I. Overview of Reproductive Technology
(1) Meaning and Classification of Reproductive Technology
1. Meaning of Reproductive Technology It is a medical technology that substitutes for one or all of the steps of the natural reproductive process.
2. Types of Reproductive Technology
(1) Artificial insemination (AI). AI is a technique in which semen is collected from the husband or a voluntary donor and injected into the female reproductive tract by a physician for the purpose of fertilization. Depending on the source of semen, AI can be categorized as AIH (artificial insemination of husband) and AID (artificial insemination of donor). The birth of this technology also created sperm banks.
(2) In vitro fertilization (IVF, in virto fertilization). It is a method of reproduction in which the egg and sperm are artificially fertilized and developed outside the human body. Because fertilization takes place in a test tube in a laboratory, babies born this way are often called "test tube babies.
Because ovulation can be triggered and the number of fertilized eggs may exceed the number needed for transfer, cryopreservation can also be used in this area, giving rise to frozen egg banks and frozen embryo banks.
The clinical use of artificial insemination and in vitro fertilization techniques has led to the emergence of surrogats mother. Surrogate mothers, also known as surrogate mothers, are women who carry a pregnancy on behalf of another person, either by artificial insemination of their own eggs or by using another person's fertilized egg to implant the pregnancy in their own uterus and then give it to another person to raise after delivery.
(3) asexual reproduction. Also known as cloning technology, is the use of modern medical technology, not through the union of the two sexes, but the higher animals (including human) reproduction technology.
Strictly asexual reproduction technology, also known as adult cell cloning technology. It is to take out the adult cells of higher animals, implant the nucleus of the cell carrying genetic information into the nucleated egg, let the union continue to develop through technology, and then transfer the embryo that has developed to a certain extent to the mother's uterus for gestation until delivery. Since the adult cells have lost the ability to differentiate from the fertilized egg, it greatly increases the difficulty of asexual reproduction.
(B) the history and reality of reproductive technology
1, the history and reality of artificial insemination
2, the history and reality of in vitro fertilization through artificial insemination and in vitro fertilization technology on behalf of other people's gestation of surrogate technology, in the United States, from the 70's of the 20th time. 2000 October Harbin Medical University Hospital, Department of Obstetrics and Gynecology, claimed that it has been successfully carried out surrogacy technology through the media. The surrogate mother is a surrogate for her sister, who had her uterus removed due to illness.
3, the history and reality of asexual reproduction strictly asexual reproduction technology, that is, the birth of reproductive cloning technology is the birth of a British named "Dolly" (Dolly) cloned sheep. February 23, 1997, Nature magazine published this news, based in Edinburgh, England, Roslin research institute Wilmot and Kembel. The research team headed by Wilmot and Kembel, extracted an egg cell from the ewe that provided the egg cell, removed the nucleus, and made an egg "empty shell" with biological activity but no genetic material, and took out an ordinary tissue cell from the mammary gland of a ewe, fused it with the abovementioned egg cell with no genetic material, and generated an egg cell containing new genetic material. This egg cell divides and develops into a new egg cell. When this egg cell divides and develops into an embryo, to a certain extent, the researchers implanted it into the uterus of a ewe, who became pregnant and gave birth to "Dolly".
Second, the ethical discussion of reproductive technology
The emergence of reproductive technology and its clinical application soon gave rise to a large number of social and ethical issues, which brought people to the "wonderful new world".1 Therefore, it is necessary to discuss the ethical aspects of it.
(I) Ethical value of reproductive technology
The significance of reproductive technology is manifested in many ways. In addition to demonstrating the great achievements of scientific development and the great increase in human capabilities, it also has the following ethical values.
1. Reproductive technology can treat and make up for infertility, which is beneficial to marriage and family Reproductive technology can solve the problem of having children for infertile couples, so people usually also call this technology assisted reproductive technology. Artificial insemination mainly solves the husband's infertility problem: AIH applies to those whose husbands can't have normal sexual intercourse due to abnormal sexual function, or applies to those whose husbands have a low number of sperms in their semen, and need to be collected several times to be concentrated in order to improve the insemination ability; AID applies to those whose husbands have no sperms in their semen, or those whose men and women are cryptic heterozygotes of the same chromosome.
