辅助生殖技术中代孕和无主胚胎的现状及伦理问题

代孕是继辅助生殖技术（ ART）诞生后的一项新型高效助孕技术,而无主胚胎是不孕夫妻经辅助生殖技术成功生育后的剩余胚胎。辅助生殖技术推动了生殖医学的发展,给不孕家庭带来了福音。但其与人类自然生殖方式以及传统伦理、道德、法律观念产生重大冲突。本文对代孕和无主胚胎的现状及产生伦理问题进行总结,并对辅助生殖技术引发的伦理问题提出建议。     

人类冻存胚胎及配子的管理和伦理问题探讨

随着辅助生殖技术（简称ART）的开展,人类冻存胚胎及配子使用现状是：冻存胚胎、配子越来越多,医源性不起用次一级的冻存胚胎,对捐赠胚胎及配子的科研需求增加等。存在着监管和伦理审查难题：即知情同意的难题;冻存胚胎及配子的使用和自由流动问题;伦理审查往往流于形式。提出相应的对策有：完善相关法律法规;发挥伦理委员会职能,建立健全医疗机构相关管理制度;加强伦理委员会的能力建设和监管制度建设。     

我国人类辅助生殖技术伦理热点研究：近20年定量研究综述

目的 归纳近20年中国人类辅助生殖技术伦理问题的研究进展文献数据,探讨该领域伦理问题研究热点与前沿。方法 检索中国知网(CNKI)2002年1月1日—2022年10月30日相关文献记录,借助CiteSpace.6.1.R2对作者、机构和关键词等内容进行可视化分析。结果 共纳入1 274篇文献,发文量总体呈上升趋势,热点主题涵盖代孕、辅助生殖技术伦理问题与法律、辅助生殖技术手段三个维度。结论 人类辅助生殖技术伦理问题研究理论与实践结合不够紧密,研究者合作网络有待进一步加强,有关代孕、生育权、基因编辑和胚胎所有权的相关研究成为近阶段主要热点与难点,应予以充分关注。     

人类辅助生殖技术临床应用的相关伦理问题探讨

通过对精子的质量与储存、卵子组合、子宫的来源与子宫的年龄、试管婴儿的数量、性别、健康以及人类辅助生殖经费等方面的有关问题进行伦理分析与思考.提出思考与对策：加强管理,完善相关法律法规;合理布局医疗机构;合理使用精子、卵子;建立并完善机构伦理委员会等工作机制;加大对技术滥用行为的打击力度,进一步推进人类辅助生殖技术的伦理研究.     

实践人类辅助生殖技术伦理原则的难题与思考

针对贯彻执行《人类辅助生殖技术与人类精子库伦理原则》的实践中遇到的胚胎冷冻的遗留问题、自精保存的难题、知情同意原则落实过程中的形式化现象等的伦理难题,指出需要不断完善与发展《人类辅助生殖技术与人类精子库伦理原则》,加强医学、伦理及法制知识的宣传普及工作,加强医护人员的道德责任感。     

辅助生育技术的发展

20多年来 ,人类生殖辅助技术取得了突飞猛进的发展 ,经历了从常规体外受精一胚胎移植一单精子卵细胞胞浆内注射一着床前遗传诊断一细胞核移植 (克隆 )技术和胚胎干细胞培养技术的过程 ,但这一医学技术是一把“双刃剑” ,它既为不孕患者带来了福音 ,也产生了法律、伦理、道德、遗传病等一系列问题 ,而倍受关注。1790年 ,医学上首例助孕技术获得成功 ,ＪｏｈｎＨｕｎｔｅｒ为严重尿道下裂者的妻子施行丈夫精子人工授精获得妊娠。1884年ＷｉｌｌｉａｍＰａｎｃｏａｓｔ报道了首例供精人工授精获得妊娠。此后的一个世纪助孕技术无重大突破 ,直至…     

我国辅助生殖技术应用中的若干问题与对策

现代辅助生殖技术（ ATR）在给无数不育不孕家庭带来了福音的同时,也对现今的伦理和法律形成新的挑战。通过对独身女性申请权、冷冻胚胎以及医疗资源的分配等ART应用中若干问题的研究,进一步明确医学标准与管理规范、重视伦理原则与道德规范、加强政策调控与法律保障,将会有利于解决ART引发的问题,推进ART发展,并保障社会的和谐稳定。     

关于人类胚胎种植前遗传学诊断的伦理问题

人类辅助生殖技术的广泛应用,为广大不孕不育患者带来了福音,但同时也引起了一系列相关伦理讨论.胚胎种植前遗传学诊断作为一项新兴辅助生殖技术,同样备受关注.     

