The Ethics of the Societal Entrenchment-approach and the case of live uterus transplantation-IVF

Guntram, Lisa; Zeiler, Kristin

doi:10.1007/s11019-019-09891-w

Cited by 4 publications

(3 citation statements)

References 63 publications

(76 reference statements)

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“…Guntram and Zeiler have shown in their paper that the "suffering in silence" of women with AUFI is emphasized as an argument in favor of UTx. 50 For reasons of justice and transparency, in our opinion, the suffering of those women for whom these measures will raise hopes, who will be frustrated and, above all, the suffering of those who have undergone the procedure, and for whom there was no success must also be valued. This is not a strong argument against the use of UTx but it is an argument against the one-sided emphasis on the suffering that is supposed to be alleviated by this measure.…”

Section: Arguments Against the Strong Normative Value Of Suffering Ad...mentioning

confidence: 99%

Is suffering a sufficient legitimation for UTx?

et al. 2023

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Uterus transplantation is a relatively new intervention. A woman with absolute uterine factor infertility receives, by a surgical procedure, a transplanted uterus, most often by living donation. The uterus recipient may thus become pregnant and conceive her own child. As with any other medical treatment, UTx requires legitimation. The anticipated benefits must outweigh the risks of the medical intervention. The risks and benefits of UTx are by no means unequivocal and cannot be easily determined. The benefits depend on the final evaluation of the suffering to be alleviated by the intervention. In the following, we will analyze the suffering addressed by UTx and discuss its normative value. First, we point out that (a) suffering is generally considered an important normative criterion in medicine as well as in the context of UTx; (b) we then describe the risks and anticipated benefits of UTx for the three persons directly concerned: the child, the donor, and the recipient; (c) we further analyze the suffering addressed by UTx. The intervention addresses a form of existential suffering. We discuss the common notion that existential suffering should be evaluated from the subjective perspective of the sufferer; (d) afterwards, we argue that in a social practice like medicine, a one‐sided evaluation stemming from the sufferer alone is not sufficient; and (e) finally, arguments from a societal perspective lead us to the conclusion that the existential suffering addressed by UTx does not possess a sufficiently strong normative value to legitimize a high‐risk, expensive procedure.

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Section: Arguments Against the Strong Normative Value Of Suffering Ad...mentioning

confidence: 99%

Is suffering a sufficient legitimation for UTx?

et al. 2023

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“…UTx is considered more socially and individually acceptable by women of reproductive age than surrogacy and adoption [46][47][48], and it is at the forefront of the motherhood options considered by AUFI women [49,50]. Although several ethical [51][52][53][54][55], psychological [56,57] and social [58][59][60][61][62] issues are actively being debated, overall there is great interest among both LDs and potential recipients towards participating in a UTx trial [63,64].…”

Section: Plos Onementioning

confidence: 99%

Uterine transplantation and IVF for congenital or acquired uterine factor infertility: A systematic review of safety and efficacy outcomes in the first 52 recipients

et al. 2020

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Uterine transplantation (UTx) associated with IVF restores fertility in women affected by absolute uterine factor infertility (AUFI). Pregnancies achieved both in women undergoing any solid organ transplantation and following IVF are associated with an increased risk of maternal and neonatal complications. This systematic review evaluated this risk in UTx-IVF treated women focusing on the safety and efficacy features of the treatment. Twenty-two studies and three press releases reporting on 52 UTx-IVF treatments were identified. Regarding the safety of treatment, 38/52 (73,1%) of surgical procedures led to the restoration of uterine function in recipients, 12/52 (23,1%) of recipients experienced post-operative complications requiring hysterectomy, and 2/52 (3,8%) of procedures failed before uterine recipients' surgery due to intra-operative complications. Regarding the efficacy of treatment, results focused on transplanted patients showing full recovery of organ functioning: 16/38 (42,1%) of patients achieved a pregnancy, including two women who gave births twice. UTx-IVF pregnancies led to 16 deliveries and all new-borns were healthy. Six out of 16 (37,5%) UTx pregnancies faced major complications during gestation. Preterm births occurred in 10/16 (62,5%) UTx deliveries. Our data indicates that the risk of gestational and delivery complications deserves important consideration in AUFI women receiving UTx-IVF treatments. However, these observations are preliminary and need to be revised after larger series of data are published.

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“…7 (3 July 2018): 34–35, 10.1080/15265161.2018.1478044; Ruby Catsanos, Wendy Rogers, and Mianna Lotz (2013) , ‘The Ethics of Uterus Transplantation’, Bioethics 27, no. 2: 65–73, 10.1111/j.1467-8519.2011.01897.x; Lisa Guntram and Kristin Zeiler (2019) , ’The Ethics of the Societal Entrenchment-approach and the Case of Live Uterus Transplantation-IVF’, Medicine, Health Care and Philosophy 22, no. 4: 557–71.…”

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confidence: 99%

May I have your uterus? The contribution of considering complexities preceding live uterus transplantation

Guntram

2021

Med Humanities

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Uterus transplantation combined with in vitro fertilisation (IVF) (henceforth called UTx-IVF) as a treatment for infertility caused by an absence or malfunction of the uterus is advancing. About 50 transplantations have been conducted worldwide and at least 14 children have been born—9 of them by women taking part in a Swedish research project on UTx-IVF. The Swedish research protocol initially stated that the potential recipient must ‘have her own donor’ who is preferably related to the recipient. But what does it mean to ask someone for a uterus? What challenges does this question instigate? And what norms may it enact? In this article, I explore how 10 women—who have considered, and sometimes pursued, UTx-IVF—describe their experiences of searching for a donor. I aim to show how an analysis of such accounts can help us unpack some of the specific relational and gendered dimensions of UTx-IVF and by doing so enrich discussions of risks, benefits, care and support in UTx-IVF. Drawing on research in social sciences and medical humanities that has demonstrated how assisted reproductive technologies and organ donation can provoke social and familial conundrums, with respect to such topics as embodiment and identity, I present three patterns that describe different dimensions of the interviewees’ quest for a uterus donor. I discuss the negotiations that took place, how expectations unfolded and how entanglements were managed as the interviewees considered asking someone for a donation. Such an examination, I suggest, contributes to make care and support more attuned to the experiences and entanglements that UTx-IVF entails for those pursuing it. This will become increasingly important if (or when) UTx-IVF becomes part of general healthcare. To conclude, I problematise responsibilities and relational challenges in medical innovation, and in this way provide insights into how the ethical debate over UTx-IVF can broaden its scope.

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The Ethics of the Societal Entrenchment-approach and the case of live uterus transplantation-IVF

Cited by 4 publications

References 63 publications

Is suffering a sufficient legitimation for UTx?

Is suffering a sufficient legitimation for UTx?

Uterine transplantation and IVF for congenital or acquired uterine factor infertility: A systematic review of safety and efficacy outcomes in the first 52 recipients

May I have your uterus? The contribution of considering complexities preceding live uterus transplantation

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