Iranian Journal of Medical Ethics and History of Medicine

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Confidentiality is anonymity of gamete or embryo donors to the recipients and resulted children and Vice Versa. In this article, I formulated the question about confidentiality through two main questions: 1- Ethically speaking, should the information about the characteristics and identity of donors be kept in specific organizations to be accessible for who considered having the right of access in the future? 2- Are receivers ethically obliged to inform their children about their biological origin? In this article, I assess the subject from Deontological, Utilitarianistic and Principalistic approaches and conclude that it is the right of such children to be informed about their biological origin. Of course in Iran, such ethical obligation should be suspended until the problems relating the heritage are solved.

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New antiviral remedies have greatly improved the prognosis of patients infected with AIDS, as well as their life expectancy and quality of life, and assisted reproductive techniques have made it possible for many HIV positive patients to have healthy children. Nevertheless, most assisted reproduction centers continue to reject these couples, and this is a factor that contributes to their isolation from the society. The present study was performed through document and library research, and the results were investigated from the viewpoints of the infected couple, their future children, and health care staff. Social and legal issues were evaluated through consultation and collaboration of experts, and related articles, guidelines and accessible material were examined for this purpose. Every individual has the right to reproduction. If it is possible for HIV positive couples to have children with the help of fertility lab techniques, and provided that throughout the process there is no danger of disease transmission to others and particularly the embryo, ART centers should not reject HIV positive couples. Rejection of these couples is against the principles of medical ethics and in violation of the current effective laws of the country. On the other hand, acceptance of patients infected with Hepatitis type C, advanced cancers, mental diseases, and so on is further proof that rejecting HIV positive couples is a form of discrimination and unethical. The word HIV itself is synonymous with the stigma of social deviance, and it seems children of infected parents are not in the ideal position from the public point of view. One step that needs to be taken is for the society to try to remove this stigma and provide support for all chronically ill patients. There is no valid justification for rejecting HIV positive couples in ART centers, and it appears to be unethical and a violation of human rights to deny these couples the right to have healthy children through modern technology.

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For some infertile couples, egg donation is the only option. In egg sharing programs, patients share half of their eggs with another couple in exchange for a discount on assisted reproductive technology. In many countries, using this method is legally discussed. Iran is the only Islamic country in which donation programs are practiced, so, we designed this study to compare egg sharing to ordinary egg donation from ethical, legal, and religious aspects.A complete review of ethical issues and debates about egg donation and sharing was done. For religious issues, we consulted clergies, Islamic texts, and current decrees (fatwas). Social issues and legal problems were examined by consulting expert opinion and jurists. Also a complete review of literature was done. Egg donation and egg sharing are both religiously accepted in Iran by the Shiite clergies as they are considered completely similar. Egg sharing has some religious (seeing and touching the female genitalia) and social (preventing repetitive donation) advantages to egg donation as well as avoiding complications of fertility drugs and procedures, financial and trading issues, advertisement and brokers. However, there are some disadvantages with egg sharing, such as reduced likelihood of conception by donating half of the eggs, challenges related to donor health, and emotional stress of failure for the donor and success for the recipient, which can be prevented by careful case selection, psychology and genetics consultation, and  practicing anonymity. As a result, egg sharing is ethically and religiously more acceptable than commercial egg donation.