Invitro Fertilization (IVF)
&
Pre-Implantation Genetic
Diagnosis (PGD)
1
Engineering 124; Spring 2003
Process of IVF
2
Engineering 124; Spring 2003
PGD:
Genetic testing performed prior to embryo transfer
•Adds $2000 to IVF
•Reduces rate of miscarriages from 23% to 10%
“The debate [around
PGD] has been building
since the late 1980s,
when doctors at
London's Hammersmith
Hospital learned how to
tease a cell from a 3day-old embryo and
study its chromosomes
for gender.”
(Zitner 2002)
•Does not increase chance of pregnancy
3
Commonly, more than 100 diseases
can be detected through testing,
including…
Engineering 124; Spring 2003
•
•
•
•
•
Hemophilia A
Muscular dystrophy
Tay-Sachs disease
Cystic fibrosis
Down Syndrome
Removal of one cell for testing
4
Engineering 124; Spring 2003
Viable and Desirable?
“This information is helping parents choose
which embryos they want--and which to reject
as unhealthy, or merely undesirable.” (Zitner 2002)
5
Engineering 124; Spring 2003
Undesirable Embryos
Disease Free
Disease Carrying
Embryos
Embryos
• Frozen in storage
• Donated to research
• Donated to
• Discarded
infertile couples
• Donated to stem
cell research/usage
6
Engineering 124; Spring 2003
Impact (Part I)
Factual
IVF
*increase in multiple births
*infertile couples can reproduce
*surrogate parenthood
(womb donors, $28K-$45K)
PGD
*decreased rate of specific
diseases in the population
(refer to next slide)
*decreased rate of miscarriage
7
Engineering 124; Spring 2003
Impact (Part II)
Axiological
IVF
*production mentality
*stem cell research
*challenges begining of life
*market for gametes
*occupation of surogate motherhood
*playing Creator
*"GenRich"
PGD
*Eugenics
*genetics arms race
*discrimintaion
*slippery slope
“GenRich” is controversial; it could be harmful or beneficial.
Production mentality is a problem. “Where amniocentesis usually provides
“[The
‘GenRich’]
will
use technology
to ensure
that their
children
have
significantly
more
information
about
aeugenics
single
fetus,
embryo
screening
allows
parents
to"slippery
judge
and
"Would
this
selection
(of
gender)
place
our
society
on
a
Fukuyama
defines
as,
“the
deliberate
breeding
of
people
for
certain
On
the potential
discrimination,
Hughes,
a Wayne
State
doctor,
said:
“Themany
“And
power
if than
scientists
to random
change
inforone
the
nation
future
of
genetically
the
human
altering
is,
in
unborn
some
advantages
the
mix
of
the
geneare
pool,
widening
therace
gap
between
the
rich
and
reject
potential
children
at
once.
And
because
it
bypasses
the
pain
of
abortion,
selected
heritable
traits.”
slope"
to
other
kinds
of
unacceptable
selections?
Possibly,
but
only
if
poor.”
(Wagner
2003)
ways,
children,
more
wouldn’t
frightening
it
be
than
hard
the
for
weapons
other
nations
of
mass
to
resist
destruction
joining
we
in
a
some fear
itwent
will be
usedthis
too freely,
coarsening
attitudes
toward theLast
embryo.”
“I
into
to
help
people
with
disease.
time
we
continue
to
use
this
powerful
technology
without
a
thorough
“Human
genetic
engineering
raises
most
directly
the
prospect
of
new
kind
of
The
wealthy
citizens,
whose
offspring
the
“GenRich”
“…do
us a great
Fetuses
products
rather
than
(Zitner
2002)
hear
‘genetic
sobecome
much
arms
about
race’
to
today.
develop
Itwill
ischildren.
abecome
anew
weapon
generation
of
mass
better
creation.”
able
to service.
checked,
gender
is pay
not
awhich
disease.”
eugenics,
with
all ethical
the your
moral
implications
with
thataword
is privilege.
fraught, and
analysis
of
its
justification
and
without
professional
standard
They
testI these
technologies
for
us and even
enormous
for
the
In a way,
(Wagner in
compete
2003)
the global economy – or in war?”sums
(Wagner 2003)
(Zitner 2002)
they
asability
guinea to
pigs
forathe
rest of set
humanity.
If youvalues."
had
of who
ultimately
the
change
human
nature.”
(Fukuyama
2002)to think
thatfunction
clearly
articulates
strong
of moral
(Scannell
2001)you’d like to
test these technologies, what better group can you imagine? They’re well informed, highly
motivated, eager, hard to coerce and they are definitely volunteers.” (Jonietz 2003)
8
Engineering 124; Spring 2003
Ethics: The issues at hand…
…weighing the goal of
pregnancy and live birth
against the medical and
moral risks of multiple
gestation.
…requires society
to make a decision
on when life begins.
…using PGD inherently makes assumptions about
the quality of life, challenging basic tenets of
society such as equality.
9
Engineering 124; Spring 2003
ethics
•
•
Address the suffering of the mother
due to her inability to have a child
“naturally”
“When having children,
people…often roll the genetic dice
and hope for the best. With embryo
sorting, "they can start their
pregnancy on Day One with a
commitment to continuing it."
