- University of East Anglia, Faculty of Arts and Humanities, Faculty Memberadd
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In this paper, we explore the ethical and legal implications of a hypothetical use of artificial gametes (AGs): that of taking a person’s cells, converting them to artificial gametes and using them in reproduction – without that person’s... more
In this paper, we explore the ethical and legal implications of a hypothetical use of artificial gametes (AGs): that of taking a person’s cells, converting them to artificial gametes and using them in reproduction – without that person’s knowledge or consent. We note the common reliance on genetic understandings of parenthood in the law, and suggest that injustices may arise if unwitting genetic parents are sued for child support. We draw parallels between the hypothetical use of AGs to facilitate unwitting parenthood, and real examples of unwitting parenthood following cases of sperm theft. We also look at the harm that might be caused by becoming a genetic parent, independently of financial obligations, and ask whether such harm should be understood in terms of theft of property. These examples help to highlight some of the current and prospective difficulties for the regulation of genetic and legal parenthood, and show how existing regulatory assumptions are likely to be further challenged by the development of AGs. We conclude by suggesting that the reliance on genetic connections to generate parental responsibility (financial or otherwise) for offspring is flawed, and that alternative ways of establishing parental responsibility should be considered.
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Perimortem gamete retrieval has been a possibility for several decades. It involves the surgical extraction of gametes which can then be cryo-preserved and stored for future use. Usually, the request for perimortem gamete retrieval is... more
Perimortem gamete retrieval has been a possibility for several decades. It involves the surgical extraction of gametes which can then be cryo-preserved and stored for future use. Usually, the request for perimortem gamete retrieval is made by the patient's partner after the patient himself, or herself, has lost the capacity to consent for the procedure. Perimortem gamete retrieval allows for the partner of a dead patient to pursue jointly held reproductive aspiration long after their loved one's death. But how can we know if the dying patient would have consented to gamete retrieval? In the UK, consent is a legal necessity for storing or using gametes-but this is not always enforced. Moreover, although the issues related to posthumous reproduction have been discussed at length in the literature, few commentators have addressed the specific question of retrieval. Gamete retrieval is an invasive and sensitive operation; as with any other intervention performed on the bodies of...
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A lack of compassion is often seen as the root of problems within the NHS. However, this assumption is open to question. It is not always clear what is meant by compassion, and it is not evident that compassion is the best way of... more
A lack of compassion is often seen as the root of problems within the NHS. However, this assumption is open to question. It is not always clear what is meant by compassion, and it is not evident that compassion is the best way of motivating healthcare workers. Addressing organisational issues by attempting to enhance compassion may therefore mask the real cause of the problems the NHS currently faces.
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Making treatment decisions for older people is difficult, because of the complex interplay of their multiple co-morbidities, but also because of the fine balance of risks vs. benefit in any chosen management plan. This becomes even more... more
Making treatment decisions for older people is difficult, because of the complex interplay of their multiple co-morbidities, but also because of the fine balance of risks vs. benefit in any chosen management plan. This becomes even more difficult when they lose the capacity to tell us what they want, and often in such situations we have to rely on information from others in order to make decisions based on their best interests. Advance care planning should help with making these decisions clearer, based on the documented preferences of what the patient would have wanted while capacity was still present. However, such documents are still very rarely used, and even if they are, health-care professionals are often wary of them for the multitude of ethical and legal problems that can arise.
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The average age of women having their first child has been rising in recent decades [1]. Since fertility declines with age, it is not surprising that larger numbers of women over 40 are seeking IVF. Any change in reproductive norms tends... more
The average age of women having their first child has been rising in recent decades [1]. Since fertility declines with age, it is not surprising that larger numbers of women over 40 are seeking IVF. Any change in reproductive norms tends to generate concern. Women's apparent postponement of motherhood has met with criticism directed variously at women themselves, and at society for its failure to support women to have children at the 'appropriate' time. The provision of IVF to women over 40 is one facet of this broader social trend towards later reproduction.In this paper I consider a number of ethical problems that might be connected with the provision of IVF to patients over 40. I look at risks to women and offspring, and also consider questions of efficacy and cost-effectiveness. I discuss the possibility that IVF for older women could raise increase the problems associated with egg procurement. Finally I address the concept of medicalisation and suggest that as long as IVF is regarded as a medical treatment, access to it should not be used as a means of social control. Nor should it be provided or withheld on the basis of moral judgements about patients' values or lifestyles.
