Zaami Simona, Driul Lorenza, Sansone Milena, Scatena Elisa, Andersson Karin Louise, Marinelli Enrico
Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Clinic of Obstetrics and Gynecology, Hospital of Udine, DAME, University of Udine, 33100 Udine, Italy.
Healthcare (Basel). 2021 Nov 1;9(11):1486. doi: 10.3390/healthcare9111486.
Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights.
不孕症是一个高度相关的全球性问题,影响着全球至少15%的育龄夫妇的生殖健康。不孕症问题的范围和严重程度在发展中国家更为普遍,主要是由于未治疗的生殖道感染。然而,不孕症不仅仅是无法生育,还会带来巨大的心理、社会和伦理影响。体外受精(IVF)和其他辅助生殖技术(ARTs)逐渐成为广泛的治疗选择。毕竟,实施医学辅助生殖程序以克服不孕症符合1994年在开罗举行的国际人口与发展会议(ICPD)制定的生殖权利议程的宗旨。尽管如此,对于如何以符合伦理的方式实施和监管此类干预措施,人们仍然心存疑虑。此类技术发展的不懈步伐扰乱了与生殖相关的性观念以及家庭本身的概念。这种分歧有可能在生物伦理可持续性和执行方面引发危机,当科学和创新超过我们在医疗实践中赖以获得基本指导的生物伦理准则时,这种危机必然会发生。作者主张一种监管和决策方法,将对这类干预措施可能对基本生物伦理原则和不可剥夺的人权带来的潜在风险进行全面评估放在首位。