Description
The Human Genome Project has triggered a technological revolution that has influenced nearly every field of medicine, including reproductive medicine, obstetrics, gynecology, andrology, prenatal genetic testing, and gene therapy. This second edition of Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies offers a thorough, timely discussion of ethical issues raised by the latest genetic and genomic technologies applied in human reproductive and prenatal medicine, providing practical recommendations, guidelines, and algorithms to support ethical clinical practice. Here, international experts consider the ethics of technologies from preconception carrier screening to genetic engineering, CRISPR gene editing, mitochondrial gene replacement therapy, sex selection, predictive testing, secondary findings, embryo reduction, and the moral status of the embryo, genetic enhancement, and the sharing of genetic data. Throughout the book, contributors adopt a global, holistic perspective on applied challenges and the moral questions around the implementation of genetic reproductive technologies. The book is an ideal resource for practitioners, regulators, lawmakers, clinical researchers, genetic counselors, and graduate and medical students.This fully updated second edition examines new developments in the field, tackling ethical aspects of organoid development, recent advances in pharmacogenomics, direct-to-consumer genetic testing, and genetic engineering.- Provides practical analysis of the ethical issues raised by cutting-edge techniques and recent advances in prenatal and reproductive genetics- Contains contributions from leading bioethicists and clinicians who offer a global, holistic perspective on applied challenges and moral questions relating to genetic and genomic reproductive technology- Discusses preconception carrier screening, genetic engineering, and the use of CRISPR gene editing, mitochondrial gene replacement therapy, and ethical issues, among others- Considers ethical aspects of recent advances and new technologies in the field, from organoid development to pharmacogenomics and direct-to-consumer genetic testing
Table of Contents
Contributors 1. Genomic editing: From human health to the "perfect childDaniela Iancu1. Introduction 1.1 Beginnings 1.2 Definitions and context 1.3 Recombinant DNA technology: The basis for DNA modification 1.4 Genome editing 1.5 Zinc finger nucleases (ZFNs) 1.6 CRISPR/Cas9 technology 1.7 Base editing technology 1.8 Principles of using genome editing in research and clinical practice 2. Ethical issues in clinical genome editing 2.1 Nonmaleficence and risk/benefit assessment 2.2 Beneficence in gene editing therapies 2.3 Respect for autonomy 2.4 Confidentiality 2.5 Applying the principle of justice in clinical genome editing 2.6 Eugenics, enhancement, and "designer babies 3. Conclusions References 2. Ethics of mitochondrial gene replacement therapyRebecca Dimond1. Introduction 2. What is mitochondrial disease and mitochondrial donation? 3. The UK timeline 4. The international position 5. Are the techniques safe? 6. Ethical issues 7. "Three parent babies and identity 8. Genetic modification and the "slippery slope 9. Risks for egg donors 10. Ethical differences between PNT and MST 11. Mitochondrial disease as complex: Diagnosis, predicting risk, and genetic counseling 12. Alternative reproductive options 13. Polar body transfer and gene editing 14. Conclusion References 3. Reproductive technologies used by same-gender couplesValentina Nastasel, Diana Badiu, and Vlad I. Tica1. Introduction 2. Procreative autonomy 3. Gamete and embryo donation 4. Surrogacy agreement 5. Trans parenthood 6. Conscience clause 7. Conclusions References Further Reading 4. Ethical issues raised by multiparentsMaria Aluas1. Introduction 1.1 Key terms of the debate: Filiation, kinship, and parenthood 2. Multiparents of children born through ARTs 2.1 Maternity 2.2 Paternity 3. Where do all these parents come from? 3.1 Sperm donation 3.2 Egg donation 3.3 Embryo donation 3.4 Surrogacy 4. Ethical issues 4.1 The right to know one's origins 4.2 Donors' anonymity 4.3 The consent of participants 5. Secondary ethical issues 5.1 Medical tourism 5.2 Slippery slope 6. Final considerations References 5. Revisiting the nondirective principle of genetic counseling in prenatal screeningOana-Maria Isaila1. Introduction 2. Genetic counseling: An overview 3. The nondirective principle in genetic counseling 3.1 "Nondirectivity or "sharing decision-making? 3.2 The nondirective principle of genetic counseling in preimplantation screening 3.3 The nondirective principle of genetic counseling in prenatal screening 4. Does the nondirective principle compromise genetic counseling in prenatal screening? 5. Does genetic counseling in prenatal screening compromise the nondirective principle? 6. The concept of nondirectivity vs the role of genetic counseling 7. Activating the conscience clause in genetic counseling in prenatal screening? 8. Genetic counseling in prenatal screening in ethnic and cultural minorities 9. Medical tourism for abortion after genetic counseling 10. Issues of genetic counseling in prenatal screening 10.1 The absence of genetic counseling 10.2 The inappropriate genetic counseling 11. Final considerations References 6. Sex selection, gender selection, and sexismIva Rincic, Amir Muzur, and Stephen O. Sodeke1. Introduction 2. The roots and reasons for sex selection 3. From politics on reproduction to biopolicy 4. Missing girls: Why and how many? 5. Legal and ethical questions 6. Conclusion References 7. The impact of Big Data on beginning-of-life issuesDario Sacchini and Antonio G. Spagnolo1. Introduction: First, what is really "Big Data? 2. Big Data and healthcare: An expanding universe 3. Big Data and Beginning-of-life issues: A field in its infancy 4. Conclusion: Work in progress References 8. The moral status of the embryo and its uses: Bioethics and social perceptionsRafael Pardo1. Introduction 2.
