Medical Technology

Genetic Screening – No



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"Genetic Screening - No"
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Almost three years ago the decision by the United Kingdom's fertility treatment and embryo research regulator the Human Fertilisation and Embryology Authority (HFEA) allowing prospective parents to test embryos created outside the body for serious genetic disorders such as aggressive breast, ovarian and bowel cancers before deciding whether to implant them sparked a firestorm of debate, which still burns today.

The decision was viewed in many camps as a radical and dangerous one as prior to this statement the HFEA had only allowed pre-implantation genetic diagnosis (PGD) for conditions that would result in certain death or severe disability early in life, such as cystic fibrosis or Huntington's disease. In announcing the change, Suzi Leather, chair of the HFEA, said: "We would not consider mild conditions, like asthma and eczema, which can be well managed in medical practice." Critics of genetic screening fear that eventually one the trend continues PGD will be used to select for cosmetic traits that are deemed desirable by the parents, in effect parents will have the ability to use PGD to design their babies.

Currently, it is only legally possible to carry out two types of advanced reproductive technologies on humans. The first involves choosing the type of sperm that will fertilize an egg: this is used to determine the sex and the genes of the baby. The second technique screens embryos for certain genetic disease where only selected disease free embryos are implanted back into the mother's womb. Some would argue that the ability to choose the sex of one's is already a huge step in the direction of manufactured babies. There is a scientific rationale as determining the sex of an embryo can be useful because some genetic diseases, like hemophilia and Duchenne Muscular Dystrophy, only show themselves in male babies. If the parents have a history of male-related disease, then techniques such as PGD, can be used where doctors then choose a healthy female embryo without the faulty gene and implant this into the mother's womb to grow into a healthy baby. In most countries sex selection is only permitted to avoid diseases that are linked to a certain gender, and in Britain it is illegal to select the sex of a child merely because the parents desire a boy or a girl.

This science of reproductive genetics has also spawned another concern and it is the genetic selection for embryos to serve as donors for chronically ill siblings. In 2004 NewScientist.com reported that five healthy babies have been born to provide stem cells for siblings with serious non-heritable conditions. The team of doctors led by Anver Kuliev at the Reproductive Genetics Institute in Chicago released a statement that the five babies were born after a technique called pre-implantation genetic diagnosis was used to test embryos for a tissue type match to the ailing siblings. The aim in these cases was to provide stem cells for transplantation to children who are suffering from leukemia and a rare condition called Diamond-Blackfan anemia (DBA). Mohammed Taranissi, at the Assisted Reproduction and Gynecology Centre, London, UK, one of the team stated that parents who attempted to naturally conceive a child for this purpose had only a 1 in 5 chance of success, while the use of genetic technology provided a 98% chance of success.

The ability to design a baby to treat a sibling remains extremely controversial and in January of 2006, the United Kingdom's Human Genetic Commission in a report on reproductive technologies stated "Children created as so-called "savior siblings" to aid a sick brother or sister must be monitored to ensure their wellbeing." The report warned that although the current possibility to select for a sibling with the appropriate tissue match and to then cultivate its stem cells was not particularly worrisome, the report did warn that the entire science must be monitored to prevent using siblings as "spare parts." The report says: "Taking blood from the umbilical cord after birth causes no ill effects, but the removal of bone marrow is more controversial as it causes discomfort, although the long-term risk of harm is slight. However, once it is accepted in principle that children can be created to save the lives of siblings, perhaps more extensive - i.e. the donation of a kidney - or repeated tissue donations may be seen as equally permissible."

The Biotechnology newsletter from the Center for the Study of Technology and Society in Washington D.C. stated that one of the most critical arguments against designing babies was the possibility in the future of eugenics "the practice of improving the human gene pool by eliminating undesirables and the techniques for designing babies give us dangerous new powers to express our genetic stereotypes and preferences." Author Lee M. Silver predicted such in his book In Remaking Eden: Cloning and Beyond in a Brave New World.' Silver predicts the following by the year 2350, "The GenRich-who account for 10 percent of the American population-all carry synthetic genes. Genes that were

created in the laboratory....The GenRich are a modern-day hereditary class of genetic aristocrats....All aspects of the economy, the media, the entertainment industry, and the

knowledge industry are controlled by members of the GenRich class." Silver predicts that the other 90% of Americans whom he refers to as Naturals will work as low paid service providers and laborers. He states "As time passes...the GenRich class and the Natural class will become the GenRich humans and the Natural humans-entirely separate species with no ability to cross-breed, and with as much romantic interest in each other as a current human would have for a chimpanzee."

As the debate rages on, scientists are working feverishly to expand the boundaries of what is possible, and despite the fact that scientists indicate that selecting for race, eye color and IQ are not on the horizon they have never stated that it is impossible. Every aspect of society seems to be debatable. The best method of weight loss is debatable, forced sterilization in China is debatable but it seems that the issue of genetic selection reaches deep into our essence and provokes a discomfort like no other issue and perhaps it is as Chair of the Council on Boiethics Dr. Leon Kass stated it is "because we have been taught by these very scientists that genes hold the secret of life, and that our genotype is our essence if not quite our destiny, we are made nervous by those whose expert knowledge and technique touches our very being."

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