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September 1988

Ethical Issues at the Outset of Life

Am J Dis Child. 1988;142(9):1007. doi:10.1001/archpedi.1988.02150090105036

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This is a worthwhile attempt to initiate a comprehensive framework for ethical issues at life's outset as they are affected by a burgeoning technology of procreation.

Leading authors cover the beginnings of life, organized in sequence: preimplantation, intrauterine, and postnatal. Following this are discussions of perinatal policy in a pluralistic society, ie, comparative anthropolitical perspectives and a discussion of the complexities of translating moral perspectives into social policy.

The editorial effort rests on three strong legs—the quality of the contributors, the developmental approach to life's beginning, and the capping section on policy formulation.

The "Baby M" case, which pitted interests of the surrogate mother against those of gamete donor and contracting parents, has made familiar the conflicts between the interests of various sorts of "parents." Less discussed are ethical implications in creating multiple embryos. The fact that termination of pregnancy is the preponderantly available intervention after fetal genetic diagnosis is

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