T2 L8 Assisted reproduction: social and ethical issues

Question 1

What are the definitions of fertility problems?

Answer 1

Inability of a woman of child-bearing age to become pregnant after a specified period of attempting to conceive
Repeated loss of pregnancy due to miscarriage
Loss of ability to conceive due to previous medical treatment
Inability to conceive due to age of women
Inability to conceive unassisted due to gender of prospective parent or single status

Question 2

Is infertility a medical or social problem?

Answer 2

Could be a symptom of underlying medical condition

Objective of treatment is the birth of a child and not the removal of the medical problem

Question 3

Describe the relationship between social values and fertility

Answer 3

Value placed upon procreation in and of itself
Strong social norms around reproducing and devaluing / stigma of childlessness
Importance placed on parenting

Question 4

How could you argue the importance placed on parenting?

Answer 4

One can become a parent to any child and not just those one gives birth to

Question 5

Describe the arguing against disease model

Answer 5

Infertility in and of itself isn’t a disease
A disease causes physical or psychological discomfort or reduce one’s projected lifespan
Not being able to reproduce may cause distress
One doesn’t have a right to one’s desired life experiences

Question 6

Why can not being able to reproduce cause distress?

Answer 6

Women’s inability to experience pregnancy and childbirth

Inability to conform to social norm of reproducing

Question 7

How does IVF challenge our ideas about parenting?

Answer 7

Consideration of: genetic/gestational /care-giving mother and genetic/care-giving father

Question 8

What are some objections to IVF?

Answer 8

It’s not natural
Catholic Church: separation of sex and conception
Moral status of the embryo, surplus embryos

Question 9

What are NICE recommendations for infertility treatment?

Answer 9

NHS should offer 3 cycles of IVF to women aged 25-39 who have an identified cause of their infertility problems or unexplained infertility for 3 years
1 cycle for women aged 40-42

Question 10

How much does a cycle of IVF cost the NHS?

Answer 10

£3000

Question 11

What are clinical commissioning groups?

Answer 11

Smaller, subunits of NHS

Each group has different rules of the NHS

Question 12

What are some examples of additional requirements given by clinical commissioning groups?

Answer 12

Not having any children already (from current and previous relationships)
Being a healthy weight
Not smoking
Falling into certain age range

Question 13

What are some non-economic considerations?

Answer 13

Women’s ability to become pregnant dramatically decreases with age so chance of IVF success decreases with age
Low success rate means destruction of more implanted embryos

Question 14

Are there any particular groups whose access for ARTs should be limited / denied?

Answer 14

Whether you already have children
Serious criminal record
Financially able to support a child
Life expectancy

Question 15

What is the welfare of the child consideration?

Answer 15

Requires that prior to being offered treatment, clinicians must assess patients in terms of risk of serious medical, physical or psychological harm to the child

Question 16

What questions do clinicians ask patients before offering treatment to assess welfare?

Answer 16

Previous convictions related to harming children
contact with social services over care of existing children
Serious violence or discord within family
Serious drug or alcohol abuse
Serious mental or physical conditions
Risk to child of a serious medical condition

Question 17

What are some arguments for the welfare of child assessment?

Answer 17

Responsibilities to potential child
Responsibilities to society including taxpayers and social services
Opportunity to prevent harm
Protect family as a valuable social institution

Question 18

What are some arguments against the welfare of child assessment?

Answer 18

Fertile parents don’t have to justify their ability to be parents
Institution of family has changed
Potential for abuse and discrimination in making judgements
Clinicians aren’t trained to assess such complex social situations
Different attitudes of clinicians with different units
Person shouldn’t be denied aspects of citizenship based on their past
Existence is preferable to non-existence

Question 19

What is the concern of the right to know law?

Answer 19

A drop in donation levels which will affect future infertile couples