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Biomedical subjects

F Shenfield

Publications and source records attributed to F Shenfield.

At least 19 recordsLinked to original sources
PubMed2006

ESHRE Task Force on Ethics and Law 11: Posthumous assisted reproduction.

This article analyses the different ethical aspects of posthumous assisted reproduction. Two situations are distinguished: cases in which the gametes or embryos are used by the surviving partner and cases in which the gametes or embryos are made available for third persons. The moral evaluation of the procedure depends on whether the act is restricted to the existing parental project. A major difficulty for the moral evaluation is the inconclusiveness of the empirical data on the psychosocial development of children born after this procedure. The Task Force concluded that posthumous reproduction by a partner is acceptable if the following conditions are met: written consent has been given by the deceased person, the partner received extensive counselling and a minimum waiting period of 1 year is imposed before a treatment can be started. For use by third parties, the usual conditions for gamete and embryo donation apply.

Advisory Committees↗
PubMed2005

ESHRE Task Force on Ethics and Law 10: surrogacy.

This 10th statement of the Task Force on Ethics and Law considers ethical questions specific to varied surrogacy arrangements. Surrogacy is especially complex as the interests of the intended parents, the surrogate, and the future child may differ. It is concluded that surrogacy is an acceptable method of assisted reproductive technology of the last resort for specific medical indications, for which only reimbursement of reasonable expenses is allowed.

Advisory Committees↗
PubMed2005

Post-mortem sperm retrieval in new European Union countries: case report.

This paper describes post-mortem sperm retrieval from a man who had given prior written consent to the retrieval and use of his sperm in assisted reproduction before his accidental death. The case illustrates some of the complex ethical and legal issues occurring in a new European Union (EU) country and the need for prior preparation by the medical teams involved. We also discuss a questionnaire sent to Centres of Assisted Reproduction in other new EU countries, which reveals a dearth of both legislation and guidelines for post-mortem sperm retrieval. If this method becomes more requested in these culturally diverse countries in the future, the situation demands public debate first of all at the national level.

Accidents↗
PubMed2005

Taskforce 9: the application of preimplantation genetic diagnosis for human leukocyte antigen typing of embryos.

This 9th statement of the ESHRE Taskforce on Ethics and Law considers ethical questions and specific dilemmas concerning preimplantation genetic diagnosis for human leukocyte antigen typing of embryos. This application is particularly complex because the interests of the sick child needing a transplantation should be balanced against the interests of the future donor child who may result from the technique. It is concluded that, if parents intend to love the child, the creation and use as a donor is not inherently disrespectful.

Cloning, Organism↗
PubMed2005

[Preimplantation genetic diagnosis in order to choose a saviour sibling].

Preimplantation genetic diagnosis with HLA matching in order to bring about the birth of a saviour sibling is not mere instrumentalisation of the future child, as long as the post natal test is used and the future child will be looked after with the same love and care as if he/she had not been selected as well for the purpose.

Bioethics↗
PubMed2005

Too late for change, too early to judge, but an oxymoron will not solve the problem.

In the face of an impending change in the recruitment of gamete donors in the UK, many predict a decrease in the number of donations. It is argued that the dangers of inordinate compensation may only increase this possible dearth by deterring altruistic donors, and that large payments may be especially prejudicial to the interests and welfare of children born as a result of gamete donation. Thus, "an 'all-inclusive' financial allowance to ...donor(s)" appears to be a contradictory statement (an oxymoron) that is unlikely to resolve the practical problems arising in gamete donor recruitment in the UK.

Bioethical Issues↗
PubMed2004

Taskforce 8: ethics of medically assisted fertility treatment for HIV positive men and women.

In this 8th statement of the ESHRE Taskforce on Ethics and Law, the focus is on the ethical issues raised by (assisted) reproduction for HIV positive men and women. Due to treatment improvements, their life expectancy has increased substantially. This, in combination with the reduction of perinatal transmission to the child, makes the creation of a family more acceptable. Recommendations are made concerning methods of avoiding HIV transmission in the couple and to their offspring. It is concluded that, if certain precautions are taken, medical assistance to reproduction of HIV positive people is ethically acceptable. For the time being, only cases of serodiscordant couples should be considered.

Anti-Retroviral Agents↗
PubMed2003

Taskforce 5: preimplantation genetic diagnosis.

The European Society of Human Reproduction and Embryology (ESHRE) Ethics Task Force sets out a recommended multidisciplinary approach to the application of preimplantation genetic diagnosis (PGD). The statement includes consideration of fundamental ethical principles, specific problems in cases of high genetic risk, and PGD for aneuploidy screening, HLA typing and sex selection for non-medical reasons.

Aneuploidy↗
PubMed2002

Ethical issues in the genetic aspects of haemophilia.

