ABSTRACT
Abstract: 15. The anonymity of gamete donors in the context of medically-assisted reproduction techniques (ART) and the right of the offspring to know their genetic or biological parents' identity is a controversial and widely debated topic in the scientific literature. The positions on the issue in each country are different. Sometimes they are in opposition to each other even in countries with strong similarities, such as those in the European Union (EU), in the framework of shared ethical values. Although some countries still enshrine the rule of anonymity, there is an undeniable tendency to guarantee the right to know one's origins by creating relevant exceptions or abolishing donor anonymity status altogether. 16. This article offers ethical and legal considerations of whether the so-called 'right to be forgotten' (RTBF) could be extended to include gamete donors' right to remain anonymous. This perspective goes against the general trend, certainly in Europe, of recognizing that offspring born from donor gametes have a right to access information relating to their genetic progenitors. The novel addition is to question whether the General Data Protection Regulation (GDPR) might provide fertile ground for questioning this approach, and effectively support those jurisdictions where anonymity is still possible.
Resumen: 20. El anonimato de los donantes de gametos en el contexto de las técnicas de reproducción médicamente asistida (RM) y el derecho de la descendencia a conocer su identidad genética o biológica es un tema controvertido y ampliamente debatido en la literatura científica. Las posiciones sobre el tema en cada país son diferentes. A veces se oponen entre sí, incluso en países con fuertes similitudes, como los de la Unión Europea (UE), en el marco de valores éticos compartidos. Aunque algunos países siguen consagrando la norma del anonimato, es innegable la tendencia a garantizar el derecho a conocer el propio origen creando las excepciones pertinentes o suprimiendo por completo el estatus de anonimato del donante. 21. Este artículo ofrece consideraciones éticas y jurídicas sobre si el llamado "derecho al olvido" podría ampliarse para incluir el derecho de los donantes de gametos a permanecer en el anonimato. Esta opinión es contraria a la tendencia general, ciertamente en Europa, de reconocer que los hijos nacidos de gametos donados tienen derecho a acceder a la información relativa a sus padres genéticos. La nueva adición consiste en debatir si el Reglamento general de protección de datos (RGPD) podría proporcionar un terreno fértil para cuestionar este enfoque y apoyar efectivamente a las jurisdicciones en las que el anonimato sigue siendo posible.
Resumo 25. O anonimato dos dadores de gâmetas no contexto das técnicas de reprodução medicamente assistida (RMA) e o direito da descendência a conhecer a sua identidade genética ou biológica é um tema controverso e amplamente debatido na literatura científica. As posições sobre a questão em cada país são diferentes. Por vezes estão em oposição umas às outras, mesmo em países com fortes semelhanças, como os da União Europeia (UE), no quadro de valores éticos partilhados. Embora alguns países ainda consagrem a regra do anonimato, existe uma tendência inegável para garantir o direito de conhecer as suas origens, criando exceções relevantes ou abolindo completamente o estatuto de anonimato dos dadores. 26. Este artigo oferece considerações éticas e legais sobre se o chamado "direito ao esquecimento" poderia ser alargado para incluir o direito dos dadores de gâmetas a permanecerem anónimos. Esta perspetiva vai contra a tendência geral, certamente na Europa, de reconhecer que os descendentes nascidos de gâmetas doadas têm o direito de aceder à informação relacionada com os seus progenitores genéticos. O novo aditamento é debater se o Regulamento Geral de Proteção de Dados (RGPD) poderá fornecer um terreno fértil para questionar esta abordagem, e apoiar efetivamente as jurisdições onde o anonimato ainda é possível.
