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1.
J Forensic Leg Med ; 69: 101891, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32056807

RESUMO

In Italy, the law n. 40 of 2004 (Norms in matter of medically assisted procreation), allows to access to the techniques of Medically assisted Procreation (MAP) exclusively to couples formed by two individuals of different sex. On the basis of this law, two couples of homosexual women were prohibited from using MAP techniques. For this reason, the couples have appealed to the competent courts that have raised doubts of constitutional legitimacy. In June 2019, the Italian Constitutional Court stated that it is not illegal to prohibit gay couples from accessing MAP techniques. In October 2019, the judgment No. 221, in which this decision is based, was published. Following the publication of the judgment, a bioethical-legal debate arose on this issue: is this a discrimination, or a simple limit based on medical-legal criteria?


Assuntos
Homossexualidade Feminina , Homossexualidade Masculina , Técnicas de Reprodução Assistida/legislação & jurisprudência , Feminino , Humanos , Itália , Masculino
2.
Soins Pediatr Pueric ; 40(311): 21-25, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31757271

RESUMO

Determined in 1994, the legal framework for medically assisted reproduction has barely evolved since. French legislation is among the strictest in Europe. Sweeping changes are planned for the next review of the law on bioethics which should be put to a vote in 2020. The current ban on surrogacy should however remain in place.


Assuntos
Técnicas de Reprodução Assistida , Europa (Continente) , França , Humanos , Técnicas de Reprodução Assistida/legislação & jurisprudência
3.
Am J Law Med ; 45(2-3): 130-170, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31722626

RESUMO

In many areas of innovation, the United States is a leader, but this characterization does not apply to the United States' position in assisted reproductive technology innovation and clinical use. This article uses a political science concept, the idea of the "democratic deficit" to examine the lack of American public discourse on innovations in ART. In doing so, the article focuses on America's missing public consultation in health care innovation. This missing discourse is significant, as political and ethical considerations may impact regulatory decisions. Thus, to the extent that these considerations are influencing the decisions of federal agency employees, namely those who work within the U.S. Food and Drug Administration, the public is unable to participate in the decision-making process. This lack of a public discourse undermines the goals of the administrative state, which include democratic participation, transparency, and accountability. The United Kingdom, on the other hand, has had a markedly divergent experience with assisted reproductive technology innovation. Instead of ignoring the various ethical, social, and legal issues surrounding assisted reproductive technology innovation, the United Kingdom engaged in a five-strand public consultation on the topic of mitochondrial transfer, a form of assisted reproductive technology that uses genetic modification in order to prevent disease transmission. This article argues that after a multi-decade standstill in terms of the public discourse related to ethical issues associated with assisted reproductive technology and germline modification, it is time for the United States to institute a more democratic inquiry into the scientific, ethical, and social implications of new forms of assisted reproductive technology and ultimately, forthcoming medical innovations that involve genetic modification.


Assuntos
Democracia , Invenções/legislação & jurisprudência , Formulação de Políticas , Técnicas de Reprodução Assistida/legislação & jurisprudência , Participação da Comunidade , Governo Federal , Fertilização In Vitro/ética , Fertilização In Vitro/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Humanos , Invenções/ética , Técnicas de Reprodução Assistida/ética , Responsabilidade Social , Participação dos Interessados , Governo Estadual , Inquéritos e Questionários , Reino Unido , Estados Unidos , United States Food and Drug Administration/legislação & jurisprudência
4.
Clin Ter ; 170(5): e364-e367, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31612194

RESUMO

In the last 40 years, the number of elderly patients that require Assisted Reproductive Technologies (ART) has risen enormously, especially after heterolougus fertilization techniques have become available. In recent years, the incidence of peripartum cardiomyopathy (PPCM) has substantially grown, as a consequence of the combined effect of increased maternal age, consequent high prevalence of hypertension and metabolic syndrome (MS). That cohort of women may be exposed to a greater number of cardiac, obstetric and anesthesio-logical complications, therefore the incidence of medico-legal issues, litigation, liabilities and claims over the past years has significantly risen. Cardiovascular and hormonal changes during pregnancy can challenge even the healthiest of individuals, and in that pregnant population the risk is even greater. These patients should be monitored before the ART, during pregnancy, delivery and puerperium, to avoid heart failure, thrombotic problems, embolic complications, stroke and death. Management issues regarding pregnancy and delivery are elaborate, including anesthesia considerations. This new population of women needs an accurate cardiac risk stratification with a thorough cardiovascular history and examination, 12 lead ECG, and transthoracic echocardiogram. Therefore, a comprehensive multidisciplinary assessment and management can provide the best opportunity to improve maternal and neonatal outcomes.


