Correcting or Perfecting?
Pre-implantation Genetic Diagnosis (PGD) is a watershed in the fields of medicine and genetics. It is a procedure that involves the screening of embryos for anatomical, physiological or genetic abnormalities prior to implantation (Gardner and Sutherland, 2004). Advocates of PGD claim that the process would be instrumental in preventing selective pregnancy termination. Furthermore, it would save many newborn babies from a lifetime of disease and disability. Despite its immense potential for further development, PGD is a course that is not without controversies.
Foremost among these debates is the division between what is acceptable to screen using PGD and what is not. Some medical ethicists are concerned that excessive reliance on PGD might result in the remedial stigmatization of certain traits such as intelligence, physical appearance and sexual preference. This outcome, in turn, would most likely promote discrimination against individuals who are found to have conditions that cannot be altered medically or whose parents cannot afford the high financial costs of undergoing PGD. Experts must see to it that PGD will be used only for curative purposes and not for aesthetic enhancement.
The History of PGD PGD was first introduced in 1990 as a means of treating embryos with X-linked genetic disorders. The therapeutic ability of PGD eventually turned it into an ethically acceptable procedure. The first reported case of PGD was in 1992 – a liveborn girl who successfully underwent the procedure for the detection and treatment of the single-gene disorder cystic fibrosis. PGD resulted in another successful pregnancy in 1995. What made this incidence noteworthy was that the course managed to detect and delete the dystrophin gene – the gene responsible for Duchene muscular dystrophy (Firth, Hurst and Hall, 2005).
Since then, PGD has expanded and developed worldwide. Such a widespread practice of PGD was attributed mainly to the growing scientific and public awareness of genetic disorders. In 2002, the European Society of Human Reproduction and Embryology (ESHRE) published its third report, which contained data from 25 centers across Europe, the United States and Australia. These data revealed that majority of the couples that availed of PGD had at least one pregnancy that resulted in a fetus or child that has a genetic disorder. Moreover, most of the same couples do not have living unaffected children (Firth, Hurst and Hall, 2005).
They therefore view PGD as their sole means of having a healthy child. The Cost of “Perfection” Some medical ethicists, however, caution against the improper use of PGD. Some unscrupulous parties might regard the procedure not as a way to correct anatomical, physiological or genetic abnormalities but as a tool to correct “undesirable” traits such as low intelligence, sex and homosexuality. As a result, these characteristics would be considered as “diseases” even if they are actually not. The “pathologization” of “undesirable” traits, in turn, would reinforce the marginalization of certain sectors in society.
Abortion: The “Solution” to the Nature-Nurture Debate The “Nature-Nurture” debate is probably the most enduring dispute in the study of homosexuality. Those on the “Nature” side argue that some people are genetically predispositioned towards same-sex activity. The supporters of the “Nurture” side, on the other hand, claim that a person’s upbringing and socialization are the major factors behind homosexuality. In the process, the erroneous belief that homosexuality is a “disease” is revived (Wilkerson, 1998). The irresponsible use of PGD would further emphasize this misconception.
The premise that homosexuality is “abnormal” might prompt the biomedical establishment to “cure” it through abortion. Parents can be told that they can elect to have their child aborted if amniocentesis indicates that the child might be gay, lesbian or bisexual. Openly homosexual people might likewise be barred from marriage and parenting due to the belief that their children might “inherit” their sexual orientation (Wilkerson, 1998). Qualification: Genes that Underwent PGD The improper practice of PGD would also result in unfair competition between the well-off and the hoi polloi for social, economic and educational opportunities.
Seeing that people who underwent PGD are more physically attractive and smarter than those who did not, schools and employers might end up prioritizing applicants who were subjected to the procedure. But what about the applicants who are equally qualified but whose parents were not able to avail of PGD due to financial constraints? They would end up disenfranchised for the simple reason that their parents cannot afford the costliness of this course (Luo, Fortunati, Law and Yang, 2006). Conclusion PGD is indeed a remarkable feat in the disciplines of medicine and genetics.
By targeting anatomical, physiological or genetic abnormalities at their very source – faulty genes – it saved many babies from selective abortion and a lifetime of disease and disability. But akin to all technologies, PGD must be used responsibly. Efforts must be made to ensure that it would be utilized in such a manner that it would remain faithful to its original objective – to improve the welfare of humankind. Otherwise, PGD would end up being just another means of sowing prejudice and division.
References Firth, H. V. , Hurst, J. A. , & Hall, J. G. (2005). Oxford Desk Reference. Oxford: Oxford University Press. Gardner, R. J. M. , & Sutherland, G. R. (2004). Chromosome Abnormalities and Genetic Counseling (3rd ed. ). Chicago: University of Chicago Press. Luo, P. , Fortunati, L. , Law, P. , & Yang, S. (2006). New Technologies in Global Societies. New Jersey: World Scientific. Wilkerson, A. L. (1998). Diagnosis: Difference: The Moral Authority of Medicine. Baltimore: Johns Hopkins University Press.
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