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Playing GoD

April 26, 2007

ivf07.jpg

Today the HFEA issued a decision on pregestational diagnostics or PGD. The press release can be read HERE. In short it says that we should look at the possibility of allowing families with high risk of having children with inherited cancer genes to screen embros to select out those with the abnormal gene. This seems like a very humane and sensible thing to do, and having seen young men and women die of these cancers, and women forced to have bilateral mastectomies and oophorectomies (surgical removal of the breasts and ovaries) at a young age because of their high risk of cancer, I am immediately sympathetic to this decision.

But…on the other hand I wonder. I am inherently and rather uncharacteristically Luddite about this sort of technology. What sort of a world will we move into when we can select particular characteristics for our children? Is it right to be creating embryos and then discarding them? Who will have the rights to these discarded embryos? How do we make a moral difference between selecting for cancer or for cystic fibrosis, or for blondeness, blue eyes or being gay, even (if such a gene is ever found). We are entering a new world with different ethics and values, and with less of the great mystery and magic which makes me glad to be alive.

What joy will there be in the birth of a child we have designed? Will it be the same as the new car we ordered from the catalogue, or the flat we buy off plan? How disappointed will we be when they don’t turn out to be perfect (because they won’t)? Playing with our genetic makeup gives us the illusion of power, but it is just that, an illusion. In the end we will all die, and some will die younger than others. I think perhaps I would prefer the unknown.

BRCA1 protein

But I think if I was a carrier of the BRCA1 or BRCA2 genes, which give a very high lifetime risk of breast cancer (36-85%) and ovarian cancer (16-60%), or the HNPCC gene, which gives an 80% risk of colon cancer, I would probably have the test, and I would probably take up the offer of PGD. Does that make me a hypocrite or a pragmatist?

Both, I suspect

But on a health economic assessment I’m sure this procedure offers value for money, as the cost of PGD will be much less than the cost of treating the subsequent cancers. So on purely economic grounds I can support it unreservedly and leave the moralising to others. So there we are, problem solved. Easy, this ethics business.

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6 comments

  1. So inherited cancer too –
    Do you think in all consciousness people with congenital diseases will forsake having children in some altruistic gesture – so as not to bring more summering and disease into the world.

    Or are we going to have to price them out with higher cost private health care.

    Alas, I’m starting to feel like Paul on the road to Damascus – I can see the light.
    If you have an illness you must pay.

    Now there may be no sin, but if you are diseased or sick – there is a price to pay. So says the Priesthood of Today, which incidentally is the same priesthood as yesteryear – you know the ones that can look at the entrails of animals and determine what you died of – or how much they can fleece you before you die.


  2. Glad to see you’re getting the idea Q9. Damascus here we come!

    Entrails. Not a bad idea, though I prefer leeches: Somehow more apt


  3. hereditary Breast Cancer Genes

    “And I punish one generation and the next …”
    Just Because I CAN, CAN!

    Was that Suzi Q


  4. Oddly enough,
    I sometimes admire those people who refuse to bring children into this sad & diseased world – but it seems survival instincts kick especially in some places where people feel threatened. Amazing how many people survived the holocaust.

    And those who will try and prolong the life of a child regardless of what diability or chronic illness or disease – are they any more selfish than the rest

    Mind you in societies where if you cannot pay you don’t get even aspirin, infant mortality has always been higher – and curiously enough those who survive are healthier or stronger – and then you can have good old tribal wars or world wars to further purge the human race.

    But it was vietnam that developed surgery and survival from gun shot or other wounds to the nth degree – and many more survived as amputees who would have died in previous wars


  5. Also interesting that the population is growing fastest in the poorest parts of the world with the least resources to support them.

    And yes many advances both technological and medical are made in time of war -that is because more resources are devoted to addressing these problems,

    (And less on the welfare state)


  6. Hi Mens Sana – ilogical & false statement:
    “population is growing fastest in the poorest parts of the world with the least resources to support them”

    The most importandt (and valuable) resource is people
    even for ‘slave-traders’

    Malthusian’s argument that the world could not sustain or feed population growth is false.

    Japan just exports its ‘excess’ population.
    Min uou it would be interesting to see China descending on the rest of the world like the hordes of Genghis Khan. And to koreans it would not be considered cannibalism to eat ‘white europeans or americans’ except who would want to eat such a diseased piece of meat.

    And there is a fervent Indian natiuonalism growing.
    Not only are some Indians in highly paid and highly advanced jobs and careers in the west – but there is a growing feeling that the world is India’s oyster.

    Philosophical as well as Cultural – and Physical!



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