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Oocyte donation.

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Directed Tissue Donation↗

Ethical consideration of intentioned preimplantation genetic diagnosis to enable future tissue transplantation.

Recently, a case was presented where a couple with one normal child requested preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing in order to conceive children who could serve as mutual donors for future transplantations if needed. While PGD for medical reasons is well defined and accepted, application for non-medical conditions is less obvious and still in debate. The present case calls to further extend the indications for PGD and raises a moral question as to whether to allow such intentioned treatment. Although it seems that all siblings might benefit from the procedure, when weighing the risks benefits and the ethical issues included in performing intentioned PGD, it seems that the procedure harbours risks and ethical issues that outweigh the benefit it offers. Therefore, it is time to constrain the slippery slope and state that intentioned PGD for conceiving children who might serve as siblings for mutual tissue donations should be declined.

Directed Tissue Donation↗

Paying organ donors.

Following an earlier paper in the journal in which Evans argued that it was commercial exploitation, not mere payment, that was morally objectionable about certain sorts of organ donation, this paper looks at the moral issues when commercial exploitation is eliminated from systems of paid organ donation. It argues that there are no conclusive moral arguments against such schemes for non-exploitative paid kidney donation.

Commerce↗

Oocyte donation: particular technical and ethical aspects.

This paper analyses the reasons that oocyte and sperm donation are experienced very differently by couples, despite their apparent similarity, and stresses the impact of the difficulties on donor recruitment in all oocyte donation programmes. The various types of donors (occasional, relational, in-vitro fertilization patient and professional) are described together with their motivations, resistance, advantages and disadvantages. The contradictory consequences with free or paid donation, the particular risks of oocyte donation (in comparison with sperm donation) both for the donor and for the recipient are highlighted. The problem of maintaining anonymity is then analysed in ethical terms but also in terms of technical efficacy. A strategy is described which, due to the decision of retaining anonymity, authorizes the sharing of oocytes between recipients. This has as a consequence, an increase in treatment efficacy by avoiding wastage of oocytes offered as a donation.

Confidentiality↗

Should donors have the right to decide who receives their gametes?

A continuing feature of gamete donation is the scarcity of available donors. A strategy to improve the meagre supply of gametes would be to adjust the donation procedure to the wishes and desires of the donors. However, giving donors the right to direct their gametes to certain groups of recipients goes against the general rule that donors relinquish all rights and duties. Moreover, allocation by the donor might very well run counter to the rules of distributional justice. On the other hand, the allocation right can be supported by the principle of autonomy and by the donor's interest in and contribution to the process. The position is taken that the donors should have the right to direct their gametes to categories accepted as relevant by the moral and religious communities in their society. They should not be given the right to add their own categories to the exclusion list. If donors are not allowed to allocate their gift, they should at least be informed as to which categories of recipient are treated by the hospital to enable them to decide whether they want to donate gametes.

Cultural Diversity↗