Assuntos
Síndrome Metabólica/etiologia , Complicações Cardiovasculares na Gravidez/etiologia , Técnicas de Reprodução Assistida/legislação & jurisprudência , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Síndrome Metabólica/prevenção & controle , Gravidez , Complicações Cardiovasculares na Gravidez/prevenção & controle , Gestantes , Técnicas de Reprodução Assistida/efeitos adversos , Fatores de Risco
5.
Clin Ter ; 170(4): e241-e244, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31304508

RESUMO

Medically-assisted procreation (MAP) has given rise to a crisis in the traditional family model, made up of a mother and a father, and led to the births of babies who are genetically and biologically unrelated to their legal parents. Italian legal statutes ban such practices, which are punishable by law; yet there is currently no legislation aimed at governing and regulating the legal registration of children born through such procedures abroad. Italian jurisprudence, on the other hand, has acknowledged the right to parenthood for homosexual couples, ruling that the children thus born be considered legally bound to their social parents, by virtue of the affection-based bond, rooted in harmony and listening, that has been formed within the family setting, however unconventional it may be. The paper's author feels that an intervention from lawmakers is urgent and inescapable, in order to provide targeted legislation in such a sensitive realm.


Assuntos
Família , Poder Familiar , Criança , Feminino , Humanos , Itália , Masculino , Técnicas de Reprodução Assistida/legislação & jurisprudência
6.
J Assist Reprod Genet ; 36(8): 1665-1681, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31346936

RESUMO

PURPOSE: The market of assisted reproductive technologies (ARTs) is rapidly evolving, raising growing ethical and social dilemmas. This paper compares the regulatory responses to technological and market developments in Israel and Spain, both intensive users of ART. We identify strengths and deficiencies in the regulation of ART in these two countries. METHODS: We developed a conceptual framework to classify the factors affecting regulations and priority setting, and applied it using a Delphi survey combined with in-depth interviews. We selected two panels of experts from various fields, trying to simulate the bioethics committees of Israel and Spain. RESULTS: ART is often wrongfully perceived as a solution to age-related infertility. Both panels embraced alternative solutions. The impact of private commercial interest on regulations is resulting in excessive practices such as the repeat of ineffective cycles and the push of sometimes unnecessary treatment add-ons. Our findings show experts dissatisfaction with the regulations of donor-eggs concerning reimbursement and registries in both countries. CONCLUSIONS: The adequacy of ART to solve age-related infertility should be confronted with alternative approaches, with emphasis on the distribution of accurate information. The magnitude of ART markets, particularly the use of donor-eggs, should raise the need for additional societal debate and the reform of regulations. The impact factors analysis leads us to question the current regulatory framework, which could be improved by nominating a non-governmental statutory central regulatory agency in Israel and by reforming the Spanish agency.


Assuntos
Infertilidade/terapia , Sistema de Registros/estatística & dados numéricos , Técnicas de Reprodução Assistida/legislação & jurisprudência , Feminino , Humanos , Infertilidade/epidemiologia , Israel/epidemiologia , Gravidez , Resultado da Gravidez , Espanha/epidemiologia , Inquéritos e Questionários
7.
Rev. bioét. derecho ; (46): 149-165, jul. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184857

RESUMO

Este artículo propone criterios para la regulación del consentimiento presunto a las técnicas de reproducción humana asistida post mortem en Argentina y argumenta brevemente sobre los fundamentos del instituto. Si bien el Código Civil y Comercial de la Nación prevé un sistema autónomo de filiación aplicable a las tecnologías reproductivas, los casos post mortem han sido desregulados. En los últimos años se han dictado numerosas sentencias que han reconocido el consentimiento presunto del difunto, aunque sin una construcción conceptual clara al respecto y con la consecuente inseguridad jurídica en torno a la filiación de las personas nacidas


This article proposes principles for the regulation of presumed consent to posthumous assisted human reproduction techniques in Argentina and argues about the basis of that institute. Although the Civil and Commercial Code of the Nation provides an autonomous filiation system applicable to reproductive technologies, posthumous cases have not been regulated. In recent years, several judgments have recognized the presumed consent of the deceased, although without a clear conceptual construction and with the consequent legal uncertainty regarding the filiation of the persons born


