Genetics (Biomedical Ethics)

Charles Lohman

Genetic Testing

• GENETIC TESTING is designed for individuals who are known to be at increased risk of having a genetic disorder with a familial mode of inheritance.

• GENETIC SCREENING is designed to test members of a particular population for a disorder for which there may be no family history or other evidence for its presence.

Preimplantation Genetic Diagnosis(PIGD)

• PIGD is a procedure that is performed on embryos prior to them being implanted in the uterine wall for pregnancy.– PIGD allows prospective parents to select among

different embryos for implantation and subsequent birth on the basis of their genetic status.• A PROGNOSIS can be given of the likely nature and

severity of a genetic disease in the people who would develop from IVF embryos.

Gene TherapyGenetic Enhancement

• GENE THERAPY is an intervention aimed at restoring physical and mental functioning to an ADEQUATE LEVEL.– For example, a child with severe anemia and the risk of

bone abnormalities and heart failure is given erythropoietin (EPO) to correct the condition, thus it is a TREATMENT.

• GENETIC ENHANCEMENT is an intervention aimed at improving already ADEQUATE FUNCTIONING.– For example, an athlete with a normal blood count takes

the hormone erythropoietin (EPO) to produce more oxygen-carrying red blood cells to be more competitive in his/her sport, thus it is an ENHANCEMENT.

Treatment -v- Enhancement The Baseline is Normal Functioning• The BASELINE between TREATMENT and

ENHANCEMENT has some deviation above or below what would be considered NORMAL FUNCTIONING.– An intervention aimed at raising one’s functioning

to the baseline would be a TREATMENT.– An intervention aimed at raising one’s functioning

above the baseline would be an ENHANCEMENT.

Treatment -v- Enhancement Based on Goals of Medicine

• The GOALS OF MEDICINE is to treat and prevent disease and thereby restore and ensure ADEQUATE FUNCTIONING.– GENE THERAPY falls within the GOALS OF MEDICINE.

• For example, a TREATMENT is when a child with severe anemia and the risk of bone abnormalities and heart failure is give erythropoietin (EPO) to correct the condition.

– GENE ENHANCEMENT falls outside the goals of medicine.• For example, an ENHANCEMENT is when an athlete with a

normal blood count takes the hormone erythropoietin (EPO) to produce more oxygen-carrying red blood cells to be more competitive in his/her sport.

Eugenics• EUGENICS, literally meaning “good creation” in Greek.

– EUGENICS can be defined as the use of science to improve the human genome.

• NEGATIVE EUGENICS -v- POSITIVE EUGENICS– Forms of NEGATIVE EUGENICS prevent or control disease.

• Examples: genetic testing, genetic screening, PIGD, and gene therapy– Forms of POSITIVE EUGENICS improves people’s normal traits

and capacities.• Example: genetic enhancement

• It is an OBLIGATION to practice NEGATIVE EUGENICS if there is DECISIVE REASON to PREVENT or CONTROL diseases.

• It is NOT an OBLIGATION to practice POSITIVE EUGENICS if there is NO DECISIVE REASON to IMPROVE normal capacities.