enerbol and Genetic-Diseases--Inborn

Author argues the preimplantation genetic diagnosis is ethically acceptable for currently intended uses, but a variety of ethical and practical issues will arise with further development of this technology.

Topics: Abortion, Eugenic; Beginning of Human Life; Ethical Review; Ethics Committees, Research; Ethics, Medical; Female; Genetic Counseling; Genetic Diseases, Inborn; Genetic Enhancement; Genetic Research; Genetic Services; Genetic Therapy; Health Services Needs and Demand; Humans; Life; Patient Selection; Personal Autonomy; Personhood; Pregnancy; Preimplantation Diagnosis; Resource Allocation; Risk Assessment

This article recapitulates and extends a discussion of the position of halakhic Judaism (traditional Jewish law and ethics) on various issues that relate to assisted reproduction, including genetic and legal relationships, disposal of untransplanted embryos, embryo tissue research, multifetal pregnancy reduction, preimplantation genetic screening and sex selection and donor gametes.

Topics: Aborted Fetus; Abortion, Induced; Beginning of Human Life; Embryo Research; Embryo, Mammalian; Ethics, Medical; Female; Genetic Diseases, Inborn; Genetic Testing; Humans; Jews; Legislation, Medical; Life; Oocyte Donation; Pregnancy; Reproductive Techniques; Research; Research Embryo Creation; Sex Determination Analysis; Sex Preselection; Siblings; Spermatozoa; Theology; Tissue Donors

Topics: Abortion, Eugenic; Beginning of Human Life; Confidentiality; Decision Making; DNA Fingerprinting; DNA, Recombinant; Employment; Ethical Analysis; Ethics; Ethics, Medical; Family; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Genetic Testing; Genetic Therapy; Genetics; Human Experimentation; Human Genome Project; Humans; Informed Consent; Liability, Legal; Life; Mass Screening; Moral Obligations; Patient Care; Physicians; Prenatal Diagnosis; Public Policy; Reference Standards; Social Responsibility

Although prenatal screening is routinely undertaken as part of a woman's antenatal care, the ethics surrounding it are complex. In this paper, the author examines the Jewish position on the permissibility of several tests, including those for Down's syndrome and Tay-Sachs disease, the latter being especially common in the Jewish community. Clearly, the status of the tests depends on whether termination of affected pregnancies is allowed, and contemporary rabbinical authorities are themselves in dispute as to the permissibility of terminating affected pregnancies. The nature of these arguments is examined and the author concludes that there are grounds on which the full range of prenatal screening is permitted in Jewish law.

Topics: Abortion, Legal; Beginning of Human Life; Congenital Abnormalities; Genetic Diseases, Inborn; Humans; Judaism; Life; Personhood; Pregnant Women; Prenatal Diagnosis; Religion and Medicine; Theology; United Kingdom; Value of Life

Results of recent research on hydatidiform moles and teratomas show that during pregnancy the embryo does not receive any message or information from the mother able to control the mechanisms of development or to produce the type of cellular differentiation necessary for building the tissues of the new human adult. Thus, the biological identity of the new human being does not depend on the sojourn in the uterus; the preimplantation embryo is the same individual of the human species as the adult, into whom the embryo can in principle develop.

Topics: Beginning of Human Life; Embryonic and Fetal Development; Female; Genetic Diseases, Inborn; Human Characteristics; Humanism; Humans; Hydatidiform Mole; Life; Male; Maternal-Fetal Exchange; Personhood; Pregnancy; Sperm-Ovum Interactions; Teratoma; Theology; Uterine Neoplasms

The thesis that the human zygote is essentially identical with the person into which it can develop is difficult to maintain, because the zygote can become several persons. In addition, the thesis depends upon ambiguities in the notions of human being, human individual, human body, and soul. A human being may be individual in the sense of either a biologically integrated unity or a psychologically integrated unity. A person is a psychologically integrated unity, because it must unify its experiences in morally imputable actions. To say that the zygote is a person requires one to assert that the zygote has the same principle of psychological integration, i.e., a rational soul, as one who can obviously manifest psychological integration. The assertion is incapable of being justified in empirical (e.g., non-religious) terms.

Topics: Beginning of Human Life; Embryonic and Fetal Development; Female; Genetic Diseases, Inborn; Human Characteristics; Human Development; Humanism; Humans; Hydatidiform Mole; Individuality; Life; Metaphysics; Personhood; Philosophy, Medical; Pregnancy; Teratoma; Theology; Twinning, Monozygotic; Zygote

Topics: Beginning of Human Life; Culture Techniques; Embryo Transfer; Ethics, Medical; Female; Genetic Diseases, Inborn; Genetic Engineering; Human Experimentation; Humans; Insemination, Artificial; Jurisprudence; Liability, Legal; Life; Moral Obligations; Morals; Pregnancy; Religion and Medicine; Replantation; Theology

Topics: Animals; Beginning of Human Life; Disease Models, Animal; Ethics, Medical; Genetic Diseases, Inborn; Genetic Therapy; Germ Cells; Humans; Life; Mitochondrial Myopathies; Moral Obligations; Nuclear Transfer Techniques; Oocyte Donation; Risk Assessment; Social Responsibility; Spermatozoa; Therapeutic Human Experimentation; Value of Life

Preimplantation genetic diagnosis (PIGD) goes some way to meeting the clinical, psychological and ethical problems of antenatal testing. We should guard, however, against the assumption that PIGD is the answer to all our problems. It also presents some new problems and leaves some old problems untouched. This paper will provide an overview of how PIGD meets some of the old problems but will concentrate on two new challenges for ethics (and, indeed, law). First we look at whether we should always suppose that it is wrong for a clinician to implant a genetically abnormal zygote. The second concern is particularly important in the UK. The Human Fertilisation and Embryology Act (1990) gives clinicians a statutory obligation to consider the interests of the future children they help to create using in vitro fertilisation (IVF) techniques. Does this mean that because PIGD is based on IVF techniques the balance of power for determining the best interests of the future child shifts from the mother to the clinician?

