Differences of Assisted Reproductive Technology (ART) Approaches of Western Australian and the Commonwealth Laws

Abstract

            The research study aims to achieve a definite purpose and objective to find out and discover valid and reliable sources of data and information that will support whatever relevant and significant details in determining the truth as well as factual basis to be discussed appropriately by the subject matter in lieu to developing an effective hypothesis. The topic will denote such accepted information in relation to assisted reproductive technology as a key technology that will have a significant impact on societies across the world.

Furthermore, it is said that many governments have created laws in an attempt to control the use of Art for social and cultural reasons. The research study examines both Western Australian and Commonwealth Laws which is related to Art and the analysis and comprehensive discussion of such reasons for the difference in their approaches to Art as well as the difference in their approaches to technology. In order to deal with the many aspects of ART policies in diverse national contexts, an analytical framework of the policy process is developed and applied by each contributor in each country. In this way, the search for common developments and general findings does not disappear into the ocean of country-specific details that usually characterizes cross-national empirical studies.  

Introduction

            Only very few issues affect the fundamental and vital aspects of human life as much as reproductive technology does. Research find out that, the rapid development of biomedical research in the last decades including work on embryonic stem cells, genetic selection and cloning calls for political regulation and guidelines. Answering extremely difficult ethical and medical questions in this area cannot be left to the traditional self-regulatory power of the medical profession. (Ivar et al., 2003) Undesired practices must be prevented, and access to modern techniques by potential users guaranteed.

            The assistance have to deal with the Assisted Reproductive Technology (ART), covering human fertilization and reproduction techniques through medical intervention instead of sexual intercourse. The authors do not restrict themselves to the consequences for policy makers of the application of these techniques or of the public debates in many countries. (Rothmayr et al., 2003) They all deal with ART as a wide and diffuse policy domain covering a number of difficult medical, ethical, legal and budgetary issues. The goal of this volume is much more ambitious than simply presenting an overview of very different national policies.  

Thesis Statement

            Today’s epoch in government of making generalizations on Assisted Reproductive Technology (ART) has been a controversial issue in the society that has gained a positive as well as negative perception by the government sectors and the individual person in lieu to the general truth that pursue every valid application of the matter as it tend to affect the level of growth principles in an individual person. Since, it has achieved a rapid attention by the authorities there occurred policies or laws about the attempt to monitor the use of such ART as well as the different approaches of the focus of the matter as well as  the different approaches to that kind of technology as used in Western Australia and to the Commonwealth Laws per se.  

Hypothesis

As assisted reproductive technologies (ARTs) are increasingly used to overcome infertility there is concern about the health of the children conceived. The empirical evidence for associations with outcomes related to child health is a variable and should be evaluated with consideration of methodological shortcomings. (Schieve et al)

Is there convincing evidence that ART treatment may increase the risk of a few outcomes?

Experimental laboratory studies document that various constituents in culture media affect various embryo characteristics both positively and negatively.

Multiple gestation pregnancy and birth are increased with ART both because of multiple embryo transfer and embryo splitting. 

There is evidence of an increase in chromosomal abnormalities among pregnancies conceived using intra-cytoplasmic sperm injection and low birth weight and preterm delivery among singletons conceived with all types of ART.

There is uncertainty about whether these risks stem from the treatment or the parental infertility.

Some outcomes, data of an increased risk with ART are suggestive at best largely because of lack of purposeful study of sufficient size and scope. These include specific perinatal morbidities, birth defects and developmental disabilities.

The evidence for an association between ART and spontaneous abortion is inconsistent and weak. There is inconclusive evidence that ART may be associated with genetic imprinting disorders. Childhood cancer, chronic conditions, learning and behavioral disorders, and reproductive effects there are insufficient empirical research to date, but given the data for more proximal outcomes, these outcomes merit further study. (Schieve et al) Therefore, future research needs to address the unique methodological challenges underlying study in this area. 

Refine Hypothesis

            Proposals for greater social oversight of ART challenge us to confront basic questions about the allocation of authority between individuals and society in the area of reproductive decision-making. Should decisions about the use of ART be viewed as primarily private matters, to be presumptively protected from societal control? Or is the technological transformation of reproduction a species-level issue, in which individual preferences should give way to a collective determination of the overall social good? How the questions are resolved will depend to a large extent on the way in which the principle of procreative liberty is interpreted by the Supreme Court. The decisions about the use of ART are entitled to no special constitutional protection, the government could regulate these decisions in virtually any manner it chooses, subject only to the constitutional constraints that apply to lawmaking generally.  

