PGD/PGT: AN ESSAY ON THE TECHNOLOGY’S MORAL PERMISSIBILITY

Harry

There is a raging debate however over whether PGT is an ethically, scientifically, and economically permissible innovation that should be allowed. Preimplantation Genetic Testing (PGT) is a procedure optionally performed for couples undergoing IVF.

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After a series of days, one or more cells are removed from each embryo, and their DNA analyzed to identify potential genetic diseases- in aiming to produce the healthiest possible child for the parent to produce into this world.
Prior to the use of PGT, couples undergo the IVF cycle- where ovum is collected from the female’s ovaries and fertilized through mixing with the male’s sperm in a dish. Multiple embryos are produced and kept in the lab for several days. A cell, or cells, is/are removed from each embryo in an embryo/trophectoderm biopsy. Embryos are frozen and cryopreserved while results are waited upon. Embryos with chromosomal abnormalities or clear genetic defects are discarded, and the healthiest embryos are implanted in the mother’s uterus.

A diagram briefly summarising the PGD process.

PGT-M (identifying hereditary conditions) and PGT-SR (chromosomal rearrangements and issues- less or more than 46 chromosomes) both ensure that the child a couple has does not suffer from any genetic or chromosomal defects that may hinder their quality of life . The technology optimally ensures that parents give birth to defect-free offspring and is an integral technology for parents with known genetic-defects or hereditary conditions in their family.

A snapshot of some hereditary and genetic conditions that PGD can diagnose and act on.

A widely supported argument is that it is our moral obligation with this technology, to utilize it and reduce the number of individuals of whom is affected by genetic disorder- of which hinder the livelihood for all parties involved. Many philosophical perspectives would assert that society is morally obliged to allow the use of this technology as it acts in the interest of humanity. Utilitarians, for example, would assert that this technology benefits a large number of people to a great degree, at some cost- and thus is morally justified. The fact that “53% of parents had to give up a full-time job to care for their child with a disability.”, is evidence that such technology has a high net benefit for the family and the child birthed, and thus is morally justified.

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However, others argue that the technology should not be permissible as life begins at conception, and thus the destruction of non-implanted embryos would be considered murder. This perspective is supported by many religious viewpoints such as Christianity and Islam. The perspective is also considered to be valid as “95% of all biologists affirmed the biological view that a human’s life begins at fertilization”. This would mean that such a decision to discard undesirable embryos, regardless of a genetic condition, is in fact murder- which would make it relatively immoral.

Economically, there is an argument that PGD technology should be accessible as it is cost-effective for families, supportive of economic growth, and contributes to a more productive and capable workforce. Those with serious medical conditions often cause a financial burden on their families, with an average annual cost for a child with a severe disability being “$18,000 for a child…, beyond the cost for a typically developing child”. Furthermore, “Nearly half (42.5%) of healthcare paid claims cost in 2014 for this study population were accounted for by patients with single-gene diseases or chromosomal abnormalities” (349 million was the total cost reported by ACO for the) according to a recent investigation by “Frontiers In Public Health”. This means that nearly half of the full ACO healthcare expense was accounted for by those suffering a severe genetic disorder- even though only 22% of children chosen fit into this category. This means that the costs of raising a child with a severe genetic condition are rather significant, placing a significant economic burden on families and children alike. Such costs on individuals limits economic growth. Therefore, PGD technology would effectively reduce these high expenses for families and the economy alike by reducing the number of children born with these defects. 

A graph conveying the costs of raising a child with a disability over their life- includes mild and moderate disabilities and non-genetic conditions. These numbers roughly align with AOC’s report.

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Despite the immediate economic advantages of PGD, some have noted how unregulated access to this technology in the private sector may widen inequality between the rich and the poor. If the technology is not regulated significantly, the private sector would increase the price to purchase such a service (as they have with most medicine products such as penicillin) – meaning only wealthier individuals would be able to access this technology. IVF already costs a significant “$15,000 to $25,000” in the United States, which prohibits many poorer individuals from accessing this technology. Dr. David King noted that when the wealthy experience biological advantages over the poor “basic notions of human equality go out the window.”. While genetic engineering is more likely to induce such inequality, unregulated access to this technology would seemingly have a similar result; wealthier individuals would produce healthier children, while poorer individuals would suffer a further economic burden- broadening inequality. 

Ultimately, all economic and ethical perspectives on this complicated matter recognize both the benefits and disadvantages of this technology. While PGD may be morally justified, it also may actually be considered murder if life begins at fertilization- and while PGD indeed does relieve the immediate economic burden off families with children affected by genetic disorders, unregulated access to the technology may widen economic inequality.  This means that such a complicated issue requires an intricate solution. 

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It would be recommended that such technology would be permitted for preventing the birth of children with genetic issues or chromosomal abnormalities- but the technology should be heavily regulated as a public service, not as part of the private sector. 

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