Daniela Cutas

Mitochondrial replacement therapy has been developed in order to prevent the transmission of mitochondrial mutations, yet it raises ethical concerns, particularly regarding the involvement of third-party DNA and the risks associated with donor procedures. This paper explores an alternative approach using synthetic DNA (synDNA) to construct mitochondrial organelles, thereby bypassing the need for donor oocytes and bypassing risks to donors. We argue that those who support mitochondrial replacement techniques as an ethically acceptable means of preventing the transmission of mitochondrial disease should consider the use of synthetic mitochondria as a preferable ethical alternative, should it prove technically viable. That this will be viable is more than we can demonstrate here. However, progress in synDNA technology suggests that it is not unreasonable to think that synthetic mitochondria creation is feasible, and perhaps even probable.

In recent decades, with the advancement of technologies facilitating reproduction, parents have been able to make decisions regarding their childrens’ reproductive potential: to preserve their fertility when threatened by genetic conditions or medical treatment; to use their gametes or embryos to make grandchildren; or even to collect their gametes posthumously and then use them to make grandchildren. While these interventions tend to be framed in terms of the interests of the children themselves, parents are not indifferent as to whether they become grandparents. At the same time, while the interest in becoming a parent and parents’ interests have been discussed extensively in reproductive and family ethics, grandparents and grandparenthood have been at best marginal in this growing literature. Against this background, I ask the question whether parents have an interest in becoming grandparents – and if so, which claims this interest generates against other parties (such as children themselves, healthcare professionals, or the state), if any. I explore possible paths towards conceptualising such an interest and the degree to which it could ground a claim to facilitate its fulfilment.

Authored by Kerry Lynn Macintosh.. Cambridge University Press, Cambridge, 2005, pp 286. ISBN 0521853281 A Professor of Law at Santa Clara University, Kerry Lynn Mackintosh presents us with a rigorously structured book on anticloning legislation. Although written for US readers and thus focusing on US context and legislation, the book is very much relevant internationally, due to the similarities between the various anticloning legislative endeavours and (in particular) between their underlying premises. The book is divided into three parts. In Part I, Macintosh identifies and discusses the five most common sources of objections to human cloning, and shows what the endorsement of each of these objections presupposes and suggests about cloning and clones: human cloning (1) offends God and nature (clones are grotesque, immoral and dangerous), (2) reduces humans to the level of manmade objects (clones are soulless, inert, unfeeling and inferior), (3) produces beings who lack individuality, copies (clones are evil, unoriginal, fraudulent, inferior, zombie-like, constrained, pathetic, disturbed, disgusting, identity thieves, destroyers, a threat …

Beliefs about the moral status of children have changed significantly in recent decades in the Western world. At the same time, knowledge about likely consequences for children of individual, parental, and societal choices has grown, as has the array of choices that (prospective) parents may have at their disposal. The intersection between these beliefs, this new knowledge, and these new choices has created a minefield of expectations from parents and a seemingly ever-expanding responsibility towards their children. Some of these new challenges have resulted from progress in genetics and neuroscience. It is these challenges that we focus on in this introduction and volume.

In this paper, we report the results from an experimental reproductive ethics study exploring questions about reproduction and parenthood. The main finding in our study is that, while we may assume that everyone understands these concepts and their relationship in the same way, this assumption may be unwarranted. For example, we may assume that if ‘x is y’s father’, it follows that ‘y is x’s child’. However, the participants in our study did not necessarily agree that it does follow. This means, at the very least, that we need to make sure all parties in a debate have the same relationships in mind when talking about reproduction and parenthood. Moreover, it gives us reason to explore more carefully the conditions which support or undermine the connections between these concepts. This cannot come from purely theoretical reasoning, nor from empirical research alone, but from the alliance between the two.

Mitochondrial replacement therapy has been developed in order to prevent the transmission of mitochondrial mutations, yet it raises ethical concerns, particularly regarding the involvement of third-party DNA and the risks associated with donor procedures. This paper explores an alternative approach using synthetic DNA (synDNA) to construct mitochondrial organelles, thereby bypassing the need for donor oocytes and bypassing risks to donors. We argue that those who support mitochondrial replacement techniques as an ethically acceptable means of preventing the transmission of mitochondrial disease should consider the use of synthetic mitochondria as a preferable ethical alternative, should it prove technically viable. That this will be viable is more than we can demonstrate here. However, progress in synDNA technology suggests that it is not unreasonable to think that synthetic mitochondria creation is feasible, and perhaps even probable.

