Transcript Document

I.V.F.
Rachel said to Jacob,
"Give me children or I shall die!“
(Gen. 30:1)
Powerpoints prepared by
Julie Arliss and Peter Vardy
30000 babies have been born
using IVF in Britain alone since
1978. In Australia and N.Z., a
significant number of school
children
have
been
born
LOUISE
BROWN,
using IVF
The first
test-tube
baby, was
born on 25th
July 1978
MALE & FEMALE
 Some forms of IVF are designed to overcome female infertility
due, for instance, to blocked fallopian tubes. The female is hyperovulated, using drugs and the eggs are harvested. The sperm is
then given to the dish and the eggs are fertilised.
 However the work done on embryo research has now enabled
techniques to be developed to deal with male infertility
(particularly males whose semen contains virtually NO sperm.)
 ICSI (intra-cytoplasmic sperm injection) injects individual sperm
taken from the testes into an ova and, as these have not had to
fight with millions of others, they may not be the ‘best’.
 1998, a team at North Shore Hospital in Sydney compared
intelligence after a year of 50 children born using traditional IVF
and 50 born using ICSI. The ICSI children had a higher
percentage of abnormalities. A Belgium study (with 200 children)
at the same time, however, found no differences – so the issue is
still open. More research is needed. (Source: ‘Gthe Baby makers’ Jack Challoner. P. 115)
THE WARNOCK REPORT…
 After the birth of Louse Brown the
Warnock Committee was created to
discuss the ethics of IVF and reproductive
technologies.
 “The positive argument in favour of IVF is
simple: the technique will increase the
chances for some infertile couples to have
a child. For some couples this will be the
only method by which they may have a
child that is genetically entirely theirs.”
(p.59)
 This is A CONSEQUENTIALIST position.
They accepted that IVF is a good thing as
it has favourable consequences.
IVF and NATURAL LAW
 Natural Law (and the Catholic Church) rejects IVF
for three reasons:
 1) Masturbation is needed by the man to produce
the sperm necessary to fertilize the egg (unless
the eggs are taken directly from the testes using
ICSI). Since masturbation is seen as an
‘intrinsically evil act’ in the Natural Law tradition,
this is held not to be permitted even if the
purpose or intention was regarded as good.
 2) IVF techniques involve fertilizing about 20
eggs and implanting two or three of these. This
means fertilized eggs which are destroyed and if
it is held that life may begin at conception, this
may involve killing people.
 3) The natural relationship is disrupted so that
one can have sex without children and children
without sex.
Kant’s Ethical Theory
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1.
Kant’s ethical theory is deontological: proper
behaviour is not dependent on consequences.
There are absolutes and through REASON we
can work out what these absolute moral laws
are. Humans alone have access to the moral law
because only humans have the capacity to
reason. The defining characteristic of what it is
to be human for Kant is REASON.
He gives notably few examples of absolutes
himself!
But he introduces a number of tests that can be
applied in ethical decision making to see if the
decision is ethical.
Is the person acting according to good will?
Good will demands a response according to
reason not personal desire.
THE CATEGORICAL IMPERATIVE
2. The Categorical Imperative has various
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3.
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formulations. The most important, is the rule of
Universalization. ‘Act so that the maxim of your
action can be a universal law’
Are you willing to carry out the rule yourself?
Can you wish all people would obey the principle
you act on?
Would all rational people of good-will agree?
Is it self contradictory? ‘Always accept and never
give’
The second formulation of the Categorical
Imperative: ‘Act in such a way that you always
treat humanity, whether in your own person or
in the person of any other, never simply as a
means, but always at the same time as an end.’
People are rational and therefore have intrinsic
KANT AND IVF
 As with Natural Law the consequences of the
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actions may not be considered.
Ask the questions:
Are the prospective parents acting out of good
will? Selfless or selfish desire? Emotional or
rational behaviour?
Can the rule that all infertile couples be provided
with a child, at whatever cost, be universalised?
Is anybody being used in this arrangement. Many
Feminists would argue that women are put under
social pressure to have children. They should be
valued independently of their reproductive
function. They also argue that there are virtually
no women working in the medical field of IVF;
these are techniques used by men who want to
control female fertility. Donors may be being used
for their gametes
Jeremy Bentham 1748 - 1832
and Utilitarianism
 Ethics are subjective – they are
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something we do for ourselves. WE
make ethics and we make laws. This is a secular
theory of ethics.
There is no God to measure human behaviour by.
The only measure is the amount of pleasure or
pain created by our actions.
