Journal articles on the topic 'Fertilization in vitro Moral and ethical aspects'

Fertility treatments raise a range of social and ethical issues regarding self-identity for family, sexual intimacy, and the interests and welfare of potential children. Eggs and sperm are combined to produce fertilized eggs. These eggs are then implanted as embryos and grow into viable fetuses, which are carried by the original mother or a surrogate mother. This artificial form of conception can challenge religious values and family structures. In-vitro fertilization (IVF) can be considered either as a medical miracle or playing with divinity. What obligation do medical professionals have to infertile women and to what extent? The bioethical dilemma of IVF use encompasses different moral issues for all involved in the process. Ethical issues address respect for personal autonomy, access and care, and the duty of the health care provider to be compassionate to persons whose actions and moral values may be different from their own. Health care providers need to impart empathy, understanding and sensitivity towards this unique type of patient population. The conflict for those treating patients who are trying to conceive by IVF includes respect for personal autonomy, nonmaleficence, justice, utility and the ethics of care. As a registered nurse in a postpartum hospital unit, I have seen antepartum and postpartum women involved with this new technology. I have worked with mothers and their partners as they experience different levels of anxiety and hope for the future. There is an underlying psychosocial connection with patients who undergo IVF treatments. The purpose of this article is to explore the ethical use of IVF on older women. Is this type of biotechnolgy being applied for the right reasons and for the best patient population?

The paper provides a definition of sexual and reproductive health and infertility and also reflects modern ideas about ways to overcome infertility using assisted reproductive technologies, such as in vitro fertilization (IVF) and surrogacy. It shows the specificity of the impact of an IVF procedure on the mental health of a potential mother. The features of the neonatal health status, as well as neuropsychiatric disorders in babies born using the IVF procedure are described. The authors present two types of surrogacy (traditional and gestational ones) and the features of their use in different countries according to governmental legislative regulation, socioeconomic and religious factors, and cultural traditions in society. They unveil the features of a psychological relationship between the mother (surrogate and presumed one) and the fetus. The consequences of surrogacy for a surrogate mother, genetic parents, and a child himself/herself are noted to be little studied. It is shown that the development of assisted reproductive technologies (IVF and surrogacy), on the one hand, helps fight infertility and, on the other hand, entails a number of problems (moral and ethical, legal, cultural and religious, socioeconomic, and neuropsychiatric ones) that need to be solved in order to prevent psychological, neurological, and mental abnormalities in all the participants (a surrogate mother, an unborn child, and potential parents) in the assisted reproductive process:

"Contemporary Health Care poses a lot of challenges, which sometimes are incompatible with the maintenance of the Christian faith. The report aims to analyze the discussions in the Russian Orthodox community to find the solution to the question: Does the participation of Orthodox infertile couples in Reproductive technologies (e.g. In Vitro Fertilization - IVF) coordinate with traditional Christian morality? Nowadays the Orthodox community is divided into conservatives, who are totally against being involved in IVF, and liberals, who suppose that some of the variants of IVF are admissible. The report provides an analysis of bioethical issues of Reproductive Technologies from the Orthodox point of view. The author posits that the dilemma discussed is false. It’s possible to avoid grievous ethical problems while using IVF. All of them are not equal. Some aspects are absolutely inappropriate. Others, falling short of the mark but not too far, still might be permitted due to the dispensation to a suffering person. The author discusses conservative and liberal arguments, which were articulated in the International Congress of Orthodox Doctors (2015) and at a panel discussion of Inter-Council Presence of Russian Orthodox Church (2017 – 2019). Cases of Orthodox infertile couples counseled by the author will show the need for some flexibility in resolving these issues. In the report the following cases of counseling will be discussed: A) Surrogacy in case of Snow Flakes Adoption); B) Ectogenesis – growing embryos and fetuses in artificial wombs; C) Cryopreservation of embryos; D) the use of IVF in secondary infertility. The work was done within the project of the Russian Science Foundation “Problems of bioethics in the historical context and socio-cultural dynamics of society” (№ 18-78-10018), carried out based on FSBEI HE PRMU MOH Russia. "

In vitro fertilization (IVF) stands out as one of the contemporary period's most extraordinary technologies, and its social and ethical consequences among the most far reaching. Despite its uncertain effectiveness and medical consequences, IVF has contributed significantly to the medicalization of infertility and the increasingly imperative character of reproductive technology. New developments in IVF, particularly oocyte donation, have created new definitions of treatable infertility and new social needs for IVF; when the technology does not result in pregnancy or healthy babies, these developments have created profound new disappointments. IVF and the commodification of the extracorporeal embryo have also confused the social meaning and legal definition of parenthood. Ultimately the relationship between prospective parents, infertility specialists, and the embryos that they create is a highly ambiguous one. This ambiguity is likely to be a long-term characteristic of efforts to develop, use, and assess assisted reproductive technologies.

Having been commonly practiced, in vitro fertilization (fertilization in a tube/baby tube program) is one of the controversial medical practices both for religious reasons and for ethical and moral reasons. From the ethical/moral point of view, the problem lies in the fact that the implication of such a practice may result in the destruction of the remaining unused embryos. In this article, the writer argues from the point of view of maqāṣid asy-syarī‘ah that the practice of in vitro fertilization is much needed by the infertile couples who want to have children. The embryo's moral status starts from the implantation of the blastocyst in the women’s uterine wall, so that the zygote of fertilization in the pre-implantation tubes does not have a moral status yet.[Walaupun telah jamak dilakukan, fertilisasi in vitro (pembuahan dalam tabung/bayi tabung) merupakan salah satu praktis medis yang konroversial baik karena alasan agama maupun karena alasan etika dan moral. Dari segi etika/moral, permasalahannya adalah implikasi dari praktik itu yang berakibat pada pemusnahan sisa embrio yang tidak digunakan. Dalam tulisan ini penulis berargumerntasi dari sudut pandang maqāṣid asy-syarī‘ah bahwa praktik fertilisasi dalam tabung sangat dibutuhkan oleh pasangan tidak subur yang mendambakan keturunan. Status moral embrio dimulai sejak implantasi sehingga zigot hasil fertilisasi dalam tabung praimplantasi belum memiliki status moral].

In-vitro fertilization is becoming a pressing issue in contemporary societies. The article considers it starting form the Polish debate but takes up its broader anthropological an ethical aspects. Dealing with the latter, it also employs some acute remarks from Dignitas Personae. Finally it considers an approach to in vitro against the background of European Convention on Bioethics. In its conclusion the paper offers a balanced pro-life stance, albeit critical of in vitro.

This world literature review tries to determine the significance of the gamete donation in the field of assisted reproductive technologies as well as the availability of treatment methods using donation in in vitro fertilization programs. Gamete donation is regulated by every country's national legislation system, and quite often the laws vary between the states. There are practically no universal standards and/or rules in this area, which, in turn, leads to an ambivalent reaction towards reproductive practices.

In Vitro fertilization (IVF) is considered objectively immoral by the Catholic Church. However, there are several alternatives that have not been specifically addressed by the Church. This article discusses several of these alternatives and examines their viability from a moral standpoint. This is done with specific attention to fertility efforts used following uterus transplantation (UTx).

AbstractEthical considerations are central to all medicine though, likely, nowhere more essential than in the practice of reproductive endocrinology and infertility. Through in vitro fertilization (IVF), this is the only field in medicine involved in creating human life. IVF has, indeed, so far led to close to 10 million births worldwide. Yet, relating to substantial changes in clinical practice of IVF, the medical literature has remained surprisingly quiet over the last two decades. Major changes especially since 2010, however, call for an updated commentary. Three key changes deserve special notice: Starting out as a strictly medical service, IVF in recent years, in efforts to expand female reproductive lifespans in a process given the term “planned” oocyte cryopreservation, increasingly became more socially motivated. The IVF field also increasingly underwent industrialization and commoditization by outside financial interests. Finally, at least partially driven by industrialization and commoditization, so-called add-ons, the term describing mostly unvalidated tests and procedures added to IVF since 2010, have been held responsible for worldwide declines in fresh, non-donor live birthrates after IVF, to levels not seen since the mid-1990s. We here, therefore, do not offer a review of bioethical considerations regarding IVF as a fertility treatment, but attempt to point out ethical issues that arose because of major recent changes in clinical IVF practice.

In Germany — as probably worldwide — in vitro fertilization (IVF) has provoked disapproval, fears, and dread, but it also raises hope and gives feelings of pride and satisfaction in a new scientific achievement. Critics look for convincing argu- ments that could ban IVF completely or at least restrict it considerably. Some of the most important arguments are outlined below.The main aspect of IVF that was new to society was that conception could take place outside the female body. Although this fact has made a deep impression on us, no ethical relevance has been attributed to it. One must look further for arguments against IVF.

In March 1988 the People's Republic of China announced the birth of the first test-tube baby born to a 39-year-old infertile peasant woman. This surprise announcement appeared in strong contradiction to China's population reduction goals amidst a population crisis. Yet, the media attention given to this medical achievement would seem to be consistent with the political, social, and economic changes taking place in the last decade, including technological innovation as the key to a modern socialist nation. In short, this announcement highlights tensions facing China as it simultaneously attempts to modernize within a trans-national economy, control population, and maintain traditional Confucian family values within a rapidly changing context.

