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Designer Babies: Navigating the Ethical Landscape of Genetic Selection

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Chapter 1: The Dilemma of Designer Babies

Imagine having the power to select the healthiest embryo to ensure that your future child is free from life-threatening diseases. Would you opt for an embryo that has a better chance of happiness and fewer risks for mental health issues like depression or schizophrenia? What about choosing traits related to athleticism or intelligence?

This once-fantastical concept is becoming increasingly feasible, thanks to companies like Genomic Prediction. They provide what is known as an “Embryo Health Score” through their PGT-P test, allowing prospective parents to evaluate embryos for susceptibility to diseases such as heart disease, cancer, diabetes, and schizophrenia.

Parents can then "compare the overall disease risks among embryos and decide which one to prioritize for transfer." Despite The American College of Medical Genetics advising that “preimplantation PRS testing is not yet suitable for clinical use,” many couples have pursued embryonic testing, leading to the birth of selectively chosen children.

Consider Jamie and Brennen Cassidy from San Diego, who opted for embryo screening after their first child was diagnosed with a severe genetic disorder. “During our first pregnancy, we learned that the baby would not survive long after birth, and we made the difficult decision to terminate,” Brennan Cassidy shared with VICE News.

When they attempted to conceive again, they chose IVF to screen embryos and ensure they did not inherit that genetic disorder. To their surprise, they discovered they could also screen for other health conditions. Brennan expressed, “I have type 1 diabetes and would do anything to prevent passing that burden to my child. Many people might think of genetic testing as a way to create a superstar child, but that's not the intention here at all.”

Currently, testing for single-gene disorders like cystic fibrosis and spinal muscular atrophy is commonplace. However, the Cassidys' approach is different, as they screened for conditions influenced by multiple genes, selecting embryos with the lowest diabetes risk.

As reported by VICE News, fewer than 100 families have had children screened using the PGT-P test, leaving uncertainty about its efficacy and potential drawbacks. Presently, Genomic Prediction is the sole provider of this service.

Elizabeth Carr, a spokesperson for Genomic Prediction and the first American baby born via IVF, discussed the application of Embryo Health Scores with MIT Technology Review. “Essentially, the embryo health score enables patients and their doctors to compare the overall disease risks among available embryos. If diabetes is a concern in your family, you can evaluate three embryos and choose the one with the lowest risk,” she explained.

Section 1.1: Disease Prevention or Ethical Quandaries?

The Cassidys and supporters of genetic testing argue that if a method exists to ensure a healthy baby with minimal disease risk, why wouldn't one utilize it? In contrast, critics argue that there isn't enough evidence to validate the effectiveness of these tests, and the long-term consequences for the babies remain largely unknown.

Laura Hercher, a genetic counselor and director of research at the Sarah Lawrence College Graduate Program in Human Genetics, cautioned in an interview with Genetic Engineering & Biotechnology News: “The rush to commercialize prenatal testing is alarming. We must exercise extreme caution, as we are operating within an area filled with uncertainties. There could be numerous negative outcomes stemming from it.”

When addressing the controversies surrounding genetic testing, Carr compared it to the initial public reception of IVF in the late 1970s. “If you have ethical objections to the procedure, then simply opt not to use it,” she stated.

Section 1.2: The Slippery Slope of Genetic Selection

Concerns about the potential overreach of genetic testing are prevalent. Arthur L. Caplan, a bioethics professor, remarked, “Some of the conditions listed, even if they are classified as diseases, verge on eugenics rather than mere health considerations.”

Katie Hasson, associate director of the Center for Genetics and Society, echoed this sentiment. “There’s no reason to believe that polygenic embryo screening will stop at conditions like heart disease and diabetes. The screening for schizophrenia and other mental illnesses is already on the table. This mirrors past eugenic efforts aimed at eliminating perceived 'feeble-mindedness.' We are essentially determining who should be born based on 'good' and 'bad' genes,” she stated in an interview with The Guardian.

What are your thoughts on genetic testing for embryos? Would you consider it? Where should we establish boundaries regarding the diseases and traits that parents can select for their children?

Chapter 2: Exploring Further

This video, titled "The ethical dilemma of designer babies | Paul Knoepfler," delves into the moral complexities surrounding the selection of genetic traits in embryos, providing valuable insights into the ongoing debate.

Another important resource is "Ethical concerns surrounding gene-edited babies," which discusses the implications of gene editing and the ethical considerations that arise from such practices.

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