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Biomedical subjects

Guido Pennings

Publications and source records attributed to Guido Pennings.

15 recordsLinked to original sources
PubMed2006

An ethical analysis of alternative methods to obtain pluripotent stem cells without destroying embryos.

Although few ethical concerns exist regarding the use of adult stem cells, the field of embryonic stem cell research is fraught with moral qualms. Several alternative sources of pluripotent stem cells have recently been presented that try to sidestep the destruction of human embryos. The goal of these new proposals is to avoid embryo destruction, the main objection to embryonic stem cell research and thus introduce a type of stem cell research that would gain widespread approval and support. This article suggests that most embryo-saving alternatives fail to reach this goal given the concessions they require with regard to the speed of progress, technical complexity, safety and security of applications, degree of dependence on limited resources and extent of the field of application. The second part of the article identifies and analyses the two main strategies that alternative sources of pluripotent stem cells are based on and points out their shortcomings.

Beginning of Human Life↗
PubMed2006

Semen donor recruitment in an oocyte donation programme.

The article presents a new system for the recruitment of gamete donors. The system is a partial application of the mirror exchange system: the male partner of a couple donates sperm, and in return, he receives the guarantee that his partner benefits from a greatly reduced waiting time for donor oocytes. More specifically, the woman will obtain donor oocytes within a period of 8 months. The procedure was very successful in recruiting sperm donors while avoiding the ethical objections raised against other incentives to attract donors. The data indicate that the system would also work to encourage IVF patients to share their oocytes.

Adult↗
PubMed2006

Subsidized in-vitro fertilization treatment and the effect on the number of egg sharers.

Egg sharing remains a controversial practice, mainly because of the presumed element of payment. In order to find out to what extent financial considerations motivated the women to share their oocytes, the data on egg sharing in Belgium are analysed. Belgium began providing full reimbursement for six in-vitro fertilization (IVF) cycles on 1 July 2003. Since this date, the numbers of egg sharers dropped approximately 70%. Although these data show that a large number of the donors were mainly motivated by the reduced cost of IVF, it cannot be concluded that money was the only motive to share. Nevertheless, to increase voluntary consent by egg sharers, public funding for infertility treatment should be provided.

Altruism↗
PubMed2005

Gamete donation in a system of need-adjusted reciprocity.

A new paradigm to collect and allocate donor gametes is proposed. In the system, called indirect mirror exchange, the partner of the person who needs donor gametes, donates in exchange for bonus points that are awarded to the infertile person. All candidate recipients of donor gametes are ranked on a waiting list and receive points according to waiting time, medical urgency, phenotypic resemblance and contribution. According to the principle of fairness, persons who benefit from a system are obliged to contribute their share. However, strict reciprocity is rejected as unfair. A contribution by the couple is thus not a necessary condition for access to the waiting list. The system of reciprocity is adjusted by taking account of need considerations. The number of bonus points awarded to contributors should be high enough to move them to the front section of the waiting list.

Female↗
PubMed2005

Questioning the assumptions in the debate on assisted reproduction: comment on the House of Commons report Human Reproductive Technologies and the Law.

The House of Commons Science and Technology Committee has issued a series of non-dogmatic recommendations. Also regarding elective sex selection, it has adopted a controversial position. Sex selection should be allowed for family balancing. However, the acceptability of preimplantation genetic diagnosis as a method for selecting the embryos can be questioned on the basis of social harm. In countries with a shortage of medical personnel and a limited health care budget, elective procedures are a loss to society. This loss should be compensated by imposing a 'social compensation tax' for every application of elective sexing.

Advisory Committees↗
PubMed2005

Commentary on Craft and Thornhill: new ethical strategies to recruit gamete donors.

The main problem for the procedure of gamete donation at present is that the abolition of the donor anonymity rule has destroyed coherence among the guidelines. To restore coherence, a new unified picture of the role of the gamete donor should be constructed. It is doubtful that payment will increase the number of candidates in a system with identifiable donors. Nevertheless, if non-financial rewards of donors do not suffice to motivate candidates, an 'all-inclusive' financial allowance analogous to volunteers in medical trials could be considered to prevent a complete collapse of the system.

Belgium↗
PubMed2004

Legal harmonization and reproductive tourism in Europe.

Legislation of ethical issues illustrates the uneasy mix of ethics and politics. Although the majority has the political right to express its moral views in the law, a number of important ethical values like autonomy, tolerance and respect for other people's opinions urge the majority to take the minorities' position into account. Ignoring pluralism in society will inevitably lead to reproductive tourism. Although European legislation and harmonization in the domain of medically assisted reproduction is presented as a partial solution to this phenomenon, it is argued that European legislation should be avoided as much as possible. Regulation of these private ethical matters should be left to the national parliaments. A soft or compromise legislation will keep reproductive travelling to a minimum. Reproductive tourism is a safety valve that reduces moral conflict and expresses minimal recognition of the others' moral autonomy.

Abortion, Induced↗
PubMed2004

The subsidiarity principle in the context of embryonic stem cell research.

