Final Report (all chapters)

4 New Frontiers of Reproductive Science and Medicine
4.1 Areas of Inquiry
In chapter 3, we introduced several ethical principles germane to any discussion of
reproductive technologies and biomedical research. We have also provided a few illustrations of
how these principles may inform political choices. In this chapter, we turn our attention to
several recent developments in reproductive medicine and biomedical research and discuss some
of the ethical concerns they may raise. We do so by characterizing each of these developments as
an instance of a broader class of cases – in other words, by adopting a taxonomy of reproductive
treatments and biomedical research. This approach represents a significant departure from the
practice, common among policy-makers and legal scholars, to focus narrowly on just one or
perhaps two specific applications of a medical or scientific development.
There are obvious reasons for taking a broader approach to discussing controversial ethical
dilemmas. When the Congress decided that aviation needed a separate administrative entity
responsible for ensuring its safety, it did not charged the newly established FAA with regulating
only the types of aircrafts existing at the time. The FAA was responsible for aviation safety in
general, i.e., for the safety of all existing and future aircraft models. Similarly, the FDA is
charged with ensuring the safety and efficacy of most current and future drugs, biologics, and
medical devices, not just of those in existence at the time its enabling legislation was passed.
Translated to our context, this means, for example, that we consider intracytoplasmic sperm
injection (ICSI) an instance of a standard reproductive technique, while pre-implantation genetic
diagnosis (PGD) is better described as a technology of reproductive customization. The former
type of reproductive treatment raises mainly health and safety concerns. The latter is
controversial for reasons other than just health and safety.
Standard reproductive techniques and technologies of reproductive customizations are two
of four distinct policy domains to be discussed in this chapter. The other two are innovative
reproductive treatments and biomedical research involving human reproductive tissues. Taken
together, these four policy domains define the scope of possible legislative and regulatory
interventions to be discussed in this report. As for any other typology, there may be instances of
reproductive treatments or biomedical research that cannot unambiguously be assigned to a
specific category. Some would probably consider ICSI an instance of an innovative rather than a
standard reproductive technique. Other examples could be found. These difficulties are intrinsic
to any classificatory scheme, and must be dealt with on a case-by-case basis. It is also worth
mentioning that ours is certainly not the only possible categorization. Other equally useful
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