The UK's Human Fertilisation and Embryology Authority (HFEA) has come under fire for allowing, for the first time in Britain, genetic screening of embryos for a disease that will not affect the child at birth. Critics say the agency made the ethically charged decision without input from experts, paving the way for indiscriminate screening of embryos for adult-onset diseases.
Preimplantation genetic diagnosis, or PGD, is generally used to screen for chromosomal abnormalities and diseases such as cystic fibrosis. In some countries, such as Australia and Jordan, it has also been used for gender selection.
HFEA granted the license on 1 November to the assisted-reproduction unit of University College Hospital in London to screen for familial adenomatous polyposis, which can lead to colon cancer in early adulthood. Couples with the genetic condition have a 50% chance of passing it on to their children. An anonymous committee of five people made the decision to grant the license.
The HFEA says that it consulted experts on PGD for various diseases, including cancers, in 2001, says Vishnee Sauntoo, a spokesperson for the agency. By law, the HFEA is allowed to grant licenses based on a decision made by a committee of five people, Sauntoo notes.
“If it is acceptable to do prenatal diagnosis and terminate an affected pregnancy then surely it is okay to do PGD and select a healthy embryo before implantation,” says Joyce Harper, deputy director of University College London's PGD center. PGD for the BRCA1 and BRCA2 breast cancer genes, is offered in other European countries, Harper notes.
If it is acceptable to do prenatal diagnosis and terminate an affected pregnancy then surely it is okay to do PGD and select a healthy embryo before implantation. Joyce Harper, University College London
But many experts have criticized the agency's move. “This is an ethically important decision which should have been discussed properly with scientists, physicians and the public,” says Mohammed Taranissi, director of the Assisted Reproduction and Gynaecology Centre in London.
The UK government's Human Genetics Commission is reviewing guidelines for reproductive decision making, notes Sue Mayer, director of the lobby group GeneWatch UK. By granting the license, “HFEA have effectively set the precedent before that process has been ended,” Mayer says.
Comment on Reproductive Ethics (CORE), a pro-life group, is considering legal action against HEFA for making an “undemocratic” decision without consulting the public or Parliament, says Josephine Quintavalle, CORE's director. CORE is also challenging the HFEA for granting a license for 'savior' sibling PGD. That case is scheduled for March 2005.
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Bosch, X. UK criticized for embryo screening decision. Nat Med 10, 1266 (2004). https://doi.org/10.1038/nm1204-1266b