chance. To the genetic lottery, apart from utilizing PGD to avoid serious ailments .
There is nothing intrinsically wrong, let alone’ gravely immoral ‘, with donor conception
But this preference does not settle whether all uses of PGD for positive selection would be wrong. One region of anxiety concerns the potentially divisive social implications of a situation in which wealthy person. The attempt to use positive eugenic selection to create a’ master race ‘. My own position is that this anxiety is not well founded, as there is no realistic prospect of genetic selection for significant abilities such as IQ.
But there remains a fundamental ethical question here, namely whether it is harmful to small children that the embryo. Which became that child, was selected because it had a certain genetic predilection. Where the disposition selected is one that affects important aspects of the child’s life, in a way that the child cannot later just choose to neglect. It is argued that the child’s capacity to take control of his or her character is harmed by the way in which an important element of this character has been intentionally selected by the child’s mothers .
A hypothetical case where this consideration applies. I think, would be one in which PGD was used to select for sexuality. Deliberate determination of sexuality is quite the wrong kind of parental interference in the life of small children. A more contested suit is that of sexual selection itself. Here the reasons in favor of the practice. A typically involving family balancing, are easily understandable. The question is whether a child’s capacity to construct a life of their own is threatened. By coming to know that their sexuality was determined by a parental decision rather than by the genetic lottery.
The issues here are subtle and speculative, and the ethical debate on them remains open .
A different group of ethical issues concerns the use of IVF in the context of donor conception. Although donor conception with sperm does not depend on IVF. The greater success of IVF as compared with donor insemination has meant that donor conception often makes use of IVF. And of course, conception with donor eggs is only possible thanks to IVF. So any study of the ethical implications of IVF needs to include reference to the ethical issues in donor conception.
Here, as with IVF, we start by briefly considering the forthright disapproval of this practice in segment 2376 of the Catholic Catechism. Techniques that necessitate the dissociation of husband and wife, by the intrusion of a person other than the couple ( gift of sperm or ovum, surrogate uterus ). It is a gravely immoral. These techniques ( heterologous artificial insemination and fertilization) infringe the child’s right to be born of a father and mom. Known to him and bound to each other by marriage.
They betray the spouses’ right to become a father and a mom merely through one another”.
This passage starts off with a contrast between the normal conception of small children by husband and wife. The’ intrusion’ of another person, which entails the’ dissociation of husband and wife ‘. One might think that the author of this passage was thinking here of adultery. But the second sentence makes it clear that the use of donor conception is being described.
As such the description is plainly inappropriate. Donors do not’ intrude’ into the conception of small children. Instead, they generously offer gametes to enable a couple. Who cannot have a child in any other way, to conceive small children that they go on to bring up as their own. It is strange, and sad, that when couples with problems of fertility merit support and empathy. As they work through their problems and come to terms with their need to rely on donor gametes to have children of their own. They face this underserved and misconceived disapproval. There is nothing intrinsically wrong, let alone’ gravely immoral ‘, with donor conception .
Despite the arguments of its critics, there are no principled moral objections to IVF that withstand critical scrutiny
Nonetheless, donor conception does give rise to some difficult ethical issues that continue to elicit discussion and debate. Especially concerning donor anonymity and the proper level of compensation to donors for the time and trouble involved in gamete gift. On the issue of donor anonymity, my own position starts from the notion that. As has been shown to be the case with young adoptees, it is greatly in the interest of donor-conceived children to be able to make contact. As young adults, with their donor so that they can discover where they have come from and thereby achieve a broader understanding of their personal identity.
It is obvious that once this possibility of contact with the donor is recognized as a right. There cannot be anonymity for gamete donors. This might have implications concerning the people who are then willing to come forward as gamete donors. But with care, an adequate supply of gamete donors who are content to donate without the promise of anonymity can be maintained .
One important consideration for such donors is the level of compensation for their gift.
In the UK, as in Europe generally, the basic principle behind gamete gift is that it should be altruistic. Since altruism offers an ethical bond between the donor and the recipient of the donation. Which is appropriate to the fact that the donor’s gamete is a fundamental and persisting ingredient. Because of its genetic constitution in the recipient’s new child. Nonetheless, it is also important that those who put themselves forward to become donors. Should be properly compensated for the trouble and inconvenience of doing so. Which is considerable in the case of women who donate eggs.
What is wanted, therefore, is a level of compensation that does not leave donors feeling that their good will is being exploited. Without defining it at such a high level that fiscal motives suffice by themselves. To attract donors who absence any altruistic motive. Within these ethical constraints, pragmatic considerations can, I think, be used to settle reasonable levels of compensation .
IVF is here to stay. It will not replace normal sexual reproduction, as most couples have no problem conceiving children through sexual reproduction. But IVF has brought great benefits to couples who cannot conceive children that way. Despite the arguments of its critics, there are no principled moral objections to IVF that withstand critical scrutiny. Some of the possibilities with which it is associated do give rise to significant ethical issues. But with adequate oversight and regulation. There is no slippery slope that will drag a society that allows the use of IVF down to some dystopian future. It is time to move beyond moral criticism of IVF .