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Reproductive Technologies

Preimplantation Genetic Screening: One Step Closer to the Perfect Baby?

Prospective parents will be able to screen embryos for almost any known genetic disease using a revolutionary “universal test” developed by British scientists, led by Prof Alan Handyside 
The £1,500 test, called karyomapping, which should be available as early as next year, will allow couples at risk of passing on gene defects to conceive healthy children using IVF treatment.  The “genetic MoT” will transform the range of inherited disorders that can be detected. Currently only 2% of the 15,000 known genetic conditions can be detected in this way. Not only can it test for muscular dystrophy, cystic fibrosis and Huntington’s disease, but it can be used for testing for the risk of developing heart disease, cancer, diabetes and Alzheimer’s in later life.

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Identifying Sperm Donors, Genetic Privacy and Public Benefit: How to Have Your Cake and Eat It Too

A story in today’s Daily Mail reveals some of the harms experienced by children born to sperm donors. Since 2005, children born to sperm donors have had access to the identity of the man who donated sperm that created them. But prior to that point, donors were not required to disclose their identity. These children are often susceptible to diseases which have a genetic component, like diabetes or bowel cancer, and are unaware that they have such susceptibility. They also sometimes describe a sense of not fitting in with their family, having a different personality and character. Many desperately and vainly seek out their biological fathers.

One problem is that historically, donors gave sperm on the condition of anonymity. Thus they consented believing they would remain anonymous. This was the case in Victoria, Australia, where similar problems have been reported.  The option to remain anonymous was thought to be necessary to ensure a supply of willing donors, and to protect donors from financial and other claims made by their offspring.  But now we place greater value on the genetics of the donor and many children wish to know their biological father and his genes.

So donors have a legitimate interest, based on the conditions of their consent and self interest, in protecting their anonymity. How is this interest to be weighed against the interests in their offspring accessing knowledge about them?

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Refusing to refer: thus conscience doth make cowards of us all

In the Australian state of Victoria next week a proposal to make abortion legal in certain
circumstances is due to be voted on by the upper house. Some doctors,
as well as the Catholic church, have attacked one clause in that
legislation, as it is said to deny doctors the right to conscientiously
object to abortion. But what is the proper role of the doctor’s
conscience in medical care, and how should it be taken into account
when it conflicts with the conscience of the patient?

Read More »Refusing to refer: thus conscience doth make cowards of us all

Testing choices: weighing up risks of death and Down syndrome for fetuses

In the Observer yesterday, researchers from a major disability charity
have claimed that the risks of screening for Down syndrome during
pregnancy have been underestimated. The researchers suggest that for
every 3 fetuses with Down syndrome that are detected by screening 2
unaffected fetuses miscarry as a complication of the testing process.
Should screening be stopped? If screening continues how should
prospective parents weigh up this risk?

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Abortion is No Place for the Law

Victorian politicians are debating how to reform law on abortion. In Victoria, as in other states, abortion remains a crime. This is inconsistent with what happens. There are nearly 100 000 abortions every year in Australia.

The Victorian government will decide between 2 Models. According to Model B, abortion will be available on request until 24 weeks of pregnancy, but after that point 2 doctors must agree that it is indicated. Doctors who fail to comply with the law would receive professional and other sanctions. On Model C, abortion is available on request all through pregnancy. Premier Brumby and a majority of politicians support Model B.

Why is the imposition of sanctions on doctors who provide abortions so attractive? Firstly, abortion is an undesirable means of birth control. Most people would prefer to find other ways of not having unwanted children. Secondly, many people believe that as the fetus grows, and looks more like a baby, its moral status increases. After 24 weeks, some fetuses are even capable of living in intensive care units, outside the womb, as extremely premature newborns.

Despite its superficial attractiveness, Model B is deeply morally flawed. According to Model B, the moral status of the fetus, and whether it is kept alive or aborted, depends on the judgement of 2 doctors. Their decisions will usually be based on whether there is a disease or disability present. But this implies that fetuses with disabilities have less of a right to life than those which do not have disabilities. This is discrimination against the disabled and those with diseases. We would not allow 2 doctors to kill a child just because it had spina bifida. Why would we think the presence of spina bifida should change the moral standing of a fetus? Doctors can withdraw medical treatment leading to the deaths of their patients, but only when the patient’s life is no longer worth living. This is not the case in virtually all abortions.

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Reproductive science: is there something we’re missing?

Thirty
years after the first test-tube baby, Nature
asks various experts for their views on what the next thirty years of
reproductive medicine will bring.
Some of the more startling predictions are:

  • No more infertility, with both children and 100-year-olds able to have children
  • Embryos created from stem cells, increasing the ease of embryo research and genetic engineering of children
  • … with the resulting greater availability of embryos making it easier to create cloned humans
  • Artificial wombs, enabling babies to develop outside the mother’s body
  • … which, some worry, could become compulsory as an alternative to abortion, or to avoid premature birth or fetal alcohol syndrome
  • ‘Genetic cassettes’ implanted in embryos to counteract the effects of inherited diseases
  • Increase in litigation following evidence that IVF babies may later suffer adverse effects from the environment in which they were grown as embryos

Read More »Reproductive science: is there something we’re missing?

Abortion for Fetal Abnormality?

Abortion remains a crime for most Australians. Laws are inconsistent between states. In contrast, long ago the UK Abortion Act 1967 repealed and replaced its antiquated legal statutes on which much of Australian abortion law is still based.

The government in the state of Victoria asked the Law Reform Commission to provide legislative options to decriminalize abortion. Law reform is expected later this year.

Read More »Abortion for Fetal Abnormality?