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Chapter 4
Chapter 4

Genetics & Reproductive Medicine

Ongoing progress in genetic technologies opens new prospects for understanding and treating disease, while advances in reproductive technologies offer opportunities to create families in novel ways — posing challenges for patients, families, physicians and society.


The fact that genetic information carries implications for others to whom the individual is biologically related raises ethical challenges of balancing confidentiality against the well-being of others.
Opinion 4.1.1

Genetic Testing & Counseling

Genetic testing is most appropriate when the results of testing will have meaningful impact on the patient’s care. It is important that patients always receive appropriate counseling. Physicians should not encourage testing unless there is effective therapy available to prevent or ameliorate the condition tested for.
Opinion 4.1.2

Genetic Testing for Reproductive Decision Making

Physicians may ethically provide genetic testing to inform reproductive decision making when the patient requests, but may also wish to offer broad screening to all persons who are considering having a child.
Opinion 4.1.3

Third-Party Access to Genetic Information

Patients who undergo genetic testing have a right to have their information kept in confidence, and a variety of state and federal laws prohibit discrimination by employers, insurers, and other third parties based on genetic information.
Opinion 4.1.4

Forensic Genetics

With the exception of genetic information (or material) collected under the jurisdiction of a coroner, medical examiner, or other medical legal officer, the release of genetic information from a physician’s records without the patient’s informed consent constitutes a breach of confidentiality. However, under limited circumstances, physicians may disclose such information to the criminal justice system.

Reproductive medicine

Assisted reproduction offers hope to patients who want children but are unable to have a child without medical assistance.
Opinion 4.2.1

Assisted Reproductive Technology

Assisted reproduction offers hope to patients who want children but are unable to have a child without medical assistance. In many cases, patients who seek assistance have been repeatedly frustrated in their attempts to have a child and are psychologically vulnerable. Those patients whose health insurance does not cover assisted reproductive services may also be financially vulnerable. Candor and respect are thus essential for ethical practice.
Opinion 4.2.2

Gamete Donation

Donating eggs or sperm for others to use in reproduction can enable individuals who would not otherwise be able to do so to have children. However, gamete donation also raises ethical concerns about the privacy of donors and the nature of relationships among donors and children born through use of their gametes by means of assisted reproductive technologies.
Opinion 4.2.3

Therapeutic Donor Insemination

Therapeutic donor insemination using sperm from a woman’s partner or a third-party donor can enable a woman or couple who might not otherwise be able to do so to fulfill the important life choice of becoming a parent (or parents). However, the procedure also raises ethical considerations about safety for the woman and potential offspring, donor privacy, and the disposition of frozen semen, as well as the use of screening to select the sex of a resulting embryo.
Opinion 4.2.4

Third-Party Reproduction

Third-party reproduction is a form of assisted reproduction in which a woman agrees to bear a child on behalf of and relinquish the child to an individual or couple who intend to rear the child. Collectively, the profession should advocate for public policy that will help ensure that the practice of third-party reproduction does not exploit disadvantaged women or commodify human gametes or children.
Opinion 4.2.5

Storage & Use of Human Embryos

Embryos created during cycles of in vitro fertilization (IVF) that are not intended for immediate transfer are often frozen for future use. Ethical concerns arise regarding who has authority to make decisions about stored embryos and what kinds of choices they may ethically make. Under no circumstances should physicians participate in the sale of stored embryos.
Opinion 4.2.6

Cloning for Reproduction

In light of the physical risks of somatic cell nuclear transfer, ongoing moral debate about the status of the human embryos, and concerns about the impact of reproductive cloning on cloned children, families, and communities, reproductive cloning is not endorsed by the medical profession. Should reproductive cloning at some point be introduced into medical practice, however, any child produced by reproductive cloning would be entitled to the same rights, freedoms, and protections as every other individual in society.
Opinion 4.2.7


The Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice.