Introduction

Of all the issues in medical ethics, probably none is more frequently in the news than reproductive ethics – construed broadly to include such controversial issues as: abortion and selective termination of pregnancy; sale and donation of gametes (sperm and eggs); surrogacy or contract motherhood; ‘therapeutic’ and reproductive cloning; non-consensual use of gametes and embryos; rights for children born as a result of sperm or egg donation to trace their genetic parents; sterilization of young people with learning disability or physical handicaps; enforced caesarean sections; ‘designer babies’ (the use of preimplantation genetic diagnosis for social rather than therapeutic purposes, such as sex selection for which there is no clinical need, (e.g. not involving a sex-related genetic condition); egg freezing and other uses of in vitro fertilization (IVF) to allow women to have children after the normal age of child-bearing; the commercial market in private banking of umbilical cord blood for the child's later use; ‘reproductive tourism’, in which people travel to other countries to obtain reproductive tests or services unavailable in their own nations.

In writing a chapter about reproductive ethics, we have thus faced a dilemma about which of the vast range of issues to include, using our criterion of direct clinical relevance to everyday practice. This chapter therefore omits some issues, such as cloning and surrogacy, which at the time of writing were unlikely to be encountered in the course of ordinary practice.