Abstracts fra Bibliotek for Læger 4/2004

Billedtema: Reagensglasbørn – musealt set.

Camilla Mordhorst

Oversigtsartikel: Humane gener, patenter og etik.

Morten Dige

Human genes, patents, and ethics.

Bibl Læger 2004; 196: 273–91.

Developments in genetic medicine and diagnosis since the early 1980s have led to patents on sequences of DNA, including human DNA. This has given rise to a need for clarification in patent law as well as more fundamental ethical questions concerning “patents on life”. Following an EU Directive in 1998 and a new Danish law in 2000 the debate has not been closed; on the contrary it has grown considerably. This is to a certain degree due to a few controversial specific cases concerning patents on DNA-sequences coding for breast and ovary cancer. But it may also have to be understood in relation to the more general debate concerning biotechnology.

The article offers a review of current legal regulation and import­ant distinctions in patent law, some of which are under pressure due to biotechnological development. Furthermore it gives an account of the notions of value involved in the field. A distinction is made be­tween values of 1) patent law, 2) biotechnology and medicine, and 3) religion and humanistic ethics. Concerning the latter, two objections against patenting genes are discussed: a) that it involves reification and b) that it involves a violation of dignity. Finally it is argued that the ethical problems are mostly connected to so-called broad product patents and that ethical values generally ought to be reflected in regulation on gene patents.

Original artikel: Børn som gave. Etiske refleksioner over donation af sæd, æg og embryoner.

Kirsten Hansen & Thomas Søbirk Petersen:

The gift of having children – on the ethics (and Danish law) of sperm, egg and embryo donation

Bibl Læger 2004; 196: 294–306.

In this paper we discuss some moral issues connected with various kinds of donations in the area of reproductive technology. We discuss several arguments for and against the anonymity of sperm, egg and embryodonation. We conclude that there, due to the lack of empirical evidence, cannot, at the moment, be given a convincing answer to the ethical question of whether donations of sperm, egg and embryos should be anonymous or not. Furthermore, we argue that eggdonation should not only be legally possible for women who are under fertility treatment. It should be legal, for women who are not under treatment for infertility, to voluntarily donate their eggs to help others having children. We also argue in favour of embryodonation, claiming that embryodonation is morally comparable with adoption.

Original artikel: At gøre det bedste for sine børn. Etiske overvejelser i forbindelse med selektion og forbedring af embryoner.

Thomas Søbirk Petersen & Kasper Lippert-Rasmussen:

Doing the best for our children – ethical considerations concerning selection and enhancement of human embryos.

Bibl Læger 2004; 196: 308–24.

It seems likely that we will become able in the future to detect genetic traits that dispose for, e.g., the development of cancer, certain forms of “violent behaviour”, and psychopathy. If we can make life better for our children by using preimplantation diagnosis or gene therapy to ­prevent the development of such diseases or patterns of behaviour, we have a good reason to use them. We argue that, given certain pro­visos, even the use of such techniques for the purpose of enhancing future children is morally desirable. These provisos include that the re­sources required by the use of these techniques are not better spent else­where, that these techniques do not involve significant risks and that they are accessible to all. Some argue that even if these conditions could be met, it would still be morally undesirable to enhance future generations, e.g. because such improvements are unnatural, involve a slippery slope, or are not real “improvements” after all. We rebut a number of these arguments in the last part of the article.

Original artikel: Fostrets moralske status 1. Hvad kan begrunde en ret til liv?

Michael Norup:

The moral status of the foetus 1. How can a right to life be justified?

Bibl Læger 2004; 196: 326–49.

The question about the moral status of the foetus is important both in relation to the debate on abortion and in relation to discussions about preimplantation diagnosis, use of foetal stem cells and foetal therapy. In order to answer this question it is crucial to decide when the foetus gains an interest in future existence or a right to life. The purpose of this article is to give an overview of the justification of the most important positions regarding this issue. The article starts with a discussion of the claim that human life starts at conception and that all human beings have an equal right to life. Against this claim it is argued that membership of the species Homo sapiens is not in itself morally relevant.

The next section turns to the problem of personal identity, as it is commonly believed that we obtained a right to life when we began to exist as the sort of beings we essentially are. Several positions regarding this problem are discussed, and it is argued that on the most plausible position we came into existence when the brain became able to sustain consciousness. This, however, does not necessarily imply that we got a right to life at that time. It seems defensible to claim that our interest in future existence does not dependent on personal identity as such but rather on a relation of psychological continuity and connectedness between mental states. If this is accepted and if our interest in our future existence is proportionate with the degree to which we are psychologically connected to that future, it can be argued that a right to life is obtained gradually.

In the last section the argument from potential is discussed. It is argued that foetal potential does not plausibly imply a right to life, but may be morally relevant if we are obliged to bring additional people with prospects of a good life into existence.

Original artikel: Fostrets moralske status 2. Menneskeligt liv er værdifuldt

Michael Norup:

The moral status of the foetus 2. Human life is valuable.

Bibl Læger 2004; 196: 352–68.

A central part of the discussions about the moral status of the foetus turns on questions about foetal rights and interests. Many intuitions in this field are, however, hardly comprehensible on these terms. In this article I present two views, which provide alternative reasons for protecting the foetus. According to one view we all share the idea that human life has intrinsic value although we disagree regarding the implications of this value. According to the other view the fact that the foetus late in pregnancy and the newborn infant are embedded in a social network provides us with a reason to protect them even if they do not lose anything in dying or have a right to life. The article con­cludes that views of this sort should be taken into account in discussions about regulation of abortion.

Forsidebillede: Tavle med fotografier af de børn, som fertilitetsklinikken på Frederiksberg har hjulpet til verden.