material-deontologia-biologica-capitulo23

Biological Ethics

Table of contents

Chapter 23. Manipulations of human reproduction.

N. López Moratalla

a) Biological meaning of sex and human sexuality

As A. del Amo -speech oral- comments, "it is surprising to note that the normal and universal mode of reproduction - from the lowest to the most organised beings - is sexual reproduction, even though this mode of reproduction appears to us as a complicated, uneconomical system, especially in aquatic plants and animals in which fertilisation is external, and the meeting of the gametes of the progenitors is very random. Especially when compared to asexual multiplication, which appears to us as an extremely simple and efficient reproduction: a fragment of the body becomes a new individual.

The biological meaning of sex seems quite clear. While asexual reproduction gives rise to genetically identical offspring, sexual reproduction gives rise to genetically heterogeneous offspring. This heterogeneity presupposes, on the one hand, the existence of individual differences between the individuals belonging to each species, which can be called the biological personality of each individual. At the same time, this increases the probability that some individuals will have an endowment Genetics that makes them fit to survive in new environmental conditions, without running the risk of the species disappearing. So, if life has made its way through time despite numerous environmental changes, not only in the physical but also in the biological environment, it has been thanks to the existence of sexual reproduction, thanks to the existence of sex. On the other hand, if life has diversified in space, it has also been due to sexual reproduction. area Indeed, as the number of individuals issue increases and the distribution of a species expands, it will inevitably end up reaching areas with different environments from the original one.

Sex is thus a biological trait at the service of the propagation of life. This is its biological meaning.

In animals there are instincts that make sexual reproduction effective, by ensuring the relationship between individuals of different sexes, so that biologically this attraction is also ordered to reproduction. Moreover, this sexual attraction between animals occurs exclusively in certain periods of time - generally with a cyclical character - which coincide precisely with the moments in which fertilisation is physiologically possible; it is logical, since if sexual attraction is at the service of reproduction, it takes place when reproduction can take place; if this attraction were eliminated from the animal kingdom, the species would become extinct. Thus, biologically, sex and sexual attraction are ordered and intimately connected with reproduction.

Sexuality in man has its own profound significance, it is a human dimension, an expression of self-giving. In man, because of his perfect unity of body and spirit, there is nothing that is merely psychic, nor is anything in him entirely reducible to the merely biological and instinctive. The body is the expression of the person and human sexuality is not, therefore, something only of the body, biological exclusively, as is the case in animals, but of man in his totality and is thus at the service of the most important human passion, which is love, the gift of self to the other.

Sexual attraction in man is fundamentally different from the mere sexual instinct of animals. Already at the most biological level, human sexual attraction is not linked to the cyclical time of female fertility, as is the case even in the most evolved of primates, nor does it have the automatism characteristic of instinct, but is fully modelled by rationality. Man, with the light of his intelligence, discovers the values and meaning of what is inscribed in his own nature and can thus develop his human personality, integrating all its dimensions harmoniously and congruently.

Human sexuality integrates everything that is inserted into biology, but at the same time, it surpasses it; and it surpasses it insofar as it is the expression of a complete gift, of the whole person, of all that one is, to the other; in this sense, as we said before, it is at the service of love, of giving oneself fully to a person of the other sex.

Every human being is marked by sexuality. In sex - male or female - lie the most characteristic features which constitute him or her as a man or a woman, biologically, psychologically and spiritually, so that it is one of the main factors which characterise him or her, it is an integral part of his or her personality. But corporeality and sexuality are not completely identified; although in its normal constitution the human body bears all the specific sexual characteristics and is therefore male or female, nevertheless, the fact that it is a body is more deeply part of the human person than the fact that it is a male or female version. This implies that, although sexuality is an integral part of the personality, it does not mean that sexual activity is necessary for human life to be fully realised. In fact, this fullness is also achieved in continence. On the contrary, however, for sexual activity to be fully human, to be in conformity with the dignity of the person, it requires not to be outside the dominion that reason must have over the appetites, it requires a realisation of agreement with the truth of man.

As A. Ruiz Retegui -cfr. chapter 16- our sexual condition is truly decisive; sexuality is not an insignificant or accessory dimension of man, for it is precisely through the exercise of that School which is linked to the human condition "divided" into men and women, that our existence begins. We exist precisely as the fruit of our parents' love. It is through sexuality, through this dimension of the human person, that our parents have become sharers in God's love. This is very great and of course holds a great mystery because it means that the parents have at their disposal the subject which is to be informed by the soul. When God creates each person, He does not do it alone, but relies on the generative capacity of the parents by virtue of sexuality. This, while giving us a sample or a reason for the transcendence of sexuality, situates its position within the human condition; sexuality - masculinity or femininity - is inscribed in man precisely for this, that is, in order to participate in the creative power of God.

