Uganda needs a body to oversee fertility treatment
Jan 07, 2009
There is more to in vitro fertilisation (IVF) than merely fertility treatment. Reproductive liberty which uses technology to subordinate early human life to extra-uterine fertilisation should be subject to moral and legal oversight. The moral issue is the
By John Mooka
There is more to in vitro fertilisation (IVF) than merely fertility treatment. Reproductive liberty which uses technology to subordinate early human life to extra-uterine fertilisation should be subject to moral and legal oversight. The moral issue is the status of the pre-implantation embryos.
The Bukoto-based fertility centre needs to disclose more information to the public about the process generally associated with IVF regarding gamete donation, embryo production, multiple pregnancies, fetal reduction, cryopreservation, discard, research, genetic diagnosis, and posthumous arrangements.
Other ethical concerns include informed consent, efficacy, access, parent determination, surrogacy, donor screening, financial compensation, decisional authority and ownership of embryos. These are complex moral issues with biological, social, and psychological risks.
The conservative view, articulated by the Catholic Church in Donum Vitae and Dignitas Personae, is the moral obligation to recognise the dignity of a person from conception to death. The zygote, the embryo, and the fetus must be accorded the rights of a person.
While the Catholic Church encourages research aimed at prevention of sterility, the moral teaching forbids all techniques of assisted reproductive technology (ART) which substitute for the conjugal act.
The Church insists on the inseparability of the unitive and procreative meanings of the conjugal act.
lTechniques which act as an aid to the conjugal act and fertilisation are permitted. Likewise, techniques directed at removing obstacles to natural fertilisation are considered licit. Gestation surrogacy and gamete donation are forbidden.
lThe extreme liberal view does not accord pre-implantation embryos and fetuses a human subject status. The only relevant ethical issues are those related to decisional authority on body tissues in treatment.
The intermediate position grants an embryo a respect greater than other human tissues because of its potential to become a person. Still, it does not accord early embryos full legal and moral rights attributed to an actual person.
Gestation surrogacy and gamete donations present problems in determining parentage due to third party involvement.
The law adopted by most states in US provides that the husband is treated in law as if he were the natural father of the child, on condition a licensed physician is involved in the artificial insemination of his wife with semen donated by another man. The husband’s consent must be in writing and signed by both him and his wife.
In some US states the donor has no paternity rights if a licensed physician is involved in the artificial insemination of an unmarried woman. In a 1986 case in California, Jhordan C. was determined by the court to be the legal father of a child conceived by a nurse who performed the insemination by herself with Jhordan’s semen. She wanted to raise the child with a woman friend without the involvement of Jhordan in parental relationship with the child. Since she did not use a licensed physician, Jhordan was granted paternity rights.
Cases of gamete ownership and disposal are not always easily solvable. In 1989 in Knoxville, Tennessee, a couple filed for divorce without reaching agreement on custody of the cryogenically preserved embryos.
The wife, Mary, wanted custody for future attempts at post marriage pregnancy. The husband preferred they remain in a fertility clinic until he could decide otherwise. The trial court vested the seven cryogenically preserved embryos in the wife for purposes of implantation. The court of appeals reversed the ruling on constitutional grounds that the husband had a “protected right not to beget a child where no pregnancy has taken place.â€
Posthumous ART arrangements are also problematic. Gamete cryopreservation has made it possible for children to be conceived after the death of the genetic parents. This raises serious moral and legal dilemmas regarding the child’s relationship to the dead and rights to the living siblings.
In 1984, a trial court in France, basing on the husband’s intention, ruled that Corinne Alain Parpalaix could legally use the sperm of her deceased husband for purposes of conceiving a child. Alain had deposited sperms with a government –operated sperm bank.
lWilliam Kane committed suicide in a California hotel, in 1991, leaving behind a will that gave custody of the sperm he deposited in a sperm bank to her girlfriend Hecht for impregnation after his death. Kane’s adult children disputed the “birth of a fatherless child.â€
The appellant court permitted Hecht the use of the sperm. While it is necessary to care for the needs of infertile couples, the flip side is the protection of the interests of children. There are many ART teenage children. Some of these children are expressing the need to know their anonymous genetic fathers leading to a conflict between the donors’ right to remain anonymous and the children’s need to identify them.
In most countries sperm banks do not disclose the identity of sperm donors. Donors are known by numbers and non-identifying information detailing profiles such as eye colour and height. Donor anonymity has also been complicated by sibling registries on the Internet which assist ART children find and communicate with each other. Since 2005, a new law in England permits children who turn 18 to know the identities of gamete donors.
The New York Times in 2005, reported a story of two half siblings whose genetic father registered in a California sperm bank as “donor 150,†they found each other on the donor registry on the Internet.
By 2007, the number of donor 150’s offspring aged between 12 and 17 had increased to six. The donor identified himself to the offspring.
With Uganda’s clan systems donor anonymity presents a danger of incest. These stories associated with actions of IVF and ART serve to alert Ugandans of the need to oversee and regulate the use of biomedical technology.
