Thursday, October 14, 2010

Case 42: IVF & delayed twinning CLOSED

This is an awesome case!  Can't wait to hear what you say about it!

24 comments:

  1. This is also a very touchy subject to some people, and also a very confusing one at that. I'm not sure I one hundred percent understand it, but I am going to give it my best shot. In this particular case I am unsure of how I feel about splitting the embryo's. Part of me says it is wrong and unjust to split a "life" into pieces, however another part of me says it is O.K. to do so, seeing as how the other pieces won't be harmed or destroyed, they will simply be frozen. Even though the children will be identical, they will each be their own unique human being, however this being said there is a lot of stigma attached to this incidence. Of course other children are going to notice that something seems "off" with this family, if every child looks exactly alike but is of different age. Some people feel very strongly one side or another on embryo splitting, and they may view the children and treat the children different accordingly. However, is it really so bad to create another life? And is it the same as cloning? I cannot honestly say one way or another how I feel about this situation, I am very much on the fence. I can see both sides of the argument, but I am not able to choose a side.

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  2. http://articles.cnn.com/1997-06-25/health/9706_25_nfm.cloning_1_embryo-splitting-ivf-fertility-labs?_s=PM:HEALTH

    http://www.lifeissues.net/writers/irvi/irvi_42pre_embryosplitting.html

    here are a couple of interesting articles concerning the case at hand.

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  3. I, like Camille am very on the fence about this case. I have never considered the possibility of splitting an embryo to have identical cells, as a way to reproduce. Personally I can't even put myself in that situation because I know so little information to actually think of what I may do in this situation. I think that a Dr must always consider a patients wishes. This includes explaining all possible outcomes, any side effects of doing the delayed twinning, the description of the lives of the embryo, etc. I think embryo splitting is an entirely different moral defensible issue than invitro fertilization. To me invitro fertilization is a normal process that is done to produce a child the same way through conception but outside of the body. It has no effect on mutilating the cell or pulling pieces apart. It falls more along the line with the morally defensibility of the cloning, etc instead, which in itself is a whole entirely different argument.

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  4. My thought is that the embryos belong to her so its her choice. I can't imagine how emotionally and physically draining it would be to have tried everything to get pregnant. If they understand all the precautions of embryo splitting, I would say it is okay. If they can live with and explain to their children later about the delayed twinning, I think it would be all right.

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  5. I agree with Camille in that I am not sure I understand this case fully. They already did the IVF, and are going to take that embryo and split it. So morally, if one was seen as acceptable, why not the other? Splitting the embryo does seem to be splitting the person. But Nellie has a point, if they are okay with it and can explain it to the children, then it is their right. So I do think that Dr T should do it if it is within his authority.

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  6. Personally, I feel there is something that is just not right with forced twinning. If an embryo divides naturally, that is one thing, but I have to go with my gut in situations like this and say that I do not think it should be allowed. To me, this gets far too close to cloning, and I'm not sure about the effects that the delayed twinning will have on the children, but I can't imagine it would be good for them to grow up knowing what medical conditions they will develop in the future as well as knowing if they are predisposed to certain things such as athletic prowess. I would have to say that I do not think delayed twinning is morally acceptable.

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  7. I feel like the problem with embryo splitting and delayed twinning is if we make it an acceptable norm that can be morally defensible how do we draw the line on other matters such as cloning. If we continue to play God will we reach a point of no return. How far is too far in the advancement of science. I find it extremely sad that some very wonderful people cannot conceive naturally, however, there are millions of babies out there without a home and billions of frozen embryos that don't have a chance. Since when is it morally permissible to create and waste. Since when were we given the power to choose what type of embryo is acceptable and which is not. Then we get the problem with people like Octamom who, in order not to waste her IVF embryos have them all implanted at once and is blessed with 8 sick babies that she can't afford or nurture effectively. So I think that even though the embryos belong to the mom and father, they do not have to moral right to decided to spilt them. Somethings should be left to God. As a twin myself, I would find it to be less of a unique individual and special if I was told that I wasn't really a twin. That I, as a four cell embryo, was decided to be split because it was more likely that one of the embryos would survive and develop into a fetus if that happened. The increase in fetuses during a pregnancy also leads to increase risk of complications for both mom and babe. Its hard to justify something that ultimately causes more hard and frustration then good.

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  8. I agree with Marion. I have strong feelings of twinning being unnatural. I honestly do not see how it is significantly different than cloning.

    If I were the younger sibling in this situation, I would constantly feel pressured to live up to the standards of my identical older sibling. If I were the older sibling, I would have serious questions about whether or not I was good enough or if I was being "replaced." It just seems to me to be a dangerous situation all around, and I have strong hesitations about this process.

