Screening embryos for cancer genes

I have been sitting on this story for a few days and haven't blogged about it because work is still crazy and frankly, I've just been too tired!

It seems that Britian's reproductive authority, the The Human Fertilisation and Embryology Authority (HFEA), has given the green light to using pre-implantation genetic diagnosis (PGD) to screen embryos for the BCRA1 or BCRA2 genes which increase the risk of breast cancer by 80% and ovarian cancer by 40%.  From a great Q&A on BBC News:

What is preimplantation genetic diagnosis?

Preimplantation genetic diagnosis, or PGD, was first introduced in 1990 as an experimental procedure.

It involves removing a cell from an embryo at the eight-cell stage of development, when it is around three-days old, and testing it for genetic disorders so that an unaffected embryo can be implanted into the mother's womb.

What were the rules on PGD?

PGD has traditionally been used to check for genes which will guarantee the resulting child will develop a condition - such as cystic fibrosis and Huntington's disease.

The HFEA has also allowed PGD can be used to check for an inherited form of bowel cancer called familial adenomatous polyposis and retinoblastoma - a very rare form of eye cancer.

It also gave the go-ahead for the technique to be used so that embryos could be selected purely because they are a tissue match for a sick sibling.

So why is this big news?  Well, in the Catholic eye, PGD is always unethical because it puts the life of the embryo at risk and usually any "defective" embryos are discarded.  But, for the rest of the world, screening for a genetic mutation that will certainly cause a devastating disease is a lot different than screening for a mutation that just might cause disease sometime later in life.  

I think the slippery slope here is pretty apparent and downright terrifying.  I loved this line from the BBC:

What are the concerns about PGD?

There are concerns that medicine is moving away from treating diseases and focusing on eliminating the carrier.

Really.  You mean PGD and pre-natal diagnosis coupled with abortion doesn't cure disease, it just gets rid of the people who have the disease?  Interesting.  I guess eliminating the person who might get the disease is easier and cheaper than actually finding a cure.

Does it occur to anyone that by the time that these embryos may or may not get  cancer in 30 to 40 years, that there will be a cure?  This is the danger of genetic determinism.  These doctors and parents cannot see past their own reality to imagine a world were having the BCRA1 or BCRA2 gene won't be an issue.  And these embryos will pay the price.

I submit to you that all of us are in some way "genetically defective."  We all carry genes that make us susceptable to cancer, or heart disease, or stroke, or high cholesterol, or obesity, or hairy backs, or thinning hair.  I think you get the picture.

Of course, not all breast cancer is caused by mutations in the BRCA1 or BRCA2 gene, but as a thought experiment ask yourself how many incredible women you know that have died from breast cancer or are breast cancer survivors.  Would your mother, or sister, or aunt or cousin have made the cut?  Check out this great list of famous people with breast cancer from Wikipedia.

This announcement is particularly disturbing when you consider the following quotes:

"When I gave a speech at Emory Law School in Atlanta, students came up to me afterward and said that, with genetic testing readily available, women shouldn't be allowed to have children with disabilities, since it raises people's insurance rates."  --Lori B. Andrews, reproductive rights lawyer

"We are entering a world where we have to consider the quality of our children."  --Robert Edwards, IVF pioneer and cloning advocate

"Margery Shaw, a doctor and lawyer, wrote in the Journal of Legal Medicine that women who carry a genetic defect such as Tay-Sachs and who go forward with a pregnancy of an affected fetus should be prosecuted as criminals."  --Lori B. Andrews, reproductive rights lawyer

Does this announcement signal a time when it will no longer be acceptable to have "defective" children?  Is a world where any naturally conceived child is a second class citizen, like that portrayed in the movie GATTACA, in our not too distant future?

I can't see how this can lead anywhere else.