Before we can even start understanding how moral in vitro fertilization (IVF) is, we must look at how honest an embryo is. This is because a crucial distinction needs to be established between the beginning of a “human life” and the front of a “person.”
When the human egg is fertilized by human sperm or otherwise stimulated to allow cell division to begin, human life is said to have begun. This is a biological question. Our best understanding is that human life begins when the human egg is fertilized by human sperm.
There are four fundamental moral foundations upon which the ethics of medicine are built:
- Autonomy refers to a patient’s freedom of treatment decision-making.
- The IVF specialist owes a duty of beneficence to the patient, which requires always putting the patient’s needs before their own.
- The famous medical tenet of “first, not harm” is an example of non-maleficence.
- As in, who gets treated and at what cost to the community, justice is about fairness and equity.
When difficult choices must be made, these ideals, which sometimes overlap, can provide a moral minefield. In vitro fertilization (IVF), however, the situation is further complex because we are examining the rights and ethical position of not one, not even two, but a minimum of three individuals: the male, the female, and the yet-to-be-born child.
Technically speaking, a fetus is not “the patient.” IVF treatment has its problems regarding the right to choose treatment, which is related to the “autonomy” principle we discussed above. What should the IVF center do if both parents have a genetic condition but refuse a pre-implantation diagnosis for any reason? Genealogical susceptibility is not the only factor. IVF doctors who bring children into the world have a legal responsibility to ensure their well-being in some jurisdictions, such as the United Kingdom.
Advice and Consent Forms
Properly counseled “informed consent” appears to be the best solution here. Before undergoing any treatment, a patient should weigh the potential benefits against the potential drawbacks, and vice versa. IVF includes the long-term implications of bringing a child into the world and being responsible for them for at least the next twenty years.
HFEA standards mandate counseling for couples pursuing donor IVF, and best practices advise that it should be the initial stop for any couple pursuing IVF from a source other than a donor. Therefore, before starting treatment, patients can thoroughly investigate and be sure of their motivations.
Informed consent is important for patients to understand the technical aspects of therapy and which options have the best chance of success. It’s possible that the least expensive option is best for them, but the most expensive one may not have superior odds. Due to market time and money limits, IVF specialists may have ethical issues. Whether the practitioner or patient made the decision, insurance requires full informed consent document before treatment (after proper counseling and technical information).
Putting the patient’s needs first
One of the essential things for IVF doctors to think about is what treatments could be best for their patients once they’ve ruled out any potential fertility-robbing causes, like smoking or being overweight. It is generally accepted that patients should be given the “simplest, cheapest, and safest treatment that is likely to work.” But according to the principle of informed consent, this is one of those times when we move into the area of “autonomy,” because the patient has a right to know what’s happening.
Always put patient safety first.
Every IVF specialist must remember that even when a patient is well-informed, this can cloud judgments where the principle of “first, do no harm” is relevant. This is especially true when the popular press writes about and praises new treatments before there is enough evidence that they work. There is a danger of failure and emotional fallout from trying something new, and such remedies may be useless and harmful. Seeking out evidence and being aware of the potential consequences is a rule of thumb here, as is ensuring the patient’s familiarity with these terms.
Fairness and justice
The ethical implications of IVF treament will continue to be debated for the foreseeable future. When it comes to healthcare, availability might be inconsistent due to difficulties of both accessibility and affordability. Because of the increased mobility of modern society, women are increasingly seeking reproductive services in other countries that do not share their own. On the other hand, medical facilities are not required to provide care to anybody who walks through their doors. The theory of fairness and justice argues that it is best to practice to ensure patients understand WHY therapy is being denied, even if the reasons are valid.
A clinic may not offer IVF services for a variety of reasons.
- Clinics often place age restrictions on female patients.
- There is no economic or medical reason to discriminate against couples who say they are single-sex. Children of homosexual couples were sometimes cited as a justification for society’s failures, but studies show that they succeed at the same rate, if not better, than their straight counterparts.
- Patients deemed medically unfit present a challenge because their classification will vary from clinic to clinic. Even though being overweight or obese is a problem in the western world for both men and women, almost half of women and 70% of men report being overweight or obese. Despite evidence that the unfitness of the male may also affect the possible child’s future health, clinics may use a ‘cut-off’ BMI, but this is usually only applicable to the woman. People who are hopeless cases are also included here; in such a scenario, it is necessary to apply the principles of beneficence and “first do no harm” to stay within the bounds of ethical conduct.