ETHICAL ISSUES IN REPRODUCTIVE TECHNOLOGY AND ORGAN TRANSPLANTATION AND ETHICS PRINCIPLES

1. ETHICAL ISSUES IN ART'S
AND
ORGAN TRANSPLANTATION

2. By :
Group 8

3. 2011510087 HITENDRA SINGH
2011510089 HASHITA HADA
2011510090 KASHISH JAFRI
2011510091 KULDEEP MEENA
2011510092 MAULIKA POONIA
2011510093 MONIKA KULHARI
2011510094 LAKSHMAN SINGH CHOUDHARY
2011510095 AJAY JAKHAR
2011510097 PROMOTH SIVA PREM KUMAR
2011510098 ASWATHY PUSHPAKARAN GEETHA
2011510099 DINUDAS
2011510100 MONICA JOSEPH

4. REPRODUCTIVE
TECHNOLOGIES
NEW HOPE TO INFERTILE COUPLE

5.  ‘Infertility’ is clinically accepted as the
inability to conceive after 12 months of
actively trying to conceive.

6. ASSITED REPRODUCTIVE
TECHNOLOGIES
A medical intervention
developed to improve an
‘infertile’ couple’s chance of
pregnancy.
One of the best achievement
in the field of reproduction.

7. SOME ART ‘S
1.IVF
2.SURROGACY
3.CLONING

8. IN VITRO FERTILIZATION
IN VITRO (OUTSIDE)
FERTILIZATION
( OVUM +SPERM)

9. WHAT IS IVF?
IVF broadly deals with removal of eggs from the woman
fertilizing it in the laboratory and transferring the
fertilized eggs into the uterus after a few days later.
Following cause may be considered for IVF
• Failed ovulation induction
•Tubal diseases
•Endometriosis
•Idiopathic infertility

10. 4 basic steps
1. Superovulation
2. Egg collection
3. In vitro fertilisation
4. Embryo transfer
ALMOST
3 EMBRYOS
IVF cycle

11. Many embryos created.
Healthy ones kept but
defective embryos are
destroyed.
Healthy embryos can be
transferred to woman or they
can be frozen for use at later
date. Sometimes they are
experimented on.

12. Do you support the idea of
producing human embryos for
medical purposes? Why?
Not supporting new production
Superovulation procedure will be
risk because of excess usage of
drugs

13. But….

14. We support the use of
frozen embyos or other
unwanted healthy embyos
for stem research……
because

15. An early embryo that has not yet implanted into the uterus
does not have the psychological, emotional or physical
properties that we associate with being a person.
An embryo in the earliest stages is not clearly defined as an
individual
A fertilized egg before implantation in the uterus could be
granted a lesser degree of respect than a human fetus or a
born baby
Before day 14, the embryo has no central nervous system and
therefore no senses. If we can take organs from patients who
have been declared brain dead and use them for transplants,
then we can also use hundred-cell embryos that have no
nervous system.
If we destroy a blastocyst before implantation into the
uterus we do not harm it because it has no beliefs, desires,
expectations, aims or purposes to be harmed.

16. Louise Brown,
On July 25, 1978, in Oldham
FIRST IVF BABY

17. KANUPRIYA AGARWAL (DURGA))
WORLD’S SECOND AND INDIA’S FIRST
TEST TUBE BABY On oct 03 , 1978
Dr. Subhash Mukhopadhyay

18. • She born just 67 days
after Marie Louise
Brown was born.
• Dr. Subhash
Mukhopadhyay was
invited by the Kyoto
University in 1979 to
present his findings during
a seminar in Japan but
denied a passport by the
Indian government.
• The depressed physician
committed suicide in 1981.
Durga's birth was
caught in ethical and
moral controversies
The physician's
achievements were not
recognised at first.

19. Today there are more than 3 million
IVF Babies

20. Fertilization is confirmed before
implantation can occur.
Gives women with damaged
oviducts, the carry their own fetus.
Sometimes it may give
opportunity to older ones .
ADVANTAGES

21. Rajo devi lohan
with her daughter
Naveen
She become mom
in 70 through IVF

22. 1. No pregnancy
2. Multiple pregnancy
3. Ectopic pregnancy
4. OHSS – ovarian
hyperstimulation
syndrome. Managed
conservatively
DISADVANTAGES

23. Nadya Suleman, the California mother who
became known as the “Octomom” after she
gave birth to octuplets in 2009

24. Average cost of total
treatment
$10,000 - $25, 000
(American dollars)
Industry generates $ 2
billion per year.
IVF INDUSTRY

25. Israel is the world capital of in vitro
fertilisation
The second highest rate of IVF procedures is
in Iceland,
Another noteworthy fact is that Israel
provides free, unlimited in vitro procedures for
its citizens for up to 2 children per woman,
under 45 years of age.
TOP IVF COUNTRIES

26. We can help any couple to have a
baby, no matter what their medical
problem !
Third party reproduction
Embryo adoption
Donor eggs
Surrogate uterus
THE PROMISE OF ART'S

27. SURROGACY

28. “surrogacy is an arrangement
in which a women carries and
gives birth to the baby for the
couple who want to have a
child ”
What is surrogacy?
Substitute..?