It is a dimension of the person, not merely a biological mechanism for the reproduction of organisms. Nothing in man is pure biology and sexuality even less so. As it is a dimension staff so that each person - man or woman - can participate in the creative power of God's love, what it inscribes in man is a capacity to co-operate with Creative Love and this capacity must therefore have the category of a sign of Creative Love: what is going to participate with Creative Love must resemble, must participate not only in its efficacy but also in its own efficient structure; this is why sexuality inscribes in man a structure of donation. This structure of donation is quite peculiar and is not the only structure of donation in man. There is another, more radical one - because of being called to God as a unique and unrepeatable person - which is the capacity to will, to give oneself; by this capacity man can give himself to many as a teacher can give himself to many disciples, or a doctor to many sick people, etc.; in this case the donation to one does not prevent the donation to another since it is given as a person and does not in itself include giving oneself with the corporeality, even if, for example, for love of a friend one gives blood or a kidney. However, the structure of donation that inscribes sexuality in the person is a donation in its singularity that essentially includes the submission of its corporeal dimension, the submission of the body in its fecund structure. As the body is the principle of its uniqueness, it makes the donation, which is in itself staff, potentially fertile and final.

Thus by the fact that man has a body, that he is human, he knows that he is not a simple animal, but a rational animal, a man. And because the human body expresses - in addition to man's humanity - the aspect of masculinity or femininity, he discovers a new meaning in his own body which is a reciprocal enrichment in the unity created by the bodily union by which a man and a woman acquire the procreative capacity. This act is not, therefore, a mere organic function for the transmission of life as in animals; but in its natural structure it is an action staff of each of the two which is an expression of reciprocal self-giving.

Hence the ethical rule - of natural law - not to break this unity between union and procreation in either of its two directions. That is to say, neither to seek sexual activity by preventing procreation, nor, on the contrary, to artificially seek procreation independent of sex.

Because it is not merely a biological act, but a human act, the whole person is involved in it: it involves taking on the sexual attraction - which is not strictly determined by the sexual instinct - in giving oneself to the other and accepting the other human being as a gift, not as an object for oneself. If the biological factors of generation were not integrated into the unity of this human act, marriage would lose its value, which is precisely the close and intimate relationship between conjugal love that leads to the mutual submission of the body and the power to generate new human lives in this gift. Human sexuality would then lose its meaning, it would be degraded, as its use would be reduced only to physiological and individual pleasure, without being oriented, as corresponds to its nature, to the procreation and Education of children, and the parent-child relationship would also lose its deepest meaning.

When the Catholic Church repeatedly sets out these moral principles1 2 3 concerning sexuality, it is not defending a principle to be accepted simply by Catholics, but principles of natural law without respect for which no man, and no society, can attain the authentic fullness of human life.

b) Manipulations of the sex-reproduction-family relationship

In man, the orientation of sexuality does not end with the transmission of life, but adds the Education of the offspring in the family, establishing a profound parent-child relationship that goes far beyond the biological sphere.

In recent decades, mainly in countries of the so-called Western culture, behaviours have been introduced and propagated that affect sex-reproductive relationships; the behaviour of partners towards each other and the relationship of offspring towards parents. Such behaviours are often even presented as progressive. Such is the case of a) sex without reproduction: for example, sterilisation, interruption of the act, anovulatories, abortive methods (direct abortion, mechanical device, abortive anovulatories), etc.; b) reproduction without sex: artificial insemination, "in vitro" fertilisation, asexual cloning, and c) breaking up the family nucleus: divorce, temporary union, hedonistic limitation of the issue of children, heterologous fertilisation, etc.

These behaviours are reprobated by both natural ethics and Christian ethics. But, in addition, as we have seen, from the biological knowledge , they are clearly aberrant and regressive. The biologist is therefore morally obliged to make this known, both to public opinion in general and to those at the head of public authorities. And he or she must take this knowledge into account, together with a profound respect for man and human life, when researching in these fields. There are techniques used for the improvement of animal husbandry, by means of which man intervenes in animal reproduction, to exploit possibilities at his service, or to increase his knowledge, which are not carried out by following natural processes, but by manipulating these processes. The application to humans of these technologies that manipulate their reproduction is not lawful. The major knowledge that has been achieved about the mode of transmission of life is currently leading to a serious deterioration of what is human; once again the power that man acquires with scientific knowledge is not accompanied by the prudence that would be desirable and necessary; once again he forgets that not everything that he can technically do, he must do, if it is not ethically admissible: the natural meaning of a human action cannot be changed by the meaning that the "manipulator" wants to give it.

