Moving forward rapidly in the clinical research phase, uterus transplantation may be a future treatment option for women with uterine factor infertility, which accounts for three per cent of all infertility in women. This new method of treatment would allow women, who currently rely on gestational surrogacy or adoption, to gestate and birth their own genetic offspring. Since uterus transplantation carries significant risk when compared with surrogacy and adoption as well as when compared with other organ transplants, it requires greater (...) justification because its goals are quality of life, not life-saving, in their scope. It is important to address questions regarding the physical, psychosocial and ethical risks and benefits of uterus transplantation for all three parties involved—the patient, the donor and the potential child—as well as discuss the regulatory implications as research on uterus transplantations moves forward. (shrink)

International surrogacy is an increasingly common phenomenon and an important global health challenge. Legal rules are a key consideration for the participants in international surrogacy arrangements. In some cases the law can help to resolve the complex issues that arise in this context, but it is important to consider the role played by law in contributing to the complex conflicts that such arrangements can generate.

It is now medically possible for a baby to have two biological mothers. A fertilized ovum from one woman can be implanted into a second woman for gestation in her uterus. In fact, there have been several such cases. The ova donor is the mother in the genetic sense: her genetic material,along with that of the sperm donor,appears in the developing baby. The uterine hostess is the birth mother: she gestates the fetus and gives birth to it. In essence, the (...) two female reproductive functions, genetic and gestational, can be and have been divided from each other. Our current conception of biological maternity has lagged behind these technological marvels and still assumes that both functions will be performed by the same woman. At a time when two "biological mothers" can and do make claims for the same child,each on the ground that she is the "true mother", it is crucial to examine our concepts of biological maternity and their relation to our social policies about maternity in these cases. In this paper I will argue that the best social and legal policy would involve a prima facie preference for the claims of the gestational mother over the claims of the genetic mother for custody of the child in a contest (if there is no question of parental unfitness on either side). That is, in any dispute, presumption should be in favor of the gestational mother. This argument is made independent of considerations about pre-birth and pre-conception contracts, because the issues raised about the roles of gestational and genetic maternity are substantial in themselves and have obvious implications about the acceptability of such contracts.Rather, I argue that a revision of our concept of biological maternity which emphasizes the importance of gestation and which would prefer the claims of the gestational over the genetic mother would have positive benefits for both women and newborns. (shrink)

It is argued that there are good reasons for believing that commercial surrogacy is often exploitative. However, even if we accept this, the exploitation argument for prohibiting (or otherwise legislatively discouraging) commercial surrogacy remains quite weak. One reason for this is that prohibition may well 'backfire' and lead to potential surrogates having to do other things that are more exploitative and/or more harmful than paid surrogacy. It is concluded, therefore, that those who oppose exploitation should concentrate on: (a) improving the (...) conditions under which paid surrogates 'work'; and (b) changing the background conditions (in particular, the unequal distribution of power and wealth) which generate exploitative relationships. (edited). (shrink)

_ Source: _Page Count 30 Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for (...) psychological similarity, for the sake of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

Human uterus transplantation is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as (...) face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx. (shrink)

What exactly is it that makes someone a parent? Many people hold that parenthood is grounded, in the first instance, in the natural derivation of one person's genetic constitution from the genetic constitutions of others. We refer to this view as "Geneticism". In Part I we distinguish three forms of geneticism on the basis of whether they hold that direct genetic derivation is sufficient, necessary, or both sufficient and necessary, for parenthood. Parts two through four examine three arguments for geneticism: (...) the property argument, the causal argument, and the parity argument. We conclude that none of these arguments succeeds. (shrink)

Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for psychological similarity, for the sake (...) of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

After surveying and criticizing some earlier definitions of "disease", we propose that a general term--malady--be used to represent what all diseases, illnesses, injuries, etc., have in common. We define a malady as the suffering, or increased risk of suffering an evil in the absence of a distinct sustaining cause. We discuss the key terms in the definition: evil, distinct sustaining cause, and increased risk. We show that the role of abnormality is to clarify these terms rather than to be used (...) directly in the definition of malady. (shrink)

Through the use of assisted reproductive technologies (ARTs), multiple children are born adding to worldwide carbon emissions. Evaluating the ethics of offering reproductive services against its overall harm to the environment makes unregulated ARTs unjustified, yet the ART business can move towards sustainability as a part of the larger green bioethics movement. By integrating ecological ethos into the ART industry, climate change can be mitigated and the conversation about consumption can become a broader public discourse. Although the impact of naturally (...) made children on the environment is undeniable, I will focus on the ART industry as an anthropogenic source of carbon emissions which lead to climate change. The ART industry is an often overlooked source of environmental degradation and decidedly different from natural reproduction as fertility centres provide a service for a fee and therefore can be subject to economic, policy and bioethical scrutiny. In this article, I will provide a brief background on the current state of human-driven climate change before suggesting two conservationist strategies that can be employed in the ART business. First, endorsing a carbon capping programme that limits the carbon emissions of ART businesses will be proposed. Second, I will recommend that policymakers eliminate funded ARTs for those who are not biologically infertile. I will conclude the article by urging policymakers and all those concerned with climate change to consider the effects of the reproductive technologies industry in light of climate change and move towards sustainability. (shrink)

