2022 年 39 巻 4 号 p. 489-494
Assisted reproductive technology (ART) in humans was started as a treatment for infertility, but has now become widespread to play a part in maintaining the population in Japan. Advances in ART will radically change the reproductive process, and there is the potential for further development in the era of genetic modification. Along with the history of ART, donated gametes, surrogate pregnancy, uterine transplantation, preimplantation genetic testing, and genetic alteration of germline have been discussed. Common issues in ART and bioethics include the harmony between women's right to self–determination regarding reproduction and ensuring the welfare of their children, consistency with social norms, and the idea of eugenics. In normal medical ethics, patient autonomy and self–determination are most respected. On the other hand, in ART, (1) a person other than the patient is born after using medical technology, and (2) borrows the help of another person in a sense different from organ transplantation–sperm, egg, gamete, uterus, ③ There is a possibility that technology will advance infinitely, ④ Social tolerance, ⑥ It can be a business, etc. It is also a big problem that the legislation for ART in Japan has not been developed yet, and it is carried out only in accordance with the views and guidelines of the Japan Society of Obstetrics and Gynecology.
Recently, public discussions have been held on NIPT and PGT –M. The most important of these two themes is that the true parties to the test are those who have the disease diagnosed by the test, and the couple who are carriers are thinking of having a child.