We will analyse some of these manipulations initiated in recent times and in which the biological -biomedical- research is directly involved. With all of them, the correct use of sexuality is harmed; in some cases, other problems are also added - serious ones, such as provoked death - which increase their ethical unlawfulness.

c) Birth control and contraception

Under the denomination of non-natural methods used for contraception are included all those systems that prevent the normal development of gametes, their release or their fusion through the employment of chemical or biological products and also the mechanical interventions on the sexual act, and their aberrations; while the latter come directly from personal behaviour, the others have their origin in scientific research that makes the necessary products and the system of use available to people. It is to the latter that we are going to refer.

Taking into account the main mechanism of their action of preventing fertilisation, a distinction can be made between those that interrupt gametogenesis by different processes, such as LH-RH analogues, anti-hormones, antimitotics that prevent multiplication, etc. A second group would be constituted by those compounds that prevent the fusion of gametes either by triggering immunological rejection phenomena or by setting in motion systems that occlude the gonophoric ducts.

From an ethical point of view, the use of any method whose direct purpose is to prevent conception is unlawful, and therefore it is also unlawful to participate in research related to this topic. The reason for the unlawfulness of these methods is - as developed above - that by preventing procreation, a profound limitation is placed on the conjugal act, which is deprived of being the expression of true conjugal love in the reciprocal submission .

Circumstances add further ethical problems to the use of contraceptive techniques. The most serious is that most of them also have an anti-implantation effect, as is the case with anti-progesterone, the anti-hCG vaccine, or intrauterine devices; therefore, if they do not prevent fertilisation, they would later produce an abortive effect which would be the cause of the non-birth rate. More recently, in 19864, the use of a progesterone antagonist, RU-486 - the so-called abortion pill - has been developed, whose primary effect is to prevent the nidation of the embryo, and which offers - according to its "inventors" - a reasonable alternative to surgical abortion, without the risk of anaesthesia, surgical complications, infertility and psychological sequelae that this produces.

On the other hand, hormonal contraception, in particular, leads to an increase in genetic alterations and disorders of the reproductive system of the offspring and increases ectopic pregnancies, as well as various side effects in those who use it. The biological processes that enable procreation are complex and precisely regulated, and interfering with any one of them throws others out of balance and exposes the individual to unnecessary risks.

It is quite different to regulate the birth rate according to the natural course based on the biological disposition of a woman's generative capacity, which is subject to a rhythm of short periods. When there are sufficient reasons, it is legitimate to resource to infertile periods; this regulation of fertility is ethically upright, as it obeys the truth of the person - inscribed in that natural order of human fertility - and is therefore in accordance with his or her dignity. It is not just another method of avoiding conception that becomes licit because it is natural; contraceptive methods, on the contrary, prevent the development of natural processes by establishing a barrier at one of the stages. Natural regulation supposes a rational and free control of sexual activity that makes use of the knowledge of natural laws legitimately, since it respects the nature of the act.

The scientific research that seeks the knowledge of the times of fertility and infertility of women in order to discover methods to know them with certainty is of great value; it tries to find reliable parameters to predict ovulation with sufficient time and to determine when it has taken place. In this way, as John Paul II5 points out, this scientific knowledge "becomes the path along which the freedom of the human person carries out procreation manager. Only in this way can married couples, in possession of the necessary knowledge , bring about a "harmonisation" of all the dimensions of their humanity and safeguard the whole truth of married love.

(d) Artificial insemination

Techniques that allow the manipulation of reproductive cells have advanced considerably and their application to livestock breeding has been very useful. Spermatozoa can be preserved for years frozen at -180ºC in liquid nitrogen and recover their mobility and fertilising capacity when they are brought back to room temperature. Artificial insemination, using sperm deposited in "sperm banks", has led to great improvements, for example, in bull breeding, as the quality of the offspring of a particular animal can be checked before large-scale insemination is carried out. Insemination is technically very simple; it boils down to depositing semen in the uterus. This technique was first applied to men during the Korean War; frozen semen, obtained from American soldiers, was used to impregnate their wives thousands of kilometres away.

On the other hand, the manipulation of oocytes - more complicated given the much smaller issue , of the order of one per menstrual cycle, but which can be increased to 10 by means of hormonal inducers - has allowed artificial fertilisation under microscopic control - "in vitro" fertilisation. After development the zygote is implanted in the uterus of a hormonally prepared woman, where the embryo development is completed.