Subject(s)
Humans , Confidentiality/ethics , Patient Rights , Directed Tissue Donation/ethics , Tissue Donors , Confidentiality/legislation & jurisprudence , Privacy , Disclosure/legislation & jurisprudence , Disclosure/ethics , Directed Tissue Donation/legislation & jurisprudence , Germ CellsABSTRACT
La reproducción asistida con donación ha venido a interrogar y a ampliar la noción de parentesco. La hegemonía del modelo biogenético dificulta que los padres de estas familias incorporen con tranquilidad la donación en su gestación. Desde los inicios de la técnica los padres han optado por no contar a su decendencia la historia de su concepción, muchas veces por miedo a que se deslegitimara su relación filial. Con el tiempo, se ha observado una apertura hacia la comunicación. Este cambio va de la mano con el desarrollo de la investigación en el área, que comenzó preguntándose por el bienestar psicológico de los nacidos por donación, por los aspectos relacionales de las familias concebidas de este modo e interrogando los beneficios de la comunicación de orígenes. Luego, investigando las percepciones en relación con su origen de las personas nacidas por donación. Finalmente, se ha publicado acerca la imposibilidad del anonimato en la era de los exámenes genéticos directos al consumidor. El modo de entender la reproducción con donante ha evolucionado, de un modelo médico en el que el foco es el lograr un embarazo saludable, a un modelo de formación de familia, en el que la motivación es contribuir a formar familias de buen funcionamiento. Esto tiene implicancias en la consejería a quienes participan del proceso, y también en los lineamientos que las sociedades científicas y comités de ética sugieren a los programas de reproducción con donante.
Gamete donation has come to question and broaden the notion of kinship. The hegemony of an biogenetic model has been an obstacle for parents of these families to incorporate donation into their history. From the beginning of the technique the parents chose not to tell their descent the history of their conception, often for fear that their filial relationship would be delegitimized. Over time, an openness to disclosure has been observed. This change goes hand in hand with the development of research in the area, which began by asking about the psychological well-being of those born by donation. Then investigating the relational aspects of families conceived in this way and questioning the benefits of disclosure. Subsequently, it was possible to study the perceptions regarding their origin of people born by donation. Finally, the impossibility of anonymity in the era of direct consumer genetic testing has been published. The way of understanding donor reproduction has evolved, from a medical model in focus is to achieve a healthy pregnancy, a family formation model, in which the motivation is to contribute to forming well-functioning families. This has implications in counseling to those who participate in the process, and in the guidelines that scientific societies and ethics committees affect donor reproduction programs.
Subject(s)
Humans , Oocyte Donation , Confidentiality , Disclosure , Donor Conception/psychology , Donor Conception/ethicsABSTRACT
Out of the many challenges in management of female factor infertility, poor responders and low response to stimulation in aged and even younger women, seems to be a common problem. It is very difficult to offer one particular management strategy or treatment protocol for optimum outcome in this group of women of poor responders. In a low resource set up, IVF (In vitro Fertilization) specialist doctors usually face a challenge in treating women with poor/ low ovarian reserve as ovum / gamete donation is considered as a taboo in various sections of society even today. Hence women insist on having an offspring of "their own" and vehemently deny ovum / gamete donations. In this article we discuss 2 cases of poor ovarian reserve retrospectively, who underwent multiple cycles of controlled ovarian hyperstimulation for embryo banking and ultimately achieved pregnancy. Both patients achieved pregnancy with the method of embryo banking. Embryo banking should be considered and discussed. Various articles have discussed the advantages and disadvantages of embryo banking or even oocytes accumulation. The advantages of this technique is patients with poor/low ovarian reserve get a chance to be pregnant with their own oocytes and also have a chance for vitrification of residual embryos. Another advantage in such patients is that the embryos can undergo PGS (Preimplantation Genetic Screening) techniques in cases of suspected genetic disorders. The disadvantage in a low resource set up like India is the cost of the treatment. Nevertheless, embryo banking and accumulation of oocytes should be given as an option for treatment of poor/ low ovarian reserve and could be considered as a ray of hope for all future mothers hoping for a child of "their own".
ABSTRACT
Objective:To investigate the medical students' cognition of ethical issues in assisted reproductive technology (ART) and discuss the importance of ethical education in medical colleges and universities.Methods:A questionnaire survey about the ethical cognition of assisted reproductive technology was conducted among 632 medical students.The questionnaire included the donation and management of gametes and embryos,and offspring problems.Results:Medical students agreed with most of the current ART-related laws and regulations.however,44.8％ of medical students considered that criteria of donating eggs should be relaxed,such as allowing women who do not receive ART treatment be paid for eggs.In addition,a total of 39.0％ of medical students supported the legalization of surrogacy technology in china.Conclusion:Medical students exists a certain misunderstanding in egg donation and surrogacy technology.We should give more training to medical students in ethical knowledge.In addition,our country can supplement and perfect the current laws and regulations to a certain extent.