玻璃化技术冻贮人类胚胎的研究

辅助生殖技术 (AssistedReproductiveTechnologyART) :体外授精胚胎移植 (InVitroFertilizationEmbryoTransplantationIVF -ET)及胞浆内单精子显微注射 (IntracytoplasmicSpermIn jectionICSI)等是近期发展起来的治疗男性不育症的新技术。而胚胎冻贮 (Embryo’sCryoPreservation)是辅助生殖技术的重要组成部分。在胚胎冻贮的研究中 ,冷冻对胚胎造成不同程度的损害 ,严重影响了胚胎冻贮的成功率 ,而冷冻速度及冷冻保护剂 (CryoprotectiveAgentCPA)是影响胚胎冻贮成功与否的最重要的两大因素。现已有多种冷冻保护剂及冻贮方法。…     

对人类辅助生殖技术的界定及其实施伦理原则的反思

从对人类辅助生殖技术概念界定的质疑入手,对实施该项技术的几个伦理原则作了追问：知情同意原则的主体仅限于患者夫妇双方在中国传统家庭决定面前是否现实？保护后代原则顾及了技术本身的可靠性和后代的健康,但人类辅助生殖技术对非遗传学后代在未来可能遭遇的各种问题是否做过评估和预防？保密原则在发挥其积极作用的同时,是否侵犯了非遗传学后代对自己身份的知情权？严防商品化原则是否会挫伤捐赠精、卵者的积极性？伦理监督原则缺乏专业人员参与,加之生殖伦理委员会的经济和隶属关系,如何保证伦理监督的严肃、客观和公平？认为应该重新审视人类辅助生殖技术的准确定义和伦理原则的可行性范围,以有利于该项技术真正造福人类。     

人类精子库的伦理问题分析及对策探讨

人类精子库的建立对于解决人类不育难题、提供生殖保险具有重要意义,但这些进步背后也存在一系列复杂的家庭、社会和法律等伦理问题.就精子库工作中常见的伦理问题,如精子的使用方式、社会问题及其他问题作了分析.并提出对策：建立定期伦理督查制度,加强人类精子库管理;加强医学、伦理及法制知识的宣传普及工作,提高医务人员的道德责任感.     

Thinking ethically about genetic inheritance: liberal rights, communitarianism and the right to privacy for parents of donor insemination children

The issue of genetic inheritance, and particularly the contradictory rights of donors, recipients and donor offspring as to the disclosure of donor identities, is ethically complicated. Donors, donor offspring and parents of donor offspring may appeal to individual rights for confidentiality or disclosure within legal systems based on liberal rights discourse. This paper explores the ethical issues of non-disclosure of genetic inheritance by contrasting two principle models used to articulate the problem--liberal and communitarian ethical models. It argues that whilst the latter provides a more constructive avenue to providing an ethics for donation than the competing and contradictory positions represented in a liberal rights approach, it raises issues of ethical judgement and authority that remain problematic. This ethical discussion is supported by a field study, funded by the Wellcome Trust, exploring the perceptions and experiences of recipients of donor sperm and their partners towards donor anonymity. The field study provides the empirical basis of an argument for making ethical judgements on the grounds of the community good rather than individual rights, that nevertheless recognises that both are inherently problematic.     

体外受精——胚胎移植中剩余胚胎去向的伦理思考

随着体外受精-胚胎移植技术不断发展和普及推广,在技术应用过程中出现了大量的剩余胚胎。剩余胚胎的去向日益成为医疗机构面临的一个亟须关心的问题,对剩余胚胎如何处置引发了一系列伦理和法律方面的争议。从生命伦理学角度出发,阐述了剩余胚胎的产生和去向,并就剩余胚胎处置中涉及的伦理和法律问题进行了分析和探讨。     

Informed consent for stem cell research in the public sector

Asking progenitors of spare embryos to donate them for use in stem cell research presents a number of complex issues, especially given the general lack of regulation of fertility medicine and the lack of public consensus on the moral status of the embryo. Particular issues include the timing of the request for donation and whether both men and women must always give consent for the use of their embryos for research. If thoughtful attention is given to these matters, there need be no ethical impediment to requesting the use of spare embryos for stem cell research.     

