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European Journal of Obstetrics,... May 2022Recently, a technique of assisted reproduction was developed to allow lesbian women to share biological motherhood of their offspring - the ROPA method (in Spanish -... (Review)
Review
Recently, a technique of assisted reproduction was developed to allow lesbian women to share biological motherhood of their offspring - the ROPA method (in Spanish - Recepción de Ovocitos de Pareja; in English - Reception of Partner's Oocytes), also known as lesbian shared in vitro fertilization. One mother provides the oocytes (genetic mother) and the other receives the embryo and gets pregnant (gestational mother). As for most issues related to medically assisted reproduction, this technique raises a lot of ethical questions in respect to patients, future offspring, gametes, and embryos. Furthermore, the fact that it is directed to homosexual women poses its own issues, both biological and social in nature. This is a state-of-the-art review of the main ethical dilemmas related to this technique, primarily focusing on the basic principles of bioethics, but also specific concerns directly related to this kind of treatments.
Topics: Female; Fertilization in Vitro; Humans; Mothers; Oocytes; Pregnancy; Sexual and Gender Minorities; Surrogate Mothers
PubMed: 35397373
DOI: 10.1016/j.ejogrb.2022.03.046 -
Bioethics Nov 2020Some commentators maintain that gestational surrogates are not 'mothers' in a way capable of grounding a claim to motherhood. These commentators find that the practices...
Some commentators maintain that gestational surrogates are not 'mothers' in a way capable of grounding a claim to motherhood. These commentators find that the practices that constitute motherhood do not extend to gestational surrogates. We argue that gestational surrogates should be construed as mothers of the children they bear, even if they fully intend to surrender those children at birth to the care of others. These women stand in a certain relationship to the expected children: they live in changed moral circumstances by reason of their pregnancy, and they engage in the practices said to define motherhood in the post-birth context. By contrast, ovum donors and embryo donors are not similarly 'mothers' because they do not find themselves involved in these circumstances. Not all women involved in three-parent in vitro fertilization qualify as mothers either. Given this analysis of mothering, we note that transmen who gestate children are engaged in mothering activity even if they otherwise function as a father to those children. By itself, this defence of the maternity of gestational surrogates does not confer moral title to the children they bear; gestation would not by itself override the contractual arrangements gestational surrogates have made regarding the disposition of their children. This interpretation of gestational surrogates as mothers does, however, undercut cultural understandings of these women as mere 'vessels', devoid of entitlement to respect as persons and parents. We also consider the meaning of mothering for 'brain-dead' women kept alive to give birth and for the prospect of extracorporeal gestation.
Topics: Child; Female; Fertilization in Vitro; Humans; Infant, Newborn; Mothers; Pregnancy; Surrogate Mothers
PubMed: 32964490
DOI: 10.1111/bioe.12808 -
Biology Feb 2023Biobehavioral synchrony, the coordination of physiological and behavioral signals between mother and infant during social contact, tunes the child's brain to the social...
Biobehavioral synchrony, the coordination of physiological and behavioral signals between mother and infant during social contact, tunes the child's brain to the social world. Probing this mechanism from a two-brain perspective, we examine the associations between patterns of mother-infant inter-brain synchrony and the two well-studied maternal behavioral orientations-sensitivity and intrusiveness-which have repeatedly been shown to predict positive and negative socio-emotional outcomes, respectively. Using dual-electroencephalogram (EEG) recordings, we measure inter-brain connectivity between 60 mothers and their 5- to 12-month-old infants during face-to-face interaction. Thirty inter-brain connections show significantly higher correlations during the real mother-infant face-to-face interaction compared to surrogate data. Brain-behavior correlations indicate that higher maternal sensitivity linked with greater mother-infant neural synchrony, whereas higher maternal intrusiveness is associated with lower inter-brain coordination. Post hoc analysis reveals that the mother-right-frontal-infant-left-temporal connection is particularly sensitive to the mother's sensitive style, while the mother-left-frontal-infant-right-temporal connection indexes the intrusive style. Our results support the perspective that inter-brain synchrony is a mechanism by which mature brains externally regulate immature brains to social living and suggest that one pathway by which sensitivity and intrusiveness exert their long-term effect may relate to the provision of coordinated inputs to the social brain during its sensitive period of maturation.
