Assisted Reproductive Technologies - Essay Example

Assisted Reproductive Technologies Introduction Assisted Reproductive Technologies (ART) is a method of fertilization available to women who do not become pregnant even after undergoing several surgical and medical treatments. The process of ART include procedures that makes it possible to bypasses sexual intercourse in process of fertilization by having artificial insemination or fertilization of the oocytes in a controlled environment such as laboratory. ART is therefore a method for women to get pregnant through artificial or partially artificial processes and involves people who are infertile although fertile couples can also undergo the processes due to genetic, sex selection or health considerations such as risk of infecting the child with AIDS. Methods used in ART include Intrauterine Insemination (IUI), which involves engaging a males sperm into a womans uterus via a tube. In Vitro Fertilization is another process in ART where sperm and eggs from the couple are taken and incubated to form an embryo with steps such as stimulation of egg maturation, egg recovery, fertilization and embryo transfer with assistance from a physician. There is also the third party assisted ART such as the use of a sperm donor, egg Donor, surrogates and gestational carriers. Even as these methods have been effective in enabling many couples achieve the dream of being parents, there have been debate over the ethical legal, social and ethical issues surrounding processes used to achieve this goal. This research paper highlights some of the ethical, legal and social arguments presented in support or opposition to ART. Ethical Issues Ethical issues in ART surround the practice of implanting multiple embryos at one time to cut on expenses for couples since there is no insurance coverage to support this form of treatment. For the process to be successful at a lower cost even when more than one attempt is undertaken couples are encouraged to fertilize many eggs at once and implanting multiple embryos while hoping one among them will be carried to term. Success rate in ART also depends on the years of women involved in the process (see the graph below). Figure 1 Live births/cycle according to woman’s age (Bryant, Sullivan and Dean 2004). Multiple fertilization of these eggs leads to the problem of multiple pregnancies with parents facing the prospect of giving birth to more than one baby. When this happens, couples especially mother and their offspring face increased social, psychological and medical problems. Research has indicated that multiple pregnancies results in a number of health complications especially those related to obstetric complications, prenatal morbidity, congenital malformations and increased mortality for mothers and maternal and foetus (Hazekamp et al. 2000; Olivennes 2000). Psychological problems related to multiple births include social isolation, being overstressed and depression for the mother with the problems persisting years after delivery. This is especially true for the mothers of triplets who report being fatigued, emotionally distressed and having difficulties establishing close relationships with the children. Increased pressure on parenting when multiple pregnancies are involved is also a matter of concern especially when the available health facilities cannot meet the costs of medical care. Highlighted problems resulting from multiple pregnancies lead to ethical concerns regarding the willingness of parents to put themselves and children through such complications. In choosing to cut costs involved in ART by sanctioning multiple fertilization of egg, couples are willingly exposing themselves and the children to complications that would otherwise be avoided by single fertilization (Elster et al. 2000). Additionally, there are ethical concerns related to the number of embryos that should be created, storage methods and how unused ones should be disposed. After fertilization and transfer has taken place, the remaining embryos are usually frozen and stored for future use by the couples if there is failure in the initial process. However, there are still multiple embryos that will never be used by the donating couples leading to ethical concerns about how these embryos are used especially since the lifespan of a cryopreserved embryo is not known. Different perspectives on when personhood begins exists, which means people have different perceptions on frozen embryos. There are those who believe that life begins at from fertilization, which implies that frozen embryos should be treated as human persons by being accorded dignity and respect as beings that have potential of developing into a person. There are also those who view the embryos as deserving less than human status and therefore do not attract ethical rights. These perspectives of the embryos lead to controversies especially those surrounding “whether or not reimplantation embryos have the same moral status as children or adults” and whether they should be protected from destructive research (Pennings and de Wert 2003, p. 397). The financial implications surrounding ART has also led to many questioning the morality of co modifying the process of childbearing. This is especially true when third part donors are used in the process of fertility treatment with concern being raised over the possibility of financial compensation of oocyte donors being chef motivator. When this happens, some women might progress with oocyte donation even when their health does not support this therefore especially since the process involves inherent medical risks. ART risks developing into business and not a treatment process due to commodification involved in buying or selling of human gametes (Levine 2011). The aspect of remuneration also increases concerns over donor participation without undue pressure through coercion or undue influence to go through the processes involved in ART (Levens and DeCherney 2008). As due to the financial remunerations involved, donors might encounter increased pressure from those around them or private medical practitioners who see ART in financial sense. Legal Issues Due to the increased number of couples who have exhausted available medical and surgical treatment for them conceive naturally and have therefore opted for ART, there is need to have regulations to provide general guidelines on acceptable conducts in this form of treatment. Legal requirements in ART vary from country to country based on the cultural orientation of the society. The differences in perception of ART has led to implementation of legal requirements that vary even within the states and provinces of in a nation making it necessary for