In recent decades, ethicists have engaged with new developments in human reproductive technologies from a variety of angles. Yet there has been relatively little effort to problematize the concept of reproduction itself. In this paper, we examine the question of what reproduction is and its relationship with biology. We show that reproduction is commonly assumed to entail biological parenthood—an assumption that we term “the biological reproduction paradigm.” Drawing on Sally Haslanger’s analysis of the biological/social division between sex and gender, we suggest that the concept of reproduction is socially constructed, despite its apparently biological nature. In turn, we argue that the supposed necessity of the relationship between reproduction and biological parenthood leads to a situation in which access to a variety of medical, legal, and social goods is constrained on the basis of spurious, inconsistent, and undertheorized assumptions. Finally, we note that, given the socially constructed nature of reproduction, we cannot take it for granted that the term “reproduction” signifies the same thing among different interlocutors and in different contexts.

Do we owe anything to our genetic relatives qua genetic relatives? The philosophical literature has primarily addressed this question in the context of procreation. But genetic matching databases raise the question of whether we owe anything to previously unknown genetic relatives. This article argues that influential philosophical arguments regarding moral claims to know one’s genetic origins (sometimes referred to as a ‘right to know’) in the context of gamete donation have implications for a broader set of claims. First, these arguments imply more than a claim to know the identity of a genetic relative; the interests which they invoke can only be satisfied through a relationship. Second, the scope of the claims is broader than tends to be acknowledged: even if procreators have special obligations towards their offspring, these arguments imply that weighty moral claims can be made against other genetic relatives in many different contexts.

In this article, I explore concerns that have been raised regarding the relation between love and uptake of reproductive technologies, embryo selection and enhancement. Objections to (certain) uses of these technologies in terms of fractures in love, either parental or between partners, come from a variety of directions, from the conservative to the liberal. I examine two claims: (1) that the separation of procreation from sex and intimacy is a threat to love, and (2) that intervention on the traits of one’s future offspring betrays inadequate parental love. I will place these concerns in a broader context of (a) technologically facilitated threats to – or aids towards maintaining – love and (b) irreversible changes to parent-child relationships that arise at the moment a prospective parent acts on the choice to select or shape the essence of their future child.

In this paper, we discuss the ethical concerns that may arise from the synthesis of human DNA. To date, only small stretches of DNA have been constructed, but the prospect of generating human genomes is becoming feasible. At the same time, the significance of genes for identity, health and reproduction is coming under increased scrutiny. We examine the implications of DNA synthesis and its impact on debates over the relationship with our DNA and the ownership of our genes, its potential to disrupt common understandings of reproduction and privacy, and the way in which synthetic DNA challenges traditional associations between genes and identity. We explore the degree to which synthetic DNA may further undermine overgeneticised accounts of identity, health, reproduction, parenthood and privacy that are prevalent in the public domain and in some areas of policy-making. While avoiding making normative claims of our own, we conclude that there is a need for reflection on the ethical implications of these developing technologies before they are on us.

Recent decades have seen the facilitation of unconventional or even extraordinary reproductive endeavours. Sperm has been harvested from dying or deceased men at the request of their wives; reproductive tissue has been surgically removed from children at the request of their parents; deceased adults’ frozen embryos have been claimed by their parents, in order to create grandchildren; wombs have been transplanted from mothers to their daughters. What is needed for requests to be honoured by healthcare staff is that they align with widely shared expectations about what people’s reproductive potential ought to be, what marital relationships ought to result in, and which kinds of ties are desirable between parents and children. Costly and invasive technologies are not considered excessive when they are used to support the building of appropriate families. However, deviations from dominant reproductive norms, even if technologically simple and convenient to the participants, are unlikely to receive support. In this paper, we offer examples of such deviations and explore their implications. If reproduction is important as a way of creating genetic relationships, should reproductive material in storage be offered to genetic relatives other than the people from whom it originated? And if parents are allowed to have reproductive material collected from their offspring, or even to use it to create babies, should offspring likewise be allowed to use their parents’ reproductive material? We tackle these questions and suggest ways in which interests in genetic ties could be operationalised in a more coherent and less-invasive manner than they currently are.