PubMed: 36829560
DOI: 10.3390/biology12020284 -
Journal of Medical Ethics May 2022Care of the critically ill newborn includes support for the birth mother/parents with regular updates around the clinical condition of the baby, and involvement in...
Care of the critically ill newborn includes support for the birth mother/parents with regular updates around the clinical condition of the baby, and involvement in discussions around complex decision-making issues . Discussions around continuation or discontinuation of life-sustaining are challenging even in the most straightforward of cases, but what happens when the birth mother is critically unwell? Such cases can lead to uncertainty around who should assume the parental role for these difficult discussions . In this round table discussion, we explore the ethical, moral and legal uncertainties raised by coincident severe maternal and neonatal illness in the context of surrogacy.
Topics: Decision Making; Family; Humans; Infant, Newborn; Morals; Parents; Uncertainty
PubMed: 33707303
DOI: 10.1136/medethics-2020-107181 -
European Journal of Health Law Oct 2023In the sphere of new modalities of creating offspring, one of the most controversial issues is related to surrogacy because it opens the space to unforeseeable ethical,...
In the sphere of new modalities of creating offspring, one of the most controversial issues is related to surrogacy because it opens the space to unforeseeable ethical, legal, sociological and psychological world of dilemmas. Surrogacy is the process whereby a woman carries and gives birth to a baby for a couple who cannot conceive naturally and it has become increasingly popular worldwide. This reproductive method relativized the biological fact of birth and denied the central moment in identifying motherhood, expressed in the ancient Roman proverb that the mother of a child is the woman who gave birth to it. Surrogate motherhood changes the notion of motherhood as it separates the natural functions of a woman as a mother, or it separates the genetic from the gestational motherhood. In such a situation, the biological riddle is: Who is the real mother of the child: the one who gives the genetic material or the one who gives birth to it? The answer to this question opens many moral and ethical dilemmas in complex relationships: the surrogate mother, the couple-clients and the child. As the successful medical practice of giving birth to another undeniably exists in different countries of the world, the further fate of this method of reproduction will significantly depend on ethical justifications.
Topics: Child; Female; Humans; Pregnancy; Surrogate Mothers; Morals
PubMed: 38382555
DOI: 10.1163/15718093-bja10115 -
Asian Bioethics Review Oct 2022Shi'i jurists have three different theories with regard to gestational surrogacy and who should be recognized as the mother of the newborn: (1) the surrogate mother (2)...
Shi'i jurists have three different theories with regard to gestational surrogacy and who should be recognized as the mother of the newborn: (1) the surrogate mother (2) or the ovum provider (biological mother) (3) or both of them. The religious law () regarding the title of 'mother' and issues such as inheritance, will (), marriage, and custody have been discussed by Shi'i jurists but no exact definition of this term has been provided by them. Because the fertilized ovum is considered the origin of humans and the formation of an embryo also determines the kinship of the newborn, the mother of the child is the woman that fetus created by her ovum. It is this woman who has all the rights and responsibilities of a mother; even if the surrogate mother is considered the mother of the child, she has no rights over the child nor does she have any duties towards him/her.
