While stringent ethical guidelines govern modern reproductive technologies, the 19th-century origins of artificial insemination are unpleasant to say the least. Elizabeth Yuko describes the “ethical nightmare” of the first successful artificial insemination in a woman for The Atlantic.

The first artificial insemination resulting in a live birth was performed in 1884. When the woman’s doctor, William Pancoast, discovered that it was her husband’s infertility that was preventing her from conceiving, the doctor decided to take matters into his own hands:

“Instead of disclosing any of this information [regarding the husband’s permanently obstructed seminal ducts] to the couple, though, Pancoast scheduled another ‘examination’ for his patient. Here’s how the first successful artificial insemination took place: In front of six medical students, Pancoast knocked out his patient using chloroform, inseminated her with a rubber syringe, and then packed her cervix with gauze. The source of the semen was one of the medical students in the room, determined to be the most attractive of the bunch.”

Pancoast disclosed this information to his patient’s husband after the birth of the child: “Together, the two men decided that she would be better off not knowing the truth about her final ‘examination’ or the biological father of her child.”

Artificial insemination is one of a group of medical procedures called ART (Assisted Reproductive Technologies) that includes all fertility treatments in which both eggs and sperm are handled. Despite the definite progress in medical ethics guiding ART procedures, they are still rife with problems.

Just this month the Washington Post published a piece on a surrogate pressured to abort one of the triplets she was carrying because the single, 50 year-old father did not want to raise three children. She filed suit to protect her decision to not have an abortion, raising questions on whether a surrogate can sign away rights to her own body.

Yuko points out that ART will always face moral conundrums:

“Even with all the advances in ART over the past century and a half… one thing has been the same since the very beginning: When babies can be created in new ways, they can also, to varying extents, be designed. It’s an old story, but an ethical debate that’s as relevant as ever.”

Is it ever possible to alter the way life is created without clashing with morality?