In reproductive medicine, advances in medical science and technology often outpace society’s opportunity for due deliberation about their ethical use. Physicians and other experts in the field explore these ethical considerations in the October issue of Virtual Mentor, the AMA’s online ethics journal.

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Employing pre-implantation genetic diagnosis followed by embryo selection to choose the sex (and potentially other traits) of a child is just one topic of debate. Virtual Mentor contributors discuss the many questions and tensions that surround evolving technologies and practices—from those that prevent or enable conception to those used in hospital labor wards.

Highlights include:

  • Judicial, legislative and professional attempts to restrict pregnant women’s autonomy.” Ruth Macklin, PhD, writes that she believes physicians may—and should—make recommendations to women for maintaining a healthy pregnancy, but until the time a baby is born, the pregnant woman alone should have the last word in deciding what happens to her fetus.
  • Natural childbirth—A global perspective.” Lauri J. Romanzi, MD, argues that industrialized nations could benefit from strategies emerging in developing nations, such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.
  • Informing patients about declining fertility.” In this commentary, Marc M. Beuttler, Kara N. Goldman, MD, and Jamie A. Grifo, MD, write about how respect for informed, autonomous decision-making demands women be made aware of useful, if anxiety-provoking, information about age-related decline in fertility.

Be sure to take this month’s ethics poll (“What do you think about using in vitro fertilization to select the sex of a child for the purpose of ‘balancing’ the family?”), and check out the October podcast.

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