Perspective Chapter: What about Embryo’s Rights?

Abstract

The scientific associations of human reproduction experienced fundamental change in the twentieth century, with the development of in vitro fertilization for the treatment of infertility. The separation of sex and hi-tech reproduction treatments led to a revolution of gender and similarity relations, while embryo diagnostics led to a shift from scheduling families to planning a child. Furthermore, the presence of fertilized eggs outside the womb is a new form of human life which can be conserved and manipulated and the embryo in the petri dish in laboratory has become the entity of reproductive market, driven by clients and their claim to a right to reproductive choice. These improvements encounter deep-set moral sensitivities of human self-respect and the relation of human beings to their own nature. The conclusion is that the prospect of a posthuman future sounds for an ethic of care and responsibility. This chapter firstly presents these moral approaches briefly, especially regarding interventions in preimplantation-stage embryos in the laboratory, suggesting environmentally suitable laboratory conditions for this entity. Additionally, new suggestions for legitimately suitable regulations takes care precisely embryo’s right, but also embryology laboratory personnel, clinics and parents.

1. Introduction

Ever since the birth of the world’s first test-tube baby in 1978 the altering scenery of human reproduction has produced public debate, moral questions and legal problems. From a realist point of view which pays close attention to the societal and cultural results of technological innovations three main issues can be distinguished: the shifting nature of medical practice, the creation of ‘the embryo’ as a new entity, and the differentiation of parenthood. All off these progresses are accompanied by shifts in roles and responsibilities which create new moral questions and problems.

These treatments were that the previously private sphere of proliferation became, in an awareness, public. The involvement of professionals, doctors, hospitals, laboratories and pharmaceutical industries in the formation of human life; the request for public funding of IVF research and IVF therapy; the need to regulate law and to develop public policy; and the media attention for all kinds of new reproductive developments and ‘idiosyncrasies’—these all-sketched breeding from the dark shelter of the private realm into the bright light of public attention and scrutiny. Furthermore, the participation of various authorities, institutions and public bodies raised the question of expert and responsibility of reproductive matters. Moreover, as a result of scientific progress in embryology, the discussion on the ontological status of the human embryo has also been raised to a more sophisticated level, enabled by new factual data provided by biomedical and social researches.

The application of Human reproduction treatments is complete with ethical problems and legal regulations. Several topics are defined in which some morally relevant developments have occurred in recent years. These advances, and the perennial conflict about the moral status of the embryo, is crucial for the development of the technology in general.

The past 30 years have seen the rapid evolution of many other assisted reproductive technologies (ARTs), which have evoked a variety of social, cultural, legal, and ethical responses. An ethic of care would necessitate the individual to performance as a moral agent, transcend self-interest, acknowledge and understand the relational background of his or her repro choices, care about embryo and for the others whose collaboration is crucial to comprehending the desire to give birth to a child, nurture getting of limitation of human control over nature, and assume responsibility for the embryo and children who are born, loving them as they are.

The possibility to create an embryo in a petri-dish, and to keep it there for a few hours up to a few days, made the early embryo much more of an ‘individual entity’. The status of the embryo also became an issue in a quite different debate, that about the property rights over gametes and embryos. Currently, however, a human embryo can be created not only by fertilization, including fertilization with technological assistance prior to implantation for reproductive purposes as well as IVF for both reproductive and research purposes. Their research signifies both the destabilizing and the generative effects of ARTs at the interface between science and society.

Different combinations of gametes, wombs and background parents concentrate many different parenting-arrangements. While some of these preparations may sound unusual or strange, many of them have been brought into practice. In short, the new reproductive technologies have increased the number of parties involved in the manufacture of a child. Not only appointing parents, donors and surrogates, but also physicians, lab-technicians and lawyers, and institutions like surrogacy agencies, sperm- and embryo-banks, infertility centers or laboratories are involved.

Furthermore, proliferation of the technology has been driven in large part by private markets, which are increasingly global, rather than being guided by public policy, ethical and legal regulations. Reproductive ethics cover a broad range of issues and concerns about the potential effect of individual choices on the very nature of the human species.

To obtain some basic answers related to reproductive ethics to direct questions, in this article I will devote myself to studying two challenging points of view on the start of human life, the dignity of the human embryo, and while doing that I will disclose the views of those in favor and those against the theory that human life starts with beginning, and with that about the dignity of human person.

The reasons for more discussion about the everyday publicity of western society currently can be found in the fact that between physicians, theologists, philosophers, politicians, ethicists and sociologists and others there is still no agreement on when human life truly begins.

The remarkable progress of biomedical science and medical technology has added new scopes to the problem of the biological, ontological and moral status of the human embryo. Two polar moral positions can be distinguished in the Embryo debate. First, those who completely oppose research with stem cells obtained from human embryos. In their opinion, the embryo has the same moral status as a person and consequently, must be (legally) protected as a person. Another, there is the perspective that young in vitro embryos, regardless of their origins, may be used for scientific research on the condition that the embryos used in the experimentations will not be implanted in the womb afterwards Most countries adopt an ‘middle view’. They search for a ‘happy medium’ between these two polar views.

