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Topic: Reproductive Medicine
November 21, 2013 | Posted By Lisa Campo-Engelstein, PhD

As I’ve mentioned in a previous blogs, men only have 2 contraceptive options—male condom and vasectomy—and neither are long-acting reversible contraceptives. If more male contraceptives were developed, would men use them? Some empirical research shows many men would, especially young, urban, and educated men. Yet, skeptics say men don’t value pregnancy prevention to the same degree that women do so they won’t be motivated to use male contraception. Another common reason given for why men wouldn’t use male contraceptives is the fear that these contraceptives will emasculate them. Here I will discuss three social beliefs that contribute to this fear. 

First, many men believe that testosterone is a crucial factor in what makes them men. Though certain levels of testosterone in the body do result in what are usually classified as masculine characteristics, such as more body hair, more muscle tone, deeper voice, aggressive behavior, and stronger sex drive, the category ‘men’ is not just a biological one, it is also a social one. There are many cultural beliefs about what it means to belong to the category ‘men,’ one of which is that men have an uncontrollable libido. Most men want and feel pressured to adhere to these dominant conceptions of masculinity so that they are considered “real” men. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

October 17, 2013 | Posted By Lisa Campo-Engelstein, PhD

Some physicians will write prescriptions in advance for young women so they can have immediate access to emergency contraception if the need arises. In order to be most effective, emergency contraception should be used within a few days of unprotected sex. Writing prescriptions for emergency contraception in advance makes it easier for women to take it right away and can reduce barriers they may face in trying to access it when they are under time pressure. My goal in this blog is to discuss some of the ethical issues raised by physicians writing preventive prescriptions for emergency contraception.

Some are concerned that the practice of physicians writing prescriptions in advance for emergency contraception will condone, and even encourage, young women’s sexual activity, especially premarital and "promiscuous" sexual activity. As with nonemergency forms of contraception and the HPV vaccine, some believe preventive measures against the risks involved with sexual activity are a tacit endorsement of sexual activity. On a related note, even if people did not oppose young women's sexual activity, they may still be concerned that writing prescriptions in advance for emergency contraception will discourage young women from using nonemergency contraception.  

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

October 7, 2013 | Posted By Ricki Lewis, PhD

On September 24, the direct-to-consumer genetic testing company 23 and Me was granted patent no. 8543339, covering the selection of traits in offspring by genotyping eggs and sperm. (“Gamete donor selection based on genetic calculations.”) An analysis of the ethical issues the patent raises is published today in Genetics in Medicine. (Coincidentally, a co-author of the paper was so critical of a recent DNA Science blog post that comments had to be cut off. Small world.)

I’d started thinking about today’s post a few weeks ago, when a prominent science writer posted on a listserv “What was the CEO of AAAS thinking?” and then quoted Alan I. Leshner telling the New York Times: “K-12 students need to know the nature of science, how scientists work and the domains and limits of science. Science can’t tell you about God. Or when life begins.”

“Um…when life begins is a pretty basic idea in biology,” commented the originator of the compelling listserv thread that followed. Actually, no.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

September 17, 2013 | Posted By Lisa Campo-Engelstein, PhD

Testicular tissue cryopreservation is a neglected topic in the fields of fertility preservation and bioethics not only because reproduction is usually associated with women and girls, but also because sperm banking is an established, easy, and cheap method that works for the majority of male cancer patients. However, norms surrounding fatherhood are changing, with more men interested in active fatherhood, and consequently fertility preservation is becoming and will continue to become increasingly important to male cancer patients.

When compared to the number of studies demonstrating the importance of fertility to female cancer patients, the literature focusing on male cancer patients’ perspectives on fertility is minimal. However, there are more researchers examining the latter topic today than in the past. Contemporary research on gendered perspectives on fertility preservation reveals a shift over time: although older studies generally found that female cancer patients value their fertility

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

August 23, 2013 | Posted By Lisa Campo-Engelstein, PhD

Unlike organs, the U.S. allows gametes to be purchased. Given this dichotomy between the legal treatment of gametes and the legal treatment of organs, the question then arises: how should we legally classify ovaries, which can be used to treat both reproductive conditions (infertility) and non-reproductive conditions (premature menopause)?  

I believe ovarian tissue should be aligned with gametes rather than organs. I recognize that this leads to concerns about the sale of ovarian tissue (e.g., price, access, limitations, etc.). However, ovarian tissue like gametes and unlike other types of transplant, can lead to pregnancy, a socially and ethically important difference. The potential to create a new life is significant because new life often engenders new relationships and legal responsibilities. Whereas organ donors, both living and cadaveric, can remain anonymous, gamete donors typically cannot, at least not fully anonymous. Gamete donors are generally required to provide personal information on a variety of topics, such as physical characteristics, family medical history, religion, personal achievements, and personality traits. Potential recipients (and fertility centers) are usually the only ones who have access to this personal information. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

July 25, 2013 | Posted By Benita Zahn, MS

The law in the United States is clear that once a person has completed their prison sentence and parole they are free to go on and live their lives. The state does not have continued control over them. While some might argue that for sex offenders and regulations regarding where they may live impinges on this, that narrow issue is not the focus of this paper. I will argue that castration, chemical or physical, is antithetical to our society. 

