Preimplantation Genetic Diagnosis

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Preimplantation Genetic Diagnosis

Preimplantation Genetic Diagnosis
How Should Labs Grapple With Ethics?

By Karen Appold

A key breakthrough in modern laboratory medicine, preimplantation genetic diagnosis (PGD) detects genetic abnormalities that cause birth defects or fatal illnesses, allowing embryos to be chosen before being implanted into a uterus, thereby avoiding selective pregnancy terminations. While this technology provides a lot of answers, its increasing sophistication is raising new questions about how to resolve the ethical controversies it creates.

A special January 2014 issue of Clinical Chemistry focusing on women’s health explores some of these ethical issues, highlighting how the rapid pace of scientific discovery can sometimes outpace society’s old categories for ethics in healthcare (Clin Chem 2014; doi:10.1373/clinchem.2013.202515). Next generation sequencing and other advancements are enabling labs to use PGD in new ways beyond the scope of simply improving chances for a successful pregnancy and avoiding disease.

The power of this technique will make dealing with the ethical implications unavoidable, wrote ethicist Arthur Caplan, PhD, an author of the Clinical Chemistry article. “I believe that the future of PGD is in both looking for traits that parents do not want in their children and in selecting for traits that they do very much want to try to pass on. The morality of eugenics, both negative—eliminating unwanted traits—and positive—selecting for desired traits—will surely loom very large as the key moral question facing those offering PGD and those seeking to utilize it.” Caplan is the director of the division of medical ethics at NYU Langone Medical Center in New York City.