This chapter analyses the implications of findings in epigenetics for the ascription of moral responsibility for children. It contrasts shared understandings of procreative responsibility and discusses its extension to include all (individual or collective) actors who influence a child’s gene expression. It also problematizes the focus on biology in this process, using the example of epigenetics as a crossover between social and biological factors that contribute to a child’s life. Epigenetics blurs the boundary between biology and the environment, and thus allows an analysis of contributions to children’s lives that goes beyond classical dualistic categories such as genetic versus environmental or biological versus social. The analysis is undertaken against the broader background of the determination of moral responsibility for children.

We tend to hold people responsible for their choices, but not for what they can’t control: their nature, genes or biological makeup. This thought-provoking collection redefines the boundaries of moral responsibility. It shows how epigenetics reveals connections between our genetic make-up and our environment. The essays challenge established notions of human nature and the nature/nurture divide and suggest a shift in focus from individual to collective responsibility. Uncovering the links between our genetic makeup, environment and experiences, this is an important contribution to ongoing debates on ethics, genetics and responsibility.

În cele ce urmează vom prezenta pe scurt zona de cercetare a eticii aplicate și locul ei în cadrul disciplinei filosofiei. Vom discuta apoi despre ce fac filosofii când fac etică aplicată. Vom trece în revistă câteva concepte importante din etica aplicată, cum ar fi deontologie, virtute, grijă sau drepturi. Apoi vom încerca să oferim un răspuns la întrebarea din titlul introducerii: de ce avem nevoie de etica aplicată? Vom povesti pe scurt despre istoria eticii aplicate în România, iar la final vom rezuma capitolele incluse în volum.

Care este statutul moral al copiilor? Ce înseamnă egalitatea morală dintre copii şi adulți? Care sunt constrângerile pe care le impune acceptarea acestei egalități în ceea ce priveşte felul în care pot fi tratați copiii în familie sau în societate? Cine are ce fel de responsabilitate pentru copii? În capitolul de față voi discuta astfel de întrebări. Voi analiza relația dintre copii, părinți şi stat, în dimensiunea ei practică (felul în care ne raportăm la copii), din punct de vedere legal (constrângerile legale asupra felului în care ne raportăm la copii) şi din punct de vedere moral (cum ar trebui să ne raportăm la copii). Voi începe cu o scurtă incursiune în istoria relațiilor dintre copii, părinți, şi stat, atât din punct de vedere legal, cât şi filosofic. Voi prezenta conceptul de statut moral şi ideea de egalitate morală între copii şi adulți. Voi ilustra schimbările sociale şi legislative în ce priveşte acceptarea statutului moral al copiilor şi a egalității morale între copii şi adulți, folosind exemple din România şi Suedia. Voi examina dinamica dintre aspirațiile legale şi morale la care aderă România în ce priveşte statutul moral al copiilor şi normele sociale despre copii, copilărie, şi familie, care nu sunt întotdeauna în acord cu aceste aspirații. Voi urmări apoi schimbările care au avut loc în ultimele decenii în ce priveşte limitele responsabilității parentale.

Internationally, there is considerable inconsistency in the recognition and regulation of children's genetic connections outside the family. In the context of gamete and embryo donation, challenges for regulation seem endless. In this paper, I review some of the paths that have been taken to manage children' being closely genetically related to people outside their families. I do so against the background of recognising the importance of children's interests as moral status holders. I look at recent qualitative research involving donor-conceived people and borrow their own words to make sense of a purported interest to know (of) their close genetic ties. I also review ways in which gamete donation may have facilitated new kinds of kinship, which are at the same time genetic and chosen. In short, in this paper, I explore what meaning there could be in genetic connections that is not about parenthood. Further, I argue that the focus on parenthood in previous work in this area may be detrimental to appreciating some of the goods that can be derived from close genetic connections.

