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ISAR conference delegates' views on Ethics and ART
Our Bureau, Indore | Monday, February 17, 2003, 08:00 Hrs  [IST]

The Assisted Reproduction Techniques (ART) laboratories in France have over 200,000 embryos kept under cryopresevation following a ban on destruction of embryo after In-Vitro Fertilization (IVF), said Paris University professor Dr Jean Cohen, discussing ethical aspects involved with ART. The laws formulated under the Catholic pressure don't allow the destruction of an embryo, thus forcing the laboratories to store them, till one is adopted.

Talking about the government control over the laboratories in France, Dr Cohen said that the authorities don't know what they are controlling. ``The other day an official came to inspect our laboratory and she was not even aware of what a microscope looked like,'' he said, highlighting the need of framing laws and allowing the recognized medical institutions/organizations to keep them under leash.

Describing laws regarding ART in different countries and their impact on societies, Dr Cohen said in Sweden, there can be no anonymous sperm donations. ``The Swedish women go to Denmark for the procedures,'' he said.

Ethics and legalities have been a major topic of discussion among the delegates of the 9th National Congress of Indian Society of Assisted Reproduction (ISAR) held here recently.

Most of them were of the view that whenever there is a development of newer technology, the ethical problems multiply this due to the non-acceptance or slow acceptance of the technology and more so when it is related to human reproduction.

The delegates felt that since centuries, abortion has been the major ethical dilemma in human reproduction. Today, throughout the world, scientists are working with human gametes and embryos are faced with ethical dilemmas.

The main issues of ethics 25 years ago, with the birth of Louise Brown, still remain with an addition of a few more questions on Pre-implantation Genetic Diagnosis (PGD), genetic manipulation, gender manipulation, designer babies and cloning.

Some of the ethical objections to the In-Vitro Fertilization (IVF) process itself was raised early and was based on the perception of the society that the whole process was unnatural and would effect human rights, social structure and health policy.

The various religions today, including Judaism, Islam and a part of Christianity, Hinduism and Buddhism have now accepted IVF as a treatment modality within marital framework, he said adding third party reproduction is still not accepted in these religious groups as it disregards sanctity of human life and separates human procreation from sexual intercourse.

The ethical dilemma in establishing the moral rights of embryo was not yet resolved. Some believe that the pre-embryo has no moral status, as it was just a collection of cells without any individuality and may be compared to any other individual human tissue.

Different countries have different legislative definitions of embryos. Despite these discrepancies, all countries have agreed upon one thing - although pre-implantation embryo is not a complete human in itself, it has the potential to become future human being and, therefore, deserves society's respect as a biological entity. And hence ethical guidelines have to be implemented with reference to current knowledge about its possible misuse, they said.

Major objections on IVF has come from the `Vatican View ' which feels that all those involved in fertilizing human gametes outside the body are trying to play God. Some believe that right from the fertilization stage, the embryo should be considered as human beings, therefore no embryo should be created, if its is not transferred into a uterus.

The feminists have a different viewpoint. They out-rightly refuse to accept reproductive technology as means of having children. They feel that it is a male dominated area where a woman's body is used as an experimental laboratory for a kind of treatment where there are more failures than success.

The possible ill effects of IVF on the offspring, due to the artificial nature of the process, are another major areas of concern - and a serious objection.

The donation of embryo donation is a very sensitive issue, especially the disclosure of identity. Here, three conflicting human rights are at stake - right of autonomy and privacy of parents, right of privacy of the donor and the right of the child to know his/her origins.

Today, sperm donation and oocyte sharing have become an integral part of ART. Gestational surrogacy has become an accepted fact. The ethical questions raised now are pertaining to the meaning of parentage - genetic, biological, surrogate or adopted - the family values and, of course, the sanctity of what some groups feel, the `natural order of human spousal procreation', the ISAR delegates felt.

Another issue of hot-debate in ISAR 2003 was the cryopreservation of embryos and embryo research. The experts felt that the research should not be subject to any commercial profits, the embryos should not be used for cloning and production of hybrids or inter species or implanting of human embryos in animal wombs.

The ethical debate went on without any firm outcome on sex selection, artificial insemination in single women, donor eggs from aborted female tissue, oocyte donation in post-menopausal women using sperm cells and immature oocytes, preserving ovarian and testicular tissue to get gametes out of them, embryo transfer after husband's death, use of frozen sperm after husband's death and others.

The newer issues like the pre-implantation genetic screening by using blastomere biopsy and FISH techniques may be acceptable to produce disease-free human race, but gender pre-selection, sex ratio manipulation and genetic manipulation to produce designer babies, need thought and debate, they felt.

Human cloning, after the induced death of first mammalian clone, Dolly, suffering from severe lung infection and arthritis, two days ago, was another topic that attracted attention.

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