When infertility clinics offer money-back guarantees, they prefer to give them more delicate names such as “shared risk,” “warranty,” or “outcome” programs. We should not allow such daintiness to distract us from the bottom line of these programs which are all about the bottom line.John Robertson and Theodore Schneyer defend such programs as special forms of insurance, what they call “risk-of-failure insurance.” They argue, in “Professional Self-Regulation and Shared-Risk Programs for In Vitro Fertilization,” that the criticisms of in vitro fertilization (IVF) shared-risk programs by the American Medical Association (AMA) and others are off the mark. It would be sufficient, Robertson and Schneyer contend, to develop guidelines for informed consent or protocols that discourage risky clinical procedures. They acknowledge that shared risk plans “present problems if not offered with full disclosure and attention to patient interests,” but they insist that “there is no reason why they cannot be implemented in an ethically sound way.”

One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART) and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity.

Preimplantation genetic diagnosis (PGD) is a new method of prenatal diagnosis that is developing from a union of in vitro fertilization (IVF) technology and molecular biology. Briefly stated, PGD involves the creation of several embryos in vitro from the eggs and sperm of an interested couple. The embryos are permitted to develop to a 6-to-10-cell stage, at which point one of the embryonic cells is removed from each embryo and the cellular DNA is analyzed for chromosomal abnormalities or genetic mutations. An embryo or several embryos found to be free of genetic abnormalities are subsequently transferred to the woman's uterus for gestation. Embryos found to carry a genetic abnormality are discarded or frozen. Extra normal embryos may be frozen for future transfer or donation to another couple.

In vitro fertilization (IVF) is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures (19.6 deliveries per initiated cycle). As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns have emerged. One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine (ASRM), the Society for Assisted Reproductive Technology (SART), and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act.

The topicality of the article is due to the strategy of transition to personalized medicine in Russia, based, among other things, on technologies of preimplantation and prenatal genetic diagnostics. The purpose of the article is to analyze the main directions of ethical and legal support for the development of these technologies. The work is based on the study of relevant international regulations, foreign and Russian legislation using the methods of legal-dogmatic and philosophical-legal analysis. The article substantiates the need for a clearer distinction between legal and moral-religious approaches to regulating relations in applying these technologies. The task is to find legal structures that can take into account the moral aspects of the problem without replacing legal regulation with an appeal to moral and religious values and norms. An example of this approach is the development of a legal regime for manipulations with embryo in vitro, in which the necessary legal protection of the embryo is provided by recognizing its special ontological status as a constitutional value of the common good. From these positions, the author identifies a range of issues that should form the organizational and legal context necessary to ensure adequate guarantees of human rights in the field of application of the considered genetic technologies. The legal regulation of this range of issues should be fixed in a special federal law on genetic testing.

When in vitro fertilization (IVF) treatments first appeared in Hungarian legislation, the related experiences and the moral dilemmas of couples who go through these procedures were unknown. Couples have to make a great variety of decisions during the IVF process. In our study, we focus on the journey of the human embryo in IVF treatment through the ethical lenses of women. In order to explore the differences between established ethical and legal frameworks and the perspectives of women who have participated in an IVF procedure in Hungary, we conducted semi-structured interviews. In contrast to the static view of embryos typical to a part of the ethics literature, which also characterizes most established legal frameworks, patients’ view of embryos of interviewees was dynamic: they interpreted embryos in a malleable and constantly changing way. Embryos were perceived differently depending on time, place, and biological characteristics, and primarily in relation to how they could contribute to achieving the goals of treatment. In this article, we also demonstrate that the main ethical framework that the participants in our research evoked in relation to the IVF process was related to the ethics of medical treatment. At the end of the paper we also make an attempt to draw some conclusions that may help ameliorate problems with the current normative ethical and legal framework by incorporating the experiences of women who participate in IVF procedures.

Abstract BACKGROUND Studying the human peri-implantation period remains hindered by the limited accessibility of the in vivo environment and scarcity of research material. As such, continuing efforts have been directed towards developing embryo-like structures (ELS) from pluripotent stem cells (PSCs) that recapitulate aspects of embryogenesis in vitro. While the creation of such models offers immense potential for studying fundamental processes in both pre- and early post-implantation development, it also proves ethically contentious due to wide-ranging views on the moral and legal reverence due to human embryos. Lack of clarity on how to qualify and regulate research with ELS thus presents a challenge in that it may either limit this new field of research without valid grounds or allow it to develop without policies that reflect justified ethical concerns. OBJECTIVE AND RATIONALE The aim of this article is to provide a comprehensive overview of the existing scientific approaches to generate ELS from mouse and human PSCs, as well as discuss future strategies towards innovation in the context of human development. Concurrently, we aim to set the agenda for the ethical and policy issues surrounding research on human ELS. SEARCH METHODS The PubMed database was used to search peer-reviewed articles and reviews using the following terms: ‘stem cells’, ‘pluripotency’, ‘implantation’, ‘preimplantation’, ‘post-implantation’, ‘blastocyst’, ‘embryoid bodies’, ‘synthetic embryos’, ‘embryo models’, ‘self-assembly’, ‘human embryo-like structures’, ‘artificial embryos’ in combination with other keywords related to the subject area. The PubMed and Web of Science databases were also used to systematically search publications on the ethics of ELS and human embryo research by using the aforementioned keywords in combination with ‘ethics’, ‘law’, ‘regulation’ and equivalent terms. All relevant publications until December 2019 were critically evaluated and discussed. OUTCOMES In vitro systems provide a promising way forward for uncovering early human development. Current platforms utilize PSCs in both two- and three-dimensional settings to mimic various early developmental stages, including epiblast, trophoblast and amniotic cavity formation, in addition to axis development and gastrulation. Nevertheless, much hinges on the term ‘embryo-like’. Extension of traditional embryo frameworks to research with ELS reveals that (i) current embryo definitions require reconsideration, (ii) cellular convertibility challenges the attribution of moral standing on the basis of ‘active potentiality’ and (iii) meaningful application of embryo protective directives will require rethinking of the 14-day culture limit and moral weight attributed to (non-)viability. Many conceptual and normative (dis)similarities between ELS and embryos thus remain to be thoroughly elucidated. WIDER IMPLICATIONS Modelling embryogenesis holds vast potential for both human developmental biology and understanding various etiologies associated with infertility. To date, ELS have been shown to recapitulate several aspects of peri-implantation development, but critically, cannot develop into a fetus. Yet, concurrent to scientific innovation, considering the extent to which the use of ELS may raise moral concerns typical of human embryo research remains paramount. This will be crucial for harnessing the potential of ELS as a valuable research tool, whilst remaining within a robust moral and legal framework of professionally acceptable practices.

Objective Assisted reproduction combines innovative technologies and new forms of procreation through gamete donation; however, it also leads to moral and ethical issues and to the wide application of referential bioethics. The objective of the present study was to understand the bioethical context of shared oocyte donation. Methods The present qualitative study used the Collective Subject Discourse methodology to interview donors and recipients in Brazil. Results Donors suffer from infertility, and in vitro fertilization opens the possibility of having a child; however, the cost is high, and helping the recipient is more important than the financial cost. The recipients regret delaying motherhood; adopting a child is their last option, and they desire to feel the physical stages of pregnancy. The recipients find the rules unfair regarding the lack of an oocyte bank and the fact that the treatment must be performed in shared cycles; however, oocyte donation makes it possible to realize the common dream of motherhood. Conclusion The obtained data showed that the patients are suffering and frustrated due to infertility, and they realize that in vitro fertilization may be the treatment they need. These women believe that children are essential in the constitution of the family, and scientific advances bring about innovative technologies and new forms of family constitution, with repercussions in the social, economic, political, and family contexts that lead to bioethical questions in Postmodernity.

Background.The moral status of the human embryo is particularly controversial in the United States, where one debate has centered on embryos created in excess at in vitro fertilization (IVF) clinics. Little has been known about the disposal of these embryos.Methods.We mailed anonymous, self-administered questionnaires to directors of 341 American IVF clinics.Results.217 of 341 clinics (64 percent) responded. Nearly all (97 percent) were willing to create and cryopreserve extra embryos. Fewer, but still a majority (59 percent), were explicitly willing to avoid creating extras. When embryos did remain in excess, clinics offered various options: continual cryopreservation for a charge (96 percent) or for no charge (4 percent), donation for reproductive use by other couples (76 percent), disposal prior to (60 percent) or following (54 percent) cryopreservation, and donation for research (60 percent) or embryologist training (19 percent). Qualifications varied widely among those personnel responsible for securing couples' consent for disposal and for conducting disposal itself. Some clinics performed a religious or quasi-religious disposal ceremony. Some clinics required a couple's participation in disposal; some allowed but did not require it; some others discouraged or disallowed it.Conclusions.The disposal of human embryos created in excess at American IVF clinics varies in ways suggesting both moral sensitivity and ethical divergence.

The development of reprogenetics during the last two decades of the XX century has brought a new age of reproduction. The paper surveys different types of reprogenetics in a wider sense, i.e. different assisted reproductive technologies (ART) that include manipulation of female reproductive cell out of a woman's womb. Development of reprogenetics is documented by available quantitative indicators of the number and success of ART procedures in developed countries at the beginning of the XXI century. Since 1978, when the first baby was born from in vitro fertilization, the number of children born that way has reached 1% of all children, and in some countries even over 3%. Moreover, existing documentation is incomplete and does not include all forms of assisted reproduction - in reality, the importance of assisted reproduction is even higher and becomes demographically significant. Hence the paper indicates existing and potential effects of the ART development on the demographic development i.e. on specific demographic aspects of this phenomenon. It also points out the effects on the level of fertility, on the changes of direct fertility determinants, and on the levels of mortality and infant mortality, as well as a new understanding of birth control, the possibility of affecting biological structures, and the changes of the fundaments of marriage and family. Development perspectives of reprogenetics are also being raised in the context of bioethical discussions and indicate ethical dilemmas related to assisted reproduction. Solutions to the dilemmas define the scope of applying new reproductive technologies in the future.

