I. Overview of reproductive technology
(A) the meaning and classification of reproductive technology
1. Reproductive technology refers to medical technology that replaces one or all steps of natural reproductive process.
2. Types of reproductive technology
(1) artificial insemination. It is a technique to collect semen from husbands or voluntary sperm donors and inject it into female reproductive tract by doctors to achieve the purpose of pregnancy. According to different semen sources, artificial insemination can be divided into homologous artificial insemination (AIH) and heterogeneous artificial insemination (AID). The birth of this technology also created a sperm bank.
(2) In vitro fertilization. It is a reproductive mode in which eggs and sperm are fertilized and developed outside the human body by artificial methods. Because fertilization is carried out in test tubes in the laboratory, babies born in this way are usually called "test-tube babies".
Because it can stimulate ovulation, the number of fertilized eggs may exceed the needs of transplantation, and freezing technology can also be used in this field, so there are oocyte freezer and frozen embryo bank.
With the clinical application of artificial insemination and in vitro fertilization, surrogate mothers came into being. Surrogate, also known as surrogate mother, refers to pregnant women. Artificial insemination with one's own eggs, or implantation of someone else's fertilized eggs into one's own uterus, and rearing by others after delivery.
(3) asexual reproduction. Also known as cloning technology, it is a technology that uses modern medical technology to breed higher animals (including people) without sexual union.
Strict asexual reproduction technology, also known as adult cell cloning technology. Adult cells of higher animals are taken out, their nuclei carrying genetic information are implanted into enucleated eggs, and the combination continues to develop through technology, and then the embryos that have developed to a certain extent are transplanted into the mother's uterus for pregnancy until delivery. Because adult cells have lost the differentiation ability of fertilized eggs, it greatly increases the difficulty of asexual reproduction.
(b) History and reality of reproductive technology
The History and Reality of Artificial Insemination
2. The history and reality of in vitro fertilization Artificial insemination and surrogacy technology of in vitro fertilization for others' pregnancy began in the United States in the 1970s. From June 5438 to 10, 2000, the Department of Obstetrics and Gynecology of the Second Hospital of Harbin Medical University announced the success of surrogacy technology through the media. The surrogate mother is the surrogate mother whose sister had her uterus removed due to illness.
3. The history and reality of asexual reproduction The birth of asexual reproduction technology in a strict sense, that is, reproductive cloning technology, is the birth of a British cloned sheep named Dolly. 1February 23, 997, Nature published this news. A research team led by wilmot and Kembel of Roslin Institute in Edinburgh, England, extracted an egg cell from a ewe that provided eggs, removed the nucleus and made an egg "empty shell" with biological activity but no genetic material. Ordinary tissue cells are taken out from the mammary glands of ewes and fused with the above-mentioned egg cells without genetic material to produce eggs. When the egg cell divides and develops into an embryo to a certain extent, the researchers implant it into the uterus of a ewe, and the ewe becomes pregnant and gives birth to Dolly.
Second, ethical discussion on reproductive technology
The emergence of reproductive technology and its clinical application soon caused a lot of social and ethical problems, and brought people to the "wonderful new world" 1. Therefore, it is necessary to discuss it ethically.
(A) the ethical value of reproductive technology
The significance of reproductive technology is manifested in many aspects. In addition to showing the great achievements of scientific development and the great improvement of human ability, it also has the following ethical values.
1, reproductive technology can cure and make up for infertility, which is beneficial to marriage and family. Reproductive technology can solve the fertility problem of infertile couples, so people usually call this technology assisted reproductive technology. Artificial insemination mainly solves the problem of husband's infertility: AIH is suitable for people whose husbands have abnormal sexual function and can't have normal sexual intercourse, or those whose husbands have less semen and need to collect and concentrate many times to improve their insemination ability; AID is suitable for men and women who have no sperm in semen or are recessive heterozygotes with the same chromosome.
2. Reproductive technology can be used in eugenics. Choosing other people's high-quality sperm and eggs for artificial insemination and in vitro fertilization can not only carry out preventive eugenics, but also carry out evolutionary eugenics For couples who have the possibility of major genetic diseases, it is undoubtedly possible to carry out preventive eugenics by using other people's germ cells for assisted reproduction; Choosing high-quality germ cells for assisted reproduction can undoubtedly carry out evolutionary eugenics. The "Nobel Sperm Bank" was established in California, USA to provide the sperm of Nobel Prize winners; Some people in China tried to establish a "celebrity sperm bank" and a "beauty egg bank". It is said that one of their motives is to carry out evolutionary eugenics.
3. Reproductive technology is beneficial to family planning. According to the population situation in China, family planning is to control the number of children for a considerable period today and in the future. The Law on Population and Family Planning stipulates: "The state stabilizes the current birth policy, encourages citizens to marry late and have children late, and encourages a couple to have one child."
4. Reproductive technology can benefit agriculture, animal husbandry and medicine, and help save endangered animals and plants. Reproductive technology is not only directly beneficial to human fertility, but also beneficial to agriculture, animal husbandry and pharmaceutical production, and beneficial to saving endangered animals and plants.
(B) Social and ethical issues caused by reproductive technology
With the emergence of reproductive technology and its clinical application, people soon found that there are a lot of social and ethical problems, which led to many medical ethical problems.
1, whether reproductive technology can be commercialized, often involves the source of sperm, eggs and embryos, whether sperm, eggs, fertilized eggs and embryos are the private property of the provider, and whether the provider can get paid for it? Including whether surrogate mothers can get paid? Fundamentally speaking, it is a question of whether reproductive technology can be commercialized.
