Tag: assisted reproductive technology

Brews and Views returns, addresses “the science and ethics of IVF and artificial wombs”

Can society and the judicial system keep pace with the technologies of in vitro fertilization (IVF), stem cell biology, artificial wombs, and in vitro gestation?

Simple green line drawing depicting a fetus and its umbilical cord inside a circular womb.

On a Friday evening in late September, there was an obvious energy in the IQ Building atrium as faculty, staff, and researchers gathered for the first in-person Brews and Views event in well over two years. Chris Contag, Director of the Institute for Quantitative Health Science and Engineering, noted this significance as he introduced the session on “Human Reproduction in a Dish: The Science and Ethics of IVF & Artificial Wombs.”

A panel of experts sat facing the audience, ready to share their perspectives on innovations to the science of human reproduction that could dramatically impact reproductive health. These experts were Jennifer Carter-Johnson, PhD, JD, associate professor, College of Law; Leonard Fleck, PhD, professor, Center for Bioethics and Social Justice, College of Human Medicine; Richard Leach, MD, professor and chair, Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine; and Margaret Petroff, PhD, professor, Department of Pathobiology & Diagnostic Investigation, College of Veterinary Medicine.

Dr. Leach, reproductive endocrinologist and infertility specialist, explained new developments in human gamete derivation or in vitro gametogenesis (IVG) for IVF. Citing research on this process that has been successful in mice, he explained a future where it could be possible to create human embryos by taking an adult’s cells and reprogramming them into egg and sperm cells. Asking attendees to consider this possible future, he noted that there are already three companies in the U.S. and Japan related to IVG.

How far are we from this type of assisted reproductive technology (ART) existing? Dr. Margaret Petroff shared that there currently are 2.5 million IVF cycles per year—more than 500,000 babies born each year globally. Dr. Petroff stressed that there is still much to learn about long-term health effects of ART, and that long-term epidemiological studies are needed to learn about impacts of all types of ART.

What is it that makes us human? Dr. Jennifer Carter-Johnson, who is an associate professor of law with a background in microbiology, asked attendees to think about how life is defined—ethically, scientifically, legally. She noted that there is no good definition, that discussing human life is legally ambiguous. In contrast, there is legal precedent about when human life ends. Dr. Carter-Johnson discussed the complexities and unknowns related to the June 2022 Dobbs decision that overturned Roe v. Wade. Individual U.S. states are now making different decisions about access to abortion, and about how a person is defined. If life were to be legally defined as beginning at conception, that would greatly impact the current and future use of IVF and ART.

Philosopher and medical ethicist Dr. Leonard Fleck introduced the idea of an artificial womb and what medical purpose it would serve were it to exist. In theory an artificial womb might be used to save a fetus that was going to be born before viability, or by someone without a uterus. He characterized it as a micro version of a neonatal intensive care unit. The idea of an artificial womb brought up a wide variety of ethical questions related to abortion, who has the right to make decisions about a fetus in an artificial womb, and the high cost of the use of such technology creating access barriers and utilizing limited healthcare resources.

One message from the panelists in the discussion that followed was the importance of thinking about guidelines for this technology now, rather than waiting. The complexity of the topic continued to be apparent—legal, ethical, scientific, safety, health policy, and societal implications.

The question and answer portion brought forth more unique perspectives, demonstrated with both passion and vulnerability from panelists and attendees.

“We can only see a limited distance into the future when trying to assess new technologies,” stated Dr. Fleck. The event generated more questions than answers, but that is the very nature of the mission of Brews and Views. Though the event had officially ended, the room remained abuzz with conversation.

While Brews and Views continued virtually during 2020 and 2021, this event was not only the first in-person offering is years, but also the first that explored a non-COVID topic since the pandemic began. The series is an ongoing collaboration between the Institute for Quantitative Health Science and Engineering (IQ) and the Center for Bioethics and Social Justice, and aims to hold moderated discussions addressing fascinating and provocative areas of bioscience and engineering.

Dr. Fleck presents on ‘Genetics, Ethics, and the Future of Human Reproduction’ at community event

Leonard Fleck photoOn November 2, Center Professor Len Fleck, PhD, spoke at the Grace A. Dow Memorial Library in Midland, MI as part of a community engagement project. Dr. Fleck’s presentation, “From Chance to Choice: Genetics, Ethics, and the Future of Human Reproduction,” is summarized below. The premise for this presentation was a comment by Philip Kitcher in his book Lives to Come: The Genetic Revolution and Human Possibilities. His comment was that we had exited the age of genetic innocence and were now in the age of genetic responsibility (from which we could not exit).

