Regulating the genetic supermarket: Preimplantation genetic testing, parental choice and the harm principle

Gavaghan, Colin (2004) Regulating the genetic supermarket: Preimplantation genetic testing, parental choice and the harm principle. PhD thesis, University of Glasgow.

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Abstract

In 1974, in one of the most intriguing footnotes in the history of political theory, Robert Nozick postulated the existence of a Genetic Supermarket, a state of affairs in which prospective parents would be able to choose - to whatever extent technology allowed - the genetic characteristics of their children. The closing decades of the Twentieth Century saw this thought experiment become a possibility, with developments in reproductive and genetic technologies allowing ex utero embryos to be tested for the presence of certain genetic traits before a decision as to which to implant. However, as technological obstacles to the unfettered choice envisaged by Nozick have disappeared, they have been replaced by regulatory barriers. In this thesis, I examine the merits of a laissez faire approach to parental choice of offspring characteristics. Specifically, I consider the case for largely unrestricted access to preimplantation genetic diagnosis (PGD), the technology that currently offers most possibilities in this regard, and which has been the subject of most discussion and controversy. My examination is considered predominantly with the interests of the various parties who might be affected by such choices, and in particular, with the prospect of harm to any of them. In Chapter 2, I argue that if our concern is with the avoidance of harm, we should acknowledge that curtailing the range of choices open to prospective parents results in a harm to them. Hence, any such restrictions much be justified by reference to the risk of a greater harm which such restrictions will plausibly avoid. In Chapter 3, I examine the purported harms that could be inflicted upon either those potential future children who would have been born but for their parents' use of PGD, or to the more tangible class of children who are in fact born as a result. With regard to the former, I argue that the attribution of interests (an essential prerequisite of harms) to merely potential beings is incoherent. Those children who are in fact born, however, are likely to be bearers of interests, and can therefore be the subjects of harm. Furthermore, I acknowledge that their unique origins, or the parental motives underlying them, could indeed see them faced with harms from which children born in more orthodox ways may be spared. However, it is my contention - a contention strongly influenced by the work of Derek Parfit - that such harms are likely to be outweighed by the benefits of existence, rendering it impossible to say of such children that they are harmed on balance. In Chapter 4, I consider the possibility of harms being occasioned to other parties, specifically, existing disabled persons and those who are denied access to the Genetic Supermarket due to lack of financial means. With regard to the former, I suggest that while harms - both subjective and objective - cannot lightly be discounted, a laissez faire approach which sees the state adopt a position of neutrality with regard to the selection of traits may diminish rather than exacerbate these. Likewise, considerations of justice create unease about the prospect of a Genetic Supermarket accessible only by the wealthy. This, however, forces us to confront wider questions about undeserved advantage, and leads me to ask whether the Genetic Supermarket approach would be any more unjust than the status quo. In my final chapter, I look critically at the decisions arrived at thus far by the various bodies charged with regulating access to PGD. In particular, the provisions of the Human Fertilisation & Embryology Act 1990, and the decisions of the Human Fertilisation & Embryology Authority which it established, are scrutinised. It is my contention that the decisions of the latter are sometimes inconsistent and difficult to reconcile with the ethical principles that they purport to uphold. In particular, they lack a coherent notion of harm, or of the duties that we owe to future persons.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: Sheila McLean
Keywords: Medical ethics
Date of Award: 2004
Depositing User: Enlighten Team
Unique ID: glathesis:2004-71341
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 10 May 2019 10:49
Last Modified: 10 May 2019 10:49
URI: http://theses.gla.ac.uk/id/eprint/71341

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