The conclusion that animal research remains necessary for the responsible introduction of new ARTs is only a first step in determining the ethical acceptability of such research. The next step concerns the question whether the aims served with ART research are important enough to justify the use of animals. Whereas in the previous section we explored whether the subsidiarity principle was met, we now turn to the question of whether such research is also proportional. To answer this question, we need to explore what is in the scales on both sides of the balance. On the moral cost side, we first need to get a clearer picture of what precisely is at stake in terms of the impact on animal wellbeing where testing animals for ART research is concerned. We will then move on to the other side of the balance in order to discuss whether the moral benefits of ART research are substantial enough to outweigh the moral cost.
The moral cost of using animals for ART research
In the “
Background” section, we described the research process using animals in different stages of their lives. How do these research procedures translate to moral cost in terms of compromised animal welfare and animal suffering? To perform animal gamete or embryo research in vitro, oocytes and sperm need to be isolated from full grown animals. In some species, such as cattle, researchers can use spare material from abattoirs to retrieve gametes. In most other species, however, such as in the mouse model, females must undergo hormone stimulation. The injections lead to short and light pain for the animals, but the hormone stimulation itself does not lead to animal distress. The mice will be euthanized and their reproductive tissues removed, after which oocytes are collected from the fallopian tubes of females and sperm from the epididymis of males. Hormonal stimulation of the females is also a first step in research involving animal embryos in vivo. A few days after mating, the carrier will be euthanized and its fallopian tubes and uterus removed in order to allow the isolation of fertilized oocytes (or embryos). Fetuses and newborn animals will be euthanized prior to being tested, for instance for epigenetic abnormalities. To test the adults, a piece of tissue will be removed which may be slightly painful, but that is something that can be avoided by sedation. Thereafter, the tissue will be tested. Ultimately, most research animals will be euthanized when they are no longer useful for the research (except for e.g. nonhuman primates).
How do we evaluate the moral cost of these procedures? If one wants to assess animal research for a specific research project, the moral cost depends on what procedures are needed for answering the precise research question and concerns elements such as the number of animals used, the use of anesthetics and which animal species are needed. Here, we want to assess the moral cost of animal research on ARTs in comparison to other practices using animals. Several accepted animal research practices are highly invasive. For instance, in studies aimed at developing therapies for cancer or burn injuries, animals are exposed to conditions that may cause significant suffering as a result of tumor growth or inflicted burns (Abdullahi et al.
2014; Workman et al.
2010). Animal research on ARTs, on the contrary, is much less invasive, since animals will be at most subjected to short and light pain and are killed painlessly instead of being subjected to significant suffering. As explained by philosopher Jeff McMahan, the general view is that “it is more important to prevent the significant suffering of animals than it is to prevent, or not to cause, their deaths” (McMahan
2002). We conclude that the harm done to animals in ART research is, in comparison to cancer or burn research, relatively low, resulting in a relatively low moral cost.
Comparing animal research on ARTs to another widely accepted practice of animal use, namely the social practice of eating meat, invites the same conclusion that animal research on ART has a relatively low moral cost. Whereas animal research should always meet strict rules in accordance with the principles of the Three Rs, these principles are not incorporated by the food industry. Consequently, research animals are generally treated with more respect and are subjected to less suffering (e.g. using anesthetics, proper housing) than food industry animals.
As animal research on ARTs comes with a relatively low level of harm, the moral cost of these procedures is low in comparison with that of other generally accepted animal research practices and with the use of animals in the meat industry. Nevertheless, since also in animal research on ARTs, animals suffer some degree of pain or are killed, their use as research models is in need of justification. This leads to the question whether the moral cost is proportional to the potential benefits.
Justifying aims of animal research: human health as a benchmark
In line with the ethical framework discussed in section “
The ethical framework for animal research”, the European Directive refers to “the avoidance, prevention, diagnosis or treatment of disease, ill-health or other abnormality or their effects in human being” as justifying aims of animal research (European Commission
2010). This reflects the widely shared notion that health is such a vital need for humans that if animal research can ever be regarded as serving a sufficiently important aim, it must be for health. If we take this as the upper end of a spectrum of considered acceptability, then most cosmetics research would be found at the lower end. Longstanding ethical concerns about the proportionality of the use of animals for consumer cosmetics has led to an official ban of this practice in the entire European Union since 2013 (European Commission
2009). Apart from the availability of possible alternative methods for safety-testing, an important reason for this is that developing products that merely cater to consumer preferences is not regarded as sufficiently weighty to justify the inevitable infringement of animal wellbeing. Taking the uncontested value of health as a benchmark, our question thus becomes where on this spectrum the benefits provided by ART research are to be positioned.
This question cannot simply be answered by pointing to the fact that the relevant research is meant to protect humans from possible health risks connected to untested technologies. While this is a necessary element of any justification of the use of animals for preclinical safety studies, it is not sufficient to make the case. As with regard to consumer cosmetics, whether the use of the relevant technology would be safe only becomes a proportionality affecting issue when it is first established that the use of the technology as such serves a morally weighty aim. Therefore, the proportionality question should be addressed on two levels. We will start our assessment on the first level, where it is questioned whether the benefits of MAR are important enough to justify the use of animals. Only when this criterion can be met, the step can be made to the second level, where it is questioned whether the aims of ART research are important enough to justify the use of animals.