Sex is not the answer to everything, though young men think it is, but it may be the answer to the intractable debate over the ethics of human embryonic stem cell research. In this paper, I advance one ethical principle that, as yet, has not received the attention its platitudinous character would seem to merit. If found acceptable, this principle would permit the beneficial use of any embryonic or fetal tissue that would, by default, be lost or destroyed. More important, I make two appeals to consistency, or to parity of reasoning, that I believe show that no one who either has used or intends to use sexual reproduction as their means of procreation, nor indeed anyone who has unprotected heterosexual intercourse, nor anyone who finds in vitro fertilization (IVF) acceptable, nor anyone who believes that abortion is ever permissible can consistently object on principle to human embryo research nor to the use of embryonic stem cells for research or therapy.

The frequency of structural chromosomal transpositions can range from 1.8 to 8% among patients with reproductive disorders. There are several types of the rarest chromosomal abnormalities: insertion (insertion of a chromosomal region) and inversion (rotation of a chromosome region). This article describes a clinical case of the infertility treatment using assisted reproductive technologies in a woman with a rare chromosomal abnormality: simultaneous insertion and inversion of chromosomes 46, XX, ins (13;4)(q34;p14p15.3), inv(4)(p14q12). The structure and frequency of chromosomal aberrations were determined by high-throughput sequencing in preimplantation embryos. The result of the sequencing analysis showed that unbalanced variants for a known pathology were detected in 9 (56.3%) out of 16 observations, while in 6 (37%) only for a pathology known in the karyotype and in 3 (19%) they were presented simultaneously with the pathology of other chromosomes or with mosaicism. According to the results of the study, in preimplantation embryos, where one of the parents had chromosomal abnormalities, in addition to unbalanced variants, there is aneuploidy of other chromosomes not involved in the known pathology. They are described in 3 (21%) out of 14 observations of all identified pathology. In this regard, patients with aberrations in the karyotype are recommended, whenever possible, to carry out preimplantation genetic testing of structural rearrangements by methods allowed to analyze all chromosomes simultaneously. For example, high-throughput sequencing on the Illumina platform may become an alternative for prenatal diagnostics, which is performed in fertile couples with high risk of having a child with hereditary or congenital disorders. In the case of detection of chromosomal changes in the fetus, patients are faced with a number of ethical issues related to the necessity for medical abortion, which may contradict their religious and moral convictions.

Преимплантационная генетическая диагностика (тестирование) (ПГД/ПГТ) моногенных заболеваний направлена преимущественно на предотвращение рождения ребенка с наследственным заболеванием посредством обследования эмбрионов до имплантации в лечебном цикле ЭКО (экстракорпорального оплодотворения). Строгим показанием для ПГД генной болезни служит высокий риск рождения ребенка с тяжелой формой многогенного заболевания при отсутствии противопоказаний и ограничений. С расширением показаний для ПГД и возможностей генетического тестирования возникают вопросы по нормативному регулированию и этической ответственности врача при проведении процедуры. Этические вопросы возникают, когда генетический риск ниже показателя, расцениваемого как высокий, заболевание не может быть однозначно отнесено к тяжелым, а также при рассмотрении возможности переноса аномального эмбриона. Этические аспекты ПГД рассмотрены с точки зрения базовых этических принципов: пользы и непричинения вреда, автономии, справедливости. В сравнении с пренатальной диагностикой, реализация этих принципов при ПГД сталкивается с рядом дополнительных сложных вопросов. Ценность эмбрионов человека, вероятность оставить супружескую пару без детей должны соотноситься с действительным риском и тяжестью возможного заболевания. Preimplantation genetic diagnosis/testing (PGD/PGT) for monogenic disorders is directed on prevention of the birth of the child with a hereditary disorders by means of testing embryos before implantation in IVF (in vitro fertilization). The high risk of severe form of a single gene disease is a strict medical indication for PGD for monogenic disorders at condition of contraindications and restrictions lack. Extension of PGD indications and genetic testing opportunities raises questions on standard regulation and ethical responsibility. Ethical questions are happening if a genetic risk is lower than the «high» or the disease cannot be classified as serious and if abnormal embryo transfer is proposed. Ethical aspects of PGD are considered in terms of basic ethical principles: beneficence, non-maleficence, autonomy and justice. In comparison with prenatal diagnostics, realization of these principles at PGD faces a number of additional difficult questions. The value of the human embryos and probability to have no children has to correspond to the valid risk and severity of a possible disease.

Marriage is a social institution. Couples may have their own children via procreation, in the standard course of nature. Unfortunately, infertile couples are unable to have children. The infertility may be either medical or social. There is an underlying urge in every human being to produce biological descendants who will carry on their lineage in society. Although, a barren couple has the task of learning to cope with their lack of children both internally and externally. As a result, they believe they must turn to artificial insemination, in vitro fertilization, test-tube babies, as well as surrogacy, amongst other methods, in order to ensure their survival in society. These methods brighten their eyes and satisfy their yearning for genetically identical offspring. These advancements have aided infertile couples and adults in overcoming reproduction difficulties caused by infertility, such as medical reasons, the loss of a spouse, being separated, homosexual couples, or gay couples, among other things. Through this paper, I would like to enlighten on surrogacy. Here we would discuss various aspects like meaning, method, types, socio-legal, ethical issues, and various reproductive techniques. In modern age surrogacy is very popular in the whole world. Therefore, surrogacy is a highly sensitive and delicate issue. Indeed, it is high time to enact a law to regulate surrogacy in India. The present paper is totally based on secondary sources of data such as legal journals, books, magazines, newspapers and websites sources etc.

Embryonic stem cells (ESC) are a useful tool for studying embryonic development, cell differentiation, and genetic manipulation. Moreover, these cells can be applied in cell-based therapies and in vitro organogenesis. The research conducted with human ESC has generated many ethical, moral, and religious considerations by scientists and laymen alike. Therefore, an animal model such as the pig (Sus scrofa) is valuable in overcoming such hurdles because this species holds physiologic parameters similar to humans. In spite of the great biomedical potential of ESC, many difficulties have been faced in maintaining these cells in a pluripotent state in vitro. For this reason, studies to elucidate the mechanisms of in vitro maintenance of undifferentiated ESC are needed to improve the culture of these cells. The objectives of this study were (1) to isolate ESC from in vitro- and in vivo-produced swine blastocysts; (2) to compare 2 in vitro culture conditions to maintain isolated inner cell masses (ICM), murine embryonic fibroblasts (MEF), or Matrigel; and (3) to identify and to compare the expression of the pluripotency markers Nanog, Sox2, and FoxD3 at ESC and in vitro- and in vivo-produced swine blastocysts. In this manner, swine blastocysts were obtained by in vitro maturation and fertilization of oocytes from ovaries collected in abattoirs. Embryos were in vitro cultured for 7 days until blastocyst stage. In addition, in vivo-produced blastocysts were obtained by superovulation followed by AI of gilts (150 days of age). Embryos were collected by post-mortem uterus flushing 5 days after ovulation. In vitro- and in vivo-produced blastocysts were submitted to immunosurgery to isolate the ICM. Briefly, zona pellucida was digested with pronase solution, and embryos were incubated with anti-swine rabbit serum to remove trophoectoderm cells and with guinea-pig complement serum. Resultant ICM (14 and 66 ICM from in vitro- and in vivo-produced blastocysts, respectively) were cultured in stem cells media (GMEM added by 15% FCS, 0.1 mM β-mercaptoethanol, 1% nonessential amino acids, and 4 ng mL-1 of basic fibroblast growth factor) over monolayer of irradiated mouse embryonic fibroblasts (MEF) or Matrigel for 3 weeks. No difference was observed between the in vitro culture conditions (MEF and Matrigel) on isolated ICM adhesion. In addition, no difference was verified between in vitro- and in vivo-produced blastocysts on adhesion of cultured ICM. However, no swine ESC was obtained. Gene expression analysis was performed only with whole in vitro- and in vivo-produced blastocysts. Results showed that Nanog and Sox2 were less expressed in in vitro-produced blastocysts. However, the expression of FoxD3, demonstrated in this study for the first time, was similar between groups. Because no ESC lineage was obtained in swine until now, we believe this species has different requirements compared with murine and human. Therefore, more studies are necessary to establish protocols to isolate porcine ESC. Acknowledgments are given to FAPESP (processes 06/58507-0 and 07/51732-0).

