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Ethics

Emily: Putting All Your Eggs in One Freezer

Meet Louise Joy Brown.

Louise with her parents.

She was born on July 25th, 1978. She was the first ever baby to be conceived through in vitro fertilization (IVF). By 2006, over 3 million babies had been born worldwide thanks to assisted reproductive technologies (ART).  And some 60,000 babies are born every year thanks to IVF.

In IVF, eggs are removed from the woman and fertilized in a lab, then implanted in a uterus for gestation. Of the eggs fertilized, the doctors pick the “best” of the lot, then usually implant around two or three so as to have a higher chance of pregnancy without risking many multiple births.

If there were enough “good” eggs, then the non-implanted ones are often frozen and cryopreserved. This allows for the couple (or woman) to try again for another pregnancy if they want another child or if the first time around didn’t take.

But problems can ensue. What if the couple doesn’t want any more children? What if they separate or divorce? This is a major ethical issue currently being fought in many courtrooms. Should the eggs be saved if one of the parents still wants to have children? Should they be donated to another couple trying to have children? Or should they simply be discarded as medical waste?

Many, many court cases have been and are being fought over frozen embryos. In many cases, the couple has split and only one of the two wants to keep the frozen embryos. Perhaps one still wants to use them to have children, or to donate them, while the other doesn’t want to become a parent. How should the court rule? First of all, how can the court classify them? They are not legally persons yet, so it’s not the same as a custody battle over a couple of toddlers. But the embryos aren’t property either – they contain the genetic material of the parents and have the potential to be life. Many U.S. court cases have resulted in the parent demanding their right to privacy and to not have their genetic material used for procreation against their will winning the case, leaving the parent still wanting to have children or donate the embryos left behind. Most times, it is the ex-husband or ex-boyfriend who doesn’t want to have the responsibility of a child, while the woman wants to keep the embryos, often because she can no longer produce eggs likely to result in a healthy baby. Cases such as increasing age or certain types or cancer are common.

If the court rules with the parent in favour of not keeping the embryos, if the couple signs an agreement or if the frozen embryos themselves are abandoned, then the cryopreserved zygotes are destroyed by being placed in water. But is it even right to so simply destroy these pieces of pre-life?

First of all, many couples don’t have the money available for ART, so the donation of unwanted embryos or eggs would be put to good use. Or the embryos could be donated for research, particularly stem cell research. Also, while many compare the process of discarding the embryos to abortion, I feel like it is something more.

Imagine first a couple who froze several extra embryos after they had a successful pregnancy. However, later, one or both of them decide they don’t want the remaining embryos and have them destroyed.

Now, imagine a second couple. They are able to naturally get pregnant, and do so with the full intention of starting a family. However, during the pregnancy, the couple decides they no longer want kids and have an abortion. Or perhaps they separate and maybe the father demands that the mother has an abortion because he doesn’t want a biological child that he would have to provide care or money for.

I feel like abortion should be legal in some cases (but this is neither the time nor the place to discuss my exact views on abortion), but I hardly think it should be allowed if a woman or couple decide that they want to have children and start a family, then decide to abort the baby partway through the pregnancy because they changed their minds. And I think that the destruction of frozen embryos (while not a perfectly similar case) is also like this.

From my research, I know at least these things about IVF: it is generally uncomfortable to stimulate and extract the eggs, and it can cost up to $15,000 for the original treatment plus up to $600 per year for embryo storage. Then I really don’t think most people would go and freeze their embryos just for kicks and giggles. So, I will assume that they created and froze these embryos with the intent of using them to have children.

If you created these embryos with he purpose of using them to have children, then I view their destruction the same way I would view it if you got pregnant to start a family, but aborted the fetus at some point during the pregnancy.

While I know that the doctors usually take more eggs than are necessary when going through IVF, I still don’t think their destruction should be undertaken so lightly and nonchalantly. At the very least, why not donate them for research? If you’re discarding them, you surely have no use for them.

My suggestion for a solution to the problem is fairly simple. I would have the eggs and the sperm frozen separately, so that in case of divorce or some other circumstance, each partner could take their own donation and be on their merry way.

I read an article recently about a court battle over some embryos. A woman and her boyfriend had frozen some embryos, but ended up splitting up. Now, the woman has had ovarian cancer and the eggs in storage are the only she’ll ever be able to have. However, since her ex-boyfriend’s sperm was also frozen with her already-fertilized eggs, he also had a say in their fate, and he did not want to have a child from his own genetic matter without it really being his kid.