Owing to different countries of the world different legal regulations exist on protection of human life, more specifically, in different countries different regulations exist on legal consequences. Considerate reproductive medicine as a new practice implies a need to create new concepts or a new vocabulary, to define new (social) roles and responsibilities and to cultivate new rules guiding this practice.

I shall focus on those issues that seem to raise certain concerns but so far have met with relatively less interest. Specifically, I shall concentrate on a prospective parent–future child perspective to examine: the embryo’s right to an open future; and the parents’ reproductive autonomy.

2. Text

2.1 The definition of the early human embryo

Before exploring the bioethical debate about the embryo, it is important to select how this paper defines the embryo. We do not follow the description of Merriam-Webster’s Dictionary of English stating that an embryo is “the developing human individual from the time of implantation to the end of the eighth week after conception.” (Merriam-Webster, n.d.), as we only focus on preimplantation-stage embryos to be used or to undergo interventions in the lab [1].

The definition of human embryo used to refer to a prenatal human entity in the first weeks of pregnancy: “a developing unborn human during the first 8 weeks after conception.” This definition was considered plausible and sufficient for the practical purposes in the era when embryos could have come to existence in only one way, that is by natural reproduction.

Some rather favors a definition of the embryo as “a totipotent single cell, group of contiguous cells, or a multicellular organism which has the inherent actual potential to continue species-specific i.e., typical, human development, given a suitable environment.” [2].

Later, when the era of ART commenced, the definition was broadened, so that it could cover also assisted reproductive treatment strategies. Furthermore, assisted reproductive technologies raise intrinsic questions about the definition of embryo outside the womb besides the moral status of embryo. Even the etymological mirrors the mystery of our moral relation to this new form of human life: some call it a “pre-embryo,” to characterize it an “early embryo” in the womb, while others prefer the term “fertilized egg cell”.

The use of different definitions and terminology, in scientific and other literature, is often confusing. It is to be expected that as reproductive strategies progresses, more accurate nomenclature will develop.

2.2 Can we reflect embryos only as biological material?

Some view is that this entity deserves the full- fledged status of “human being” and recognition as a subject of human rights. Another view is that there is a gradation in the acquisition of moral status that parallels the development of the fertilized egg from a preimplantation embryo, to one that implants in the womb, differentiates into placenta and fetus, grows to become viable independent of the womb, and finally is birthed as an infant.

Jurgen Habermas, an opponent of genetic modification of embryos, considered the idea of one human being determining the genetic makeup of the other as a challenge to “the moral self-understanding of the human species” [3]. Others justify their objection to the prospect of designer babies in terms of the child’s right to an open future. On the other hand, proponents emphasize the benefits of scientific progress and the individual’s right to reproductive liberty and choice.

Dutch Embryo Act [4] and is articulated by the Health Council of the Netherlands as follows: “since it is human in origin and has the potential to develop into a human individual, the embryo has intrinsic value on the basis of which it deserves respect” [5]. The French National Consultative Ethics Committee supports the position that “the embryo or fetus has the status of a potential human being who must command universal respect” [6]. These advisory figures defend to use spare and research embryos, and both believe the embryo has essential value because it is a potential human being, a potential person. Others say that because the embryo is only a potential person it does not merit full respect and have used the potentiality argument in defense of human embryo research [7].

Most ethical philosophies, nevertheless, hold that whereas preimplantation embryos do earn protection, they need not be valued as persons [8]. Those in favor of this fact consider that a human being should be protected in his biological attribute, no matter which one of the attributes and capabilities he possesses.

Regarding the ‘embryo as a potential person’, the internal factors are the features of the embryo itself (e.g. its genetic structure, its growing potential).

Belgian Senate’s Bill on Embryo Protection describes an embryo as a “cell or cohesive system of cells with the capacity to develop into a human being”. Because of this potential, the argument goes, the embryo deserves special respect [9].

2.3 Some views and discussions on embryo research

In the beginning of this century, egg cells became an entity of demand for embryonic stem cell research for the purpose of personalized regenerative medicine. And the argument of the usage of embryos for research was reawakened by the discovery of the potential of embryonic stem cells. The question has superior importance because of the large possible therapeutic profits that might result from the ability to regulate and manipulate human embryonic stem cells.

Before the end of the first quarter of the twenty-first century, scientific advances are emerging at a unprecedented pace, challenging our traditional approaches to pregnancy, parenthood, and life itself. Since IVF was incorporated into reproductive clinics, it has been possible to create an embryo in a petri dish, implant it in the womb, freeze it in a nitrogen tank, discard it, or use it for scientific research [10].

The fundamental problem is that once one allows the generation and use of embryos for beneficial purposes, it becomes very hard to justify a ban on generating and using embryos for morally equivalent purposes.

Researchers’ interest shifted to a certain degree from embryonic to adult stem cells following investigation of a scandal surrounding embryonic stem cell research, in Korea in 2005, which found both fraud in the reporting and ethical misbehavior in the appropriation of the human egg cells that were used. However, egg cells remain an important raw material currently for research in reproductive and regenerative medicine. Embryonic stem cells (the origin of all other types of cells in the body) may also be obtained by other means, by ‘reprogramming’ differentiated cells of various tissue types (skin, muscle, heart, etc.), which makes them turn ‘backwards’ into stem cells (so-called induced pluripotent stem cells) [11].

