1,720,965 research outputs found
Decellularization and tissue engineering. Viable therapeutic prospects for transplant patients and infertility?
Full text linkDecellularization and tissue engineering: Viable therapeutic prospects for transplant patients and infertility
Uterus transplant and controversial assisted reproductive technologies: can the right to parenthood clash with ethical precepts?
No full text: Fast-developing assisted reproductive techniques based on innova- tive technologies have given rise to incredibly consequential ethical challenges of unprecedented scope. The development of innovative assisted reproductive technologies (ARTs) has steadily risen since the late 1970s. Until just over 20 years ago, those who sought to become parents had no way to overcome their infertility or sterility issues, but can now achieve parenthood and have children with at least a partial genetic and/or biological relationship. Treatments aimed at ovarian stimulation, artificial insemination, either by using the sperm of a husband or of an unrelated donor, in vitro fertilization with embryo transfer, gamete and zygote intrafallopian transfers, and intracyto- plasmic sperm injection are among the options currently available. A major ethical quandary linked to ARTs is the one arising from unused embryos, i.e. supernumerary embryos which were not implanted. Still, aside from ethical concerns stemming from embryo rights, in such a fast-evolving field, a solid ethical foundation is absolutely necessary to provide guidance for regulations and legislation. This is especially true considering how assisted reproductive practices such as surrogacy and uterus transplant (UTx) are even more controversial, hence the need to rely on a broadly acknowledged and shared set of principles for their regulation, by virtue of their unique distinctive traits which challenge our ethical and moral compass at its very core
Covid-19: when health care resources run short, how to pick who should (not) get treated?
Full text link: The World Health Organization had long warned of the onset of a pandemic that could throw national health systems into a major crisis, even in wealthy developed nations. Nonetheless, almost a year and a half after its appearance, Covid-19 continues to make painful triage choices necessary in granting access intensive care. Based on the opinions of numerous ethics committees and scientific societies, the article aims to illustrate the difference between the utilitarian-collectivist approach and the ethical approach, which inspired the guidelines drawn up in Italy in 2021 by SIAARTI in collaboration with SIMLA. Only medical parameters should be evaluated to establish the prognosis through which to identify the patients to be treated as a priority. Otherwise, the patient's interest is subordinated to that of the community. But moral judgment cannot concern only the choices of doctors. According to the principle of beneficence, hospital directors and national and local health policy managers must also take action, in particular to eliminate waste of economic resources so as to allocate more of them to health protection, especially in consideration of the predictability with which infection rates increase, and in light of the fact that immunization through vaccination is only temporary
Comment on the article by Zaami et al "Increasing abuse of anabolic steroids and chemsex drugs as performance and image-enhancing agents". Eur Rev Med Pharmacol Sci 2021; 25: 455-458
Full text linkAdvances in medically-assisted procreation technologies: can malpractice claims and "reproductive damage" be identified?
Full text linkMedically assisted procreation and assisted reproductive techniques have made giant strides over the past decades, enabling countless couples to achieve parenthood. Still, the ethical and moral concerns that have come to the fore as a result of A R T s rise pose a multi-faceted issue that lawmakers have struggled to keep up with; procedures such as heterologous fertilization arc strictly regulated, and even banned, in several nations around the globe, among which Italy, where a controversial piece of legislation was passed in 2004; such a reform has been partly nullified by court decisions, among which the Italian Constitutional Court and even the European Court of Human Rights. Relevant scientific articles were identified from Medline, Cochrane Central. Scopus. Web of Science, Science Direct. EMBASE and Google Scholar, through February 2020, by using the following keywords: "assisted reproductive techniques", "heterologous fertilization", "European rulings on ART', "reproductive damages". The rise of ART has laid bare a shortage of adequate legal tools for the purpose of guaranteeing the exercise of reproductive rights for all. Hence, the harmonization of regulations, at least at the European level, is greatly needed in order to ensure equality of parental opportunities for all
Identity and reproductive rights of transgenders. Are current legal and ethical frameworks soon to be outdated? Medicolegal implications of potentially life-changing decisions
Full text linkThe level of recognition that transgender individuals (i.e. those whose gender does not match the sex assigned at birth) enjoy in our societies has certainly made giant strides. Still, there is no denying that the far-reaching ramifications arising from choices about one's gender expression do affect vital aspects of identity in school, workplaces, and the community, and should be clearly defined and addressed by laws and policies. One of the arguments most commonly used by supporters of transgender rights relies on the concept of inalienable human rights, including the rights to live safely, freely, and without fearing discrimination. The authors have set out to succinctly outline and elaborate on the dynamics that have been shaping the legal reco-gnition of transgender individuals in light of the unique legal, social and ethical complexities that such an evolution entails. Moreover, as assisted reproduction technologies make considerable progress and innovations open up new horizons for fertility preservation and restoration, it is worth exploring how such advance can play a role in upholding the reproductive rights of transgender patients who wish to achieve parenthood, and how counseling ought to be implemented taking into account the psychological traits of transgender patients and the implications of every choice they make
The highly complex phase of intrapartum management. When clinical and medico-legal aspects overlap
No full textObjective. Some intrapartum obstetrical practices, such as episiotomy or Kristeller Maneuver, are highly controversial within the scientific community, from the ethical, political and social perspectives. Guidelines or recommendations for the management of intrapartum care, revolving around a thorough informed consent process, can be decisive to avoiding deeply conflicting situations, where the phrase “obstetric violence” has unfortunately become relatively widespread.