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In this paper we will look at the various ways in which infertility can be understood and at how need for reproductive therapies can be construed. We will do this against the background of research with artificial gametes (AGs). Having... more
In this paper we will look at the various ways in which infertility can be understood and at how need for reproductive therapies can be construed. We will do this against the background of research with artificial gametes (AGs). Having explored these questions we will attempt to establish the degree to which technologies such as AGs could expand the array of choices that people have to reproduce and/or become parents. Finally, we will examine whether and in what ways the most promising developments of such technologies are likely to bring about the "end of infertility".
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... This Article. Public Health Ethics (2008) 1 (3): 273. doi: 10.1093/phe/phn030 First published online: January 1, 2008. ExtractFree; » Full Text (HTML)Free; Full Text (PDF)Free; All Versions of this Article: phn030v1; 1/3/273 most... more
... This Article. Public Health Ethics (2008) 1 (3): 273. doi: 10.1093/phe/phn030 First published online: January 1, 2008. ExtractFree; » Full Text (HTML)Free; Full Text (PDF)Free; All Versions of this Article: phn030v1; 1/3/273 most recent. ... Editors. Dr. Angus Dawson. Dr. Marcel Verweij ...
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New reproductive techniques and paternity testing raise a plethora of ethical questions. Anna Smajdor enjoyed a film that presents the donor conceived children who meet their genetic father
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Whole body gestational donation offers an alternative means of gestation for prospective parents who wish to have children but cannot, or prefer not to, gestate. It seems plausible that some people would be prepared to consider donating... more
Whole body gestational donation offers an alternative means of gestation for prospective parents who wish to have children but cannot, or prefer not to, gestate. It seems plausible that some people would be prepared to consider donating their whole bodies for gestational purposes just as some people donate parts of their bodies for organ donation. We already know that pregnancies can be successfully carried to term in brain-dead women. There is no obvious medical reason why initiating such pregnancies would not be possible. In this paper, I explore the ethics of whole-body gestational donation. I consider a number of potential counter-arguments, including the fact that such donations are not life-saving and that they may reify the female reproductive body. I suggest if we are happy to accept organ donation in general, the issues raised by whole-body gestational donation are differences of degree rather than substantive new concerns. In addition, I identify some intriguing possibilit...
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This chapter introduces the concept of medical ethics. It describes how the ancient Hippocratic Oath and its more modern formulations have provided a basis for ethical practice. It emphasises the importance of critical thinking, requiring... more
This chapter introduces the concept of medical ethics. It describes how the ancient Hippocratic Oath and its more modern formulations have provided a basis for ethical practice. It emphasises the importance of critical thinking, requiring reasons for acting in a particular way
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This chapter covers the Human Fertilisation and Embryology Act 1990 and includes topics on Activities involving embryos, Prohibition on germline cells, Prohibitions on Storage and Use of Gametes, The Definition of Mother, and Definition... more
This chapter covers the Human Fertilisation and Embryology Act 1990 and includes topics on Activities involving embryos, Prohibition on germline cells, Prohibitions on Storage and Use of Gametes, The Definition of Mother, and Definition of a Father.
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Who is a child’s father? Is it the man who raised her, or the one whose genes she carries—or both? WIn this chapter, we look at the view that men who have raised children they falsely believed to b ...
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Ellie Anderson had always known that she wanted to have children. Her mother, Louise, was aware of this wish. Ellie was designated male at birth, but according to news sources, identified as a girl from the age of three. She was hoping to... more
Ellie Anderson had always known that she wanted to have children. Her mother, Louise, was aware of this wish. Ellie was designated male at birth, but according to news sources, identified as a girl from the age of three. She was hoping to undergo gender reassignment surgery at 18, but died unexpectedly at only 16, leaving Louise grappling not only with the grief of losing her daughter, but with a complex legal problem. Ellie had had her sperm frozen before starting hormone treatment, specifically so that she would retain the chance of becoming a parent after her gender reassignment. Ellie had considered what might happen to the sperm if she died and was adamant that her children should be brought into the world. She made her mother promise to ensure that this would happen. But according to UK law, Ellie’s mother has no legal right to retain her sperm, or to use it to fulfil Ellie’s wishes. In this paper, we raise several key ethical questions on this case, namely: does a refusal to ...
