Ethical Concerns Associated with the Pre-Implementation Screening Process

kara1In 1992, Dr. Alan H. Handyside was able to successfully test a fertilized embryo for cystic fibrosis before implanting the embryo back into the mother [1]. First, Dr. Handyside extracted multiple eggs and sperm, fertilized the eggs, and allowed the embryos to develop in the lab for a few days, part of the process of in vitro fertilization that is commonly used to help those who cannot conceive. He then did a biopsy on the embryos to test them for cystic fibrosis, and the embryo that was found to not have cystic fibrosis was implanted into the mother’s uterus. This process of identifying genetic traits of embryos before they are implanted into the female is known as the Pre-Implementation Screening Process (PSP). Since 1992, applications of the PSP have increased in number so that it is now a very common process. Currently, only genetic disorders and sex are commonly screened for, although one could potentially screen for any trait.

Clearly, there are many positive implications for the use of the PSP. Couples may use the PSP to have a child who can act as a “savior sibling” for another child who is sick and in need of cells, bone marrow, and transplants. The savior sibling may be screened through the PSP to be made as genetically similar to the older, sick child as possible [2]. In addition, unnecessary suffering can be ended by decreasing the number of people with genetic disorders in addition to creating an alternative treatment method for extremely sick children.

Nevertheless, there are many ethical concerns with its usage. Couples may opt to discard embryos found to possess undesirable traits, such as  genetic disorders, and some feel that discarding embryos violates the sanctity of human life and equates to an act of murder. Many also feel that it is wrong to screen embryos for traits because they see it as playing God and interfering with fate. For instance, Pope Francis recently spoke out against the use of in vitro fertilization and other artificial reproductive procedures like the PSP: he saw them as “sins against God as the creator” [3]. Moreover, some consider the creation of savior siblings to be wrong because it does not respect the birth of the younger child, who would essentially be used for parts.

Worse, there is little current regulation of the PSP. No law restricts which traits may be screened for. Thus, many fear the process to be a slippery slope. If our knowledge of genetics becomes sophisticated enough to understand how complex traits like eye color, hair color, or even intelligence arise, people may use the PSP to screen embryos on the basis of these non-essential traits, known as creating a “designer baby”. We might witness the rise of eugenics and selection against children who simply have undesired or below average looks. As our knowledge of genetics gets more and more sophisticated everyday, it is increasingly probable that this could occur. Consequently, it is urgent for countries to create regulations on the Pre-Implementation Screening Process. These regulations should specify which traits parents are allowed to screen for and how to ensure that parents are making responsible choices.kara2

Although there is the potential for a eugenics movement, many scientists point out that in order for parents to create “designer babies,” they have to possess or carry these desired traits themselves to pass it on to their child. If a family wants a daughter with blonde hair, blue eyes, and above-average intelligence, the parents have to carry the appropriate genes. Otherwise, no matter how much screening is done, they cannot have a baby with these traits. This would prevent the creation of “designer babies.” As a result, some do not consider the process of screening to be wrong since the potential already exists for these traits to appear.

Even though there are ethical concerns, the benefits of using the PSP cannot be understated. While the PSP is extremely expensive, many families cannot afford to take care of children with disabilities. Families with histories of genetic disorders could benefit greatly from using the PSP. Thus, it is important that this service becomes more affordable. Some insurance companies have already started to cover the service for couples that have family histories of genetic disorders, but more work still needs to be done to ensure the widespread use of the PSP for families that want and need to use it.

The usage of the Pre-Implantation Screening Process is a complex issue with many ethical and religious considerations. Policy makers need to create regulation for the usage of this technology. As our knowledge and understanding of genetics improves, the possibility of “designer babies” becomes more relevant. Consequently, we must decide how much choice a couple has in determining the traits their baby will have and work to ensure that all couples who want access to the service have it regardless of their socioeconomic standings.

References:

[1] Alan H. Handyside et al., “Birth of a Normal Girl after in Vitro Fertilization and Preimplantation Diagnostic Testing for Cystic Fibrosis,” New England Journal of Medicine 327, no. 13 (1992): pg. # 905, doi:10.1056/NEJM199209243271301.

[2] “Who Uses PGD?,” Centre of the Cell, 2012, Saviour Siblings, http://www.centreofthecell.org/centre/?page_id=214.

[3] Francis X. Rocca, “Pope Calls Abortion, Euthanasia, IVF Sins ‘against God the Creator'” Catholic News Service, November 17, 2014, http://www.catholicnews.com/data/stories/cns/1404767.htm.

Image References:

[1] “Number of Test-tube Babies Born in US Hits Record Pct – World Bulletin.” World Bulletin. February 17, 2014. http://www.worldbulletin.net/haberler/129058/number-of-test-tube-babies-born-in-us-hits-record-pct.

[2] Kropp, Caitlin. “Ethical Issues regarding Designer Babies Spark Controversy.” The Globe :. January 29, 2010. http://www.chsglobe.com/2689/features/ethical-issues-regarding-designer-babies-spark-controversy/.

 

Kara Zielinski is a freshman at George Washington University and is a biophysics major. She is very interested in the crossover of science and society, especially in terms of science and international affairs and development. Follow The Triple Helix Online on Twitter and join us on Facebook.

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