Newly, researchers around the world have been asking for permission and state funding for stem cell research with a fundamental explanation that it is necessary to spend the excessive number of embryos. Specifically, they would like to use unused, at conception unspent, embryos. Such embryos could be used for treatment of some incurable diseases. Many state that this is prohibited, because it disobeys the fundamental right of integrity of the human body, with more than a pure request to use it in therapeutical purposes to help a third party. Adrian Holderegger, considers that the “embryo becomes a foreign body” [12].

This view raises serious doubt about the validity of restrictions combined in regulation like the restriction in the United States that only stem cell lines derived before a certain date can be used for federally funded research or the German rule that embryonic stem cell lines created before a certain date in another country can be imported even though embryo research is prohibited.

IVF embryos that are to be used in research deserve some sort of respect, comparable to that given to human corpses serving educational purposes. Most doctors supported for legalization of embryonic stem cell manufacture from spare embryos. Ethicists were opposed to every kind of donation and research on surplus embryos. Most human geneticists and obstetricians approved egg, but not embryo, donation to other couples.

In terms of embryo ethics, pressing questions include, when does life begin—namely, does an embryo constitute a human life [13]. Are all embryos created equal, or can/should some be culled before embryo transfer for the purposes of research, disposal, or stem cell manufacture [13]. These questions are beginning to be studied in earnest by anthropologists, particularly in the new era of so-called reproductive medicine [14].

Examination of the use of human embryos for research will be structured around two ethical principles, specifically the subsidiarity principle and the separation principle. The subsidiarity principle states that no research on organisms with a high moral status should be performed if the same results can be obtained by research on organisms with a low moral status. The separation principal cuts the link between the wrongful act (the destruction of the embryo) and the subsequent use of the material that is obtained as a result of the wrongful act [15].

Steinbock also states that “a human embryo is something special, and a source of awe...” and deserves moral respect that imposes some restrictions on our use and disposal of embryos [1].

Preclinical embryo research is highly debatable, mainly because the embryos involved are used ‘instrumentally’. The important controversy is whether preimplantation embryos have the same moral status as children or adults, who are to be protected from ‘damaging’ research:

The “embryo is a person in the making”, states the embryologist and philosopher, Guenter Rager, Director and the embryo has its own dignity so therefore should not be instrumentalized or used in therapeutical or research purposes. Prof. Rager reflects that for the purpose of therapeutic one disease embryos should not be sacrificed, because an embryo is a human person in the making. He therefore considers that the order of things should be respected, and the fact is that a person in the making is more important than curing one of the many different degenerative diseases and states of individual persons. Additionally, he considers, that concerning ethical boundaries does not mean the culmination of science itself [16].

Habermas stated “Embryos should never be formed for the purposefulness of research, and this would comprise the predictable surplus of embryos from IVF treatments” [3].

Raymond added “Creating embryos for research is being examined out of concern for the independence and the interests of the women donating oocytes for research” [17]. After all, women must undergo invasive processes, which has some health risks. Additionally, there is a risk of abuse, in view of the temptation to withhold detailed information on risks for anxiety of losing ‘willing’ candidate donors [17, 18].

Outka and Zoloth suggested a new method: Embryos that are considered to have a low chance of surviving freeze-thaw cycles or of developing to term are not cryopreserved or replaced. Since these embryos are intended for destruction, it is more suitable to use them for research. This indication has been expressed as the ‘doomed embryo’ rule [19] or the ‘nothing is lost’ rule [20].

Recently, A specific and comparatively rare application of PGD, i.e. typing embryos on their HLA type, is analyzed. However, this application, like social sexing, indirectly traces upon the original justification of performing PGD, i.e. preventing the birth of handicapped offspring. Progressively, the indications are widened to include transitional and social reasons. It can be predicted that gradually complex cases will present themselves. A nuanced ethical attitude is needed to do justice to such cases.

Whatever the moral perspective, whether the human embryo is viewed as the subject of rights, research in human embryos and their genetic manipulation for reproductive purposes are ethically sensitive activities, due to concern about the imaginable impact on future generations. For the time being, there is an international consensus that reproductive cloning and inheritable genetic modification are impermissible. Yet these conventions are challenged of late by advocates of research into mitochondrial replacement (three-parent babies), as well as by consumerist demand to select and enhance embryos based solely on personal preference.

In the United States, embryo disposition decisions (i.e., to discard or to donate to other infertile couples or to stem cell research) appear to be emotionally significant for couples and are frequently unresolved [13]. And, research in the private sector is restricted only by state laws prohibiting embryo research. In states that have no laws against it, privately funded embryo research is essentially unregulated.

Respective groups have recommended several steps to preserve the separation between the decision to donate embryos for research and the research itself [21].