ABSTRACT This paper investigates the concept of wrongful disability. That concept suggests that parents are morally obligated to prevent the genetic transmission of certain conditions and so, if they do not, any resulting disability is ‘wrongful’. In their book From Chance to Choice, Buchanan, Brock, Daniels and Wikler defend the concept of wrongful disability using the principle of avoidability via substitution. That principle is scrutinised here. It is argued that the idea of avoidability via substitution is both conceptually problematic and (...) rather insensitive. Instead, it is suggested that the question of whether or not bringing a particular disability about is wrongful does not simply hinge on whether or not substitution takes place. Rather, it involves an evaluation of parental aspirations and responsibilities. It is argued that the desire not to be responsible for creating challenges for others that lie outside what is perceived to be an acceptable range provides a justification for termination of pregnancy on the grounds of projected disability that neither commits one to a wrongful life claim, nor requires that one substitute a non‐disabled child instead. The ramifications of such an approach are explored. The paper concludes by suggesting that the question of what is considered to be an acceptable range of human capability is an increasingly important one. It is argued that, when addressing that question, we should be acutely aware of the social context that may go some way to define what we consider to be an acceptable range. (shrink)

Lawyers tend to look to the law to resolve disputes and to create certainty about the rights and responsibilities of parties to relationships. There is a particularly acute need for certainty in the context of global trade in surrogacy services, both because of the number of parties who may be involved in creating familial relationships and because of the vulnerabilities created as a result of surrogacy arrangements. Participants in the Global Health Challenges conference were invited to consider to what extent (...) law is implicated in global health challenges — both in terms of how law might help to resolve the challenges, and, how law might contribute to or create these challenges. (shrink)

In Saudi Arabia in 2000 the world's first human uterus transplant was attempted with some success. In 2011 the second successful human uterus transplant took place in Turkey. Doctors in the United Kingdom have recently announced that uterus transplants will be carried out in the UK if doctors can raise enough funds to complete their research. As scientists continue to make progress in this domain this is anticipated to be the next breakthrough in the arena of assisted reproductive technologies. The (...) procedure is designed to restore fertility in women unable to gestate due to an abnormal, damaged, or absent uterus. At present, the only other option for such women to achieve genetic motherhood is via surrogacy, which in Islam is widely regarded as haram or forbidden. This article examines the benefits of this technology so as to facilitate discourse between Islam and the West. It argues for Islamic scholars to consider these advances so as to ensure Muslims living as minorities in Western countries, such as the United Kingdom, are able to utilize such technology (if indeed regarded as permissible) should the government move to enact legislation to permit this procedure. (shrink)

In this paper we re-examine Hugh LaFollette's proposal that the state carefully determine the eligibility and suitability of prospective parents before granting them a ?license to parent?. Assuming a prima facie case for licensing parents grounded in our duty to promote the welfare of the child, we offer several considerations that complicate LaFollette's radical proposal. We suggest that LaFollette can only escape these problems by revising his proposal in a way that renders the license effectively obsolete, a route he implicitly (...) adopts in his recent revisiting of the licensing proposal. We conclude that there is little merit in the idea of licensing ?natural? parents as a practical policy proposal, and raise some questions about its continued use in relation to adoptive and foster parents. (shrink)

Many critics have suggested that international paid surrogacy is exploitative. Taking such concerns as its starting point, this article asks: how defensible is the claim that international paid surrogacy is exploitative and what could be done to make it less exploitative? In the light of the answer to, how strong is the case for prohibiting it? Exploitation could in principle be dealt with by improving surrogates' pay and conditions. However, doing so may exacerbate problems with consent. Foremost amongst these is (...) the argument that surrogates from economically disadvantaged countries cannot validly consent because their background circumstances are coercive. Several versions of this argument are examined and I conclude that at least one has some merit. The article's overall conclusion is that while ethically there is something to be concerned about, paid surrogacy is in no worse a position than many other exploitative commercial transactions which take place against a backdrop of global inequality and constrained options, such as poorly-paid and dangerous construction work. Hence, there is little reason to single surrogacy out for special condemnation. On a policy level, the case for prohibiting international commercial surrogacy is weak, despite legitimate concerns about consent and background poverty. (shrink)