In this paper, the authors aimed to highlight how the use of intrapartum obstetric practices is, at times, necessary and instrumental in ensuring the well-being of the mother as well as the foetus.
Materials and Methods. A broad-ranging search has been conducted, using the scientific search engines PubMed, Google Scholar, Medscape, Medline Plus and Scopus, via the following search string: “obstetric violence”, “gender violence”, “intrapartum care”, “episiotomy”, “caesarean section”, “Kristeller”, “childbirth”, “informed consent”, taking into consideration the articles from 2015 to February 2021.
Results. Results of our research point to the fact that the woman’s need for information on obstetric procedures is often not adequately met by health professionals, and the informed consent process is therefore not thoroughly implemented.
Conclusions. The authors argue in favour of adopting an informed consent model to be submitted to the pregnant women regarding any intrapartum obstetrical procedure that may become necessary before and during labour, in order to make professional conduct more transparent and protect health
care personnel from claims and lawsuits arising from unwarranted practices
From the maternal uterus to the “uterus device”? Ethical and scientific considerations on partial ectogenesis
Full text linkThe article aims to elaborate the progress made in partial ectogenesis research on sheep as well as human embryos. Since the ban on embryos experimentation after the 14-day window is a major roadblock in terms of partial ectogenesis research, the authors have weighed the possibility that such a ban could be reconsidered. In favor of easing such a restriction, it may be argued that: (a) unlike the Catholic approach, prevalent ethics precepts hold that the embryo’s interest ought to be balanced against the interests of the other parties involved; (b) an extension of the 14-day deadline would no longer make ethically untenable practices acceptable; hence, the “slippery slope” argument, although generally worthy, would not conclusively apply to partial ectogenesis; (c) in mainstream embryo research efforts, there is a conflict between the lives of embryos and the health of individuals already born; as for partial ectogenesis, however, such a conflict would be between the lives of embryos and the lives of fetuses which would not survive otherwise. Still, in light of the embryo’s status as a human being, the authors conclude that such research practices should only be allowed on supernumerary embryos
The march 2021 italian constitutional court ruling on surrogacy: a prelude to common european legislation for the sake of reproductive health?
No full textPurpose: Surrogacy is an arrangement by which a surrogate mother bears a child for another couple or person, and is often thought of as a form of ‘treatment’ for couples (or even individuals) with fertility or sterility issues. Still, surrogacy entails ethical issues related to gender, fundamental human rights, exploitation and inequality. Materials and methods: Starting from the Italian state of affairs, the authors have set out to briefly expound upon such complexities, taking into account relevant jurisprudence on the subject, with a particular focus on inter-country surrogacy and second-parent adoption, which can themselves engender significant legal dilemmas. When residents of countries where surrogacy is banned travel abroad and hire a surrogate, that may lead to considerable legal hurdles as well. Results: In Italy and elsewhere, the courts have all too often had to fill the vacuum left by the lack of targeted legislation. The Italian Constitutional Court has recently urged lawmakers to enact new legislation to uphold the minor’s best interests. In fact, while some countries recognise the surrogate as the legal parent, others ascribe parenthood to the commissioning parents. That discrepancy can lead to a ‘clash of laws’, resulting in children ending up stateless and unable to maintain an already established family relationship. Conclusions: Just like fundamental protection of human rights and public health, the regulation of revolutionary technologies that change the very notion of reproduction, parenthood, and human identity needs to be governed by uniform standards, shared at least by nations which espouse common core values
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