Topics: Adult; Beginning of Human Life; Decision Making; Disabled Persons; Ethics, Medical; Female; Genetic Diseases, Inborn; Human Rights; Humans; Infant, Newborn; Life; Male; Moral Obligations; Personal Autonomy; Pregnancy; Pregnant Women; Preimplantation Diagnosis; Quality of Life; Risk Assessment; United Kingdom; Value of Life

It is argued that the policy of excluding from further life some human gametes and pre-embryos as "unfit" for existence is not at odds with a defensible idea of human equality. Such an idea must be compatible with the obvious fact that the "functional" value of humans differs, that their "use" to themselves and others differs. A defensible idea of human equality is instead grounded in the fact that as this functional difference is genetically determined, it is nothing which makes humans deserve or be worthy of being better or worse off. Rather, nobody is worth a better life than anyone else. This idea of equality is, however, not applicable to gametes and pre-embryos, since they are not human beings, but something out of which human beings develop.

Topics: Beginning of Human Life; Ethical Theory; Ethics, Medical; Female; Genetic Determinism; Genetic Diseases, Inborn; Genetics, Behavioral; Human Rights; Humans; Life; Personhood; Pregnancy; Preimplantation Diagnosis; Public Policy; Social Justice; Social Values; Value of Life

Testing embryonic cells for genetic abnormalities gives us the capacity to predict whether and to what extent people will exist with disease and disability. Moreover, the freezing of embryos for long periods of time enables us to alter the length of a normal human lifespan. After highlighting the shortcomings of somatic-cell gene therapy and germ-line genetic alteration, I argue that the testing and selective termination of genetically defective embryos is the only medically and morally defensible way to prevent the existence of people with severe disability, pain and suffering that make their lives not worth living for them on the whole. In addition, I consider the possible harmful effects on children born from frozen embryos after the deaths of their biological parents, or when their parents are at an advanced age. I also explore whether embryos have moral status and whether the prospects for disease-preventing genetic alteration can justify long-term cryopreservation of embryos.

Topics: Age of Onset; Altruism; Beginning of Human Life; Beneficence; Child; Cryopreservation; Disabled Persons; Embryo Disposition; Embryo, Mammalian; Ethics; Eugenics; Fetal Diseases; Fetus; Genetic Diseases, Inborn; Genetic Engineering; Genetic Enhancement; Genetic Testing; Genetic Therapy; Germ Cells; Humans; Individuality; Life; Moral Obligations; Pain; Parents; Personhood; Persons with Mental Disabilities; Posthumous Conception; Preimplantation Diagnosis; Quality of Life; Reproduction; Reproductive Techniques, Assisted; Risk; Risk Assessment; Self Concept; Social Justice; Social Responsibility; Stress, Psychological; Time Factors; Value of Life; Wounds and Injuries; Wrongful Life

Topics: Beginning of Human Life; Chimera; Cloning, Organism; Criminal Law; Embryo Research; Embryo Transfer; Female; Fertilization in Vitro; Genetic Diseases, Inborn; Genetic Engineering; Germ Cells; Germany; Government Regulation; Humans; Informed Consent; Jurisprudence; Life; Oocyte Donation; Physicians; Posthumous Conception; Pregnancy, Multiple; Preimplantation Diagnosis; Reproduction; Reproductive Techniques, Assisted; Research; Sex Preselection; Social Control, Formal; Spermatozoa; Surrogate Mothers; Tissue Donors

Topics: Aborted Fetus; Abortion, Eugenic; Beginning of Human Life; Blood Transfusion; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Counseling; Diabetes Mellitus; Eugenics; Fetal Diseases; Fetal Tissue Transplantation; Fetus; Genetic Diseases, Inborn; Humans; Infant, Premature; Life; Neural Tube Defects; Parents; Pharmaceutical Preparations; Pregnancy; Pregnant Women; Prenatal Diagnosis; Preventive Medicine; Quality of Life; Value of Life; Vitamins

Topics: Advisory Committees; Beginning of Human Life; Embryo Research; Embryo, Mammalian; Federal Government; Genetic Diseases, Inborn; Government; Government Regulation; Human Rights; Humans; Life; Morals; Public Policy; Reproduction; Research; Risk; Risk Assessment; Social Control, Formal; United States

Topics: Beginning of Human Life; Cultural Diversity; Ethical Theory; Ethics, Medical; Female; Genetic Diseases, Inborn; Humans; Life; Philosophy; Pregnancy; Prenatal Diagnosis; Religion and Medicine; Secularism; Social Values; Value of Life

Topics: Advisory Committees; Attitude; Beginning of Human Life; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Embryo Research; Embryo, Mammalian; Family Relations; Fertilization in Vitro; Genetic Diseases, Inborn; Genetic Engineering; Humans; Individuality; Legislation as Topic; Life; Mass Media; Personhood; Politics; Public Policy; Reproductive Techniques, Assisted; Research; Research Embryo Creation; Science; Social Change; Social Sciences; United Kingdom; Value of Life

Topics: Attitude; Beginning of Human Life; Communication; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Embryo Research; Embryo, Mammalian; Ethics; Fertilization in Vitro; Genetic Diseases, Inborn; Government Regulation; Humans; Individuality; Infertility; Life; Mass Media; Personhood; Politics; Public Opinion; Public Policy; Research; Research Personnel; Social Control, Formal; United Kingdom; Value of Life; Wedge Argument

In this paper I want to try to clarify the nature of the two different problems indicated in the title: there is a lively debate on whether or not genetic selection is a morally licit practice, and there are strong disagreements on whether or not the embryo is a person. I think that most of such controversies depend on confusions and/or unclearness about specific problems involved in each issue, I have no precise normative proposal on the morality of genetic selection, but I hope that my analysis will be helpful in avoiding some current confusions.

Topics: Abortion, Eugenic; Beginning of Human Life; Catholicism; Embryo, Mammalian; Embryonic and Fetal Development; Ethics; Eugenics; Genetic Diseases, Inborn; Genetic Testing; Homicide; Humans; Individuality; Life; Personhood; Philosophy; Prenatal Diagnosis; Science

The questions of changes in the human genetic program have been debated by world legislatures, churches, and scientific communities. Papal teachings emphasize a global respect for each patient and the sacred dignity of all human beings. We outline six moral principles proposed as Catholic Christian perspective applicable to a bioethical evaluation of advances in human gene transfer.

Topics: Beginning of Human Life; Catholicism; Embryo, Mammalian; Ethics; Eugenics; Genetic Diseases, Inborn; Genetic Engineering; Genetic Therapy; Germ Cells; Guidelines as Topic; Health Care Rationing; Human Experimentation; Humans; Individuality; Life; Patient Selection; Personhood; Quality of Life; Religion; Resource Allocation; Social Justice; Theology; Value of Life

Some conditions detrimental to human well-being, such as sickle-cell anaemia, cystic fibrosis, muscular dystrophy, Lesch-Nyhan disease and various immunodeficiencies, are genetically determined. One potential means of preventing the development of such conditions is the manipulation of genetic material in the conceptus of an organism which would otherwise develop such conditions. Genetic manipulations could take the form either of excising and substituting genetic material, excising but not substituting genetic material, adding but not excising genetic material or reorganizing existing genetic material. To succeed, manipulation would have to change genetic structure so as to change its informational content. It might be thought, however, that all or some such manipulations would involve causing particular individuals to cease to exist and involve bringing into existence new, distinct individuals. Gene therapy could not, therefore, be a procedure which improved the circumstances of the particular individual to whom it is applied. It might be suggested that once the metaphysics of identity and the facts of gene therapy are understood, certain interesting conclusions concerning the ethics of gene therapy emerge. Some such conclusions have been discussed in this journal by Noam J. Zohar and Jeffrey P. Kahn. More, however, needs to be said about them since neither Zohar nor Kahn draws the correct conclusions. While both have pertinent things to say, neither has given a completely clear account of the metaphysics of gene therapy and so neither has completely traced out the implication of the metaphysics for the ethics of gene therapy. This paper attempts to remedy these defects.

Topics: Beginning of Human Life; Embryonic and Fetal Development; Fetal Diseases; Fetus; Genes; Genetic Diseases, Inborn; Genetic Therapy; Genetics; Humans; Individuality; Life; Moral Obligations; Pedigree; Personhood; Philosophy; Risk; Risk Assessment; Social Responsibility; Value of Life

Topics: Abortion, Eugenic; Beginning of Human Life; Biomedical Research; Civil Rights; Criminal Law; Cryopreservation; Dehumanization; Disabled Persons; Embryo Research; Embryo Transfer; Embryo, Mammalian; Eugenics; Female; Fertilization in Vitro; Financial Support; Gamete Intrafallopian Transfer; Genetic Diseases, Inborn; Genetic Therapy; Germ Cells; Germany; Government Regulation; Health Care Rationing; Humans; Insemination, Artificial; Jurisprudence; Legislation as Topic; Liability, Legal; Life; National Health Programs; Parent-Child Relations; Patient Selection; Physicians; Politics; Pregnancy; Pregnancy, Multiple; Pregnant Women; Preimplantation Diagnosis; Prejudice; Reproductive Techniques, Assisted; Research; Research Personnel; Sex Preselection; Social Change; Social Control, Formal; Spermatozoa; Spouses; Surrogate Mothers; Tissue Donors; Women's Rights

Mapping the human genome is an immense project with numerous objectives. Indeed, it is likely that some of its most important ramifications and applications remain as yet unglimpsed. All we can presently attempt is to focus on some of the more obvious possibilities and prepare for the problems already looming on our horizon. One such possibility is that of Prenatal Genetic Intervention (PGI), which might be said to be a therapeutic intervention on behalf of the embryonic child. In this paper, I argue that "genetic therapy" is likely to be a misnomer, and that if PGI becomes possible, we should generally resist its inclusion under the special moral duty of providing health care. "Therapy" necessarily means helping a person, while PGI -- though effecting improvements from an impersonal perspective -- will frequently not consist in directly helping any person. This is due not to the embryo not being a person, but rather to the basic philosophical problem of personal identity persisting through significant alterations -- especially the alteration of genotype. The decisive moral question then hinges on the definition of "significant" alteration. I shall examine the feasibility of drawing analogies from criteria for personal identity proposed in discussions of how persons maintain their identity across time and through physical and psychological change. Certain metaphysical aspects of human identity and individuality will be also touched upon, partly in terms derived from classical Judaism. In conclusion I argue that, regarding embryos in particular, persistence of genotype must generally be deemed a necessary condition for maintaining personal identity. Therefore, many proposals for PGI should be excluded from the notion of therapeutic intervention and thus denied the special moral status of requests for therapy.

