In Vitro Fertilization and Ethics
In Vitro Fertilization is an advanced type of fertility treatment where sperm and egg are mixed in an artificial setting outside the uterus. Several embryos formed may be placed into the womb of the woman, in which they will embed and flourish in the wall of the womb. Adverse reactions involving IVF medications and treatments are uncommon (Asplund, 2020).
After the recent passage of the Revised IVF Act, the United Arab Emirates has released special guidelines to amend and simplify several restrictions regarding clinically assisted reproductive technology (Inhorn, 2021). According to the Islamic perspective, it is acceptable and recommended to pursue a remedy for impotence to conceive. All advanced fertility technologies are legal under Islamic Shariah (Serour & Serour, 2019).
This comprehensive study will elaborate and highlight the ethical and legal aspects of In Vitro Fertilization, considering the ethical consideration of Islamic Shariah and the recent law introduced by the government of UAE.
There seems to be a delicate relationship involving fast technological growth and evolving cultural attitudes considering in vitro fertilization abnormalities (Lawrenz, et al., 2020). Despite secularization, religion continues to serve a significant part in the legislation and practice of IVF in several nations, such as the United Arab Emirates (Inhorn, 2021). Morality is the branch of ethical beings and is conducted methodically. The three aspects of this ethical study are the UAE government’s regulations, healthcare, and an Islamic perspective, to put it simply.
The UAE President, Sheikh Khalifa Bin Zayed Al Nahyan, introduced the Revised IVF Ordinance on 19th December 2019. The previous IVF Law was replaced by the Current IVF Law, which took effect on 1st January 2020. The Guidelines with the Revised IVF Law were issued in the Official Government Gazette in 2020. (The UAE’s provisions on medical assistance for reproduction, 2022)
The preservation of embryos and egg and sperm before fertilization is among the most significant innovations the Current IVF Regulation brought about for patients opting to conceive (Inhorn, 2021). In assisted reproduction, the Current IVF Regulation also establishes a structure based on dialogue and decisions about selecting outcomes and restricting research analysis. Such reforms follow the National Strategy 2021 and the Centennial 2071 initiative by the UAE government; both seek to improve the worldwide standing of the UAE.
The Revised IVF Law specifically mentions preserving patient information and safeguarding client privacy. It is in keeping with the UAE’s growing emphasis on data protection and cyberspace that corresponds to a global impact along with the identical subject. The stance underneath the revised IVF Law stands that egg and sperm contributions and promoting a surrogate mother are unlawful since only a husband and wife should produce offspring jointly (Inhorn, 2021). This Current IVF Regulation has substantially shifted how embryonic cells are frozen. Embryos may be frozen for up to five years in medical clinics under favourable conditions. Embryos could not be frozen underneath the previous IVF legislation. However, only unfertilized gamete cells may be frozen (Asplund, 2020).
There has been a tremendous amount of respect and scientific understanding gained in the forty years since the first effective human fertilization through IVF (Asplund, 2020). Individuals with offspring were more inclined than the parents without to get a good attitude about their care. Individuals with a high degree of knowledge, money, or social status were less probable to have a favourable attitude about their treatment. The findings of research that found a link connecting a patient’s viewpoint on treatment and their maturity level or sexuality yielded mixed findings on the orientation of the link.
The Role of UAE Government
The duration of fertility problems was linked to the patients’ perceptions of treatment. The duration of therapy was negatively linked to patients’ attitudes toward their medication. The fewer rejected IVF rounds a patient had, the higher probability they were to have an unfavorable opinion of their care. According to Harrison, et al., (2017), upper-middle-aged females who have a baby after IVF are frequently subjected to critics. Evidence-based arguments include the possibility of events such as a normal pregnancy or the woman’s mortality before the baby is ready to sustain itself and the repercussions of those occurrences (Inhorn, 2021).
The Healthcare sector has brought clinical advancements that have been proven beneficial from healthcare and patient perspectives. Patients like to have a positive connection with all members of the fertility specialist personnel, but particularly with their physicians. They also want everyone at the clinic, particularly the physicians, to have a positive mindset. Moreover, they preferred sensitive reproductive clinic personnel with whom they could place their faith. The utilization of PGT for initial-onset chronic or deadly single-gene disorders and architectural chromosomal translocations is comparatively morally uncontroversial (Asplund, 2020). Therefore, IVF has been proven the best solution for patients with complications in conceiving.
Doctors gives assurance that it is the safest method that is a future to eradicate fertility issues. The most pressing ethical concerns regarding giving IVF or other types of fertility treatment to unmarried females or individuals with homosexual partners have been the child’s well-being. (Asplund, 2020). Pre-implantation genetic testing provides a means to avoid a conception with a seriously ill child in households where a baby with quite a serious monogenetic illness has already been delivered or when there is a significant likelihood of chromosomal abnormalities (Lawrenz, et al., 2020). The doctor’s role is to assist a couple in ensuring effective fertilization, pregnancy, and childbirth. Multi-fetal conception elimination should not be done on purpose as in IVF; thus, it is solely permitted if multi births have arisen naturally and jeopardize the many embryos’ survival
According to the Islamic perspective, it is acceptable and recommended to pursue a remedy for impotence to conceive. All advanced fertility technologies are legal under Islamic Shariah, provided they are permissible under Shariah teachings (Serour & Serour, 2019). The sperm and ovum are collected, and the uterus is obtained from a husband and wife during their marital relationship (Inhorn, 2021). However, it is not authorized to use frozen stored sperm after the spouse’s death.