The creation of a government bioethics advisory commission is crucial. Such a body would map out moral oversight and policy framework to guide the conduct of biomedical research in Uganda.
The writer is a priest and works with Duquesne University, Pittsburgh, US
There is more to in vitro fertilisation (IVF) than merely fertility treatment. Reproductive liberty which uses technology to subordinate early human life to extra-uterine fertilisation should be subject to moral and legal oversight. The moral issue is the status of the pre-implantation embryos.
The Bukoto-based fertility centre needs to disclose more information to the public about the process generally associated with IVF regarding gamete donation, embryo production, multiple pregnancies, fetal reduction, cryopreservation, discard, research, genetic diagnosis, and posthumous arrangements.
Other ethical concerns include informed consent, efficacy, access, parent determination, surrogacy, donor screening, financial compensation, decisional authority and ownership of embryos. These are complex moral issues with biological, social, and psychological risks.
The conservative view, articulated by the Catholic Church in Donum Vitae and Dignitas Personae, is the moral obligation to recognise the dignity of a person from conception to death. The zygote, the embryo, and the fetus must be accorded the rights of a person.
While the Catholic Church encourages research aimed at prevention of sterility, the moral teaching forbids all techniques of assisted reproductive technology (ART) which substitute for the conjugal act.
The Church insists on the inseparability of the unitive and procreative meanings of the conjugal act.
lTechniques which act as an aid to the conjugal act and fertilisation are permitted. Likewise, techniques directed at removing obstacles to natural fertilisation are considered licit. Gestation surrogacy and gamete donation are forbidden.
lThe extreme liberal view does not accord pre-implantation embryos and fetuses a human subject status. The only relevant ethical issues are those related to decisional authority on body tissues in treatment.
The intermediate position grants an embryo a respect greater than other human tissues because of its potential to become a person. Still, it does not accord early embryos full legal and moral rights attributed to an actual person.
Gestation surrogacy and gamete donations present problems in determining parentage due to third party involvement.
The law adopted by most states in US provides that the husband is treated in law as if he were the natural father of the child, on condition a licensed physician is involved in the artificial insemination of his wife with semen donated by another man. The husband’s consent must be in writing and signed by both him and his wife.
In some US states the donor has no paternity rights if a licensed physician is involved in the artificial insemination of an unmarried woman. In a 1986 case in California, Jhordan C. was determined by the court to be the legal father of a child conceived by a nurse who performed the insemination by herself with Jhordan’s semen. She wanted to raise the child with a woman friend without the involvement of Jhordan in parental relationship with the child. Since she did not use a licensed physician, Jhordan was granted paternity rights.
Cases of gamete ownership and disposal are not always easily solvable. In 1989 in Knoxville, Tennessee, a couple filed for divorce without reaching agreement on custody of the cryogenically preserved embryos.
The wife, Mary, wanted custody for future attempts at post marriage pregnancy. The husband preferred they remain in a fertility clinic until he could decide otherwise. The trial court vested the seven cryogenically preserved embryos in the wife for purposes of implantation. The court of appeals reversed the ruling on constitutional grounds that the husband had a “protected right not to beget a child where no pregnancy has taken place.â€
Posthumous ART arrangements are also problematic. Gamete cryopreservation has made it possible for children to be conceived after the death of the genetic parents. This raises serious moral and legal dilemmas regarding the child’s relationship to the dead and rights to the living siblings.
In 1984, a trial court in France, basing on the husband’s intention, ruled that Corinne Alain Parpalaix could legally use the sperm of her deceased husband for purposes of conceiving a child. Alain had deposited sperms with a government –operated sperm bank.
lWilliam Kane committed suicide in a California hotel, in 1991, leaving behind a will that gave custody of the sperm he deposited in a sperm bank to her girlfriend Hecht for impregnation after his death. Kane’s adult children disputed the “birth of a fatherless child.â€
The appellant court permitted Hecht the use of the sperm. While it is necessary to care for the needs of infertile couples, the flip side is the protection of the interests of children. There are many ART teenage children. Some of these children are expressing the need to know their anonymous genetic fathers leading to a conflict between the donors’ right to remain anonymous and the children’s need to identify them.
In most countries sperm banks do not disclose the identity of sperm donors. Donors are known by numbers and non-identifying information detailing profiles such as eye colour and height. Donor anonymity has also been complicated by sibling registries on the Internet which assist ART children find and communicate with each other. Since 2005, a new law in England permits children who turn 18 to know the identities of gamete donors.
The New York Times in 2005, reported a story of two half siblings whose genetic father registered in a California sperm bank as “donor 150,†they found each other on the donor registry on the Internet.
By 2007, the number of donor 150’s offspring aged between 12 and 17 had increased to six. The donor identified himself to the offspring.
With Uganda’s clan systems donor anonymity presents a danger of incest. These stories associated with actions of IVF and ART serve to alert Ugandans of the need to oversee and regulate the use of biomedical technology.
The creation of a government bioethics advisory commission is crucial. Such a body would map out moral oversight and policy framework to guide the conduct of biomedical research in Uganda.
The writer is a priest and works with Duquesne University, Pittsburgh, US