Topics: Beginning of Human Life; Embryo, Mammalian; Eugenics; Fetal Diseases; Fetus; Genetic Diseases, Inborn; Genetic Therapy; Germ Cells; Human Genome Project; Humans; Individuality; Judaism; Life; Moral Obligations; Parents; Pedigree; Personhood; Philosophy; Quality of Life; Religion; Risk; Risk Assessment; Self Concept; Social Responsibility; Theology; Value of Life; Wounds and Injuries; Wrongful Life

... We must attempt to explain, how, if ever, our existence may harm us. To address this and the other questions raised, I propose to examine what constitutes harm and whether it makes sense to say that our genetic makeup may harm us. To do this I will describe three approaches to the problem of describing the status of negative effects our genes have upon us, which I have named the "technical harm" view, the "constitutive" view, and the "harmful conditions" view. On the technical harm view, the standard definitions of harm are applied to genetic disposition in an attempt to couch genetic defects or flaws in terms of harming. The constitutive view rejects applying the concept of harm to genetic disposition on the grounds that it is impossible to separate genetic disposition from individual identity. Lastly, the harmful conditions view, which I conclude is the most successful of the three, focuses on the tendency of certain genetic dispositions to cause harm in the future and thus avoids what I will argue are the "context" shortcomings of the other two approaches. To conclude the discussion I will very briefly analyze the ramifications of a harmful conditions view for the concept of genetic disease and the prospects for genetic counseling, gene therapy, and reproductive decision making.

Topics: Altruism; Beginning of Human Life; Beneficence; Eugenics; Fetal Diseases; Fetus; Genetic Diseases, Inborn; Genetic Therapy; Genetics; Goals; Health; Human Rights; Humans; Individuality; Infant, Newborn; Life; Moral Obligations; Pedigree; Personhood; Philosophy; Quality of Life; Risk; Risk Assessment; Self Concept; Social Responsibility; Terminology as Topic; Value of Life; Wounds and Injuries; Wrongful Life

Several important issues are raised and illuminated in "Genetic Harm"; not least, in its detailed discussion of specific genetic disorders. In particular, it focuses on a type of disorder whose ill effects are not manifested at birth, but only at a later stage in life. The conclusion, with its significant implications for practice, seems quite valid: a moral duty should be recognized to genetically (or otherwise, if feasible) cure an embryo of that which is expected to (later) cause such prospective suffering. Yet the reasons given for that conclusion, as well as much of the argument throughout, concentrate on a debatable notion of "harm". On an alternate account -- drawn in terms of personal identity -- what makes the moral difference in this type of case is rather that the genotype manifests itself, and that a life-history begins, prior to (and thus independently of) any effects of the gene(s) we are called to alter.

Topics: Altruism; Beginning of Human Life; Beneficence; Embryo, Mammalian; Fetal Diseases; Fetus; Genetic Diseases, Inborn; Genetic Therapy; Humans; Individuality; Life; Moral Obligations; Pedigree; Personhood; Risk; Risk Assessment; Social Responsibility; Wounds and Injuries

In his paper on the effects of Prenatal Genetic Intervention (PGI) on personal identity, Noam Zohar comes to a conclusion about genetic makeup and the uses of gene therapy quite different from the one I reach in another piece in this issue. Zohar's argument rests on the contention that personal identity changes with alteration of the genome, following what I have identified as the "constitutive" view. To see that this is the pillar supporting the weight of his argument, consider the following. Questions of identity aside, how can it be that altering the genome of children suffering from Lesch-Nyhan syndrome or Tay-Sachs disease so that they now produce the enzyme that they formerly lacked does not benefit them? Clearly, if their identities were not changed, such individuals would in fact realize great benefit from PGI, since the devastating bad effects of the genetic flaw would be avoided. Such a change would certainly make the altered individuals better off, that is, it would benefit them. On this, Zohar and I do not disagree. Persistence of identity through such genetic change is the sticking point.

Topics: Altruism; Beginning of Human Life; Beneficence; Embryo, Mammalian; Eugenics; Fetal Diseases; Fetus; Genetic Diseases, Inborn; Genetic Therapy; Genetics; Germ Cells; Humans; Individuality; Life; Pedigree; Personhood; Risk; Risk Assessment; Wounds and Injuries

The natural desire for couples to be parents and the medical practitioner's inability to treat most genetic diseases have been responsible for some of the most exciting research into infertility and genetic disorders. This has led in the United Kingdom to the establishment of the Warnock Committee of Inquiry into Human Fertilization and its report in 1984, and to a Review of the guidance on Research Use of Fetuses and Fetal Material published in 1989 and known as the Polkinghorne Report. The Warnock Report, among other ethical issues, considers the most fundamental question which has been debated for thousands of years, namely, What is life and when does it begin? More recently, the report has been responsible for new legislation which imposes ethical and legal restrictions on the scientific and medical community. The Polkinghorne Report recommends a voluntary code of practice which is morally and ethically acceptable within our society. We are also fortunate in the U.K. to have a parliamentary structure which allows debate on such important human issues and is prepared to impose ethical restrictions.

Topics: Abortion, Induced; Beginning of Human Life; Embryo Research; Ethics, Medical; Female; Fertilization in Vitro; Fetal Research; Gamete Intrafallopian Transfer; Genetic Diseases, Inborn; Government Regulation; Human Experimentation; Humans; Legislation, Medical; Life; Prenatal Diagnosis; Social Control, Formal; United Kingdom; Value of Life

Topics: Beginning of Human Life; Embryo Research; Ethics, Medical; Fallopian Tubes; Female; Fertilization in Vitro; Genetic Diseases, Inborn; Government Regulation; Humans; Life; Personhood; Public Policy; Risk Assessment; Social Control, Formal; Statistics as Topic

Embryo research is lawful in the United Kingdom: Human Fertilisation and Embryology Act 1990. Subject to licence and regulation. Embryo research raises medical, scientific, legal, social, philosophical, and ultimately conscience, moral and ethical issues. In the end each individual has to make his own value judgment, to be respected by all the rest of us.