Unless the following criteria are fulfilled, has IVF been certified Islamically legal. First and foremost, IVF should be performed on a husband and wife. Second, the eggs and sperm should come from the spouses (Serour & Serour, 2019). Third, this must occur in the framework of a legal marital relationship. Fourth, a skilled group of healthcare experts should carry out the technique to avoid losing or combining zygotes from various spouses while maintaining them in liquid nitrogen. Fifth, surrogacy for a child is not permitted (Rinda, 2019). Lastly, no further fertilized eggs must be transported to the womb than is necessary. Even though there are generally more fertilized eggs generated, it is prevalent to transmit hardly 2-3 fertilized eggs. Most healthcare facilities only shift one or two eggs at a time (Serour & Serour, 2019).
Impact of Revised IVF Law on Patients
The most ethical pathway and the concerns raised by IVF that should be followed include the reliability of the stakeholders’ approval, the encouragement of the partners, the utilization and repercussions of biological tests that should be conducted before implantation procedures, the admissibility of gender selection or the screening of embryonic cells for other traits, and the stockpiling and disposition of excess embryos.
Suppose there is any disagreement developing from an Islamic perspective. In that case, couples should contact a reproductive professional, ideally, one who is Muslim, whose ideas and attitude are much more likely to fit with pro-life values than a clinician who does not believe in the Quran and hadith (Serour & Serour, 2019). Couples should not be afraid to ask questions in any scenario. Before beginning IVF treatment, a couple must thoroughly understand the technique.
The couples interested in IVF should plan accordingly by going through the UAE’s law and their choice of preferences. Taking appropriate follow-ups and appointments for counselling by performing all types of medical check-ups is the most ethical pathway to navigate the issues arising from IVF (Inhorn, 2021). Considering the cost of IVF, it is a difficult method of conceiving a child. According to Colliers, the Emirati spends over $200 million on reproductive therapy like IVF every year. (Elkalyoubi et al., 2017).
Conclusion:
Pharmacologically assisted conception and comparative genomics are still hot topics in the United Arab Emirates. Perhaps the revised IVF Act and guidelines take numerous constructive efforts to improve healthcare laws favouring customers is extremely promising because it will eventually contribute to higher clinical results conception levels considering the ethical and legal aspects of IVF. The preservation of embryos before fertilization is among the most significant innovations brought about by the Current IVF Regulation for patients opting to conceive. According to the Islamic perspective, all advanced fertility technologies are legal under ethical consideration of Islamic law imposed by the UAE government, provided they are permissible under Shariah teachings. As a result, not only are efforts to heal the fertility rate allowed but they are actively promoted.
References
Asplund, K. (2020). Use of in vitro fertilization—ethical issues. Upsala Journal of Medical Sciences, 125(2), 192-199. https://doi.org/10.1080/03009734.2019.1684405
Elkalyoubi, M., Garg, N., Farag, T. E., Fakih, A., Jain, R., Madkour, W., … & van Gils, C. (2017). The cost-effectiveness of IVF treatments Gonal-F® versus HP-HMG in the United Arab Emirates (UAE). Value in Health, 20(9), A522. https://doi.org/10.1016/j.jval.2017.08.700
Harrison, B. J., Hilton, T. N., Rivière, R. N., Ferraro, Z. M., Deonandan, R., & Walker, M. C. (2017). Advanced maternal age: ethical and medical considerations for assisted reproductive technology. International Journal of Women’s Health, 9, 561. https://dx.doi.org/10.2147%2FIJWH.S139578
Inhorn, M. C. (2021). 13 Infertility, in vitro fertilization, and fertility preservation Global perspectives. The Routledge Handbook of Anthropology and Reproduction. https://books.google.co.in/books?hl=en&lr=&id=YkxDEAAAQBAJ&oi=fnd&pg=PT211&dq=in+vitro+fertilisation+UAE+freezing&ots=13wH9xkCnE&sig=jMxpnoexinMZrL5eNnvd69SJaw8&redir_esc=y#v=onepage&q&f=false
Lawrenz, B., Coughlan, C., Melado, L., & Fatemi, H. M. (2020). The ART of frozen embryo transfer: back to nature!. Gynecological Endocrinology, 36(6), 479-483. https://doi.org/10.1080/09513590.2020.1740918
Rinda, P. (2019). DUE TO LEGAL POSITION AND LEGAL SURROGACY AGREEMENT AS AN INNOMINAAT AGREEMENT IN THE PERPECTIVE OF CIVIL LAW, ISLAMIC LAW AND NATIONAL LAW. Jurnal Pembaharuan Hukum, 6(1), 90-108. https://scholar.archive.org/work/lwpwp4jrvneatdkw7ocf3mohk4/access/wayback/https://jurnal.unissula.ac.id/index.php/PH/article/download/4672/pdf
Serour, G. I., & Serour, A. G. (2019). The Islamic perspective: Application of advanced reproductive technologies to screen human embryos during IVF. In Human Embryos and Preimplantation Genetic Technologies (pp. 85-93). Academic Press. https://doi.org/10.1016/B978-0-12-816468-6.00010-2
The United Arab Emirates’ Government portal. 2022. The UAE’s provisions on medical assistance for reproduction. [online] Available at: <https://u.ae/en/information-and-services/health-and-fitness/woman-reproductive-and-sexual-healthcare/fertilisation> [Accessed 28 February 2022].
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