Over at Opposing Views, bioethicist Jacob Appel argues that pre-implantation genetic screening for severe disease mutations should be compulsory for parents undergoing IVF.
Appell dodges one obvious criticism of this suggestion – that it unacceptably limits parental autonomy – by pointing out that “Western societies have long acknowledged that parental authority cannot undermine the medical interests of a child”. As examples, Appell cites the facts that Jehovah’s Witnesses cannot deny their own children blood transfusions, however strong their religious opposition, and that “American courts consistently compel pediatric cancer therapy, even when parents object”.
Given these precedents, Appell argues that allowing children to be brought into the world with a severe genetic disease, when this situation could be easily avoided with large-scale genetic screening, is morally indefensible and analogous to child abuse.
I’m wary of any argument that violates parental autonomy – but Appell’s argument certainly seems consistent with emerging Western values weighing child protection above parental choice (so long, of course, as such protection does not extend to embryos).
I actually suspect that top-down coercion will not ultimately be required to enforce embryo screening for severe diseases, however – social pressure will be a far more effective tool.
Once pre-natal screening for severe disease (both through IVF embryo testing and maternal blood testing) becomes effective and cheap, parents of disabled children will be increasingly viewed by society as being responsible for their child’s disease. Social ostracism will always trump legality as an incentive to change moral values.
Whether you see such a world as right or wrong will of course depend on your political and religious beliefs, but I really can’t see how these changes can be avoided; they are an inevitable consequence of advances in genetic technology coupled with human nature. In other words: like it or not, genetic diseases like cystic fibrosis and muscular dystrophy will almost certainly be little more than historical curiosities within a decade or two.
I must admit that I find it hard to view this prospect with anything approaching sadness.