HCE 4220 Unit 1 Exam
Identify two key ethical concerns regarding sperm donation.
- Can have a lot of offspring if number of births is not limited - Costly
According to Marquardt, Glenn, and Clark (2010), children of sperm donors indicate several negative experiences in relation to their being children of sperm donors. Identify three that you find most significant.
- Disturbed that mother never met father - no intimate relationship - Their existence was a "transaction" - They do not know their biological mother/father - sad seeing other kids - Might date someone you are related to
Identify two key ethical concerns regarding egg donation, including one that is not present in sperm donation.
- Lack of education about egg donation - informed consent - Producing a lot of eggs - painful/harmful - OHSS -Validity of the Drugs being used Eggs prioritized over woman
Identify two key ethical concerns regarding surrogate motherhood.
- Thoughts/feelings of surrogate mother - how she will feel after giving birth - Harms to children - how they will feel about not coming from their mom's womb - Harms to surrogate -Parents want abortion - now what?
1. Explain the No-Duty-to-Sustain argument (JJ Thomson) in favor of abortion. What reply (replies) does Schwarz raise in objection to this argument?
-A woman has no duty to sustain the fetus/child (Violinist) -She may expel the fetus as an intruder -She may defend herself against it if it is a threat to her life Reply: Crucial distinction between withholding support and intentional killing. Thomson's argument tries to justify abortion as an act of withholding support. But it is primarily an act of intentional killing. So even if it were justified under the heading of "withholding" it is not justified because it falls under the heading of intentional "killing". -The argument about the right over one's body proves the wrongness of abortion: the child has a right not to have his/her body destroyed -Abortion is intentional killing because it intends the destruction of the pre-born baby so that there is no child that one is responsible for -A pregnant woman is carrying a child who is her own child, entrusted to her. She has a special relation to this child, which implies an obligation to take care of him/her; failure to do so is child neglect. Hence unplugging is wrong already on the level of intending to withhold support -Mankind has a general obligation to come to the rescue of others, to save their lived, to sustain them if they need us to live? Perhaps we have this duty even to a violinist; we certainly do sin cases that are significantly less in terms of the hardship they represent
Identify two key ethical concerns regarding ESCR that have nothing to do with the moral status of the human embryo.
-Cost -Immune rejection/cancer -cells differentiate into unwanted cell types
What concerns (beyond those of somatic modification) does germline modification introduce?
-Don't know long term affects - Certain diseases have benefits - removing that in future generations by doing germline -Decreasing genetic diversity in the population -Invalidating people with the disease - disability argument
Identify three responses to support embryo selection (tissue matching) to save a sibling's life.
-Having a life better than not having a life -umbilical cord/non invasive -Growing a family/having another child -People will try to make a savior sibling anyways -Cheaper than the costs of treatment
Explain the body-soul unity argument for the plausibility that personhood begins at conception.
-I am my body, it's so closely united to me that my body/soul have to go together- So when you are conceived your soul is also there
Based upon the reading and lecture, identify two non-consequential reasons that support the position it is unethical to bring about new human life through a technical act of bringing gametes together.
-IVF Wrongfully plays God - assumes we have dominion over an event that shouldnt be under human control -gametes are too personal to donate -Wrong to disrespect human life - wrong to create embryos with intention to not implant some of them or to possibly abort some -IVF reproduction is an unworthy beginning of human life (undignified origins)
What is somatic cell nuclear transfer? Explain the process.
-Somatic cell nucleus is injected into an egg cell without a nucleus - new cell begins to divide like an embryo -Cells can be used for reproductive cloning (making yourself) or therapueric cloning (cells that can be used to repair tissue) -Could solve the rejection problem
What are stem cells? What are embryonic stem cells and how are they derived? What are adult stem cells? What kinds of stem cells come from umbilical cord blood?
