Technological development has greatly improved and influenced people's choices regarding the kind of children that they might give birth to. Assisted reproductive technology has given hope to millions of couples who wish to have children of a specific sex. However, it also presents countless challenges especially ethical, legal, and moral concerns. The objective of this paper is to determine to what extent does the law allow and should allow reproductive autonomy in the context of preimplantation genetic diagnosis. Generally, people have the right to choose whether they should or should not have a child. With the advancement of the reproductive technology such as the prenatal screening diagnosis and preimplantation genetic diagnosis, people can somehow make choices regarding the kind of child they might have. This means that people can chose to give birth to a seriously impaired or a child with a disease or disorder. However, with the advancement of technology in this area, people will be presented with a range of choices, especially moral and ethical. Further, the extent to which the evolutionary science in relation to selective abortion or the use of preimplantation genetic diagnosis will be morally, ethically, and legally acceptable in the society is still an issue to be discussed and debated on if a lasting solution is to be found. This paper aims at examining the extent to which the law does and should allow reproductive autonomy in relation to the preimplantation genetic diagnosis.
Definition of Terms
The assisted reproductive technology is associated with various terms that need to be explained so as to understand the topic well. First, the term preimplantation genetic diagnosis (PGD) is defined as vitro testing embryos or oocytes to determine different abnormalities. This procedure aims at assisting couples who have great risks of transmitting the genetic disorders to the child. This kind of technology first experimented on rabbits in 1968 with the aim of determining the vitro fertilization (IVF). However, as the technology advanced years later, scientists discovered genetic diagnosis of a single cell, a discovery that led to the preimplantation genetic diagnosis in the human body later in 1989. As Peter Blaude and other state, PGD is an evolving technique that provides couples who are at risk of transmitting some of the serious genetic conditions to their children with alternative options to prenatal diagnosis and termination of pregnancy. For nearly 25 years, the use of PGD has evolved; initially it was used to offer alternative solutions to prenatal diagnosis with the aim of minimizing cases of serious genetic disease or disorder transmission from the parent to the offspring. Today, the use of PGD has advanced and evolved; people are not only able to identify the potential reproductive risks, but also establish viable pregnancies due to miscarriages caused by different conditions such as chromosome rearrangement (Peter 942). PGD can be used to test different conditions such as single gene disorder, aneuploidy screening, inherited chromosome abnormalities, non-medical sexing, and sexing for X-linked diseases Harvey 282).
Prenatal diagnosis (PND) involves sapling cells of foetal origin with the aim of increasing the accuracy, rapid outcome of pregnancy. It is also considered to be an alternative to the couples who have greater risks of transmitting the genetic disorders to their offspring. Peyvandi and others argue that the prenatal screening or diagnosis is a kind of prenatal care that aims at detecting any problems with the pregnancy as early as possible. After the problem has been detected through the prenatal screening method, the doctors may pursue additional information regarding the problem through the prenatal diagnosis. The most common method prenatal diagnosis includes the chronic villus sampling technique. Elias and others argue that approximately 40 to 60% of human embryos are abnormal and the number continues to increase as people grow older. According to the authors, these abnormalities result in low implantation rates of embryo. Therefore, prenatal diagnosis screening is used to detect such risks that may reduce the survival chances of the embryo.
Reproductive freedom has been defined by the World Health Organization as recognition of the basic rights of all couples to decide on the number, spacing, and timing of their children. It also means the right to attain the best standards of sexual and reproductive health and the rights to make decisions regarding reproduction free of coercion and violence. According to Rosalind McDougall, "reproduction is a personal and self-expressive decision that people are entitled." To the women, reproductive rights may include the right to legal and safe abortion, birth control, freedom from coerced sterilization among other important rights.
