Bioethics in Faith and Practice, Volume 4, Number 1

19 Bioethics in Faith and Practice ⦁ 2019 ⦁ Volume 4 ⦁ Number 1 biopsy “had no meaningful impact on the developmental competence of the embryo as measured by implantation and delivery rates.” 57 The comparatively high implantation failure of cleavage-stage biopsy for PGD is troubling on a practical level for those trying to conceive, as well as on a moral level if life begins at conception. However, polar body biopsy is limited in application and blastocyst biopsy faces challenges in both embryo survival and procedure completion time. Yet even if biopsy can be completed efficiently without harming the growing embryo, there are significant ethical questions surrounding the practice of PGD itself. Ethics Clearly, to rid the world of genetic diseases would be an objectively good outcome. From a consequentialist perspective, this would avoid significant suffering due to genetic conditions. Further, it is possible that PGD by polar body biopsy could prevent abortions by enabling parents to only create children they are willing to carry to term. However, this raises the question of whether it is ever appropriate to select for certain traits when attempting to conceive offspring via IVF. There are three general categories to examine here: diagnosis of genetic diseases before fertilization, diagnosis of genetic diseases after fertilization, and selection for ‘non-medical’ traits. First, since PGD by polar body biopsy occurs before fertilization, it avoids questions of personhood and gets at the simplest ethical question around medical genetic selection, namely, to what extent artificial selection among humans is ever acceptable. However, the relevance of this issue is diminished given the limited applications of polar body biopsy as addressed above. As such, a full treatment of this scenario is beyond the scope of this paper, but it is crucial to keep this central question in mind when looking at the following cases. Second, PGD based on cleavage-stage or blastocyst biopsy may be problematic since selecting only healthy embryos to implant inevitably results in the discard of affected embryos. If life begins at conception, this is tantamount to murder, though the sterile and impressive environment of the laboratory obscures this reality. The discard of embryos also breaks the Kantian imperative to treat people as ends in themselves and never merely as means only. Though PGD is intended to provide the best life for a child by choosing a child who doesn’t suffer from genetic diseases, it may prematurely end the lives of those that do. Further, while genetic diseases unfortunately cause significant suffering to many, it is also clear that many individuals affected by genetic diseases and disabilities live happy and productive lives. Some have argued that the normalization of PGD to select against embryos with genetic diseases and disabilities may cause further discrimination against and stigmatization of individuals with these conditions. It is also crucial to consider what conditions qualify to be treated as debilitating conditions eligible for PGD, as this technique could easily become a slippery slope into practical eugenics. On the other hand, it is also interesting to consider the rare but real situations in which parents choose to implant the ‘affected’ embryo rather than the ‘normal’ one. For example, some deaf couples “regard deafness as a distinctive culture rather than a disability” and would prefer to raise a deaf child in that 57 Richard Scott et al., "Cleavage-Stage Biopsy significantly Impairs Human Embryonic Implantation Potential while Blastocyst Biopsy does Not: A Randomized and Paired Clinical Trial," Fertility and Sterility 100 (2013), 624-630.