A critical view on using "life not worth living" in the bioethics of assisted reproduction.

This paper critically engages with how life not worth living (LNWL) and cognate concepts are used in the field of beginning-of-life bioethics as the basis of arguments for morally requiring the application of preimplantation genetic diagnosis (PGD) and/or germline genome editing (GGE). It is argued that an objective conceptualization of LNWL is largely too unreliable in beginning-of-life cases for deriving decisive normative reasons that would constitute a moral duty on the part of intending parents. Subjective frameworks are found to be more suitable to determine LNWL, but they are not accessible in beginning-of-life cases because there is no subject yet. Conceptual and sociopolitical problems are additionally pointed out regarding the common usage of clear case exemplars. The paper concludes that a moral requirement for the usage of PGD and GGE cannot be derived from the conceptual base of LNWL, as strong reasons that can be reliably determined are required to limit reproductive freedom on moral grounds. Educated predictions on prospective well-being might still be useful regarding the determination of moral permissibility of PGD and/or GGE. It is suggested that due to the high significance of subjective experience in the normativity of beginning-of-life bioethics, the discipline is called to more actively realize the inclusion of people with disabilities. This regards for instance research design, citation practices, and language choices to increase the accessibility of societal debates on the reproductive ethics of genetic technologies.

Nine Months.

When did we begin to exist? Barry Smith and Berit Brogaard argue that a new human organism comes into existence neither earlier nor later than the moment of gastrulation: 16 days after conception. Several critics have responded that the onset of the organism must happen earlier; closer to conception. This article makes a radically different claim: if we accept Smith and Brogaard's ontological commitments, then human organisms start, on average, roughly nine months after conception. The main point of contention is whether the fetus is or is not part of the maternal organism. Smith and Brogaard argue that it is not; I demonstrate that it is. This claim in combination with Smith and Brogaard's own criteria commits to the view that human organisms begin, precisely, at birth.

The somatic integration definition of the beginning of life.

The somatic integration definition of life is familiar from the debate on the determination of death, with some bioethicists arguing that it supports brain death while others argue that some brain-dead bodies exhibit sufficient somatic integration for biological life. I argue that on either interpretation, the somatic integration definition of life implies that neither the preimplantation embryo nor the postimplantation embryo meet the somatic integration threshold condition for organismal human life. The earliest point at which a somatic integration determination of life could be made would be the beginning of the fetal stage, 9 weeks postfertilization. Bioethical implications are considered, specifically with respect to the moral status of the postimplantation embryo in embryo research and abortion.

The Problem of Spontaneous Abortion: Is the Pro-Life Position Morally Monstrous?

A substantial proportion of human embryos spontaneously abort soon after conception, and ethicists have argued this is problematic for the pro-life view that a human embryo has the same moral status as an adult from conception. Firstly, if human embryos are our moral equals, this entails spontaneous abortion is one of humanity's most important problems, and it is claimed this is absurd, and a reductio of the moral status claim. Secondly, it is claimed that pro-life advocates do not act as if spontaneous abortion is important, implying they are failing to fulfill their moral obligations. We report that the primary cause of spontaneous abortion is chromosomal defects, which are currently unpreventable, and show that as the other major cause of prenatal death is induced abortion, pro-life advocates can legitimately continue efforts to oppose it. We also defend the relevance of the killing and letting die distinction, which provides further justification for pro-life priorities.

The Two tragedies argument.

Opposition to induced abortion rests on the belief that fetuses have a moral status comparable to beings like us, and that the loss of such a life is tragic. Antiabortion, or pro-life, theorists argue that (1) it is wrong to induce abortion and (2) it is wrong to allow others to perform induced abortion. However, evidence suggests that spontaneous abortion kills far more fetuses than induced abortion, and critics argue that most pro-life theorists neglect the threat of spontaneous abortion and ought to do more to prevent it. Friberg-Fernros contends such an obligation would be implausibly strong, arguing that induced abortions are far worse than spontaneous abortions because while both involve the tragedy of the death of the fetus, induced abortion involves a second tragedy-one person killing another. I argue this two tragedies argument fails to explain what is morally relevant about induced abortion.

Mapping Bioethics in Latin America: History, Theoretical Models, and Scientific Output.