Topics: Beginning of Human Life; Biomedical Research; Embryo Research; Embryo, Mammalian; Genetic Diseases, Inborn; Government Regulation; Human Experimentation; Humans; Legislation, Medical; Life; Moral Obligations; Nontherapeutic Human Experimentation; Research; Risk Assessment; United Kingdom

Consideration of the ethics of human gene therapy does not seem to raise questions that have never been asked before. However, particularly when gene therapy is extended to modification of the germ cells, several ethical issues take on an added importance or significance. These issues are: (i) possible moral limitations on tampering with "human nature"; (ii) the extent of our responsibility to future generations; (iii) the appropriate use of early human embryos in genetic research. Furthermore, standard norms in clinical and research ethics require careful application to trials of human gene therapy, even if only somatic rather than germ-line improvements are sought.

Topics: Beginning of Human Life; Cultural Diversity; Embryo Research; Embryo, Mammalian; Ethical Analysis; Ethical Theory; Ethics; Ethics, Medical; Forecasting; Genetic Diseases, Inborn; Genetic Engineering; Genetic Therapy; Human Characteristics; Human Rights; Humans; Internationality; Life; Moral Obligations; Personhood; Religion and Medicine; Social Responsibility; Social Values; Value of Life

10% of infertile women who become pregnant with the aid of hormonal stimulation become pregnant with multiple fetuses. 20% of mothers of triplets experience preeclampsia and 35% risk serious postpartum hemorrhage. Risk increases with the number of fetuses for venous stasis, varicose veins, phlebothrombosis, thrombophlebitis, and embolic phenomena. Risk increases proportionally with increased number of fetuses for fetal morbidity and mortality. Selective abortion is often used as a method of reducing risk to both the woman and the fetuses, thus increasing the chance that 1 or 2 fetuses will be born healthy. A related issue is the selective reduction of fetuses in multiple pregnancies that may have a genetic defect like Hurler's syndrome, microcephaly, Tay-Sachs disease, spina bifida, hemophilia A, or thalassemia major. In cases where 1 fetus in a set of twins is so inclined, the reduction of the defective fetus increased the success of the remaining co-twin. Selective reduction should not pose a problem for Jewish women since the procedure does not violate any Jewish legal or moral rules. In Jewish law an unborn fetus is not considered a person until it is born. Until the 40th day of pregnancy it is considered as 'mere fluid.' In order to stress the positive aspect of selective reduction it should be called "enhanced survival of multifetal pregnancies."

Topics: Abortion, Induced; Beginning of Human Life; Female; Fertilization in Vitro; Fetal Death; Genetic Diseases, Inborn; Humans; Judaism; Life; Maternal-Fetal Relations; Personhood; Pregnancy; Pregnancy, Multiple; Pregnant Women; Theology; Value of Life

Reasons are given for suggesting that individuation of the human embryo does not begin until the primitive streak forms at about the fourteenth day after conception; this view, though contested by many, is held by very many committed Christians of all denominations. In the conceptus or pre-embryo, after the formation of a blastocyst at about four-five days after fertilisation, biopsy of a single cell from the outer layer of cells (which later can form the membranes and placenta) can be used to determine the sex of the conceptus and will ultimately be used to detect the presence of an abnormal gene such as that for Duchenne-type muscular dystrophy, without detriment to development of the basal cell mass from which the embryo forms. The potential benefits in the prevention of inherited disease are profound.

Topics: Beginning of Human Life; Christianity; Embryo Research; Embryo, Mammalian; Ethics, Medical; Female; Genetic Diseases, Inborn; Government Regulation; Humans; Life; Pregnancy; Prenatal Diagnosis; Protestantism; Research; Sex Determination Analysis

In Western culture, the ethical principles of respect for persons can be further divided into 2 categories - a) autonomy and b) protection of the vulnerable; beneficence; and justice. The principles of ethics can be directed towards 2 levels: microethics - concerned with the individual and macroethics - concerned with the greater community. In the case of obstetrical procedures such as in vitro fertilization, prenatal diagnosis, and fetal sex selection, the principles of microethics and macroethics conflict. The exact number and/or kind of babies may benefit the parents by they may not benefit a society that is expected to accommodate these new members. This aspect can also be addressed when dealing with abortion. Support for and against has led to a questioning and reexamining of present abortion laws; the aim is to either restrict abortion or reduce the abortion time limit from 28 to 24 weeks. Policies of the United States have an effect on other policies, worldwide. Abortions are needed as a form of birth control in developing countries; 500,000 women/year die from birthing complications and 100,000 die from complications of illegal abortions. There has also been some questioning of in vitro fertilization. Why fertilize a certain number of eggs which may never be allowed to grow and mature? There has also been some questioning of whether or not an embryo in vitro fertilization is a person or not. Deciding the status of the embryo has opened up research possibilities in the United State and the United Kingdom. Discussion on in vitro fertilization has opened up discussion on surrogacy. There seems to be more support for surrogacy in the United States than in the United Kingdom - where there is a restrictive ban on commercial surrogacy.