LANGUAGE NOTE | Document text in Chinese; abstract also in English.因人類輔助生殖技術應用引發的生命倫理問題，已成為現代生命倫理學界研究的重點領域。隨著輔助生殖技術的進步與發展，所產生的生命倫理問題也愈來愈複雜，現代生命倫理學各學派對這些倫理問題的爭論也愈來愈激烈。本文以儒家家庭倫理觀對這些倫理問題進行解析，以期為解決這些倫理問題爭論提供一個新的視角。Assisted reproductive technology (ART) has provided both opportunities and crises for people to achieve pregnancy and reproduction by artificial or partially artificial means. As Chinese people have been shaped by Confucian family values, they are committed to pursuing the continuity, integrity, and prosperity of the family. Applying ART is not unethical in principle. However, different types of ART carry different ethical implications and should be defined clearly according to the Confucian moral perspective.Confucian ethics is committed to maintaining the continuity of the family. For infertile couples, both artificial insemination (AI) and in vitro fertilization (IVF) can be beneficial and justifiable, as long as the sperms and eggs involved are only from the husband and wife. However, according to the Confucian understanding of the integrity of the family, an AI or IVF by donor, rather than the husband, would destroy the blood-tie of the family, and is therefore ethically unjustifiable. In addition, Confucianism appreciates that a normal family must have both a husband and a wife, and that a child ought to be born in a normal family with both a father and a mother. Accordingly, it is ethically problematic for single men or women to use ART to conceive a child. Moreover, it is very difficult for Confucians to defend the practice of surrogate motherhood because the intrusion of another woman into a family would significantly threaten the peace and integrity of the family and be harmful to the development of the child.This paper does not intend to argue that all traditional Confucian ethical views are absolutely right and should never be changed. It does, however, argue that Confucian moral values and commitments should be taken seriously. These values and commitments are still vibrant in Chinese people’s lives, although they have not been promoted systematically in national politics. As they are embedded in the Chinese ways of life, Chinese bioethicists should carefully examine these views and provide relevant arguments for their preferred programs and solutions regarding the application of reproductive technologies.DOWNLOAD HISTORY | This article has been downloaded 169 times in Digital Commons before migrating into this platform.

The problem of consent in the question of the right to life Under particular questions in the field of the right to life occurs the problem of consent which is discussed mainly in the context of legalization of abortion, euthanasia, in vitro fertilization and capital punishment. The question of consent in filed of the right to life is important for the discussions to this theme and is related to the understanding of nature of the right to life, both in juridical and moral perspective. The common accordance in the right to life has an impact on the actual solutions in the range of respect for life and concrete activities and choices of people in this field. The presented paper explains the nature of the consent in the question of the right to life, indicates problematic aspects in this regard and shows some arguments in the process of achievement of common accordance in the problem of the right to life. Wśród szczegółowych zagadnień w obszarze problematyki ochrony prawa do życia występuje zagadnienie konsensu, które jest dyskutowane głównie w kontekście legalizacji ustawodawstwa dotyczącego aborcji, eutanazji, sztucznego zapłodnienia, kary śmierci. Zagadnienie konsensu w kwestii prawa do życia jest kluczowym dla społecznych dyskusji na ten temat i wiąże się z rozumieniem natury prawa do życia, zarówno w perspektywie prawniczej, jak i moralnej. Problem ten ma także znaczenie dla przyjmowanych rozstrzygnięć w zakresie poszanowania życia ludzkiego oraz konkretnych działań i wyborów ludzi w tym obszarze. Niniejszy tekst jest próbą wyjaśnienia istoty konsensu w kwestii prawa do życia, wskazuje na kwestie problematyczne w dyskusjach na ten temat i przedstawia niektóre argumenty w procesie dochodzenia do powszechnej zgody w zakresie prawa do życia.

Human embryonic stem (ES) cell lines have opened great potential and expectation for cell therapy and regenerative medicine. Monkey and human ES cell lines, which are very similar to each other, have been established from monkey blastocysts and surplus human blastocysts from fertility clinics.Nonhuman primate ES cell lines provide important research tools for basic and applicative research. Firstly, they provide wider aspects of investigation of the regulative mechanisms of stem cells and cell differentiation among primate species. Secondly, their usage does not need clearance or permission from the regulative rules in many countries that are associated with the ethical aspects of human ES cells, although human and nonhuman embryos and fetuses are very similar to each other. Lastly and most importantly, they are indispensable for animal models of cell therapy to test effectiveness, safety, and immunological reaction of the allogenic transplantation in a setting similar to the treatment of human diseases.So far, ES cell lines have been established from rhesus monkey (Macaca mulatta), common marmoset (Callithrix jacchus), and cynomolgus monkey (Macaca fascicularis), using blastocysts produced naturally or by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). These cell lines seem to have very similar characteristics. They express alkaline phosphatase activity and stage-specific embryonic antigen (SSEA)-4 and, in most cases, SSEA-3. Their pluripotency was confirmed by the formation of embryoid bodies and differentiation into various cell types in culture and also by the formation of teratomas that contained many types of differentiated tissues including derivatives of three germ layers after transplantation into the severe combined immunodeficiency (SCID) mice.The noneffectiveness of the leukemia inhibitory factor (LIF) signal makes culture of primate and human ES cell lines prone to undergo spontaneous differentiation and thus it is difficult to maintain these stem cell colonies. Also, these ES cells are more susceptible to various stresses, causing difficulty with subculturing using enzymatic treatment and cloning from single cells. However, with various improvements in culture methods, it is now possible to maintain stable colonies of monkey ES cells using a serum-free medium and subculturing with trypsin treatment. Under such conditions, cynomolgus monkey ES cell lines can be maintained in an undifferentiated state with a normal karyotype and pluripotency even after prolonged periods of culture over 1 year. Such progress should facilitate many aspects of stem cell research using both nonhuman primate and human ES cell lines.

Abstract Thirty percent of patients who need a hematopoietic stem cell transplant (HSCT) have an HLA-matched related donor. Many other patients find a suitably matched unrelated donor through one of the registries of volunteer donors available worldwide. However, some children (and especially children from ethnic minorities) will still not be able to secure a suitable donor. In these cases, parents may seek to have another child in order to create a matched sibling donor – often called a ‘savior sibling’. This practice is morally contentious and generates intense debate. A process is now available to assist parents in this endeavor. It involves three technologies that are proven, legal, available and in use – namely, in vitro fertilization, pre-implatation genetic diagnosis and HLA typing. There is currently no clinical consensus about whether (and if so, how) to advise parents about this option. A study has been conducted examining the attitudes of health professionals and parents concerning the creation of ‘savior siblings’, and of the relevant clinical practices. The study includes in-depth, semi-structured interviews with a range of health professionals involved in the care of children needing HSCT. Twenty-one interviews were conducted with practitioners in clinical genetics, genetic counseling, hematology, oncology, immunology, neurology, and nursing regarding knowledge about the combined technologies, clinical indications for their potential use, and ethical issues arising regarding savior siblings. Interviews were also conducted with ten parents who have been faced with decisions about HSCT for a sick child, to find out how much they know and understand about treatment options, to identify any issues they raise concerning the combined technologies, and discuss what information they expect from health professionals. All interviews were transcribed and analyzed using established qualitative methods to identify emergent themes. Major findings from the study include the following. Clinicians, including pediatric hematologists and oncologists, rarely discuss these technologies unless the parents raise the topic themselves. They do not discuss these combined technologies for a number of reasons including: lack of knowledge about the techniques (including cost and availability); doubts about their clinical utility; and the moral appropriateness of using these technologies to create a savior sibling. In the parental interviews, parents consistently reported wanting to know about all therapeutic options and overwhelmingly dismissed the ethical arguments raised against creating a savior sibling. Interestingly, despite concern about discussing this potential option with parents, when health professionals placed themselves in the position of a parent making treatment decisions for their children, they reported that they would also want full disclosure about available technologies. These finding are relevant to not only the combined technologies involved in creating a savior sibling but to any new drug or technology involved in hematology and transplantation. Discussions involving emerging or contentious technologies need to occur consistently in the clinical setting.

Le tecniche di riproduzione assistita (ART) offrono la possibilità di una maternità surrogata alle coppie sterili o senza figli. Alla fine degli anni ‘80, specialisti qualificati in India hanno approfittato della disponibilità di madri surrogate e dell’assenza di regole per creare un mercato di maternità surrogata per i clienti sia indiani sia esteri. Il Ministero della Salute è intervenuto con le linee guida solo dopo forti proteste di gruppi di donne e cittadini, facendo seguito alle storie su ostelli surrogati, bambini abbandonati e sfruttamento. Nel frattempo, le cliniche dell’infertilità si sono moltiplicate, offrendo gameti di donatori, fecondazione in vitro e maternità surrogata ad un costo molto inferiore rispetto ai paesi occidentali. Dai primi anni del 2000, l’India è divenuta la destinazione più popolare per la pratica della maternità surrogata. In risposta alle proteste e consapevole del divieto di accordi di maternità surrogata negli altri paesi, il Governo indiano ha emanato le linee guida ART che erano via via restrittive; ma tali disposizioni non sono state in grado di arginare il business ormai florido. Infine, nel 2016, il governo ha proposto un disegno di legge per porre fine alla maternità surrogata commerciale. Il regolamento Bill 2016 considera esclusivamente gli accordi di maternità surrogata, non considerando tutti gli altri aspetti della riproduzione assistita e delle cliniche coinvolte. La legislazione è stata rivolta principalmente alle questioni sociali e agli elementi di sfruttamento della maternità surrogata commerciale, più che al processo tecnico. Se approvata, tale legge vieterà efficacemente maternità surrogata commerciale in India. ---------- Assisted Reproductive Technologies (ART) offer the possibility of unrelated surrogacy arrangements to infertile couples and childless human relationships. In the late 80s, qualified specialists in India took advantage of the availability of willing surrogates and the absence of regulations, to create a market in commercial surrogacy for clients from within the country and abroad. The Ministry of Health stepped in with guidelines only after strong protests from women’s groups and citizens, following media stories of surrogate hostels, abandoned children and exploitation. Meanwhile, ‘infertility’ clinics mushroomed, offering donor gametes, in-vitro fertilization and surrogacy services at a fraction of the cost in western countries. By early 2000s, India had emerged as the most popular destination for commercial surrogacy arrangements. In response to protests from doctors, citizens and human rights groups, and mindful of the ban on commercial surrogacy arrangements in most developed countries, the Government issued ART guidelines that were progressively restrictive; but these did not have the teeth to rein in the lucrative business that commercial surrogacy had transformed into. Finally, in 2016, the Government proposed a Bill that would bring an end to commercial surrogacy. The Surrogacy (Regulation) Bill 2016 addressed surrogacy arrangements exclusively, taking it out of proposed ART Bill that was aimed at comprehensively regulating all other aspects of assisted reproduction and the clinics involved. The legislation was directed mainly at the social issues and exploitative elements specific to commercial surrogacy arrangements, rather than the technical process. If passed, the Surrogacy Bill will effectively ban commercial surrogacy in India.