29. TYPES OF SURROGACY

30. •TRADITIONAL SURROGACY
•GESTATIONAL SURROGACY
Surrogate is genetically related to child
Surrogate is not genetically related to child

32. ALTRUISTIC SURROGACY
TWO KINDS OF SURROGACY
ARRANGEMENTS
COMMERCIAL SURROGACY

33. Cindy reutzal act as surrogate for her daughter
Emily jordan in 2012
Cindy reutzalEmily jordan
What will be relation of child to the
surrogate…?
Mike jordan & Emily jordan

34. Commercial surrogacy is
legal in india since 2002
INDIA….why?
•Low cost
•Abundance of medical expertise
in the field.
•Inter- country commercial
surrogacy is unregulated.

35. ADVANTAGES
1. A Good Alternative to Adoption
2.Good option for couples who are of the
same gender and single parent.

36. Surrogacy for homosexuals…?
Illegal in india.
But legal in many other countries like
holland, belgium , canada, spain
As a doctor, patients decision is our
concern(autonomy) but be sure to respect law
( justice)
No interfere in personal life .

37. Legal aspects varies in different countries

38. DISADVANTAGES
issues in surrogates
Baby gammy with his
surrogate mom
Pattaramon Chanbua
Gammy’s biological parents
with his twin sister Pipah

39. Baby Manji--stateless baby,
july 2008 in India

40. Male homosexual couples, single
foreign men and women, nonmarried
couples and couples from countries
where surrogacy is illegal
Surrogacy is provided to single
men and women who are indian
citizens

41. AAMIR – KIRAN ‘S
SURROGATE BABY
BROUGHT SURROGACY
ISSUES IN INDIA INTO
SPOTLIGHT In 2011
CELEBRITIES OF INDIA

42. SHAHRUKH KHAN – GAURI ‘S 3RD
BABY BOUGHT
PREGNANACY THROUGH SURROGACY INTO
CENTRE STAGE IN INDIA in 2014

43. SOME SURPRIZES IN THE
WORLD OF ART'S…..

44. CLONING

45. The production of multiple, exact
copies of a single gene, DNA
fragment, cell line, or organism.

46. recombinant DNA technology,
reproductive cloning
therapeutic cloning
3 types of cloning
technology

48. DOLLY AND LAN WILMUT,
in 1996

49. ADVANTAGES
Genetically-Modified Animals
Transgenic Animals
Infertility Patients
Cosmetic Surgery
New Possibilities for Organ Transplants
Rejuvenation
Health Improvement Opportunities

50. DISADVANTAGES
Abnormal Gene Expression
Telomeric Differences
Extremely High Failure Rate
Problems During Later Development

51. HUMAN CLONING
IS IT POSSIBLE?

52. It may be like this?

53. Is it a good idea to use cloned humans for organ
transplants? Why?
Cells seem to have a defined life span
built into them.
Eg:"Dolly" was created from a cell that was about
six years old; this is middle age for a ewe. Dolly's
cells were also middle-aged. She was expected to
live only for five years, which is shorter than the
normal life span of 11 years.
 If this is also true of humans, then cloned
people would have a reduced life expectancy.
The cloning technique could take many years
off their life

54. Do you think cloned humans will have the same
talents as the original one? Why?
Some talents seem to be genetically influenced.
There is no guarantee that the first cloned
humans will be normal.
The fetus might suffer from some disorder that is
not detectable by ultrasound. Disorders may
materialize later in life.
They may be born disabled.

55. Experiments conducted: Failed
Experiments
1999 2002
A company called Clonaid
announced that they
successfully cloned the
first human. Experts say
it is impossible for the
company to clone a human
due to inadequate
technology.
Scientists secretly
placed a human
cloned embryo
into a pig. The cell
onlylived to be 32
days old.

56. Panayiotis Zavos, a fertility
doctor, claimed he has cloned 14
human embryos and implanted 11
of them into four women.
The experiment was conducted in
a secret laboratory most likely in
the Middle East.
None of the women
became pregnant
This is Cady, who died at age 10
ina car accident. More recently, Dr.
Panayiotis Zavos infused her DNA into
a cow's egg to study human cloning.
HUMAN CLONING EXPERIMENT in 2009

57. India does not have specific law
regarding cloning but has guidelines
prohibiting whole human cloning or
reproductive cloning.
India allows therapeutic cloning and the
use of embryonic stem cells for research
proposes

58. THERAPEUTIC CLONING
A NEW WAY
TO
ORGAN TRANSPLANT

59. ORGAN TRANSPLANTATION

60. What is organ donation?
It is the process of removing organ or
tissue from a live ,dead or recently
dead person to be used for another
person.
The person who donates is DONOR
and who receives is RECIPIENT.