心脏死亡器官捐献中的伦理与法律解读

通过对2013年美国胸科协会、国际心肺移植协会、重症医学学会、器官获取委员会以及美国器官资源共享网络,根据目前的临床数据和经验,对心脏死亡的供体器官捐献的伦理学与法律问题修订的新的指南进行解析后认为,在我国特殊的器官移植环境中,心脏死亡器官捐献存在着伦理和法律等方面的问题：知情同意、前后期干预、死亡判定、临终护理。     

人类精子库运行中常见的伦理问题及应对机制

尽管2003年我国卫生部公布了《人类辅助生殖技术和人类精子库伦理原则》,从社会、伦理、道德、法律等角度进一步明确了人类精子库运行中如何保障供精者和受者个人、家庭、后代的健康和权益,维护社会公益,但是人类精子库运行过程中仍可能存在诸多的伦理问题,我们应该加强人类精子库的管理,制定并执行相关的规章制度及标准的操作程序。生殖医学伦理委员会要定期及不定期进行监督、检查,以最大限度地减少人类精子库伦理问题的发生。     

本科护生人工辅助生殖技术认同度的调查与分析

目的探讨本科护生对人工辅助生殖技术的认同度及相关影响因素,分析本科护生思想中存在的伦理误区。方法自行设计人工辅助生殖技术认同度调查问卷,包括学生的一般资料、一个典型案例及所附带的6个伦理问题,对372名本科护生进行问卷调查。结果本科护生对人工辅助生殖技术伦理问题持较为宽容的态度;70%的本科护生对"名人精子库"持否定态度;16.3%的本科护生对"名人精子库"诞生的孩子必然成为名人的说法持否定态度;54.1%的本科护生对告知由人工辅助技术出生的孩子其真实身世的态度上是否定的。不同性别本科护生在"名人精子库"、"单身母亲"、"代孕母亲"等问题的态度上存在显著差异(p﹤0.05);不同家庭收入的本科护生在"单身母亲"态度上存在显著差异(p﹤0.05)。结论大部分本科护生对人工辅助生殖技术持有较为理性的态度,少数本科护生存在伦理误区,教学中要开展有针对性的教育,同时需健全和完善相关法律法规。     

Public attitudes in Edmonton toward assisted reproductive technology.

OBJECTIVE: To determine public attitudes toward the use and possible limitations of assisted reproductive technology (ART). DESIGN: Mail survey based on telephone numbers selected at random by computer. SETTING: Edmonton. PARTICIPANTS: A total of 602 Edmonton residents aged 16 years or more (57% of eligible subjects) reached by telephone agreed to participate. Completed questionnaires were received from 455 subjects (76%). MAIN OUTCOME MEASURES: Attitudes toward egg donation, sperm donation, selective fetal reduction, embryo freezing and experimentation, and surrogacy, as determined through responses to five cases. Comments and demographic data were also solicited. MAIN RESULTS: Overall, 66% and 63% respectively of the respondents would donate an egg or sperm to a sibling; the corresponding rates for donation to a stranger were 41% and 44%. Selective fetal reduction was supported by 47% of the respondents, although only 24% would support fetal reduction to eliminate fetuses of an undesired sex. Most (64%) thought that live embryo freezing should be permitted by law. A total of 74% agreed with surrogacy if done for medical reasons, but 85% opposed its use for reasons of convenience. Overall, 72% of the respondents thought that ART should be regulated. A total of 58% felt that physicians should be primarily responsible for determining the allowable limits of this technology, and 38% felt that the public should be primarily responsible. Only 21% agreed with public funding of ART. Religious affiliation strongly influenced attitudes toward ART. CONCLUSIONS: Public support for ART varies depending on the circumstances of its use. Education is needed to make the general community aware of the various aspects of ART. The results of this survey should help physicians and governing bodies make informed decisions about the future directions of ART in Canada.     

Brave new world--nine months away?

Reproductive technologies were the main theme of the Aberdeen Medical Group day conference. Among the topics discussed were the physician's right and duty to determine a couple's suitability for in vitro fertilization (IVF) and artificial insemination by donor, the ethical aspects of surrogate motherhood, the production of surplus embryos for use in IVF and research, and the legal status of embryos. Speakers also addressed the issues involved in genetic screening, prenatal diagnosis, and disclosure of fetal abnormalities, as well as the need to coordinate information on services for the handicapped.     

Organ donation after cardiac death: legal and ethical justifications for antemortem interventions

Organ donation after cardiac death increases organ availability, but raises several legal and ethical issues, including consent. Medical interventions for people who are unconscious usually require guardian consent and must meet patients' best-interests standards. Antemortem procedures can improve the success of organ transplant after cardiac death, but do not serve the patient's medical interests, and it is contentious whether consent for antemortem interventions is legal under current Australian guardianship legislation. We argue that consent decisions should take patients' wishes as well as their medical interests into account. Antemortem interventions are ethically and legally justified if the interventions are not harmful and the person concerned wished to be an organ donor.