Embryonic stem cell research is regulated by different forms of the subsidiarity principle, i.e. research on embryos should only be conducted if no suitable alternatives exist. Four types are discussed: animal versus human material, adult versus embryonic stem cells, affected or at risk embryos versus healthy embryos, and supernumerary versus research embryos. Three major arguments regarding the subsidiarity principle are discussed: the necessity argument, the least offensive moral approach and the 'nothing is lost' argument. It is proposed that the burden of proof should be shifted onto those who oppose embryonic research. When the freedom of research and the moral obligation to relieve human suffering is taken seriously, the opponents of this research should first demonstrate that embryonic stem cells do not work or that adult stem cells work better.

Animals↗
PubMed2004

Sex selection, public policy and the HFEA's role in political decision making - response to Edgar Dahl's 'The presumption in favour of liberty'.

The Human Fertilisation and Embryology Authority's report on sex selection is criticized because its recommendation to prohibit all techniques for social sexing is based on unsupported allegations. As a body with a scientific status, the Authority should allow the application of some methods of sex selection for non-medical reasons in a strictly regulated fashion, in order to gather empirical evidence about the psychosocial as well as medical consequences for all people involved.

Ethics, Medical↗
PubMed2003

Decisional authority and moral responsibility of patients and clinicians in the context of preimplantation genetic diagnosis.

Case reports reveal that clinicians applying preimplantation genetic diagnosis are increasingly confronted with requests by patients which they consider ethically problematic. These requests raise the question to what extent physicians share responsibility for the welfare of the future child. Two categories of situations are analysed: when patients unilaterally review the agreement made with the medical staff and when they request an application that increases rather than reduces the risk of having a termination of pregnancy. It is concluded that physicians have their own responsibility in the process, which allows them to introduce conditions before starting infertility treatment.

Abortion, Induced↗
PubMed2003

The physician as an accessory in the parental project of HIV positive people.

The question of the moral acceptability of infertility treatment to HIV positive persons raises a number of interesting ethical points regarding the responsibility of the infertility specialist for the outcome of his or her actions. The analysis of the physician's responsibility is conducted within the framework of accomplice liability. The physician is a collaborator in the parental project of the principals--that is, the intentional parents. Both causal contribution and intention are considered as elements of complicity. It is concluded that a two per cent risk of vertical transmission when the woman is HIV positive is insufficient to blame the infertility specialist who helps her to conceive. Helping an infertile HIV positive infertile couple to have a child does not constitute reckless behaviour. When the couple is fertile, infertility treatment is directed at risk reduction and falls under the physician's obligation to act in the best interests of his patients.

Attitude↗
PubMed2002

Personal desires of patients and social obligations of geneticists: applying preimplantation genetic diagnosis for non-medical sex selection.

The arguments against the use of preimplantation genetic diagnosis (PGD) for non-medical sex selection are analysed. It is concluded that the distinction between medical and non-medical reasons is difficult to maintain, that the disproportionality of means and end is not a decisive counterargument and that the fear of damage to the reputation of PGD does not justify the refusal of controversial applications. Moreover, since non-medical sex selection does not belong to basic health care, it should not be equally accessible to all. The position defended in this article is founded on two basic principles: (1). medical reasons have priority on non-medical reasons, and (2). personal reasons do not qualify for public funding. In order to respect both principles, it is proposed that restrictions should be installed to control the number of requests for social sexing and that a tax should be imposed on these elective services. The tax should compensate the society for the investment it made in the training and education of the physician.

Adult↗
PubMed2001

Ovarian tissue cryopreservation: therapeutic prospects and ethical reflections.

Along with improved survival, methods to preserve or restore the fertility potential of young women and children treated with cytotoxic chemotherapy or pelvic radiotherapy have been developed or are in the offing. Surgery, radiotherapy and chemotherapy can all impact on the future ovarian function, but patient and disease tailored application and use of preventive measures can limit ovarian damage. When the loss of reproductive ovarian function is unavoidable, different alternatives to preserve fertility or at least to restore the procreative potential are available. Creation of embryos by IVF, oocyte donation and cryopreservation of mature or immature oocytes are potential issues, the advantages and limitations of which are discussed. Recently, ovarian tissue cryopreservation has spurred interest in the medical literature as well as in the lay press as a method for preservation and restoring fertility. Considering the available data and current state of knowledge, we want to stress that this methodology is still in an experimental phase and we would like to caution against unwarranted enthusiasm of physicians and patients. The medical information preceding the informed consent should mention the actual uncertainties of this method. Moreover, the imperative character of the offer and in particular for paediatric oncological patients, the force of the moral rules that define parental obligations towards children should not be ignored.

Journal Article↗
PubMedDate not supplied

Evolving ethics in medically assisted reproduction.

Ethical problems arising from the application of assisted reproductive technology are discussed for four specific areas, namely embryo research, multiple pregnancies, preimplantation genetic diagnosis (PGD) for social sexing, and finally PGD with HLA typing.

Ethics, Medical↗