2. Reproductive technology can be used for eugenics. Selection of other people's high-quality sperm and eggs for artificial insemination and in vitro fertilization can be used for both preventive eugenics and evolutionary eugenics. For couples with major genetic diseases, the use of other people's germ cells for assisted reproduction can undoubtedly be used for preventive eugenics; the selection of high-quality germ cells for assisted reproduction can undoubtedly be used for evolutionary eugenics. In the United States, California has set up a "Nobel Sperm Bank" to provide sperm from Nobel Prize winners; in China, there are attempts to set up "celebrity sperm banks" and "beautiful women's egg banks", one of the motives of which is said to be to carry out evolutionary eugenics. One of the motives for this is evolutionary eugenics.
3. Reproductive technology can be beneficial to family planning. According to China's demographic situation, family planning today and for a considerable period of time in the future, is to control the number of births, the Population and Family Planning Law stipulates: "The State stabilizes the existing fertility policy, encourages citizens to marry late and have children late, and advocates that a couple have one child."
4. Reproductive technology can be beneficial to agriculture, animal husbandry, medicine, and to the rescue of endangered plants and animals Reproductive technology, in addition to being directly beneficial to human beings in their own fertility, can also be beneficial to agriculture, animal husbandry, and medicine production, and is conducive to the rescue of endangered plants and animals.
(2) Social and ethical problems caused by reproductive technology
The emergence of reproductive technology and its clinical application, people soon found that there are a large number of social and ethical problems, which put forward a large number of medical ethical questions.
1. Can reproductive technology be commercialized? The use of reproductive technology often involves the question of the source of sperm, eggs and embryos, which leads to the question of whether sperm, eggs, fertilized eggs and embryos are the private property of the provider, and whether the provider can be paid for them? Can the provider be paid for this, including the surrogate mother? Fundamentally, it is a question of whether reproductive technology can be commoditized.
In the United States, it has become the norm for sperm providers to be paid. Some people in our country have also suggested that sperm can be commoditized? The main reason is that sperm commercialization can greatly increase the supply of sperm, and the sperm banks in China generally have problems with too few donors and the possibility of too much single fertilization. However, more people believe that the problems associated with commoditization will greatly offset the benefits of increased sperm supply, for the following reasons:
(1) Sperm commoditization may cause donors to be unconcerned about the consequences of their actions, and to conceal their physical, behavioral, and psychological defects, either intentionally or unintentionally. For example, if the sperm donor conceals a genetic disease in himself or his family or his homosexual behavior, he may transmit genetic diseases and AIDS to the child born through artificial insemination.
(2) Sperm banks may neglect the quality of the sperm due to competition or the pursuit of profitability. Sperm banks, in their pursuit of high quality, provide only one type of sperm that they consider to be "the right kind" of sperm, and as a result, human genes may become monotonous and lacking in diversity.
(3) The commodification of sperm is not only harmful to the child inseminated as described above, but also creates a slippery slope that leads to the commodification of other human tissues and organs.
(4) Sperm commoditization is also contrary to the donor's own wishes. The donor of the sperm donor is supposed to give a piece of love to others, to help solve the problem of infertility of others, and to provide sperm for the sake of the happiness of others' families, which is a kind of humanitarian and noble behavior, and does not seek money as a reward, and the commoditization is contrary to the donor's original intention.
The same problem is encountered with the provision of eggs, fertilized eggs and embryos.
2. Reproductive technology leads to confusion in human ethical relations "A new question raised by AID is 'what is fatherhood?' A child born using AID technology can be said to have two fathers? One is the father who raises him/her and the other is the father who provides half of his/her genetic material." "The question of 'what is a father' posed by AID expands to the question of 'what is a parent' as AID is combined with in vitro fertilization and embryo transfer techniques. ...... Mothers are categorized as 'genetic mothers', 'gestational mothers', and 'nurturing mothers', and those who are all three in one is 'full mother'; fathers are divided into 'genetic father', 'nurturing father' and 'full father' when all three are united. The father, on the other hand, is divided into the 'genetic father' and the 'nurturing father'.
