Invitro Fertilization (IVF)

1
Invitro Fertilization (IVF) Pre-Implantation
Genetic Diagnosis (PGD)
2
Process of IVF
3
PGD Genetic testing performed prior to embryo
transfer
The debate around PGD has been building since
the late 1980s, when doctors at London's
Hammersmith Hospital learned how to tease a cell
from a 3-day-old embryo and study its chromosomes
for gender. (Zitner 2002)

• Adds 2000 to IVF
• Reduces rate of miscarriages from 23 to 10
• Does not increase chance of pregnancy

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Commonly, more than 100 diseases can be detected
through testing, including

• Hemophilia A
• Muscular dystrophy
• Tay-Sachs disease
• Cystic fibrosis
• Down Syndrome

Removal of one cell for testing
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Viable and Desirable?
This information is helping parents choose which
embryos they want--and which to reject as
unhealthy, or merely undesirable. (Zitner 2002)
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Undesirable Embryos

• Disease Free Embryos
• Frozen in storage
• Donated to infertile couples
• Donated to stem cell research/usage

• Disease Carrying Embryos
• Donated to research
• Discarded

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Impact (Part I)
8
Impact (Part II)
GenRich is controversial it could be harmful
or beneficial. The GenRich will use
technology to ensure that their children have
significantly more advantages than the random mix
of the gene pool, widening the gap between the
rich and poor. (Wagner 2003) The wealthy
citizens, whose offspring will become the
GenRich do us a great service. They test
these technologies for us and even pay enormous
sums for the privilege. In a way, they function
as guinea pigs for the rest of humanity. If you
had to think of who youd like to test these
technologies, what better group can you imagine?
Theyre well informed, highly motivated, eager,
hard to coerce and they are definitely
volunteers. (Jonietz 2003)
Production mentality is a problem. Where
amniocentesis usually provides information about
a single fetus, embryo screening allows parents
to judge and reject many potential children at
once. And because it bypasses the pain of
abortion, some fear it will be used too freely,
coarsening attitudes toward the embryo. Fetuses
become products rather than children. (Zitner
2002)
"Would this selection (of gender) place our
society on a "slippery slope" to other kinds of
unacceptable selections? Possibly, but only if we
continue to use this powerful technology without
a thorough analysis of its ethical justification
and without a professional standard that clearly
articulates a strong set of moral values."
(Scannell 2001)
Fukuyama defines eugenics as, the deliberate
breeding of people for certain selected heritable
traits. Human genetic engineering raises most
directly the prospect of a new kind of eugenics,
with all the moral implications with which that
word is fraught, and ultimately the ability to
change human nature. (Fukuyama 2002)
The power to change the future of the human race
is, in some ways, more frightening than the
weapons of mass destruction we hear so much about
today. It is a weapon of mass creation. (Wagner
2003)
And if scientists in one nation are genetically
altering unborn children, wouldnt it be hard for
other nations to resist joining in a genetic
arms race to develop a new generation better
able to compete in the global economy or in
war? (Wagner 2003)
On the potential for discrimination, Hughes, a
Wayne State doctor, said I went into this to
help people with disease. Last time I checked,
your gender is not a disease. (Zitner 2002)
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Ethics The issues at hand
World Views
Utilitarianism
Rights Ethics
Care Ethics

• weighing the goal of pregnancy and live birth
  against the medical and moral risks of multiple
  gestation.

requires society to make a decision on when life
begins.
using PGD inherently makes assumptions about
the quality of life, challenging basic tenets of
society such as equality.
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ethics

• Address the suffering of the mother due to her
  inability to have a child naturally
• When having children, peopleoften roll the
  genetic dice and hope for the best. With embryo
  sorting, "they can start their pregnancy on Day
  One with a commitment to continuing it."
• (Zitner 2002)
• PGD can save parents massive heartbreak and
  financial strain

• Address the view of the potential child
• Will the child have adequate support and a stable
  home?
• If there are multiple fetuses, will the children
  receive adequate care/attention?
• PGD has the laudable goal of stopping deadly
  genetic diseases such as Tay-Sachs and
  Huntingtons. This research has growing support
  because it can save children from enormous
  suffering and early death.
• (Wagner 2003)