The application of the technique of extracorporeal fertilisation to humans was presented to public opinion on the occasion of the birth, in July 1978, of the first so-called "test-tube girl" as a technological success achieved by doctors R. Edwards and P. Steptoe. The hype surrounding this event was not well received in the scientific media - where the publication was initially rejected - as it was considered that these techniques had been used for some time, with minor differences in animals, and therefore did not contribute anything new to science. Later in the publication of work it was made known that Louise Brown was born after more than 100 failed attempts in which lives begun "in vitro" failed to reach their full embryonic development . The double purpose of this work, which was on the one hand to investigate and on the other to provide a system that would allow maternity in women with sterility due to obstruction of the fallopian tubes, was explicitly stated by Edwards in the beginnings of the development of this technique6.

In recent years, artificial methods of conception based on these two techniques have been developed and have been presented as solutions to overcome sterility, although logically neither of them cures it. There are, however, solutions to eliminate sterility in some cases, which therefore allow the possibility of subsequent natural conception; tubal microsurgery currently has the same success rate as "in vitro" fertilisation; but the efforts of internship and of the medical - and biomedical - research have focused almost exclusively on the development of artificial methods of fertilisation rather than on knowing in depth and achieving the elimination of these types of defects that produce sterility.

Both artificial methods of conception coincide in that in both cases there is a total separation between fertilisation and sexual intercourse, and for this reason they are ethically unlawful. A more detailed description of the processes involved is given below, in order to fill in the analysis from an ethical point of view, as each of them has its own characteristic aspects.

In vitro fertilisation

This procedure - in vitro fertilisation with embryo transfer (IVFET) - first requires the collection of both gametes. The eggs are obtained - under anaesthesia - either by laparoscopy or by transvesical ovarian puncture under direct ultrasound vision. In the first years of the use of these techniques, the eggs came from a normal ovarian cycle, and were therefore obtained one at a time. Given the difficulties in achieving the correct nidation of the embryo, the possibilities of success were so limited that the induction of multiple ovulation by means of employment of various substances or hormones was added as a preliminary stage. In this way, not one but several eggs obtained from one woman in the same cycle are used for fertilisation.

Sperm is usually obtained by masturbation, which is employment an immoral means. And if it comes from donors, it is preserved, for the time after freezing, in so-called "sperm banks".

Eggs maintained for about 8 hours in an appropriate culture medium are fertilised by the addition of a concentrated suspension of motile spermatozoa. Once fertilisation is verified, the embryo is maintained in culture until the blastocyst stage.

Three of the embryos in the blastocyst stage are then transferred into the uterus of a woman who has been suitably prepared, by hormone treatment, to make nidation possible; generally, if the first one fails to implant, it can, however, facilitate the implantation of one of the other two. They are introduced into a catheter with the woman's own serum through the cervical canal into the uterine fundus. The rest, the "surplus embryos" are frozen for later transfer, or are destined for experimentation. The perfect implantation and further progress of the embryo development is not technically achieved; according to the initiators' own statistics7 90% of the embryos die in this transfer to the uterus; in a deadline of less than 3 years they transferred 1200 embryos from which 139 children were born.

In vitro fertilisation is used in a number of clinics in various countries to treat infertility problems, which can be classified as follows:

a) Tubal infertility - Fertilisation is carried out with the woman's own eggs and the husband's sperm or sometimes from an anonymous donor. Frozen surplus embryos may be used years apart for the parents to have other children, twin siblings of the first, or are donated to other couples. Usually, it is the biological mother - the egg donor - who completes the gestation, although it may be a different woman to whom the embryo is transferred. It thus becomes a trade surrounded by great economic incentives.

Within this subject - which is where the application of the technique began - is what is known as homologous fertilisation, i.e. where the gametes belong to a man and a woman who are joined in marriage.

b) Female infertility due to abnormality of the uterus with normal ovaries: In these cases the gametes of the husband and wife are artificially fertilised and the embryo is transferred to a "uterine mother" who completes the gestation. The child will have all the characteristics of the parents, but will be born to another woman.

c) Female infertility due to the absence of oocytes: Fertilisation of a donor egg is carried out with the husband's sperm and the embryo is transferred to the wife, who will carry out the gestation. It is therefore a heterologous fertilisation. The child is biologically the husband's, but adopted by the wife.

d) Infertility of the couple due to incompatibility Genetics or immunological incompatibility - A donated embryo is transferred to the wife. It is really an adoption of a child at a very early stage of its life, while it is still in its uterine stage of life. This is intended to give the wife a sense of "fulfilment" in this gestation.

e) Male infertility: Fertilisation of the wife's eggs with donor sperm and subsequent transfer of the embryo. Logically, in this heterologous fertilisation, the child is the woman's child and could be considered adopted by the husband.

