Genetic Testing and Ethics

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

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Access to Free Contraceptives Lowers Pregnancy, Abortion Rates

For this they needed a study?  Apparently the answer is “yes.”   You’ll find news reports scattered over the media today reporting on it, but they are mostly quite similar.   Researchers provided women with free contraceptives for three years.  They gave women a choice of methods.   The result?

women experienced far fewer unintended pregnancies than expected: there were 4.4  to 7.5 abortions per 1,000 women in the study, after adjusting for age and race — much fewer than the national rate of 19.6 abortions per 1,000 women and lower  also than the rate in the St. Louis area of 13.4 to 17 abortions per 1,000  women.

Surely the causation here is pretty obvious–if women use contraceptives they do not get pregnant they do not need abortions.

A Right To Genetic Testing?

I’m going to pull away from that extremely lively discussion of surrogacy (always a fascinating topic) to talk a bit about another story that caught my eye a while back.    At the end of August the European Court of Human Rights found that Italy violated the rights of a couple carrying cystic fibrosis when it refused to allow them to do PIGD.   (We’ve talked about PIGD before on the blog.   It is pre-implantation genetic diagnosis and it allows you those doing IVF to screen pre-embryos before they are transferred into a woman’s uterus.)   To put this slightly differently–the court ruled that the couple had a right to screen the pre-embryos before transfer.

Italy is one of three European countries (the others are Austria and Switzerland) that ban use PGID. 

Why You Want A Surrogacy Contract (Even If There’s No Chance You Can Enforce It)

Two recent stories about surrogacy can be tied together here to offer an important lesson:  People who contemplate surrogacy should, at a minimum, work out a detailed agreement that describes what it is they think they’ve agreed to.   (Of course, people really ought to do a great deal more than that.  In particular, they ought to have serious counselling and engage in extensive reflection about whether surrogacy is really for them.  This, as I’ve said before, is really the key to having surrogacy work for you.)  But at the same time, you should keep in mind that what you write in the terms may not be enforcable.

First we have this story of what might be surrogacy gone awry.   Except, of course, that it may not be surrogacy at all.   

Is Being A Grown-Up All About Facing Regret?

Once again I have fallen way behind in the comments.   It’s the nature of summer, I fear.   As before, I will return to them and do my best to get caught up shortly.  Many of the topics cycle round regularly so if there are particular points I miss I trust they will be raised again and I’ll have another chance.   To the extent this is avoidance (and I know it is) it’s general (all comments) rather than specific (your comment) so please do not take it personally.

At the same time, it is important to me, too, to add new content and continue the trains of thought that wander through my mind even when I’m on vacation.   I’ve been thinking about the sorts of major decisions that are often discussed here.  Giving a child up for adoption is for me an obvious and enormous one.   Or choosing to adopt a child.   Related decisions like deciding not to have children (which might include having an abortion). 

If A Fertilized Egg Is A Person, Where Does That Lead?

There’s an article in today’s NYT about a proposal to amend the Mississippi state constitution to declare that  fertilized human egg is a person.   While the drive is primarily fueled by those opposed to abortion, the implications of the amendment are obviously broader and touch on some of the topics I often address here.

One obvious impact would be on IVF.   In IVF, embryos are created in a laboratory and then transferred into a woman’s uterus.    (Do keep in mind that some heterosexual couples do this with their very own gametes, so there’s no necessary connection to all the commodification issues that we’ve been talking about with regard to sale/purchase of sperm and eggs.)   

Genetic Testing and Sex Selection: The Messenger and the Message

This story was on the front page of the NYTimes (and doubtless a lot of other places a couple of days ago.   There’s a new over-the-counter genetic test that allows you to determine fetal sex at seven weeks.  It’s part of the general march of technology that makes a lot of people (sometimes me included) nervous.

What people worry about with this particular technological advance is the use of abortion for sex selection.   Women have a right to elect abortion at seven weeks.   (And if you’re wondering, I’m committed to that right.  I know other people disagree, of course.)   I’m prepared to assume that for some women it is easier to elect abortion early on in the process.