This article analyzes the slippery slope argument and its application to the problem of legalizing euthanasia and physician-assisted suicide. The argument is often referred to in discussions of abortion, in vitro fertilization, etc., but it has been little developed in the Russian-language literature. This explains the relevance and novelty of this article. The focus is on the ways of representation of the argument in research. It distinguishes its main types: logical (disintegrating into no-principle distinction argument and the soritical argument), empirical (or psychological argument), and non-logical (metaphorical). Each of these types of argument is constructed according to a certain principle and has a number of features and critiques. A common place for criticism of an argument is its focus on the future so that it makes reasoning probabilistic. The logical type of argument is centered around denoting the transition between the original event and its adverse consequences and denotes the action of social factors to accelerate the transition. The no-principal distinction argument implies that there is no moral distinction between the events at the beginning and the end of the slope. The soritical argument involves intermediate steps between questionable and unacceptable practices. The conceptual slope is another variant of the logical kind of argument. The empirical argument illustrates a situation of changing societal values which results in an easier acceptance of morally disapproved practices. The metaphorical argument is used to illustrate the metaphor of slope and the situation of the accumulation of small problems that lead to serious undesirable results. The non-logical kind of argument centers around the routinization of practice, desensitization, and exploitation of unprotected groups in society. Exploitation can be called the victims' slope. It grounds its consideration on the abuse of the practice being administered. Application of the ethical methodology (theoretical-logical and empirical-historical) to the types of arguments and ways of their application allows us to highlight the value component of the argument, to determine its dilemma nature and to correlate it with bioethical principles. The application of bioethical principles to suppress the transition to undesirable consequences is critiqued on the basis of particularly difficult cases in which one is unable to articulate one's decision. The criticism of the argument is built on the probabilistic nature of the reasoning, the lack of reflection on the underlying premise and the lack of empirical evidence. It concludes that the slippery slope argument is incapable of being the only valid justification for rejecting the practices of physician-assisted suicide and euthanasia.

The sphere of reproductive rights is still beyond the scope of a thorough legal analysis, and it is not given due attention in the legal literature. This may be due to the fact that the concept of reproductive rights is new to Ukrainian law and has not yet found its proper place in the general system of law. There is a lack of scientific development in the issue of protection of the rights of the child to birth, trafficking in human beings for the purpose of exploiting surrogate mothers or children born as a result of surrogate motherhood, etc. The purpose of the study is to analyze the legislative, doctrinal and moral aspects of reproductive rights and to identify effective legal measures to improve the legal regulation of surrogate motherhood in Ukraine and the proper legal protection of the child before and after birth. Experimenting with human gene material as a conception in vitro turns children into a commodity. There is an artificial situation in which wealthy men will hire women to provide contracting services to their offspring. It is difficult to disagree that in surrogate motherhood, as in any business, personal financial gain dominates. So, from this point of view, surrogacy is a kind of market and business. The conception of the child is not a right, but an opportunity that is not given to all, but surrogate motherhood turns the child into an "object of economic agreement and contract, a kind of ordering of goods." The child cannot be considered as an object of property. It is unacceptable to consider the practice of surrogacy as ethical. In addition, forced commercial surrogate motherhood falls within the definition of trafficking in human beings. The issue of reproductive technology must be addressed in such a way that the child born as a result of surrogate motherhood does not fall prey to further exploitation. The author concluded that in many countries with a licensing or altruistic regime, many aspects of the use of assisted reproductive technologies and surrogate motherhood remain unregulated. There is no clear understanding of all the principles and standards governing the use of assisted reproductive technologies and surrogacy agreements. In general, the legislation lacks sufficient standards and provisions to protect the rights of parties to surrogacy agreements. The most controversial issues are the rights of the surrogate mother, the expectant parents and the children born as a result of the surrogate motherhood. At the present stage, legal adaptation of society to the development of medicine in the field of reproductive technologies has not yet taken place in Ukraine. Cases such as the birth of several children by surrogate mothers, births of a child with developmental disabilities, birth of a dead child or miscarriage, the need for an artificial interruption of pregnancy according to the medical opinion of doctors, the termination of marriage by genetic parents, the death of one or both parents. Keywords: reproductive rights, surrogacy motherhood, legal regulation, legal protection, embryo, child rights, family, surrogacy agreement.

Abstract Abstract 4536 Background Allogeneic hematopoietic cell transplantation (HCT) is the only proven cure for pediatric patients with sickle cell disease (SCD). Because rates of disease-free survival are highest with human-leukocyte-antigen-(HLA)-matched siblings, the paucity of suitable donors has limited its use. Hundreds of cases of HLA-matched embryo selection have been reported using in-vitro fertilization (IVF) combined with pre-implantation genetic diagnosis (PGD) for diseases that are significantly less prevalent than SCD. Despite the wide availability of these procedures, few families of children with SCD have undergone IVF and PGD for HCT purposes. Objective To elicit SCD patient and caregiver understandings of SCD, IVF, PGD, and HCT, including their opinions on using these technologies to produce genetically ideal HCT donors for existing children with SCD. Methods Adult patients and parents of children with the Hb-SS genetic variant of SCD were recruited from outpatient pediatric hematology clinics and the pediatric inpatient unit of a New York City hospital. Participants first completed a questionnaire and received written information on IVF, PGD, and HCT. A 40-minute, semi-structured interview was conducted at a following appointment. Individual interviews were recorded, transcribed, and analyzed using qualitative methods with three independent coders. Results To date, 23 participants have completed the interview process. In this ethnically diverse sample, 14 participants had Medicaid, 5 had Medicare, 3 had private medical insurance, and 1 had no insurance. 7 participants were unaware of HCT as a potential cure for pediatric SCD, and 17 did not realize IVF and PGD could be combined to prevent SCD before pregnancy. Only 2 had heard of IVF/PGD being used to select HLA-matched embryos for potential HCT of an existing child with SCD. After receiving basic information, the participants unanimously supported discussing them to all SCD families as a potential cure of SCD. As anticipated, a significant minority (6) of participants expressed strong ethical, religious, and/or moral misgivings about undergoing IVF/PGD for HCT purposes and stated that, if offered, they would likely decline the procedures. However, the majority of participants (17) concluded that, while the rights of the donor child should be considered, the potential to perform curative HCT for a child with SCD would justify their decision to undergo IVF and PGD. Regardless of their position, all participants identified the primary barrier to accessing IVF and PGD as financial. Interestingly, preliminary data analysis suggests that the procedures would increase in acceptability if IVF and PGD were made financially accessible via medical insurance coverage. Conclusions The selection and implantation of HLA-matched embryos for the purpose of collecting ideal umbilical cord blood for HCT has engendered worldwide debate. However, these discussions rarely incorporate the perspectives of those who would directly benefit from these procedures: people who suffer from diseases curable by HCT or have children who do. Though our single-institution study was limited by our reliance on hypothetical scenarios to elicit participants' opinions, our interviews voiced the attitudes that 23 SCD patients or their families had about IVF, PGD, and HCT. As anticipated, opinions were divided. Yet, regardless of their beliefs, the sample unanimously claimed that lack of awareness and high cost are the two fundamental barriers that patients and families affected by SCD face to accessing these procedures. These findings suggest not only that medical professionals have neglected to adequately educate the SCD population about available treatment options, but that medical insurance has failed to provide adequate coverage for preventive procedures and curative therapies for SCD patients. Only through increased patient education and more comprehensive medical insurance can SCD families make informed decisions that could impact the prognosis of their, or their children's, disease. Disclosures: No relevant conflicts of interest to declare.

