Children's Bioethics Centre, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
J Med Ethics. 2024 Oct 22;50(11):778-785. doi: 10.1136/jme-2022-108512.
Reproduction is broadly recognised as fundamental to human flourishing. The presumptive priority of reproductive freedom forms the predominant position in the literature, translating in the non-sexual reproductive realm as an almost inviolable right to access assisted reproductive technology (ART). This position largely condemns refusal or restriction of ART by clinicians or the state as discriminatory. In this paper, I critically analyse the moral rights individuals assert in reproductive pursuit to explore whether reproductive rights entitle hopeful parents to ART. I demonstrate that none of the protected actions performed, or entitlements generated are sui generis 'reproductive' rights, leading to the claim that there is no such thing as a right to reproduce. Under scrutiny, the reproductive right is a far narrower and weaker rights assertion than is recognised in the literature. I argue that the predominant position is grounded in a fundamental misunderstanding of the scope and strength of reproductive claims.I also highlight a significant conceptual inconsistency in the literature. On one hand, there is broad consensus that reproductive rights are predominantly negative, yet access to fertility treatment is framed as a component of the right. This wrongly contorts the negative nature of reproductive rights into a positive claim-right to ART. I conclude that this mistakenly frames ART access as sitting within the scope of reproductive freedom. I offer a revised conceptual paradigm of reproductive rights that has important clinical and policy implications for the provision and regulation of ART.
生殖被广泛认为是人类繁荣的基础。生殖自由的假定优先地位构成了文献中的主要立场，在非性生殖领域转化为获得辅助生殖技术（ART）的几乎不可侵犯的权利。这一立场在很大程度上谴责临床医生或国家拒绝或限制 ART 的行为是歧视性的。在本文中，我批判性地分析了个人在生殖追求中主张的道德权利，以探讨生殖权利是否使有希望的父母有权获得 ART。我表明，没有任何受保护的行为或产生的权利是独特的“生殖”权利，因此没有所谓的生殖权利。经过审查，生殖权利是一种比文献中所承认的更为狭隘和脆弱的权利主张。我认为，主要立场是基于对生殖主张的范围和强度的根本误解。我还强调了文献中的一个重大概念不一致。一方面，人们广泛认为生殖权利主要是消极的，但获得生育治疗被视为权利的一个组成部分。这错误地将生殖权利的消极性质扭曲成了对 ART 的权利主张。我得出结论，这错误地将 ART 准入框定为生殖自由的范围。我提供了一个经过修订的生殖权利概念范式，这对提供和监管 ART 具有重要的临床和政策意义。
