An educated, thoughtful discussion of the ethics of the new medical techniques concerned with conception. Australians Singer and Wells—philosopher (Practical Ethics, The Expanding Circle
) and Member of Parliament respectively—gathered the latest on scientific research, medical practice, government recommendations, and popular polls from Australia, Britain, and the US. (Public opinion does not define right, the authors acknowledge; but it is nevertheless important to know what the majority is thinking.) Five practices are systematically examined: in vitro fertilization, surrogate motherhood, ectogenesis ("growth and development of a being outside its mother's womb during a period when it would normally be inside the womb"—as in care of premature babies), cloning and sex selection, and genetic engineering. Singer and Wells pronounce definitely on each practice, at its current level of development. On IVF, for instance, they find that most current objections—charges of "unnaturalness," the 'rupture of sex and procreation," the risk of abnormal children—can be dismissed on medical or philosophical/ethical/ moral grounds. Legally, embryos can be viewed either as property or as potential children, subject to child custody laws; in either case, the authors stress, care must be taken beforehand: "If a couple has been well counselled and has signed statements covering the most likely eventualities, few of these disputes should need to go to court." Though the other techniques are not yet as prevalent, Singer and Wells maintain that we can be comfortable with surrogate motherhood supervised by a "Surrogate Board," with guidelines for use; and that while ectogenesis is best considered on an individual basis, we must reject the desire to save all babies ("the proposal to grow nonsentient embryos beyond the point at which they would normally have become sentient"). On overall recommendations, Singer and Wells founder with the rest of us: their basic proposal is for expert national bioethics committees to address these issues—however difficult it would be to decide the power of such groups or their membership. In spite of its final uncertainty: a serious, practiced addition to current discussion.
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