UNESCO Universal Announcement on the Human Genome and Human Rights, 1997 releases the declaration that the human genome underlies the essential unity of all members of the human family and is, in a symbolic sense, the “heritage of humanity.” This and other international human rights tools also make it clear that the manipulations of genetic science should request to improve the health of humankind. But the spread of Assisted Reproductive Treatments has been led in unlimited part by markets and by incentive for personal prominence and profit rather than by a public awareness in health [1].

We only focus on preimplantation-stage embryos to be used or to undergo interventions in the lab. It rather favors a definition of the embryo as “a totipotent single-cell, group of contiguous cells, or a multicellular organism which has the inherent actual potential to continue species-specific i.e. typical, human development, given a suitable environment.” [2].

Although Steinbock proceeds from Sandel in her proposal that respecting embryos does not mean we can treat them as inviolable or we should prohibit embryo experimentation (as the all-approach suggests), we should still inaugurate some regulations and restrictions for the embryo manipulations and embryonic microsurgery that will help alleviate a wide range of human sufferings [1].

2.4 Are embryos complete humans who have full moral status? Or nothing but accumulations of cells, and do not have any moral status?

Conventionally, bioethical debates about embryo research tend to resort to moral status arguments and both subjects are deeply tangled. Bioethicists arguing in favor of embryo research who embrace what we call the “none- approach” use psychological or physiological arguments to claim that embryos do not have any moral status. On the other hand, major participants in the debate arguing against embryo research usually adopt what we call the “all-approach,” using development-based and metaphysical moral arguments to defend the claim that embryos have a moral status [1].

These discussions, while pushing the limits of our imagination, bring up new moral questions within the discipline of bioethics regarding the embryo. it is important to elaborate not individual arguments but their common point of origin: moral status. Therefore, the discussion will (i) intricate the im/practicality of the all-or-none approach to moral status in the lab; (ii) support the unequal consideration of moral status approach developed by ref. [22] with the notion of “moral respect” borrowed from ref. [1] and (iii) outline what moral respect for embryos entails in practice.

The all-or-none approach to the moral status of the embryo includes two poles. The first one, which we call the all-approach, claims that “embryos are complete humans who have full moral status.” By contrast, the second position, which we call the none-approach, asserts that “embryos are nothing but accumulations of cells, and do not have any moral status.” Next, we will examine these two viewpoints and then challenge the alleged practicality of these two majors polarized traditional approaches to the embryo debate [1].

It seems that a vital issue is from when the human embryo matters morally, and if it matters per se—as such, because of its inherent characteristics as a being—or if it requires moral respect simply because of its value to other people.

Additionally, reproductive technologies increase central questions about the moral status of the human embryo outside the womb. Even the etymological imitates the mystery of our moral relation to this new form of human life: during laboratorial manipulations, some call it a “pre-embryo,” to distinguish it from an “early embryo” in the womb, while others prefer the term “fertilized egg cell.” The Catholic view is that this entity earns the full- mature status of “human being” and recognition as a subject of human rights. The Jewish view is that there is a gradation in the acquisition of moral status from pre-embryo to infant.

Ontological and moral status of human embryo matters per se—as such, because of its inherent characteristics as a being—or if it requires moral respect simply because of its value to other people.

Living entities regarded as valuable by the involved moral subjects. According to Matthew Liao, the Some Assisted Reproductive manipulations like enucleation or genetic editing are of such nature that both eggs, or both embryos, cease to exist and a third egg, or embryo, is created. In order to understand Liao’s argument, we must bear in mind that an egg, or embryo, is an organism. An organism, as a kind of thing: (1) starts to exist when the capacity to regulate and coordinate the various life processes (respiration, absorption, metabolism and so on) is there; (2) it persists if there is a continuing ability to regulate and coordinate the various life processes and (3) it ceases to exist when the capacity to regulate and coordinate the various life processes is permanently gone [23].

Related to this, 4 facts were made by editors of the “Moral status of the human embryo” (Der moralishe status menschilcher Embryonen), G. Damschen, scientific collaborator at the Institute of philosophy of the Martin Luther University in Halle Wittenberg and D. Schoenecker, science assistant at the same university. That specification characterized the situation:

1. Fact of species: as members of Homo sapiens sapiens species embryos are humans and with that, they have dignity.

2. Fact of continuity: embryos are, unless no morally relevant procedures are made, constantly developing into fully grown humans which have dignity.

3. Fact of identity: embryos are from the morally relevant point of view identical to fully grown humans who have dignity.

4. Fact of potential: embryos have the potential to become fully grown humans and that potential requires full protection [24].

From a virtuously biological point of view, this statement is completely correct, because the embryo belongs to the human species (Species H. sapiens sapiens).

2.4.1 Embryo manipulations and morality

It has been generally acknowledged that regardless of the way they have come into existence, human embryos are considered valuable by the people who have some connection to them. These are not only parents or gamete donors (nowadays not necessarily the same people) but, as we argued, “embryos created by IVF of an egg by a sperm and allowed to develop to the eight-cell stage before implantation, with the intention to create a pregnancy, have always been treated with respect by doctors and scientists.”

