Ethical Dilemmas in Reproduction - Hardcover

Hardcover

ISBN 10: 1842140930 ISBN 13: 9781842140932

Publisher: CRC Press, 2002

Synopsis

Ethical Dilemmas in Reproduction examines the ever-changing interaction between ethics, society, and scientific advances in reproduction. It covers:
*The implications of preimplantation genetic diagnosis becoming selection rather than diagnosis
*Defining the embryo and its status in relation to the child to be
*How the debate on the embryo and its status changes with advances such as therapeutic cloning and the use of stem cells
*Evaluating the risks of multiple birth pregnancies and the material, psychological, and marital stress a couple may face
*The dilemmas that new techniques such as oocyte and ovarian freezing raise for women considering ways to preserve their fertility
*Preparing prospective parents for the psychological effects o f secrecy and anonymity associated with children conceived through gamete donation
*The dilemmas involved in helping HIV patients have children

The medical profession as a whole faces the responsibility of integrating the benefits of a new technique within the ethical questions raised in using that technique. Nowhere is this more evident than in the science of reproduction. Your patients depend upon your advice when making decisions in this sensitive area. Ethical Dilemmas in Reproduction provides a framework for articulating the issues and making decisions.

About this title

From The New England Journal of Medicine

In this sequel to their previous book, Ethical Dilemmas in Assisted Reproduction, published in 1997, Shenfield and Sureau tackle many of the ethical dilemmas inherent in the clinical application of cutting-edge assisted reproductive technology. The book's contributors address such wide-ranging topics as fertility care in patients who are seropositive for the human immunodeficiency virus (HIV), cloning, gamete donation, and the cryopreservation of ovarian tissue as a means of extending fertility. There are also discussions of preimplantation genetic diagnosis and the implications of its becoming a means of selection, rather than a means of diagnosis; the ramifications of multiple births; and the sensitive issues of secrecy and anonymity in gamete donation. There are nine chapters, and among the seven contributors (who include the editors themselves) are several practitioners of assisted reproduction. This book, which is just over 100 pages long, contains an index and is amply referenced. Overall, the book reads most like a summary of the proceedings of a symposium on the ethical dilemmas in reproduction. The authors, like invited speakers, present overviews and then bring their own viewpoints to the debate. As a result, the topics are presented not with a single voice but rather with the distinct voices of authors with different outlooks. Nevertheless, there is an overall tone, which strives for social responsibility without unnecessarily curtailing individual procreative choices. The book has a distinctively European feel, in that it quotes legal precedents from European countries. Indeed, all of the authors are European. This should not dissuade American readers from availing themselves of the book's rich fund of knowledge, but they should understand that the writing has a particular vantage point. Many of the references are to the European literature, including British law and British and French newspapers, and many of the referenced works are in French. For example, the first chapter discusses ovarian-tissue cryopreservation as a strategy for "fertility insurance" for women. If women could preserve gametes for future use, they would then be able to reproduce at some point in the future, when fertility without such insurance may be uncertain. There is a very good summary of the technical aspects of cryopreservation of both oocytes and ovarian tissue, a discussion of the inherent ethical aspects of the technology, and a discussion of its current application, given the uncertain nature of its ultimate success. The author of this chapter, who is from a Dutch institution, alludes to two advisory reports of the Health Council of the Netherlands but does not mention the committee report of the American Society for Reproductive Medicine. The chapter concludes with a practical test for the application of this technology, suggesting that it may be applied in women who have "nothing to lose" so that women do not "risk ending up with fewer rather than more fertile years." Several of the other topics covered are interesting; they include the question of who should give consent to preserve the reproductive capability of minors with cancer. Although the discussion is replete with references to the laws of the United Kingdom, the intriguing arguments made may indeed serve as a model for similar arguments in the United States and other parts of the world. The thorough discussion of the treatment of HIV concludes that HIV seropositivity alone should not be an absolute exclusion criterion for medically assisted reproduction, an opinion shared by authors of other treatises on this subject. There is a discussion of reduced parental life expectancy, the probability of illness, and the responsibility of the physician in assisting with fertility treatment. The American Society for Reproductive Medicine document on HIV is not mentioned. The overall tone of this book is perhaps best summarized in the final chapter, which describes the various disagreements in different parts of the world about what is "ethical" as "cultural diversity, but common goals." Most American physicians and practitioners will find this book long on arguments and short on practical applications. It is best intended for students of ethics, particularly those interested in assisted reproduction, who will most appreciate the thorough discussion and the references. Richard J. Paulson, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

"The subject of this compilation is not only topical but radicalAll the contributors deserve praise for venturing into these waters and trying to dredge up some principle, coherent deduction or statement of natural justiceI recommend this book wholeheartedly" - Gillian Tindall in the Journal of the Royal Society of Medicine, December 2002

About this edition

• Publisher: CRC Press
• Publication date: 2002
• ISBN 10: 1842140930
• ISBN 13: 9781842140932
• Binding: Hardcover
• Edition number: 1
• Number of pages: 128
• Editor: Shenfield Dr Francoise, Shenfield Francoise, Sureau Claude