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This is a guest editorial for the special issue of Bioethics.
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In debates on the ethics of artificial gametes, concepts of naturalness have been used in a number of different ways. Some have argued that the unnaturalness of artificial gametes means that it is unacceptable to use them in fertility... more
In debates on the ethics of artificial gametes, concepts of naturalness have been used in a number of different ways. Some have argued that the unnaturalness of artificial gametes means that it is unacceptable to use them in fertility treatments. Others have suggested that artificial gametes are no less natural than many other tissues or processes in common medical use. We suggest that establishing the naturalness or unnaturalness of artificial gametes is unlikely to provide easy answers as to the acceptability of using them in fertility medicine. However, we also suggest that we should be cautious about repudiating any relationship between nature and moral evaluation. The property of being natural or man-made may not per se tell us anything about an entity's moral status, but it has an important impact on the moral relationship between the creator and the created organism.
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In this paper, we explore the ethical and legal implications of a hypothetical use of artificial gametes (AGs): that of taking a person's cells, converting them to AGs and using them in reproduction-without that person's knowledge... more
In this paper, we explore the ethical and legal implications of a hypothetical use of artificial gametes (AGs): that of taking a person's cells, converting them to AGs and using them in reproduction-without that person's knowledge or consent. We note the common reliance on genetic understandings of parenthood in the law and suggest that injustices may arise if unwitting genetic parents are sued for child support. We draw parallels between the hypothetical use of AGs to facilitate unwitting parenthood and real examples of unwitting parenthood following cases of sperm theft. We also look at the harm that might be caused by becoming a genetic parent, independently of financial obligations, and ask whether such harm should be understood in terms of theft of property. These examples help to highlight some of the current and prospective difficulties for the regulation of genetic and legal parenthood, and show how existing regulatory assumptions are likely to be further challenged ...
Research Interests: Ethics, Applied Ethics, Bioethics, Parenting, Personal Relationships, and 11 moreMedical Ethics, Reproductive Ethics, Fatherhood, Reproductive medicine, Parental Responsibility, Reproductive Genetics, Ethics of Assisted Reproductive Technology, Artificial Gametes, Genetic Parents, In Vitro Generated Gametes, and Synthetic Gametes
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Can discussion with members of the public show philosophers where they have gone wrong? Leslie Cannold argues that it can in her 1995 paper ‘Women, Ectogenesis and Ethical Theory’, which investigates the ways in which women reason about... more
Can discussion with members of the public show philosophers where they have gone wrong? Leslie Cannold argues that it can in her 1995 paper ‘Women, Ectogenesis and Ethical Theory’, which investigates the ways in which women reason about abortion and ectogenesis (the gestation of foetuses in artificial wombs). In her study, Cannold interviewed female non-philosophers. She divided her participants into separate ‘pro-life’ and ‘pro-choice’ groups and asked them to consider whether the availability of ectogenesis would change their views about the morality of dealing with an unwanted pregnancy. The women in Cannold’s study gave responses that did not map onto the dominant tropes in the philosophical literature. Yet Cannold did not attempt to reason with her participants, and her engagement with the philosophical literature is oddly limited, focussing only on the pro-choice perspective. In this paper, I explore the question of whether Cannold is correct that philosophers’ reasoning about...
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PMDs raise questions about the relationship between morality and medicine, threatening the conceptual discreteness of medicine itself. Everyday items such as phones or watches are increasingly used for quasi-medical purposes. Conversely,... more
PMDs raise questions about the relationship between morality and medicine, threatening the conceptual discreteness of medicine itself. Everyday items such as phones or watches are increasingly used for quasi-medical purposes. Conversely, products designed for medical use are entering marketplaces and being used in ways that serve users’ values and interests without mapping neatly onto established paradigms of medical need and authority. One example of this is the so-called keepsake ultrasound. When sought outside routine medical care, our lack of ability to monitor and regulate these scans raises ethical challenges. Devices or procedures such as keepsake ultrasounds, which can have both medical and non-medical applications and which can be used by both medical professionals and members of the public, thus raise new questions for regulatory authorities.