Some ethicists would be in favor of IVF and PGD
as long as the decision is loving and promotes
positive relationships.
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Definition of Moral Community for Rights Based
Ethics
Before one can decide to whom rights apply, one
must determine the moral community.
As individuality is a sine qua non for
personhood, it seems safe to consider 14 days of
normal embryonic development to be the minimum
requirement before a human being can emerge.
Other criteria might place the earliest time
point at a later stage, for example, 28 days,
when the neural tube closes and the development
of the central nervous system necessary for
rationality begins. Or, with Aristotle and St.
Thomas Aquinas, one might consider 40-90 days of
development to be necessary to allow a human soul
to be present or as the Roman Catholic Church
taught for centuries, one might require body-form
and movement to be present before full human
status was recognized. (J.E.S.Hansen)
Therefore, embryos lack rights as individuals
because they are not part of the moral community.
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Rights Based Ethics
Embryos are mass-produced, screened, discarded
and used in experiments are they products or
people with rights? According to Hansen (see
previous slide), the treatment of embryos is not
an issue.

• Based on John Lockes principles, all people have
  the right (in America) to life, liberty and the
  pursuit of happiness.
• What becomes of the idea that everyone is created
  equal if you start designing children?
• Loss of autonomy because of a necessity to be
  competitive in society
• Inherently discriminatory makes assumptions
  about quality of life
• "Most people with disabilities rate their quality
  of life as much higher than other people think.
  People make the decision to reject embryos
  based on a prejudice that having a disability
  means having a low quality of life.
  (Zitner 2002)

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Utilitarianism
The greatest good for the greatest number
suggests that

• The alleviation of suffering for many is
  important.
• IVF helps many infertile couples achieve a
  life-long dream of having a child.
• PGD helps those same couples reach their goal of
  a disease free child.
• A disease free society is preferable for all
  members.

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What does religion have to say about Embryo
technology?

• The Christian view
• Life is sacred
• Only God should create life and take it away.
• God knows you even when you are in the womb...

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• You created every part of me you put me together
  in my mothers womb... When my bones were being
  formed... when I was growing there in secret, you
  knew that I was there.
• Psalm 139 13-16

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Do all Christians have the same opinion about
Embryo technology?

• Roman Catholic Church thinks embryo technology
  is wrong. This is because you are a person from
  the moment of conception.
• Church of Scotlanddoes think that life is sacred
  but agrees with using embryos until the 14th day
  of development.
• Both churches disagree with the idea of designer
  babies

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(No Transcript)
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.Christian View

• The Church of Scotland teaches that life must be
  protected from the moment of conception. Genetic
  engineering for cosmetic purposes is rejected
  because it is playing God to decide which
  people are to be valued and which are not.
  Medical research up to 14 days is accepted.

19
The Muslim View

• Life is a gift from Allah.
• He breathes life into the embryo, this when you
  become a person.
• Some Muslims think this happens on the 42nd day
  of development. Others say it is on the 120th day.

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Muslim View

• Life is sacred and a gift from Allah Surah
  1733, 4070
• How we treat other living things throughout life
  will form our judgement by Allah
• There is disagreement about when Allah breathes
  life into the foetus so some accept research up
  to a certain stage.

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• Some Muslims agree with embryo research.
• Some say that Allah has given humans
  intelligence. We should use this to make life
  better if you can make someones life better by
  using embryo research then you should.
• Some argue therefore, that using pre-embryo's or
  embryos for research is acceptable if the
  possible benefits are great enough.

22
Embryo research and UK law

• Licenses for embryo research must be provided by
  the HFEA (Human Fertilization and Embryology
  Authority)
• Research is allowed up to 14 days of development
• Frozen embryos can only be stored for up to 5
  years.

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Why are human embryos used for research?

• Gives more accurate picture of how the
  illness/treatment might affect a person.
• The research could help to eliminate diseases
  such as Parkinsons and Alzheimers.
• The embryo is not a human being , just a
  collection of cells, so it is acceptable to
  extract genetic material form it and use it to
  benefit others.

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Do human embryos have rights?

• No it is only a cluster of cells, not a person.
  Only a person has rights. It has no awareness or
  feelings.
• Yes It is a potential human being and deserves
  to be respected. Life begins at conception.