(Zitner 2002)
•
PGD can save parents massive
heartbreak and financial strain
•
Address the view of the potential
child
–
–
•
Will the child have adequate support
and a stable home?
If there are multiple fetuses, will the
children receive adequate
care/attention?
“[PGD has] the laudable goal of
stopping deadly genetic diseases
such as Tay-Sachs and
Huntington’s. This research has
growing support because it can
save children from enormous
suffering and early death.”
(Wagner 2003)
Some ethicists would be in favor of IVF and PGD as long as
the decision is loving and promotes positive relationships.
10
Engineering 124; Spring 2003
Definition of Moral Community
for Rights Based Ethics
Before one can decide to whom rights apply, one must determine
the moral community.
“As individuality is a sine qua non for personhood, it seems safe to consider 14
days of normal embryonic development to be the minimum requirement before
a human being can emerge. Other criteria might place the earliest time point at
a later stage, for example, 28 days, when the neural tube closes and the
development of the central nervous system necessary for rationality begins. Or,
with Aristotle and St. Thomas Aquinas, one might consider 40-90 days of
development to be necessary to allow a human soul to be present; or as the
Roman Catholic Church taught for centuries, one might require body-form and
movement to be present before full human status was recognized.” (J.E.S.Hansen)
Therefore, embryos lack rights as individuals because they
are not part of the moral community.
11
Engineering 124; Spring 2003
Rights Based Ethics
Embryos are mass-produced, screened, discarded and used in
experiments: are they products or people with rights?
According to Hansen (see previous slide), the treatment of embryos is not an issue.
Based on John Locke’s principles, all people have the right (in America) to “life,
liberty and the pursuit of happiness.”
•What becomes of the idea that everyone is created equal if you start designing
children?
•Loss of autonomy because of a necessity to be competitive in society
•Inherently discriminatory; makes assumptions about quality of life
"Most people with disabilities rate their quality of life as much higher than
other people think. People make the decision [to reject embryos] based on a
prejudice that having a disability means having a low quality of life.“
(Zitner 2002)
12
Engineering 124; Spring 2003
Utilitarianism
The greatest good for the greatest number suggests that…
• The alleviation of suffering for
many is important.
– IVF helps many infertile couples
achieve a life-long dream of
having a child.
– PGD helps those same couples
reach their goal of a disease free
child.
• A disease free society is
preferable for all members.
13
What does religion have to say
about Embryo technology?
Engineering 124; Spring 2003
• The Christian view:
• Life is sacred
• Only God should
create life and take
it away.
• God knows you even
when you are in the
womb...
14
Engineering 124; Spring 2003
• You created every part
of me; you put me
together in my mother’s
womb... When my bones
were being formed...
when I was growing
there in secret, you
knew that I was there.
• Psalm 139: 13-16
15
Do all Christians have the same
opinion about Embryo technology?
Engineering 124; Spring 2003
• Roman Catholic Church: thinks
embryo technology is wrong. This is
because you are a person from the
moment of conception.
• Church of Scotland:does think that
life is sacred but agrees with using
embryos until the 14th day of
development.
• Both churches disagree with the idea
of designer babies
16
Engineering 124; Spring 2003
17
Engineering 124; Spring 2003
….Christian View
• The Church of Scotland teaches that
life must be protected from the
moment of conception. Genetic
engineering for cosmetic purposes is
rejected because it is ’playing God’ to
decide which people are to be valued
and which are not. Medical research
up to 14 days is accepted.
18
Engineering 124; Spring 2003
The Muslim View
• Life is a gift from Allah.
• He breathes life into the
embryo, this when you
become a person.
• Some Muslims think this
happens on the 42nd day of
development. Others say
it is on the 120th day.
19
Engineering 124; Spring 2003
Muslim View
• Life is sacred and a gift from Allah –
Surah 17:33, 40:70
• How we treat other living things
throughout life will form our
judgement by Allah
• There is disagreement about when
Allah breathes life into the foetus so
some accept research up to a certain
stage.
20
Engineering 124; Spring 2003
• Some Muslims agree with embryo
research.
• Some say that Allah has given humans
intelligence. We should use this to make
life better: if you can make someone’s life
better by using embryo research then you
should.
• Some argue therefore, that using preembryo's or embryos for research is
acceptable if the possible benefits are
great enough.
21
Engineering 124; Spring 2003
Embryo research and UK law
• Licenses for embryo research must
be provided by the HFEA (Human
Fertilization and Embryology
Authority)
• Research is allowed up to 14 days of
development
• Frozen embryos can only be stored
for up to 5 years.
22
Why are human embryo’s used
for research?
Engineering 124; Spring 2003
• Gives more accurate picture of how the
illness/treatment might affect a
person.
• The research could help to eliminate
diseases such as Parkinson’s and
Alzheimer’s.
• The embryo is not a human being , just
a collection of cells, so it is acceptable
to extract genetic material form it and
use it to benefit others.
23
Do human embryo’s have
rights?
