Bioethics@

Whose Property Are They?

Written and prepared by Dr. Adah Leshem-Ackerman, Department of Zoology & Genetics, Iowa State University.

Michelle and Brian Clifford were married for five years before they decided to try to conceive a child. Five years later they were still childless. They contacted Dr. Morgan, a fertility expert, and underwent a series of tests to determine what the problem was. It soon became clear that Michelle's fallopian tubes* were blocked. The blockage was due to severe scarring most likely a result of pelvic inflammatory disease. Dr. Morgan did not think that surgery would result in successful opening of the tubes and instead recommended that they undergo assisted reproduction, specifically In Vitro Fertilization (IVF). The couple checked with their health care provider and were allowed coverage for four IVF procedures.

Michelle began to take a medication called Clomid that increases the number of eggs produced at ovulation. This is done so that a maximum number of eggs can be harvested each month. After harvesting, the eggs were introduced to Brian's sperm in a laboratory setting and the resulting union of a sperm and egg created 15 viable blastocysts. Four days later, four viable embryos were inserted into Michelle's uterus. The remaining seven viable embryos were placed in a special freezer that allows the embryos to be maintained indefinitely. During their time in the freezer the embryos do not develop any further. Unfortunately none of the embryos inserted into Michelle implanted into Michelle's uterine wall. The IVF procedure was conducted three more times and each time the procedure was unsuccessful.

At this point the Clifford's insurance company was unwilling to fund further assisted reproduction therapies. As a consequence of the four IVF procedures a total of 20 embryos remained in the special freezer. The couple decided not to discard the embryos at this point hoping that they might try assisted reproduction at a later date.

During the two years following the last IVF procedure, Michelle and Brian's marriage began to fall apart. They tried counseling but it only made matters worse. In the end couple filed for divorce. During the divorce proceedings Brian requested that the couple's embryos be removed from the freezer and donated to Advanced Cell Technology Inc., a private research laboratory that was conducting research on embryonic stem cells for therapeutic purposes. Michelle, who was by now 40 years old, did not like this option and requested that the embryos be maintained in the freezer indefinitely as she was hoping to raise funds so that she may undergo further IVF treatments in the hopes that she might become pregnant.

What should be done with Michelle and Brian's frozen embryos?

*Fallopian tubes/oviducts are two very narrow tubes that extend out of the uterus at the top left and right sides and open up around each ovary. Eggs released from the ovaries travel through the fallopian tubes towards the uterus. Fertilization of the egg by a sperm typically occurs in the fallopian tubes.


ASSIGNMENT

Students in room 204 and 208 will meet up in room 204 and count off from 1-7.

Students in each group should exchange email addresses and phone numbers.

One week from today we will conduct a mock trial of the divorce proceedings where attorneys for Brian and Michelle will call witnesses to provide evidence to support their case in front of federal mediators. The attorneys will be presented by the two sections' TA's.

Students in group #1 will represent the Coalition for the Advancement of Medical Research (CAMR) and provide evidence to support Brian Clifford's request.

Students in group #2 will represent Advanced Cell Technology Inc. and provide evidence to support Brian Clifford's request.

Students in group# 3 will represent both the Juvenile Diabetes Research Foundation and/or the National Parkinson's Foundation and provide evidence to support Brian Clifford's request.

Students in group #4 will represent the National Right to Life Coalition (NRLC) and provide evidence to support Michelle Clifford's request.

Students in group #5 will represent the members from the U. S. Conference of Catholic Bishops and provide evidence to support Michelle Clifford's request.

Students in group #6 will represent the Coalition of Americans for Research Ethics and provide evidence to support Michelle Clifford's request. This coalition advocates research of stem cells isolated from umbilical cords, placentas and adult stem cells.

Students in group #7 will be objective mediators appointed by the federal court.

You have one week to collect information. Groups 1-6 must assign the following members:
1. Team leader who will be responsible for organizing the team and organizing the preparation of the final document to be handed in for grading.
2. Spokesperson who will present the evidence to support the evidence for either Brian or Michelle.
3. Scribe who will take notes during the presentation of evidence and will record the question to the group from the mediators.
4. Spokesperson who will answer the question presented by the mediators.

Group #7 must assign the following members:
1. Team leader who will be responsible for organizing the team and organizing the preparation of the final document to be handed in for grading.
2. Scribe who will take notes during the presentation of evidence and will record the questions formulated by the mediators and the respective answers.
3. Spokesperson who will ask the questions.

You are welcome to meet with your group during the next few days if you can arrange this (it isn't necessary ­ you will have time in class). However you must collect the necessary information prior to next week's lab meeting ­ without this information you will not have enough time to prepare your arguments. You will have 50 minutes to work with your group during lab time prior to your presentation at next week's lab meeting. The mock trial will be conducted during the last 60 minutes of lab session. Groups 1-6 will be allowed three minutes each to present the moral and/or scientific reasons of the group they are representing to support either Michelle or Brian. Group #7 will then be given 10 minutes to consult and formulate one question for each group. Each group (1-6) will have two minutes to respond to their question (including "thinking time"). Group #7 will then have 3 minutes to discuss and then present its recommendations. Following this each group will have one minute to comment on the recommendation. The remaining time will be used for class discussion.

Two weeks from today groups 1-6 will hand in a 3-4 page (typed) summary of this mock trial. The summary should include a synopsis of the presentation made by your group followed by a list of references used to prepare the presentation. The summary should include a summary of the presentations by the other groups and the final recommendations. Group #7 will hand in a 3-4 page (typed) summary of the presentations by groups 1-6 as well as the list of questions prepared by the mediators, the answers and on what basis (philosophical or ethical) the recommendation was made, as well as a list of references.

Please consider the following questions in both the class discussion (following the mock trial) and in your summary report to be handed in:

1. Michelle, rather than use the embryos for her own possible pregnancy, requested that the embryos be donated for adoption.

2. Michelle and Brian are killed in an automobile accident. They did not sign consent forms as to what should be done with the embryos. What do you think should be done?

This project will be worth 25 points.


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Published by: Office of Biotechnology, Bioethics Outreach
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Last Update 06/06/03