Medicine and Eugenics: Cure or Selection?

The Antena 3 website publishes a news story titled as follows: “Doctors at a hospital in Tenerife manage to give birth to healthy babies free of genetic diseases.”

What this information tells us, presenting it as new, is no different from what we know Preimplantation Genetic Diagnosis (PGD), which involves the genetic analysis of the blastomere, one of the cells that form the embryo in the early stages of development, to detect the existence of anomalies in its genome. Since, to date, it has not been possible to intervene in these embryos to correct these anomalies, the utility of PGD is exclusively eugenic: selecting healthy embryos and eliminating defective ones.

in this matter An interdisciplinary group of medical experts and biologists has promoted the birth of four children free of a rare hereditary disease: osteogenesis imperfecta, also known as ‘brittle bones’, from which their parents or relatives suffered.

To achieve this, Dr. Diaz-Flores Estevez, one of the team members, explains that “the first thing we do is get a patient who may have one of these rare diseases and we do genetic studies. We do. If patients wish to have children, they always want their children to be free from the disease that causes them so much pain” and “We recommend that they undergo a preimplantation diagnosis that is done in conjunction with the human reproductive unit He further explains that “there is not always 100% success, it is also important that the couple undergoing treatment knows this.”

This process involves the generation by in vitro fertilization of several embryos, from which a single cell will be extracted for the analysis of its DNA to check for the presence of this mutation. If the result is positive, that is, the fetus is affected by the disease, it is directly discarded and terminated. Some of the embryos free of mutations are selected to be implanted in the uterus of a pregnant woman.

background

The first cases of PGD in the prevention of transmission of hereditary genetic diseases occurred in 1990 and involved couples with hereditary diseases linked to sex chromosomes, in which the sex of the fetus was identified through amplification of specific sequence DNA. Y chromosome.

First publication of A Pregnancy achieved through PGD in Spain It was carried out jointly by the Department of Cellular Biology of the Autonomous University of Barcelona and the Dexeus Institute in 1994, in a woman who was a carrier of hemophilia.

The development and incorporation of polymerase chain reaction (PCR) technology has allowed us to expand the study of specific mutations in monogenic diseases. Thus, La Fe Hospital in Valencia, in collaboration with the Valencian Infertility Institute (IVI), was, in 2000, able to diagnose cystic fibrosis for the first time in Spain. Subsequently, the reproductive team of the Jiménez Díaz Foundation did the same with Huntington’s disease in 2001, followed by other advances in the field of PGD, such as the case of the Sant Pau-Fundación Puigvert Hospital, which used it in this case in 2003. Implemented. Anhidrotic ectodermal dysplasia.

bioethical assessment

The eugenic orientation of PGD techniques makes it complicated bioethical acceptability Among these advances in genetic diagnosis. Although avoiding the transmission of genetic diseases through heredity is a desirable goal in medicine, it means attacking against human life Embryonic.

The news that concerns us today, like all the news related to embryo selection using PGD, involves the implementation of unacceptable methods due to the production of multiple embryos. in vitro fertilization Those who will be subjected to “genetic screening” to select healthy people and eliminate the sick. Furthermore, more disease-free embryos may be obtained than those that will ultimately be implanted, and if they are not reused in new pregnancy attempts, they may also be destined for destruction or cryopreservation. Will be.

The headline that is presented to us today in the above media: “Doctors in a hospital in Teneriffe manage to produce healthy children free of genetic diseases”, could be written in another, less euphemistic way: “In a hospital in Teneriffe After getting rid of the diseased fetuses, the doctors at the hospital manage to produce healthy children free from genetic diseases.

The application of PGD at the present time does not allow the correction of genetic errors in the offspring, being used exclusively as a eugenic method, which is reprehensible from a bioethics that protects the life and rights of all, Especially the most vulnerable.

julio tudela

Bioethics Observatory

Institute of Life Sciences

Catholic University of Valencia