3. Reproductive technology destroys the laws of nature In human genetics and reproductive biology, there is an iron law that has been observed so far: the offspring are produced by the parents through the union of DNA, the genetic material in the sex cells. Childbearing is the eternal embodiment of marriage and love union. Reproductive technology cuts off the link between childbearing and marriage, and it is said to have turned childbearing into mating, and the sacred store of the family into a biological laboratory, and at the same time divided human beings into two categories: those who reproduce by technology and those who reproduce by nature.
4. Reproductive technologies can be misused or abused "Misuse" refers to the fact that the motives for practicing reproductive technologies are ethical, but for a variety of reasons unethical outcomes can occur. For example, in Sweden, a white couple was artificially inseminated and instead had a dark-skinned child, due to a technician's error.
"Misuse" refers to operators who do not operate reproductive technologies in accordance with socially acceptable ethical principles in the first place. For example, a specialist in artificial insemination in the United Kingdom claimed to use her husband's sperm or purchased sperm from a sperm bank for couples requesting artificial insemination services, but in fact used her own sperm for artificial insemination, resulting in the birth of more than 6,000 artificially inseminated babies, and thus earning her the title of "father of the world's most productive child", which has led to endless consequences.
Third, on the ethical status of reproductive technology in China
(a) Artificial insemination and in vitro fertilization-embryo transfer of ethical principles
1, the principle of purity of purpose Artificial insemination and in vitro fertilization-embryo transfer of the purpose can only be for the purpose of treating, compensating for the reproductive function of the married couples, only can be for preventive eugenics. Evolutionary eugenics is not permitted at this time.
Anyone who, due to the health condition of the couple, is in line with China's marriage law and family planning policy, can of course have children through artificial insemination and IVF-embryo transfer and other methods of compensatory procreation.
2, the principle of informed consent The artificial insemination and in vitro fertilization-embryo transfer surgery, must get the informed consent of the person who receives the surgery; and must get the informed consent of both spouses.
3, the principle of equal rights of the children born and the legitimate children The children born form a parent-child relationship with the couple who accepts the reproductive technology, and have nothing to do with the man or woman who provides the reproductive cells, and the relationship between the rights and obligations of the children born and the legitimate children is equal to the rights and obligations of the legitimate children. Examples may be given.
4, the sperm donor, egg taker conditions are restricted principle Not anyone can donate sperm, egg donation, must be examined to meet certain conditions. For example, the human sperm bank should carry out health checks and strict screening of sperm donors, and shall not collect semen from people with one of the following conditions: a family history of genetic diseases or hereditary diseases; psychiatric patients; patients with infectious diseases or carriers of disease sources; people who have been in long-term contact with radiation and hazardous substances; people with unqualified semen examinations; and patients with other serious organic diseases.
5. The principle of avoiding consanguineous marriages and keeping medical secrets Measures must be taken to avoid consanguineous marriages. Relevant departments such as the marriage registration department and household registration department can establish files; limit the number of sperm donor and egg donor donation and medical structure.
Confidentiality should be maintained for sperm donors, egg donors, couples undergoing reproductive technology, as well as for artificially inseminated children and test-tube babies. Confidentiality should be kept both from the community and among themselves to avoid unnecessary trouble.
6, the principle of determining the technical and health standards Medical structure must have certain conditions, for example, with a variety of necessary testing technology, equipment conditions; a professional and technical team; a certain number and size of sperm donor and egg donor team; strict rules and regulations.
(II) About surrogacy and asexual reproduction
Although surrogacy is not prohibited in some countries, it is prohibited according to the ethical situation in China, the degree of acceptance of the people, and the possibility that it may bring about a large number of disturbances in human relationships. Therefore, the State Ministry of Health issued the "human assisted reproduction technology management measures" clearly stipulates: medical institutions and medical personnel shall not implement any form of surrogacy technology.
Reproductive cloning technology, or human asexual reproduction, is currently the dominant international medical ethics considered immoral. Our government has also made it clear that it "does not favor, support, allow, or accept any human cloning experiments."