Pre-implantation genetic diagnosis: Where do we set the limits?

The medically feasible urges society as a whole to answer fundamental ethical questions

by Christa Schönbächler and Stefanie Dadier, insieme Switzerland, Berne (excerpt)

From the exceptional to regular selection

Misleadingly it is often attempted to equate PGD with prenatal diagnosis. But the argument that the same diseases or chromosomal changes can be detected by both methods, falls short. With prenatal diagnosis the parents-to-be, in particular the pregnant woman, have to decide whether the embryo will be held in the womb of the woman and live. They do not select the “best” embryo of several. They are faced with the question of whether they want to keep the one child and are able to opt for a life with a disabled child. For PGD, however, a sample of embryos is artificially produced, the couple or medical staff decide which embryo is to be implanted due to its genetic disposition.

Little-known facts

As a motive for the introduction of PGD the main argumentation is that it helps couples with fertility problems. Medical studies show, however, that PGD does not increase the chance of getting pregnant with IVF (cf. Harper among others 2010). In addition hormone stimulation puts a considerable strain on the woman’s body, as up to 12 eggs and more are required for PGD. The possibility of PGD in combination with “Social Egg Freezing” raises false hopes on problem-free motherhood at an advanced age (cf. insieme 2014 a). It should further be noted that the introduction of PGD is also going to entail huge economic benefits. In Austria and in Italy, PGD is still banned entirely, in France and in Germany it is regulated restrictively. In case of a liberal legislation Switzerland becomes an attractive place of treatment for infertile couples from surrounding countries. [...]

Referendum 2015: Chance for a public discussion

On 14 June 2015 the Swiss people will vote on whether Article 119 of the Federal Constitution will be changed so that in future, embryos in greater numbers can be developed and stored outside the womb. This constitutional amendment is a prerequisite for the modified Reproductive Medicine Act to become effective.
Insieme Switzerland and other organisations for the disabled see the referendum as an opportunity for a public debate about preconceived value judgements about people with disabilities.
They want to introduce considerations and warnings from the perspective of people with disabilities into the debate (insieme 2014 b):

“disease and disability belong to life, but they do not determine its value. PGD entails an evaluative selection of life. For people, who are genetically impaired in a way that is regarded as undesirable, this selection will inevitably have an impact on their perception of themselves and of others.
Most disabilities come into existence during or after birth and are not genetic. PGD gives rise to the misleading notion that disabilities and diseases could be prevented by using prenatal diagnostics.
Should chromosome screening be allowed, all prospective parents would be under progressively increasing pressure as a result of people’s expectations that they undertake everything that is technically feasible to prevent the birth of a child with a disability. Thus it would become increasingly difficult to decide in a free and autonomous fashion.
We must avoid a situation where parents are exposed to pressure to justify their actions or, in extreme cases, have to bear negative consequences if they decide against prenatal diagnostic or if they deliberately decide in favour of a child with a disability.”

For centuries, people with a trisomy were part of our society. If the development of PGD continues unreservedly, this may change. Is that what we want? Things will not stop at the testing for hereditary diseases and trisomies. There will be a demand for screening and eliminating further “undesirable” dispositions and characteristics. Imagine: Which ones will that be? What image of humanity will we let ourselves be guided by? •

Source: <link http: insieme.ch wp-content uploads präimplantationsdiagnostik_wo-setzen-wir-die-grenzen_vhn.pdf external-link seite:>insieme.ch/wp-content/uploads/2015/04/Präimplantationsdiagnostik_wo-setzen-wir-die-Grenzen_vhn.pdf

(Translation Current Concerns)