To intend by supposing the relation to the human embryo to involve a slight second-person point of view, and not just a third- person, scientific point of view push court, is intended as a way of avoiding instrumentalizing or commodifying views on human embryos.

Suchlike the moral standpoint, whether the human embryo is viewed as the subject of rights, research in human embryos and their genetic manipulation for reproductive purposes are ethically sensitive activities. It is because of concern about the possible impact on future generations. For the time being, there is an international agreement that reproductive cloning and inheritable genetic adjustment are unallowable. Yet these conventions are challenged of late by advocates as well as by entrepreneurial request to select and enhance embryos based solely on personal preference.

Jurgen Habermas, an adversary of genetic modification of embryos, considered the idea of one human being determining the genetic makeup of the other as a challenge to “the moral self-understanding of the human species” [3]. Others defend their opposition to the viewpoint of designer babies in terms of the child’s right to an open future. Instead, proponents highlight the benefits of scientific progress and the individual’s right to reproductive liberty and choice.

Unfortunately, the assessment of an embryo is bestowed on it by those who choose its destiny: whether it is to be implanted and given the chance of further development into a living human, or it is to become a research embryo allowed only limited growth in vitro (approximately 14 days) and preserved as a source of research (in the future, also therapeutic) material.

Furthermore, genetic manipulation of embryos may produce unintended, unwanted, and irreversible side effects that are passed on to future generations. These practical oppositions to genetic engineering noise for the exercise of precaution and limit.

Also, there is a deontological dispute that genetic manipulation and enhancement should not be allowed, because when existing persons make decisions about the genetic arrangement of another, they generate a relationship of producer-produced which undermines the very possibility of mutual social relations and hence the initial evidence of equality between human beings [3].

2.4.2 Embryo deserves only moral respect or full moral status?

There are several issues implied by the concept of morally significant interests that are especially relevant to the question of the moral status of the human embryo. Should we say that only self-conscious beings can have a moral status? This seems not to be the case. If we agree that the absolute value presented by an embryo to others seems a rather uncertain basis for any justification of its own moral value, we should analyze other possible practicalities for its moral status.

The key idea forward-thinking by the defendants of the time of fertilization view is that because an embryo has its unique genotype, even “the early human embryo is one and the same individual human being from the start.” means that even at the early stage it is the same individual as later, at the stages of being a fetus, newborn, infant, child, and an adult. Admittedly, the early embryo’s identity with the adult may seem reasonable.

Referring this problem to the human embryo, DeGrazia frames it as the question of whether we can ascribe morally relevant interests to the pre-sentient human being based on what it becomes—or rather what it can become, because the concept of potentiality is involved in his reasoning, as well. If we adopt the stance that only those beings that are, not merely potentially, sentient can have morally relevant interests, the obvious conclusion could be drawn that not only human embryos but also fetuses before late gestational age do not have any moral interests [22].

Of course, we cannot say that “Sentient creatures that are able to feel both pain and pleasure and as such can be harmed or benefitted, respectively, we can talk about their welfare and their quality of life, and that is a sufficient basis for them to be granted a moral status.”

It is maintained that the embryo is an individual ‘from the moment of fertilization’ or, while not yet an actual person, should be preserved and valued as a individual because of the inherent potential to progress into a person the ‘strong’ version of the so-called potentiality argument [25, 26].

2.5 When the life begins? What is the relations with identity and human essence?

The most extreme approach is to endowment it such status from the very beginning, that is from the moment when the zygote appears, which traditionally is referred to as conception, but which presently does not essentially mean natural fertilization. Embryological sign shows that the embryo—or pre-embryo, to use the scientifically suitable term for the entity at this stage of expansion, that is in the first 14 days. At this stage “the embryo functions less like a single integrated, energy-using unit of the sort we call an organism than like a collection of single-cell organisms contingently stuck together” [22].

Also, another widespread attitude that from the very beginning the zygote demonstrates polarity and has directional orientation—meaning that it is inclined to develop in a certain direction [22].

Additional shared opinion, often pointed to by advocates of the zygote approach, that conception is the moment when the egg’s and sperm’s respective sets of chromosomes unite [22].

The key idea advanced by the defendants of the time of fertilization view is that because an embryo has its exceptional genotype, even “the early human embryo is one and the same individual human being from the start” [1].

The most noteworthy biological detail in this regard is the totipotency of the early embryo’s cells, which means that a human organism can develop from each of them. Up to the eight-cell stage, if one of the cells is separated from the rest, it can develop into a distinct human being. Furthermore, not all the early cells will develop into parts of the embryo. Some will shape the placenta, but which ones is not decided before 14 or 15 days of the early embryo’s development, when some middle cells begin to differentiate. Early embryo is that until the primitive streak, which is the predecessor to the spinal cord, is formed on around the 14th day of its development, it can undergo processes known as twinning and fusion. From a biological point of interpretation, the possibility of division or fusion challenges the opinion that the early embryo is one integral organism. We can also study the reverse situation, when there are two early embryos, coming from two eggs fertilized by two sperms at the same time (the fraternal twins), which fuse into one entity, biologically called a chimera, that then progresses into one human being. In this case, genetically, the chimera has two different sets of chromosomes, however it is one individual. In discussing the problem of identity. Aaron Simmons has offered an interesting challenge to the view that human identity must be transitive [27].