The moral importance of medically assisted reproduction
With regard to the first level, the aim for which MAR was originally developed, i.e. helping people with fertility problems to have children, has led to a long debate about whether infertility should be regarded as a disease (Holm
1996). Reasons for an affirmative answer (Zegers-Hochschild et al.
2017) are that on the level of biological functioning, fertility problems can be ascribed to observable or presumed abnormalities in the reproductive system. Although MAR does not take away or ‘cure’ those abnormalities, it provides fertility patients with something (a child) for which reproductively healthy couples need no medical help. Clearly, for those taking this view, developing new ARTs for people with fertility problems is a matter of developing health care, putting the importance of the needed research in the higher end of the spectrum.
Others have however argued that infertility is not so much a disease, but rather a (social) handicap (Holm
1996). In their view, childlessness becomes a problem in the context of societal expectations and personal desires, rather than as a direct consequence of a biological abnormality. This also connects with the idea that for those who regard their childlessness as a problem, there are other options for having a child, thus relativizing the importance of developing new ARTs. For example, adoption is an alternative to medical treatment, or having a child through low-tech donor insemination is an alternative to high-tech ICSI. This might lead to the conclusion that the importance of developing new ARTs is relatively low. However, the value that many people place on having a child with a genetic link to (ideally) both partners, points in the opposite direction and is an important driver for developing new ARTs capable of providing just that: a child of which both partners are the genetic parents.
Currently, ARTs are not only being developed to help the infertile to have genetically related children, but also to help other people, regardless of their fertility status. Future MAR options using SCD-gametes will to a large extent serve that aim. This might also make it possible for people who are unable to reproduce due to their sexual orientation, relationship status or age to have a genetically related child. For women who for whatever reason expect not to be able to fulfill their child-wish prior to running out of functional oocytes, the development of SCD-gametes will also make oocyte or ovarian tissue cryopreservation redundant. Since it is obvious that when dealing with this wider range of requests, MAR does not respond to a health problem and that for those involved there may be alternative routes to having a child, the question becomes how the importance of these reproductive services relates to the uncontested value of human health on the one end of the spectrum and the trivial importance of consumer cosmetics on the other.
A specific form of MAR entails helping people to have children who are not only genetically related, but also healthy. This concerns people who may or may not have a fertility problem, but who want to avoid having a child with a genetic disorder that they are at risk of transmitting. MAR treatments that will allow them to have a child without the specific genetic disease include PGD, MRT, or possibly germline gene editing (CRISPR-cas9) in the future. In terms of our spectrum, treatments to avoid the transmission of genetic diseases might be regarded as falling in the category of health. The argument behind this reasoning is that a healthy child can only be realized by ensuring that the child is born without the genetic defects of which their parents are healthy or affected carriers. However, to realize the aim of having a healthy child, parents can also choose for using donor gametes or adoption instead of medical treatment. Nevertheless, many patients choose the latter option, despite the invasiveness of ART treatments. This shows, again, that there is apparently a socially determined motive for preferring the options leading to a genetically related child over other alternatives.
As it appears most appropriate to say that the practice of MAR serves the aim of helping people to have a genetically related child, our question about the moral weight of developing new ARTs requires an assessment of the importance of this aim. Although research has shown that there are no significant differences considering psychological well-being between biologically and non-biologically related parents and children (Golombok et al.
2004,
2006; Lansford et al.
2001), and although some commentators have called the preference to have genetically related children ‘irrational’ (Holm
1996; Bayles
1984), it is clear that many people do consider the genetic link to be very important. For instance, the decision to establish a family through donor conception is often only made after a long process of failed ART treatments with the prospective parents’ own gametes and coming to terms with this situation may for many be possible only after a period of serious grieving. Moreover, what are often presented as alternative ways of having a child are not always available due to strict conditions (adoption) or scarcity (donor oocytes) or come with challenges of their own. For example, the abolishment of donor anonymity in a growing number of countries (which in itself can be regarded as reflecting an increased societal emphasis on the importance of the genetic link (Pennings
2012)) has made donor conception less attractive to many couples who are weary about future contact of their child with the donor and the possible role that the donor may want to play in their family (Brewaeys et al.
2005).
We acknowledge that given the different views about the importance of the genetic link, MAR cannot be said to serve a vital human need in the same way some other medical interventions do. However, it would neither be correct to say that it serves a trivial preference. Given that those different views connect to the plurality of understandings of what a flourishing life means, and in the light of the value attached to that plurality in our liberal society, we argue that the practice of MAR does indeed serve a morally weighty aim.
Is MAR important enough to justify the use of animals in research aimed at improving the practice (if no alternative methods are available)? We see two reasons for arguing that it is. Firstly, as long as the large-scale use of animals for food, where alternatives are readily available in the form of vegetarian or vegan lifestyles, is considered morally acceptable by society, it seems difficult to maintain that research aimed at improving MAR would not be sufficiently important. Secondly, the earlier observation that, also in comparison with the use of animals in the meat industry, preclinical ART research has a relatively low impact on animal wellbeing, further supports this conclusion.