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Ethics in Biotechnology
Published in Firdos Alam Khan, Biotechnology Fundamentals, 2020
Despite having already succeeded in mapping and identifying the whole genetic sequence of humans, scientists do not yet know the exact function of most genes. A gene contains information on hereditary characteristics such as hair color, eye color, and height, as well as susceptibility to certain diseases. The term embryo refers to the first 6 weeks of development after a sperm fertilizes an egg. Due to variation in fertility in few couples, some seek medical assistance in the form of in vitro fertilization (IVF), during which fertilization occurs outside of the mother’s body, with the embryos then being placed in her womb. Although it is unknown to what extent genes can influence someone’s skills, psychology, or overall health, it is possible to carry out tests on embryos created during IVF (before placement in the womb) to detect severe genetic defects. This technique is known as preimplantation genetic diagnosis (PGD). Concerns have been raised that this technique will result in a modern form of eugenics where people with certain disabilities will be screened out of existence, while others argue that PGD is a way of reducing pain and suffering. PGD is also used to help treat ill children. For example, in the United States, the parents of a girl named Molly Nash, who was born with a rare incurable disease called Fanconi’s anemia, underwent a controversial procedure to conceive another child who could help cure Molly. Embryos created using IVF were tested for signs of the gene responsible for the disease. Embryos that did not carry the disease underwent further testing to find those that would be a tissue match for Molly. As a result, a boy, Adam, was born, who was free of the disease and who could donate cells from his umbilical cord to treat his sister. Many people argue that there are several ethical problems with this “savoir sibling” technology. The question that arises is whether Adam would have been born at all had Molly been a healthy child or whether he was born only to save her life. Adam and Molly’s parents refute this and say that they would have had another child anyway, but that this technology ensured Adam would be healthy and that Molly’s life would be saved. Critics also express concern over whether children like Adam will constantly be called upon to donate tissue or maybe even organs (e.g., kidneys) to their sick siblings. Concerns are also raised about the possibility of “savior siblings” viewing their birth merely as a means to an end and seeing themselves as an instrument for curing disease. Another argument against selecting “savior siblings” is that several healthy embryos that are not exact tissue matches will be discarded.
Ethics in biotechnology
Published in Firdos Alam Khan, Biotechnology Fundamentals, 2018
Despite having already succeeded in mapping and identifying the whole genetic sequence of humans, scientists do not yet know the exact function of most genes. A gene contains information on hereditary characteristics such as hair color, eye color, and height, as well as susceptibility to certain diseases. The term embryo refers to the first 6 weeks of development after a sperm fertilizes an egg. This can happen naturally, but as one in six Irish couples experience fertility problems, some seek medical assistance in the form of in vitro fertilization (IVF), during which fertilization occurs outside of the mother’s body, with the embryos then being placed in her womb. While it is unknown to what extent genes can influence somebody’s skills, psychology, or overall health, it is possible to carry out tests on embryos created during IVF (before placement in the womb) in order to detect severe genetic defects. This technique is known as preimplantation genetic diagnosis (PGD). Concerns have been raised that this technique will result in a modern form of eugenics where people with certain disabilities will be screened out of existence, while others argue that PGD is a way of reducing pain and suffering. PGD is also used to help treat ill children. For example, in the United States, the parents of a girl named Molly Nash, who was born with a rare incurable disease called Fanconi’s anemia, underwent a controversial procedure to conceive another child who could help cure Molly. Embryos created using IVF were tested for signs of the gene responsible for the disease. Embryos that did not carry the disease underwent further testing to find those that would be a tissue match for Molly. As a result, a boy, Adam, was born, who was free of the disease and who could donate cells from his umbilical cord to treat his sister. Many people argue that there are a number of ethical problems with this “savoir sibling” technology. The question that arises is whether Adam would have been born at all had Molly been a healthy child or whether he was born only to save her life. Adam and Molly’s parents refute this and say that they would have had another child anyway, but that this technology ensured Adam would be healthy and that Molly’s life would be saved. Critics also express concern over whether children like Adam will constantly be called upon to donate tissue or maybe even organs (e.g., kidneys) to their sick siblings. Concerns are also raised about the possibility of “savior siblings” viewing their birth merely as a means to an end and seeing themselves as an instrument for curing disease. Another argument against selecting “savior siblings” is that a number of healthy embryos, which are not exact tissue matches, will be discarded.
Genetic ethics and mtDNA replacement techniques
Published in The New Bioethics, 2021
PGD is a technique used to test a fertilised egg to determine genetic chance of transmission of specific diseases (National Academies of Sciences Engineering and Medicine 2016). However, determining the risk of transmission through PGD is hard to predict, especially when the woman carries a high mutation load within her mitochondria and a low mutation load around her ovaries (Reznichenko et al.2016). Moreover, PGD to prevent mtDNA disease transmission involves selecting the embryo with the lowest detectible heteroplasmy level, which means this technique can reduce, but not eliminate, the risk of transmission (National Academies of Sciences Engineering and Medicine 2016). mtDNA replacement techniques are the only known medical intervention that eliminate risk of mitochondrial disease transmission. Since mitochondrial diseases cause, in many cases, shortened life expectancies, severe pain, secondary medical conditions (i.e. diabetes mellitus), affect multiple organs, and an overall lower quality of life, the application of the mtDNA Replacement Techniques is ethically supported (National Academies of Sciences Engineering and Medicine 2016).
Ordinary ethics. Examining ethical work in the Argentine fertility clinic
Published in Tapuya: Latin American Science, Technology and Society, 2020
This article offers preliminary results from a study regarding the use of pre-implantation genetic diagnosis and screening (PGD/PGS1) in the City of Buenos Aires, Argentina. PGD/PGS refer to a set of genetic testing techniques used to identify the chromosomic constitution of the embryo before its transfer to the uterus, during assisted reproduction cycles. Whereas pre-implantation genetic diagnosis (PGD) refers to the testing for specific and well-documented genetic anomalies (like trisomy 21, which causes Down’s syndrome), pre-implantation genetic screening (PGS) refers to a general, exhaustive screening of the embryo’s constitution in search for unknown genetic differences.2 The main force behind PGD/PGS is the birth of a “healthy baby” (Franklin and Roberts 2006); a result achieved by ruling out the presence of genetic anomalies in the fertilized, transferable egg. In the case of PGS, another relevant factor for its development is the need to provide further medical responses to patients who are unable to conceive after a number of ART attempts (see below). Between eight and ten cells are extracted from the embryo before its transfer to the uterus, usually on day five of development (blastocyst stage). Biopsied cells are then analyzed using complex biomolecular technologies with the purpose of establishing if they possess any genetic alteration that may cause a genetic illness or disability in the potentially resulting person.
“I did everything humanly possible”: the process of making reproductive decisions in the context of assisted reproduction in Chile
Published in Tapuya: Latin American Science, Technology and Society, 2020
For example, the information provided by prenatal diagnostic technologies – ranging from ultrasound to preimplantation genetic diagnosis (PGD) – can be used to make decisions and intervene in the reproductive process. Since mothers and fathers want to give their children the “best possible start in life” (Beck-Gernsheim 2002), they want to avoid the birth of children with disabilities or serious illnesses (Rapp 1999). Some of the decisions taken by the actors involved (mothers, fathers, health professionals) to control reproduction and ensure the birth of “desirable babies” consist of selecting donors with specific characteristics, selecting embryos or terminating pregnancies if the baby is not expected to be healthy. The people who may use PGD want to have healthy children but are concerned about the moral and ethical implications of discarding embryos (Genoff et al. 2018; Hershberger and Pierce 2010).