Nels Granholm

Just because we can do something, ought we?

I’m speaking about a new medical procedure called preimplantation genetic diagnosis. PGD enables one to screen for specific genetic diseases like early-onset Alzheimer’s, Tay-Sachs, sickle-cell anemia and others in the preimplantation embryo prior to the actual implantation process when the embryo becomes embedded in the mother’s uterus. In theory and if it works, PGD frees us from the worry of producing offspring that will one day become abnormal due to genetic mutations. However, could PGD and related embryo manipulations damage the embryo and cause birth defects?

A recent comprehensive study on the analysis of risk for “test tube” babies concluded, “Infants conceived with the use of assisted reproductive technology were more likely than naturally conceived infants to have multiple major defects and to have chromosomal and musculoskeletal defects; infants conceived with use of intracytoplamic sperm injection or in vitro fertilization have twice as high a risk or a major birth defect as naturally conceived infants.” Assuming that this and related studies are valid, ought we do PGD?

We know we can do PGD. And we can get even better at it. But should we? Ought we embark on a program of PGD that may well lead to large-scale embryo screening? And for what genes will we be screening? Where will we draw the line between screening for obvious, harmful, life-threatening genes and so-called “enhancement genes” such as genes for intelligence, personality, height, hair and eye color, sex, debate prowess, musicality (assuming these traits have genetic components)? The marketplace rather than a set of standards based on compelling ethical principles will dictate future PGD.

So, what are we to do? As in virtually all issues of bioethics, the answer to this question boils down to how we view humanity. Do we see humanity as instrumental to some other more fundamental value such as our happiness? Or do we see humanity as embedded with certain intrinsic values that are so fundamentally important that only the advancement of powerful and cogent moral reasons will allow us to make exceptions? Is a human embryo in a culture dish the same as a pork belly on the Chicago Exchange?

Knowing where to draw the line is the hard part. Based on the apparent risk of a two-fold increase in birth defects, the absence of any meaningful participation by children in the very decision that results in their “being” (no informed consent), commodification of human embryos, quixotic dictates of the marketplace, absence of a compelling foundation of ethical deliberation, and others, the line ought to be drawn prior to PGD.

E-mail comments to Dr. Granholm at [email protected].