Bioethicists often refer to the four basic principles of health care ethics when evaluating the merits and difficulties of medical procedures.  Ideally, for a medical practice to be considered "ethical", it must respect all four of these principles: autonomy, justice, beneficence, and non-maleficence.  The use of reproductive technology raises questions in each of these areas.

• Autonomy

          Requires that the patient have autonomy of thought, intention, and action when making decisions regarding health care
          procedures.  Therefore, the decision-making process must be free of coercion or coaxing.  In order for a patient to
          make a fully informed decision, she/he must understand all risks and benefits of the procedure and the likelihood of
          success.  Because ARTs are highly technical and may involve high emotions, it is difficult to expect patients to be
          operating under fully-informed consent.
 

• Justice

The idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in
society. Requires that procedures uphold the spirit of existing laws and are fair to all players involved.  The health care provider must consider four main areas when evaluating justice: fair distribution of scarce resources, competing needs, rights and obligations, and potential conflicts with established legislation.  Reproductive technologies create ethical dilemmas because treatment is not equally available to all people.
 
• Beneficence

Requires that the procedure be provided with the intent of doing good for the patient involved.  Demands that health care providers develop and maintain skills and knowledge, continually update training, consider individual circumstances of all patients, and strive for net benefit.
 
• Non-maleficence

Requires that a procedure does not harm the patient involved or others in society.  Infertility specialists operate under the assumption that they are doing no harm or at least minimizing harm by pursuing the greater good.  However, because
assistive reproductive technologies have limited success rates uncertain overall outcomes, the emotional state of the patient may be impacted negatively.  In some cases, it is difficult for doctors to successfully apply the do no harm principle.

[Home] [Previous]