OBJECTIVE: To present a narrative review of the history of bioethics in Latin America and of scientific output in this interdisciplinary field. METHODS: This was a mixed-methods study. RESULTS: A total of 1458 records were retrieved, of which 1167 met the inclusion criteria. According to the Web of Science classification, the predominant topics of study were medical ethics (n= 488), social sciences and medicine (n= 354), and environmental and public health topics (n= 279). Four themes of bioethics output in the Latin American literature have emerged: (a) issues involving the beginning and end of life, (b) ethics in human research, (c) patient-provider relationships, and (d) ethics training for health professionals. CONCLUSION: Although bioethics is a growing interdisciplinary field in Latin America, its academic impact is still very low, and programmes are highly concentrated in large urban centres in a few countries. Challenges includes the regional and international impact of local scientific output.

Stages of life: A new metaphysics of conceptionism.

When a human being comes into existence is crucial in bioethics. Conceptionism is the view that a human being comes into existence at conception. The twinning argument is an influential objection to this view. All versions of the twinning argument rely on a metaphysics of material objects, namely, endurantism. Given this, a strategy for defending conceptionism against the twinning argument is to deny endurantism and adopt an alternative metaphysics of material objects. A version of this strategy which has been debated in this journal is to adopt perdurantism, or the 'multiple occupancy view', on which monozygotic twins share the zygote region as a temporal part. We present a novel version of this strategy: conceptionists can evade the twinning argument by adopting an exdurantist metaphysics of material objects. We suggest reasons for thinking that this is a plausible and, indeed, preferable way for conceptionists to avoid the twinning argument.

[Philosophical aspects. Why the embryo is a issue]. / Aspects philosophiques. Pourquoi faire de l?embryon une question.

How raising the embryo's issue today ? Far from evidences and certainties, we have to face the confrontations to understand them. Embryo's issue crystalise all cultural and human tensions. Beyond ontological disagrement on the embryo being what can we expect for mankind today and tomorrow ? Through an anthropological thinking, embryo's issue challenges us in our common capability of decision.

The Moral Status of the Human Embryo.

Moral status ascribes equal obligations and rights to individuals on the basis of membership in a protected group. Substance change is an event that results in the origin or cessation of individuals who may be members of groups with equal moral status. In this paper, two substance changes that affect the moral status of human embryos are identified. The first substance change begins with fertilization and ends with the formation of the blastocyst, a biological individual with moral status comparable to that ascribed to human organs. The second substance change begins at implantation and ends late in embryological development with the formation of the human body, an organism with moral status as a human being. The bioethical implications of each substance change are explored. The Two Substance Change theory is contrasted with continuity theories, which recognize no substance change in embryological development and with fertilization-only substance change theories.

If Abortion, then Infanticide.

Our contention is that all of the major arguments for abortion are also arguments for permitting infanticide. One cannot distinguish the fetus from the infant in terms of a morally significant intrinsic property, nor are they morally discernible in terms of standing in different relationships to others. The logic of our position is that if such arguments justify abortion, then they also justify infanticide. If we are right that infanticide is not justified, then such arguments will fail to justify abortion. We respond to those philosophers who accept infanticide by putting forth a novel account of how the mindless can be wronged which serves to distinguish morally significant potential from morally irrelevant potential. This allows our account to avoid the standard objection that many entities possess a potential for personhood which we are intuitively under no obligation to further or protect.

The status of the human embryo in various religions.

Research into human development involves the use of human embryos and their derivative cells and tissues. How religions view the human embryo depends on beliefs about ensoulment and the inception of personhood, and science can neither prove nor refute the teaching of those religions that consider the zygote to be a human person with an immortal soul. This Spotlight article discusses some of the dominant themes that have emerged with regard to how different religions view the human embryo, with a focus on the Christian faith as well as Buddhist, Hindu, Jewish and Islamic perspectives.

[The beginning of human life: ethical and legal perspectives in the context of biotechnological progress]. / O marco inicial da vida humana: perspectivas ético-jurídicas no contexto dos avanços biotecnológicos.

Questions concerning the beginning of human life have pervaded society since antiquity. In the post-modern world, scientific and technological advances have fueled discussions on the issue, such that debates previously concentrated on abortion now also focus on biotechnological interventions. The article addresses the latter, reflecting on the extent to which human dignity can be considered a (hermeneutic) reference in establishing ethical and legal parameters for biotechnological advances in the definition of the beginning of human life. The study's method was critical hermeneutic ethics, with ethics at the center of the process of understanding and interpretation, observing the contours of facticity. No consensus was found on the beginning of human life, so it is essential to engage in dialogue with the new reality resulting from biotechnological advances in the process of defining ethical and legal principles for protecting the embryo and human nature, with human dignity as the reference.

