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The Paradox of Altruistic Gamete Donation and Surrogacy

The various forms of artificial human reproduction are, all of them, problematic; not least because they present all sorts of complex moral and legal issues. And this blog touches on such issues but, before going into the complexity, let us first have a little simplicity.

Let us, therefore, consider what appears to many to be the least problematic forms of artificial human reproduction: altruistic gamete donation and altruistic surrogacy. They are called ‘altruistic’ because they are the freely given gifts of women who seek no profit; women who simply want to do good, and who are under no pressure to do so.

Such an altruistic woman is Anne, a healthy young woman who donates eggs so that an infertile couple can have children. Let's suppose that no monetary exchange is involved, not even in the form of compensation for expenses, which is still a subtle form of exchange. Anne, remember, expects nothing in return from the couple. This is altruism, not commerce. Some people would find her action morally acceptable, even laudable; and they would see no good reason why it should not be considered perfectly legal.

Another such altruistic woman is Marie. Like Anne, Marie is a healthy young woman and absolutely altruistic. Anne acts as a surrogate mother for a couple because the woman who wants to become a mother cannot carry a pregnancy. Again, let's suppose that no monetary exchange is involved, not even in the form of compensation for expenses. Marie allows the use of her womb for mere altruism and expects nothing in return from the couple. Some people would find her action, too, to be morally acceptable; even laudable. This, too, they believe, should be perfectly legal.

Certainly, appropriate forms of regulation would be necessary in the cases of both, Anne and Marie, to anticipate and avoid possible conflicts that just might arise between the parties involved. But, in general, there are not many people who would find the actions of either Anne or Marie to be, in any way, dreadfully, seriously, problematic.

Now, let us imagine another healthy, young, and exceptionally altruistic woman, whom we shall call, for obvious reasons, Annemarie. Annemarie, in this imaginary case, both donates her eggs to, and, acts as a surrogate mother for, a particular infertile couple, the woman of which cannot carry a pregnancy. Annemarie does the same, and is the same, as Anne and Marie. The same: but, different.

Yes, here is the paradox: while some people would approve of the actions of Anne, and of Marie, the actions of Annemarie seem to them to be very different. Because very few people would consider the practice of conceiving and gestating a child with the deliberate intention to give the child away to a commissioning couple, even for purely altruistic reasons, to be either morally or legally acceptable. So, with Anne and Marie: not problematic. Yet, with Annemarie: so problematic.

What is so wrong in the case of Annemarie that is not seemingly wrong in the cases of Anne or Marie? If two actions are individually good, why are they not good when combined together?

The paradox obviously does not arise for those who do not consider gamete donation – that is the donation of either eggs or sperm - or surrogacy, (or both,) to be in any way acceptable. For others, the paradox is there.

Ova are donated with a view to generating children; and if a surrogate mother is needed to complete the process why shouldn’t she be the very same woman who donates the eggs?

Similarly, if an altruistic surrogate mother is doing something good, isn’t she doing something even better if she is also the altruistic donor? Would it be different if Annemarie donates her ova to one couple and acts as a surrogate for a different couple?

We can easily imagine all sorts of permutations and combinations of roles, genders, relationships, number of people involved, etc., between the process of gamete donation and surrogacy. We can easily imagine just how complex and problematic the whole business can become.

In the reality of the world out there, cases are usually much more complicated that those presented here in such a simplified way. But, even as we discuss clear cut simplified cases, sooner or later some contradiction appears; and it points to something seriously wrong with splitting up the normal, and naturally composite, action of becoming the mother and the father of a child.

Those who would defend altruistic gamete donation and surrogacy should, if they are being logical, also defend the practice of generating children with the purpose of donating them to couples. For that is the logic of it all. Somehow, we feel that there is more to this than cold logic; this does not feel right and proper.

And those who have no problems with some form of compensation (be it a fee, or expenses, or whatever) for gamete donation and surrogacy, should have no problem with turning the bringing of a child into this world into a commercial business.

We demand to know: Since when has treating children as commodities to be given is progress?






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Applied Ethics Primer, by Letitia Meynell and Clarisse Paron - Reviewed by Angelo Bottone - Teaching Philosophy (Philosophy Documentation Center) pdcnet.org/teachphil/content/t

Applied Ethics Primer, by Letitia Meynell and Clarisse Paron - Reviewed by Angelo Bottone - Teaching Philosophy (Philosophy Documentation Center) pdcnet.org/teachphil/content/t

Ever more people simply don’t want to have children

Personal choice more than circumstances is the reason why younger generations are not having children, a new study reveals.

