Reproductive Technology: Ethical Issues

In vitro fertilization, even with anonymously donated ovum or sperm, is usually accepted as enabling a couple to experience gestation and create a family. However, the in vitro procedure typically creates more embryos than will be implanted. These excess embryos are usually frozen and may remain viable (able to develop normally) for several years. Is it ethical to create embryos that will never be developed? Are the embryos of a couple joint property, which can be divided upon divorce, or should they be considered children, with custody awarded to one parent or the other? What should be done with frozen embryos as they lose their viability?

The ability to fertilize an ovum in a glass dish makes it possible to combine gametes from any man and woman and implant the fertilized ovum into any other woman. Should this be done for other than a husband and wife? For instance, should a reproductive specialist be allowed to refuse to help an unmarried or same-sex couple have a child? Antidiscrimination laws cover some of these issues, but the application of this law to reproductive technology services is still developing.

In vitro fertilization also raises the possibility of employing a woman to be a surrogate mother, acting as the carrier of a child who is expected to be raised by another woman. Women have contracted to render this service in exchange for having all their medical costs covered and in exchange for a stipend to be paid when the baby is delivered. The ethical and legal problems posed by such arrangements have drawn much attention, and many states regulate the boundaries of such agreements.

The birth mother (surrogate) usually signs a contract to allow the adoption of the baby upon birth. However, hormonal changes during pregnancy, especially the increased levels of oxytocin, can produce a variety of behavioral changes, often termed "maternal instinct," in the pregnant woman. The woman may have been quite willing to surrender the child upon birth, but she may have become unwilling to do so after birth.

In general, the birth mother has the principal right to decide about fulfilling her contract to give over the baby, but the state has stepped in, making contrary decisions when the welfare of the child is at stake. Surrogacy has other potential problems, such as what happens when there are prenatally diagnosed abnormalities and termination decisions must be made or when there are differing standards of prenatal care between the surrogate and the contracting party, and when there is a desire for control of the contracting individual or couple over the surrogate.