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Reproduction: Beginning Lives 04.02.15

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Sarah Chan

on 4 February 2015

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Transcript of Reproduction: Beginning Lives 04.02.15

SEX
REPRODUCTION
SEX
adoption
IVF
gamete donation
surrogacy
artificial insemination
mtDNA transplant
(3-parent embryo)
contraception
abortion
Changing social attitudes
Reproductive choices
What sort of choices are available?
(What sort of choices should be available? And to whom?)
What does reproduction mean to us?
What do we mean by ‘reproduction’?
And why is it important?
What is reproduction?
Genetic
Biological / gestational
Social / rearing
production of genetically related children
gamete donation
natural sexual reproduction
reproductive cloning?:
100% genetically related
physical gestation of child
currently (mostly) women only
womb transplants
for men?
founding a family
raising a child
forming relationship with new individual
parental responsibility
ectogenesis?
gamete donors:
genetic without biological or social

... although donor children will
be able to find parents in future
surrogacy:
gestational without
(necessarily) genetic or social

... although disputes over parenthood
adoption:
social parenthood without genetic or gestational link
& why is it important?
Sex and reproduction
(part 2)

Link between sex and reproduction has in the past led to link between sex and (reproductive) morality
Eg, incest, extramarital sex, homosexuality
Female role in reproduction is still a biological necessity (for now)
But does this mean it is and should remain more important to women?
‘Reproductive sexism': is reproduction ‘women’s business’?
Procreative autonomy
or "reproductive liberty"
freedom (right?) to control (aspects of) our own reproduction:
whether, when and how to reproduce
(what sort of children to have?)
characterised as a fundamental right:
“central importance to individual meaning, dignity and identity” (Robertson)
“right to control their own role in procreation” (Dworkin)
Respect for autonomy and for values underlying procreation
Freedom to make choices about one's life
Reproduction as a lifestyle choice vs children as individuals of value?
The right (not)
to reproduce

Do we have the right to choose not to reproduce?
Why wouldn't we?
obligation to sustain human race?
Women: bodily integrity
Men?
Children of Men (film)
The Handmaid's Tale (Atwood)
Battlestar Galactica (TV)
If so, is this a negative right, a mere liberty?
Right to non-interference with act of reproduction
Or is it a positive right that implies some sort of correlative duty of assistance?
access to assisted reproduction
financial support for raising children?
Is there a right to
have children?
Who should have access to ART?
IVF is available...
on the NHS
but not everywhere
and not necessarily to everyone

HFEAct 1990 (mod 2008):
factors that must be considered
Australia: McBain case
Right to IVF for single mothers and lesbian parents
"socially infertile"??
Is there an entitlement
to state-funded IVF?

Inefficient use of resources
Justice and equality
Post-menopausal mothers
Who are our children?
Non-genetic and non-biological reproduction is a valid form of procreation (Eg adoption)
Creation of ‘intellectual heirs’
Do ‘children’ have to be human?
How does this compare with right to adopt?
A duty not to reproduce?
Could there ever be a duty not to reproduce?



Population control
The "life not worth living":
are there some children who should not be brought into existence?
Regulating reproduction
Future reproductive technologies
What's important about genetics?
The Evans case
Ms Evans suffered from ovarian cancer
She wanted to have children
She and Mr Johnston created IVF embryos together before the cancer treatment, knowing this would be her last chance to have her own children
The couple then separated, but Ms E still wanted to have children
Mr J refused permission for Ms E to have the embryos implanted
Can embryos be rightfully considered as property?
Who controls them and determines their fate?
If they are, who owns them?
Equal shares because
of contribution?
They could have half each
But this was not the essence
of Mr J’s objection
The story
Who owns the embryos?
The dilemma
Whose claim should win?
Is Ms E’s claim to have her own genetic children stronger than Mr J’s claim not to have his own genetic children brought into existence?
A right not to have to sustain and support children, yes
What is the moral significance of genetics?
What if Mr J had a twin brother? Would he have the right to prevent him having children?
Is there a right to have one's own genetic children?
Is there a right not to?
Then can there be a positive right to have one’s own genetic children?
Reproduction is more than just genetics:
Contribution of time and labour
Emotional investment

Maybe if one is going to invest these things, there is a right to choose whether the child in which they are invested is genetically related?
But there would still be no right NOT to have genetic children
What measures can/should the state legitimately take to control reproduction?
Is this an example of naturalistic bias?
What if all reproduction required technological intervention?
What if contraception was universal?
Is restricting availability of IVF discriminating against those who are infertile?
Who should be 'allowed' to reproduce?
We do not (usually) enforce contraception or sterilisation on those who can reproduce naturally
Forced sterilisation: infringement of procreative autonomy...
...or not?
Buck vs Bell - US 1927
Perhaps all parents should be licensed?
Ectogenesis
Stem cell-derived gametes
To what extent do current social and regulatory attitudes towards reproduction reflect existing (though not necessarily justified) social normativities regarding relationships and family structures?
Exploding the nuclear family ideal:
for better or worse?
How do emerging family forms (often enabled by ARTs) challenge these normativities?
"childless by choice"
poly-parenting
co-parenting outside romantic/sexual relationship
single parenting
older parents
gay parents
In what ways does this lead us to reconceptualise our understandings of reproduction and family?
choices about which aspects of reproduction to pursue
Womb transplants
Reproductive cloning
Male pregnancy
'Cybrid' embryos
In-vitro gestation
Would remove physical link with mother
... and need for woman's body
Implications for abortion
and men's reproductive rights
as well as women's - addresses biological asymmetry
Might one day allow production of gametes from any cell of the body
Implications for same-sex reproduction
... and for genetic privacy?
Potential to allow women with Uterine Infertility Factor to carry and bear children
(why is this important?)

... and to alter notions of gestational parenthood
Would allow 100% genetic reproduction

Risks of procedure
Other ethical issues?
Would enable men also to gestate and bear children
Implications for men's and women's reproductive rights

... and also for understandings of gender and biological roles
Cytoplasmic hybrid embryos
using human nucleus and animal oocyte

At present for research only...

... but what other ethical issues might arise?
1978: Louise Brown,
first test-tube baby
allows infertile couples to reproduce
also
single parents
gay parents
post-menopausal mothers
PGD
allows selection of children
for various characteristics
Non-obligatory but potentially still coercive state policies to encourage people to reproduce – eg “baby bonus” in some countries?
Sex, gender & reproduction
Should reproduction (and especially pregnancy) remain primarily 'women's business'?
If so... why?
How does the biological asymmetry of sex in relation to reproduction influence gender norms in society more generally?
Why are possibilities that transgress the norms of sex and gender perceived as so threatening - particularly with respect to reproduction?
http://www.news-medical.net/news/20120213/Transgender-man-falls-pregnant-and-becomes-a-natural-mother.aspx
"Transgender man falls pregnant and becomes a natural mother"
"Medical ethics experts have called for a full inquiry into the issues surrounding transgender births, saying the interests of the child should not be risked to “fulfill the rights of an adult”."
“I don't think it is in the interests of the child to distort nature this way. We are prepared to do anything possible to fulfill the rights of the adult. But I think it is at the expense and rights and welfare of the child.” (Josephine Quintavalle, CORE)
"“You are hardly going to end up with a baby that's going to have a happy, productive and optimal childhood.” (Dr Trevor Stammers, St Mary's University College, London)
Note also laws in various countries requiring sterilisation before trans person recognised as appropriate gender!
Full transcript