In the United States, it has become a common practice for people who provide sperm to get paid. It has also been suggested in China that sperm can be commercialized? The main reason is that the commercialization of sperm can greatly increase the supply of sperm. However, there are many problems in sperm banks in China, such as too few sperm donors and too single fertilization. But more people think that the problems brought by commercialization will greatly offset the benefits of "commercialization can increase sperm supply" for the following reasons:
(1) The commercialization of sperm may lead donors to ignore the consequences of their actions and intentionally or unintentionally conceal their physical, behavioral and psychological defects. For example, sperm providers conceal that their family members have certain genetic diseases or homosexual behaviors, and as a result, they transmit genetic diseases and AIDS to children born through artificial insemination.
(2) Sperm bank may ignore the quality of sperm because of competition or pursuit of profit. In order to pursue high quality, sperm banks only provide one kind of sperm that they think is "good". As a result, human genes may become monotonous and lack diversity.
(3) The commercialization of sperm not only brings harm to the above-mentioned artificial insemination children, but also forms a landslide to promote the commercialization of other human tissues and organs.
(4) The commercialization of sperm also goes against the wishes of sperm donors. Sperm donors who provide sperm should give love to others. It is a noble humanitarian act to help solve the infertility of others and provide sperm for the happiness of others' families, not to seek financial returns. Commercialization goes against the original intention of donors.
Providing eggs, fertilized eggs and embryos will also encounter the same problem.
2. Reproductive technology leads to the confusion of human ethical relations. "A new question raised by aid is' What is a father?' A child born with assistive technology can be said to have two fathers. One is the father who raised him (her), and the other is the father who provided half of his (her) genetic material. "With the combination of AID with in vitro fertilization and embryo transfer technology, the question of' what is a father' put forward by AID has expanded to the question of' what are parents'. ..... Mothers can be divided into three types: genetic mothers, pregnant mothers and nurturing mothers, and a complete mother is a combination of the three. Fathers are divided into' genetic fathers' and' nurturing fathers', and the combination of the two is' complete fathers'.
3. Reproductive technology destroys the laws of nature. In human genetics and reproductive biology, an iron law has been observed so far: parents produce offspring through the combination of genetic material DNA in sexual cells. Childbearing is the eternal embodiment of the combination of marriage and love. Reproductive technology has cut off the connection between fertility and marriage. Some people say that it turns fertility into reproduction, the sacred shop of the family into a biological laboratory, and divides human beings into two categories: those that reproduce by technology and those that reproduce by nature.
4. Reproductive technology may be misused or abused. "Misuse" means that the motive of implementing reproductive technology is moral, but immoral results may occur for various reasons. For example, in Sweden, a white-skinned couple gave birth to a black-skinned child through artificial insemination, which was due to the mistakes of technicians.
"Abuse" means that some operators do not operate reproductive technology according to socially recognized ethical principles. For example, an artificial insemination expert in Britain claimed to use her husband's sperm or buy sperm from a sperm bank, but actually used her own sperm for artificial insemination, thus giving birth to more than 6,000 children who were artificially inseminated. Therefore, she was awarded the title of "the father who has the most children in the world", which caused endless troubles.
Third, about the current situation of reproductive technology ethics in China.
(A) the ethical principles of artificial insemination and in vitro fertilization-embryo transfer
1, pure purpose principle The purpose of artificial insemination and in vitro fertilization-embryo transfer can only be to treat and compensate the reproductive function of married couples, and also to prevent eugenics. Evolutionary eugenics is not allowed at present.
Anyone who meets China's marriage law and family planning policy because of the health status of husband and wife can of course have children through artificial insemination, in vitro fertilization-embryo transfer and other compensatory birth methods.
2, the principle of informed consent For artificial insemination and in vitro fertilization-embryo transfer surgery, the informed consent of the patient must be obtained; And must obtain the informed consent of both husband and wife.
3. The principle of equal rights between children born in wedlock and children born out of wedlock forms a parent-child relationship with couples who receive reproductive technology, and has nothing to do with men and women who provide reproductive cells. The rights and obligations of children born in wedlock are equal to those of children born in wedlock. You can give an example.
4. The principle that the conditions of sperm donors and egg attackers are restricted is that no one can donate sperm or eggs and must meet certain conditions after inspection. For example, the human sperm bank should conduct health examination and strict screening of sperm donors, and should not collect semen from people with one of the following circumstances: family history of hereditary diseases or hereditary diseases; Mental patients; Infectious disease patients or pathogen carriers; Long-term exposure to radiation and harmful substances; Those who fail the semen examination; Other patients with serious organic diseases.
5. The principle of avoiding consanguineous marriage and keeping medical secrets must take measures to avoid consanguineous marriage. Marriage registration departments, household registration management departments and other relevant departments can establish files; Limit the number of donations and medical structure of sperm donors and egg donors.
For sperm donors, egg donors, couples who receive reproductive technology, artificial insemination and IVF, confidentiality should be maintained. We should not only keep secrets from the society, but also keep secrets between them to avoid unnecessary troubles.
6. Principles for determining technical hygiene standards Medical institutions must meet certain conditions, such as having all kinds of necessary testing technologies and equipment conditions; Have a professional technical team; There are a certain number and scale of sperm donors and egg donors; Strict rules and regulations, etc.
(2) Surrogacy technology and asexual reproduction
Although surrogacy technology has not been banned in some countries, according to the current ethical situation in China, people's acceptance may have caused a lot of confusion in interpersonal relationships, so surrogacy technology is prohibited. Therefore, the "Measures for the Administration of Human Assisted Reproductive Technology" promulgated by the Ministry of Health clearly stipulates that medical institutions and medical personnel may not implement any form of surrogacy technology.
Reproductive cloning technology, namely human asexual reproduction, is considered immoral by the leading medical ethics in the world at present. Our government also made it clear: "We don't approve, support, allow or accept any experiments of human cloning."