Controversies on the beginning of human life - science and religions closer and closer.

One of the most controversial topics in modern bioethics, science, and philosophy is the beginning of individual human life. In the seemingly endless debate, strongly stimulated by recent technologic advances in human reproduction, a synthesis between scientific data and hypothesis, philosophical thought, and issues of humanities has become a necessity to deal with ethical, juridical, and social problems. Furthermore, in this field there is a temptation to ask science to choose between opinions and beliefs, which neutralize one another. The question of when human life begins requires the essential aid of different forms of knowledge. Here we become involved in the juncture between science and religion, which needs to be carefully explored.

O marco inicial da vida humana: perspectivas ético-jurídicas no contexto dos avanços biotecnológicos / The beginning of human life: ethical and legal perspectives in the context of biotechnological progress / El marco inicial de la vida humana: perspectivas ético-jurídicas en el contexto de los avances biotecnológicos

Resumo: As indagações com relação ao termo inicial da vida humana perpassam a sociedade desde a antiguidade. No mundo pós-moderno, os avanços da ciência e da técnica potencializam as discussões acerca do tema, de modo que os debates que anteriormente se concentravam em torno do aborto, também passaram a ter como objeto as intervenções da biotecnologia. O presente artigo trata do último aspecto, a saber, refletir em que medida a dignidade humana pode ser considerada um referencial (hermenêutico) na construção de parâmetros ético-jurídicos para os avanços biotecnológicos na definição do marco inicial da vida humana. Para desenvolver a pesquisa, utilizou-se como método de abordagem a ética hermenêutica crítica, mediante a qual a ética encontra-se no centro do processo de compreensão e interpretação, observando-se os contornos da facticidade. Constatou-se que não há consenso no que diz respeito ao termo inicial da vida, de forma que é fundamental dialogar com a nova realidade decorrente dos avanços biotecnológicos, no processo de construção de preceitos éticos e jurídicos de proteção do embrião e da natureza humana, tendo como referencial a dignidade humana.

Abstract: Questions concerning the beginning of human life have pervaded society since antiquity. In the post-modern world, scientific and technological advances have fueled discussions on the issue, such that debates previously concentrated on abortion now also focus on biotechnological interventions. The article addresses the latter, reflecting on the extent to which human dignity can be considered a (hermeneutic) reference in establishing ethical and legal parameters for biotechnological advances in the definition of the beginning of human life. The study's method was critical hermeneutic ethics, with ethics at the center of the process of understanding and interpretation, observing the contours of facticity. No consensus was found on the beginning of human life, so it is essential to engage in dialogue with the new reality resulting from biotechnological advances in the process of defining ethical and legal principles for protecting the embryo and human nature, with human dignity as the reference.

Resumen: Las investigaciones relacionadas con el inicio de la vida humana han acompañado a la sociedad desde la antigüedad. En el mundo posmoderno, los avances de la ciencia y de la técnica potencian las discusiones sobre este tema, de modo que los debates que anteriormente se concentraban en torno al aborto, también pasaron a ser objeto por las intervenciones de la biotecnología. El presente artículo trata acerca de este último aspecto, a saber, reflexionar en qué medida la dignidad humana puede ser considerada una referencia (hermenéutica) en la construcción de parámetros ético-jurídicos para los avances biotecnológicos, en la definición del marco inicial de la vida humana. Para desarrollar la investigación, se utilizó como método de enfoque la ética hermenéutica crítica, mediante la cual la ética se encuentra en el centro del proceso de comprensión e interpretación, observándose los contornos de la facticidad. Se constató que no existe consenso en lo que se refiere al término inicial de la vida, de forma que es fundamental dialogar con la nueva realidad, derivada de los avances biotecnológicos, en el proceso de construcción de preceptos éticos y jurídicos de protección del embrión y de la naturaleza humana, teniendo como referente la dignidad humana.

Pro-Life Arguments Against Infanticide and Why they are Not Convincing.