Topics: Beginning of Human Life; Ethics, Medical; Female; Fertilization in Vitro; Genetic Diseases, Inborn; Humans; Legislation, Medical; Life; Pregnancy; Pregnant Women; Reproduction; Sex Determination Analysis; Surrogate Mothers

Topics: Abortion, Eugenic; Beginning of Human Life; Coercion; Disabled Persons; DNA, Recombinant; Economics; Ethics; Eugenics; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Genetic Testing; Genetic Therapy; Heterozygote; Humans; Individuality; Liability, Legal; Life; Mandatory Programs; Mass Screening; Personhood; Prenatal Diagnosis; Public Policy; Quality of Life; Risk; Risk Assessment; Social Change; Stereotyping; Stress, Psychological; United States; Value of Life; Voluntary Programs; Wrongful Life

Topics: Abortion, Criminal; Abortion, Eugenic; Abortion, Induced; Abortion, Legal; Adolescent; Beginning of Human Life; Child, Unwanted; Contraception; Economics; Evaluation Studies as Topic; Female; Fetus; Genetic Diseases, Inborn; Government Regulation; Humans; International Cooperation; Internationality; Jurisprudence; Labor, Obstetric; Life; Maternal Welfare; Minors; Morbidity; Mortality; Pregnancy; Pregnant Women; Public Health; Public Policy; Risk; Risk Assessment; Social Change; Social Control, Formal; Statistics as Topic; Stress, Psychological; United States; Women

Topics: Advisory Committees; Beginning of Human Life; Cryopreservation; Embryo Research; Embryo, Mammalian; Embryonic and Fetal Development; Fertilization in Vitro; Genetic Diseases, Inborn; Government Regulation; Humans; Life; Prenatal Diagnosis; Public Policy; Research; Risk; Risk Assessment; Social Control, Formal; United Kingdom

Topics: Beginning of Human Life; Embryo Research; Embryo, Mammalian; Female; Fertilization in Vitro; Genetic Diseases, Inborn; Government Regulation; Humans; Life; Politics; Pregnancy; Research; United Kingdom

West Germany's Enquete Commission released its report on the prospects and risks of gene technology, Chancen und Risiken der Gentechnologie, in January 1987. Sass, a philosopher, criticizes the body for confusing ethics with emotion, and moral assessment with deep thinking, in its deliberations. In his words, the Commission's report "is a good case study for both forms of methodological and conceptual moral malpractice in matters of applied ethics." Sass identifies three methodological deficiencies that he believes led the Commission to reject many forms of genetic technology, in particular, germline therapy and research with human embryos: (1) moral assessment is based on the evaluation of worst case scenarios; (2) human life is identified with human persons; and (3) general terms like "human dignity" are applied to concrete situations for which the terms are too blunt and impractical.

Topics: Advisory Committees; Beginning of Human Life; Cultural Diversity; DNA, Recombinant; Embryo Research; Embryo, Mammalian; Ethical Analysis; Ethics; Eugenics; Genetic Diseases, Inborn; Genetic Engineering; Genetic Therapy; Germ Cells; Government Regulation; Humans; Individuality; Jurisprudence; Life; Moral Obligations; Personhood; Public Policy; Research; Risk; Risk Assessment; Social Control, Formal; Social Responsibility; Social Values

Topics: Altruism; Beginning of Human Life; Beneficence; Catholicism; Dehumanization; Embryo, Mammalian; Emergency Medical Services; Ethical Analysis; Ethical Theory; Ethics; Eugenics; Fetal Diseases; Genetic Diseases, Inborn; Genetic Engineering; Genetic Therapy; Germ Cells; Human Characteristics; Humans; Individuality; Jurisprudence; Liability, Legal; Life; Maternal-Fetal Relations; Moral Obligations; Parent-Child Relations; Parents; Personhood; Public Policy; Reference Standards; Risk; Risk Assessment; Social Responsibility; Social Values; Stress, Psychological; Value of Life

Topics: Abortion, Eugenic; Amniocentesis; Beginning of Human Life; Canada; Chorionic Villi Sampling; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Criminal Law; Fetal Diseases; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Humans; Individuality; International Cooperation; Internationality; Jurisprudence; Liability, Legal; Life; Methods; Personhood; Prenatal Diagnosis; Prenatal Exposure Delayed Effects; Reproductive Techniques, Assisted; Singapore; United States; Wrongful Life

Topics: Abortion, Eugenic; Abortion, Induced; Abortion, Therapeutic; Attitude; Beginning of Human Life; Bioethical Issues; Bioethics; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Contraception; Dissent and Disputes; Euthanasia, Passive; Fetal Diseases; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Genetic Engineering; Genetic Testing; Genetic Therapy; Group Processes; Heterozygote; Humans; Individuality; Infant, Newborn; Jews; Judaism; Life; Mass Screening; Maternal Welfare; Personhood; Politics; Pregnancy; Pregnant Women; Prenatal Diagnosis; Reproduction; Value of Life; Voluntary Programs

Topics: Aborted Fetus; Abortion, Eugenic; Abortion, Induced; Beginning of Human Life; Civil Rights; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Disabled Persons; Embryonic and Fetal Development; Euthanasia, Passive; Fetal Viability; Fetus; Genetic Diseases, Inborn; Government Regulation; Health Care Rationing; Humans; Individuality; Infant, Newborn; Infant, Premature; Intensive Care Units; Jurisprudence; Liability, Legal; Life; Maternal-Fetal Relations; Methods; Moral Obligations; Patient Care; Patient Selection; Personhood; Physician-Patient Relations; Physicians; Pregnancy; Pregnant Women; Prognosis; Quality of Life; Reference Standards; Resource Allocation; Social Control, Formal; Social Responsibility; Supreme Court Decisions; Withholding Treatment; Wrongful Life