Engineering 124; Spring 2003
• No: it is only a cluster of cells, not
a person. Only a person has rights.
It has no awareness or feelings.
• Yes: It is a potential human being
and deserves to be respected. Life
begins at conception.
24
Engineering 124; Spring 2003
Other Views on Embryo research:
• British Humanist Association
• Spare embryos produced through fertility
treatment are routinely disposed of, so it
is better that they are used to benefit
other people.
• Embryo is fertilized egg with potential to
be a person but it has no self-awareness,
no ability to feel pain or emotion.
Therefore it cannot suffer.
25
Engineering 124; Spring 2003
Peter Singer (Preference Utilitarian)
• We already allow this kind of treatment.
It has benefited many people.
• Individuals should be free to make their
own choices on this issue as it is a private
matter harming no-one else.
• Many children have been born as a result
of this technology. It hasn’t harmed any
of them or society so we should conclude
that it is acceptable.
26
Engineering 124; Spring 2003
Mary Warnock (Philosopher)
• Immense benefits come from using human
embryos therefore it is right that they are
used.
• The key stage of embryo development is
the ‘primitive streak’ at 14 days.
• The ‘slippery slope’ argument is not valid as
there are specific laws to stop this
happening , eg the ’14 day rule’
27
Engineering 124; Spring 2003
International Policies on PGD
•Banned PGD for ALL usages
•Used to select child’s
gender only when there
is medical need
•Clinics set policies; no
federal or state restrictions
28
Engineering 124; Spring 2003
What is your opinion?
29
Questions: answer these fully in
your jotters.
Engineering 124; Spring 2003
1. Name two ways in which Christians
and Muslims agree about embryo
research
1. When does the Catholic Church
think that life begins?
30
Describe UK law relating to the
use of human embryos in
research.
Engineering 124; Spring 2003
• Human cloning is not allowed.
• Therapeutic cloning is allowed.
• Licences must be provided by the
HFEA.
• Research allowed up to 14 days of
development.
• Frozen embryos can only be stored for
up to 5 years.
31
Describe a secular viewpoint in
relation to genetic selection
Engineering 124; Spring 2003
• Peter Singer (a Utilitarian)
• We already allow genetic selection by encouraging
prenatal diagnosis of conditions such as Downs
Syndrome as this often leads to selective abortion.
• If humans have already developed the ability to
prevent certain genetic disorders then we should use
this technology to benefit people.
• Individuals should be free to make their own choices
on this issue as it is a private matter harming no one
else.
• However, Singer also points out that human genetic
engineering may lead to a loss of diversity among
human beings. This may reduce humanity's capacity
to adapt to changing circumstances.
32
Engineering 124; Spring 2003
• This may also lead to an increasing gap
between rich and poor in society as the
children of the rich, who can afford to
genetically enhance their offspring, gain
more advantages over the children of the
poor.
• Singer suggests the State should control
human genetic engineering so that
everyone can share in the benefits.
33
What arguments might
scientists use to support using
human embryos in research?
Engineering 124; Spring 2003
• A human embryo gives a more accurate
picture of how the illness/treatment may
affect a person.
• The embryo is not a human being but only a
collection of cells.
• It has no self-awareness, thoughts,
internal organs etc. Therefore, material
can be extracted to benefit others.
• The research could help to eliminate
diseases such as Parkinson’s, Alzheimer’s
and even cancer.
34
How far does the religious viewpoint you have
studied agree with using embryos for stem
Engineering 124; Spring 2003
cell research
• Only God has the right to create life.
Whenever humans try to behave like God
they mess up.
• Humans are made in God’s likeness –
Genesis 1:27.
• ‘Do not commit murder’ – Exodus 20:13.
• Life is sacred and should only be ended by
God – Job 1:21.
• God cares for the developing foetus –
Psalm 139:13-16.
35
Engineering 124; Spring 2003
• The Roman Catholic Church teaches that
life begins at conception. Therefore life
must be protected from the moment of
conception. However, gene therapy is
acceptable where it is of medical benefit.
• The Church of Scotland teaches that life
must be protected from the moment of
conception. Genetic engineering for
cosmetic purposes is rejected because it is
‘playing God’ to decide which people are to
be valued and which are not.
36
Engineering 124; Spring 2003
• The Church of Scotland does accept
medical research up to 14 days.
• The Bible also teaches that Christians
should be compassionate towards others
leading some to suggest that this includes
medical research if it can provide cures for
diseases or help those with fertility
problems.
37
Engineering 124; Spring 2003
• Islam
• Agree
• Life is sacred and a gift from Allah –
Surah 17:33, 40:70.
• How we treat other living things
throughout life will form part of our
judgement by Allah.
38
Engineering 124; Spring 2003
• However
• There is disagreement about when
Allah breathes life into the foetus so
some accept research up to a certain
stage
39
How might medical scientists
define an embryo?
Engineering 124; Spring 2003
• A fertilised egg from 14 days to 8
weeks.
• The Human Fertilisation and
Embryology Act defines an embryo as
a live human embryo where
fertilisation is complete.
•
or
• An egg in the process of fertilisation.
40