There are variations on the described types of this method of artificial fertilisation. Thus, after the death of the mother, the frozen embryo can fill in its embryonic development if it is transferred to the uterus of another woman. An unmarried woman who wishes to have a child, completely independent of a man, would complete the gestation of an embryo obtained by fertilising her own egg with sperm from an anonymous donor. Or the extreme case - accepted by the Swedish legislation adopted on the subject and order also in England - of seeking "motherhood" in a homosexual couple in which one would contribute the egg, which, fertilised by donor sperm, would be transferred to the uterus of the other, who would give birth to the child8. In 1986, Robert Winston, head of the fertilisation laboratory at London's Hammersmith Hospital, announced his attempts to achieve a male pregnancy by implanting an embryo in the renal region of the abdomen.

The gestation of a human embryo obtained by "in vitro" fertilisation in the uterus of animals is also being considered. There is even talk of interspecies fertilisation with higher primates.

Last but not least, there is the question of the disposal of unused embryos: what to do with "surplus" embryos or embryos that may be defective? If they are abnormal and the doctor detects an abnormality, he may be tempted to destroy them or to send them to research; it should be noted that the necessary manipulation of the gametes and the exhibition of the embryo in an unnatural environment leads to a higher rate of malformations than in natural conception.

Artificial insemination

In the face of male infertility problems, insemination of the woman with sperm from an anonymous donor is being used to produce artificial heterologous fertilisation. The use of these techniques - albeit without the hype of "in vitro" fertilisation - is becoming quite common. It is striking, for example, that in 1982 there were 1,000 pregnancies by this method procedure in Great Britain alone9 , a country which is not exactly characterised by a high birth rate. This is known as donor insemination, DID.

The use of procedure is also being considered if, after the husband's death, the wife wishes to have a child, using his frozen sperm for fertilisation. And there are discussions in various clinics as to whether or not it is appropriate to artificially fertilise single women who wish to have a child and whether or not they have the right to have their request granted.

Variants of this technique have also been introduced, aiming for closer gamete proximity and higher sperm concentration in homologous artificial insemination, thus using sperm from the husband rather than from a donor (AIH). The results obtained with intrauterine insemination (IUI) and intraperitoneal insemination are negative for some teams, while others find them satisfactory10.

evaluation ethical and legal aspects of artificial insemination

The so-called right to a child: The primary purpose of homologous fertilisation is good, even if the legitimate desire of a man and a woman, united in marriage, to be parents does not in itself justify resource to any procedure. There is no right of the spouses to have a child because no human person is owed to another, as if he or she were simply a thing, an object. They have, logically, the right to have no one, no subject of authority, impose on them what issue of children and when they can have them; it is a matter of the conscience of the spouses in the use of their free and manager paternity. But the recognition of and response to this right is distinctly different from the assertion that the child is due to them. Spouses have the right to natural acts leading to procreation, but no right to actual procreation.

Heterologous fertilisation: In heterologous fertilisation the purpose is distorted. The conjugal context is the only legitimate context in which to generate a human life and educate the person born. Not only is motherhood outside marriage ethically inadmissible, but also when artificial fertilisation has been carried out with gametes belonging to a man or woman other than the spouses. The husband or wife is not the biological father or mother, and the biological father or mother will not be the one to raise the child, but is merely a gamete donor; these donors decline all responsibility - and even have to hide their identity - as parents. This fertilisation subject is contrary to the unity of marriage; "the fidelity of the spouses, in the unity of marriage, entails the reciprocal respect of their right to become parents exclusively through each other"3.

The ethical judgement that qualifies heterologous fertilisation as immoral is not so much because of the fact that paternity is anonymous, or because of the danger of consanguinity in small populations, etc., but because it is contrary - as in the case of homologous fertilisation - to the connection that by nature exists between the unitive and procreative meanings of conjugal sexuality.3 These are other factors that aggravate the ethical judgement of heterologous fertilisation. These are other factors that aggravate the ethical judgement. But these factors must also be taken into consideration because a rupture or weakening of the natural parent-child relationship has in fact very serious repercussions on a human life.

As Lejeune11 pointed out, referring to heterologous artificial insemination, "it is possible to think that its psychological effects would be more serious. The dissociation between parenthood and the act of love, which has been compared to the affective sublimation that occurs in adoption, is in reality very different, because one of the procreators, the mother, is a "bona fide" biological parent, while the other, the father, is an absolute stranger to his children. Generation by these methods could lead to the creation of an even greater "fracture" between the generations, with all the affective and racial instability that we can sense". In vitro fertilisation may also lead to the possibility of separation between the biological mother, the egg donor, and the uterine mother who receives the zygote; "the objective consequences," adds the same scientist, "will be even more serious... we will see the last natural link between the generations being broken. If there has always been a doubt about paternity in certain cases, there could never be a doubt about maternity after having attended a birth. Now we see that this bond can be completely broken, at least in some particular cases.... I even fear that coming into possession of this technique may contribute to the ruin of the natural good sense and respect we have for human beings".

