FINE LINES
Thom Graves Media
The ethical dimension of assisted reproduction cannot be divorced from the science, as was illustrated by two seemingly contradictory decisions by the United Kingdom's Human Fertilization and Embryology Authority. The HFEA approved an application for use of preimplantation genetic diagnosis (PGD) for a couple that had an existing child with Fanconi anemia. They wished to conceive a second child, both free of the disease and HLA compatible with the first. Stem cells taken from umbilical cord blood could be used to treat the elder sibling.
Yet the HFEA rejected a similar application from a couple with a child who has diamond blackfan anemia. DBA presumably involves a sporadic mutation rather than a hereditary condition, and therefore, argued the HFEA, PGD could not ensure freedom from disease. In vitro fertilization pioneer Robert Edwards argues that under this reasoning, parents with such ill children might as well...
REGIONAL REGULATION
The United States has one of the most lightly regulated fertility industries, with clinics free to adhere to or ignore policy recommendations from the American Society of Reproductive Medicine (ASRM). Tyler Medical Clinic in Los Angeles, for example, has advertised PGD for sex selection even though the ASRM advises against it.
The Council of Europe's Convention on Human Rights and Biomedicine condones sex selection only where it bypasses serious inherited sex-linked diseases, but not all European Union members have adhered. In the United Kingdom, private clinics not part of the state-owned National Health Service are permitted to offer sperm sorting for sex selection. France has until now taken a softer line with no explicit regulations concerning sex selection, while Germany prohibits all forms of PGD under all circumstances, even to prevent disease.
SEX SELECTION
The use of PGD for sex selection is accepted by many fertility experts but is a question for individual countries and cultures to grapple. Population imbalance is a main concern, and for this reason the use of PGD for sex selection was banned in India (2001) and China (2003). In the United Kingdom, a public consultation organized by the HFEA decided that sex selection would not cause population imbalance, as preferences aren't heavily weighted in one direction. But fertility expert Ian Craft says this reasoning would not apply within the country's sizeable Muslim community.
- Compiled by Brendan A. Maher
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