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Other Views on Embryo research

• British Humanist Association
• Spare embryos produced through fertility
  treatment are routinely disposed of, so it is
  better that they are used to benefit other
  people.
• Embryo is fertilized egg with potential to be a
  person but it has no self-awareness, no ability
  to feel pain or emotion. Therefore it cannot
  suffer.

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Peter Singer (Preference Utilitarian)

• We already allow this kind of treatment. It has
  benefited many people.
• Individuals should be free to make their own
  choices on this issue as it is a private matter
  harming no-one else.
• Many children have been born as a result of this
  technology. It hasnt harmed any of them or
  society so we should conclude that it is
  acceptable.

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Mary Warnock (Philosopher)

• Immense benefits come from using human embryos
  therefore it is right that they are used.
• The key stage of embryo development is the
  primitive streak at 14 days.
• The slippery slope argument is not valid as
  there are specific laws to stop this happening ,
  eg the 14 day rule

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International Policies on PGD

• Banned PGD for ALL usages

• Used to select childs gender only when there is
  medical need

• Clinics set policies no federal or state
  restrictions

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What is your opinion?
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Questions answer these fully in your jotters.

• Name two ways in which Christians and Muslims
  agree about embryo research
• When does the Catholic Church think that life
  begins?

31
Describe UK law relating to the use of human
embryos in research.

• Human cloning is not allowed.
• Therapeutic cloning is allowed.
• Licences must be provided by the HFEA.
• Research allowed up to 14 days of development.
• Frozen embryos can only be stored for up to 5
  years.

32
Describe a secular viewpoint in relation to
genetic selection

• Peter Singer (a Utilitarian)
• We already allow genetic selection by encouraging
  prenatal diagnosis of conditions such as Downs
  Syndrome as this often leads to selective
  abortion.
• If humans have already developed the ability to
  prevent certain genetic disorders then we should
  use this technology to benefit people.
• Individuals should be free to make their own
  choices on this issue as it is a private matter
  harming no one else.
• However, Singer also points out that human
  genetic engineering may lead to a loss of
  diversity among human beings. This may reduce
  humanity's capacity to adapt to changing
  circumstances.

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• This may also lead to an increasing gap between
  rich and poor in society as the children of the
  rich, who can afford to genetically enhance their
  offspring, gain more advantages over the children
  of the poor.
• Singer suggests the State should control human
  genetic engineering so that everyone can share in
  the benefits.

34
What arguments might scientists use to support
using human embryos in research?

• A human embryo gives a more accurate picture of
  how the illness/treatment may affect a person.
• The embryo is not a human being but only a
  collection of cells.
• It has no self-awareness, thoughts, internal
  organs etc. Therefore, material can be extracted
  to benefit others.
• The research could help to eliminate diseases
  such as Parkinsons, Alzheimers and even cancer.

35
How far does the religious viewpoint you have
studied agree with using embryos for stem cell
research

• Only God has the right to create life. Whenever
  humans try to behave like God they mess up.
• Humans are made in Gods likeness Genesis 127.
• Do not commit murder Exodus 2013.
• Life is sacred and should only be ended by God
  Job 121.
• God cares for the developing foetus Psalm
  13913-16.

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• The Roman Catholic Church teaches that life
  begins at conception. Therefore life must be
  protected from the moment of conception.
  However, gene therapy is acceptable where it is
  of medical benefit.
• The Church of Scotland teaches that life must be
  protected from the moment of conception. Genetic
  engineering for cosmetic purposes is rejected
  because it is playing God to decide which
  people are to be valued and which are not.

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• The Church of Scotland does accept medical
  research up to 14 days.
• The Bible also teaches that Christians should be
  compassionate towards others leading some to
  suggest that this includes medical research if it
  can provide cures for diseases or help those with
  fertility problems.

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• Islam
• Agree
• Life is sacred and a gift from Allah Surah
  1733, 4070.
• How we treat other living things throughout life
  will form part of our judgement by Allah.

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• However
• There is disagreement about when Allah breathes
  life into the foetus so some accept research up
  to a certain stage

40
How might medical scientists define an embryo?

• A fertilised egg from 14 days to 8 weeks.
• The Human Fertilisation and Embryology Act
  defines an embryo as a live human embryo where
  fertilisation is complete.
• or
• An egg in the process of fertilisation.