Aquest article proposa criteris per a la regulació del consentiment presumpte a les tècniques de reproducció humana assistida post mortem a l'Argentina i argumenta breument sobre el fonament de l'institut. Si bé el Codi Civil i Comercial de la Nació preveu un sistema autònom de filiació aplicable a les tecnologies reproductives, els casos post mortem no han estat regulats. En els últims anys s'han dictat diverses sentències que han reconegut el consentiment presumpte de la persona morta, encara que sense una construcció conceptual clara sobre aquest tema i amb la conseqüent inseguretat jurídica entorn de la filiació de les persones nascudes


Assuntos
Humanos , Técnicas de Reprodução Assistida/legislação & jurisprudência , Consentimento Livre e Esclarecido/legislação & jurisprudência , Mudanças Depois da Morte , Concepção Póstuma/legislação & jurisprudência , Argentina , Criopreservação/ética , Concepção Póstuma/ética
9.
J Assist Reprod Genet ; 36(6): 1041-1048, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31127476

RESUMO

PURPOSE: To heighten awareness of the potential legal and financial burdens faced by those providing cryopreservation storage services of embryos and gametes in light of recent lawsuits involving inadvertent thawing of specimens. METHODS: Case law review of US legal databases and courthouse dockets with a focus on lawsuits against reproductive endocrinologists and cryostorage facilities offering cryopreservation. Emphasis was placed on court decisions, awarded damages, and legal and media coverage related to cryostorage failure events. RESULTS: Lawsuits pertaining to two notable ongoing cases of cryostorage failure that occurred at fertility clinics in the US in 2018 were reviewed. Media coverage of these events and plaintiff and defense attorney strategies were evaluated. Legal documents from previous, similar cryostorage failures were also reviewed. Common claims in cryostorage system failures include breach of contract and negligent handling of property. Facilities offering cryostorage services are vulnerable to significant burden, legally and financially, if they are to experience a storage system failure. CONCLUSION: Providing cryostorage services is not without significant financial risk. Inadvertent thawing of specimens can lead to high damage awards against cryostorage facilities and those individuals linked to a cryostorage failure event. Because monetary damages can surpass insurance policy limits, those providing cryostorage services should be aware of plaintiff attorney strategies, common legal defenses, and basic asset protection principles to safeguard themselves if ever faced with these situations. Facilities should also carry out regular maintenance and safety checks on equipment and alarm structures to deter such events.


Assuntos
Criopreservação , Imperícia/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Manejo de Espécimes , Feminino , Células Germinativas/transplante , Humanos , Masculino , Técnicas de Reprodução Assistida/economia
10.
Med Sci (Paris) ; 35(4): 356-363, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31038114

RESUMO

This contribution aims at analysing and presenting a comparative dimension concerning the issues raised for the upcoming French Bioethics law revision in the field of assisted reproductive technologies (ART) : access of female same-sex couples and single women to ART ; the authorization of post-mortem procreation ; enlarging eligibility criteria for oocyte self-conservation ; and lifting the anonymity of gamete donation. These questions touch at the very heart of the French bioethics model conceived in 1994, and their revision would constitute a conceptual upheaval.


Assuntos
Temas Bioéticos , Técnicas de Reprodução Assistida/ética , Técnicas de Reprodução Assistida/legislação & jurisprudência , Anônimos e Pseudônimos , Bioética/tendências , Feminino , Preservação da Fertilidade/ética , Preservação da Fertilidade/legislação & jurisprudência , Humanos , Infertilidade Feminina/psicologia , Infertilidade Feminina/terapia , Casamento , Doação de Oócitos/ética , Doação de Oócitos/legislação & jurisprudência , Concepção Póstuma/ética , Concepção Póstuma/legislação & jurisprudência , Técnicas de Reprodução Assistida/normas , Técnicas de Reprodução Assistida/tendências , Minorias Sexuais e de Gênero/legislação & jurisprudência , Pessoa Solteira/legislação & jurisprudência
11.
Med Law Rev ; 27(3): 509-518, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31006032

RESUMO

In September 2018, the Federal Court of Australia found that a Victorian woman did not need her estranged husband's consent to undergo in vitro fertilisation treatment (IVF) using donor sperm. The woman, who was 45 years of age, made an urgent application to the Court for permission to undergo IVF using donor sperm. In a single judge ruling, Griffiths J held that the requirement in the Assisted Reproductive Treatment Act 2008 (Vic) ('ART Act') for a married woman to obtain the consent of her husband discriminated against the woman in question on the basis of her marital status in contravention of the Commonwealth Sex Discrimination Act 1984 (Cth) ('SD Act'). His Honour declared the Victorian law in this instance 'invalid and inoperable' by operation of section 109 of the Commonwealth Constitution to the extent it was inconsistent with the Commonwealth law. Although the declarations by the Federal Court were limited in their terms to the circumstances of the case, the judgment raises broader issues about equity of access to assisted reproductive treatment (ART) in Victoria. The issue of partner consent as a barrier to access to ART was specifically raised by an independent review of the ART Act in Victoria. The Victorian Government released an interim report late last year as a first stage of the review, which canvasses some options for reform. This raises a broader question as to whether prescriptive legislation imposing detailed access requirements for ART is necessary or even helpful.


