Posted on 03/06/2009 6:42:06 AM PST by GOPGuide
When physicians at University College in London last month announced the birth of what they described as the world's first "breast-cancer gene-free baby," a designer infant pre-screened for the BRCA1 cancer gene, critics focused public debate on the question of whether or not such screening should be permitted.
Yet as genetic screening becomes increasingly routine, it is the opposite question that will likely raise far more ethical challenges: If pre-implantation genetic diagnosis during in vitro fertilization (IVF) can successfully prevent children from developing serious illnesses, why shouldn't such screening be required?
Women who carry the BRCA1 gene have approximately an 80% chance of developing breast cancer and a 40% chance of developing ovarian cancer. The mother in this particular case opted for screening after the mutant gene had triggered malignancies in her husband's mother, sister, grandmother and cousin.
While breast cancer can be treatedfive year survival rates now stand at 88%a girl born without BRCA1 has a drastically reduced likelihood of confronting mastectomy or chemotherapy. Since 2005, British doctors have used the same technology to prevent retinoblastoma, a defect that causes blinding pediatric tumors. More recently, parents have been permitted to screen out highly-genetic forms of colon cancer. There is no evidence that the procedure causes any adverse side effects for the offspring
The most obvious advantage of mandatory screening is that it will reduce the long-term suffering of the children who are spared disease. At the same time, preventing future cancers will certainly save tax dollars. These savings could be redirected toward researching new therapies and providing quality care for current patients. The money might also help to defer the enormous public costs of fertility therapy, coverage for which a growing number of states now require of private insurance plans. If all policy holders are indirectly subsidizing fertility therapy through higher healthcare premiums, it does not seem so unreasonable for them to ask that the couples who benefit try to produce healthy kids. While similar screening cannot realistically be imposed upon individuals conceiving "the old-fashioned way," for obvious reasons of logistics and privacy, these invasive aspects of screening do not apply to IVF.
Opponents of mandatory screening will likely point out that such a rule significantly limits the reproductive autonomy of parents. This is certainly true. However, Western societies have long acknowledged that parental authority cannot undermine the medical interests of a child. Jehovah's Witnesses may not deny their children blood transfusions; Christian Scientists cannot substitute prayer for life-saving antibiotics. As United States Supreme Court Justice Wiley Rutledge wrote in the landmark case of Prince v. Massachusetts, "Parents may be free to become martyrs themselves, but it does not follow that they are free, in identical circumstances, to make martyrs of their children."
Child welfare laws certainly prevent a mother from intentionally exposing her daughter to an environmental toxin that produces an 80% risk of future cancer. Our society would view this act as child abuse, and rightly so. Similarly, American courts consistently compel pediatric cancer therapy, even when parents object. Yet once one accepts the right of the government to elevate the best interests of the child over the parents' private wishes, as we do in our society, the distinction between mandating pre-implantation screening and requiring post-birth care appears to be both arbitrary and indefensible.
The fear expressed by many opponents of genetic screening, both elective and mandatory, is that our civilization is sliding down a slope toward selecting embryos for their skin complexion or their eye-color. These skeptics equate all forms of eugenics, even benign and socially-beneficial programs, with Nazi sterilization laws and unscientific theories of racial superiority. The reality is that pre-implantation genetic selection, like many technologies, can be used either for good or for evil. On this continuum, the prevention of serious illness seems like an unambiguous and inimitable good. Maybe the benefits are so clear-cut that opting out shouldn't be an option.
adult stem cells have proven far better
Their not talking about stem cells, their talking about screening embryos for disease.
first IVF embryos- then all fetuses
to be checked for imperfections and aborted to save cost to society
Mandatory? Whenever the government mandates something like this, it’s not a good thing. Mandatory genetic testing of the unborn in a nation where abortion is legal IS eugenics.
Destroying embryos because one doesn’t like their genetic outlook is always eugenics and is indeed already underway in the U.S., as the steady decline in trisomy births indicates; the state mandating it is state-sponsored eugenics, and really just the logical consequence of state-managed health care.
You know, I typically refrain commenting on the abortion/stem cell threads, but this one just screams for a response... What kind of warped mind argues, “It’s in the best interests of the child,” to ABORT it? If it’s dead, how on earth can it be in the child’s best interests??
Tell me again how this is in the best interests of the child?
So, Mr. Anonymous Author, and yes I'm sure you're male, are you volunteering to be shot as soon as you contract a serious illness? No, I thought not. It's always other people's lives that are surplus to requirements.
Hitler called them “lives not worth living.” That was his decision, not theirs.
It’s appalling that we’re even discussing this.
Is there any "bioethicist" who's not a Death Eater?
I wonder why the OP didn't include the author in the post header, since the information was at the site.
Actually, with some conditions, prenatal testing can be the basis for prenatal treatment, and greatly improve the outcomes for someone born with a genetic disease, by normalizing the course of development before birth. There’s not much of this happening yet, but it’s likely to become widespread within the next 10 years.
The notion that preimplantation genetic diagnosis could become mandatory is simply preposterous. This would require outlawing sex, and that just ain’t gonna fly.
You hit the nail on the head. As much as the current economic situation worries me, our descent into moral darkness truly horrifies me. I would bet my last dollar that if such genetic testing becomes mandatory, it will eventually result in only “Perfect” children, the rest will be aborted. Parents who have genetic flaws will not be allowed to procreate. I believe all children are a unique creation of an Almighty God. They are a Blessing from God, that parents are entrusted to Love, nurture and protect. It seems the number of people who believe this gets smaller every day. How completely sad.-—JM
This is laughable. The costs of mutation rates involved in IVF reproduction wildly outweigh any benefit from genetic screening.
How does “screening” accomplish anything? He’s not telling the whole truth here.
If you simply substitute “killing” for “screening” in this article, you get a true picture of what he’s really advocating.
Sick times we live in.
But before we go turning people into race horses we should take a long hard look at race horses.
In genetics, as with capitalism, there is no such thing as a free lunch. Almost all things come with an associated cost, a trade off, a point of diminishing returns.
Race horses have thin legs for speed, thin legs that are prone to break. Race horses have thin skin for dumping heat, so thin that it often cracks. Race horses are not as robust and fecund as most other horses.
Are we, as a species, willing to undergo these trade offs?
What traits do you think government would desire among its populace. Free thinking fun loving rebelliousness would not be a desired trait, no doubt.
As to the subject at hand, elimination of a genetic allele that will most certainly cause cancer or insanity or early death is a personal choice and should remain exactly that, a free and personal choice by a private citizen, unencumbered by the long arm of government. IMHO.
I misread this...I didn’t see that this is only about IVF, which is immoral anyway, since it results in the deaths of unborn children. If you’ve already accepted IVF, it’s hard to argue against what he’s advocating.
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