Recent figures from the Central Statistics Office showed that fewer children are being born in Ireland and the fertility rate is well below the replacement level. Understanding the reasons why people choose not to have offspring is crucial for comprehending the shifting demographics and future family structures.

A new study from the Pew Research Center on U.S. adults without children offers a detailed examination of the various reasons why this is the case, highlighting significant trends and differences across age groups.

The survey is based on two distinct cohorts: adults aged 18-49 and those aged 50 and older.

Lifestyle choice is a predominant reason for the decision not to have children, especially among younger adults.. Over half (57pc) of childless adults under 50 state they simply do not want to have kids. This figure is notably higher than among older adults (ages 50 and above), where only 31pc cite the same reason. This indicates a generational shift towards valuing personal autonomy and lifestyle choices over traditional expectations of parenthood.

Comparing these findings with past surveys reveals a clear move towards more people opting out of parenthood by choice rather than by circumstance. The share of non-parents under 50 who say they are unlikely to have children has increased by seven percentage points since 2018.

Thirty-nine percent of older adults report that having children "just never happened," indicating that circumstances and timing played a certain role for them. This contrasts with younger adults, where the primary reason is a deliberate personal choice. Additionally, 33pc of older adults cite not finding the right partner as a major reason, whereas younger adults are more likely to mention wanting to focus on other aspects of life, such as their careers or personal interests.

Infertility and other medical reasons also play a role for both age groups, but they are more significant among older adults compared to younger ones.

Financial concerns are another major factor. About 36pc of adults under 50 indicate that they cannot afford to raise a child, compared to just 12pc of older adults who give this reason.

Among adults under 50, women (64pc) are more likely than men (50pc) to say they do not want children as the reason for not being a parent. Additionally, women are more likely to mention negative experiences with their own families as a factor in their decision, highlighting the personal and emotional dimensions influencing their choice.

Among the older age cohort, women (42pc) more than men (27pc) felt pressure from society to be parents.

Men, on the other hand, are more likely than women to cite financial concerns (14pc vs 9pc) and the state of the world (15pc vs 10pc) as major reasons for not having children. This reflects a broader societal expectation on men to be financial providers.

Education also impacts these decisions. Among older adults, those with higher educational attainment are more likely to cite career focus and personal choice as reasons for not having children. In contrast, those with less education are more likely to point to financial concerns and the state of the world.

This research reveals that the decline in fertility rates is driven not just by economic factors but also by significant cultural shifts. Especially among younger adults, the preference for personal autonomy and lifestyle choice is a predominant factor. This reflects a broader societal shift towards individualism and self-fulfilment, often without considering the consequences for the common good.

A similar shift in values is probably happening here in Ireland as well. It is not just economic factors that have driven down our fertility rate to just 1.5.

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Committee hears the most extreme pro-‘assisted dying’ view yet

Assisted suicide should be available on demand to any adult who wants it, the Oireachtas Committee on Assisted Dying has heard. This is the direct equivalent, applied to assisted suicide and euthanasia, of demands from the abortion lobby that a termination of pregnancy be available to women for any reason.

The call came from Philip Nitschke, founder and director of Exit International, which has an Irish branch headed by Tom Curran. Nitschke says no medical condition should be required to qualify, and the medical profession should not have to be involved.

Notably, there was no pushback from pro-euthanasia advocates on the committee such as Gino Kenny and Lynn Ruane who say they want to restrict the procedure to those within six months of death. They frequently pushback against those who warn of a slippery slope even though right in front of them on this occasion was a man who wants us to go right down to the bottom as soon as possible.

Nitschke told the Committee that Ireland should adopt the Swiss model, whereby “any person can be assisted to die, as long as the motive of those providing the assistance is altruistic in kind. In Switzerland, there is no requirement that the person receiving the assistance has been diagnosed with an illness of any kind”.

He mentioned the cases of couples who want to die, where one is sick and the other is not, or elderly people with no terminal or chronic conditions.

“We see too many people who have really good non-medical reasons for wanting to die and I will not try to interfere with them”, he said.

Mental capacity in Switzerland is assumed. A psychiatric assessment is required only if that person has been already diagnosed with a psychiatric or neurological condition. Otherwise, no medical professional need be involved. Assisted suicide is provided on demand. What appears to have kept figures relatively low there is that people have to self-administer their poison. Where doctors do it, numbers availing of the procedure rise rapidly.

