As assisted reproductive technologies become increasingly popular, debate has intensified over the ethical justification for restricting access to ART based on various medical and non-medical factors. In 2010, the Australian state of Victoria enacted world-first legislation that denies access to ART for all patients with certain criminal or child protection histories. Patients and their partners are identified via a compulsory police and child protection check prior to commencing ART and, if found to have a previous relevant conviction or child protection (...) order, are given a “presumption against treatment.” This article reviews the legislation and identifies arguments that may be used to justify restricting access to ART for various reasons. The arguments reviewed include limitations of reproductive rights, inheriting undesirable genetic traits, distributive justice, and the welfare of the future child. We show that none of these arguments justifies restricting access to ART in the context of past criminal history. We show that a “presumption against treatment” is an unjustified infringement on reproductive freedom and that it creates various inconsistencies in current social, medical, and legal policy. We argue that a state-enforced policy of restricting access to ART based on the non-medical factor of past criminal history is an example of unjust discrimination and cannot be ethically justified, with one important exception: in cases where ART treatment may be considered futile on the basis that the parents are not expected to raise the resulting child. (shrink)

Prenatal diagnosis challenges the issue of parental autonomy. Two ethical aspects of the parental decision making process with reference to PND have been taken into consideration: the duty to know and the right not to know. Whilst the first approach has been widely discussed in literature, the latter seems to be overlooked. In order to find good moral reasons supporting the right not to know, firstly the duty to know approach was critically analysed. Subsequently, the emphasis was put on the (...) unconditional parental love and the issue of child’s best interests as the features supporting parental right not to know. The clarification of what is good parenthood was presented as the best normative approach supporting the parental right not to know in case of PND. Apart from parental autonomy, raising the question of the right not to know is important in the debate about the place and role of people with disabilities in society. (shrink)

Wrongful life claims have always been controversial. Courts in England,1 the USA,2 and Australia3 have generally refused to accept them. However, are wrongful life claims becoming more commonly accepted in continental Europe? After the widely discussed Perruche case in France ,4 and a judgment of a Brussels tribunal in July 2002 that has passed almost unnoticed, the Court of Appeal of The Hague, the Netherlands, in a lengthy and motivated judgment of 26 March 2003, awarded moral damages to a child (...) born with a severe chromosomal disease.5 This judgment differs from the Perruche and Brussels judgments in that both of the latter failed to show to what extent the negligence towards the mother can at the same time be a negligence towards the unborn child. The Court of Appeal of The Hague did at least attempt to explain this.According to the Court of Appeal the midwife looking after the mother had a legal obligation not only towards the pregnant woman but also towards her fetus. This obligation can be derived from the medical treatment contract concluded between, on one hand, the employer of the midwife, the Leiden University Medical Centre, and on the other hand, the parents of the child. The Court held that the unborn child could legally be considered as a party to this contract. But even when one does not accept the existence of a contract between the …. (shrink)

For most of the 20th century, it was possible to regard fertilisation as the identifiable point when life begins, because this moment could be defined unequivocally and was thought to be the single most essential biological step in the establishment of a new human entity. Since the successful reproductive cloning of Dolly and other mammals, it is clear that any human cell has the potential to supply the full genome of an embryo, and hence a person, without going through fertilisation. (...) At what point in time do such embryos acquire the respect accorded to human beings? The authors argue that the time of implantation is the most useful point at which the potential and the intention to create a new person are translated into reality, because from that point a new life develops. Implantation differentiates a somatic cell in culture from a human entity that has acquired its own identity and developmental potential. The authors examine the value of quickening or viability as alternative developmental stages in the process of acquiring respect for the Dolly embryo. (shrink)