The years that have passed since Lejeune made these comments have shown that his fears were not unfounded. Legislation and proposed laws regulating the ownership of embryos, their inheritance rights, or the legal action for the inadequacy of the fertilisation team, etc., which we shall see later, demonstrate the ruin of this natural good sense and respect for human beings.

Surrogate motherhood also presents serious ethical problems: "it represents an objective offence against the obligations of maternal love..., it offends the dignity and the right of the child to be conceived, gestated, brought into the world and educated by its own parents. It instigates a detriment to the family, a division between the physical, psychological and moral elements that constitute it"3.

The product of a technical act: Artificial insemination would also be illicit if another aspect, no less serious, were taken into account. Man is of such dignity that he cannot be "manufactured" by another man, but must be generated through the love of his parents. It is true that the love of a couple with a problem of sterility is what moves their desire to have a child; but in artificial fertilisation the act that begins the life of the child is a technical act carried out by a third party; "Only an act of love in which the whole person of the spouses is involved is worthy of giving rise to a new human person"12. What is given out of love in this case - the gametes - is a product of the body and not the person itself. The child not begotten in the sexual act is not properly the fruit of its parents' love. Hence, its dignity is also harmed.

The technological development has so accustomed the man of today's civilisation to manufacture anything, that it has become difficult at times to realise the seriousness of removing the origin of a new human life from the profoundly human environment of conjugal sexuality, to place it in the world of technology where the father or mother, converted into simple gamete donors, are no longer irreplaceable, and the only thing that remains indispensable is the work of a trained and skilful technician.

To such an extent that a relationship is established similar to that between the person who makes an order and the person who receives it, that among the problems raised there is already the problem of suing the team for technical imperfection, or the non-acceptance of a child with defects. It even establishes the right to choose the embryos that correspond to the desired sex for transfer to the uterus, or the most suitable time for gestation.

Other ethical problems: There are also other problems which, although circumstantial, that is to say, which could be avoided with modification or greater technical perfection of the methods, increase the Degree of illegality. On the one hand, the high and unnecessary risk of death to which a high number of embryos are subjected issue .

At the 1985 Helsinki International congress the following figures were released: 124,585 artificially fertilised eggs resulted in 1,369 pregnancies with 628 miscarriages and about 600 births; and only 17% of artificially fertilised couples have a child.

On the other hand, the primary purpose of these techniques, that of producing a new life, is also often combined with the goal, of course, from any illicit point of view, of obtaining "human material" for experimentation, impossible to obtain otherwise, by using surplus embryos; although this problem may in fact disappear if fewer eggs were fertilised or if all fertilised eggs were implanted.

The freezing phase of the embryo must also be taken into account; no one owns the life of a human being and therefore no one has the right to interrupt the vital process, "it constitutes an offence to the respect due to human beings, since it exposes them to serious risks of death or damage to their physical integrity, deprives them at least temporarily of the reception and gestation of the mother3 .

Legislation

The continuous abuses that have occurred in the internship of artificial fertilisation and the confusion about rights and duties in this "atypical business" involving biological father and mother, biomedical equipment, physiological mother, and the possibility of making contracts for the "sale and purchase" of gametes and embryos, etc. has led to the urgent need for legislation in many countries order .

Elisabeth Panthon in 1982, examined the problems raised by "in vitro" fertilisation and the freezing, for various purposes, of embryos obtained by fertilisation on laboratory13. He pointed out the need to consider from a legal point of view the solution to "cases" that could arise, given that frozen embryos can be sold, or implanted in order to continue their development in a woman other than the donor of the egg, or left for a long period of time in freezing before being implanted in the uterus, etc. Among the "cases" to be decided, he raised, for example, the question of to whom the child born in the event of a conflict between the biological mother and the "uterine" mother belongs; or whether there is a right to claim the paternal inheritance by the child born years after the death of its father, etc.

Once again, the ethical question of how to proceed with regard to the dignity of man, his value, the safeguarding of the family, etc. is replaced in permissive societies by a question of whose interests should take precedence: those of the future child, those of the parents, those of science or the purely economic. Reducing what is moral or immoral to what is penalised or not penalised, technical science is completely disorientated and, far from being at the service of man, it becomes at the service of men's desires and ignoble interests. sample Testart, who was involved in the conception of the first French "test-tube-child", later became concerned about the growing demands of this medical technique at the service of desire: "as soon as we were able to give birth to a child by "in vitro" fertilisation, we were asked about the possibility of choosing the sex. How can we not suppose that, as soon as this becomes possible, the anxiety of couples who want a boy instead of a girl will be as great as that of infertile couples today? In 1987 Testart retired from the field, as did his colleague Vicenzo Abate, the Italian gynaecologist who delivered his country's first child by FIVET and embryo freezing.