Assuntos
Fertilização In Vitro/legislação & jurisprudência , Acesso aos Serviços de Saúde , Consentimento Livre e Esclarecido/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Cônjuges/legislação & jurisprudência , Feminino , Humanos , Jurisprudência , Estado Civil , Pessoa de Meia-Idade , Sexismo/legislação & jurisprudência , Vitória
13.
Cien Saude Colet ; 24(3): 917-928, 2019 Mar.
Artigo em Português | MEDLINE | ID: mdl-30892513

RESUMO

The Federal Medical Council (FMC) published FMC Resolution No. 1,358/1992 with the aim of adopting ethical standards for the use of Assisted Reproduction Techniques (ART). This resolution was updated in 2010 (CFM No. 1957/2010), in 2013 (CFM No. 2,013/13) and the last update was in 2015 (CFM No. 2.121/2015). The scope of this article is to conduct a critical analysis of the evolution of the ethical norms proposed by FMC for the use of ART in Brazil. A documentary analysis of the text of the four published Resolutions was carried out, in which the ethical standards for the use of ART were described. It was observed that the resolution evolved in relation to the rights of homosexuals, adopted more permissive measures regarding cryopreservation, donation of gametes and embryos and uteruses on loan and lastly authorized some procedures in ART such as postmortem reproduction, donation and shared gestation. From 2013 onwards the resolution gained a liberal character being updated in terms of clinical practice. For the next updates it would be interesting to include procedures in ART not previously addressed such as nuclear and cytoplasmic transfer. The update frequency (every two years) should be kept to the ethical standards enabling the ART to continue evolving together with the advancement of science.


Assuntos
Bioética , Direitos Sexuais e Reprodutivos/ética , Técnicas de Reprodução Assistida/ética , Brasil , Criopreservação/ética , Direitos Humanos/legislação & jurisprudência , Humanos , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Minorias Sexuais e de Gênero/legislação & jurisprudência , Doadores de Tecidos/ética
15.
Gac Med Mex ; 155(1): 3-14, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30799447

RESUMO

The use of donated gametes and embryos in assisted reproduction techniques (ART) makes it necessary to examine interests that involve relevant ethical and legal considerations, which include the autonomy and privacy rights of the intended parents, donors' right to privacy and the right of the minors to know their genetic origin. This article presents arguments to consider policies of more openness to obtain information from donors in order to protect the child's best interest in knowing his/her genetic origins. It concludes with the situation in Mexico, where ART has been carried out with donated gametes since several years ago; however, due to the absence of regulations to control these procedures, each establishment imposes its own criteria for the operation of its programs.


Assuntos
Confidencialidade/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Doadores de Tecidos/legislação & jurisprudência , Acesso à Informação/ética , Acesso à Informação/legislação & jurisprudência , Confidencialidade/ética , Destinação do Embrião/ética , Destinação do Embrião/legislação & jurisprudência , Feminino , Células Germinativas , Humanos , Masculino , México , Doação de Oócitos/ética , Doação de Oócitos/legislação & jurisprudência , Técnicas de Reprodução Assistida/ética , Doadores de Tecidos/ética
16.
BMC Pregnancy Childbirth ; 19(1): 46, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691390