-Stem cells - Capable of dividing/renewing themselves into cells with specialized functions -Embryonic Stem cells derived through IVF or SCNT from Inner cell mass of approx 5 days old embryo in blastocyst stage of development - Totally undifferentiated- can become any type of cell -Adult Stem Cells- Multipotent Undifferentiated cell found among differentiated cells in a tissue or organ Sources: brain, bone marrow, peripheral blood, blood vessels, skeletal muscle, skin, the liver, umbilical cord blood, amniotic fluid Can renew itself and differentiate to yield some or all of the major specialized cell types of the tissue or organ. Replace cells that deteriorate as a consequence of injury or disease. -Umbilical Cord- haematopoietic stem cells - Can become blood cells/immune system cells
Explain three reasons against embryo selection (tissue matching) to save a sibling's life.
-Treating child as means to an end -Lack of autonomy -Pressure on savior sibling
When women using the "combined pill and minipill" perfectly follow the method instructions, what percentage of women have an unintended pregnancy in the first year of use?
0.3%
According to Pallone, when women using the Billings or Creighton cervical mucus method or symptothermal method perfectly follow the method instructions, what percentage of women have an unintended pregnancy in the first year of use? (Give the percentage for each method.)
0.3-0.5%
Based upon the data presented in class, approximately what percentage of babies born in the U.S. are IVF babies?
2016 - 1.95% of US live born infants from IVF (20-30% successful)
(The answer to this question will be explained in class.) According to Schwarz, what are the conditions of killing in self-defense? How does Schwarz claim these conditions are not met in the case of abortion to save the mother's life? [See Schwarz, 1990.]
3 Conditions: Extremely serious threat Person is doing harm No other alternative Schwarz claims these conditions are not met in the case of abortion bc the child is not threatening
Approximately how many days per menstrual cycle are days it is possible for sexual activity to lead to fertilization? Sexual intercourse can lead to fertilization if (assuming the woman has hospitable cervical mucus) sexual intercourse occurs up to ___ day(s) before ovulation and up to ___day(s) after ovulation. ("Day" = 24 hours.)
5 Before, 1 after
How can a baby have "two [genetic] mothers?" (See Deech, pp. 158-9.) What is the unhealthy condition that would motivate pursuing having a child with two genetic mothers?
A baby can have two genetic mothers through embryo/egg repair. if one mother has unhealthy mitochondrial DNA, a donor egg with healthy mitochondria can be used with its nucleus removed and the other mother's nucleus entered (egg repair) - same can be done with embryos
According to Schwarz's Non-Achievement View of persons, what are four key marks of personhood? (See class slide.)
A kind/type of being (vs. Achieved State) A being with strong, enduring, immaterial self I remain the same person over time despite various changes in my body & in my personality. Has the basic inherent capacity (BIC) to think/act as a person (If given the right conditions, will actualize itself via free acts of the will; personal manners of thinking/ experiencing) Does not admit of graduality
Explain the argument that abortion is justified in cases of rape. What reply (replies) does Schwarz raise in objection to this argument?
Abortion is justified in cases of rape because this is not a decision that was made by the woman Reply: Abortion Intensifies trauma, baby is innocent - wrong to kill child so also wrong to kill pre born Abortion won't change what happened
According to Smajdor, how ought we to respond to ethical challenges in fetal surgery? Whose interests should take priority, those of the fetus or those of the mother?
According to Smajdor it is tough to decide who gets priority. Sometimes when a woman wants to have fetal surgery because she is altruistic, it may not be in her best interests. Restriction her options, however, takes away her autonomy. However, when a fetus is in need of surgery, informed consent gets a little hazy, and usually the doctors decide whether or not to perform the surgery, taking away a woman's autonomy. Some argue that even though the fetus is special, its interests are subordinate to the mother. The problem is that the mother usually wants to act in the best interest of the fetus, which is harmful to her.
How would defenders of the "dignified origins" claim clarify (elaborate upon, defend) the "dignified origins" position in response to the following criticisms? B) If IVF is wrong based upon the "dignified origins" idea, adoption must also be wrong—for the adopted child is not created from the conjugal act of the adoptive parents.
Adoption is not wrong because of the fact that an adoption does not involve creating a child from the genetic material of others. Loving couples adopt children whose parents had unfortunate circumstances that did not allow them to raise the children.