In 1982, the UK government commissioned Mary Warnock to training of a committee researcher to examine the techniques and their implications and to formulate recommendations for future government policy. In July 1984 the report was made public and deadline was given until the end of the year for interested bodies and private citizens to submit their suggestions, which would be carefully considered before decisions were made and legal standards were set. Fundamental ethical principles are conspicuously absent from report and the human being is largely regarded as an object of experimentation or exploitation.

Other non-substitutive systems of sexual exercise

For some scientists, artificial fertilisation was presented as science's answer to the desire of many infertile couples to become parents. The conviction that it is their intentionality that gives meaning and significance to realities made them forget or ignore the truth of the conjugal act and the dignity of the human person, which means that it can never be treated as an object. The initial enthusiasm was followed by disenchantment, as we realised once again that technical science is never source of progress if it is not guided by ethical criteria. But the problem of sterility is and must be a challenge that the biomedical sciences are facing; scientific knowledge and the technological development can really contribute to eliminate the limitation that causes sterility or, at least, to propose procedures in which "the technical means does not replace the conjugal act, but is a facilitation and a financial aid so that the former can achieve its natural purpose" (cfr. no. 6 of quotation 3).

More recently, publications have started to appear about preliminary experiences using gamete transfer techniques that facilitate the meeting of gametes without replacing the natural act14.

e) Asexual cloning

Until recently, the artificial production of "cloned" men - exactly the same as each other because they have the same information Genetics- obtained asexually from a single parent, which provides the nuclei of some of its somatic cells, has simply been the topic of numerous science fiction novels.

Nucleotide transfer cloning

Vegetative multiplication had been achieved in amphibians by replacing the nucleus of the fertilised egg with the nucleus of a somatic cell; the resulting individual possesses the characteristics of the donor of the nucleus and not, of course, of the donors of the gametes that made up the egg. This results in an exact copy - or multiple copies if the process is carried out several times - of the somatic cell donor.

The irreversible modifications that the mammalian genome undergoes during the embryonic development establishes a biological barrier to obtaining cloned individuals from an adult progenitor, given that the genetic message of its cells cannot be expressed again after transplantation into a zygote. For this reason, human cloning seemed to be only a figment of the imagination of amateur novelists at topic; however, this natural barrier has been broken by obtaining in 198115 clones from an early mouse embryo, by means of nucleus transfer; therefore, the possibility exists that it is technically possible to "produce" men in series from the nuclei of the cells of an early embryo. Logically, this claim has been described in scientific circles as "the greatest folly in history"; but, nevertheless, some biologists see it as a desirable goal ; as Marcel Blanch16 reports, Joshua Lederberg, award Nobel Prize in Medicine, was one of the first to defend human cloning as a means of reproduction, without risk of deterioration of the genetic heritage, of "superior individuals" and thinks that cloned humans would be especially apt for jobs that require close partnership, such as a surgical operation or a space mission statement .

Others point out that these serial men would be of great value to science, because they are biologically identical, if they are used by scientists to carry out experiments aimed at discovering the importance of the nature factor and the culture factor in human beings.

For Joseph Fletver of the University of Virginia, society may have a need for specialised male clones to fulfil specific functions, such as individuals who are particularly resistant to radiation, or small in stature for high-altitude flight or space travel.

A blastomere nuclei transfer from an 8- or 16-cell sheep embryo into fertilised eggs, from which the nucleus has been removed, has been successfully carried out in 1986. This allows the cloning of domestic animals17.

Induction cloning of multiple twins

The development of extracorporeal fertilisation techniques and the possibility of indefinite conservation of embryos after freezing have once again given rise to the topic of cloning by successive divisions of a morula, which, cultivated and transferred to the uterus of several women, would give rise to numerous cloned individuals.

One project that some have come up with is the following: separation of cells from a female morula before implantation to fill in her gestation, development of these cells to blastocysts and freezing. When she has reached adulthood, she will have the possibility to fill in in her uterus - or in the uterine mother's uterus - her own copy; a twin sister 15 to 20 years apart. This is therefore an attempt to artificially direct the emergence of twins by mechanically dissociating the cells belonging to an early embryo.

