Section 3: Ethics and the future in .NET Make barcode 128 in .NET Section 3: Ethics and the future

Section 3: Ethics and the future generate, create none none for none projects Web application framework consider the wel none none fare of the child What about the cutoff point regarding the mutant load of embryos to be transferred It is of utmost importance to give balanced information about possible alternative reproductive options, including the use of donated oocytes. In the future, it might become possible to eliminate defective mitochondria by means of somatic cell nuclear transfer into a healthy enucleated oocyte. The ethics of this approach is beyond the scope of this chapter (De Wert, 2000) .

. The parental autonomy model Some commentator none none s argue that prospective parents should be free to use PGD for the selection of any offspring characteristic they prefer, as selection for medical as well as non-medical purposes is part of reproductive freedom (Robertson, 1992). In the context of PGD, this view might receive somewhat broader support as many people consider embryos to have a lower moral status than fetuses. The paradigm case for the parental autonomy model is PGD for social (non-medical) sex selection, but clearly, other applications, which may raise partly specific moral problems, will emerge.

There seems to be a strong consensus in European countries that this type of sex selection is not acceptable. In fact, it is prohibited in many countries. Objections are, among others, that children should be accepted and loved unconditionally, that non-medical sex selection might set the scene for designer babies, that it may reinforce sexist views and gender stereotypes, and that it may distort the sex-ratio.

Conversely, critics of a prohibition argue that this procedure is not necessarily sexist, and that reproductive freedom should be respected if there is no evidence of foreseeable harm from allowing people freedom to choose. They argue that concerns that boys would be favored if selection was permitted, and that, as a consequence, the sexratio would be distorted, could easily be circumvented by allowing non-medical sex selection only for family balancing. Adhering to this condition may also lessen the risk of sexism.

Both the UK Parliamentary Science and Technology Select Committee and the Ethics Committee of the American Society of Reproductive Medicine (ASRM) have concluded that there is insufficient empirical evidence to support the prohibition of non-medical sex selection. The ESHRE Task Force on Ethics and Law has not been able to reach a unanimous decision in this regard (Shenfield et al., 2003) .

. Sex selection for non-medical reasons The Health Counc none none il of the Netherlands suggested some sort of a compromise, namely to allow sex selection for family balancing when PGD is necessary for medical reasons anyway and no additional testing is needed (Health Council, 1995, 2006). For many people, the latter will probably be more ethically acceptable than IVF/PGD specifically for non-medical sex selection. Is the sex of the child so important that it is proportional to perform and undergo IVF/PGD for non-medical reasons and if so: why precisely Isn t the request indicative of undue stereotyping The ethical debate might be enriched and better informed if counselors could provide information about specific motivations of individual applicants.

If we could reasonably conclude that applicants may, in individual cases, have a strong and ethically acceptable interest in IVF/PGD for non-medical sex-selection, it should only be done for balancing, and it should not be collectively funded (Pennings, 2002). It would be unacceptable if clinics were to become overloaded by performing IVF/ PGD for family balancing and had to postpone clients with a medical indication for PGD . If doctors take the Health Council principle that doctors should not perform any additional actions for the purpose of (non-medical) sex selection seriously, there is little room left for such selection, since doctors should give priority to embryological criteria in deciding which embryos to transfer.

Clearly, to start a new IVF cycle while there are still (high-quality) embryos of the non-preferred sex available for transfer would blur the distinction between non-medical sex selection in the context of medically indicated IVF/PGD, on one hand, and IVF/PGD just for non-medical sex selection, on the other. To modify the transfer policy for family balancing would raise problems of fairness in the context of medically indicated IVF/PGD as well ..

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