I see both people’s sides here. While I can imagine the woman’s desire to have kids that were actually her own, I can also see the man’s desire not have a child out there that was half him but really not his, not to mention probably having to pay child support or something of the like.

Again, abortion enters heavily into this discussion. For those who believe that life begins at fertilization, the destruction of frozen embryos would be no less than murder. For people like Plato, who believe that  “the human soul does not enter the body until birth”, then it is very much the same as doctors discarding any other medical waste. So, as Mariana said, “Ethics are very personal.”

So, basically, here are the problems that surround frozen embryos and their fate:

  • Do embryos count as people? Are they legally property?
  • Which is more valued: a parent’s right to have their own children (whom they paid for with a lot of money) or a parent’s right not to have their genetic material taken and used for a child that is not really theirs?
  • Is it ethical to give parents the resources to have a family without ensuring they plan ahead in case of divorce, separation or death?

I hope I have made this clearer, even though I am still not entirely sure what to think. Oh, ethics.

 

My slew of sites used for information may be found at Delicious.com

 

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Discussion

3 thoughts on “Emily: Putting All Your Eggs in One Freezer

  1. Reading this made me think of Megan’s post about designer babies and while it’s a tangent, they each go hand in hand with regards to population control, individuality and personal thoughts.

    With regards to having one’s own children, if one truly desires to become a parent then the money they paid should be secondary to actually raising and nurturing said child. And this is just my poorly informed opinion (and excuse the cliche sound) but there is absolutely nothing that can be more “you” than your own genetic material. As it takes two to conceive a child naturally, it should take two (to agree of course) to conceive one unnaturally as well.

    For your last question I’d like to bring up the US housing market crash and how it happened. Basically (again to my admittedly slim best knowledge) banks loaned out money and charged interest that they knew people couldn’t pay, took back the houses that were bought with said borrowed money and sold to other such unsuspecting victims. If the doctors represent the banks, it’s important that they check admittedly less tangible factors, perhaps the duration of the relationship, and influence decisions based on those.

    Great finds on a pretty murky topic!

    Posted by carrotdandan | December 11, 2012, 4:41 am
    • Thanks, Daniel! I agree, it would be very important to see if the couple would actually raise the child and stay together long enough to do so. However, while I know there is at least some kind of application, many things on this subject are extremely touchy and I can just imagine people becoming very angry and possibly suing for discrimination. And I don’t think the doctors should have to be the ones to decide if someone’s marriage will last (someone more qualified, for sure), since they already have to make many weighty decisions every day, not to mention what to do with abandoned embryos (many parents avoid the hospitals’ letters so they won’t have to choose themselves).

      With your point on how it should take two to agree to conceive unnaturally as well, I certainly agree. At the time of fertilization, I’m sure both parties agreed. But upon divorce, they no longer agree, as you said. But again we hit the problem of the woman who could no longer produce healthy eggs, but still wanted biological children. I think things would go more smoothly if each person froze their own genetic material separately, so as not to give two people the final call over what happens to it (the only issue would be an increased need for storage!).

      Emily

      Posted by anafricanswallow | December 11, 2012, 6:06 pm
  2. Thanks for this very articulate introduction to one of a few threads of applied ethics that are finding their way into emerging health technologies like IVF and some of the other innovations (closing, gene therapy, etc) people have written about on the blog this week. Even if coming to a resolution about what *should* be done in some of the cases you highlight is difficult, something I take away from these stories is a little like the criticism Jeff Goldbloom’s character offers near the beginning of Jurassic Park (before he is eaten by the T-Rex in the portapotty): “You were so busy trying to figure out if you could, you never stopped to think about whether or not you should.”

    Now, maybe that’s a little strong; I personally think that if we are able to aid willing parents in becoming parents, there’s nothing much I would change about us being able to help them like this. However, what these couples, and their doctors, neglected to consider was working out some of the potential legal/custodial implications of the couple breaking up. Why wasn’t something about a potential divorce written into that paperwork??

    Something that is interesting to consider, and why an education in ethics is increasingly important in the health-services field, is that as we continue to improve our technologies that create new contexts around cases of birth and paternity, we must also evolve our understanding of what the ethical implications of these advancements might be. People with an understanding of ethics, both societally and as individuals, will hopefully not be left behind in conversations about just what we *can* do with the science of life.

    Posted by Mr. J | December 12, 2012, 10:17 pm

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