61. WHAT CAN BE DONATED?

62. ORGAN DONATION

63. TISSUE
DONATION

65. Valery Spiridonov
set to be first for
world's first full
HEAD transplant by
Dr Sergio Canavero
to happen about in
2017
“is it actually
possible to fuse two
spinal cords and stop
the recipient’s body
from rejecting the new
head?”

67. TYPES OF DONOR
Living donor
Cadaver donor

68. PENIS TRANSPLANT , IN 2014
Surgeons at
Stellenbosch
University and
Tygerberg Hospital
performed a nine-hour
operation to attach a
donated penis.
Took place on Dec. 11,
2014, but was not
publicly announced until
this MARCH 2015while
doctors waited to see
how the patient would
recover.

69. TYPES OF DEATH
BRAIN DEATH CARDIAC DEATH

70. Elijah Smith a columbus
man said he wanted to
be an organ and tissue
donor
Elijah Smith a columbus
man said he wanted to
be an organ and tissue
donor
After his brain death the
family don’t want his
organs to be harvested.
After his brain death the
family don’t want his
organs to be harvested.

71. People of all ages.
Any healthy willing person.
Only one exception is that HIV
and ACTIVE CANCER patients
cannot donate
MEDICAL REQUIREMENTS

72. In INDIA around 6000 people die every day
waiting for organ transplant.
Every 17 minutes someone dies waiting for
transplant.
Every 13 minutes someone is added to a
waiting list.
STATUS IN INDIA

73. INTERNATIONAL ORGAN TRADE
Developed by WHO due to the
shortage of an indigenous “supply” of
organs, where potentialreceipients
travel abroad to obtain organs through
commercial transactions

74. PROS CONS
Religious reasons
Family beliefs
Misconceptions
Donors are scared of their
own health
A single donor can save
more than one life.
People who are certified
brain dead are capable of
donating many body parts
Organs can be donated after
death and can be 'banked'
Potential donors are easy to
find

75. AS THE
TECHNOLOGIES
AIMS FOR THE
WELL BEING OF
EVERY
PERSON.....

76. But…
ETHICAL ISSUES
Never ends

77. WHAT IS AN ETHICAL ISSUE?

79. We are future doctors
We must have idea to solve
Such dilemmas

80. Recognise that
a dilemma exist
Dissect the
problem
Do you need more
information?
Identify and apply any
relevant legal or
professional guidelines
Is the issue
resolved?
No
Yes
Can you justify the
dilemma with sound
arguments?
Analyse
the facts
Is this issue resolved?
Yes
No
Seek help of a BIOETHICIST

81. WHAT IS “BIOETHICS”?
Bioethics: “a field of study concerned
with the ethics and philosophical
implications of certain biological and
medical procedures, technologies,
and treatments, such as organ
transplants, genetic engineering, and
care of the terminally ill”

82. PRINCIPLES OF BIOETHICS

83. AUTONOMY
Respect a person’s right to make their own decisions
Teach people to be able to make their own choices
Support people in their individual choices
Do not force or coerce people to do things
‘Informed Consent’ is an important outcome of this
principle

84. BENEFICENCE( To do good)
Our actions must aim to ‘benefit’ people – health, welfare, comfort,
well-being, improve a person’s potential, improve quality of life
‘Benefit’ should be defined by the person themselves. It’s not what we
think that is important.
Act on behalf of ‘vulnerable’ people to protect their rights
Prevent harm
Create a safe and supportive environment
Help people in crises

85. do not to inflict harm on people
do not cause pain or suffering
do not incapacitate
do not cause offence
do not deprive people
do not kill
NON-MALEFICENCE(to do not harm)

86. Treating people fairly
Not favouring some individuals/groups over others
Acting in a non–discriminatory / non-prejudicial way
Respect for peoples rights
Respect for the law
JUSTICE

87. Distributive Justice – sharing the scarce
resources in society in a fair and just manner (e.g. health
services, professional time)
How should we share out healthcare resources?
How do we share out our time with patients?
Deciding how to do this raises some difficult questions
Patients should get…..
an equal share ?
just enough to meet their needs ?
what they deserve ?
what they can pay for ?

88. Ethics
2 broad philosophical
theories
CONSEQUENTIALISM
DEONTOLOGY

89. It is not only our duty
to know ethics but
also how to handle it
in a wise manner
THANK YOU…