Any ethical argument involving the problems of access to assisted reproductive technologies should entail the discussion of the decision protocol and consider the individual deliberating on the appropriateness of these remedies from the point of view of self and community. Yet, arguments based on patients' own moral calculations are rare in the bioethics literature. The moral voice behind most discourses concerning ARTs is that of an outwardly independent spectator, who nonetheless proceeds to justify a personally significant worldview in the utilization (...) of these resources. Investigators grounded in social and legal sciences have offered relevant arguments in this regard, but because their discourses are derived from research protocols specific to their respective disciplines, they fail to provide a general rationale applicable to moral deliberation. (shrink)

The papers of Burley and Harris, and Draper and Chadwick, in this issue, raise a problem: what should doctors do when patients request an option which is not the best available? This commentary argues that doctors have a duty to offer that option which will result in the individual affected by that choice enjoying the highest level of wellbeing. Doctors can deviate from this duty and submaximise--bring about an outcome that is less than the best--only if there are good reasons (...) to do so. The desire to have a child which is genetically related provides little, if any, reason to submaximise. The implication for cloning, preimplantation diagnosis and embryo transfer is that doctors should only produce a clone or transfer embryos expected to enjoy a level of wellbeing which is less than that enjoyed by other children the couple could have, if there is a good reason to employ that technology. This paper sketches what might constitute a good reason to submaximise. (shrink)

The screening of in vitro embryos resulting from in vitro fertilization treatment for chromosomal abnormalities has as a primary aim to help patients achieve a successful pregnancy. Most IVF centers will not transfer aneuploid embryos, as they have an enhanced risk of leading to implantation failure and miscarriage. However, some aneuploidies, such as trisomy-21, can lead to viable pregnancies and to children with a variable health prognosis, and some prospective parents may request transfer of such embryos. I present two cases (...) where the testing for and detection of trisomy-21 can lead to conflicts between IVF professionals and patients and argue that in most such cases respect for choices of patients should prevail. (shrink)

The growing scope of gamete donation and themanipulation of gametes makes it essential to developa coherent theory of the nature of gametes and theclaims which may be made in relation to them. Thenature of gametes is ambiguous, they blur thedistinctions between persons and property, but thecurrent legal framework which governs gamete donationand manipulation fails to address their status. Thisleaves unanswered fundamentally important questionsabout control of processes involving gametes andrights to use or control the gametes themselves andthe information which they represent. (...) These areclaims which are rooted in the concept ofproperty. A property based analysis highlights thethemes of autonomy, personhood and control which lieat the heart of the claims made in relation to gametesand an account based on the notion of property forpersonhood offers a more coherent justification forrecognising claims in gametes and mediating disputes. This perspective exposes the inadequacies andinconsistencies of the legal construction of gametesand the legal regulation of gamete donation. Thepresent legal framework has not sought to develop acoherent construction of gametes, but to constrain thepractices of the assisted reproductive technologies(including gamete donation) within a framework whichis presented as least damaging to the traditionalideologies of the creation of the family. (shrink)