Monday, June 30, 2008

Picking Perfect Babies

A British family chose IVF and screened embryos that had a breast cancer gene:
By screening out embryos carrying the gene, called BRCA-1, the couple, from London, will eliminate the hereditary disease from their lineage.

About 5% of the 44,000 cases of breast cancer diagnosed in Britain each year are estimated to be caused by the BRCA-1 and BRCA-2 genes, both of which can be detected in embryos.

Doctors say thousands of cases of breast cancer could be avoided by screening embryos using the technique called preimplantation diagnosis (PGD).
Eleven embryos were created. Six had the bad gene. Six were destroyed. Two were implanted. One malfunctioned. Two were frozen for "future use".

As a doctor, I find the notion of avoiding the future pain of such a disastrous disease--55-85% of those with this gene end up with the cancer--exciting and hopeful. But I shudder, too, at the implications and the callous actions taken. Creating eleven lives, destroying six, so that one ostensibly healthy one is created..... It's the destruction that is so problematic. No one would dream of having eleven children, and then dumping six overboard because they had a 50-85% chance of suffering down the road.

Doctors and parents choosing this procedure view embryos as specimens not life. With time, genetic markers will identify everything from depression to homosexuality to heart disease. Given the rationale used in genetic selection, there will be no ethical reason to prevent its use for nearly any dysfunction.

Destroying embryos is okay in order to have a healthy baby:
Agree
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Cross-posted at Right Wing News

6 comments:

  1. The goal of an IVF cycle is 1 healthy baby, and the IVF process already produces more than one embryo in the hopes that 1 will survive.

    According to our doctors, the average IVF patient produces 8 eggs, 6 of which fertilize. Only about half of those are considered viable at the 3 or 5 day mark, when implantation would occur. Generally 2-3 embryos are implanted to give the greatest possibility that there is 1 live birth 9 months later. Overall, odds are about 50% that a given cycle succeeds.

    You're already playing the "11 lives are created" game in hopes of 1 healthy child. All genetic screening adds is a selection mechanism that helps you determine which embryos are healthiest if you're lucky enough to have more viable embryos than your current cycle requires.

    It seems to me that the ethical quandaries are in the areas of:

    * Would this couple have not gone forward with implantation if all their viable embryos had the genetic markers for breast cancer?

    * Would this couple have aborted a pregnancy if in utereo genetic testing (amneo) showed the cancer markers?

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