Kitcher wrote that comment more than twenty years ago, when that comment still had a futuristic tinge to it. Today we are solidly in the age of genetic responsibility. Thirty years ago, future possible parents had to conceive “in fear and trembling” (to quote Soren Kierkegaard). They had no idea what genetic risks they might impose upon their future possible children. If a child was born with a serious, life-threatening genetic disorder, this was unfortunate, but no one was ethically blameworthy for that outcome. Today, with the availability of whole genome sequencing for about $1000, a couple can find out whether or not they might pose some serious genetic risk to their future possible children, along with alternative reproductive options that might allow them to bypass that risk, such as pre-implantation genetic diagnosis of eight-cell embryos conceived in vitro. With that new knowledge (or possibility for knowledge) comes new responsibility.

What sort of responsibilities might these future possible parents have? They might chose to have their children in the usual way. A liberal, pluralistic democratic society would be politically obligated to respect such a choice because these parents have both privacy rights and procreative liberty rights. This might mean a child will be born with cystic fibrosis, and all the health costs associated with that. That same liberal, pluralistic society will have obligations of justice and beneficence to provide the care (at social expense) needed by that child to have as good a life as possible (even though some taxpayers might object to paying for avoidable health care expenses).

There will also be many in our society who will object to permitting other future possible parents availing themselves of pre-implantation genetic diagnosis (PGD), which will involve the creation and discarding of some number of excess embryos carrying a serious genetic defect. However, this too is a liberty right and privacy right of these parents, which advocates for a Right to Life position may not justly deny these parents. Further, the cost of having a child via PGD will be about $40,000. This is a cost that might also require public financial support, which would be a matter of social genetic responsibility. Right to Life advocates might object to paying taxes to support an intervention to which they deeply conscientiously object. Still, this is what they are ethically and politically obligated to do. This is a matter of reciprocity, what the political philosopher, John Rawls, refers to as fair terms of cooperation.

In the future we will see our capacity to do gene editing at the embryonic level successfully evolve, which will require yet more ethical analysis of what this means for parental and social responsibility. It will also politically require much more mutual respect for diverse understandings of responsible reproductive decision making, which is what the ideals of a liberal, pluralistic society justly expects.

Intentional Parenthood’s Promise: Redefining Legal Parentage for the 21st Century

bbag-icon-decIntentional Parenthood’s Promise: Redefining Legal Parentage for the 21st Century

Event Flyer

Who is a legal parent? The answer used to be fairly straightforward. For instance, a woman who gave birth to a child was presumed the legal and genetic mother of the child. The increased use of assisted reproductive technology (“ART”) means that a birth mother may not necessarily be the child’s legal or genetic mother. Rather, a gestational surrogate may have been implanted with an embryo created by the sperm and oocyte of donors for a couple who wishes to parent the child. Courts have slowly begun to embrace intentional parenthood doctrine; that is, the person who intends to parent the child and engaged in actions that resulted in the child’s birth (such as hiring a surrogate) is the child’s legal parent. Most states have laws that provide that a sperm or oocyte donor is not a child’s legal parent, but application of those laws varies due to jurisdictional differences, complicated facts, or variance with other laws. Although intentional parentage has been used in some jurisdictions to determine legal parentage, its embrace is far from uniform. Should all jurisdictions employ intentional parenthood doctrine? If so, what impact will (should) intentional parenthood doctrine have for families that do not use ART?

feb-18-bbagJoin us for Melanie B. Jacobs’ lecture on Wednesday, February 18, 2015 from noon till 1 pm in person or online.

Professor Melanie B. Jacobs joined the Michigan State University College of Law faculty in 2002 and as of July 2013, she also serves as the Associate Dean for Graduate and International Programs at MSU College of Law. Professor Jacobs has written articles and given numerous national and international presentations regarding the need to establish legal recognition for non-nuclear families. She is the 2014 Chair-Elect of the Association of American Law Schools’ Family & Juvenile Law Section. Most recently, she has given lectures in China and Dubai, UAE regarding the 21st Century American Family. Professor Jacobs’ current research and scholarship explores the link between procreative autonomy and intentional parenthood. Professor Jacobs received her A.B. from Columbia College in New York City, her J.D. from Boston University, and her LL.M. in Legal Education from Temple University. She is admitted to the Massachusetts Bar.

In person: This lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Can’t make it? All webinars are recorded! View our archive of recorded lectures (over 30 lectures and counting!).