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  9. I feel that if the first batch of fertilized embryos produced a fetus for the woman, then she could be allowed to use the last embryo and split it till she got to have that last child. But I do not think that she should be allowed to create identical kids of different ages by choice. Not to be rude, but life is worth more than 8 thousand dollars. If she wants more than one child (because of the splitting of the last embryo), they need to throw the other away or save it and not use it, and just drop another 8 stacks on trying the process again. 16 thousand dollars is a lot for 2 kids but creating a genetically identical second child of a different age shouldn’t be allowed. I feel the younger child would have some serious mental problems trying to grasp the fact that his older brother is the same thing he is and that he is the same as his brother. All-in-all, if this family is that desperate that they want to make 2 kids from 1 embryo, with the chances of problems, all to save 8 thousand dollars, so be it. Science and populations will be better off seeing what the results are so that future generations can benefit.

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  10. I believe that this situation has several aspects to look at: identical twins of different ages, physical an emotional stress the couple is going through, the money involved, etc. This case is very neutral in the fact that there is no black or white, or even remotely close to that, answers. I think that it would be wrong to do the twinning because in the cases of twins it is up to "mother nature" to make the decision of who gets this unique situation and who doesnt. To force a these cells into twinning is playing a position that is not intended for humans and its messes with the destinys of the embryo before the embryo even becomes the life it could be. And if the embryo were to be split and the implantation and pregnancy was a success how might that child handle the fact that he/she could have an unborn sibling frozen somewhere? And the knowledge of that could also come back and haunt the parents.

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  11. IVF in itself is a controversial ordeal. To further the chaos and add splitting is even more troublesome. First off my own personal opinion it is sad that this couple cannot produce their own offspring, but performing IVF is against my own religion. Furthermore there are many children today without parents and adpotion would be a preferable route. But not based off of personal opinion, the dr should advise the couple that since it hasn't worked with a full embryo, the statistics that a fourth of one will work is very slim. If they still want to proceed the Dr has to grant their wishes. As far as delayed twining, not only will it be morally questionable it would be hard socially for the children and are the parents really that selfish enough to put hardship on their possible future children?

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  12. I personally have never thought about wanting to make twins out of one embryo, if partners were trying to conceive . I know very little information about this research , so I don’t know if what I’m saying makes sense. If the mother wanting these twins and knew about the consequences about the splitting, then it should be her choice because it’s her embryos. On the other hand, if the mother was able to conceive, but wants two of the same child to say they have twins, I feel like it’s not morally acceptable. Even, when the Dr. tell the patient about the outcomes the doctor should consider what the patient and family wants overall. I then think about how this could be related to the topic of cloning because you are forcing the embryo to split by human hand and not by nature. Like Kimberly said, if you chose to split the embryo , you would have the constant battle of sibling rivalry and it would especially come into play if the two looked identical.

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  13. In my opinion, Dr. T should act in accordance with the wishes of the couple, but in doing so should tell the couple the possible effects that could occur.
    I also believe embryonic splitting can be morally defensible if used for IVF and embryo and only if used for that couple.
    I would also say that embryo splitting and delayed twinning is less morally problematic than cloning via somatic cell nuclear transfer.

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  14. Seeing as that's what the couple wants to try and do, they must not have a problem with the idea of having two children that look identical but are different ages. They also sound like they are having problems conceiving so I think Dr. T should honor the couple's wishes. I think embryo splitting is ok. Karen is having problems getting pregnant with normal IVF and found the surgery of recovering her eggs to be unpleasant, so she wants to take the last embryo and basically get three more out of it instead of undergoing the expensive surgery again. Plus this isn't really hurting anyone or causing any problems at the moment. It may eventually cause some family problems in the future when the children begin to experience emotions and think in a psychological manner and put the puzzle pieces together. I find embryo splitting and delayed twinning to be less of a problem because what's the difference in having another child with part of the same embryo as the first, or having one child, and then another child later but having two seperate embyos. Really the only problem would be the explanation to the children as to why they are different ages but look the same.

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  15. It seems I like most of my classmates am on the fence concerning this issue. While I understand how emotionally and financially taxing the process of IVF must be to go through without having any success, I’m not sure it would justify the idea of delayed twinning. The concern I am considering is whether or not this could cause psychological problems for the children involved in the delayed twinning. Also, like Christy I feel this could be a slippery slope—if it is morally defensible to force the production of two genetically identical children from embryos then how far is the jump to considering cloning morally defensible? I’m not sure the doctor should act in accordance with the patients’ wishes on this case.