In this paper, we present the case of a couple who refused to disclose the sex of their child to others, and some of the responses that this case prompted in the international media. We outline the ethical issues that this case raises, and we place it into the more general context of parental preferences regarding the gender (development) of their children and of the impact on children of parental choices in the matter. Based on current knowledge of gender identity development, we identify some of the potential pitfalls of such a course of action and we briefly present some alternative strategies that could be implemented in order to ensure more freedom of gender formation in children.

De ce este importanta familia? Care este statutul moral al copiilor si cine are ce responsabilitati fata de ei? Ce este consimtamintul si care sint conditiile in care este valid? Care ar trebui sa fie rolul religiei in dezbaterile publice dintr-o societate democrata? Cum ar trebui sa fie gestionate inegalitatile sociale create de mosteniri? Ar trebui ca vaccinarea sa fie obligatorie? Este legitim sa fie cenzurate anumite forme de discurs? Avem datoria sa votam si, daca da, care sint considerentele morale care ar trebui sa ne ghideze votul? In aceasta carte analizam teme precum cele de mai sus, folosind atit metodele filosofiei analitice, cit si abordari interdisciplinare. Printr-un efort colectiv, conectat la spatiul romanesc, ilustram felul in care etica aplicata poate contribui la intelegerea problemelor morale ale lumii actuale. Speram ca textele incluse in aceste pagini sa fie de folos in reflectia asupra moralitatii alegerilor noastre individuale si colective.

Even though co‐parenthood is one of the most significant close personal relationships that people can have, there is relatively little philosophical work on the moral duties that co‐parents owe each other. This may be due to the increasingly questionable assumption, still common in our societies, that co‐parenthood arises naturally from marriage or romantic coupledom and thus that commitment to a co‐parent evolves from a commitment to a marital or romantic partner. In this article, we argue that co‐parenthood should be seen as a relationship in its own right, which generates specific moral duties. Co‐parents should come to explicit agreements with each other regarding the most important areas of potential conflict between them. Such agreements may have to be renegotiated over time. We explore some possible non‐negotiable co‐parental duties such as the duties not to alienate the child from the other parent(s) and not to trap a co‐parent in a particularly vulnerable situation. We consider some legal and societal implications of our argument and, finally, suggest some pragmatic benefits of our proposal.

This chapter explores current and prospective reproductive technologies and some of their likely implications for reproductive and family ethics and policymaking. The technologies discussed include uterus transplants, mitochondrial transfer, ectogenesis, the development of in vitro gametes, and solo reproduction. The chapter considers the impact of these developments on the content of concepts such as 'infertility', 'mother', or 'father'. Another layer to this process of redefinition originates in ongoing socio-cultural changes that shift the focus in parenting from the way in which children have come into the world, to relationships within the family. Considering these scenarios beforehand can help to clarify some of the current challenges in defining and regulating infertility. The chapter therefore aims to raise a number of questions rather than provide answers.

The chapter starts with an exploration of what the family is in order then to move on to look at its parts. The family has been defined in terms of its form (e.g. a mother, a father, and their biological offspring) or its function (e.g. adults taking and/or sharing custodial responsibility for children). In both of these cases, children are a necessary ingredient for a unit to be called a family – but the chapter also briefly reviews proposals to extend the accolade of “family” to beyond child-rearing. From a perspective concerned primarily with family form, biological and more specifically genetic parents have been seen as those to whom children should be born, and by whom they should be raised. From a perspective concerned with family function, this is not necessarily the case. Lastly, the chapter looks at the relation between parents and the requirements that co-parenting may generate in this regard.

Who is a child’s father? Is it the man who raised her, or the one whose genes she carries—or both? We look at the view that men who have raised children they falsely believed to be ‘their own’ have been victims of a form of fraud or are ‘false fathers’. We consider the question of who has been harmed in such cases, and in what the harm consists. We use conceptual analysis, a philosophical method of investigating the use of a concept and the logical implications of its various interpretations. We devise and discuss a number of possible scenarios in which a couple (arguably) become the parents of a child. We use these scenarios to illustrate the tenuousness of the claim that we can simply rely on biology to clarify parent-child relationships. We also discuss some of the underpinnings and implications of the language in which the debate on ‘paternity fraud’ has been framed: ‘duped’ or ‘false’ fathers and ‘cuckoo children’.