Alberto Giubilini and Francesca Minerva's controversial article 'After-Birth Abortion: Why Should the Baby Live?' has received a lot of criticism since its publishing. Part of the recent criticism has been made by pro-life philosopher Christopher Kaczor, who argues against infanticide in his updated book 'Ethics of Abortion'. Kaczor makes four arguments to show where Giubilini and Minerva's argument for permitting infanticide goes wrong. In this article I argue that Kaczor's arguments, and some similar arguments presented by other philosophers, are mistaken and cannot show Giubilini and Minerva's view to be flawed. I claim that if one wants to reject the permissibility of infanticide, one must find better arguments for doing so.

Recommended Ethical Safeguards on Fertilization of Human Germ Cells Derived from Pluripotent Stem Cells Solely for Research Purposes.

Production of human fertilized embryos by using germ cells derived from pluripotent stem cells (PSCs) entails ethical issues that differ fundamentally depending on the aim. If the aim is solely to conduct research, then embryo generation, utilization and destruction must respect for the human embryo as having the innate potential to develop into a human being. If the aim is human reproduction, this technology must never be used to manipulate human life, confuse social order, or negatively affect future generations. Researchers should distinguish the aims and then accordingly establish a consensus on the safeguards needed to proceed with scientifically significant and socially accepted research, or otherwise set a moratorium. Currently, in Japan, germ cell production from human PSCs is permitted, whereas fertilization of these germ cells is not. The Japanese Expert Panel on Bioethics in the Cabinet Office has proposed that all of the following conditions must be met to approve fertilization for research purposes: (1) the research is significant for the life sciences and medicine; (2) the benefits or anticipated benefits are socially accepted; (3) human safety is assured; and (4) safeguards are put in place. If fertilization is ethically approved, I recommend the following safeguards: limitation of the purpose to improving conventional ART as an initial step; permitted culture of human embryos until the appearance of the primitive streak; restriction of the number of embryos produced to the minimum necessary; prohibition of transplantation into a human or animal uterus; and provision of human-derived ova that are not required for ART treatment.

Ethical Assessment of Human Embryonic Stem Cell Research According to Turkish Muslim Scholars: First Critical Analysis and Some Reflections.

BACKGROUND: Turkey, with a Muslim population of officially over 99 %, is one of the few secular states in the Muslim world. Although state institutions are not based on Islamic juridical and ethical norms, the latter play a significant role in defining people's attitudes towards controversial issues in the modern world, especially when backed by opinions of Muslim scholars living in Turkey. Accordingly, opinions of Muslim scholars undoubtedly have an important effect on bioethical decisions made by institutions and individuals. OBJECTIVE(S): To explore the ethical positions of Muslim scholars living in Turkey and their arguments used in the ethical assessment of embryonic stem cell research; to discuss the biological-moral tensions arising in medical research on human embryos. DESIGN: Qualitative study. SETTING: Muslim scholars located in different parts of Turkey. METHODS: Qualitative method, involving the collection of opinions of various scholars, by means of 15 individual semi-structured interviews, evaluated using thematic qualitative analysis. RESULTS: Positions regarding embryonic stem cell research differ among Muslim scholars in Turkey. On the other hand, even where positions are similar, they are often supported by different arguments. CONCLUSION: Despite the heterogeneity of the arguments presented, the dominant position considers embryonic stem cell research as morally acceptable.

Ethical challenges in the new world of maternal-fetal surgery.

This article explores some of the complex ethical challenges that exist in the field of fetal diagnosis and treatment, especially surrounding maternal-fetal surgery. The rise of these new treatments force us to reconsider who or what is the fetus, what are our obligations to the fetus, and what are the limits to those obligations. In addition, we will consider provider and professional biases, disability issues, and how maternal-fetal surgery has, for a select group of women, changed the very experience of motherhood.

ETHICS, EMBRYOS, AND EVIDENCE: A LOOK BACK AT WARNOCK.

The Report of the Committee of Inquiry into Human Fertilisation and Embryology, the Warnock Report, forms the basis of the UK legislation on embryo research, and its influence continues to be felt, even though over 30 years have passed since its publication. The Warnock Committee was the first of its kind to consider how advancements in human fertilisation and embryology should be regulated. This article examines the evidence submitted to the Warnock Committee, upon which its members ultimately reached their conclusions. With ongoing debate as to the status of the human embryo, it is important to recognise that the legislative position is one that was reached after extensive consultation and consideration of submitted evidence by the Warnock Committee. This article considers the differing ethical viewpoints that were expressed by organisations both prior and post-publication of the Warnock Report, and how the Committee used that evidence to reach their conclusions, and ultimately calls for a new Warnock-style committee.