The issue of the journal opens with an article dedicated to the formation of metrology as government regulated activity in France. The article has discussed the historical process of development of metrological activity in France. It was revealed that the history of metrology is considered as an auxiliary historical and ethnographic discipline from a social and philosophical point of view as the evolution of scientific approaches to the definition of individual units of physical quantities and branches of metrology. However, in the scientific literature, the little attention is paid to the process of a development of a centralized institutional metrology system that is the organizational basis for ensuring the uniformity of measurements. The article by Irena Grebtsova and Maryna Kovalska is devoted to the of the development of the source criticism’s knowledge in the Imperial Novorossiya University which was founded in the second half of the XIX century in Odesa. Grounding on a large complex of general scientific methods, and a historical method and source criticism, the authors identified the stages of the formation of source criticism in the process of teaching historical disciplines at the university, what they based on an analysis of the teaching activities of professors and associate professors of the Faculty of History and Philology. In the article, the development of the foundations of source criticism is considered as a complex process, which in Western European and Russian science was the result of the development of the theory and practice of everyday dialogue between scientists and historical sources. This process had a great influence on the advancement of a historical education in university, which was one of the important factors in the formation of source studies as a scientific discipline. The article by Tetiana Malovichko is devoted to the study of what changes the course of the probability theory has undergone from the end of the 19th century to our time based on the analysis of The Theory of Probabilities textbook by Vasyl P. Ermakov published in 1878. The paper contains a comparative analysis of The Probability Theory textbook and modern educational literature. The birth of children after infertility treatment of married couples with the help of assisted reproductive technologies has become a reality after many years of basic research on the physiology of reproductive system, development of oocyte’s in vitro fertilization methods and cultivation of embryos at pre-implantation stages. Given the widespread use of assisted reproductive technologies in modern medical practice and the great interest of society to this problem, the aim of the study authors from the Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine was to trace the main stages and key events of assisted reproductive technologies in the world and in Ukraine, as well as to highlight the activities of outstanding scientists of domestic and world science who were at the origins of the development of this area. As a result of the work, it has been shown that despite certain ethical and social biases, the discovery of individual predecessor scientists became the basis for the efforts of Robert Edwards and Patrick Steptoe to ensure birth of the world's first child, whose conception occurred outside the mother's body. There are also historical facts and unique photos from our own archive, which confirm the fact of the first successful oocyte in vitro fertilization and the birth of a child after the use of assisted reproductive technologies in Ukraine. In the next article, the authors tried to consider and structure the stages of development and creation of the “Yermak”, the world's first Arctic icebreaker, and analyzed the stages of preparation and the results of its first expeditions to explore the Arctic. Systematic analysis of historical sources and biographical material allowed to separate and comprehensively consider the conditions and prehistory for the development and creation of “Yermak” icebreaker. Also, the authors gave an assessment to the role of Vice Admiral Stepan Osypovych Makarov in those events, and analyzed the role of Sergei Yulyevich Witte, Dmitri Ivanovich Mendeleev and Pyotr Petrovich Semenov-Tian-Shansky in the preparation and implementation of the first Arctic expeditions of the “Yermak”icebreaker. The authors of the following article considered the historical aspects of construction and operation of train ferry routes. The article deals with the analysis and systematization of the data on the historical development of train ferry routes and describes the background for the construction of train ferry routes and their advantages over other combined transport types. It also deals with the basic features of the train ferries operating on the main international train ferry routes. The study is concerned with both sea routes and routes across rivers and lakes. The article shows the role of train ferry routes in the improvement of a national economy, and in the provision of the military defense. An analysis of numerous artefacts of the first third of the 20th century suggests that the production of many varieties of art-and-industrial ceramics developed in Halychyna, in particular architectural ceramic plastics, a variety of functional ceramics, decorative tiles, ceramic tiles, facing tiles, etc. The artistic features of Halychyna art ceramics, the richness of methods for decorating and shaping it, stylistic features, as well as numerous art societies, scientific and professional associations, groups, plants and factories specializing in the production of ceramics reflect the general development of this industry in the first half of the century and represent the prerequisites the emergence of the school of professional ceramics in Halychyna at the beginning of the 20th century. The purpose of the next paper is to analyze the formation and development of scientific and professional schools of art-and-industrial ceramics of Halychyna in the late 19th – early 20th centuries. During the environmental crisis, electric transport (e-transport) is becoming a matter for scientific inquiry, a subject of discussion in politics and among public figures. In the program for developing the municipal services of Ukraine, priorities are given to the development of the infrastructure of ecological transport: trolleybuses, electric buses, electric cars. The increased attention to e-transport on the part of the scientific community, politicians, and the public actualizes the study of its history, development, features of operation, etc. The aim of the next study is to highlight little-known facts of the history of production and operation of MAN trolleybuses in Ukrainian cities, as well as to introduce their technical characteristics into scientific circulation. The types, specific design solutions of the first MAN trolleybus generation and the prerequisites for their appearance in Chernivtsi have been determined. Particular attention has been paid to trolleybuses that were in operation in Germany and other Western European countries from the first half of the 1930s to the early 1950s. The paper traces the stages of operation of the MAN trolleybuses in Chernivtsi, where they worked during 1939–1944 and after the end of the Second World War, they were transferred to Kyiv. After two years of operation in the Ukrainian capital, the trolleybuses entered the routes in Dnipropetrovsk during 1947–1951. The purpose of the article by authors from the State University of Infrastructure and Technologies of Ukraine is to thoroughly analyze unpaved roads of the late 18th – early 19th century, as well as the project of the first wooden trackway as the forerunner of the Bukovyna railways. To achieve this purpose, the authors first reviewed how railways were constructed in the Austrian Empire during 1830s – 1850s. Then, in contrast with the first railway networks that emerged and developed in the Austrian Empire, the authors made an analysis of the condition and characteristics of unpaved roads in Bukovyna. In addition, the authors considered the first attempt to create a wooden trackway as a prototype and predecessor of the Bukovyna railway.

The aim. The purpose of this study is based on a study of Ukrainian experience in the field of legal regulation of the use and donating of embryos in vitro for research purposes and infertility treatment, analyzing cases of European Court on human rights in this field, to suggest ways to fill the gaps in current legislation of Ukraine and bring it into line with international law. The subject of the research was the legal regulation of donating embryos for scientific research and for the infertility treatment in Ukraine, which is an interesting experience for scientists from other countries, since Ukraine has become a candidate for European Union (EU) membership, and thus the peculiarities of the legal regulation of embryo donation in Ukraine will allow us to identify the positive and negative aspects of embryo donation and the possibility of conducting a comparative analysis with foreign regulation. In Ukraine, donation of gametes and embryos is a procedure according to which donors, with written voluntary consent, provide their reproductive cells-gametes (sperm, oocytes) or embryos for use in other persons within the treatment of infertility. The application of embryo donation is carried out according to medical indications, subject to the presence of written informed voluntary consent of the patients, ensuring the anonymity of the donor and maintaining medical secrecy. The study is based on an interdisciplinary approach to the analysis of the problem of legal protection of the embryo using dialectical, comparative legal, and systemic methods. The research used scientific developments in the field of problems of the legal status of the human embryo, international acts, the legislation of Ukraine, the practice of the European Court of Human Rights (ECHR). Conclusion. The issue of legal protection of intellectual property rights, the object of which is the human genome, tissues or cells, is currently being hotly debated in the world. However, legal approaches to the possibility of patenting such objects can be divided into those that completely deny the patenting of the human genome, as well as other human tissues and cells, and those that cause such a process of certain restrictions of moral, ethical and legal nature, such as for example, the issue of ensuring the confidentiality of information about the person whose materials are being investigated. It seems that in view of the above practice of the ECHR, it would be appropriate to establish the possibility of free use of the results of such research, which would be in the interests of society and science. Donors of embryos in Ukraine can be patients of the in vitro fertilization program, who have unused cryopreserved embryos left in the cryobank after the birth of a child. In case of fertilization of donor oocytes with donor sperm, their transfer into the recipient's uterine cavity or cryopreservation (with subsequent transfer in subsequent cycles) are possible. With the voluntary, informed, written consent of donor patients, these embryos may be used for donation to an infertile patient/recipient couple, as well as unmarried female recipients. Assignment of embryos and embryo-fetal materials to the category of biological material does not mean that they are subject to the rules of property law, but they should be considered as special objects that are under state protection and are in close legal personal connection with the above mentioned persons, who are given the right to determine their future fate within the limits established by law. The right to dispose of embryos for research purposes may be granted by the woman and the man for whom the embryo was created, subject to informed consent and consent to the processing of personal data.

Scientific innovations continue to advance the possibilities of human reproduction, raising important empirical and ethical questions. In vitro fertilization, disease reproductive genetic technologies, and enhancement reproductive genetic technologies are three reproductive technologies with varying moral support. Instead of assuming moral poles, we use original, nationally representative survey data of US adults ( N = 8107) and multinomial logistic regression to examine how religiosity and orientations toward science shape the moral acceptability, amorality, and the moral rejection of in vitro fertilization, disease reproductive genetic technologies, and enhancement reproductive genetic technologies. We find that increased confidence and trust in science lowered the odds of holding moral concerns, while greater religiosity was associated with higher odds of viewing these technologies as morally wrong. Moral attitudes further varied across religious tradition as certain religious groups had significantly higher odds of viewing these technologies as amoral. Findings have implications for advancing understandings of morality around the faith-science interface beyond conceptions of a moral binary.

In a society in which the decoupling of sexuality and human reproduction has become normal, In vitro fertilization (IVF) has mutated into a kind of standard procedure. There is little awareness of the ethical ruptures that the mechanization of human reproduction causes. The basic ethical problem with extracorporeal fertilization in a test tube is that a child is not conceived through the personal union of a man and a woman, but is “produced” in a laboratory. In the context of human creation, this entails a series of ethical problems. The technique does not merely offer another possible option for action, but it leads to a fundamental change in the attitude towards human life as such. A look at the history of assisted reproductive technology (ART) since the 1970s reveals that ethical problems, eugenic visions as well as medical experiments on humans have been inherent to the method from the very beginning. Considering that eugenic thinking has been a driving force from the very beginning it astonishes that this delicate point has hardly been recognized and highlighted so far. Robert Edwards' (1925–2013) vision went far beyond the mere treatment of infertility through the use of IVF, which he saw as enabling the selection of so-called “unhealthy life.” The article considers the risks of IVF and includes recent studies by physicians involved in reproductive medicine who are increasingly critical of their industry. Furthermore it emphasizes the core ethical question on human reproductive technology, contrasting the “ethics of procreation” with the “ethics of production.” Summary The article highlights historical aspects, considers the risks as well as the ethical questions on assisted reproductive technology.