RESUMO

BACKGROUND: Advances in science and technology coupled with globalization are changing access to and utilization of reproductive health services. This includes the transnational phenomenon of families who use surrogate mothers to reproduce, with forms of altruistic and commercial surrogacy becoming more commonplace. Simultaneously, changes in law, regulation, and policy are necessary to protect surrogates, intended parents, and resulting children. These developments have been slow to adapt to challenges inherent to surrogacy arrangements, most specifically in low-and middle-income countries, including in South American countries. METHODS: We conducted an interdisciplinary non-systematic literature review and legal analysis of existing and pending policy, laws, and regulations related to commercial surrogacy arrangements in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela. The review focused on articles that discussed topics of domestic and international law, policy, regulation, and governance related to commercial surrogacy. We queried PubMed, JSTOR, and Google Scholar for Spanish and English-language articles limited to those published between 2000 and 2016. RESULTS: Our literature and legal review found a wide variance in how different countries address the issue, including two (Brazil and Uruguay) that have issued guidance attempting to clarify the legality of commercial surrogacy, others who have introduced surrogacy-specific legislation, and a final group with no specific legal mechanisms in place. Our extracted legal case studies also indicate that courts have a hard time interpreting existing law and its applicability to surrogacy. The influence of Catholicism also played a role in the adoption of surrogacy and other advanced reproductive technology (ART)-related legislation. CONCLUSIONS: Changes in global infertility rates, the emergence of new family structures, and advancement of ART are factors that will influence future development of legal frameworks addressing surrogacy in South America. Despite a growing transnational market for commercial surrogacy in many of the countries examined, the current patchwork of policy does little to clarify what forms of surrogacy are legally permissible, nor do they adequately protect surrogates, intended parents, or the children themselves. This points to an urgent need for regional legal and policy harmonization specifically designed to align with public health and human rights principles.


Assuntos
Turismo Médico/legislação & jurisprudência , Mães Substitutas/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudência , Feminino , Direitos Humanos/legislação & jurisprudência , Humanos , Gravidez , Técnicas de Reprodução Assistida/legislação & jurisprudência , América do Sul
19.
Med Law Rev ; 27(3): 365-389, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30690476

RESUMO

Australian medical professionals whose patients undertake assisted reproductive treatment abroad face a conflict: to try to provide optimal and on-going care for their patient at the same time as ensuring compliance with Australian legal, ethical, and professional rules which proscribe as unsafe or unethical key aspects of such treatment. A major suggestion from literature on medical travel is that risks to the patient can be mitigated through the involvement of the local professional. However, the force of legal regulation and ethical guidance in Australia strenuously directs clinicians away from involvement in overseas reproductive treatment. This article reports on 37 interviews with Australians travelling abroad for surrogacy, egg donation, and embryo donation, reflecting on patients' experiences with Australian medical professionals both before and after they travelled. Patient reports demonstrate a fragmented and bewildering medical landscape in Australia, in which the ability to access domestic care and expertise varied markedly depending upon the kind of treatment patients were seeking abroad, and the mode of practice of the Australian doctor. Doctors practicing within licensed IVF clinics were notably more constrained than those outside such a setting. Patients seeking egg donation were offered information and received a wide range of diagnostic and preparatory treatments, while those seeking surrogacy were shunned, chided and offered limited (and sometimes covert) assistance. While recent changes to national ethical guidance improve clarity on information giving, the ethical and legal propriety of Australian medical professionals providing diagnostic or preparatory treatment for cross border reproduction remains uncertain.


Assuntos
Ética Profissional , Pessoal de Saúde/ética , Pessoal de Saúde/legislação & jurisprudência , Turismo Médico/ética , Turismo Médico/legislação & jurisprudência , Técnicas de Reprodução Assistida/ética , Técnicas de Reprodução Assistida/legislação & jurisprudência , Adulto , Austrália , Continuidade da Assistência ao Paciente , Feminino , Guias como Assunto , Redução do Dano , Humanos , Entrevistas como Assunto , Masculino , Turismo Médico/normas , Gravidez , Técnicas de Reprodução Assistida/normas
20.
Bioethics ; 33(1): 68-75, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30182368

RESUMO

In vitro gametogenesis (IVG) is believed to be the next big breakthrough in reproductive medicine. The prima facie acceptance of this possible future technology is notable when compared to the general prohibition on human reproductive cloning. After all, if safety is the main reason for not allowing reproductive cloning, one might expect a similar conclusion for the reproductive application of IVG, since both technologies hold considerable and comparable risks. However, safety concerns may be overcome, and are presumably not the sole reason why cloning is being condemned. We therefore assess the non-safety arguments against reproductive cloning, yet most of these can also be held against IVG. The few arguments that cannot be used against IVG are defective. We conclude from this that it will be hard to defend a ban on reproductive cloning while accepting the reproductive use of IVG.


Assuntos
Clonagem de Organismos/ética , Gametogênese , Engenharia Genética/ética , Células Germinativas , Reprodução/ética , Técnicas de Reprodução Assistida/ética , Células-Tronco , Criança , Clonagem de Organismos/legislação & jurisprudência , Dissidências e Disputas , Engenharia Genética/legislação & jurisprudência , Humanos , Pais , Técnicas de Reprodução Assistida/legislação & jurisprudência , Controle Social Formal
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