[Paleopsych] WebMD: Coming Soon: Designer Babies?

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Coming Soon: Designer Babies?
http://my.webmd.com/content/Article/96/103766.htm?printing=true

    Embryo screening for genes that cause disease is already happening.
    How far will it go?

    By [2]Jeanie Lerche Davis
    WebMD Medical News Reviewed By [3]Michael Smith, MD
    on Thursday, November 04, 2004

    Is the age of "designer babies" looming closer? In Britain, four
    couples have won approval for embryo screening for cancer genes. Some
    consider it a controversial case.

    All the couples are affected by an inherited form of aggressive colon
    cancer and are getting in vitro fertilization (IVF) treatments to get
    pregnant. The couples appealed to the Human Fertilization and
    Embryology Authority -- which governs embryo screening in Britain --
    to allow them to select an embryo without the cancer gene.

    They have won that right. Now, their child and future generations are
    unlikely to have the cancer gene.

    Could this happen in the U.S.? Are we on a slippery slope leading
    toward designer babies with "basketball star" genes, green eyes, or
    curly hair? To find out, WebMD spoke with a few experts.

    Embryo Screening Still Evolving

    "The use of the technology to prevent disease is wonderful. ... When
    you're preventing lethal and horrible disease in children, it's a good
    use," Art Caplan, PhD, director of the University of Pennsylvania's
    Center for Bioethics, tells WebMD.

    "But when you get into hair color and freckle selection, that's a
    whole different story," Caplan says. "In our market, whatever you can
    pay for, you can do. We don't have [a regulatory agency] here to stop
    us from going where money and bias can take us. The prospect for a
    slippery slope has been handled in England because they have built
    stairs."

    However, fertility doctors in the U.S. do have ethical guidelines that
    limit the use of embryo screening technology, says Cecilia Dominguez,
    MD, a reproductive endocrinologist with the Center for Reproductive
    Medicine at the Emory University School of Medicine.

    "Right now, preimplantation genetics is used exclusively for major and
    small groups of genetic abnormalities like Duchenne muscular
    dystrophy, which is a devastating disease, costs a lot of money, yet
    leads to early death of the child," she tells WebMD. "We can prevent
    this fatal disease, which is very important for families with strong
    genetics."

    David Wolmer, MD, chief of reproductive endocrinology and fertility at
    Duke University School of Medicine, agrees. "If a family has a known
    genetic disorder like muscular dystrophy, we feel it is OK to transfer
    embryos that do not have that gene," Wolmer tells WebMD. "We do the
    same with families who have cystic fibrosis -- specifically screening
    embryos for those genes, to try to avoid having a child with that
    disorder."

    Needed: Embryo Screening Review Process

    However, says Wolmer, "We need a review process that allows people who
    aren't just doing it to be self-serving. Some couples are asking for a
    blanket embryo screening, to look at the huge realm of possibilities.
    That's the slippery slope to me, that people with no family history of
    a disease are asking us to take a blanket look at the huge realm of
    possibilities like Down syndrome, for example, which is a genetic
    abnormality but not an actual genetic disorder."

    It's important "to be very careful at that point," Wolmer says. "We
    need to look at the family's intent when they request embryo
    screening. In our society today, different yardsticks are used to
    measure if this is OK or not -- science, theology, law. I think that
    an Institutional Review Board process in the U.S. needs to be applied
    here. We can't lose sight of what is research and what is accepted
    therapy."

    Everyone involved in IVF and embryo screening must consider ethics at
    every point, says Wolmer.

    Embryo Screening Not 100% Accurate

    Wolmer brings up another point: Embryo screening is not a perfect
    process; there is no 100% guarantee. "There's a question whether that
    one cell may be abnormal, but the others may be normal," says Wolmer.
    "Also, one abnormal cell doesn't mean the whole trait or disorder will
    develop."

    Ordering up "basketball player genes" or green eyes -- those things
    just aren't possible with current technology, Dominguez tells WebMD.
    "Figuring that out from one or two embryonic cells is very tricky.
    We're not anywhere near the point of being able to do that."

    Even after embryo screening for genetic abnormalities, "there's still
    a chance you're wrong," Dominguez says. "Screening is very difficult
    to do, and it can only be done in the best labs. Some day we will be
    able to fully fingerprint an embryo. But even if someone has a cancer
    gene, there's no 100% certainty they will develop the disorder. There
    are other factors, like environment, that play into this, too."

    Published Nov. 4, 2004.
      _________________________________________________________________

    SOURCES: Art Caplan, PhD, director, University of Pennsylvania's
    Center for Bioethics. Cecilia Dominguez, MD, reproductive
    endocrinologist, Center for Reproductive Medicine, Emory University
    School of Medicine. David Wolmer, MD, chief of reproductive
    endocrinology and fertility, Duke University School of Medicine.

References

    2. http://my.webmd.com/content/Biography/7/1756_50703.htm
    3. http://my.webmd.com/content/Biography/7/1756_53096.htm