The aim of this paper is to put some of the ethical considerations concerning the genetic aspects of haemophilia not only in the national, but also in the international context, especially from the point of view of human rights. Particular attention is given to the issues pertaining to consent from children, and the respect for their autonomy within family relationships. This will be analysed within the context of genetic screening and testing, as well as codes of practice and guidelines. The specific issues around prenatal diagnosis in general and pre-implantation genetic diagnosis (PGD) are also discussed.

Ethics, Clinical↗
PubMed2000

[Human cloning: judicial and legislative framework].

The application, either theoretical or fantastical, of the somatic cloning which resulted in the birth of Dolly the sheep to human reproduction has led to international uproar. A paragraph specifically banning reproductive cloning (defined as "any intervention seeking to produce genetically identical human individuals in the sense of individuals sharing the same nuclear gene set") was added to the Council of Europe Convention on Human Rights and Biomedicine in January 1998. In several responses both at national and international level, reproductive cloning is banned either directly or indirectly. The challenge for the future is the consideration of integrating therapeutic cloning in legislations both nationally and in international declarations.

Cloning, Organism↗
PubMed1998

Statutory information for the children born of oocyte donation in the UK: what will they be told in 2008?

In the UK, non-identifying information on the donor is recorded by statute in assisted reproduction with gamete donation. This may be made available eventually to the resulting children. Prospective parents are counselled about openness, and often wish to know what may be available if the child has access to this information. We analysed forms from the Human Fertilisation and Embryology Authority completed by all donors at the Lister in-vitro fertilization unit. We found that 94% of oocyte donors did not respond to the last question asking for a brief description of themselves, leaving only profession and interests as information to be given in the future. There was a significant difference between the known and anonymous responders. This has important implications for the future parents who want to tell their child of his/her origins.

Adolescent↗
PubMed1998

Recruitment and counselling of sperm donors: ethical problems.

The recruitment and counselling of sperm donors raise several ethical issues. The word 'donation' implies no payment and informed consent for donation is essential in respecting the autonomy of the giving party. This implies looking into the motivation of donors and, when accepted, information about the screening and its results. It is a sensitive issue, especially when pathology is uncovered in someone who has not asked to be screened for his own immediate benefit. Counselling may result in a refusal to take part by the prospective donor, and selection by the recruiter; the main problem being the ethical basis of the selection process. Other elements may also lead to a clash of interests between the donor, the recipients and even the prospective child, particularly in the field of anonymity and information giving about the specific circumstances of use of the donation. Implication and support counselling are essential tools in achieving an acceptable balance.

Counseling↗
PubMed1997

What are the effects of anonymity and secrecy on the welfare of the child in gamete donation?

A perennial concern when using donated gametes in infertility treatment is the effect on the child and his/her family of the traditional anonymity of the donor, and of the secrecy of the procedure. As all involved, from potential parents to carers, wish to maximize the 'welfare of the child' born of gamete donation, conflicting attitudes, sometimes translated into diverging legislations in Europe, are analysed. In the face of the lack of evidence on the consequences of secrecy or openness, it is concluded that future parents are best placed to decide on this matter for the potential children.

Confidentiality↗
PubMed1997

Current ethical dilemmas in assisted reproduction.

Assisted reproduction in general is replete with ethical issues, either revolving around the status of the embryo or the possible conflict between the duty of care to prospective parents, and the responsibility of the carer to the potential offspring; duties to intermediaries in gamete donation are yet another dimension, which may wane in view of the more recent technique of ICSI, a radical transformation in the treatment of male infertility. Specific problems relating to andrology are analysed within the larger context of different ethical theories.

Ethics, Medical↗
PubMed1995

In-vitro cervical mucus-sperm penetration tests and outcome of infertility treatments in couples with repeatedly negative post-coital tests.

The results of in-vitro cervical mucus-sperm penetration tests and cross-hostility tests in 178 couples with repeatedly negative post-coital tests were recorded. Using a protocol of three cycles with intra-uterine inseminations (IUI) followed by three cycles with ovulation induction + IUI, the association between the cause of infertility, results of the in-vitro tests and the outcome of infertility treatment was investigated. We found that repeatedly negative post-coital tests are a good indicator of a cervical mucus-sperm penetration problem. The cross-hostility test clearly differentiates the abnormal factor in this interaction, and a good performance of the donors' spermatozoa in the cervical mucus correlates with increased pregnancy rate. In male factor infertility, failure of the husbands' spermatozoa to penetrate cervical mucus was not indicative of a deficient fertilization potential in vivo. In these patients a serious attempt should therefore be made to reverse the infertility by treatment with IUI or ovulation induction + IUI before attempting assisted reproduction. Women with polycystic ovaries and repeatedly negative post-coital tests should be investigated for sperm receptivity of the cervical mucus. Low receptivity of the cervical mucus may imply that endometrial receptivity and oocyte quality are also low. Ovulation induction and not IUI alone should therefore be used as the preferred mode of treatment to improve pregnancy rate.

Cervix Mucus↗