Simmons noticed that the recognition of the principle of transitiveness in human identity required: not only physical or psychological stability, but also the nonexistence of any ‘branch-line cases’—that is, it cannot be the case that there exist two numerically distinct humans who are both physically or psychologically continuous with one and the same human organism [27].

All living creatures, regardless of their respective levels of biological development, have morally significant interests because they have specific needs that must be addressed to keep them alive. It seems reasonable to argue that to have morally significant interests, a living being must be sentient, that can have conscious sensations and experiencing feelings.

Single oocyte, sperm cell or somatic cell could be considered a potential embryo. Consequently, the pre-sentient human being is a creature whose award naturally inclines it to develop in such a way that it “will eventually accomplish sentience”.

Individuals with means would want to improve their embryos themselves; genetically enhanced individuals would marry one another; the gen-rich and gen-poor would not intermarry; the human species would split into humans and posthumans [28].

2.6 Who would be the embryo assigned authority? Can embryo choose its own fully authorized microsurgeon?

The embryo is a highly ambiguous entity in both moral and biological context. For this reason, bioethical discussions over embryos seem never to reach a mutual conclusion from a theoretical point of view. Yet, embryo manipulations need to be regulated more clearly, given that embryos are expected to become part of reproductive clinics once genetic intervention finds a way to overcome moral, theological, and legal obstacles. It is thus significant to find a practically viable common ground in between all- and none-bioethical approaches [1].

The assistants, biologists, or technicians are not considered to be embryologists proper, but their responsibilities can, under some circumstances, be carried out by embryologists, so there can be some confusion between the roles. Numerous titles are presently used for clinical embryology positions. This leads to confusion about the roles and responsibilities for each [29].

I personally partly agree with this view: The question was not ‘what are we allowable to do with embryos’ but ‘are embryos pre-born children, property, or something else’ and ‘who has authority over extracorporeal embryos?’ [1].

In such unclear situations it is logical to ask: Who has the right, or, in what way does someone have the right to decide on when human life starts? In human rights law, the accepted view is that human beings become the subject of rights from the moment of birth onward neglecting embryonic life in laboratory.

While being the embryo’s right, it is simultaneously a duty for a clinical embryologist who ought to be a guardian keeping all options open until the embryo becomes autonomous and will have the capacity.

2.6.1 Who is the fully authority for embryo microsurgery?

Of course, “embryo development in natural way” view may change should we observer the growth of artificial wombs such that in vitro embryos were able to be established into babies in them.

All the training programs that currently exist involve the review and/or evaluation of both theoretical knowledge and practical know-how and skills but not involve medical hierarchy, full medical authority or meaningful regulations to keep not only embryo, also parent’s, additionally institution’s rights.

Clinical Embryologists do not fit precisely into any of the outdated categories of laboratory workers, such as technician, biologist or technologist.

This is because the work of the Clinical Embryologist is typified by a high degree of technical skill and experience, extensive medical knowledge, and day-to-day responsibility for making many of the routine, but crucial, decisions that directly affect patients’ treatment, like a Medical Director. The most other ‘medical laboratories’ that are already directed by a physician with specialist training in specific areas of laboratory medicine.

Some authorities state that “if we are saying “clinical” meaning carries medical capacity and responsibility”; If we are talking about embryo has an individual capacity; if we are mentioning that embryo manipulations are namely “microsurgery”; it would not be surprised choosing a laboratory director among medical doctors received a special education from authorized institutions carrying a clinical embryologist specialist diploma. Because The role of the embryologist typically encompasses clinical treatment, microsurgery, clinical laboratory testing and laboratory management. They are hierarchically overing nurses, technicians, biologists and technologists. Within these broad categories, the Clinical Embryologist makes treatment decisions, reviews records and consults with other members of the ART team as well as with patients [30].

Many Clinical embryologists tend to think the problem is one of design, of specifying the best types of persons so that they can proceed to produce them. Thus, they worry over what sort of individual there is to be and who will control this procedure. They do not tend to think, perhaps because it weakens the importance of their role, of a system in which they run a “reproductive bazaar,” meeting the individual specifications of prospective parents. The term reproductive bazaar can deal with many reproductive processes and services, such as preimplantation genetic screening both for disorders and abnormalities and for positive traits or sex; sale/donation of mitochondria, of female and male gametes and of embryos; surrogacy; or the use of germline reproductive technologies.

Kevles stated that: Without any regulation or medical authorizations, some embryonic manipulations like eugenics fell into disgrace in the rouse of the Nazi policy of “racial hygiene” because of the painful and inhumane methods it used to “purify” the Arian race and rid it of evidently mediocre individuals, including mentally retarded individuals [31].

2.6.2 Current regulations

Regulatory authorities and professional associations do not always appropriately recognize the meaning of Clinical Embryologist as a title or key role of the Clinical Embryologist as an organization’s scientific professional, or their roles in effective ART laboratory hierarchy, direction and management. International agreement on the character, role and hierarchal place of the Clinical Embryologist was currently absent in terms of medical law or ethical regulations. Embryo has a part of legitimate, moral and ethical right like.

