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Reproductive manipulation: technical advances, options, and ethical ramifications.

To raise nurses awareness of the issues surrounding reproduction manipulation the technological advances and options as well as the ethical ramifications are discussed. Clearly it may soon be possible to bypass the human body and bring to birth a human child in a completely artificial environment. The technical options that may become available as techniques are perfected include: 1) in vivo fertilization and transfer to an artificial womb; 2) in vivo fertilization and transfer to a surrogate mother; 3) in vitro fertilization and transfer to a surrogate mother; 4) in vitro fertilization and implantation in the biological mother; 5) in vitro fertilization implantation to biological mother with later transfer to surrogate mother or artificial placenta; 6) in vitro fertilization followed by the use of the artificial womb; 7) in vitro fertilization and transferrence to an animal surrogate followed by transfer to an artificial womb surrogate mother or natural mother; and 8) freezing of the gamete with later implantation. Among the questions that arise are whether the process of inquiry should be continued now that the pace and direction of technological experimentation are apparent and whether human procreation is such an essential feature of our humanity that its loss or partial replacement by in vitro fertilization would eliminate or significantly reduce our humanity. Even if biomedical technology should proceed unchecked and does add to our humanity there are risks to the child-to-be in experimenting with in vitro fertilization. There are many more urgent and diverse ethical issues and the ethical dialogue needs to include significant input from many health-care professionals including nurses.