Just a brief post here on a particularly interesting article prominently featured in today’s NYT. It’s about preimplantation genetic diagnosis–also called PIGD. This is a topic I have written about before.
The idea with PIGD is simple, though the issues raised are anything but. When one does IVF the pre-embryos grow to something around an 8-cell stage in a petri dish. Without causing any harm to the developing embryo you can take one of those cells and do all kinds of genetic testing on it. It is that ability to do genetic testing that presents ethical quandaries.
Of course, some people will say that all IVF is bad/immoral (I believe this is the formal position of Catholic doctrine). But let’s just assume for the moment that we think IVF is okay.
The least controversial use of PIGD, it seems to me, is in selecting healthy embryos for transfer. Remember that there are virtually always more embryos created than can/should be transferred at any one time. Suppose you have six. You only want to transfer one or two. I’m fine with using PIGD to eliminate embryos without potential to develop into viable fetuses. Indeed, I think some would say you should use PIGD to select the “strongest” embryo(s), and perhaps this would allow you to transfer only one embryo, which obviously reduces the risk of twins, etc.
The article discusses a different use of PIGD and raises a whole other set of issues–are there times when one should be obliged to use it? Amanda Baxley carries a gene which will, in time, lead to an early and fairly horrible sounding decline/death. If she wants to have a genetically related child should she take the chance of passing that gene on? At a minimum, doesn’t it make sense to use PIGD to ensure that her children don’t have to face the children she herself faces?
But there’s a further suggestion: Given the availability of PIGD, is it ethical not to test–to leave the matter to chance or fate or however you would like to describe it? If we can eliminate the risk, shouldn’t we do what we can to do just that? This is the flip side of “is it okay to test?”
There are also difficult questions with the entire question of screening. You can use PIGD to screen for a lot of things and surely we are going to be adding more things to that list. Would it be okay to use PIGD to pick an embryo likely to produce a tall child over an embryo likely to produce a short one? While the eugenic overtones of this are chilling, I also find myself thinking that maybe it isn’t for me to tell other people what to do. If there’s a line to be drawn between the permissible screening and the impermissible, why would I be the one who gets to draw it? Is it a personal choice or a societal one?
I find myself thinking about abortion, too. I support the right of a woman to elect to have an abortion and I don’t think I get to tell her the list of acceptable reasons she can choose from. So if a woman could abort a fetus that carried a particular gene, doesn’t it make sense that she can screen out the pre-embryos that carry that gene? Of course, it’s easier not to use a particular embryo than it is to choose to have an abortion. And so maybe that means that embryos would get screened out that would not get aborted. But assuming this is so, does it mean I treat the decisions differently?
I wouldn’t leave this problem just to the ethicists, as I think it is one we all need to consider. That’s not to say, though, that I wouldn’t be interested in listening in on their conversations.