It is a CONSEQUENTALIST theory – it is the
consequences, measured in terms of the AMOUNT
of pleasure or pain that makes an action good or
bad, right or wrong.
The resultant pleasure does not have to be evenly
distributed. It could be the intense pleasure of
one person set over the mild discomfort of many
others.
BENTHAM’S HEDONISTIC CALCULUS
 INTENSITY - How intense is the pleasure? Eg intense but short,
sex
 DURATION - For how long does it last? Eg less intense but
longer, eg a party
 CERTAINTY - How certain is it that the pleasure will be attained
- what are the risks? The cost of a good dinner versus a bet
 NEARNESS AND REMOTENESS - How close is the pleasure to
being realised? Long and short term pleasure
 FRUITFULNESS - How much does the immediate pleasure
generate longer term pleasure and other pleasures?
 PURITY - How pure is the pleasure and how little pain is mixed
in?
 EXTENT - How many people are affected by the pleasure? The
more affected the better
CONSIDER ALL OF THE ABOVE BOTH FOR A DECISION TO
ABORT OR NOT. CONSIDER THE RELEVANCE OF:
WOMAN, FETUS, DOCTORS, NURSES, SOCIETY, FATHER.
 PIG PLEASURES V
John Stuart Mill
Mill followed Bentham and
supported Utilitarianism but
made two major
adjustments:
1. Not all pleasures are of
equal worth.
2. Laws on the whole should
be made to secure the
greatest good for the
greatest number and so laws
should be followed.
HIGHER PLEASURES
UTILITARIANISM AND IVF
 The utilitarian seeks to maximise happiness and
minimise pain and just as infertility can be a source of
misery, the success of IVF can bring enormous
happiness. In the words of Jan Brennan, the mother of
an IVF baby:
 “Since Pippin’s birth she has been an eternal
source of happiness and delight. We love her so
dearly and are so very proud of our little girl. How
empty our lives would have been without her,
how pointless I would have felt my existence if I
had been denied this opportunity of being
Pippin’s Mum and the opportunity to show her
just how much we love her and how she means
more than anything else in the world to us”
UTILITARIANISM AND IVF
 BUT what are the costs?
 $2500 - $8000 per treatment. Success rate of the
1st cycle 17%.
 25% of IVF is done with state funding.
 How much pain does infertility cause in comparison to
other malfunctions? It is not life threatening and it does not
cause discomfort. But there is emotional distress.
 Is emotional distress due to infertility as serious as the
actual physical pain caused when someone needs a hip
replacement? Can using resources and medical staff be
justified on the pleasure pain scale?
 If Utilitarianism is about creating pleasure then it
would support IVF but if it is about minimising
pain, maybe not!
 A Utilitarian might broaden the question to
include global concerns – can the amount of
money involved be justified when the same
amount of money would SAVE the lives of
hundreds of already existing children in
developing countries.
IVF and embryo research
 The availability of spare embryos from IVF
has aided embryo research. Most couples
are happy to give permission for spare
embryos to be used for research.
 If IVF is rejected because embryos are
wasted, then embryos research will also
be rejected as it will involve using
embryos as a means to the end of
understanding embryo development –
again this is a CONSEQUENTIALIST
approach.
 Young children or babies who have had
severe cancer treatment and may be
infertile, can now have ova or sperm
stored so that, should they so wish, they
may have children later in life.
EMBRYO
EXPERIMENTATION
AIMS OF EMBRYOLOGY
 Research on embryos will help to identify how the
3 billion letters that make up the human genome
work.
 Experimentation on embryos holds out the hope
of treating diseases or injuries caused by the
death of certain cells which the body cannot
replace.
 The correction of genetically transmitted
conditions, such as Down’s syndrome and cystic
fibrosis before birth.
 Ultimately the discovery of stem cells holds out
the promise of newly created organs from a stem
cell for one that has worn out.
Aims of Embryology (2)
 The promise of genetically
enhancing individuals – for sporting
ability, music, better looks etc..
 The promise of improving the
human species as a whole.
 The promise of producing stem
cells that can cure diseases or
defects later in life.
TOTIPOTENT
CELLS
THE HUMAN EGG - DIVISION
At conception, the sperm enters
the egg and these then fuse to
create a single cell, the ZYGOTE.
The zygote divides countless
times to form the 216 different
cell types that comprise the
human body.
Up to the stage of eight cells
each one can develop into a
full human being and these
cells are called TOTIPOTENT.
Cloning these cells gives
scientists no end of embryos
to experiment on.
After 5 days 64 stem cell lines
are developed. These cells will
further divide and become
increasingly specialised.