Cloning by parthenogenesis

A different attempt at human cloning, in this case from an adult, had been carried out earlier, in 1976, by Schettles18: he transplanted the nucleus of a spermatogonia with an endowment Genetics of 46 chromosomes into a denucleated egg. After "in vitro" culture, it developed to the blastocyst stage and, as the author refers to in the publication, he destroyed the embryo at this stage for fear of the final result in case it had completed its embryonic development once implanted in the uterus. This would be cloning by parthenogenesis, which is not natural in mammals. In lower species, such as insects or fish, a new individual can be formed from a single gamete. It is reassuring, in a sense, that there is an insurmountable biological barrier to adult cloning in mammals. It has recently become known19 that the paternal and maternal contribution Genetics are not equivalent, but different and complementary, and both are necessary for the embryonic development to be secured. During gametogenesis, there is a specific "marking" of the two gametes that allows them to act in a specific way: the endowment derived from the father acts preferentially in the extra-embryonic tissues, while that of the mother acts in the embryo. In this way, biology requires for the development of a new mammalian individual that the nucleus of what is to be the zygote cell be formed by the two halves of the endowment Genetics provided by each of the gametes of its progenitors.

The unlawfulness of human cloning is obvious; in addition to the ethical principles we have considered in this chapter, it violates the right of every human being to have his or her own identity Genetics not chosen by anyone, whatever the reasons for that choice. It is clear from these approaches that it is man himself who is final inhumanely treated and his dignity attacked when, with the power granted to him by the scientific knowledge , he sets himself up as an absolute dominator for whom even the human person is an instrument at the service of the tasks he sets himself.

Notes

(1) PAUL VI. Encyclical Humanae Vitae, no. 12.

(2) JOHN PAUL II. General Audience 22.VIII.84.

(3) Document of the Congregation for the Doctrine of the Faith. "Instruction on Respect for Human Life at Birth and the Dignity of Procreation". Cardinal Ratzinger. Rome, February, 1987.

(4) COUZINET, B., STRAT, N., ULMANN, A., BAULIEU, E.E., and SCHAISUN, G., N. Engl. J. Med. 1986, 315, 1565-1570.

(5) speech to congress International for the Study of Marriage and the Family. L'Osservatore Romano. 785.

(6) EDWARDS, R.C. "Reproduction: Chance and Choice". In Genetic Engineering. (Ed. Patterson). British Broedeasting. London, 1969. pp. 25-32. Cf. Gobstein C. "External Human Fertilization". Sci. Am. 240, 33-43, 1979.

(7) EDWARDS, R.G. "status current in vitro fertilisation. bulletin IPPF Medical, 18, 5, 1984.

(8) Some publications: Fertility and sterility, 13. 182-184, 1985; Arch. Intern Med. 145, 527-531, 1985; Arch. Intern. Med. 145, 419-420, 1985.

(9) "Legal restraints proposed for UK". Nature, 310, 266, 1984.

(10) Some articles on this subject: Lancet 1984, 533-35; 1986, 693-694; 1986, 972-973; 1986, 916-17; 1987, 270; 1987, 52-53.

(11) LEJEUNE, J. "Les manipulations génétiques". Palabra, 175, III, 1980.

(12) CAFFARRA, C. "Genetics and manipulation". Pamphlets M C, nº 396, 1985.

(13) PANTHON, E. "Embrions humains congelés: qui sont les parents?". Le Recherche, 137, 1196, 1982. E. Panthon's "prophecies" about the possible problems have been fulfilled. To cite a few examples, it suffices to recall some of the controversies that have arisen and which have been widely reported in the press. French twins Magali and Christina Sevault fighting for Stephane, the fruit of Christina's insemination with the sperm of Magali's husband, who was sterile after an accidental miscarriage. Surrogacy has divided opinion in the USA over the fate of "Baby M"; the Sterns had paid $10,000 for Mrs. Whitehead to be inseminated by Mr. Stern and subsequently give them the child; after the birth the mother refuses to give him up. Sperm banks have become a real black market and have even been set up with the specificity of racists and feminists. Corinne Parpalix has obtained a favourable ruling for the restitution of her deceased husband's sperm from one of the banks.

(14) McLANGHLIN, D.S., TROIKE, D.E., TEGENKAMP, T.R. and McCARTHY, D.G. "Tubal ovum transfer: a Catholic approved alternative to in vitro fertilisation". Lancet, p. 214, 1987.

(15) ILLMENSE and HOPPE, G. Cell 23, 30, 1981; see also MARX, J.L. "Three mice 'cloned' in Switzerland". Science, 211, 375-376, 1981.

(16) BLANCH, M. "Clonaje des mammiferes: le 'meilleur des mondes' est il pour demain"? La Recherche, 121, 482-483, 1981.

(17) WILLADSEN, S.M. "Nuclear transplantation in sheep embryos". Nature 320, 63, 1986.

(18) SCHETTLES, L.B. "Diploid nuclear replacement in mature human ova with cleavage". Am. J. Obstet. Gynecol., 133, 22-25, 1976.

(19) HAMMER, R.E. et al. J. Embriol exp. Morph. 97 (Suppl) 1986, 257-262.

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