Abstract Background Current preimplantation genetic testing (PGT) technologies enable embryo genotyping across the whole genome. This has led to the development of polygenic risk scoring of human embryos (PGT-P). Recent implementation of PGT-P, including screening for intelligence, has been extensively covered by media reports, raising major controversy. Considering the increasing demand for assisted reproduction, we evaluated how information about PGT-P is communicated in press media and explored the diversity of ethical themes present in the public debate. Methods LexisNexis Academic database and Google News were searched to identify articles about polygenic embryo screening. This led to 535 news articles. 59 original articles met the inclusion criteria. Inductive content analysis was used to analyse these articles. Results 8.8% of articles gave embryo polygenic scoring a positive portrayal, while 36.8% expressed a negative attitude. 54.4% were neutral, mostly highlighting limited practical value of the technology in in vitro fertilization settings. We identified five main ethical themes that are also present in academic literature and the broader debate on reproductive technologies: a slippery slope towards designer babies, well-being of the child and parents, impact on society, deliberate choice and societal readiness. Conclusions Implementation of embryo polygenic profiling engenders a need for specific recommendations. Current media analysis discloses important ethical themes to consider when creating future guidelines for PGT-P.

Photo by Sangharsh Lohakare on Unsplash ABSTRACT The public should debate the ethical and social challenges arising from heritable human genome editing (HHGE). The notorious case involving He Jiankui may have led to the disfavor of gene editing and a precautionary approach. While the de facto global moratorium on HHGE is clearly justified considering our current inability to implement it safely and effectively, the difficult ethical considerations should be addressed prior to the ability to initiate widespread HHGE. This piece argues that prospective patients and other members of society beyond the scientific community must be included in the conversation. It emphasizes the potential role of those not directly participating in HHGE science, calling the broader academic community not simply to wait for scientists’ results and only afterward react. Pointing to key historical examples, I contend that scientific progress is intrinsically linked with the surrounding societal discussion and that it is not only scientists who can influence where the HHGE story ends. INTRODUCTION l. Rogue Scientists Chinese biophysicist He Jiankui announced the world’s first genetically modified babies in 2018. Naturally, the treatment aroused the attention of the world’s media, which focused on He’s reckless actions. Indeed, in setting up and carrying out the procedure in question, he flouted norms of good scientific practice on a range of levels—errors paid with time in prison. Since the He controversy, few scientists have aggressively approached heritable human genome editing (HHGE) and challenged the current research norms. The most outspoken exception is the Russian molecular biologist Denis Rebrikov of the Pirogov Russian National Research Medical University. He publicly declared his intention to apply clustered regularly interspaced short palindromic repeats (CRISPR) to embryos to help couples avoid passing serious medical conditions to their children. However, Rebrikov met fierce opposition both inside and beyond Russia and, with leading CRISPR scientists and bioethicists abroad describing him as a “cowboy” who had “weak data” and was trying to “grab some attention.”[1] So far, Rebrikov’s plans have failed to come to fruition. Although there are 126 entries listed in a registry of HHGE research recently created by the World Health Organization (WHO),[2],[3] it seems that clinical HHGE has been paused for the time being. ll. Steering the Conversation A section of the scientific community has been trying to steer the ethical debate on HHGE away from the actions of rogue scientists and back to an issue that is central to the matter—the interests of patients. The majority would agree that the most compelling potential application of germline genome editing is for the prevention of devastating genetic conditions, for example, when both parents carry Huntington’s disease, for which “genome editing offers the only prospect of bearing a healthy, genetically related child.”[4] Despite such justification for scientists to continue pursuing research in the area, there has been a notable reticence in the wider academic community regarding making the ethical case for HHGE and clarifying in which medical situations such a technique might be reasonably applied. Even among those who recognize that the HHGE cases' controversies should not be a reason for panic over designer babies, some believe that starting the ethical debate is premature. A key part of the argument is that the current technological and scientific knowledge available is far from ready to deliver on treatments. A similar stance preventing debate in the wider society is that “difficult questions” about cost, accessibility, and social justice remain.[5] Whether intended or not, the implication is that the position of wider society in the HHGE story should be a reactive one, namely waiting to see what the scientists throw at them and then dealing with it. I argue that there is not only an immediate need for broader academic and societal input on the ethical and social aspects of the HHGE debate but that there is a deep symbiosis between scientific progress and its surroundings, whereby science both shapes and is shaped by the societal environment in which it takes place. The WHO published a position paper, recommendations, and a framework for governance. The framework for governance describes global standards for the governance and oversight of HHGE.[6] The position paper emphasized the importance of global and inclusive dialogue,[7] and many other boards have also called for broad public engagement.[8] It is imperative that WHO’s governance framework meets everyone’s needs. After all, as with any medical treatment, it is not the scientist who developed the treatment or the doctor who delivers it that is most important– that honor falls to the patient. In the case of HHGE, the beneficiaries include those members of society who hope to reproduce. Yet HHGE has the potential to impact society. We all should have an opportunity to be a part of world-changing decisions that lead to the creation are made and feel a responsibility to participate. lll. Shutting Down the Academic Debate At the 30th Annual Conference of the Japanese Association for Bioethics, which took place in late 2018 after He’s experiment, the discussion about HHGE was shut down quickly. Notwithstanding the understandable issues raised with He’s case, one participant after another stood up to voice support for an outright and complete ban on the use of CRISPR.[9] The ban was based on the grounds that editing the human genome would result in a cascade of unforeseen and irreversible consequences for future generations. One participant forcefully argued that “the deoxyribose nucleic acid (DNA) rubicon should never be crossed for above all, it was deeply immoral to do so when there was no way of obtaining the consent of those who would actually stand affected—our descendants.”[10] Another saw it as putting humanity on a slippery slope toward enhancements, and some feared the catastrophic mistakes that might result from their use.[11] While the above event provides just one snapshot of the debate that was taking place around the world at the time, it captures the strong reservations in the scientific community. It is a common view, not only in Japan, that the human genome is something sacred, a relic handed down from generations, that we ought to treasure and preserve. In support of such a view, religious and other more pragmatic reasons are offered. For example, some may fear the disasters that might befall us if we choose to intervene in the process through which we pass our genetic code from one generation to another. Such arguments are certainly still at the heart of the ethical debate, but the foundations upon which they are built are by no means universally accepted. Stanford University bioethicist Henry Greely writes, “the human germline genome” does not exist; instead, each of us has a unique genome.[12] Greely argues that HHGE is no different from the changes our genomes have undergone through numerous medical interventions. For example, synthetic insulin has increased the number of people with DNA variations that lead to diabetes. Those with this condition would have died as a child in the past. However, now they live long enough to be able to reproduce. Similarly, the transition from hunting to farming centuries ago resulted in a greater number of copies in our gene pool of starch-digesting genes. Yet Greely suggested that, practically, HHGE is “not very useful in the near- to midterm” (by which he means “the next several decades”)[13] “mainly because other technologies can attain almost all the important hoped-for benefits of [HHGE], often with lower risk,” citing embryo selection and somatic gene editing as two alternative options. Greely argued that applying HHGE for enhancement beyond disease prevention and is currently not a realistic option because we lack the necessary knowledge. In Greely’s opinion, “how worried should we be [about HHGE]…? A bit, but not very and not about much.”[14] Greely’s assertions that other scientific debates should take precedence and that the concerns are not ripe for debate yet are concerning. lV. Why Shutting Down the Debate Might Not be a Good Idea First, the timeframe described by Greely seems somewhat out of line with that described by leading scientists. As far back as 2018, at the same Summit where He made his revelations, George Q. Daley stressed that HHGE is scientifically feasible here and that the ethical considerations can no longer be put off: “…a number of groups have applied gene editing now to human embryos in the context of in vitro fertilization and attempting to determine variations of a protocol that would enhance the fidelity and reduce mosaicism. I think there has been an emerging consensus that the off-target problem is manageable, and in some cases even infinitesimal. There are some interesting proofs of principles, like diseases such as beta-thalassemia that could potentially be approached with this strategy.”[15] It would also be possible to challenge Greely on various other aspects. One of which would be the number of cases to which HHGE would be relevant and the kinds of moral allowances that might be made, and each case concludes that more urgency is required in the ethical debate. Greely suggests that most people can use preimplantation genetic testing (PGD), which is the embryo selection process, and that perhaps HHGE could apply to couples where both have the same autosomal recessive gene.