Pre-Implantation Genetic Diagnosis

Question 1

What are the ethical principles/values of these treatments?

Answer 1

1. Maximise benefit/minimise harm
2. Fair use of resources (justice)
3. Autonomy and rights

Question 2

What types of criteria exist for In-Vitro Fertilisation (IVF)?

Answer 2

No previous parenthood
Normal/good BMI
Only medically in subfertility (i.e. not in same-sex couples/single people)

Question 3

What is prenatal testing?

Answer 3

Genetic testing of a FOETUS in an ESTABLISHED PREGNANCY - usually done vis Chorionic Villus Sampling (CVS) at 11-14 weeks or amniocentesis at 15-20 weeks

Question 4

What is pre-implantation genetic diagnosis (PIGD)?

Answer 4

Genetic testing is done at the EMBRYONIC stage in which embryos are created using IVF techniques and then genetically screened

Question 5

What types of conditions can be tested for?

Answer 5

Spinal muscular atrophy
Fragile X syndrome
Cystic fibrosis
Thalassaemia
Haemophilia

Question 6

What are the different types of spinal muscular atrophy (SMA)?

Answer 6

Various presentations ranging from death in infancy (type I) to adult onset muscle weakness (type IV)

Question 7

What is stated in the Human Fertilisation and Embryology Act (HEFA)?

Answer 7

1. It is unlawful to store or use gametes or embryos without a license granted
2. Counselling must be offered to families involved in this treatment
3. Welfare of child must be considered
4. Specification of legal mother and father

Question 8

When does the Human Fertilisation and Embryology Act (HEFA) permit embryo testing?

Answer 8

1. Establishing whether the embryo has an abnormality that will reduce the chance of a live birth
2. Establishing whether embryo has an abnormality that may result in serious disability or illness
3. In order to determine tissue compatibility with a sibling with a serious medical condition which could be treated with umbilical cord blood, bone marrow or other tissue of any resulting child EXCEPT whole organs i.e. saviour sibling

Question 9

Is sex selection ever permitted?

Answer 9

ONLY when there is a risk of sex-related abnormalities that may result in serious disability or illness

Question 10

What does the Human Fertilisation and Embryology Act (HEFA) say about embryo selection?

Answer 10

You cannot prefer embryos that carry genes carrying a chromosome/mitochondrion abnormality involving sig. risk of serious medical condition or select a sex that carries this risk

Question 11

How can you maximise benefit and minimise harm?

Answer 11

1. Consider who are the potential beneficiaries or who might be at risk:
   - Parents
   - Existing children
   - Embryo/foetus/baby
2. Consider different types of harm:
   - Physical
   - Psychological (of not having baby)
   - Can you be harmed by being bought into existence say, with a certain condition?
   - Harm as -ve messages about those with disabilities?

Question 12

How can you use resources fairly?

Answer 12

Look at funding issues and who (if anyone) should get treatment via:

• Post-code lottery
• Criteria

Question 13

How can you respect autonomy and rights?

Answer 13

Balancing parents right to procreate, right over method/details of procreation and to choose features of child WHILST demonstrating respect for the life i.e. embryo