Yesterday during a slow period at work I took a poll on one of our computers about genetic testing, specifically pre-natal testing. Some of the questions inspired me to write a piece on the topic.
The first question of this poll was on the topic of sex selection. Should a couple who is undergoing IVF (in vitro fertilization) be allowed to choose the sex of their baby? I don’t think so. Perhaps this technique would prevent infanticide in places like China where there are restrictions on the number of children, and where one sex is much more desirable over another, but in the United States I do not think it should be allowed. It allows for the promotion of discrimination and opens the door for selecting other kinds of traits (such as blue eyes, blonde hair, etc.) More on trait selection in a second.
We also discussed a similar scenario in my human genetics class: a couple with four girls is experiencing an unplanned pregnancy. They wish to undergo pre-natal genetic testing to determine the sex of their child. If the child is another girl, they will terminate the pregnancy. If the child is a boy they will continue. If they do not recieve the testing, they will terminate the pregnancy anyway. In this case I’m not sure what to do. I am against sex selection, but in this case there is a chance of actually preventing an abortion if the test is performed. I am fundamentally pro-choice, but in the same way that Bill Clinton was: abortion should be safe, legal, and RARE. I am willing to let women make their own choices and deal with the consequences but I would and will NEVER promote abortion.
There was not a question about this in the poll I took, but there is another face to trait selection. Many couples with traits that they feel define their community, such as dwarfism or deafness, would prefer to have a child with whom they share that particular trait. We also discussed this in my human genetics class. Is it okay to select for embryos with, say, dwarfism or deafness? I’m not sure. On the one hand, having a child who is also part of the community you belong to would be just one more way to bond with your child. Do you remember the movie Mr. Holland’s Opus? Mr. Holland was a music teacher with an extreme passion for composition, and his son was deaf. He had a very difficult time bonding with his son because neither could comprehend the other. A hearing child born to deaf parents might be subject to the same difficulties. Wanting to have a child like yourself…there is nothing wrong with that. I think in this scenario I would allow pre-natal testing.
The second question of the poll was on selecting for a particular histocompatability trait. In layman’s terms that means blood group and certain other proteins. What if a couple was having another child so that the second child could say, be a bone marrow donor for the first? (Let’s not debate the ethics of that, let’s assume the couple is ready for implantation and just needs the embryos tested.) I would absolutely allow testing of the embryos for this case. You have the chance to both create new life and save a current life. (What’s more pro-life than that? Seriously.) I would be honored to have been created for a purpose such as that.
The last question of the poll was on testing for a homosexuality gene. Now…just to clarify…scientists HAVE NOT FOUND such a gene. And I doubt that homosexuality is determined by just one gene. Scientists don’t even understand heterosexual attraction, much less homosexual. But let’s ignore that and assume that there is one gene. Not all people who are homosexual have this gene, and not all who have it are homosexual. There is a 75% correlation. (This is the exact scenario given in the poll.)
I would absolutely NOT allow pre-natal testing in this case. Homosexuality is still too persecuted and I can certainly imagine a child who was chosen to have the gene arguing with his or her parents: “Why would you CHOOSE this life for me?” And what if the parents get the testing and choose a child without the gene who is homosexual anyway? What if the opposite happens? Will the parents love their child any less? Will they resent themselves, the doctors, their child for not turning out the way he or she was supposed to? There are far too many questions without answers for this type of testing to even be considered. Thankfully we are far away from even being able to think about testing for this.
One response to the poll regarding the homosexuality question went something like this: “If a parent knew their child was likely to be homosexual, they could begin to create a support network for their child.” That’s all well and good, but shouldn’t parents be creating support networks for their children regardless of whether they like boys or girls (or both)? When I have children they will know that they are loved and that I fully support them, regardless of whose locker they stuck a love note in.
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One quick note, which I was reminded of by the first comment. Pre-natal screening is performed for many different genetic disorders, including achondroplasia, trisomy-21 and trisomy-18, and hemophilia. Screening for the possibility of developmental disorders, such as Down’s Syndrome is also usually done, more to prepare the parents for the specific challenges of a special needs baby. Pre-natal screening is also performed to make sure that the mother’s Rh factor is compatabile with her baby’s.
Newborn screening (which is not really related to the topic at hand) is also required in many states. For example, children with PKU (phenylketonuria, a disease that can cause severe mental and developmental retardation) can escape most of the effects of the disease with a diet low in phenylalanine. If detected right away children can lead rather normal lives.
Parents can of course refuse the tests, but why would you? By performing the tests, the doctor is giving you information. What you do with the information is of course up to you, but I would rather know about potential problems now and be prepared for them.
Derailing My Train of Thought 
Pre-natal test is definitely a ‘gray area’, as different scenarios really do change the perception.
So far in our pregnancy, we’ve done the standard/non-invasive screenings. First trimester we did risk screening for chromosomal and fetal abnormalities such as Trisomy-21 and -18 (both came back normal, so there was no need for additional testing).
In the second, we did the quad screen, which looks for possible genetic disorders, as well as chromosomal and developmental abnormalities (which all came back normal).
But again, these tests were 1) non-invasive tests that simply identified risk for certain abnormalities and 2) were more for us to be used as preparation, rather than choice of continuing the pregnancy (we agreed early on that if our child had any sort of abnormality such as Down’s, we would still keep the pregnancy).
I feel like tests such as sex selection do indeed open the door to other trait-preference tests, but there are certain scenarios, as you explained, that would certainly be okay. I am a little bothered, though, by parents that would choose to terminate a pregnancy because they wanted a boy rather than a 5th girl. I can understand that many parents’ don’t have the time/resources/etc. to care for a special-needs child, but I feel like to terminate a pregnancy solely based on the gender/eye color/etc. of the child is just absurd.
Oh, and of course we’re in agreeance on the homosexuality thing. Because I would be absolutely okay with my child if he had the ‘homosexuality gene’ because then my baby would be FABULOUS!!!