The progress that has taken place in clinical embryology has given rise to the need for new conceptualizations of the human embryo.

The role of Clinical embryologist as a reproducer, the physician as a co-reproducer, which has been neglected in the bioethical debate, can be questioned, as can the role and responsibilities of other professional or institutional co-reproducers: the lab, the sperm-bank or the infertility center.

In many countries, like physicians or mimicking physician’s role, the embryologist is responsible for communicating with patients about laboratory procedures and the progress of their embryo development in the laboratory.

The value they accord to the embryo is variable and depends also on criteria external to the embryo and related to intentions of people. At present, for example, only some countries had officially recognized certification.

Similarly, It is a virtually unknown qualification in the ‘outside world’. In France, only specially qualified clinicians can run ART laboratories, everyone else is a technician. In the USA, for example, the American Board of Bioanalysis has defined educational, and training requirements for five different levels of certification (including Technical, Supervisor, Embryology Laboratory Director, and High-complexity Clinical Laboratory Director). Another good example, Only qualified specialists are running ART in Turkish Governmental Hospitals. Turkish medical faculties have specific laboratory medicine physician program namely Medical Histology and Embryology Specialization program to be good candidate to manage not only Embryology laboratories also Tissue and Cell Laboratories with full authority. But Turkish private clinics still prefers to keep non-physician individuals stating some excuses financially or lacking number of Specialist related to this field. Personally, I would like advocate Turkish governmental system as a good hierarchical model in terms of embryo ethics, embryo moral right and legitimacy of reproductive medicine. Also, this model protecting institutions from insurance companies of parents blamed lab personnel stating “what happened to my baby” If something happens their embryo. I am presenting this model as a “Turkish medical reproductive management model” in some seminar and congress [30].

2.6.3 Preparing external conditions for embryo

If we evaluate the to prepare convenient environment discussion on embryo manipulations from the point of view of the new and innovative character of reproductive technologies, at some points this debate has been underdeveloped.

Human embryos deserve moral respect because soon they may become part of clinical procedures in reproductive clinics. Thus, to adopt such a significant future application, we need to use the transitory time period we are currently in to discuss and regulate such interventions in advance.

The embryo as a new entity created by these techniques has been discussed at length, but the creation of new relationships and responsibilities has received rather fragmented and one-sided attention, while the shift in medical practice itself (from therapeutic to productive) has gone largely uncommented. We must now analyze to takes seriously the technological character of our present culture.

In the years subsequent the first IVF-birth, many governments, institutions and authorities started to make a start in the path of regulating the new reproductive techniques. According to Walters, the period 1979 till 1988 can be considered the “heyday of guideline writing” [32]. Many ethical and advisory committees were appointed to issue statements and references that were tried to be both ethically defensible and politically acceptable. Thus, these statements form a special kind of bioethical discussion directed towards agreement and public policy creation. Over 85 committee statements were prepared in 25 countries. Walters’ review of the 15 major reports issued between May 1979 and December 1986 shows that IVF was unanimously considered ethically close to be acceptable but not enough in terms of new social necessities or hi-tech development of this field.

A large part of the literature in this third period does not actually discuss normative problems surrounding IVF. Others compare the several reports, laws and regulations issued in various countries and some even discuss the role of law, philosophy and ethics in public policy making. Other authors, especially those with a legal background, make suggestions or issue proposals for new laws or regulations themselves.

Equally important principles the instruction suggest the right of every human being to life a physical integrity from the moment of fertilization; the right of the family as an institution; and the right of the child to be conceived, brought into the world, and brought up by his parents [1].

Given the wide acceptation of 14 days limit among ethicists and committee members, there may be some difficulties in justifying this limit “philosophically” it clearly works in practice.

The concept ‘pre-embryo’ for the embryo during these first 14 days can be characterized as a realistic intervention in the argument. It presents a new term to designate a new entity, it makes it easier to speak about questions surrounding this new entity, and it combines the idea of gradual protectability. The new term ‘pre-embryo’ both enables and expresses a consensus on this point. New perspective and technique of embryo manipulations opened or created a new practice, different from traditional medicine. While IVF used to be described as a therapy for infertility, it can just as well be described as a “service to bypass childlessness”.

Once it was possible to cultivate the embryo outside a body, and especially after it had become possible to preserve the embryo almost open-endedly by freezing it, it also became imaginable to ask to whom this (frozen) embryo belonged (to the providers of the gametes, to the embryo-bank, or to the lab?); and once it was possible to operate or extinguish the embryo at will, it developed imaginable to ask what one was allowed to do with it.

We consider that with the act of merging the oocyte and the spermatozoid a long-lasting procedure. Any effort at ending the process of development would be a criminal act. Because what would be the difference in guarding dignity, we can ask ourselves, between a newborn of a few weeks and a newborn of a few seconds. Therefore, the human embryo should be protected from its very beginning. This point of view is also shared by L. Honnefelder, who states that the description of the embryo’s dignity is done by relocating the moral status of the born to the unborn human based on identity and continuity of development, which principals from the unborn to the born human [33].

