IVF and Prenatal Genetic Diagnosis: A Move Toward Modern Day Eugenics ?

IVF and Prenatal Genetic Diagnosis: A Move Toward Modern Day Eugenics ?

Advances in modern medicine are often accompanied by some sort of ethical debate as is the case with in vitro fertilization(IVF) and the ability to select embryos void of genetic disease. As one of the first successful IVF babies in the U.S I’ve always had a special interest in advances in the field. IVF is began as an effective infertility treatment and now how uses in preventing genetic diseases. IVF begins by stimulating ovaries using FSH then physicians monitor estrogen levels and, by means of ultrasound, follicular growth. Spontaneous ovulation during the cycle is typically prevented by the use of to block the natural surge of LH and allow the physician to start the ovulation process by using medication. Once the follicles have reached a certain degree of maturation they are harvested then sent to a lab where they are fertilized with sperm at 75,000:1 ratio and allowed to mature to the 6-8-cell stage. At this point healthy embryos are implanted back into the mother’s uterus (Papanikolaou et al ). Prenatal genetic diagnosis (PGD) is usually preformed before implantation. Physicians can use PGD to prevent inherited diseases, to use gender selection to prevent a gender-linked disease, and to help couples who already have a child with an incurable disease and need compatible cells from a second healthy child to cure the first, resulting in a sibling that matches the sick child(Mastenbrook). There is debate regarding the ethics of PGD and whether or not it is a form of modern day eugenics.

Eugenics in its most basic form is the practice of selection to improve the genetics in the population. It is commonly referenced in regards to the Nazi movement when Hitler was advocating breeding a “superior” race. Now some individuals argue when parents select against certain traits even if it includes a genetic disease, it should also be considered Eugenics and ethically immoral (Scott). The main concern Scott discusses surrounds the selection of embryos before the implantation process. Many people feel that since only the embryos void of the disease will be implanted and the diseased embryos are thus discarded that a potential life is wasted (Scott). There is concern that those with disabilities in the community are further devalued and some groups go as far as to say physicians and researchers are “playing God” by eliminating the disease from future generations. I personally feel PGD is an amazing medical advancement. Physicians strive to end human disease and suffering and why not start at the very root, by eliminating the disease from the gene pool via PGD. That is not to say that I don’t understand the ethical dilemma that author’s like Scott present. Any new medical treatment is going to spur ethical debate. However in this case, if parent’s wish to prevent their children from having a debilitating disease they should be allowed to choose PGD as a treatment option. I do however have to agree with Scott’s paper on the issue of cost. IVF and PGD are unfortunately costly and therefore this treatment option is only readily available to the wealthy this could bring about the debate of separation of class and access to health care. I’m curious to see how others feel about the use of PGD and IVF. Do you think it is modern day Eugenics ? Because it is a treatment option that is so expensive, could it cause a situation as seen in movies like GATTACA?

Papa Nikolaou EG, Camus M, Kolibianakis EM, Van Landuyt L, Van Steirteghem A, Devroey P (2006). "In Vitro Fertilization with Single Blastocyst-Stage versus Single Cleavage-Stage Embryos".N Engl J Med 354 (11): 1139–46

Mastenbroek, S.; Twisk, M.; Van Der Veen, F.; Repping, S. (2011). "Preimplantation genetic screening: A systematic review and meta-analysis of RCTs". Human Reproduction Update 17 (4): 454–466.

Scott, R Choosing between possible lives: legal and ethical issues in preimplantation genetic diagnosis.[Oxf J Leg Stud. 2006