This paper is focused on the analysis of two documents (the Council of Europe's Bioethics Convention and the Additional Cloning Protocol) inasmuch as they refer to the relationship between human dignity and human genetic engineering. After presenting the stipulations of the abovementioned documents, I will review various proposed meanings of human dignity and will try to identify which of these seem to be at the core of their underlying assumptions. Is the concept of dignity proposed in the two documents coherent? Is it morally legitimate? Is it, as some might assume, of Kantian origin? Does it have any philosophical roots?

Whilst the choice of becoming a parent in the natural way is unregulated all over Europe (and proposals of regulation raise vehement objections), most European countries have (either legal or professional) regulations imposing criteria that people must satisfy if they wish to gain access to assisted reproduction and parenting. These criteria may include relationship status, age, sexual orientation, financial stability, health, and willingness to attend parenting classes. The existence of regulations in this area is largely accepted, and the objections raised usually concern the suitability of specific criteria rather than the legitimacy of imposing criteria at all. The inequality (if unsupported) could be solved by requiring both prospective natural and assisted parents to satisfy the same criteria (with some qualifications specified below) and, more importantly, to be subject to the same degree of monitoring, regardless of the way in which they became parents. Often people argue that proposals to regulate natural reproduction revive dreaded eugenic policies of the past, and that their implementation would violate some of our most cherished interests and rights: in particular the interest in becoming a parent and the right to reproduction and parenting. However, the same interests and rights are not equally safeguarded when one needs assistance to become a parent, and proposals to reduce the extent to which prospective parents requiring assistance are scrutinized are unpopular. In this paper we challenge the alleged justification of the current practices, and we show that there are serious inconsistencies in the treatment of, respectively, people who become parents naturally and people who require assistance to become parents. Thus, we propose that regulation of reproduction and parenting be revised in such a way as to eliminate the inconsistencies.

This book examines, through a multi-disciplinary lens, the possibilities offered by relationships and family forms that challenge the nuclear family ideal, and some of the arguments that recommend or disqualify these as legitimate units in our societies. That children should be conceived naturally, born to and raised by their two young, heterosexual, married to each other, genetic parents; that this relationship between parents is also the ideal relationship between romantic or sexual partners; and that romance and sexual intimacy ought to be at the core of our closest personal relationships - all these elements converge towards the ideal of the nuclear family. The authors consider a range of relationship and family structures that depart from this ideal: polyamory and polygamy, single and polyparenting, parenting by gay and lesbian couples, as well as families created through current and prospective modes of assisted human reproduction such as surrogate motherhood, donor insemination, and reproductive cloning.

In this paper we argue that society should make available reliable information about parenting to everybody from an early age. The reason why parental education is important (when offered in a comprehensive and systematic way) is that it can help young people understand better the responsibilities associated with reproduction, and the skills required for parenting. This would allow them to make more informed life-choices about reproduction and parenting, and exercise their autonomy with respect to these choices. We do not believe that parental education would constitute a limitation of individual freedom. Rather, the acquisition of relevant information about reproduction and parenting and the acquisition of self-knowledge with respect to reproductive and parenting choices can help give shape to individual life plans. We make a case for compulsory parental education on the basis of the need to respect and enhance individual reproductive and parental autonomy within a culture that presents contradictory attitudes towards reproduction and where decisions about whether to become a parent are subject to significant pressure and scrutiny.

It has been argued that, when there is a probable imminent risk of loss of children’s fertility, their parents should take active steps to preserve their reproductive potential if possible – or even that children have a right to such interventions being undertaken on them on their behalf, as an expression of their right to an open future. In this chapter, I explore these proposals and some of their implications. I place the discussion of fertility preservation for children into the more general context of the choices that parents might have to help keep their children’s future reproductive (and parenting) choices open. I discuss the role of desert and fairness in arguments for fertility preservation and their relevance for framings of infertility in general, as well as the relation between having a (slight) possibility to reproduce and becoming a parent.