Medical Ethics By Amar and James

Key Definitions IVF - A procedure in which eggs are removed from a woman’s ovaries and fertilised with sperm in a laboratory. The fertilised egg is then replaced into the woman’s uterus. AID - When a woman is made pregnant by the sperm of a man other than her partner, but not through having sexual relations with him. AIH: When a woman is made pregnant by the sperm of her husband, but not through having sexual relations with him. Surrogacy: A form of fertility treatment in which an embryo from another couple is created through IVF and then implanted into the ‘host’ woman. The woman carries the baby throughout pregnancy and gives it to the other couple after birth. Human genetic engineering: The modification of gene make-up to change the features of a human. Embryology: The study of human embryos. Stem cell research: A cell, most often taken from a 4 – 5 day old embryo (blastocyst), whose role in the body is yet to be determined. Cloning: The scientific method by which animals or plants can be created which have exactly the same genetic make up as the original, because the DNA of the original is used. Transplant surgery: When someone else’s organs are put into a patient. Blood transfusion: When a patient is given extra blood as part of an operation.

Stem cell research and medicine Stem cells are originators, they are the beginnings of tissue and have the capacity to divide constantly and repair themselves. Embryonic stem cell lines come directly from human embryos. Stem cells can be used to ‘grow’ organs like kidneys, as well as help to repair parts of the brain that are damaged or diseased. Ethical issues with stem cell research are that once the stem cells are removed, the embryos die; some may view this as devaluing human life (even if embryos are only 14 days old or less)

Embryo research Embryo research is when scientists use embryos to learn about diseases, especially genetic diseases, as well as the development of embryos. This research is done in the hope to help to find cures for these diseases. In order to study a human embryo, they must be removed from the womb, so the only way to obtain a human embryo to use a leftover from fertility treatment or create embryos for research. Embryo research is only allowed on embryos younger than 14 days old.

Genetic engineering Everyone is made up of DNA containing 100,000 genes. Scientists have worked on gene research and can modify the genetic make up of cells to successfully treat hundreds of genetic disorders and diseases. This is known as human genetic engineering.

Cloning Cloning is done by creating a human foetus from one person, using an egg and cells (asexual reproduction). The foetus has the same genetic make up as the original because the DNA of the original is used.

Blood Transfusions People undergoing an operation may lose a lot of blood; if this happens, they may need extra blood to replace the blood they have lost. When the extra blood is given to them, it must match the same blood type as the recipient. This procedure is known as a blood transfusion.

Transplantation Organ transplantation occurs when a person’s organ has failed, is failing, or is damaged to the point where it is no longer functioning properly. Many organs used for organ transplantation are donated from the dead, or are donated from a loved one of the recipient. Some animals can be genetically modified so that their organs can be used in humans; this is known as xenotransplantation.

Fertility treatment (IVF) IVF: In vitro fertilistation - The procedure in which eggs are removed from a woman’s ovaries and fertilised with sperm in a petri dish in a laboratory. After a few days the fertilised egg develops into a blastocyst and is then replaced into the woman’s uterus. This procedure only has 25% success rate. Unused blastocysts must be destroyed within 14 days by law.

Fertilisation treatment (Surrogacy) Surrogacy is when another woman carries a pregnancy to full term for a couple. Conception is done by an artificial method. It can be done using the couple/donors egg and sperm. It is used in cases where the woman cannot medically carry a pregnancy. It is illegal to pay someone to be a surrogate mother in the UK.

Fertility treatment (AID/H) Artificial insemination by donor/husband. Semen is taken from the male and is inserted into the woman’s womb when she ovulates. AIH occurs when the husband has a low sperm count. AID occurs when the husband is infertile or has a genetic disease. The success rate of this treatment is very low.

Sanctity of life Many religions believe that life is sacred and special, either because it is created by God, or because it is part of the journey to enlightenment. Many religious believe that the only way to a pregnancy should be sexual intercourse. God created stewardship and dominion over his creation, so God must permit scientific knowledge and medicine as part of humanity looking after life.

Religious attitudes to fertility treatment Christian: Go forth and multiply (Genesis) God knows each of us intimately, and has set a plan for our life (Old Testament|) Infertility is a call from God to adopt (Roman Catholic teaching) Some Christians accept fertility treatment as part of God’s gift of medicine. Roman Catholics view it as wrong, because children should be conceived by a couple within the confines of marriage.

Islam: Allah gives life to whom he chooses (Qur’an) ‘Marriage is my tradition’ (Muhammad pbuh) Do not come near adultery or fornication for it is shameful (Qur’an) Fertility treatment is accepted Using donor materials is seen as adultery, so is considered wrong.

Some views towards fertility treatment Some views towards fertility treatment. These can be applied to some of the four types of fertility methods. It is down to YOU to decide where each comment best fits Against It is wrong to carry someone else’s child. It is wrong to expect a woman to give up her child. There are enough children already in the world. There are other alternatives to fertility treatment, e.g. adoption. Children should be born to a married couple. Children are a gift from God. It is God’s role only to create human life. AID is the same as adultery In Favour It is already illegal in the UK to receive payment for surrogacy This could be the only way a couple can receive a child Safeguards and support are already in place. A surrogate mother can decide to keep her child, if she wishes. God gave us a brain, we should use these technological advances to help people who are infertile. Pupils should already have in books.

Should we just accept infertility? Agree: God works in mysterious ways and our understanding is limited. God sees the big picture God has created us in a set way for his own reasons Therefore, we should trust that God is good and accept infertility Disagree God may have given us the knowledge to challenge infertility God could be working through doctors to grant children Doctors could be working in partnership with God and fulfilling the duty to go forth and multiply The knowledge is there to make people happier. Why not use it? Intentions behind fertility treatments are always good