couple to travel to countries and regions that permit certain aspects of ART that are perceived to be affordable for them (Collins and Cook 2010). Moving from one country to another for ART for legal and fiscal reasons, also referred to as cross-border reproductive care (CBRC) has continued to increase and account for up to 10 percent among patients seeking IVF globally (Ferraretti, Pennings, Gianaroli, Natali and Magli 2010); Collins and Cook 2010). CBRC has resulted in a number of legal concerns surrounding ART especially in the case of international surrogacy (Humbyrd 2009). Areas of legal concern in this case include the individual rights, exploitation and citizenship of the child born by international gestational carriers (Damelio and Sorensen 2008). Performance of ART with participant from different countries with varied legal interpretation of the process provides grounds for future conflicts. There are instances where separation of the child from genetic parents is possible as observed in various cases in the United States where law courts have ruled in favour of the birth mother even when there are no genetic relations (James, Chilvers, Havemann and Phelps 2010). While there might be an agreement between the involved parties during the initial processes of ART, posthumous use is also an area that can result in legal conflicts. The use of gametes or embryos after the death of a man is based on levels of consent provided before death. Men with sperm stored before their death may allow their partner to use the sperm following their death. It is however important that physicians and couples follow the wishes of such partners when they have expressed their wish for their sperms not to be used posthumously as that might violet existing contract between the involved parties (Nelson 2014). The noted problems involved in multiple pregnancies and births have led to introduction of legal measures to restrict the number of embryos that can be transferred at a time. Regulation in practice of ART is based on the realization of health, financial costs involved in the process (Ledger, Anumba, Marlow, Thomas and Wilson 2006). Available statistics involving ART indicates the total health care system costs in United Kingdom to be approximately 3313 pounds for singleton birth, 9122 pounds in twin birth and 32,354 pounds in triplet birth (Ledger et al 2006). Laws such as Human Embryology & Fertilisation Act have played a significant role in regulating different forms treatment involved in ART including prohibiting reproductive cloning, mixing of human and animal eggs and sperms through practices such as transfer of a non-human embryo to a woman or a human embryo into an animal. There is also strict regulation of sex selection to prevent the use of ART for non-medical reasons and. Commercial surrogacy arrangements between the involved parties is also a matter of legal concern with the law providing for provision of clear information for all the parties involved. Introduction of Human Fertilisation and Embryology Authority (HFEA) has also played an important role in regulating the practice of ART based on the responsibility the body has over licensing of fertility clinics and regulating the use of donor gametes. HFEA has also provided for limitations in the number of embryos transferred for every reproductive cycle with women below 40 year being allowed 1 to 2 embryos with a maximum of three embryos for those over 40 years (Sclater 2009). Consequently, considerations of legal issues in ART involves meeting the regulatory requirements in a given country province or state. Couples should ensure they meet the licensable requirements. This involves observance of legal issues concerning limits in the number of excess embryos to that, which meets the scientific requirements to achieve the desired goals of the activity. Social Issues Among the areas of social concerns are the recommended groups that should qualify for any process in ART. This is because the practice of ART has attracted couple from both homosexual and heterosexual unions who might want to have children. However, many professionals recommend heterosexuals with infertility problems to be the most suitable group for such processes especially legally married couples or in stable relationships (Kindregan and McBrien 2006). This preference for married or in-stable relationship couples is based on continued social emphasis on family structures. The changes in interpersonal relationships over the years have not diminished the perception of a family as one formed by the mother who is female, father who is male and their children who are genetically related to the parents. Children brought up in society with this family structure are thought to be at an advantage compared to those from single parent families or those formed by homosexual couples. This is because such children receive better parental guidance that comes from both the father and mother and feels comfortable relating to them. Single women and lesbians can have children based on the legal provision, which gives women the right to decide when and how to conceive. This creates a situation where there exist children without legal fathers leading to increased concerns over their psychological wellbeing, social recognition and acceptance of these families (Regnerus 2012). Older couples who have also gone through ART to have children at this stage have led to concern regarding their wide age difference and generational gap with the children. Such couples might not be able to cope with the physical and psychological stress of parenting. While is the social right for everyone to have children, concern over older couples in relation to ART is informed by the need to consider the social welfare of the children. Therefore, for couples to have children that they can adequately provide for up to when they are independent, it is important that they consider average life span to ensure the children are not left behind to be taken care of by society (Schenker 2011). Conclusion The foregoing research paper has highlighted a number of ethical, legal and social issues surrounding the use of ART. Ethical issues have been found to be of considerable interest in ART based on the handling and disposal of the embryos resulting from multiple fertilization of the egg. Legal concerns have been raised based on the need for the processes undertaken to meet the regulatory requirements provided for in the state. While being aware of the legal and ethical concerns is essential, parents should also focus on social issues in ART since they would want their children to fit into their society for positive upbringing. 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