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Updated: Apr 28, 2026

FISH for Pre-implantation Genetic Diagnosis
Published on: February 23, 2011
Accepting adoption's uncertainty: the limited ethics of pre-adoption genetic testing
1Department of Philosophy, American University, Washington, DC, USA, Leighton@American.edu.
Insights
Pre-adoption genetic testing (PAGT) is increasingly requested for children adopted internationally. While intended to ensure genetic matching, it may increase risks for vulnerable children by encouraging preferences over their well-being.
Area of Science:
- Bioethics
- Adoption Law
- Genetic Testing
Background:
- Growing international adoptions from regions with poor medical/environmental conditions.
- Increasing demand from prospective parents for genetic testing before adoption due to medical history concerns.
Purpose of the Study:
- To analyze the ethical arguments surrounding pre-adoption genetic testing (PAGT).
- To examine the 'best match' argument for expanding genetic testing in adoption.
- To evaluate the impact of PAGT on the best interests of adopted children.
Main Methods:
- Ethical analysis of prevailing arguments on PAGT.
- Critique of the 'best match' rationale in adoption.
- Examination of potential harms and benefits of PAGT for children.
Main Results:
- A consensus exists against PAGT unless permissible for all children.
- A counter-argument supports PAGT based on the state's duty to ensure parental "matching."
- The "best match" argument prioritizes parental genetic preferences over child welfare.
Conclusions:
- PAGT, particularly when driven by parental genetic preferences, does not serve the best interests of adopted children.
- It may exacerbate risks for children by creating unrealistic expectations and uncertain genetic backgrounds.
- Ethical considerations must prioritize the protection and well-being of vulnerable adopted children.
Abstract:
An increasing number of children are adopted in the United States from countries where both medical care and environmental conditions are extremely poor. In response to worries about the accuracy of medical histories, prospective adoptive parents increasingly request genetic testing of children prior to adoption. Though a general consensus on the ethics of pre-adoption genetic testing (PAGT) argues against permitting genetic testing on children available for adoption that is not also permitted for children in general, a view gaining traction argues for expanding the tests permitted. The reasoning behind this view is that the State has a duty to provide a child with parents who are the best "match," and thus all information that advances this end should be obtained. While the matching argument aims to promote the best interests of children, I show how it rests on the claim that what is in the best interests of children available for adoption is for prospective adoptive parents to have their genetic preferences satisfied such that the "genetics" of the children they end up adopting accurately reflects those preferences. Instead of protecting a vulnerable population, I conclude, PAGT contributes to the risks of harm such children face as it encourages people with strong genetic preferences to adopt children whose genetic backgrounds will always be uncertain.
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