Topics: Abortion, Eugenic; Abortion, Induced; Beginning of Human Life; Bioethical Issues; Bioethics; Catholicism; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Death; Euthanasia, Passive; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Genetic Testing; Humans; Infant, Newborn; Judaism; Life; Pastoral Care; Persons with Mental Disabilities; Prenatal Diagnosis; Reproduction; Tay-Sachs Disease; Value of Life

Topics: Beginning of Human Life; Child Abuse; Civil Rights; Compensation and Redress; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Criminal Law; Economics; Eugenics; Federal Government; Fetus; Genetic Diseases, Inborn; Government; Government Regulation; Health Facilities; Humans; Individuality; Infant, Newborn; Jurisprudence; Liability, Legal; Life; Malpractice; Parents; Personhood; Physicians; Prenatal Exposure Delayed Effects; Preventive Medicine; Public Policy; Social Control, Formal; United States; Wrongful Life

Topics: Beginning of Human Life; Female; Genetic Diseases, Inborn; Genetics, Medical; Humans; Judaism; Life; Male; Oocyte Donation; Religion and Science; Risk Assessment; Value of Life

A review of prominent ethical issues during 1981 focuses on three areas: prenatal diagnosis and the fetus as a patient, public policy on abortion, and in vitro fertilization and embryo transfer. Moral concerns, litigation, proposed legislation, and federal aid are noted. Several other bioethical issues important in 1981 are touched on briefly.

Topics: Abortion, Eugenic; Abortion, Induced; Beginning of Human Life; Bioethical Issues; Bioethics; Embryo Transfer; Federal Government; Fertilization in Vitro; Fetus; Financial Support; Genetic Diseases, Inborn; Government; Health Care Rationing; Humans; Individuality; Infertility; Legislation as Topic; Life; Patient Care; Patients; Personhood; Prenatal Diagnosis; Public Opinion; Resource Allocation

Topics: Abortion, Eugenic; Altruism; Amniocentesis; Attitude; Beginning of Human Life; Beneficence; Disabled Persons; Ethicists; Ethics; Eugenics; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Humans; Individuality; Life; Moral Obligations; Parents; Pediatrics; Personhood; Physician's Role; Prenatal Diagnosis; Social Justice; Social Responsibility; Stereotyping; Stress, Psychological; Wedge Argument

Topics: Advisory Committees; Beginning of Human Life; Embryo Transfer; Embryo, Mammalian; Federal Government; Fertilization in Vitro; Financial Support; Financing, Government; Genetic Diseases, Inborn; Government; Homicide; Humans; Individuality; Life; Morals; Personhood; Public Policy

Topics: Abortion, Eugenic; Abortion, Induced; Abortion, Therapeutic; Beginning of Human Life; Child, Unwanted; Eugenics; Fetal Viability; Fetus; Freedom; Genetic Diseases, Inborn; Genetics; Homicide; Humans; Individuality; Life; Personal Autonomy; Personhood; Pregnancy; Pregnant Women; Social Change; Socioeconomic Factors; Value of Life

Topics: Beginning of Human Life; Civil Rights; Compensation and Redress; Economics; Fetus; Genetic Diseases, Inborn; Humans; Individuality; Jurisprudence; Liability, Legal; Life; Personhood; Prenatal Exposure Delayed Effects

Topics: Abortion, Induced; Amniocentesis; Beginning of Human Life; Bioethical Issues; Death; Ethics, Medical; Female; Fertilization; Fetus; Genetic Diseases, Inborn; Genetic Engineering; Health Education; Human Experimentation; Humans; Jurisprudence; Life; Personhood; Pregnancy; Research; United States

Topics: Abortion, Eugenic; Beginning of Human Life; Decision Making; Double Effect Principle; Ethics; Fetus; Genetic Diseases, Inborn; Human Rights; Humans; Individuality; Intention; Life; Moral Obligations; Motivation; Personhood; Quality of Life; Social Responsibility; Value of Life

Topics: Abortion, Eugenic; Abortion, Induced; Beginning of Human Life; Embryonic and Fetal Development; Fetus; Freedom; Genetic Diseases, Inborn; Government Regulation; Humans; Individuality; Life; Morals; Personal Autonomy; Personhood; Politics; Religion; Social Control, Formal; State Government

Topics: Abortion, Induced; Beginning of Human Life; Catholicism; Contraception; Embryonic and Fetal Development; Family Planning Services; Fetus; Genetic Diseases, Inborn; Humans; Individuality; Life; Moral Obligations; Personhood; Prevalence; Social Responsibility

Topics: Abortion, Induced; Beginning of Human Life; Euthanasia; Female; Fetus; Genetic Diseases, Inborn; Genetic Engineering; Homicide; Humans; Individuality; Life; Personhood; Social Values; Women's Rights

The technique of amniocentesis, by which an abnormal fetus can be detected in utero, has brought a technological advance in medical science but attendant medical and moral problems. Dr Seller describes those congenital disabilities which can be detected in the fetus before birth, for which the "remedy" is selective abortion. She then discusses the arguments for and against selective abortion, for the issue is not simple, even in the strictly genetic sense of attempting to ensure a population free of congenital abnormality.