Identify two future possibilities that would allow same sex female couples to have children without a donor.
Artificial Gametes via Induced Pluripotent Cells Cloning
What is cloning? Have scientists yet cloned a human embryo?
Basically somatic cell nuclear transfer - egg cell develops and implanted into surrogate - you make a clone of yourself. No they have not yet cloned a human embryo but they have done it to a sheep.
Explain the argument that personhood cannot begin prior to segmentation (possible twinning). What is Schwarz's response to this argument?
Before 14 days, the embryo has not split up into two beings. So an embyro cannot be identified with only one human being. A person cant exist and then split into two after 14 days, there is a time period where there is not personhood. Schwarz says Two selves could exist in one body for some time One body could give rise to another body which will have its unique self For organisms that will become twins, no self prior. Otherwise, you have a self when fertilization is complete
What reasons does Steinbock give to refute the idea that human embryos have moral standing? Evaluate the strengths and weaknesses of these reasons.
Blastocyst Stage - cluster of cells- no heart no brain no organs - to rudimentary in development to have rights It is not the possession of a human genome that makes a cell a human - it is the status as a human organism - an integrated whole with the capacity for self directed development Twinning problem - twins are not seperated until 14 days- cant say blastocysts are human beings bc they are not yet Wouldn't save 100 embryos over one baby - clearly not on the same moral standings Twinning argument is pretty strong - cant say it is one organism because it is not yet Just bc the blastocyst does not have human organism characteristics does not mean that it doesnt have the potential to become a human.
Identify a key disadvantage of ectogenesis
Child/Mother Relationship/Intimacy is gone Removes "femininity" of the female body - Brassington
Are there any documented cases of a mix-up of IVF embryos (embryos transferred to the wrong woman) or cases of the wrong gamete(s) being used to create a couple's embryo(s)?
Deech Reading - Mr. and Mrs. A and Mr. and Mrs. B - white couple had a mixed race child
Besides health-related concerns, identify and explain two significant concerns (objections) regarding preimplantation genetic diagnosis and selection. (There are more than two correct answers.)
Disability Critique - o Wrongful discrimination o What does it say to the ppl who are living with the disability? How they feel Finding cures/research? Adrienne Asch: If a woman wants to be a mother, then she should be willing to accept the child she will have, regardless of whatever particular characteristics that child will have
According to the disability critique, how does PGD and selection (or prenatal testing and abortion) send a negative message to persons born with disabilities?]
Disability Critique - o Wrongful discrimination o What does it say to the ppl who are living with the disability? How they feel Finding cures/research? - will this be less emphasized now?
As originally defined by Green, what is the difference between genetic treatment and genetic enhancement?
Genetic treatment - using tools to fix a problem that is present in an individual's genome - fatal Genetic Enhancement - "improving" or making changes to a genome that was not in need of fixing - COSMETIC
What is the Human Fertilisation and Embryology Authority? What oversight of assisted reproduction exists in the United States?
HFEA for short - in the United Kingdom - oversees and regulates IVF, donor insemination, embryo research, storage of gametes and embryos In the United States o CDC - Collects data on ART procedures o FDA - controls approval and use of drugs/products - jurisdiction over screening and testing of reproductive tissue o Centers for Medicare/Medicaid Services - Regulate lab testing to ensure quality
Identify two key advantages of ectogenesi
Helps women be freed from biologically determined roles (being child bearers) Allows women who cannot give birth still have a child (Pregnancy not required to be a mom) Removes the pains/discomforts/inconveniences of pregnancy
By reflecting on my life as a continuum, what (according to Schwarz) becomes evident?
I have a self that was present in past experiences and endures over time The person I was years ago is the same person I am now, despite personality changes It can be that there is no clear line between who you are now and then but there are still different realities
If human embryos are persons, many assume there is nothing ethically problematic with using leftover IVF embryos for ESCR (and other embryo research), claiming it is better to use these embryos than to allow them simply to die. Explain a reason for an opposing position, using an analogy regarding born humans who are not expected to live much longer.