Essay

            Research in the field of assisted reproductive technologies (ART) is directed at making infertility treatments more effective. This research can take the form of making a small modification to an already established technique or making retrospective analyses of existing results. (Trounson, Alan) Each research proposal is carefully debated and put forward to an ethics committee to ensure that the proposed study is legal, ethical and has the potential to benefit patients. Once the studies have been completed the results may be presented at scientific meetings and become an important component of the established clinical ART services. It is very important to ensure that adequate scientific design and statistical analyses are included and that full disclosure of information such as culture media composition is provided so that method variations can be properly assessed by practitioners of ART.

            New developments are often introduced into ART from technology developed in animal experimentation but may also be introduced by direct adoption from limited human studies. Perhaps the best example of the latter is the discovery and implementation of microinjection of sperm into eggs (ICSI). This is now a basic component of ART with little evidence of any increased risk of developmental abnormality in the concepts.

            Another example of a technique developed from human experimentation is cytoplasm transfer, in which the part of the cell that does not contain genes is moved from a normal healthy donor egg to an infertile patient's egg to try to boost the embryo's developmental potential. This technique still needs to be evaluated for benefits and for any risk to resulting offspring. Some techniques are easily accepted by scientists, clinicians and patients but others are more controversial. Pre-implantation Genetic Diagnosis (PGD) is a very successful component of ART as it offers testing of embryos prior to pregnancy as an alternative to prenatal diagnosis and therapeutic abortion for patients with inherited genetic disease.

            Dramatic advances may occur in the near future with the introduction of micro array analyses of gene expression of embryos. This process will examine all of the genetic components of an embryo thus identifying those that are developmentally competent. This will lead to single embryo transfers for all ART cycles. Once "successful" embryos are identified the way is paved to develop ways to identify "receptive" or "unreceptive" endometrial for implantation - long sought after in reproductive medicine, and the evolution of new embryo transfer techniques.

            The discovery of how to produce human embryonic stem cells and their potential for a very wide range of therapies for disease and tissue damage will also directly affect the way ART clinics operate. For example, in the United Kingdom, the Medical Research Council is funding the upgrade of a number of the major ART clinics to Good Medical Practice (GMP) to enable the production of GMP standard embryonic stem cells from embryos donated that is excess to the patient's own needs.

            The advent of human embryonic stem cells also provides a pathway for producing germ stem cells and gametes. Recently it has been reported that both sperm and eggs can be produced from mouse embryonic stem cells, although neither the sperm nor the eggs were shown to be developmentally competent. Progress in this research will provide a strategy for treating human sterility by converting other cells from the patient into embryonic stem cells by a process called nuclear transfer.

            Age related infertility and the loss of fertility for other reasons could be treated by forming embryonic and germ stem cells. This would provide an alternative to ovarian tissue preservation and open the reproductive window that limits fertility in women to the first three and occasionally four decades of life. This would be an extraordinary shift that is entirely feasible, although presently not permitted under Australian law.  

Statistical Data 

Proportion of Australians approving ART to help infertile married couples based on fourteen community opinion polls conducted over a 20 year period.

 

Statistical Data Source:  Gabor T Kovacs et al (2003). Available at: http://www.mja.com.au/public/issues/179_10_171103/kov10255_fm.html 

Findings

            Interest in assisted reproductive technologies (ART) has grown with events such as the birth of the cloned sheep Dolly and a court in Victoria allowing a doctor to remove sperm from a woman's deceased husband for the purposes of artificial insemination ensuring the issues remain in the media.

            The technologies available to infertile couples are constantly increasing. From when the world's first IVF baby was born in England in 1978, procedures such as Gamete IntraFallopian Transfer, IntraCytoplasmic Sperm Injection and Cryopreservation of sperm, embryos and ovum have become commonplace. It is estimated that approximately one per cent of all live births in Australia are as a result of assisted reproductive technologies.

            There are many ethical questions surrounding assisted reproductive technology. The most fundamental question concerns access to the technology Western Australia’s access is restricted to married or de facto heterosexual couples. The legislation has not been interpreted so restrictively, enabling single women and lesbian women who are medically infertile to gain access to the technologies.

            Controversy centers on members of same sex couples, single women and women who have passed their natural child-bearing age. Other ethical issues include parentage of children born as a result of assisted reproductive technologies, and consequent rights and responsibilities towards the child record keeping and disclosure of identifying information about donors and storage of embryos, eggs and sperm. The issue of the costs associated with assisted reproductive technology, and particularly whether or not the community or individuals seeking treatment should pay for the procedures.