Legal Aspects of Reproductive Autonomy in respect to PGD
The existing laws provide reproductive freedom which includes selecting when to have a baby. However, in respect to the preimplantation genetic diagnosis, the law under the United Kingdom provides requirements or conditions in which PGD should be carried out. A report by House of Common in 2005 highlights the regulations under the Human Fertilization and Embryology Authority (HFEA), which was formed as a result of the Human Fertilization and Embryology Act of 1990 (HFEA). The report highlighted the regulations of assisted reproduction which includes licensing the embryology research. The embryology Act of 1990 provides three main concerns; embryology research, the welfare of the child, and abortion. The amendments that were done later provided the limits for abortions to 24 weeks. In the United Kingdom, it is considered illegal to use any method to select the sex of a child through the assisted reproductive technology. However, scholars have argued whether it should remain illegal and on what grounds should it be considered illegal. The illegal process of law involves something that harms others or tends to spearhead injustices to others. In order to show that the law is justified, it must demonstrate how someone has been harmed in the process of an event or practice. Scientists believe that selecting a sperm is not causing harm to the embryo or foetus. The existing European Convention for the Protection of Human Rights under article 8 provides individuals with the right to respect for private and family life. The provisions of this article are still relevant to the HFE Act of 1990. This article further demonstrates that there should not be interference by a public authority with the exercise of private life except it affects the economic well-being of a country, aims at preventing crime, protection of health or morals, protection of rights and freedom of others. Under article 12, the convention also provides the right to marry and have a family. Lastly, article 14 of the convention protects against discrimination in various aspects such as sex, race, colour, language, religion, political, social opinion among another status. The above articles are relevant to the provisions of HFE Act of 1990. The report by House of Common shows that even though the HFEA policies do not allow the use of PGD for sex selection for social reasons, it still not considered illegal. Other activities involved in PGD process such as sperm sorting are also not provided in the UK law. However, under article 18 of the HFE Act, the law requires that adequate protection is accorded the embryo in case of research.
Moral and Ethical Perspective of Reproductive Autonomy
The advancement of reproductive techniques, people are becoming more aware of the genetic basis of diseases. As a result, the genetic tests for different conditions and diseases are increasingly becoming available to couples with a history of genetic disease to enable them to select a healthy offspring. However, some couples wish to have children with disability or condition; this aspect presents various ethical and moral concerns. Scholars have argued on the moral and ethical perspectives of reproductive autonomy. Some scholars support the acceding to genetic tests while others strongly oppose it. Julian Savulescu in "Procreative Beneficence: Why we should Select the Best Children" explains that the eugenic selection has opened up a wide range of choices in which people can select embryos through the assisted reproductive techniques. Sparrow also supports Julian's belief that people have obligation to select the child of the possible children they could have and get one with the best life based on the relevant and available information. Sparrow agrees with Julian's "obligation concept" that parents are obligated to make choices that appear independent of their ideas. However, Sparrow disagrees with the extent to which the autonomy should reach. The author argues in "Procreative Beneficence, Obligation, and Eugenics" that the fact that parents have obligation to make choices regarding the future life of their children does not mean that they have to pass the level of their obligation. Sparrow believes that Julian's concept of obligation has been overrated and exaggerated especially when it comes to the use of assisted reproductive techniques. He believes that despite that parents are "obligated to choose the best child, but it is wrong for them to do anything else." He further notes that it would seem wrong for a parent with a disability to choose an embryo to implant on the basis that it has a genetic predisposition to certain disability condition. Ethics are important aspects of considering the rightness or wrongness of a decision. It defines the limits that people or practitioners need to consider and whose interest needs to be considered in the process. However, in order to determine the limits, people need to interrogate their moral intuitions to determine the validity of their choices. Julian criticizes the "right not to be born" citing that people need to have the right information and view every option before deciding to have a child through assisted reproductive methods. In her criticism, Julian claims that what constitutes a right is a complex issue that needs to be considered or approached carefully so as not to distort the meaning. According to Julian, a right protects interests. However, she disagrees with many cases that have happened where people claim that giving birth to a child should be in their interest. Citing from one of the Indian cases where a couple was awarded 50,000 rupees as damage to the couple who gave birth to their fourth child, Julian asserts that such incidences are called "fictional cases." Julian further states that some people believe that being born with a disability or disease such as Down syndrome constitutes a life not worth being alive; something she disagrees with citing that even those born with conditions can sometimes lead happy and worthwhile lives just like any other person.
Julian explains two key principles of reproductive ethics; the reproductive autonomy and the procreative beneficence. However, Julian has focused more on the principle of procreative beneficence supporting it with different arguments regarding the parental duty to have the child who will have the best life in future. Julian explains the principle of procreative beneficence citing that potential parents should select the best child of possible children that could have. Julian's procreative beneficence involves selecting the best possible traits of the possible children that a couple could have. This principle has been defended and objected in some instances by different scholars who have different perceptions regarding the autonomy of reproductive techniques. Jul...
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