If a person was about to die - you wouldn't just use their bodies for research purposes instead of allowing them to simply die - that's not right. Would not end their life to benefit someone else. If embryos are persons, why would you do this on an embryo?
Explain the argument that abortion is justified in cases where the woman's life is at stake. What reply (replies) does Schwarz raise in objection to this argument? (The answer lies partly in the answer to the question below.)
If birth is going to be dangerous
Explain how there can be a medical reason for sex selection. Identify an additional reason (besides mere preference of parents) supporting for sex selection?
If there is a genetic disorder that can result from having a certain sex of a child
Answer the following question according to your own reasoning. Integrating points made in the assigned reading and/or in class, what is the strongest argument to justifying abortion even if the human embryo is a person? What is the strongest objection to this argument?
In terms of Rape, Schwarz: Abortion is justified in cases of rape because this is not a decision that was made by the woman. I think this is a strong argument because of the fact that the woman did not ask for the child, or make a conscious decision to have sex with someone she loves or is attracted to, it was forced onto her The strongest objection for this argument is the fact that the child is innocent in the case of rape - it is wrong to kill a child so it is also wrong to kill a pre-born.
Identify three facts you learned from Dr. Yeung's presentation regarding contraception or IVF.
Infertility is a symptom not a disease- there's an underlying issue 1 in 10 women suffer from endometriosis, which is a common reason of infertility NaProTechnology- charting cycle, targeted hormone therapy
If human personhood implies having a "Self", (i.e., if personhood does not imply achievement or a social construct), can the first moment of human personhood be proven? Why or why not?
It is hard to prove the first moment of personhood because of the fact that you can't show the moment that self is united to body. To act as a person you must be a person already and that means having a self.
Identify a reason it is problematic to assume consciousness must exist before a human being's personhood (as Schwarz understands it) can exist.
It is problematic to assume consciousness must exist before a human being's personhood because it is strange to think the presence of Self not existing until a human acts/thinks like a person. Only if I already am a person can I act as a person
Explain why it is problematic to assume the development of a human organism is required in order for personhood (as Schwarz understands it) to exist.
It is problematic to assume the development of a human organism is required in order for personhood because there are infants and people who are neurologically handicapped - are they still people?
Some argue that preimplantation genetic diagnosis (PGD) and selection are important because they prevent the harm of passing on defective genes to one's (or the couple's) child. (Similarly, the HFEA at one time claimed it is legitimate for embryos to be selected for tissue matching only if the PGD and selection conferred a therapeutic advantage upon the embryo.) Why is it problematic to claim PGD and selection help to prevent a harm to the born child (or help to confer a therapeutic advantage upon the embryo)?
It is problematic to claim this because of the fact that the born child did not escape any harm. The born child never had the genetic defect in the first place so it had nothing to escape from.
If embryos are not persons, for what reasons could they be entitled to non-Kantian respect? What would this mean practically?
Kantian - don't treat people merely as a means to an end Non Kantian respect owed to human embryos bc potential to develop into people (Steinbock) Practically it means that embryos cannot be considered as something that you can just use for research without considering the harm and suffering aspect - even animals have some moral standing
Who was the first IVF baby? When was she born?
Louise Brown - 1978
What is the main objection some raise against providing emergency contraception after sexual assault?
One of the main objections would be that providing the oral contraception could lead to the abortion of the child if the woman had been ovulating or could potentially ovulate close to the time of the assault. The egg could then be fertilized and taking the contraceptive would work by preventing the implantation, which would lead to the abortion of the zygote.
According to the assigned reading by Skoto, Levine, and Goldstein, how do persons with Down Syndrome perceive their quality of life?
People with down Syndrome were happy with their lives, liked how they looked, a lot felt like they could make friends easily, loved their families, share similar hopes/dreams to people without DS
Using ideas expressed by Pope Paul VI and Pope John Paul II, Smith & Kaczor write, "Contraception is similar to telling a lie to get what one wants, whereas NFP is more akin to remaining silent when something should not be spoken" (Smith & Kaczor). A) Explain the idea that contraception is similar to telling a lie.