            These comprehensive guidelines do not have the force of legislation, and a failure to comply with them will not result in any penalty being imposed. In NSW, the Human Tissue Act 1983 also applies the act regulates the supply of semen by requiring authorization of businesses engaged in the collection and supply of semen, and requiring certification from semen donors pertaining to the potential contamination of the semen. The options for regulation are many, and vary across the States as well as internationally. The most common approaches focus on licensing practitioners and clinics, and the prohibition of certain practices, such as mixing human and non-human gametes, surrogacy. Note (Source of above findings): Simpson, Rachel (June1998) ‘Article Background on Assisted Reproductive Technology’  

Discussion

            Embryo research is a sensitive topic that has been publicly debated in Australia and overseas in recent years. The main findings if the study was that nearly 30% of couples indicated that they would consider donating their excess embryos to research. The finding was consistent with those of a previous study which reported that 10% of couples from a Sydney IVF clinic had indicated it was probable and 34% indicated that it was possible that they would donate their embryos to research, and that 29% of patients from their clinic actually did donate embryos to research during the year 2001. (McMahon et al, 2003)  

            A non-significant trend for those who were more religious to be less inclined to donate to research was also reported in the Sydney study. (Ibid., 2003) We found no preference for stem-cell research or research to improve IVF techniques, but respondents’ comments indicated that some couples would need specific information about the type of research program proposed before considering donation.

            The consistency with the Sydney study, which found that lack of control over the type of research was a major concern for couples. (2003) Indeed, in accordance with the Research Involving Human Embryos Act 2002, the NHMRC guidelines for research involving human embryos stipulate that researchers must obtain specific consent for each research project.

            Recent study shows that couples in Western Australia are more likely to donate embryos to research than to donate to another infertile couple. The reluctance of couples to donate their embryos to another infertile couple is at odds with the relatively high level of acceptance of this form of embryo donation in the general community. (Kovacs et al, 2003) However 83% of the couples surveyed in our study had children in the relationship, and this has previously been shown to negatively influence parents’ decisions to donate their embryos to other infertile couples. The major concerns reported in this and other studies (Kovacs et al and Soderstrom et al) were the possibility of sibling marriage, having unknown children and the legal ramifications.

            The Western Australian Human Reproductive Technology Act 1991 bans ‘human cloning’ which means ‘the use of reproductive technology for the purpose of producing, from one original, a duplicate or descendant that is, or duplicates or descendants that are, genetically identical, live, born and viable’. The act has the problem definition ‘genetically identical’ and also allows the creation of a cloned zygote, embryo, and fetus clearly objectionable to those who feel that all early life must be protected. 

            Assisted reproductive technologies (ARTs) have generated a host of new choices that were unimaginable to persons in previous generations. Since the first child conceived through in vitro fertilization (IVF) was born nearly twenty-five years ago, infertility has been transformed from an uncontrollable life circumstance into a disease and medical treatment has come to be seen as the standard response. ART have also expanded reproductive options for individuals without fertility problems.

            Helen Alvare argued that separating sex and procreation is invariably harmful, because the conception of a child should always result from an intimate and loving act. In contrast, others maintained that ART offer important benefits to infertile couples, particularly those whose religious beliefs preclude legal adoption.

            Robertson initially expressed some hesitation about applying the principle of procreative liberty to reproductive cloning although more recently he has suggested that the principle might apply to individuals who are unable to have a child genetically or biologically related to the rearing partners through other available reproductive techniques, such as IVF. He suggests that the principle of procreative liberty also should extend to procedures without which people might not want to reproduce.

            Rather than attempting to define the precise contours of the constitutional right to procreate, the group developed a list of factors that it regarded as important elements of the constitutional protection of procreative freedom.  

The list included the following considerations:

• Bodily integrity

• Marital intimacy

• The relationship between coital reproduction and sexual intimacy

• The importance of being a parent and raising a child

• Importance of carrying on a genetic line

• The religious dimensions of decisions about procreation and child rearing

• The woman's interest in carrying a fetus and giving birth

• The intrusiveness of attempts to enforce laws limiting decisions about procreation

Language about procreation in the Court's prior decisions have emphasized the importance of decisions about having and raising children, not the relationship between reproduction and sexual intimacy. (58) The fact that ART require medical interventions does not mean they fall outside the scope of constitutional protection. After all, the right to abortion is a right to a medical procedure; the fact that terminating a pregnancy requires medical intervention has never been thought to be inconsistent with recognizing abortion as a constitutional right. Constitutional protection of ART cannot be justified by the equality concerns that underlie some of the Court's recent abortion jurisprudence.

Restrictions on access to abortion and contraception raise significant concerns for gender equality, if for no other reason than it is only women who must endure the physical burdens of unwanted pregnancies. Restrictions on access to ARTs, however, affect both women and men. (74) Indeed, granting constitutional protection to ART may actually impede efforts to promote social equality. If all restrictions on ARTs are subjected to heightened scrutiny, this approach might be difficult to sustain.

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