Topics: Abortion, Induced; Beginning of Human Life; Congenital Abnormalities; Ethics, Medical; Female; Genetic Diseases, Inborn; Genetics, Population; Humans; Life; Personhood; Pregnancy; Prenatal Diagnosis; Quality of Life; Stress, Psychological; Value of Life

Topics: Abortion, Legal; Abortion, Therapeutic; Beginning of Human Life; Female; Fetus; Genetic Diseases, Inborn; Human Rights; Humans; Jurisprudence; Liability, Legal; Life; Personhood; Pregnancy; Prenatal Diagnosis; Supreme Court Decisions

Topics: Abortion, Eugenic; Abortion, Induced; Beginning of Human Life; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Euthanasia; Euthanasia, Active; Fetus; Genetic Diseases, Inborn; Humans; Individuality; Infant, Newborn; Infanticide; Life; Morals; Parent-Child Relations; Personhood; Prenatal Diagnosis

Topics: Animals; Beginning of Human Life; Clone Cells; Female; Genetic Diseases, Inborn; Genetic Engineering; Genetics, Medical; Human Experimentation; Humans; Hybridization, Genetic; Life; Male; Ovum; Personhood; Social Values; Sociology; Transplantation, Autologous; Transplantation, Heterologous; Transplantation, Homologous

Topics: Aborted Fetus; Abortion, Induced; Beginning of Human Life; Ethics Committees, Research; Ethics, Medical; Female; Fetal Research; Fetus; Genetic Diseases, Inborn; Human Experimentation; Humans; Informed Consent; Life; Parental Consent; Personhood; Physician-Patient Relations; Pregnancy; Research; United States

The law which, to some extent at least, reflects contemporary mores, has not kept pace with the recent scientific advances in genetics. Because of the rate of advance in the science of genetics there is a real risk that we shall know how to change the traditional nature of man before we possess the knowledge necessary to enable us to use the new knowledge for humane purposes. Clonal reproduction may produce a creature who, for the purposes of the law, especially the criminal law, which defines when a child becomes a human being in terms of "old-fashioned" motherhood, may not be a human being, so that putting him to death may not be homicide. Similarly, in vitro fertilization and development in an artificial uterus may result in the "birth" of one who, though having human attributes, may not, in law, be a human being. While cloning and in vitro fertilization may not have immediate legal implications because of the state of the art, genetic manipulation in the form of amniocentesis has very real legal implications now because it is a matter of current practice. The assumption that detection of genetic abnormality in the foetus is a beneficial development because it enables parents to have the option of terminating the pregnancy, though valid in the United Kingdom and the United States, is invalid in Canada. Abortion on demand is not part of the law in Canada and the liberalization of the abortion provisions of the Criminal Code of Canada in 1969 expressly avoided including as a criterion for therapeutic abortion the risk that the child, if born, would be likely to suffer from such physical or mental abnormalities as to be seriously handicapped. Beyond the more technical issues raised by scientific advances, however, lies the fundamental question whether a handicapped life is a life not worth living.

Topics: Beginning of Human Life; Canada; Compensation and Redress; Disclosure; Genetic Diseases, Inborn; Genetics, Medical; Humans; Jurisprudence; Legislation, Medical; Life; Personhood; Value of Life

Major advances in prenatal genetic diagnosis have occurred in the past few years which pose difficult challenges to the law. This paper raises questions relative to family history taking, genetic counseling, carrier detection, amniocentesis, and prenatal genetic studies, and also raises questions with respect to the rights and responsibilities of the patient, the fetus, the physician, and society in light of such modern advances. Law reform often occurs only after prior harm to an individual, family or group. Perception and delineation of the most important issues in this area should serve to stimulate the development of medicolegal guidelines and corrective legislation prior to the occurrence of a genetic tragedy.. Prenatal genetic diagnosis poses critical moral, legal, and ethical dilemmas involving the family, the physician, society, and the fetus. Questions arise involving family history taking, genetic counseling, carrier detection, amniocentesis, and prenatal genetic diagnosis. The rights of the patient, the fetus, the physician, and society are unclear. The physicianneeds legal clarification of his right to contact blood relations of a patient with a genetic condition. The question arises of who hasthe responsibility to make an infant aware of being a carrier of a serious disease. Failure of a physician to inform a woman that she is at risk for hacing defective children could expose him to legal liability. A physician might also be in legal jeopardy if he fails to recommend diagnostic tests to a patient. The essential aim of amniocentesis is to assure parents that their offspring will be normal, and the risks should be discussed with both parents prior to the procedure. Courts generally hold the physician responsible for informing a patient so that she may give informed consent. The status of the fetus is most unclear. It is hoped that medicolegal guidelines will be developed prior to the occurrence of a genetic tragedy.

Topics: Amniocentesis; Beginning of Human Life; Confidentiality; Disclosure; Female; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Human Rights; Humans; Informed Consent; Jurisprudence; Liability, Legal; Life; Medical History Taking; Personhood; Pregnancy; Prenatal Diagnosis; United States

Topics: Beginning of Human Life; Civil Rights; Coercion; Ethics; Eugenics; Fetus; Genetic Counseling; Genetic Diseases, Inborn; Genetic Engineering; Human Rights; Humans; Individuality; Jurisprudence; Legislation as Topic; Life; Mandatory Programs; Personhood; Privacy; Reproduction; Reproductive Techniques, Assisted; Social Control, Formal

Topics: Abortion, Eugenic; Abortion, Induced; Abortion, Legal; Amniocentesis; Beginning of Human Life; Embryonic and Fetal Development; Female; Fetus; Genetic Diseases, Inborn; Homicide; Humans; Individuality; Life; Personhood; Prenatal Diagnosis; Quality of Life; Value of Life; Women's Rights

Topics: Abortion, Eugenic; Abortion, Induced; Beginning of Human Life; Christianity; Decision Making; Fetus; Genetic Diseases, Inborn; Humans; Individuality; Intention; Life; Moral Obligations; Motivation; Personhood; Pregnancy; Pregnant Women; Social Justice; Social Responsibility; Social Values; Stress, Psychological; Value of Life