Premise 1: Sexual union has an objective meaning. A couple engaged in sexual intimacy expresses a mutual loving gift of their whole selves (body and soul) to each other Premise 2: When a couple uses contraception, they hold back an important aspect of their bodies Premise 3: Therefore, contraception is a lie
Besides concerns mentioned in "Will We Create a Genobility?" what are objections to genetic modification of human beings? Are there problems/weaknesses with these objections? If so, explain them.
Relentless striving for genetic perfection places undue emphasis on perfecting technical values -Blind us to what is distinctly loveable in each unique person -Can take our focus off of more important achievements of the person -Threatens self acceptance Socioeconomic divide Risk of Disappointing parents
5. What is a salpingectomy? What is a salpingostomy? According to Kaczor's reasoning, does a salpingostomy to treat an ectopic pregnancy meet the conditions of the principle of double effect? Explain.
Salpingectomy - Remove part of the fallopian tube Salpingostomy - remove embryo from the tube Yes it does meet the principle of double effect Action (removing part of fallopian tube or removing embryo) itself is not something wrong to intend Bad effect not intended *only foreseen Not trying to achieve bad effect (Death of embryo) as means to good Proportionate reason for allowing the evil effect
Explain what you find as the two strongest criticisms to any of the arguments that deny human embryos are persons.
Sherwin - fetus is not a personn bc it can't make social relationships and its existence is based on the mother it is bound to - what about the handicapped people - they are still persons. Maguire Morgan - personhood is socially constructed- you are accepted into a community of human beings -Criticism - does this mean someone in a different part of the world that is isolated is not a person? False. If personhood were socially constructed people would have the ability to say a certain race/group of people are not persons (ex Racism) Tooley: having an interest in own continued survival, infanticide OK, 1) self consciousness and 2) conscious desires, potential person does not mean you are one -Shwarz - the BIW is just a smaller version of a born child, it is the same person - continuity argument. Embryo IS a person.
According to the SLED argument, which "SLED" differences exist between pre-born and born human beings? For each of these differences, how does Schwarz's pro-personhood position aim to explain that these differences are not relevant to personhood?
Size Level of development Environment Degree of dependency Size: child in the womb simple a smaller child Level of Development: equally a person, same person at that stage of development just less Environment: where you are changes nothing about the dignity/personhood of someone Degree of dependency: everyone dependent on others to some extent.
What is the difference between somatic modification and germline modification?
Somatic Modification - affects you only Germline Modification - affects people down the line from you, happens at an embryonic level
Identify four key uses that ESCR potentially could offer.
Support basic research on embryonic development Develop new drugs by first developing models of diseases Test drugs without harming animals Treat disease/injury (replace defective cells)
Integrating points made in the assigned reading and/or in class, explain what you find as the two strongest non-religious reasons (not motivations) to deny that human embryos are persons?
The Annas/Glantz example -Nobody would save 100 embryos over 1 baby - it is clear hat embryos are not persons. They are not morally comparable to babies. Warren Conciousness, reasoning, self motivation, communicate, self awareness Something that satisfies NONE of these is not a person.
What concerns does Green raise in his chapter, "Will We Create a Genobility?" How does he respond to such concerns?
The concern is that the use of genetic enhancement will lead to the rich/people with access to genetic enhancement to oppress the poor and create a larger social divide and that people will be entitled to certain genetic endowment and not how they were made Responding to these concerns, he thinks that gene enhancement used properly could reduce the gap between rich/poor by getting rid of health disparities. Gene enhancements could lower health costs by preventing costly treatments.
How would defenders of the "dignified origins" claim clarify (elaborate upon, defend) the "dignified origins" position in response to the following criticisms? A) The "dignified origins" claim erroneously assumes if a baby is conceived and born as the product of technology, then it was not born out of the love of its parents' union. In truth, a couple, or even individual, that is dishing out the money, energy and time to create a child as something to love and cherish, may even love that child more than a couple who naturally conceived.
