Assisted Reproduction - 2

Bobbie Bailey
Assisted Reproduction
Grand Canyon University
HLT 318V December 19, 2010

Abstract: In this paper I will discuss the ethical issues surrounding surrogacy, egg donation, and discuss exploitations of women who choose to become a surrogate mother. In addition to these moral issues I will also explore the ethics and morals of IVF and the implantation of multiple eggs to one subject that may result in multiple births. In the occurrence of multiple births the subject is faced with the decision of selective abortion or the choice to give birth to all the fetuses with the risk of severe premature infants. With the birth of premature infants there are additional ethical decision involved in the treatment of those infants that may be afflicted with mental defects and a multitude of medical challenges. Surrogacy is the process in which a baby is created in a petri dish from the sperm of a man and the eggs of a woman; the resulting embryo is than transferred into a host or surrogate in order to gestate. The surrogate simply carries the baby to term for couples who are unable to carry their own child. They are helping regular people become parents. Ethics involved in surrogacy are the views of some that believe those that are unable to conceive or carry a fetus should adopt. Also some believe that those who choose to be surrogates may be exploited. The truth is that adoption is a very rigorous process with lengthy applications and waiting lists. The requirements in most cases take age of the adopting parents into consideration and they must interview with a social worker. In many cases once the adoptive parents have jumped through hoops, and attended the Doctor appointments, paying for medical expenses, decorated the nursery face disappointment because the birth mother has decided to keep the child. I believe more people would adopt if the rules were more accommodating for couples who wish to become parents and those children waiting to be adopted in foster homes and group homes (Ethics of Surrogacy).Although surrogacy is not as heavily regulated as adoption it is far easier for couple to use surrogacy to complete their family. I don’t believe that surrogates are exploited because this would imply that only the rich are participating in surrogacy births when in actuality it is the middle classes that choose this process of conceiving a child, they use any financial means necessary even if it means taking out a second mortgage on their home. They are educated people and have steady employment usually as school teachers, military personnel or social workers. They are much like the population of people that choose to be surrogates (Arguments against Surrogacy). Surrogates are compensated but the money gained by surrogates is often used to put a down payment on a house, or pay for their adult child’s college education or their own. They may choose to be a surrogate in order to remain at home with their own young children rather than to work outside of the home. In fact one of the requirements for someone to become a surrogate is they must have children of their own. Other qualifications of a surrogate are she must be at least 21 years of age in order to be able to enter into a legal binding contract. They are provided with their own attorney to go over the contract with them and they undergo a physiological test to be certain they have the correct mindset to be able to carry a child for someone else. These women are not being taken advantage of; in fact they are generous women by nature who are willing to give the ultimate gift. Egg donation and IVF also raise many ethical issues. In the process of IVF the woman’s body is stimulated to produce many eggs that can be fused with her partner’s sperm to create useable embryos for implantation. Some women are unable to produce their own eggs therefore must seek the eggs of others. Due to these circumstances the demand for egg donation is high. Women are donating their own eggs to assist infertile couple in conceiving a child. The issue brought up in egg donation is whether the woman should be paid. Some are compensated for travel expenses and childcare, but further compensation seems viable since these women have to undergo an outpatient surgical procedure in order to stimulate the ovaries and recover the eggs. There is significant health risks involved in the procedure. There are fewer ethical concerns regarding sperm donation because there aren’t any health risks involved and the male can make as many as 50 donations in a six-month period.
Woman who chooses to donate their eggs can earn several hundred dollars man of whom use to pay for college. They are of a particular level of intelligence and may possess some physical qualities that are desired. The argument in sperm and egg donation is that males can make a fairly lucrative earning with little risk involved while women have to experience surgical procedures and risks of complications for less compensation than their counterparts’ (Fertility Expert). In the process of IVF eggs are harvested and stored for future use. In most cases multiple eggs are implanted into the womb because the procedure is so costly and the chances of conception are better. The two main ethical questions that arise from IVF are what is done with the eggs that are stored, and the ethical questions surrounding the cases of multiple births due to several eggs being implanted. This leads us to selective abortion. Many of the eggs that are stored for future use do not get used thus face disposal. Many view this as selective abortion even though the embryos are in petri dishes and not in a womb. Some eggs may be used for research which also raises many ethical questions and concerns. Selective abortion often occurs when multiple eggs have been implanted and it results in the possibility of multiple births. The fetuses are selected for abortion to increase the chances of survival for the remaining fetus or fetuses. In some cases the abortion in therapeutic because the resulting pregnancy could endanger the health of the mother. In some countries selective abortion is utilized because of sexual preference of the fetus. Typically this occurs in cultures where male babies are preferred and female babies are aborted. It is usually referred to as female foeticide. It occurs in countries such as India, and some Asian counties. In other cases selective abortion is used when embryos are screened for genetic abnormalities. If a genetic defect is found the pregnancy is terminated (BBC, ). In these cases such ethical questions that arise are the severity of the condition, the quality of life of the child contributions of the child and economic factors. As a result of multiple egg implantation involved in IVF resulting in multiple births, the chance of premature birth is highly likely. Although there have been advances in technology that have allowed neonatologists to provide premies with mechanical ventilation, intravenous nutrition and artificial surfactant there still remains many other uncontrollable complications. The ethical question that arises is at what cost and to what extent do providers take to keep these babies alive. Who makes the decision? The health care provider has a responsibility to the mother’s autonomy but to the beneficence of the fetuses as well in cases of selective abortion (NCBI, ). As defined by World Health Organization prematurity are babies that are born before 37 weeks. Babies that are born at 36 weeks are slow to eat and failure to thrive. Babies at 33 weeks have serious problems usually involving lung function, and babies born 28 weeks have significant problems and a minimal survival rate. They are risk of hypothermia, hypoglycaemia, hypocalcaemia, respiratory distress syndrome; they are more susceptible to retrolental fibroplasia and blindness. The morbidity of premature babies is inversely related to gestational age. If the babies are discharged they have a higher readmission rate than babies that were born full term (Patient UK, ). Thus with all the complications that occur in a premature births the question that should be asked is what is the quality of life going to be for these children. It is very costly to keep these children thriving and even once they have been discharges from the hospital they are still faced with health, psychomotor, and behavioral problems in the future. In families of multiple births this can be quite burdensome. I do believe that as a community we have a responsibility to what we can for these children that have defied all odds and have survived. Due to medical advances in reproductive technology there has been a huge benefit to couples who have been able to have children due to these advancements. But with technology comes great responsibility and it is necessary to take a step back and look at the history, the technology and the ethics that surround these advancements. As humans we make choices, some good and some bad. But with each choice we affect society.

