Ethics: use and misuse of assisted reproductive techniques across species.

Abstract

The boundaries of what we are able to do using ARTs are fast-moving. In both human and veterinary medicine, this presents a fundamental question: ‘Just because we can, should we?’ or, to rephrase the same question: ‘How can we distinguish between what is a use and a misuse of an ART, across species?’ This paper assesses the scientific evidence base for and against the use of ARTs and offers a personal opinion on how we can use such evidence to inform an ethical distinction between justifiable and unjustifiable uses of the techniques. It is argued that the law provides a necessary but insufficient basis for such distinctions. Based on the evidence about harms and benefits, ARTs may be classified into three groups: those which should be rarely used; those for which current evidence supports arguments both for and against their use and those which there is an ethical imperative to use. To which category a particular ART falls into varies depending upon the species to which it is being applied and the reason we are using it. In order to ensure that our ethical oversight keeps up with our technical prowess, the medical and veterinary professions should keep discussing and debating the moral basis of the use of ARTs, not only with each other but also with the lay public.Lay summaryThe use of assisted reproductive techniques (ARTs) has become commonplace in both human and veterinary medicine. Technical limitations are rapidly advancing. This raises a fundamental issue: ‘How can we distinguish between what is a use and a misuse of an ART, across species?’. ‘Misuse’ may be defined both in terms of physical and psychological harms and of moral disquiet about ‘interfering with nature’. This paper assesses the scientific evidence base for and against the use of ARTs and provides a personal opinion on how we can use such evidence to inform an ethical distinction between justifiable and unjustifiable uses of the techniques. We need to consider not only legal but also non-legal ethical justifications for their use. Based on the evidence about harms and benefits, ARTs may be classified into three groups: those which should be rarely used; those for which current evidence supports arguments both for and against their use and those for which there is an ethical imperative to use. To which category a particular ART falls into varies depending upon the species to which it is being applied and the reason we are using it. Open discussion between the medical and veterinary professions and the public is necessary to ensure that ethical oversight of the use of ARTs across species keeps up with technical developments.