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Human Reproduction, Vol. 18, No. 3, 465-471, March 2003
© 2003 European Society of Human Reproduction and Embryology

Extending preimplantation genetic diagnosis: the ethical debate

Ethical issues in new uses of preimplantation genetic diagnosis

John A. Robertson

School of Law, The University of Texas, 727 Dean Keeton Street, Austin, Texas, USA. e-mail: jrobertson@mail.law.utexas.edu

The use of preimplantation genetic diagnosis (PGD) to screen embryos for aneuploidy and genetic disease is growing. New uses of PGD have been reported in the past year for screening embryos for susceptibility to cancer, for late-onset diseases, for HLA-matching for existing children, and for gender. These extensions have raised questions about their ethical acceptability and the adequacy of regulatory structures to review new uses. This article describes current and likely future uses of PGD, and then analyses the ethical issues posed by new uses of PGD to screen embryos for susceptibility and late-onset conditions, for HLA-matching for tissue donation to an existing child, and for gender selection. It also addresses ethical issues that would arise in more speculative scenarios of selecting embryos for hearing ability or sexual orientation. The article concludes that except for sex selection of the first child, most current extensions of PGD are ethically acceptable, and provides a framework for evaluating future extensions for nonmedical purposes that are still speculative.

Key words: embryo screening/ethics/gender selection/HLA matching/preimplantation genetic diagnosis


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