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 Continue reading
I’ve been thinking about the desire for control and how it fits in with the topics here–perhaps most particularly with ART, but really much more generally. It’s a little unformed, but it might start some interesting discussion.
In my experience of parenting, the desire for control is omnipresent. I suppose I mean control over a child’s life–which is not exactly the same as control over the child. To varying degrees I’ve wanted to pick a child’s teachers and/or friends, direct them to certain activities, inspire them to choose certain types of interests over others, and so on. I still vividly recall how in the first weeks of my son’s life I wanted nothing more than to be able to get him to sleep when I though he should. And one of the most astonishing lessons for me was that you cannot make a child sleep–all you can do is arrange the conditions in the room. I think this is probably a lesson all parents have to learn–and perhaps it’s really just a variation on “you can lead a horse to water but you can’t make him drink.”
In sum, while I may be atypical, or perhaps at an extreme of a spectrum, I think most parents want to have control over their child’s lives–if only so we can make them safe and healthy and happy. Continue reading
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. Continue reading
There are a couple of items in the paper today that lead me to revisit the topic of our increasing capacity for genetic testing and where this might lead us. (Both of them happen to have Seattle connections, which is really neither here nor there, but I notice these things.)
On the front page of the NYT you can find this story about the ability to do genetic testing of a fetus by drawing blood from the pregnant woman and collecting DNA samples from genetic parents of the child. Virtually the entire genome of the fetus can be determined with no risk of causing miscarriage. Of course, we don’t yet know what to do with all that information–we don’t know a lot about what most of it even means. But you can 3000 diseases that are caused by a defect in a single gene. Some of these are quite serious. Continue reading
Some months ago I wrote about the sorry history of involuntary sterilization in North Carolina. At the time, North Carolina was considering what compensation would be appropriate. The appointed commission made it’s recommendations yesterday. The recommendation is for compensation of $50,000 for those still living. North Carolina, assuming it approves the payments, will be the first state to offer compensation, though it says about half-a-dozen states had similar programs. I don’t have comments on this, I’m just following up for those who are interested.
My last post reintroduced questions about the role of money in ART and, perhaps most specifically, in the use of third-party gametes. This has really been a recurrent theme on the blog and it’s good to come back to it from time to time.
It also comes up in the news with some regularity. Here’s a recent story from Australia. It’s not exactly clear to me that this is news per se–I mean, I don’t see that anything is actually happening around the matter. It’s really a discussion piece. And it raises (albeit briefly) a number of the points that make the whole question of money complicated.
If there is no compensation at all for egg/sperm providers or for surrogates, you won’t entirely eliminate those practices, but you will severely restrict them. Continue reading
While there’s a discussion about the future of ART I thought I’d add this news note. The HFEA (which has apparently survived the bonfire of the quangos thus far) has been asked to assess three-person IVF.
The idea here, which is one I discussed a couple of years or so ago, is to avoid difficulties created by defective mitochondrial DNA. To do this you’d start with the egg and sperm and create a fertilized egg. That part is conventional IVF. But if the mitochondrial DNA of that original egg were flawed (and the article notes possible birth defects that could result from this type of flaw) you’d avoid those flaws by moving the newly created nucleus of the fertilized to a different egg (from a third person) where the mitochondrial DNA didn’t have that flaw. Continue reading
In the last year I joined the American Society for Reproductive Medicine (ASRM). One fringe benefit is that I get a subscription to Fertility and Sterility, which is their bi-weekly journal. I’ve written about this journal before, and as I said then, the vast majority of it is beyond my comprehension. The primary audience is medical/scientific.
Anyway, the latest issue has a “Editor’s Corner” piece by a very well-known ART physician who just turned 100–Dr. Howard Jones, Jr. It’s called “Seven roads traveled well and seven to be traveled more” and it is a look back on the last 30 years of progress in IVF as well as a look forward at where we will be/should be/are going. (I’m sorry that there doesn’t seem to be a way to link to this for folks.) The fifth and sixth roads to be traveled caught my attention and I thought I’d mention them here.
Dr. Jones says “[t]h fifth road seeks to improve not the quantity but the quality of our IVF offspring.” Continue reading
I realized yesterday evening that there might be a nice connection between two recent posts, the first on exploitation and the second on eugenics. These words have some notable characteristics in common.
Eugenics and exploitation are both frequently invoked in discussions of ART. They are also both heavily freighted with meaning, much of it accrued over time. And they are to some degree conversation stoppers: It’s hard, if not impossible, to be in favor of eugenics or exploitation. Continue reading
This is just a quick follow-up on a recent post about genetic screening/eugenics. Here’s another story from the UK. It’s about a baby born following successful IVF. What makes this notable is the level of genetic screening employed in an effort to ensure a successful pregnancy.
I don’t think this is what most people think of as eugenics, but the techniques employed are ones that might seem problematic in another context. Whose to say? Continue reading