The Assisted Reproductive Treatment market is motivated for the most part by for-profit motivation. New reproductive technologies generate new markets of consumers; supply generates demand. Immediately a new market is established, the hunger of medical entrepreneurs is complemented by a consumerist address of desire. The language of “would like” or “want” translates into “need,” which then turns into a sense of claim, the declaration of a “right to use the technology”, and a demand for instant satisfaction [34].

Leist reflects that with this fact is based on the belief that there is a general prohibition on killing any human being where a human being is considered that which is alive and belongs to the human species, a category in which the human embryo falls. Appropriately, the conclusion could be made that “human life starts with the fertilized egg cell” [35].

Almost every country has similar article says, “Every human being has the right to live” or “A person’s liberty and personality are paramount” and “No-one should be subjected to any kind of abuse or, without consent, medical or scientific experimentation. Forced and obligatory labor is forbidden” From these totally well-defined constitutional principles follows the conclusion: the question of protection of human life is existential question of a human community, one human species which supports the dignity of a human being.

3. Conclusions

Most authorities are seeking competency-based framework factors on consideration for Direction level Clinical Embryologists. These manuscripts are mostly mentioning “Ideally, earned doctorate in biomedical science”, but they are forgetting doctorate degree is an academic degree not clinical.

Rather, Clinical Embryologists are more like ‘practitioners’ in the general sense of the word, rather than the specific sense used in the Turkey in the definition of hierarchical roles, responsibility in clinical embryology and reproductive medicine.

We determined that, while embracing diverse moral thoughts and religious beliefs about the embryo, we can use the potential of embryo manipulations to help human beings.

We can discriminate firm factors playing a part in the probability that an embryo develops into a person: (1) the amount of resemblance to the human bodily form, (2) the degree of independence or self-sufficiency with respect to a particular environment (e.g. the endometrium), and (3) the fact that the embryo has passed some critical and easily identifiable markers in its development (individuality, development of the spinal cord, brain stimulation, becoming a responsive being, etc.).

Although I personally consider that human life begins with fertilization, that moment when the possibility that a living human being develops from an embryo.

In this chapter I have searched for an answer to the question: when does human life begin, and answer to the question who has the right to decide that life begins with fertilization or in some other phase of growth of the human embryo.

In this respect I have revealed numerous and conflicting opinions of view about when human life begins, listing different arguments, arguments of those who are in favor of human life beginning with fertilization and consequently the need to protect the dignity of the human embryo, and arguments of those who consider that the dignity of a human person is not the same as the dignity of the human embryo.

I personally respect their intuition that embryos should not be treated merely as any other type of body tissues and there should be some limits to the uses of human embryos.

Consequently, the fundamental question is asked: when does human life accurately begin, i.e. when does a human being undertake the right not to be destroyed? Nevertheless, without clear legal regulations there will always be the possibility to perform morally questionable procedures on the human embryo. In the case of embryos, this respect-commanding quality is connected to the embryo–child’s potential to become a person consistent with its consecutive phases.

Picking the future child’s height, hair or eye color, sex and, possibly at some point, cognitive skills, artistic or sporting capacities may seem instinctively wrong, as it implies conditional acceptance as well as rejecting the idea of the child as a gift. It also involves designing and shaping—in other words, interfering with— the child’s future, which may lead to violating her autonomy.

Embryology laboratory is a tentative mother for embryo. This means that if something is human, then it should be sheltered, and that should be the value of all actions. Embryos have human dignity and need protection.

According to our proposal, the concept of moral respect involves that embryo should be handled by a physician/ specialist trained in embryology. If we argue that respect to embryos can be shown by leaving their handling to embryologists, a reform in postgraduate medical education may become necessary. To our knowledge, clinical embryology training as a postgraduate medical specialty for medical doctors exists only in a few countries.

Consistent with the accepted legislation, in order to be an embryologist in Turkey (similarly some part of Dutch, France and Belgium), it is necessary to be a reproductive specialist medical doctor who fully authorized for microsurgery and intra cytoplasmic micro injections alike manipulations [30]. Additionally these individuals must pass the specialty examination in medicine. This specialty program is called Medical Histology and Embryology belongs to Medical Histology and Embryology Department belongs to Faculty of Medicine. This Medical Clinical Embryologist Group also have an international organization open access is called Society of Histologists and Embryologists SoHE/ hemud [36].

Throughout this chapter, we defend the view that preimplantation embryos used in the lab deserve moral respect in some point, because (i) they have an inherent potential to become “one of us”; (ii) they are human organisms in a biological sense, and (iii) they will soon be considered as patients in reproductive clinics. We also suggest that if embryos soon are to be considered as patients being subjected to genetic intervention in a petri dish, then they need to be handled by a physician/specialist trained in microsurgery and has full authorization to deal with embryos: a medical clinical embryologist.

Acknowledgments

This chapter did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors declare no conflict of interest.

Notes/thanks/other declarations

I wish to thank Society of Histologist and Embryologist SoHE/hemud committee members.