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  16. Like other people I am also very confused about this case and don't know if I am going to answer this correctly. Personally, I have no problem with IVF because it helps women get pregnant. However, like Christy and Melissa have said I don't think I can agree with splitting the embryos. It is coming too close to being like cloning because there is another person that is genetically identical to someone else living life even though thye may be different ages. Also, it is getting one step closer to becoming like God. Even though we have the tools to help create life, we shouldn't step into God's role where he creates life. Also, I don't agree with the splitting of an embryo because I think personally later on the kid will have problem psychologically because they are same as someone else. I could be wrong because not every situation is the same, but you never know.

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  17. I agree with most of the posts. IVF I think can be very helpful with women who cannot get pregnant on their own. The splitting of the embryos I don't think I agree with. Like Jamie said it is coming very close to cloning. If this did go on, how is it any different that cloning? I believe that the Dr should tell the patients everything that that comes along with delayed twinning. If the Dr does not know much about it, I believe he should not preform the procedure. Maybe he could help the couple find another Dr that knows more about delayed twinning.

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  18. I see no problem with IVF when a woman cannot get pregnant on her own. Some women want to be mothers so badly, but they cannot do it without help from IVF. And like most people, I do not agree with splitting embryos. Like Christy said, I feel like people try so hard to play God. This is a lot like cloning and I really don't understand the fasciantion with this and the idea of delayed twinning.

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  19. Brittany Buechel: Wow, what a subject. I believe the doctor should have a very long ethical talk with the family. This is more than just a doctor fulfilling the wishes of his patient. This situation could lead into a long process of excitements, disappointments, snd questions from outsiders. I know people will do whatever they can to have their own children to make a product of a hard working marriage, but sometimes God has a different path for people. Maybe the doctor should bring up adoption, I know hey have spent so much money already, but f the next embryos fail, where do they go from there? I do not think that embryo splitting should be done. IT is such a rare and honored gift to have twins, and I do not think it should be forced by doctors. Being a twin, I think it would be so awkward to see myself a couple years older. The child would have some social issues with wanting to be different. I think cloning and delayed twinning are on the same ethnic scale. Neither of them are natural, but if one is ethical enough to be supported then the other might as well be too.

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  20. I understand the couples desire to have a child that is their own, but I think that splitting the cells could be a bad idea. I think that their future children would be really confused if they were 3 years apart and identical. I think that it would be great to have children, if I were in their situation, but it could cause some issues. Maybe they could implant the same group of split cells, so that they have the same chances, but the children will be different if they have more down the road. I think the doctor should send them to the psychiatrist to discuss with them the issues that could arise and also discuss their status with having two failed attempts at IVF.

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  21. Like the others, i believe this is a bad idea for the family to do because it could lead into many other different problems. I think the doctor should have a talk with this family about delayed twinning and what goes along with it. As far as IVF, i have no problem with it because it is almost every girls dream to have a child at some point in their life. If they are unable to produce on their own then i see no problem with IVF

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  22. I agree with many of the posts above. I do believe that IVF is more morally accepted because it is conception for those who cannot conceive naturally. There is no splitting of the already conceived embroyo. While I do not know much about delayed twinning, it seems there is little physical problems with the delayed twinning. This, however, does not excuse the psychological effect that would almost be certain to occur after birth. As kimberly stated, it would be difficult for the siblings to understand their own identity when having a sibling so genetically similar, but at a completely different age. Having said this, I still believe it should be up to the parents. If they understand the procedure, the risks, the benefits, etc. then they should be allowed to procede as they wish.

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  23. I also concord with the above arguments that IVF is morally acceptable but to a certain limit or circumstance. I think if it was truly the wish of the couples to split the embryos for further pregnancies and resulting in genetically identical progeny, then Dr. M has no obligation but to act in accordance to the couple's wishes. I personally think that embryo splitting is morally wrong compared to IVF. I also think that embryo splitting and delayed twinning is more morally problematic than cloning via somatic cell nuclear transfer.

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  24. I do not think Dr. T should fulfill the wishes of the couple. I think he should explain the effects that delayed twinning could have on both. I believe that it would confuse the children to see his or herself as younger or older. Both children could have identity issues or feel he or she needs to be the same as the other child. Also if this attempt failed as well that could cause problems as well and the wife was already not comfortable about the idea in the beginning. I think the doctor should discuss adoption as well. I believe that embryo splitting and cloning are along the same lines of being morally problematic. They both create identical children that I believe should be something that happens naturally. As Brittany said above having twins is a gift.

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