Swiss law does not regulate the substances to be used in killing yourself. Nitschke has developed “Sarco”, a suicide machine that releases nitrogen and supposedly kills in a short period of time.

When he began speaking about the specific drugs used to kill those who request assisted suicide, the public session of the Oireachtas Committee had to be suspended as there were concerns about vulnerable members of the public.

Nitschke’s views on assisting patients to die has always been extremely controversial. In 2016 he ended his medical career and left his native Australia, moving to the Netherlands, after his medical licence was temporarily suspended and then the Medical Board imposed on him onerous restrictions. The head of the UK branch of Exit has been convicted of three murders in South Africa for helping three people to end their own lives.

Last week the committee heard that Exit was involved in the assisted suicide in Switzerland of an Irish man with mental health issues.

Nitschke, in his written submission, refers to the Irish director of Exit International, Tom Curran, who also defended the Swiss model when he spoke to the Committee last month. Nitschke and Curran reject the “medical model”, whereby doctors are involved in the assessment of who can qualify for assisted suicide.

Nitschke told the committee members: “My involvement in the right to die movement over the past 27 years has taught me that any framework that creates an exclusive ‘club’ of people with a distinct qualification criteria ends up discriminating against far more people than it will ever help. By its very nature far too many deserving people will find that they do not quite qualify to use such a law: they will not be sick enough, or their diagnosis will have an ambiguous prognosis. People like the late partner of my good colleague and friend Tom Curran, Marie Fleming, provide a good example. With a diagnosis of progressive MS, Marie’s neurologist could never say when she was likely to die. Tom tells the story that Marie could have died in two months, two years or 20 years. No one could say. A medical model law excludes people like Marie. … By thinking beyond the medical model, Ireland is well placed to make laws that benefit the majority, rather than the select few who are sick enough to qualify for a law which by its very nature is exclusionary, rather than inclusionary. Such a law would honour fully the courageous legal battle (and the memory) of Marie Fleming.”

Politicians will not go as far as Exit International wants on this occasion, but they do want to open the door and eventually we could easily get to the appalling world Exit wants of assisted suicide on demand.

List of my articles published by @griptmedia

Medical Council Ethics Guide now less ethical
gript.ie/medical-councils-ethi

Cardinal Newman letters feature in Dublin exhibition gript.ie/cardinal-newman-lette

Does Leo Varadkar toast his conscience first or the state?
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The HSE backed researcher who wants ethical porn taught in schools
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Time for Irish pharmacists to be given proper conscience rights
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The Citizens Assembly now has the special status of marriage in its sights
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Quantifying the enormous good the church does worldwide
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15 Italians who were in Ireland test positive for Coronavirus on return to Italy
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The Italians agreed a protocol for return to public masses. We should do the same
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The grim reality of surrogacy in Ukraine
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Ireland at back of queue for return of public worship
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Getting the facts right about reversing effects of abortion pills
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Programme for Government will ban pro-life vigils outside hospitals
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Irish marriage rate now lowest on record
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For pro-choice campaigners ignorance about abortion is bliss
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A debate on how to tackle a shrinking population is long overdue
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Countries with legal abortion have higher rate of abortion for unexpected pregnancies gript.ie/countries-with-legal-

Why leading doctors oppose assisted suicide
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Abortion law review looms – and some want to make it more extreme
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Covid caused a bigger decline in Catholic weddings than civil ones. Why?
gript.ie/covid-caused-a-bigger

New study finds Catholic pupils and teachers being subjected to bullying
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Studies: Religion has a positive effect on mental health during lockdown
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A totalitarian twist as assisted suicide law targets Catholic hospitals
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‘The UN’s review of Ireland is a total joke. Here’s why.’
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‘New ERSI report on disability ignores eugenic abortion’
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The extreme philosophy behind a new suicide machine
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A big victory for the rights of parents
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How religious sisters are the real founders of modern nursing
gript.ie/how-religious-sisters

The appalling recommendations of the surrogacy committee
gript.ie/the-appalling-recomme

Exploring the link between family breakdown and anti-social behaviour
gript.ie/exploring-the-link-be

The key facts of life left out of new RSE courses
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The convicted murderer who helped an Irishman die by assisted suicide
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Insurance companies could easily offer euthanasia in the future

The Oireachtas Committee on ‘assisted dying’ continues to hear expert testimony on the matter. Last week it heard from a Dutch academic who was once a supporter but has now turned into a critic. He spoke of how insurance companies in his country are already funding the procedure for one provider, which is a chilling possible glimpse of the future.

