Pre Implantation Genetic Diagnosis And Genetic Enhancement Notes

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Pre-implantation genetic diagnosis and Genetic Enhancement When can PGD be used?

• HEFA 1990 Sch 2 1ZA as amended by HEFA 2008:(1) A licence under paragraph 1 cannot authorise the testing of an embryo, except for one or more of the following purposes—

E+W+S+N.I. o (a)establishing whether the embryo has a gene, chromosome or mitochondrion abnormality that may affect its capacity to result in a live birth, o (b) to establish whether it has a gene, chromosome or mitochondrion abnormality  Where there is a particular risk that it will have so  AND (2) the Authority is satisfied • (a)in relation to the abnormality of which there is a particular risk, and • (b)in relation to any other abnormality for which testing is to be authorised under sub-paragraph (1)(b), o that there is a significant risk that a person with the abnormality will have or develop a serious physical or mental disability, a serious illness or any other serious medical condition. o (c) to establish the sex of the embryo  Where there is a particular risk of • (i)a gender-related serious physical or mental disability, • (ii)a gender-related serious illness, or • (iii)any other gender-related serious medical condition,  (3)For the purposes of sub-paragraph (1)(c), a physical or mental disability, illness or other medical condition is gender-related if the Authority is satisfied that—

• (a)it affects only one sex, or • (b)it affects one sex significantly more than the other. o (d) to create a saviour sibling  Where the sibling suffers from a serious medical condition which could be treated by • Umbilical cord blood stem cells • Bone marrow • Or other tissue  To establish whether the tissue of any resulting child using the gametes of the parents would be compatible with that of the sibling o (e)where there is uncertainty about whose gametes were used in the embryo's creation, to find out

Should PGD be permitted?

• To select against disability o Would seem that if a woman can abort a foetus with a disability, should also be able to select one  But if couple choose to discard one with cystic fibrosis, then what does this say about society's attitude towards cystic fibrosis?

• Perhaps we're saying that a life with cystic fibrosis is not worth living?

• Asch and Wasserman: Perhaps this reveals something about society which encourages the use of tests for disabilities that is the most concerning.  Mahowland: Might be able to both try and ensure that someone with disabilities is not disadvantaged, while seeking to prevent disabilities where possible • In this sense we dislike the disability characteristic, but not the person with it • Me: unfortunately, we seem to fall into a fallacy here - b/c the embryo is selected against, they are never born at all - so we are saying their life is not worth living.

• To select for a disability? o e.g. the Deaf Lesbians - said child would more easily learn deaf sub-culture and fit in with their lifestyle more if also deaf. o Savulescu: Have they harmed that child? Is that child worse off than it would otherwise have been (that is, if they had selected a different embryo)?

• No—another (different) child would have existed. The deaf child is harmed by being selected to exist only if his or her life is so bad it is not worth living. • Deafness is not that bad. Because reproductive choices to have a disabled child do not harm the child, o couples who select disabled rather than non-disabled offspring should be allowed to make those choices, even though they may be having a child with worse life prospects o John Stuart Mills - some people live better lives than others - there are higher pleasures - but people need to be free to experiment to find what works best for them.

• To select sex? o This is specifically permitted under Para 1ZA, but only to avoid sex related disorders  It does not permit selection based on family balancing or to replace a dead child with one of the same sex o Objections  Demographic impact

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