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A lack of compassion is often seen as the root of problems within the NHS. However, this assumption is open to question. It is not always clear what is meant by compassion, and it is not evident that compassion is the best way of... more
A lack of compassion is often seen as the root of problems within the NHS. However, this assumption is open to question. It is not always clear what is meant by compassion, and it is not evident that compassion is the best way of motivating healthcare workers. Addressing organisational issues by attempting to enhance compassion may therefore mask the real cause of the problems the NHS currently faces.
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1. Reproductive Technologies and the Birth of the HFEA 2. Ethics, Embryos, and Infertility 3. Saviour Siblings, Designer Babies, and Sex Selection 4. Fertility is a Feminist Issue 5. Private Lives and Public Policy: The Story of Diane... more
1. Reproductive Technologies and the Birth of the HFEA 2. Ethics, Embryos, and Infertility 3. Saviour Siblings, Designer Babies, and Sex Selection 4. Fertility is a Feminist Issue 5. Private Lives and Public Policy: The Story of Diane Blood 6. Human Rights and Reproduction 7. Deconstructing the Family: The Welfare of the Child Clause 8. Embryonic Stem Cells and Therapeutic Cloning
Research Interests: Law and Medical Law
A number of cases have arisen over recent decades in which sperm has been extracted from dead and dying men without their prior consent. These extractions are undertaken in order to allow the man's partner to become a mother, or his... more
A number of cases have arisen over recent decades in which sperm has been extracted from dead and dying men without their prior consent. These extractions are undertaken in order to allow the man's partner to become a mother, or his parents, to become grandparents. Currently, the techniques used to perform such extractions are highly invasive, requiring either the use of an electric probe inserted in the anus to stimulate ejaculation, or surgical removal of all or part of the testicles. However, the development of artificial gametes may make it possible to produce sperm from skin cells, in which case the interventions required are far less invasive. In this paper I consider whether artificial gametes would offer a morally preferable way of producing sperm from dead or dying men without their consent. I evaluate the role played by bodily integrity, and reproductive autonomy in such cases. I suggest that artificial gametes would be less problematic than current techniques. And I a...
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Who is a child’s father? Is it the man who raised her, or the one whose genes she carries—or both? In this chapter, we look at the view that men who have raised children they falsely believed to be ‘their own’ have been victims of a form... more
Who is a child’s father? Is it the man who raised her, or the one whose genes she carries—or both? In this chapter, we look at the view that men who have raised children they falsely believed to be ‘their own’ have been victims of a form of fraud or are ‘false fathers’. We consider the question of who has been harmed in such cases, and in what the harm consists. We use conceptual analysis, a philosophical method of investigating the use of a concept and the logical implications of its various interpretations. We devise and discuss a number of possible scenarios in which a couple (arguably) become the parents of a child. We use these scenarios to illustrate the tenuousness of the claim that we can simply rely on biology to clarify parent-child relationships. We also discuss some of the underpinnings and implications of the language in which the debate on ‘paternity fraud’ has been framed: ‘duped’ or ‘false’ fathers and ‘cuckoo children’.
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Ellie Anderson had always known that she wanted to have children. Her mother, Louise, was aware of this wish. Ellie was designated male at birth, but according to news sources, identified as a girl from the age of three. She was hoping to... more
Ellie Anderson had always known that she wanted to have children. Her mother, Louise, was aware of this wish. Ellie was designated male at birth, but according to news sources, identified as a girl from the age of three. She was hoping to undergo gender reassignment surgery at 18, but died unexpectedly at only 16, leaving Louise grappling not only with the grief of losing her daughter, but with a complex legal problem. Ellie had had her sperm frozen before starting hormone treatment, specifically so that she would retain the chance of becoming a parent after her gender reassignment. Ellie had considered what might happen to the sperm if she died and was adamant that her children should be brought into the world. She made her mother promise to ensure that this would happen. But according to UK law, Ellie's mother has no legal right to retain her sperm, or to use it to fulfil Ellie's wishes. In this paper we raise several key ethical questions on this case, namely: does a refu...
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This is a guest editorial for the special issue of Bioethics.