Ethical issues and practical problems in preimplantation genetic diagnosis

Gattaca as a lens on contemporary genetics: marking 25 years into the film's "not-too-distant" future

The 1997 film Gattaca has emerged as a canonical pop culture reference used to discuss modern controversies in genetics and bioethics. It appeared in theaters a few years prior to the announcement of the "completion" of the human genome (2000), as the science of human genetics was developing a renewed sense of its social implications. The story is set in a near-future world in which parents can, with technological assistance, influence the genetic composition of their offspring on the basis of predicted life outcomes. The current moment-25 years after the film's release-offers an opportunity to reflect on where society currently stands with respect to the ideas explored in Gattaca. Here, we review and discuss several active areas of genetic research-genetic prediction, embryo selection, forensic genetics, and others-that interface directly with scenes and concepts in the film. On its silver anniversary, we argue that Gattaca remains an important reflection of society's expectations and fears with respect to the ways that genetic science has manifested in the real world. In accompanying supplemental material, we offer some thought questions to guide group discussions inside and outside of the classroom.

The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment

For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

Bioethics and the determination of personhood

In today's technological world, humanity continuously surpasses the limits set by previous achievements. Although evidence of such progress exists in several fields of study, one clearly sees this in the medical and biotechnological fields. Despite the countless opportunities for longer, more productive lives, medicine and science have regressed in their conception of the human person. In an effort to overcome any moral and legal ramifications that research and medical practices entail, physicians and researchers have come to reduce personhood to only a matter of biological qualities and functioning. This essay attempts to show, first of all, the classical Christian understanding of the person, currently held by the Orthodox Church. It then looks at three fields of bioethical discussion; namely, abortion, brain death, and human embryonic cloning, and shows how each issue reduces the human person to his or her biological components. The essay concludes by suggesting a return to an understanding of personhood based on personal and communal levels of relationships.

Genetic modification of preimplantation embryos: toward adequate human research policies

Citing advances in transgenic animal research and setbacks in human trials of somatic cell genetic interventions, some scientists and others want to begin planning for research involving the genetic modification of human embryos. Because this form of genetic modification could affect later-born children and their offspring, the protection of human subjects should be a priority in decisions about whether to proceed with such research. Yet because of gaps in existing federal policies, embryo modification proposals might not receive adequate scientific and ethical scrutiny. This article describes current policy shortcomings and recommends policy actions designed to ensure that the investigational genetic modification of embryos meets accepted standards for research on human subjects.

On our obligation to select the best children: a reply to Savulescu

The purpose of this paper is to examine critically Julian Savulescu's claim that people should select, of the possible children they could have, the one who is expected to have the best life, or at least as good a life as the others, based on the relevant, available genetic information, including information about non-disease genes. I argue here that in defending this moral obligation, Savulescu has neglected several important issues such as access to selection technologies, disproportionate burdens on women, difficulties in determining what is best, problems with aggregate effects of individual choices, and questions about social justice. Taking these matters into account would call such a moral requirement into serious question.

Preimplantation diagnosis

Preimplantation genetic diagnosis is a valuable addition to the repertoire of reproductive medicine because it gives individuals with a documented history of a genetic disorder the opportunity to begin a wanted pregnancy with little or no fear that they are transmitting this disorder to their offspring. An outstanding example of this is the recent report of PGD being successfully used to avoid the conception of a child that could have inherited a predisposition to early-onset Alzheimer disease. However, if this service becomes embroiled in the detection of conditions having little or nothing to do with health and disease in order to satisfy patient demand or to be a profitable business, its activities will be much more ethically suspect.

Ethical dimensions of genetic counseling

Genetics is one of the most exciting and most dynamically developing fields of medicine. Genetic counseling has reached the limelight of public attention. Given the fact that the subject of counseling is of momentous consequences and has important effects for the short and long-term, its ethical aspect is paramount. It is crucial that the relevant regulation be designed. The center of the ethical questions is occupied by the treatment of important personal information and the method of its being made public. The way the problems are dealt with is always changing just as society is in a constant process of change. It is important, however, that we always be ready to offer proper help to those in need when they need it.