Ethical challenges in reproductive medicine: posthumous reproduction

摘要

Introduction: New technologies in the field of reproductive medicine have given rise to new possibilities for the application of this technology These possibilities have in turn led to new ethical and policy dilemmas This paper discusses the complex moral, ethical and legal concerns that posthumous assisted reproduction (PAR) gives rise to: questions such as what constitutes informed consent, and whether it is ethical to retrieve spermatozoa from patients who are in a coma It considers legal issues, such as whether gametes can be considered as property and the need to clarify the legal definition of paternity in cases of children born in such circumstances It outlines the various considerations that need to be taken into account in deciding on the advisability of PAR, including respect for the wishes of the deceased donor and the imperative need to protect the interests of the unborn child It examines the motives of gestating women, and discusses the effects on the children born by means of this process Methods: The paper makes use of legal studies of cases of posthumous reproduction, and draws on the experiences of fertility clinics to consider the motives of gestating women and mistakes that can be made in fertility treatments It refers to philosophical discussions of the ethical considerations involved, and considers the legal and regulatory framework around assisted reproduction in the UK and in other countries Conclusions: The paper helps to raise the awareness of policy makers and clinicians in the field of assisted reproduction of the complex legal, ethical and moral issues that PAR involves. It urges policy makers to evaluate the issues at stake, particularly regarding the need for consent and for the children concerned to have a legally recognisable father and inheritance rights, and to formulate a suitable legislative response It argues that caution should be exercised in encouraging PAR, and market forces should not influence decisions on the practice It asserts the need for responsible accounting on the part of fertility clinics, calling on them to help the bereaved to reach an unbiased but informed decision on PAR Finally, the welfare of unborn children must be taken into account by both clinicians and policy makers.