The dignified origins claim is not saying IVF couples love their children any less. What the dignified origins claim is saying is that when a child is made through IVF, it is made apart from a direct act of sexual intercourse and instead made from technical expertise. The complete self giving that is involved in spousal intercourse is lost. The child has thus been treated like a product in its conception and not shown respect. All artificial technology is not bad, it can be used to assist nature in conceiving children but not replace nature.
What is the gradualist position? Why does Schwarz find this position problematic?
The gradualist position is that the change from nonperson to person happens gradualy over time , like from night to day, from child to adult. Schwarz finds this problematic because it confuses being as a person vs functioning as a person. Personhood does not require us to function as a person NOW or in the immediate future, this will happen gradually.
Explain the key informed consent problem that Larimore and Stanford claim often exists with regard to women obtaining prescriptions for commonly used forms of oral contraceptives.
The informed consent problem presented by Larimore and Stanford is that often times women are not fully explained the full extent of post fertilization effects that can come with Oral contraceptives, which can impact them based on their beliefs on when life begins. On the other side, the overemphasis of post fertilization effects might make women choose less effective OCs resulting in unwanted pregnancy.
How does "therapeutic cloning" differ from "reproductive cloning"? Why is it confusing to use these terms to convey the distinction?
Therapeutic - Using somatic cell nuclear transfer to make embryonic stem cells used for medical treatment Reproductive cloning - using it to make a clone of yourself, bring back extinct animals or make an elite individual or replica of an entity.
Deech and Smajdor write: "The aims of therapeutic and reproductive cloning are very different. One aims at creating a living replica of another entity. The other aims at creating cells genetically identical to those of a potential patient" (p. 28). Explain how this text is misleading.
This text is misleading because of the fact that both of these processes involved SCNT which creates an egg that will be induced to divide like an embryo. The difference is therapeutic uses embryonic stem cells thus killing off the embryo while reproductive cloning aims to go all the way. Both cases the egg cell is an exact replica (DNA wise) of an entity.
What does it mean for a human cell to be totipotent? pluripotent? Multipotent?
Totipotent- give rise to all other cells in the body Pluripotent - can develop into virtually any kind of cell (not placenta or umbilical) Multipotent -can produce cell types belonging to a particular tissue
Explain Lyerly's argument about risk management in pregnancy. During pregnancy, providers often (over/under) treat, but during birth, providers often (over/under) treat (choose the correct response).
Under, over
According to Peck & Velez (2013), does levonorgestral/"Plan B" more often a) inhibit ovulation, or b) prevent the implantation of a fertilized egg (embryo)?
We don't know if it truly stops ovulation - we don't actually know if it has an abortive effect (preventing implantation) Many studies provide compelling evidence of post fertilization method of action
Explain the difference between personality and Schwarz's idea of personhood/being a person.
Who I was in the past vs now is one in the same Person, even though personality (what I like or what I do) can change. My essence as a person was the same before as it is now.
Besides OHSS, identify a significant medical risk for women related to non-donor IVF.
Women's health - multifetal pregnancies o Hypertension, Preeclampsia, gestational diabetes, increased rate of C-Section
Identify points/arguments in favor of genetic modification (either germline or somatic). Are there problems/weaknesses with these points/arguments? If so, explain them.
· Increased IQ/Life Span · General human progress - SPACE · Natural socioeconomic divide · Eradicate Disease · Improving the quality of life · Getting rid of stigma · Artificially select what's most appropriate for humans · Star football player · Increase human capabilities · If not 1st, you're last · How many??
Besides health risks, identify challenges faced by couples who decide to attempt IVF.
· Informed consent · Cost - IVF very expensive · Emotional toll of failed IVF Experiences · Issue with "spare" embyros if couple splits up · Staying on top of hormone regimen
What is ovarian hyper-stimulation syndrome (OHSS), and how is it related to non-donor IVF?
· OHSS - When ovaries become swollen and painful leading to bloating, abdominal pain, shortness of breath etc · Can be a side effect of all the different hormones women need to take in order to proceed with IVF
Identify health risks for children associated with non-donor IVF.
· Premature birth and low birth weight · For twins - may have increased chance for malformation, stillbirth, cerebral palsy