Selected Issues > Reproduction & Technology
Reproduction & Technology

assisted repro imageIn the three decades since the landmark birth of the first “test tube baby,” the options for assisted reproduction have expanded and the ethical questions have grown more complex.

In vitro fertilization (the original “test tube” technique) involves mixing eggs and sperm in a petri dish and implanting the fertilized eggs. To help men with low sperm count become biological fathers, there is an in vitro procedure called intracytoplasmic sperm insertion in which a single sperm is injected into an egg. If a woman’s eggs are unsuitable, a novel technique called ooplasm transfer may be beneficial. It combines the nuclear genetic material of her eggs with the cytoplasm of a younger woman’s eggs and the sperm of the first woman’s partner. Thus it is now possible for a baby to be genetically related to more than two parents.

From the Hastings Center

Bioethics Briefing Book

Assisted Reproduction

By Adrienne Asch and Rebecca Marmor

Hastings Center Report

A Proposal for Modernizing the Regulation of Human Biotechnologies

By Franco Furger and Francis Fukuyama
As reproductive technologies evolve into tools to customize and enhance children, taking a “wait-and-see” attitude toward their regulation or relying on the existing statutory system would be misguided. A new regulatory architecture is needed. It must be flexible and dynamic yet rooted in broadly acceptable ethical principles, and it must be protected from the political and administrative pitfalls into which regulation on controversial matters easily falls.

Hastings Center Report

Tied Up in Nots over Genetic Parentage

By Josephine Johnston 
What I find strange about Fukuyama and Furger’s proposal for regulating reprogenetics is one of the prohibitions that they suggest is key to safeguarding children’s interests: they seek to outlaw the creation of children who are not the genetic offspring of one man and one woman.

Hastings Center Report

The Virtues of Muddling Through

By John A. Robertson 
Are we ever going to do anything about assisted reproduction? Call me a noninterventionist libertarian, but I suggest that we do nothing special—certainly not creating a national agency or commission. Why not just let our mixed public-private regulatory system, with its strong common law tradition, handle it nonsystematically, as it has for years?

Hastings Center Report

Can We Trust Democratic Deliberation?

By Leonard M. Fleck
A number of bioethicists strongly advocate a mechanism known as “rational democratic deliberation” for addressing in a way that is fair and legitimate some of the controversial ethical and policy issues related to medicine and health care policy. I am among them. Unfortunately, whether and how deliberative outcomes can actually alter public policy is not quite clear.

Hastings Center Report

Managing Reproductive Pluralism: The Case for Decentralized Governance

By James W. Fossett
Any attempt to set national reproductive policy is both politically unachievable and substantively unwise. The inability of the national government to establish a coherent reproductive policy is not the result of “political failure,” as Fukuyama and Furger would have it, but rather of profound disagreement in our country about a variety of complex and controversial issues. Attempts to force a national consensus where none now exists are almost certain to fail.

Hastings Center Report

May Doctors Refuse Infertility Treatments to Gay Patients?

By Jacob M. Appel 
One of the most sacrosanct principles of medical practice in the United States is that physicians have a right to choose their own patients as long as the patient is not in a medical emergency. However, this sort of physician autonomy is not without certain limits. No physician or hospital receiving government funding, including Medicare and Medicaid, may discriminate against potential patients on the basis of race, color, religion, or national origin, and many states have expanded these protections to cover gender and sexual orientation. What remains unclear is whether physicians with bona fide religious objections to treating certain patients are exempt from these proscriptions. A California case, currently on appeal before a state court, may soon decide the matter.

Hastings Center Report

Liberty and Solidarity

By Gregory E. Kaebnick
What would it take to justify a restriction on an important liberty? This question is one of several at play in the essays in this issue of the Report on regulating reprogenetic technologies—technologies that help parents make decisions not only about whether and when to have children but also about what kind of children to have. Deciding how to cross the line from philosophy to politics—from opprobrium to a ban—has been decidedly difficult for critics of biotechnology.

Bioethics Forum

The Berger Commission Proposes Big Changes for New York Hospitals

Alicia Ouellette and David Pratt

Resources

American Society for Reproductive Medicine  

U.S. Department of Health and Human Services, "Infertility"

Markens, Susan, Surrogate Motherhood and the Politics of Reproduction (Berkeley: University of California Press, 2007)

President's Council on Bioethics, Reproduction and Responsibility: The Regulation of New Technologies (Washington, D.C., 2004)

U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention, ART Success Rates: National Summary and Fertility Clinic Reports (2005)