From IVF to Immortality: Controversy in the Era of Reproductive Technology Book

Abbreviations xi

List of Illustrations xiii

Introduction 1

I The legal framework of the Human Fertilisation and Embryology Act 3

II Resources, to fight and to enforce 3

III The power of the media 4

IV Politics 4

V Ethics 4

The ongoing need for regulation 5

1 Reproductive Technologies and the Birth of the HFEA 7

Natural reproduction: what is 'supposed' to happen, and why does it go wrong? 11

The process 12

When problems arise 13

Artificial insemination (AI) 15

In vitro fertilization (IVF) 17

Surplus embryos 20

Risks of IVF 20

Intracytoplasmic Sperm Injection (ICSI) 21

Preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) 22

Out of the freezer... 24

Cloning 25

Therapeutic cloning and stem cell research 28

2 Ethics, Embryos, and Infertility 29

Relief of infertility as a worthy goal 30

Ethics, law, and regulation 32

Respect for autonomy 34

Autonomy and safety 35

Autonomy and the public good 38

Autonomy and consent 39

Autonomy and privacy 42

Parental autonomy and harm to children 43

Health risks to children 44

Family setup and the welfare of the child 47

The non-identity problem 49

3 Saviour Siblings, Designer Babies, and Sex Selection 53

Preimplantation Genetic Diagnosis (PGD) 53

Positive selection 58

Screening for carriers 61

Sex selection 62

Saviour siblings 65

4 Fertility is a Feminist Issue 77

Equal interests in reproduction? 78

Egg freezing 81

The older mother 81

Risks associated with fertility treatment 87

Women's autonomy and fertility treatment 91

Future developments 95

Artificial gametes 95

Artificial wombs 97

5 Private Lives and Public Policy-The Storyof Diane Blood 101

Consent 103

Does it matter what happens when we are irretrievably unconscious or dead? 104

Informed consent 106

Dignity 108

Is there a doctrine of 'best interests'? 109

Clinical and other interests 110

The spouse's testimony 112

Some further implications 117

Moral responsibility and the media 123

6 Human Rights and Reproduction 127

Prisoners and the right to reproduce 127

The rights in question 130

The extreme view: the right to reproductive choice 134

The right to privacy and family life: does it entail a right to reproduce? 135

Positive and negative rights 138

Rights and duties 138

The right to marry 140

Rights and regulation 141

The individual and society 142

A perverse incentive? 148

The downside of rights and European law 149

Rights and the precautionary principle 150

Homogeneity and national integrity 152

7 Deconstructing The Family 153

Donated gametes 155

Different views on anonymity 157

Babies with two mothers? 158

Surrogacy 159

Single parents: no need for a father...or a mother? 165

Non-discrimination 172

The role of empirical data 174

Same sex parents 175

Changing values 177

8 Embryonic Stem Cells and Therapeutic Cloning 179

What are embryonic stem cells? 182

Foetal stem cells 186

Adult stem cells 187

Ethical concerns 188

Loss of potential 190

'Personhood' and special attributes 192

Social harms 194

Obtaining eggs 196

Do the benefits outweigh the harm? 198

Global concerns 199

Broadening the scope 200

Legal challenges 201

Other ways of obtaining stem cells 203

Single cell biopsy 203

Dead embryos 204

Parthenogenesis 204

The role of the HFEA 206

National differences in legislation/regulation 206

A Germany 206

B Italy 209

C The USA 209

How do the various approaches compare? 211

Afterword 215

Notes 217

Index 231