Reproductive Technology: Ethical Issues

Ova and sperm can be genotyped so that particular genes or combinations of genes can be selected. While this is usually very expensive and not yet foolproof, success has been reported in influencing the sex of a child.

Cells from early embryos can be removed for even more precise genotypic determination and selection. Such selection has the potential of being more and more precise. Technology may even become capable of altering traits, as the genome becomes better understood. What kind of genetic selection should be allowable in embryos? Should one avoid mental retardation in potential children? Should one select for possibilities of greater intelligence? Is it ethical to choose to have a child only of a particular sex?

Genetic analysis also allows parents to have children whose genes can help others. But should a child be brought into the world simply for the sake of another, or should it be brought in only for its own sake? In a widely reported case in 2000, a couple selected for implantation an embryo that was found to be a perfect bone marrow match for their child, whose own marrow was failing due to Fanconi anemia.

Testing showed that the embryo did not have the recessive disease and that his marrow would not be rejected by his sister, who needed a transplant. The parents attested to their desire for another child, they refused to give birth prematurely for the sick child's sake and they refused to put the infant in any risk by extracting marrow for transplant. They used only the stem cells from the placenta to begin the repopulation of the older daughter's marrow. The process worked! This case highlights the difficult issues involved, and probably represents the best process and outcome possible in such a case. The future may bring more problematic cases as the technology advances to allow treatment of more conditions through tissue or stem cell transplantation.