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[Medically assisted reproduction in couples carrying the human immunodeficiency virus].

Today, in developed countries, many HIV-infected people remain in good health thanks to antiviral medication, and a growing number of them want to have children. The benefit of resorting to assisted procreation and the contamination prevention strategies, throughout pregnancy, are summarized as well as the changes in ethical considerations. The balance between the importance of the message of prevention and the benefit for patients of being assisted in their desire for a child, has evolved towards a growing interest for medical intervention in order to avoid the risks of spontaneous conception outside health care structures. We are presenting the medical structure adapted at Erasme hospital and the 38 first requests taken into account by our pluridisciplinary team. This approach, which is coherent from a scientific point of view, respects both the autonomy of people, carrying HIV as well as the essential interest of the child, in being born uninfected, and also has the enormous advantage of allowing access to parenthood without destroying the consistency and coherence of the message of prevention of sexual contamination.

Carrier State↗

[Human life, the fruit of a meeting -- in connection with couple infertility].

Reproductive Medicine is first seen in the light of Michel Foucault's work, The Birth of the Clinic. Archaeology of the Medical Perception. Then, the different levels of the procreative meeting are described: emotional, sexual and cultural meetings. These levels may be in conflicting situation in infertility. This is illustrated by some clinical observations of infertility. The endogamic society such as described by Germaine Tillion in The Republic of Cousins has been faced with recessive autosomic diseases that may cause a decrease of fertility for some individuals and for the ethnic group. One particular observation provides an illustration thereof.

Cultural Characteristics↗

Procreative tourism and reproductive freedom.

In many societies, the use of assisted reproduction technology has produced a desire to control and regulate this form of treatment. Politicians have taken most decisions. These regulations hold important implications for patients, and there are no two countries with the same regulations. These important differences have led to a traffic of infertile couples across legislative borders to seek a solution to their problem. Would harmonization of laws have positive effects? It seems that it would lead to a minimal common legislation. Procreative tourism is actually a 'safety valve' for many European couples.

Europe↗

Therapeutic versus genuine cloning: what are the real moral issues?

In order to answer the question raised in the title of my paper, I first put forward a general ethical theory, which is based on the traditional maxim neminem laedere. Second, I show how this principle in conjunction with certain assumptions concerning the value of life entails certain fundamental bioethical principles. Thus killing a living being Y is morally wrong whenever the intrinsic value of the life that Y would otherwise live is positive. But procreating a living being Y is prima facie (i.e., with regard to the interests of Y) morally neutral, i.e. neither bad nor good. Third I will argue that the question of moral rights should always be reduced to the question of the morality of certain corresponding actions. In particular, granting Y a right to life should be taken to mean that it would be morally wrong if someone else were to put an end to Y's life. In a similar vein, I suggest answers to some other questions of the reproductive rights issue. Fourth, with respect to the controversial issue of genuine cloning, I do not see any compelling moral reasons against this utopian way of procreating full-grown individuals. Nevertheless, I think there are a lot of other good (pragmatic, rational) reasons not to try to produce a human Dolly. Finally, as regards the use or abuse of human embryos as potential suppliers of stem-cells for the cure of other people's diseases, it seems morally safe to perform experiments at least with those embryos which, like spare embryos that remained from measures of in vitro fertilization, would not have a life anyway. It's more difficult to decide, however, whether it would be morally safe to produce embryos (for instance through cloning) only for the sake of using them in the aforementioned way.

Abortion, Induced↗

Arising from the dead: challenges of posthumous procreation.

The medical capabilities derived from modern reproductive technology, such as in vitro fertilization and cryopreservation, have enabled physicians and scientists to intervene in the procreative process in innumerable ways. However, this intervention in the natural reproductive process raises both moral and legal concerns. In this Article, Professor Schiff explores some of the conflicts that may result when an individual or couple elects to cryopreserve gametes or embryos and subsequently, one or both of the contributors dies, or when gametes are harvested from a dead body. This Article will specifically address the moral and legal responses to circumstances where the decedent has either clearly expressed opposition to posthumous use of the reproductive material or else the decedent's intent regarding posthumous use of the material is ambiguous. By discussing philosophical and moral positions relating to personhood and the body and analyzing legal issues such as reproductive choice and organ donation, Professor Schiff creates the necessary format to examine and recommend the proper legal treatment of this controversial aspect of posthumous procreation.

Cryopreservation↗

[Genetic counseling of parents of children with eye diseases].

What is the empirical risk for children to be born with a disease or a malformation? In healthy families, the parents being normal, the probability is 2 to 4% and when the parents are first cousins, although healthy, it is 5%. Of course, the risk is greater in affected families. When the mother or the father is affected and when there is no consanguinity, the risk is 20%, but when the parents are first cousins, it is 32,5%. When the two parents are affected, it is 100%. When the parents are normal, but when already one child is affected, the risk for the other children is 25%. When the mother or the father is affected and when there is already one child affected, the risk for the other children is 50%. When a grand parent is affected, the risk for the grand children is 10%. When an aunt or an uncle is affected, the risk for the nephews and nieces is 7%. In the case of genetic counseling, the parents must understand that no physician can guarantee that a child will be normal. On the other side, they must understand that the mendelian risks are the same for each pregnancy. Finally, they must know that at each birth there is a risk of 2 to 4% of having a major congenital anomaly. On the human and psychological point of view, the physician must convince the parents that they are not responsible and that, if a woman may be a gene carrier, the husband may also carry pathological genes, as each individual carries 2 to 10 pathological recessive genes. Finally, it is not the geneticist who has to impose a procreative decision. Only the parents have to decide if they want or do not want other children.

Eye Diseases↗

Women's reproductive health: monotheistic religious perspectives.

It is important to those who practice reproduction techniques to learn about the different religious attitudes related to reproductive health problems. Religion exerts an influence on civil authorities in the field of reproduction such as prevention or procreation and in issues such as abortion and infertility therapy. The Jewish attitude towards reproduction can be learned from the fact that the first commandment of God to Adam was be fruitful and multiply. Judaism allows the practice of all techniques of assisted reproduction when the oocyte and sperm originate from the wife and husband, respectively. All Rabbinical rulings permit the use of contraception for medical indications. Economic difficulties and inconveniences of raising children are not indications for birth control practice. According to Judaism abortion on demand is forbidden but it may be performed if the mother's life is in danger. The attitude toward reproductive practice is different among the different divisions of Christianity. The practice of assisted reproduction is not accepted by the Vatican, however, it may be practiced by Protestant, Anglican and other Denomination's. According to the Roman Catholic doctrine the primary purpose of marriage is procreation. The contraceptive act destroys the potential of producing new life by sexual intercourse and violates the purpose of marriage and, therefore, is a sin against nature. The Christian tradition views the embryo as a human being since conception and, therefore, abortion is strictly forbidden. According to Islam, the procedure of IVF and ET is acceptable, however, it can be preformed only if it involves the husband and the wife. It allows contraception practice only under some circumstances and only in some special cases abortion can be preformed. Religion, being concerned with affairs that are regarded as extraordinary and as having unique importance in life, is an intrinsic aspect of the culture of all societies, religious groups, however, still exert influence on the civil authorities in issues of reproduction such as contraception, procreation, abortion, and infertility therapy. They have been active in pressing their bioethical positions on the public arena in pluralistic societies. Developments in science and technology in reproduction raise new religious questions that do not always have clear answers. The role of theology in bioethics is foremost to clarify for the different religious communities the perceived attitudes toward these developments. Therefore, it is important to those who practice reproduction techniques to learn about the different religious attitudes related to reproductive health problems.

Abortion, Induced↗