Ethics at the Beginning of Life

  • Matjaž Zwitter


Ethical and political debates on conception and abortion are often hot and one-sided. In an attempt to present a balanced view, we will discuss the whole spectrum of issues, from normal conception on one side to surrogate motherhood on the other. The main ethical issues are female/male imbalance regarding the side effects of contraception, uncritical use of the “morning-after pill,” abortion on demand without accompanying counselling, preimplantation or prenatal screening for selection of fetus regarding gender, abortion for minor fetal abnormalities, artificial insemination for a healthy woman, anonymity in case of donation of sperm or egg cells, and financial compensation for surrogate motherhood.


Gender-related burden of contraception Sterilization Abortion Prenatal diagnostics Medically assisted fertilization Surrogate motherhood 


  1. 1.
    Ziglar S, Hunter TS. The effect of hormonal oral contraception on acquisition of peak bone mineral density of adolescents and young women. J Pharm Pract. 2012;25:331–40.CrossRefGoogle Scholar
  2. 2.
    O’Brien SH. Contraception-related venous thromboembolism in adolescents. Semin Thromb Hemost. 2014;40:66–71.PubMedGoogle Scholar
  3. 3.
    Primic-Žakelj M, Evstifeeva T, Ravnihar B, Boyle P. Breast-cancer risk and oral contraceptive use in Slovenian women aged 25 to 54. Int J Cancer. 1995;62:414–20.CrossRefGoogle Scholar
  4. 4.
  5. 5.
    MacPherson Y. Images and icons: harnessing the power of media to reduce sex-selective abortion in India. Gend Dev. 2007;15:413–23.CrossRefGoogle Scholar
  6. 6.
  7. 7.
  8. 8.

Suggested Reading

  1. Bawany MH, Padela AI. Hymenoplasty and Muslim patients: Islamic ethico-legal perspectives. J Sex Med. 2017;14:1003–10. Scholar
  2. Benward J. Mandatory counseling for gamete donation recipients: ethical dilemmas. Fertil Steril. 2015;104:507–12. Scholar
  3. Birkhäuser M. Ethical issues in human reproduction: protestant perspectives in the light of European protestant and reformed churches. Gynecol Endocrinol. 2013;29:955–9. Scholar
  4. Blyth E, Crawshaw M, Frith L, Jones C. Donor-conceived people’s views and experiences of their genetic origins: a critical analysis of the research evidence. J Law Med. 2012;19:769–89.PubMedGoogle Scholar
  5. Burrell C, Edozien LC. Surrogacy in modern obstetric practice. Semin Fetal Neonatal Med. 2014;19:272–8. Scholar
  6. Brezina PR, Kutteh WH. Clinical applications of preimplantation genetic testing. BMJ. 2015;350:g7611. Scholar
  7. Catlin AJ, Volat D. When the fetus is alive but the mother is not: critical care somatic support as an accepted model of care in the twenty-first century? Crit Care Nurs Clin North Am. 2009;21:267–76. Scholar
  8. Gong D, Liu YL, Zheng Z, Tian YF, Li Z. An overview on ethical issues about sperm donation. Asian J Androl. 2009;11:645–52. Scholar
  9. Holten L, de Miranda E. Women’s motivations for having unassisted childbirth or high-risk homebirth: an exploration of the literature on ‘birthing outside the system’. Midwifery. 2016;38:55–62. Scholar
  10. Howe D. Ethics of prenatal ultrasound. Best Pract Res Clin Obstet Gynaecol. 2014;28:443–51. Scholar
  11. Johnson BR Jr, Kismödi E, Dragoman MV, Temmerman M. Conscientious objection to provision of legal abortion care. Int J Gynaecol Obstet. 2013;123(Suppl 3):S60–2. Scholar
  12. Kamm FM. Bioethical prescriptions: to create, end, choose, and improve lives. Oxford: Oxford University Press; 2013. ISBN-13: 978-0190649616.CrossRefGoogle Scholar
  13. Lackie E, Fairchild A. The birth control pill, thromboembolic disease, science and the media: a historical review of the relationship. Contraception. 2016;94:295–302. Scholar
  14. Lanzone A. Ethical issues in human reproduction: catholic perspectives. Gynecol Endocrinol. 2013;29:953–4. Scholar
  15. Londra L, Wallach E, Zhao Y. Assisted reproduction: ethical and legal issues. Semin Fetal Neonatal Med. 2014;19:264–71. Scholar
  16. Mercurio MR. Pediatric obstetrical ethics: medical decision-making by, with, and for pregnant early adolescents. Semin Perinatol. 2016;40:237–46. Scholar
  17. Minear MA, Alessi S, Allyse M, Michie M, Chandrasekharan S. Noninvasive prenatal genetic testing: current and emerging ethical, legal, and social issues. Annu Rev Genomics Hum Genet. 2015;16:369–98. Scholar
  18. Morrell KM, Chavkin W. Conscientious objection to abortion and reproductive healthcare: a review of recent literature and implications for adolescents. Curr Opin Obstet Gynecol. 2015;27:333–8. Scholar
  19. Neri M, Turillazzi E, Pascale N, Riezzo I, Pomara C. Egg production and donation: a new frontier in the global landscape of cross-border reproductive care: ethical concerns. Curr Pharm Biotechnol. 2016;17:316–20.CrossRefGoogle Scholar
  20. Pace TN. Bioethics: issues and dilemmas. Waltham, MA: Nova Biomedical; 2013. ISBN-13: 978-1617282904.Google Scholar
  21. Ravelingien A, Provoost V, Pennings G. Open-identity sperm donation: how does offering donor-identifying information relate to donor-conceived offspring’s wishes and needs? J Bioeth Inq. 2015;12:503–9. Scholar
  22. Samorinha C, Pereira M, Machado H, Figueiredo B, Silva S. Factors associated with the donation and non-donation of embryos for research: a systematic review. Hum Reprod Update. 2014;20:641–55. Scholar
  23. Schenker JG. Human reproduction: Jewish perspectives. Gynecol Endocrinol. 2013;29:945–8. Scholar
  24. Serour GI, Serour AG. Ethical issues in infertility. Best Pract Res Clin Obstet Gynaecol. 2017;43:21–31. Scholar
  25. Zampas C. Legal and ethical standards for protecting women’s human rights and the practice of conscientious objection in reproductive healthcare settings. Int J Gynaecol Obstet. 2013;123(Suppl 3):S63–5. Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Matjaž Zwitter
    • 1
    • 2
  1. 1.Faculty of MedicineUniversity of MariborMariborSlovenia
  2. 2.Institute of OncologyLjubljanaSlovenia

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