UNP-MEDICINE 2021 BIOETHICS

APPLIED ETHICS
LECTURER: IRWINA LAZO, MD OCTOBER 21, 2019

HEAD NOTES IN VITRO FERTILIZATION

 TITLE/EMPHASIZED - several eggs and sperms will be collected or harvested and let
 AUDIO it fertillized outside the body (test tube/petri dish) and more
 NOTES/RECALLS/ADD-ONS than 1 healthy or undefective zygotes, which are from the
union of sperm and egg cell, will be implanted in female’s
CLINICAL BIOETHICS uterus
Practical & applied discipline that aims to improve patient care & patient - other defective zygotes will be discarded (some may be use
outcomes by focusing on a right (scientific & technical abilities) and for research);
good (ethical standards) medical decision. - PRINCIPLE APPLIED: Inviobility of Life

Ethical theories & doctrines

↓
applied to specific clinical situations
(valid and legitimate)
↓
applied Clinical Ethics

APPLIED CLINICAL ETHICS

I. Care at the beginning of life
1. In-vitro fertilization (IVF)
2. Artificial insemination (AI)
3. Surrogacy
4. Genetic engineering
5. Human cloning
6. Abortion
7. Contraception & birth control
II. Other moral issues
1. Stem cell research & therapy
2. Organic transplant

IN-VITRO FERTILIZATION (IVF)

 IN VITRO means “OUTSIDE”- harvest an egg cell from female and
sperm cell form male and fertilize outside the human body
 IN VIVO menas “INSIDE”- normal process
 Fusion of gametes/ sex cells outside the human body
a. “laboratory fertilization”
b. “within-a-glass-petri dish”
c. “test-tube”
 Conception outside the uterus/ womb
 “procreation without the conjugal act”
 PRINCIPLE APPLIED: Personalized sexuality
- Yes, there’s a procreation but NO unitive aspect is done  Goals of IVF
when it comes to in vitro fertilization  Observe & evaluate the process of fertilization in vitro
 Test the effectiveness of anti-fertility agents
 Assess the structural & biochemical normality of the conceptus
IN VIVO FERTILIZATIO: Normal Process in patients with repeated abortions
 Understand mechanisms for genetic studies
 Advance understanding of normal & abnormal cell growth &
differentiation
 Alleviation of genetic disorders & other deformities

 Ethical Considerations
 Christian Ethics:
- Preservation of the biological process of human
reproduction must be upheld at all times
- No medically scientific end, however noble it may be, can
in any way justify the manipulation of human embryos,
whether viable or not, either inside or outside the mother’s
womb- manipulation of normal process of fertilization
 Moral pragmatist & utilitarian moralist:
- Scientific knowledge gained by biomedical specialists is
beneficial, useful, advantageous and profitable in the
understanding of human reproduction
- Million ang halaga, most of the times first try is not
successful so they try for the second time.

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 UNP-MEDICINE 2021 BIOETHICS
- Discovery of medical drugs for fetal disorders & children’s  Justice
diseases - Prohibitive cost
- Limits availability only to the rich
 Situational ethics: - If public funds are used: essential needs may be
- Answer to childlessness abandoned
- Scientific technological way by which sterile couple can  Respect for persons
“subdue nature” in order to carry out the mandate of “go & - Human body, egg, sperm, uterus become commodities
multiply” - Unused embryos are discarded or disposed as desired
- Non-biological means (procreation without the conjugal  Personalized sexuality
act) is justified to attain a good end (begetting a child) - Separation of unitive & procreative aspect of the conjugal
act

ARTIFICIAL INSEMINATION (AI) SURROGACY

 Depositing a man’s semen through the use of instruments:  Latin word – “surrogatus” – “in place of another”
a. Intravaginal (vaginal vault)  English word – “surrogate” – “substitute”
b. Intracervical (cervical cavity)  Surrogate Motherhood
c. Intrauterine (uterine cavity) - biomedical technique where a fertilized ovum is implanted
- In here, it can be that the mother/wife can conceived naturally, to the uterus of another woman who will carry the baby to
ang problema nito is the father or the sperm source. term either as a favour or for a fee
- Harvest a sperm from the husband or donor and deposit into - “womb for hire”
the uterus - “uterus for rent”
- Traditional surrogacy (IUI)
 TWO TYPES OF AI - Gestational surrogacy (IVF)
 Homologous AI (AIH) - sperm donor is the husband
 Heterologous AI (AID) - sperm donor other than
husband