REFERENCES
BBC. N.d. Ethics Guide. Selective Abortion. Retrieved December 2, 2010 from: www.bbc.co.uk/ehtics/abortion/medical/selective_1.shtml Fertility Expert. N.d. Ethics of Egg Donation. Retrieved December 2, 2010 from: www.fertility expert.co.uk/ethics-egg-donation.html
Information on Surrogacy. N.d. Ethics of Surrogacy. Retrieved December 2, 2010 from: www.information-on-surrogacy.com/ethics-of-surrogacy.html NCBI. Gerri R. Baer and Robert M. Nelson. A Review of Ethical Issues Involved in Premature Birth. www.ncbi.nlm.nih.gov/books.NBK11389/ Patient UK. N.d. Premature Babies and their Problems. www.patient.co.ukprinter.asp:doc=400024676 Penner A. Novemberr 14, 2005. Selective Abortion: Three Ethical Dilemmas. Retrieved December 2, 2010 from: www.goshen.edu/bio/Biod1410/bsspapers05/annepenner.htm

References: BBC. N.d. Ethics Guide. Selective Abortion. Retrieved December 2, 2010 from: www.bbc.co.uk/ehtics/abortion/medical/selective_1.shtml Fertility Expert. N.d. Ethics of Egg Donation. Retrieved December 2, 2010 from: www.fertility expert.co.uk/ethics-egg-donation.html Information on Surrogacy. N.d. Ethics of Surrogacy. Retrieved December 2, 2010 from: www.information-on-surrogacy.com/ethics-of-surrogacy.html