The Dutch expert, Theo Boer, who is a professor of healthcare ethics, said the legalisation of euthanasia in the Netherlands has turned our view of suffering, ageing and taking care upside down. The numbers are speeding up and the biggest increase is now in illnesses that are not terminal.

He was initially supportive of euthanasia legislation and now, having reviewed 4,000 cases on behalf of the Dutch government, has become critical of it.

He told the committee that in 20 years the numbers availing of it in his country have quadrupled and, in some neighbourhoods, medically assisted euthanasia account for 15pc to 20pc of all deaths. These figures are underestimated, he said, as a governmental evaluation has found that between 10pc and 15pc of doctors do not report their participation in the programme.

He noted that there has been an expansion in the reasons for euthanasia — from those at the end of a terminal illness, to people today fearing loneliness, alienation and care dependency. Once euthanasia is introduced, why should it be provided only for terminally-ill patients, or for those suffering from physical illness and pain, he asked. Sometimes it is the absence of hope that provokes the suffering, he said.

“That is why we have now a law in parliament that legalises euthanasia for all people over 74 years, with or without an illness. Their age is the only reason they can have assisted dying. That in turn is why we now have a regulation that allows parents to request euthanasia for their young children aged from zero to 11 years old. I am convinced it is only a matter of time before we take the next hurdle, namely, allowing children of dementia patients to request euthanasia for their demented parents”, he told the committee.

The second expert who spoke was Silvan Luley, representing Dignitas, a group that facilitates assisted suicide in Switzerland, where it has been legal since 1942. Currently, about 1,700 per year avail of it. He claimed that Dignitas has almost 100 Irish members and 12 people from Ireland have been helped to kill themselves by his organisation.

Dignitas offers assisted suicide not only to those who are terminally ill but also to anyone who has an “endurable incapacitating disability” or suffers ‘unbearable pain’. Mr. Luley told the committee that fewer than 50pc of those who avail of their assistance are terminal. He explained that they offer a professional alternative to violent suicides.

“It is about having an emergency exit door that provides emotional relief and can prevent people from using rough, violent do-it-yourself suicide methods. The people in Ireland should have what everyone deserves: a legal way to exercise the human right of freedom of choice on all options of professional care to soothe suffering and end life at their home” he said.

Luley was challenged by Prof Boer who referred to new studies presented at a congress of 250 psychiatrists he attended recently. One study found that since the Netherlands allowed euthanasia for reasons of psychiatry, dementia and long-term chronic illnesses, the number of violent suicides has risen against expectations by 35pc, while it went down by 10pc in neighbouring Germany.

Moreover, another new study showed that “in places where there is more euthanasia, there is also a slightly higher suicide rate. … It cannot be proven that if one provides euthanasia, it will bring the suicide numbers down”, according to Prof Boer.

(Previous research from the Anscombe Bioethics Centre found similar results ionainstitute.ie/assisted-suic)

Prof Boer said that there is a general societal pressure that makes feel the patients a burden to their families and to their country.

He also pointed out that in the Netherlands, one organisation, funded by insurance companies, offers euthanasia. The cost is €3,300, of which the performing physician receives €2,000. “For some of these physicians it is kind of a profit thing. I have heard several of them say that they need this money for several reasons, even though most of them are retired. However, it is officially not for profit. … they only offer euthanasia. They do not offer any other help. They do not offer psychiatric or social help. They can only refer the patient back to where they came from.”

The Swiss group Dignitas, which is also not-for-profit, charges the equivalent of about €11,500, plus VAT, for the complete service, which includes funeral and administrative costs.

As the population ages, and healthcare costs mount, it is easy to envisage insurance companies offering to pat their customers for euthanasia. Think of all the money they would save.

Do you also have this bad habit of reading many books at the same time?like beginning a new one before you finish the one you have started? I think I'm currently reading seven of them! I have a schedule for most of them and some are slow reading, a couple of pages per day or per week.

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> _“ shows tend to have an internal locus of control, which means they believe that their decisions, as opposed to external forces, control their destiny. , meanwhile, tend to have an external locus, which means they believe their lives are determined by forces beyond their control. People with an internal locus of control […] tend to be happier and have healthier habits, like good diets and frequent exercise, while people with an external locus of control […] have higher rates of anxiety and depression and are more likely to abuse drugs and neglect their . When you believe you have no control, you don’t.”_

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