PubMed: 36203710
DOI: 10.1007/s41649-022-00217-2 -
Reproductive Biomedicine Online Oct 2022This review reports on the experiences of surrogates and intended parents of surrogacy arrangements. The findings from 47 studies, conducted across 12 countries and... (Review)
Review
This review reports on the experiences of surrogates and intended parents of surrogacy arrangements. The findings from 47 studies, conducted across 12 countries and investigating predominately gestational surrogacy in a commercial setting, were analysed thematically, and are reported in a narrative summary. The findings reveal that the experiences of both parties of surrogacy arrangements are largely satisfactory and frequently involve positive relationships forming between one another, which they hope to maintain after birth. Some surrogacy participants experience challenges, particularly when the surrogate and intended parents reside in different countries. Intended parents face legal hurdles when returning home after an international arrangement. Concerningly, multiple reports of clinical practices in India have been published, in which commercial surrogacy was accessed by foreign intended parents, which infringed on surrogates' autonomy during the pregnancy. Intended parents turn to these international destinations when they face barriers to accessing surrogacy in their home country, such as the prohibition of commercial surrogacy. Looking beyond the altruistic and commercial dichotomy may alleviate some of the barriers to domestic surrogacy. Collaboration between professional fertility organizations to develop best practice guidelines can support clinics in providing international surrogacy services that minimize the risk of harm to those accessing care.
Topics: Altruism; Female; Humans; Pregnancy; Surrogate Mothers
PubMed: 35909052
DOI: 10.1016/j.rbmo.2022.06.006 -
Indian Journal of Pediatrics May 2022To study determinants and predictors of body fat in Indian children and adolescents.
OBJECTIVE
To study determinants and predictors of body fat in Indian children and adolescents.
METHODS
In this cross-sectional study, 5175 children and adolescents [3014 boys, age 12.8 (3) y, 5-18 y] participated. Determinants and predictors of body fat were assessed using partial correlation (corrected for age, and gender) and linear regression.
RESULTS
Fat percentage correlated negatively with the duration of physical activity (r = -0.091, p < 0.01) and sleep (r = -0.044, p = 0.01) and positively with parental body mass index (BMI) (r = 0.202, p < 0.01 for father and r = 0.235, p < 0.01 for mother), and birth weight (r = 0.050, p < 0.01). On linear regression, fat percentage was positively associated with parental BMI and birth weight, and negatively with physical activity and sleep duration. All adiposity markers [BMI standard deviation score (SDS) (r = 0.863, p < 0.01), weight SDS (r = 0.827, p < 0.01) waist to height ratio (r = 0.819, p < 0.01), waist circumference SDS (r = 0.765, p < 0.01) wrist circumference (r = 0.21, p < 0.01), and neck circumference (r = 0.19, p < 0.01)] correlated significantly with fat percentage, showing highest correlation with BMI SDS.
CONCLUSION
Reduced sleep and physical activity are the key modifiable risk factors for adiposity. BMI SDS is the best clinical surrogate of body fat in Indian children and adolescents. There is a need to explore the impact of lifestyle interventions targeting sleep and physical activity on adiposity.
Topics: Adipose Tissue; Adolescent; Birth Weight; Body Mass Index; Child; Cross-Sectional Studies; Humans; Male; Obesity; Waist Circumference
PubMed: 34236600
DOI: 10.1007/s12098-021-03815-4 -
The New Bioethics : a Multidisciplinary... Dec 2020
Topics: Female; Humans; Pregnancy; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 33200958
DOI: 10.1080/20502877.2020.1835205 -
Journal of Medical Ethics Mar 2023In this article, I critique the commonly accepted distinction between commercial and altruistic surrogacy arrangements. The moral legitimacy of surrogacy, I claim, does...
In this article, I critique the commonly accepted distinction between commercial and altruistic surrogacy arrangements. The moral legitimacy of surrogacy, I claim, does not hinge on whether it is paid ('commercial') or unpaid ('altruistic'); rather, it is best determined by appraisal of virtue-abiding conditions constitutive of the surrogacy arrangement. I begin my article by problematising the prevailing commercial/altruistic distinction; next, I demonstrate that an assessment of the virtue-abiding or non-virtue-abiding features of a surrogacy is crucial to navigating questions about the moral legitimacy of surrogacy; in the final part, I reject other moral heuristics that might be proposed as alternatives to the commercial/altruistic dichotomy, and reiterate that a virtue-ethical framework is the most suitable way forward.
Topics: Female; Pregnancy; Humans; Surrogate Mothers; Morals; Altruism; Virtues
PubMed: 35314464
DOI: 10.1136/medethics-2021-108093