Orcs and Super Orcs – genetic
alterations for defects raise real
concerns.
The Human Fertilization
and Embryology Act 1990
 Britain is one of the few countries that has a
regulatory authority (The Human Fertilization and
Embryology Authority – HFEA) which approves
IVF work AND Embryo experimentation. It has
licensed 114 centres and 23 research projects at
18 different hospitals and universities.
 HFEA has 70 full time inspectors and every centre
is inspected at least every 3 years. More than half
of the committees members of HFEA have to be
lay people and there is heavy stress on public
consultation.
 Research must never result in the embryos
concerned being implanted and all research must
be clearly defined and directly relevant to clinical
problems. Use of spare embryos from IVF can
only be used with permission of the ‘parents’.
Egg Supplies
 Supplies of sperm are not generally a
problem to acquire but the eggs that are
needed to make an embryo have proved
more problematic.
 Various sources have been explored:
 Spare eggs from IVF
 The eggs of aborted fetuses – ripened
and then harvested.
 The eggs of cadavers – women have
plenty of eggs left when they die.
 Cloning of totipotent cells from one
fertilised egg provides a virtually
unlimited supply of eggs.
Papal condemnation
 In 1982, Pope John Paul 2 said:
 ‘I condemn, in the most explicit and formal way,
experimental manipulations of the human
embryo, since the human being, from conception
to death, cannot be exploited for any purpose
whatsoever.'
 The Catholic Church's document 'Donum Vitae' took an
identical line. The Jesuit, Karl Rahner, came to a very
different conclusion. He says:
 'It would be conceivable that, given a serious
positive doubt about the human quality of the
experimental material, the reasons in favour of
experimenting might carry more weight,
considered rationally, than the uncertain rights of
a human being whose very existence is in doubt.'
(Theological Investigations. p. 236 note 37)
 In 1988, the Archbishop of York, John Habgood, maintained that
only when the cells differentiate rather than multiply can the
embryo be firmly considered to be a person.
Kant and Embryology
 If the fetus is a person and to be respected as a person the
issue of embryology is ruled out by the second formulation
of the Categorical Imperative, ‘Act in such a way that
you always treat humanity, whether in your own
person or in the person of any other, never simply
as a means, but always at the same time as an
end.’
 The embryo is used as a means to a scientific and
exploratory end which will perhaps benefit others, before
itself being disposed of.
 If the fetus in the early stages is not to be regarded as a
person then one must examine motives for research – is
research done out of duty or for personal gain?
 Can the rule that all embryos be experimented on be
universalised?
 The consequences of the research are not to be considered
– either it is a good action, and can be universalised to all,
or it is a bad action.
Utilitarianism and Embryology
 Arguably Embryology may contribute to
the greatest good for the greatest number.
It promises to help find cures for diseases
and to prevent much human suffering.
 Pre-embryos do not feel pain, and the
anticipated good that will result from the
research will outweigh any consideration
for the embryo.
 For a Rule Utilitarian the Law and the
controls in place would be considered.
Mice and Men
 Most people consider that it is morally acceptable
to kill a mouse for research purposes whereas it
is not similarly permissible to kill a human being.
The issue can be presented as follows:
 (1) It is permissible to experiment on
mice and not on human beings because
mice are significantly different from
human beings.
 (2) It is permissible to experiment on preembryos and not on human beings
because pre-embryos are significantly
different from human beings.
 The question is whether (2) is significantly
different from (1).
 Humans are considered to be self-conscious and
intelligent in a way in which animals are not,
However it can be argued that persons are selfconscious and intelligent in a way which preembryos are not.
 Human life is given its special status because
humans are considered to be self-conscious and
intelligent in a way in which animals are not.
However it can be argued that pre-embryos are
not self-conscious or capable of being so.
 Peter Singer
 Of course, it is still true that a pre-embryo HAS
THE POTENTIAL to become an embryo and then a
person, but this raises a different issue…..
A Blastocyst 5 days after
conception
 WHAT IS A PERSON? It was
from a complex of cells like this
that we all originated. But is
that what a person is? If not,
what is a person? What is it to
be fully human? Which genetic
alterations will preserve human
nature and which would
diminish it? How will we judge
enhancements – is removing a
homosexual gene an
enhancement? WHO WILL
DECIDE? HOW WELL
EQUIPPED WILL THEY BE
TO MAKE THESE
DECISIONS?
What is the future for the
Shire?
Will genetic engineering produce people capable of love,
compassion, loyalty, bravery and the other virtues? Perhaps
concentration on physical improvement misses what is most
important about being human…..