The eighth amendment prohibits cruel and unusual punishment. Mutilation would be considered cruel and unusual punishment and castration clearly falls under that banner. It involves a surgical procedure to remove the testicles or in women, the removal of their ovaries. One need to look no further than to realize physical castration to control sexual predators should not be permitted.    

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

July 15, 2013 | Posted By Lisa Campo-Engelstein, PhD

Despite the fact that fertilization requires mutual, active participation by both eggs and sperm, gender roles are often projected onto reproductive biology, leading to the portrayal of eggs as passive and sperm as active. For example, the opening credits in the 1989 movie Look Who’s Talking portray a common perception of fertilization. As the Beach Boys’ song “I Get Around” plays in the background, we see sperm inside a women’s reproductive tract moving toward her egg. The scene is narrated by one of the sperm, though we can hear some of the other sperm talking. The narrating sperm tells the others, “Ok, follow me … I know where we’re going … I’ve got the map. Follow me kids, keep up.” Upon seeing the egg, the sperm says “I think I see something … this is it, this is definitely it … jackpot!” to which another sperm relies “Yee haw!” We then see a bunch of sperm on the outside of the egg, seeking entrance through the egg membrane – a difficult task as evidenced by the lead sperm stating, “kinda tough here.” The egg then envelopes one sperm as it cries “Ohhh, ohh, I’m in, I’m in.” In this scene, the egg is portrayed as passive, merely drifting along waiting to be discovered by the sperm, whereas the sperm is active, strong, and on a mission to reach the egg. 

A colleague and I were interested in seeing if this misperception of fertilization is limited to the media or if it is also seen in scientific writing. We analyzed science textbooks from the middle school to the medical school level to determine if fertilization in human reproduction is described in gender biased language regarding the sentence structure, amount of information provided for female and male processes/parts, and neutrality in describing female and male processes/parts.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

July 5, 2013 | Posted By John Kaplan, PhD

Usually when I write about stupidity in Congress I wait a couple of months before doing it again. However, I cannot help myself. This is low hanging fruit and I have to pick it. This is “truth is stranger than fiction” type of stuff. You cannot make this up. In this blog post I would like to introduce the readers to Representative Michael Clifton Burgess M.D., republican representative from Texas’ 26th Congressional District. Dr. Burgess was born in December 1950. I mention this only because it was the same month I was born. He graduated with a Bachelors of Science from North Texas State University. He graduated from medical school at The University of Texas Health Science Center at Houston. He completed his residency in Obstetrics and Gynecology from Parkland Memorial Hospital in Dallas. He also completed a Masters degree in Medical Management from the University of Texas at Dallas. Dr. Burgess is the founder and chair of the Congressional Health Care Caucus, albeit it’s only member. This all suggests the likelihood that Dr. Burgess is smart. His recent statements seem to refute that likelihood.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

June 17, 2013 | Posted By Lisa Campo-Engelstein, PhD

One of the major concerns with human egg donation is that there is no federal or systematic oversight. The UK has the Human Fertilisation and Embryology Authority (HFEA) that regulates the use of gametes and embryos for fertility treatment and research. In contrast, the US is the “Wild West” when it comes to reproductive medicine as we lack any real regulation in this field (there are soft policy guidelines from various medical and scientific organizations but these don’t have teeth). 

Without any oversight, many concerns are raised about the screening of donors. For example, women can donate at multiple centers without any of the other centers knowing. There are no good studies on the effects of donating eggs numerous times, but many believe it could be detrimental to women’s health. Another problem with women donating to multiple centers is that if their eggs are to be used for research purposes, it could lead to less diversity in the research sample. If their eggs are being used for reproductive purposes, then there is a greater chance of creating many half-siblings. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

May 28, 2013 | Posted By Zubin Master, PhD

For Part I of this blog, I will highlight a new discovery where scientists have now been able to create cloned stem cells and I will review two ethical debates that were central to earlier discourse surrounding stem cell research: (1) the moral status of human embryos and (2) the potential physical and social harms to women as egg providers.

So finally research cloning (a.k.a. therapeutic cloning) has been achieved! The technique is called somatic cell nuclear transfer (SCNT) and now has been used to derive human embryonic stem cells (hESCs) (Tachibana et al.Cell 2013). Performing SCNT using human oocytes is an astonishing accomplishment and has significant ethical and clinical implications.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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