Procreative Autonomy Versus Beneficence in Assisted Reproductive Technologies

Since its beginning, healthcare has focused its attention on helping patients become healthier and live longer. One of the areas in which medical technology has made impressive strides is assisted reproductive technologies. Some bioethical issues are common to most or all of these newer reproductive technologies. The uncertainty of long-term risks posed by reproductive technologies generate potential challenges to the values of beneficence and non-maleficence and strain the already divisive dichotomy between procreative autonomy and procreative beneficence. Procreative autonomy and procreative beneficence are both important values that physicians and prospective parents ought to evaluate when considering the use of assisted reproductive technologies. However, the moral prescriptives associated with each value may diverge and conflict with one another; when this occurs, minute arguments may shift the balance between them. For physicians, prioritizing the value of procreative autonomy or procreative beneficence mainly influences the way in which they choose to present information–that is, whether they are directive or non-directive when consulted about family-planning options. Assisted reproductive technologies have dramatically increased the range of choices available to prospective parents, and this breadth of choice may lead to potential ethical conflicts between the competing values of procreative autonomy and procreative beneficence. In the following article, we will address this friction, focusing our attention on normative considerations related to medical risk management and the telos of the prospective child.

Gay and Lesbian Collaborative Co-Parenting in New Zealand and the United Kingdom: ‘The Law Doesn’t Protect the Third Parent’

In many jurisdictions, legislation reflects, retains and reiterates heteronormative two-parent models of family. Lesbian and gay individuals and an increasing number of heterosexual individuals who choose to parent outside the paradigm of the conjugal couple relationship find neither their interests nor the welfare of their children is sufficiently protected in law. This article is based on the findings of two empirical research projects investigating the procreative autonomy of lesbians and gay men in New Zealand and the United Kingdom. It focuses on collaborative co-parenting families formed by lesbian couples and gay men, with reference to the allocation of legal parenthood in these kinds of families and case law across both jurisdictions. Two such families are introduced. Attention is drawn to the ways the law hampers these families’ preferred parenting arrangements. The article highlights the need for legislative change. It concludes that a more flexible, inclusive concept of legal parenthood that honours the intentions of those involved in these arrangements would potentially benefit all people interested in non-traditional parenting.

Procreative autonomy, gender equality and right to life: the decision of the Inter-American Court of Human Rights in Artavia Murillo v. Costa Rica

Resumo The trial and the reasons adopted by Inter-American Court of Human Rights (IACtHR) in Artavia Murillo v. Costa Rica represent significant progress in protecting women’s procreative autonomy. The decision of the IACtHR revoked a decision of the Constitutional Chamber of Costa Rica that banned the use of In Vitro Fertilization (IVF) in the country. With this decision, the IACtHR not only clearly linked universal rights of freedom with procreative autonomy for women and men; the IACtHR also strongly reinforced an interpretation on the “right to life” that favors procreative autonomy. Moreover, the decision is remarkable to include a standard of equality in matters of procreative autonomy insofar as the IACtHR has held that women, because of negative gender stereotypes in society, have been greatly undermined by the decision of the Chamber of Costa Rica to ban IVF. Finally, as will be argued, courts may, in similar future cases, introduce the Convention of Belém do Pará in the analysis, considering that the elimination of IVF services (or other limitation of women’s procreative autonomy) can be seen as a form of violence against women’s moral integrity.

Balancing Procreative Autonomy and Parental Responsibility

In Rationality and the Genetic Challenge: Making People Better? Matti Häyry provides a clear and informed discussion and analysis of a number of competing answers to the above questions. Häyry describes three main perspectives on the morality of prenatal genetic diagnosis (PGD), the “restrictive,” “moderate,” and “permissive” views, and his analysis illuminates that these views can be distinguished in terms of their different “rationalities”—their respective understanding of what counts as a reasonable choice for parents to make in light of PGD.