Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

JME Blog, 15 November 2017
Authors: Rosalind J McDougall, Lynn Gillam, Clare Delany, Yasmin Jayasinghe
“These were the kinds of questions that doctors brought to our clinical ethics service. They wanted ethical advice about offering surgical procedures for young children with cancer, aimed at preserving fertility. This is an area of rapidly developing science, but there is currently little evidence that the fertility preservation process works for very young patients.”
Find article here.

Designing Ethical Trials of Germline Gene Editing

N Engl J Med 2017; 377:1911-1913
Author: Bryan Cwik
“Much of the biomedical ethics literature on gene editing has focused on broad social issues related to how it should be done, such as questions about using it for enhancing human cognitive abilities. Comparatively little has dealt with more ground-floor ethical issues about the design of clinical trials and use of gene editing in reproductive medicine. The time for that discussion has now come: foreseeable use of gene editing in reproductive medicine is no longer science fiction, and it’s important to consider seriously what would be required for the conduct of ethically sound clinical trials of this new technology.”
Find article here.

Bioethicists raise alarm about conflicts of interest in Australia’s IVF industry

SMH, 2 November 2017
Author: Esther Han
“A team of Australian bioethicists has found that conflicts of interest are leading to fertility doctors making decisions that financially benefit them and their employer, at the expense of their patients.”
Find article here.

Dealing with treatment and transfer requests: how PGD-professionals discuss ethical challenges arising in everyday practice

Med Health Care and Philos, 2017, pp1-12
Authors: Soto-Lafontaine, M., Dondorp, W., Provoost, V. et al.
“How do professionals working in pre-implantation genetic diagnosis (PGD) reflect upon their decision making with regard to ethical challenges arising in everyday practice? Two focus group discussions were held with staff of reproductive genetic clinics: one in Utrecht (The Netherlands) with PGD-professionals from Dutch PGD-centres and one in Prague (Czech Republic) with PGD-professionals working in centres in different European countries. Both meetings consisted of two parts, exploring participants’ views regarding (1) treatment requests for conditions that may not fulfill traditional indications criteria for PGD, and (2) treatment and transfer requests involving welfare-of-the-child considerations.”
Find article here.

Ectogenesis, abortion and a right to the death of the fetus

Bioethics. 2017;31:697–702.
Author: Joona Räsänen
“Many people believe that the abortion debate will end when at some point in the future it will be possible for fetuses to develop outside the womb. Ectogenesis, as this technology is called, would make possible to reconcile pro-life and pro-choice positions. That is because it is commonly believed that there is no right to the death of the fetus if it can be detached alive and gestated in an artificial womb. Recently Eric Mathison and Jeremy Davis defended this position, by arguing against three common arguments for a right to the death of the fetus. I claim that their arguments are mistaken.”
Find article here.

Let us talk about eggs! Professional resistance to elective egg vitrification and gendered medical paternalism

Med Health Care and Philos (2017), p1-13
Authors: Judit Sándor, Lilla Vicsek, Zsófia Bauer
“In this paper, by applying a feminist bioethical perspective, we identify a new form of medical paternalism that still shapes contemporary legal policies on human egg cryopreservation performed without medical reasons. The fear of negligent, careless women who opt to delay their pregnancy for mere convenience is a widely known gender biased stereotype. Nevertheless, the opinions and judgments of medical professionals on this issue have not yet been sufficiently explored by in-depth research. In this essay, therefore, first we look at the broader bioethical, legal, and social aspects of human egg cryopreservation. In the second part of the paper we discuss a unique qualitative study conducted with professionals working at Hungarian IVF clinics.”
Find article here.

Nudge me, help my baby: on other-regarding nudges

Journal of Medical Ethics 2017; 43: 702-706.
Authors: Hafez Ismaili M’hamdi, Medard Hilhorst, Eric A P Steegers, Inez de Beaufort
“In the period surrounding pregnancy, maternal choice behaviour has a significant influence on perinatal morbidity and mortality as well as the development of chronic diseases later in life. One’s health is thus a matter of one’s own as well as one’s maternal choices. Therefore, self-regarding and other-regarding nudges should be considered as viable strategies to promote health. In this article, we introduce the concept of other-regarding nudges. We use the harm principle and the principle of beneficence to justify these other-regarding nudges. We conclude by stressing the importance of a fair assessment of expectations towards the nudgee, when determining whether a nudge is aimed at preventing harm or promoting a good.”
Find article here.

Call for change to human cloning law to prevent genetic disorder

SMH, 21 September 2017
Authors: Aisha Dow, Melissa Cunningham
“A procedure to create “three-person babies” could be on its way to Australia, with a campaign launched to overhaul a law on human cloning in an attempt to prevent babies from suffering a severe genetic disorder.”
Find article here.

Evolving State-Based Contraceptive and Abortion Policies

JAMA. 2017; 317(24): 2481-2482
Authors: Divya Mallampati, Melissa A. Simon, Elizabeth Janiak
“This Viewpoint discusses the importance of US state-based contraceptive and abortion policies given renewed focus by the Trump administration on restrictions to federal funding for reproductive services.”
Find article here.