Question

Sally and Francesca are a married (lesbian) couple. They would like to begin a family. Both have blocked fallopian tubes and therefore cannot use artificial insemination. They have thought about adoption but would prefer to have a child who is related to them biologically. They have decided to avail themselves of in-vitro fertilization - with Sally being the donor and Francesca being the one who would carry the pregnancy to term. They have a friend who has agreed to be the sperm donor and also serve as a godfather/uncle to the children. The reproductive technologist has explained to them that in order to achieve a successful pregnancy they have to implant several fertilized ova, hoping one will attach to Francesca's uterus.

However, there is a possibility they could all attach (all four) and result in multiple pregnancy. This carries its own risks. Sally has other health complications, and can't be the gestating mother. Francesca as propensity for borderline high blood pressure. Thus - if there are multiple pregnancies - they will need to selectively abort some to achieve a successful delivery of the others. They ask for an ethics consultation to see what they should do. Pretend you are an ethicist and have been requested to provide an ethical consultation.

Drawing on insights from our readings - what issues might you raise and/or respond to that are present in this case? Are there ethical issues about a non-traditional couple parenting? Are there issues about selectively aborting some of the embryos? Are the use of reproductive technologies to replace natural procreation inherently problematic from an ethical perspective?

Answer 1

Ans) Having described various concerns regarding EPGD and efforts to address the related decision-making challenges, it explores a future that is speculative, even if highly plausible. We cannot know with certainty what technological advances will be possible and what the institutional and cultural reactions will be to those that unfold. But because new technologies often emerge before we have contemplated their implications, and because efforts are already under way to advance the very technologies that would make EPGD possible, call to pause and consider what EPGD would mean for parents, society, and the potential providers of EPGD.

If EPGD were to become a viable technology, it would raise and exacerbate many of the same issues we have faced with other reproductive technologies—their impact on the experience of reproduction, their influence on societal norms and behavior, and their implications for reproductive decision making. Contemplating a world where EPGD is the norm pushes us to consider the potential harms of unlimited, unrestricted reproductive choice and to recognize that the promise of expansive options may ultimately be illusory.

- The tyranny choice could lead to the abdication of choice by some, which may lead to efforts by professional groups, fertility clinics, and commercial labs to intervene. It concludes that some of the potential efforts to ameliorate the tyranny of choice—such as restrictions of information or decision-making algorithms—may raise their own sets of issues for individuals, professionals, and society.

- For all of these reasons, my hope is that a careful examination of EPGD, before it becomes a viable option, will prevent us from adopting this new technology simply because technological advances seem to propel us inevitably toward it. Instead, we should think carefully about what kind of reproductive choice we want and whether it offers all that it promises.