对多遗传病的植入前遗传检测:一个法律,伦理和科学挑战
Perrine Ginod1,2, Michael H Dahan1,3
1MUHC Reproductive Centre, McGill University, Montréal, Quebec, Canada.
Seminars in reproductive medicine
|March 22, 2024
概括
商业化胚胎健康评分 (EHS) 选多基因条件,但忽略了环境因素并引发了伦理方面的担忧. 在广泛采用之前,需要进一步的研究和合作来解决社会影响.
科学领域:
- 生殖遗传学 生殖遗传学
- 生物伦理学生物伦理学
- 公共卫生 公共卫生
背景情况:
- 胚胎健康评分 (EHS) 的商业化允许对多基因条件进行植入前遗传测试,旨在降低后代疾病风险.
- 像Orchid Health这样的公司已经将测试范围从20个以下扩大到900多个条件,包括出生缺陷.
研究的目的:
- 批判性地评估商业化多基因胚胎查 (PES) 的科学实用性和社会影响.
- 检查 PES 带来的伦理,法律和社会挑战,包括它对生殖自主,公平和遗传多样性的影响.
主要方法:
- 对健康的"基因化"进行分析,忽视环境因素和试管婴儿风险.
- 审查监管格局,并指出PES的合法性在全球范围内有所不同.
- 检查患者和医生的关系向一个消费者模式的发展.
主要成果:
- 欧洲社会党对社会不平等的增加,潜在的污名化以及对"可取"特征的选择表示担忧.
- 在监管监督有限的地区,这种做法正在扩大.
- 关于生殖自主权,歧视,家庭动态和遗传多样性的道德和法律困境仍然存在.
结论:
- 由于排除了环境影响,因此质疑EHS的科学实用性.
- PES重新定义了医疗保健关系,并承担着加剧社会差距的风险.
- 采取多学科的方法对于解决PES对胚胎选择的社会影响和可接受性至关重要.
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