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Spring 2002
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Beginning
of Life: Ethical Perspectives
SPECIFIC
RECOMMENDATIONS ON REPRODUCTIVE ISSUES
BY THE CANADIAN MEDICAL ASSOCIATION
SOCIAL CONSIDERATIONS
That society
recognizes that the right to have children is a socially guaranteed
right and not a duty; that this right finds its basis in the fact of
social membership itself and, therefore, is not absolute; and that it
is subject to the limiting conditions that affect all other socially
grounded rights.
That the right to have children should be seen as the right
to take advantage of the opportunity to function in parental capacity,
where it is an underlying assumption of this notion that, in the
normal course of events, this opportunity will arise because of the
exercise of normal biological functions.
That the possibility of taking advantage of this
opportunity may shift as the resources and abilities of society
change.
That the right to have children (in the sense indicated) be
seen as subject to certain preconditions.
That these preconditions center in the capability of
individuals to make reasoned choices and to function in a parental
role.
That society should assist handicapped persons, who have
the capacity to parent, but who can exercise that capacity only with
societal assistance.
That the concept of a family be defined functionally as a
basic social unit that may include children.
That the child is entitled to the same respect and to the
same treatment as all other persons.
That if developments in the domain of reproductive
technology cannot sustain such a perspective, and if these
developments reduce the child to the status of an object, or they
require that those who are involved adopt an instrumentalistic outlook
toward children, such developments should not occur.
That prospective parents should be counseled to exercise
responsibility in having children.
PROFESSIONAL CONSIDERATIONS
That the profession of medicine should not necessarily be
considered the only body involved in the development or delivery of
techniques of assisted reproduction.
That medical exclusivity should extend only as far as it
relates to matters that fall within the domain of medical practice as
defined in terms of the physician-patient relationship.
That qualified physicians engaged in providing assistance
in the realm of new reproductive technologies should not refuse to
provide these services on the basis of criteria that involve
discrimination.
That the techniques of assisted reproduction should be
developed with due regard to the rights and the welfare of all members
of society.
That these should only be employed with full awareness of
the fact that the long-term consequences of such technology cannot as
yet be foreseen.
That there should be a balanced societal and professional
approach that would include an examination of the social forces that
in some cases underlie the desire to have biologically related
children.
HEALTH AND INFERTILITY
That infertility be defined functionally as the inability
of someone to engender children during a stage of their life when
biologically this should be impossible.
That in keeping with this definition, infertility be seen
as a condition of ill health.
That it be accepted that the significance of infertility as
a condition of ill health is shaped by societal and cultural
interpretations.
That in keeping with the association’s understanding of
the nature of health, the treatment of infertility should be
considered a health service.
That there should be coordinated and ethically, as well as
scientifically, valid research on a national scale into the nature,
causes, and means of prevention of human infertility.
That as a matter of fundamental principle, the development
and availability of techniques of assisted reproduction should come as
close as possible to allowing individuals who happen to be infertile
to achieve biological parenthood the way in which it occurs in the
normal course of events.
That the use of techniques of assisted reproduction should
remain voluntary.
That access to socially funded programs of assisted
reproduction should be determined solely by equitable criteria that
find their basis in health reasons rooted in the health status of the
individual; and that socially funded access should not become an
instrument of furthering economic plans or privately held values, but
should be in keeping with the rationale underlying access to existing
health care services.
That the new reproductive technologies should never be seen
as an avenue of first choice when it comes to having children, but
should be reviewuated in the light of alternatives open in the normal
course of events.
That the development and use of these technologies should
always preserve the dignity of the human person.
reviewUATION
That the various methodologies currently being used in
assisting reproduction be reviewuated as to scientific validity and
effectiveness.
That any new methodology or regimen of assisted
reproduction be reviewuated for scientific validity and ethical
acceptability in the same way in which pharmaceuticals are currently
reviewuated before being recognized as acceptable in the health care
setting.
ACCESS
That assisted reproductive services should be available to
all members of society on an equitable basis.
That access to publicly funded assisted reproduction
services be only on the condition that it is a health
service and not a matter of private choice.
That if the need for access to these technologies is the
result of a voluntary decision that reflects a matter of private
choice and not the result of an attempt to correct an inequitable
situation, the service should be privately funded.
That the criteria of access to assisted reproduction
services should include the criteria that are considered socially
appropriate for deciding whether applicants for adoptions will be
deemed suitable parents in a given case.
That if the reason why certain people cannot have
biological offspring is by its nature irremediable regardless of
technology, then society cannot be expected to attempt to provide a
remedy.
GAMETE DONORSHIP
That gamete donation should be a privilege that is open to
every adult and competent member of society, subject only to those
medical criteria that are appropriate for determining the health
status potential of the donated gametes.
Reprinted from:
Monagle, John F., Thomasma, David C., (1995). Genetics and
Reproduction. Medical Ethics. Policies, Protocols, Guidelines &
Programs (1:3)1
Monagle, John F., Thomasma, David C., (1995). Genetics and
Reproduction. Medical Ethics. Policies, Protocols, Guidelines &
Programs (1:3)1
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Course
Overview