 Justifications for AIH

 Husband’s impotence
 Anatomical defects of husband’s urethra
 Oligospermis
 Spinal injury/medical probems hindering normal
intercourse
 Desire to beget children after vasectomy
-Vasectomy is a permanent contraception in males
 Sperm cannot reach the ovum due to physiological
obstructions in the genital apparatus of the wife

 Justifications for AID

 Azoospermia
 Husband is carrier of hereditary disease
 Wife’s fallopian tubes are defective/ damage (eq gonorrhea)
 Ethical Considerations
 Christian Ethics:
AIH
- Child is not a fruit of
conjugal love
- Transfers procreation into
a biological laboratory
Sperm bank
 Ethical Considerations
AID
- Contrary to the unity of
marriage, dignity of
couples & vocation proper
to parents and to the
child’s right to be
conceived to the world in
marriage & from marriage
 Christian Ethics:
- high-tech form of “baby-farming”
- by all indications, not suitable and proper for human
nature
 Situation Ethics:
- allowed out of “agapeic love”
- solve childlessness or infertility
- noble end: having child
means: natural process of conception
 Utilitarian Ethics:
- what counts is the greatest benefits and happiness that
surrogacy will bring forth a childless couple and infertile
individual

GENETIC ENGINEERING (GE)

 Inviolability of life
- Unwanted zygotes are allowed to die
 Stewardship
- Procedure is artificial & replaces the conjugal act
 Non-maleficence
- “genealogical bewilderment syndrome”
- If donor-sperms → unknown biological lineage
- Mother is psychologically harmed by unsuccessful attempts
 Greek words- genea- “breed, kind ”
 Genesis- “origin”
 Engineering
 Essence: design, construction, operation and building
 Introduction of human design (order or arrangement) into the
formation of new genetic produce or result
 Biochemical studies or chromosomal analysis
 Purpose: detects diseases caused by genetics
 Genetic modification or genetic manipulation of an organism’s genes
using biotechnology
 Changing base-pair (A-T or C-G)
 Deleting a region of DNA
 Introducing an additional copy of a gene

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 UNP-MEDICINE 2021 BIOETHICS
 Extracting DNA from one organism & combining it with the DNA of
another organism

End result: modification of characteristics

The Hierarchical Structure of DNA through to the Chromosome

 Have humans been cloned?

 Despite several highly publicized claims, human cloning still
appears to be fiction. There currently is no solid scientific
evidence that anyone has cloned human embryos.
 Ethical considerations
 DNA (genes and other nucleotides) reside in 46 chromosomes
 Justifications
 Human DNA stretched out measures some 6 feet/1.8 meters
 Genes are nucleotides that get expressed in the real world a. Way to perpetuate genius
 Nucleotides are multiple segments of DNA base pairs b. Improvement of human race
 DNA is a combination of 4 possible amino acids, bound in pairs, c. Prevention of genetic disease in selected fosterity
in a double helix structure d. It provide “immortality” to donors
 Christian ethics
 Ethical Considerations - Chromosomal manipulation or intervention is contrary
 Genetic intervention, for certain noble ends, may “intervene” in
to the dignity, integrity & identity of the human being
the “human genome” – the genetic package of human
development  Inviolability of life
 DNA & RNA - Embryos are destroyed
 Christian Ethics:  Stewardship
- genetic intervention if strictly therapeutic, whose - Process is artificial being a laboratory procedure
explicit objective is the healing of medical disease  Nonmaleficence
resulting from chromosomal defects, is considered
- Concept of family is distorted
desirable and morally acceptable
- Psychological & physical risk to the child
 Justice
Human Cloning
 Greek word “clone” – twig - Only the rich can afford the procedure
 Cutting a pkant stuck in the soil in which the cut twig is able to grow  Respect for persons
into a “new plant” with the same genetic composition as the original - Denatured & destroyed by stockbreeding with no
 Non-sexual reproduction uniqueness & individuality
 Cloning procedure: - Embryo becomes tools for experimentation
 Personalized sexuality

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