NEW YORK, Apr 08 (Reuters Health) -- Advances in the tests used to genetically screen human embryos may lead "consumer-driven" eugenics, with parents choosing their children according to their own set of criteria, an expert warns.
"It is... possible to imagine (embryo) selection on grounds of IQ, skin colour, physical build and facial features," writes Dr. David King, editor of the magazine GenEthics News. His views are published in the April edition of the Journal of Medical Ethics.
The use of embryo preimplantation genetic diagnosis (PID) is currently restricted to subfertile couples pursuing in vitro fertilization and other reproductive technologies. During PID, genetic tests are run on a number of embryos to determine which are the most likely to be free of genes associated with birth defects or increased risks for disease. King notes that whereas up to 10 embryos may be produced in each cycle of IVF, only two or three "which have the desired genetic profile" are implanted in the prospective mother's uterus.
This technology may be most useful in pinpointing serious defects such as cystic fibrosis or anencephaly (absence of a functioning brain), for example. However, King points out that there is currently no set 'list' of gene abnormalities meriting rejection of the embryo.
For example, King asks, could embryos carrying specific disabilities -- deafness, for example, or clubfoot -- someday be deemed 'disposable'? This might result in "a systematic bias against the birth of genetically disabled children," King warns, a bias that "can only be called eugenic."
He also points out that decisions regarding the life or death of a potential child may be easier when parents are confronted with an embryo in the laboratory versus a fetus in the woman's uterus (as happens today following amniocentesis). "Embryos that are still outside the mother's body have a far lower emotional weight than a fetus, which a couple already think of as their baby," he explains.
The very fact that the embryo is in the hands of medical staff places any decision regarding its future further away from the parents concerned, King believes. Indeed, the British government in 1990 passed the Human Fertilization and Embryology Act, which stipulates that doctors have a voice in determining whether or not to implant an embryo into a woman's womb.
Many ethicists, including King, therefore envision a future in which power struggles between parents and physicians may become commonplace, as parents seek to have 'imperfect' embryos implanted against their physician's wishes.
Still, it is the specter of what he calls "consumer eugenics" that worries King the most -- a society in which parents begin "choosing their children in a way which is not so far removed from their experience as consumers, choosing amongst different products."
To prevent such a trend before it begins, King urges that strict regulations be put in place to regulate PID, especially the key question: "for which conditions should it be permissible to conduct PID."
"If no lines are drawn," he warns, "it is difficult to see what will prevent a progression towards a full-blown consumer eugenics."
SOURCE: Journal of Medical Ethics 1999;25:176-182.