[16] Greely rules out considering HHGE in cases where PGD is applicable. Greely concedes PGD does not already represent the answer on this topic, as it often fails to provide couples with enough healthy embryos to transfer. As a resolution to this issue, he points to the creation of eggs using induced pluripotent stem cell (iPSC) techniques, whereby eggs can potentially be created from other cells.[17] However, given the extremely limited success of iPSCs in the clinical arena to date, in vitro gametogenesis is a highly speculative solution. Certainly, the progress of iPSC research is not such a safe bet that placing all our hopes on it at the expense of HHGE techniques is currently justified. (Also, it should be noted that making eggs using the iPSC technique is hardly an ethical problem-free area itself.) In summary, the cases of couples looking to conceive that Greely rules out by pointing to PGD should be kept on the HHGE table, as various other scholars have suggested.[18] Many of us debating HHGE are not scientists, so the best we can do is draw from the information we glean from those more technically capable. As a society, we are not just passive observers of science; we should have influence over decisions that impact society. Indeed, even if the available science is not yet at a place where we should be worried about large-scale ethical and social concerns, the story will continue to unfold in the future. While Greely is happy to see the human race “muddle through” the ethical challenges of scientific breakthroughs, such a position fails to recognize that society at large is far from powerless. V. Society Influencing Scientific Progress There are some notable examples of society’s impact on scientific progress. For example, political policies led to the development of nuclear technology for war and strategic deterrence, despite societal objections seen through demonstrations of people protesting using the slogan “no nukes.” Furthermore, the Bush administration drastically limited the use of embryonic stem cells in the 2000s due to a strong religious and cultural influence on policy.[19] Societal debate potentially serves as a powerful factor in guiding science. Where societal acceptance is ambiguous, science tends to operate on its own. But where science would impact life’s fundamental issues like war, how embryos should be valued, or the end of life, society should weigh in and influence the role of science. Societal views on the current global moratorium on HHGE could lead to a ban, as has been advocated.[20] On the other hand, societal views that value HHGE as a way to expand reproductive autonomy may justify permitting its use. Opening an ethics debate about it would enable scientists to pursue technologies that society deems justifiable as well as set limits for where they should stop. Making this process more difficult, the He affair has clearly colored public discourse on HHGE in a way that inhibits debate. In Japan, a sequence of questionnaires in 2016, 2018, and 2019 showed that the widely publicized HHGE scandal led to a significant decline in the acceptance of genome editing technology in general, particularly for human reproduction. Specifically, the surveys revealed a stark rise in disapproval of the technology’s use on fertilized human eggs—from 12 percent in 2018 to 29 percent in 2019.[21] The three scientists that conducted these surveys suggested that “the news of the twin babies in China had a substantial influence on the Japanese public,” damaging the reputation of HHGE.[22] It seems likely that the public distaste for HHGE was prompted by He’s research rather than considerations about the scientific potential of HHGE The change in public opinion may also make politicians and scientists more hesitant when it comes to taking the lead in the HHGE debate. Ultimately, this can restrict the public discussion of the central ethical challenges of the technology and hinder efforts to determine whether there is a responsible path forward other than an outright ban. Stressing the importance of the issue again to potential patients and failing to engage further with the HHGE debate is surely not something society should allow. While there are many important ongoing debates about genetics, like biohacking and DIY hobbyists, HHGE deserves attention as well. In fact, attention to the ethics of HHGE should help — more awareness of how these tools can be applied and what germline genome editing is will make people more alert to the existing danger and better understand how to mitigate it. Perhaps more importantly, a clear message from society to researchers about what objectives are reasonable to pursue regarding the HHGE technologies will facilitate good science. Having a publicly determined criterion would allow scientists to not live in fear that they might be blacklisted for seeking progress in grey areas and instead confidently chase progress where it is allowed. Vl. What Now? HHGE is here (or will be soon) and brings many ethical and social challenges. However, the challenges should not be left to individual scientists and couples in desperate situations to manage alone. Moving toward how these challenges can be met practically, it is helpful to draw a parallel with the issue of implementing human rights. In the early 21st century, political philosopher Michael Freeman of the University of Essex lamented that implementing human rights had been left to lawyers. Although legal experts were clearly essential in putting together the global human rights framework, Freeman’s concern was that they were not best placed to understand implementing human rights in various contexts. Setting out a broader, interdisciplinary approach, he called for social scientists to tackle these difficult questions, ultimately moving human rights forward around the world. Similarly, in medical technology like HHGE, scientists are crucial to the story, but at the same time, they are not trained to deal with all the accompanying challenges. Bioethicists are also important, clarifying the arguments that society needs to resolve. There is a need for even wider input from across the scholarly community. For instance, as with human rights, international and domestic regulation is required, and clearly, the legal community has a role here. Moreover, as described by Freeman, since all law is political in its creation and has impacts across society, political scientists and sociologists can provide impactful input. CONCLUSION We are in it together, and we have roles to play in the discussion of HHGE. Societal discourse does not always trail the scientific reality, but rather, it can condition the path that science will follow. Given the importance of what is at stake, not only for the potential patients, but for humanity, we should not leave the HHGE debate only to scientists, and we should not leave it until later. - [1] Cohen J. “Embattled Russian scientist sharpens plans to create gene-edited babies,” Science, 21 Oct. 2019. doi:10.1126/science.aaz9337. [2] World Health Organization. “WHO issues new recommendations on human genome editing for the advancement of public health,” News release, 12 July 2021, www.who.int/news/item/12-07-2021-who-issues-new-recommendations-on-human-genome-editing-for-the-advancement-of-public-health. [3] World Health Organization. “Human Genome Editing Registry,” https://www.who.int/groups/expert-advisory-committee-on-developing-global-standards-for-governance-and-oversight-of-human-genome-editing/registry. [4] Daley GQ, Lovell-Badge R, and Steffann J. “After the Storm–A Responsible Path for Genome Editing,” New England Journal of Medicine 380, no. 10 (2019): 897-9. doi:10.1056/NEJMp1900504. [5] Daley GQ, Lovell-Badge R, and Steffann J. “After the Storm–A Responsible Path for Genome Editing,” New England Journal of Medicine 380, no. 10 (2019): 897-9. doi:10.1056/NEJMp1900504 [6] World Health Organization. “WHO issues new recommendations on human genome editing for the advancement of public health,” News Release, July 12, 2021, www.who.int/news/item/12-07-2021-who-issues-new-recommendations-on-human-genome-editing-for-the-advancement-of-public-health. [7] WHO 2021. Human Genome Editing: Position Paper, WHO Expert Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing. [8] Daley GQ, Lovell-Badge R, and Steffann J. “After the Storm–A Responsible Path for Genome Editing,” New England Journal of Medicine 380, no. 10 (2019): 897-9. doi:10.1056/NEJMp1900504. [9] 30th Annual Conference of the Japanese Association for Bioethics, 8-9 Dec. 2018, Kyoto Prefectural University, Kyoto. [10] 30th Annual Conference of the Japanese Association for Bioethics, 8-9 Dec. 2018, Kyoto Prefectural University, Kyoto. [11] 30th Annual Conference of the Japanese Association for Bioethics, 8-9 Dec. 2018, Kyoto Prefectural University, Kyoto. [12] Greely HT. “Why the Panic Over ‘Designer Babies’ Is the Wrong Worry,” LeapsMag, 30 Oct. 2017, leapsmag.com/much-ado-about-nothing-much-crispr-for-human-embryo-editing; Greely HT. “CRISPR’d babies: human germline genome editing in the ‘He Jiankui Affair’,” Journal of Law and the Biosciences 2019; 6(1): 111–83. doi: 10.1093/jlb/lsz010; Greely HT. CRISPR People: The Science and Ethics of Editing Humans (Massachusetts: Massachusetts Institute of Technology Press, 2021). [13] Greely HT. “Why the Panic Over ‘Designer Babies’ Is the Wrong Worry,” LeapsMag, 30 Oct. 2017, leapsmag.com/much-ado-about-nothing-much-crispr-for-human-embryo-editing. [14] Greely HT. “Why the Panic Over ‘Designer Babies’ Is the Wrong Worry,” LeapsMag, 30 Oct. 2017, leapsmag.com/much-ado-about-nothing-much-crispr-for-human-embryo-editing. [15] Daley, G. (n.d.). Genome-editing-pathways to Translation. Transcript of the Human-Genome Editing Summit 2018 Hong Kong. Retrieved March 17, 2022, from https://diyhpl.us/wiki/transcripts/human-genome-editing-summit/2018-hong-kong/george-daley-genome-editing-pathways-to-translation/ [16] Greely HT. “CRISPR’d babies: human germline genome editing in the ‘He Jiankui affair’,” Journal of Law and the Biosciences 2019: 6(1): 111–83. doi:10.1093/jlb/lsz010. [17] Greely HT. CRISPR People: The Science and Ethics of Editing Humans (Massachusetts: Massachusetts Institute of Technology Press, 2021). [18] Rasnich R. “Germline genome editing versus preimplantation genetic diagnosis: Is there a case in favour of germline interventions?.” Bioethics 2020; 34(1): 60–9. [19] Murugan, Varnee. “Embryonic stem cell research: a decade of debate from Bush to Obama.” The Yale journal of biology and medicine vol. 82,3 (2009): 101-3. [20] Lander E, Baylis F, Zhang F, et al. “Adopt a moratorium on heritable genome editing,” Nature 2019; 567(7747): 165–8. pmid:30867611. [21] Watanabe D, Sato Y, Tsuda M, and Ohsawa R. Increased awareness and decreased acceptance of genome-editing technology: The impact of the Chinese twin babies. PLoS ONE 2000; 15(1): 1-13. doi:10.1371/journal.pone.0238128. [22] Watanabe D, Sato Y, Tsuda M, and Ohsawa R. Increased awareness and decreased acceptance of genome-editing technology: The impact of the Chinese twin babies. PLoS ONE 2000; 15(1): 1-13. doi:10.1371/journal.pone.0238128.