The argument that selection against specific genetic traits will lead to increased discrimination is both compelling and troubling. Indeed, it is reasonable to conclude that if a large number of people use PGD to select against traits they consider to be disabilities then the probability of increased discrimination and marginalization would be greatly increased. However, as this Note argues, most participants in the PGD disability debate overlook important limitations of both trait selection and large-scale PGD adoption that will likely mitigate the negative potentially negative impact of PGD technology.
The Potential Impact of Preimplantation Genetic Diagnosis on Discrimination of the Disabled: Analysis of Mitigating Factors
1. The Potential Impact of Preimplantation Genetic
Diagnosis on Discrimination of the Disabled: Analysis
of Mitigating Factors
Blaine T. Bettinger, Ph.D., J.D.
April 2009
I. Introduction
Preimplantation Genetic Diagnosis (“PGD”) is a technique used to characterize genetic
traits and chromosomal structure of embryos that are created through in vitro fertilization
(“IVF”).1 During a traditional IVF cycle, eggs are harvested from a woman following ovarian
stimulation and are fertilized with sperm to create embryos.2 Two to four days after fertilization,
one or two cells are removed from the eight-celled embryos for genetic analysis.3 Following the
analysis, the selected embryo or embryos are implanted in the woman’s uterus.
To characterize genetic traits or chromosomal structure, the DNA of the harvested
embryonic cells is isolated and subjected to either polymerase chain reaction (PCR) analysis to
examine specific genetic sequences (such as those associated with cystic fibrosis, sickle cell
anemia, and Huntington disease) or fluorescent in-situ hybridization (FISH) to examine
conditions such as chromosomal abnormalities.4 Currently, PGD analysis is typically limited to
suspected traits or conditions based on the genotypes or family history of the biological parents. 5
1
Molina B Dayal & Shvetha M Zarek, Preimplantation Genetic Diagnosis, EMEDICINE,
http://emedicine.medscape.com/article/273415-overview (last visited Mar. 25, 2009).
2
Id.
3
Id.
4
Id.
5
Id.
2. However, as new technology such as microarray analysis becomes affordable, a PGD test will
include thousands of genetic traits and reveal a wealth of information about the genetic profile of
the embryo.6 As a result, parents will have the ability to screen embryos based on thousands of
tested traits.
The ability of parents to screen tested embryos has raised concerns, even at the current
technological state of PGD testing, about the potential for increased discrimination against
individuals possessing or exhibiting genetic disabilities.7 These concerns are based upon the
belief that as society is given the tools to select against specific genetic traits, people who
possess those traits will be stigmatized and marginalized, leading to increased discrimination.
Timothy Krahn of Novel Tech Ethics summarized the argument thusly:
“The moral danger does not lie with the people who seek [PGD] testing; rather,
the danger lies in how this testing could promote further stigmatization of and
discrimination against people with genetic impairments or their parents. Indeed,
testing could entrench a culture of prevention and perfectionism and promote a
culture of intolerance.”8
Even the Pope has decreed that using PGD to screen embryos based on genetic disorders is
discrimination.9
6
See, e.g. Justin Perrone, Empire Genomics Will Provide Reprogenetics With Chips for IVF Cell Screening
Worldwide, BIOARRAY NEWS, Oct. 16, 2007, http://www.genomeweb.com/arrays/empire-genomics-will-provide-
reprogenetics-chips-ivf-cell-screening-worldwide (last visited Mar. 25, 2009) (discussing the recent success of
microarray chip analysis of the genomic profile of single cells).
7
See, e.g., Jaime King, Predicting Probability: Regulating the Future of Preimplantation Genetic Screening, 8
YALE J. HEALTH POL'Y, L. & ETHICS 283 (2008) (arguing that “widespread use of the technique can harm not only
the individuals involved in it, but also society in general by increasing discrimination, stigmatization, and health
disparities.”); J.C. Roberts, Customizing Conception: A Survey Of Pre-implantation Genetic Diagnosis And The
Resulting Social, Ethical, And Legal Dilemmas, 2002 DUKE L. & TECH. REV. 0012 (2002) (noting that “[t]he
disability discrimination claim maintains that prenatal or preimplantation screening for disabilities results in
discrimination against those with the disability by reducing the numbers of people affected.”); David S. King,
Preimplantation Genetic Diagnosis and the ‘‘New’’ Eugenics, 25 J. MED. ETHICS 176 (1999).
8
Timothy Krahn, Where Are We Going With Preimplantation Genetic Diagnosis?, 176 CMAJ 1445, 1445 (2007).
9
Nicole Winfield, Pope Decries Genetic Discrimination, THE SYNDEY MORNING HERALD, Feb. 22, 2009,
http://news.smh.com.au/breaking-news-world/pope-decries-genetic-discrimination-20090222-8edd.html.
2
3. Just as troubling, widespread adoption of PGD technology could ultimately lead to
discrimination along socioeconomic lines. Depending on the cost of PGD and IVF cycles,
socioeconomic classes unable to afford those costs will be unable to select against certain genetic
traits. As a result, the conditions associated with those genetic traits will manifest in an
increasingly smaller percentage of higher socioeconomic classes, in effect making the manifest
condition (which will usually be called a disability) one that belongs primarily to lower
economic classes.
The argument that selection against specific genetic traits will lead to increased
discrimination is both compelling and troubling. Indeed, it is reasonable to conclude that if a
large number of people use PGD to select against traits they consider to be disabilities then the
probability of increased discrimination and marginalization would be greatly increased.
However, as this Note argues, most participants in the PGD disability debate overlook important
limitations of both trait selection and large-scale PGD adoption that will likely mitigate the
negative potentially negative impact of PGD technology.
II. Trait Selection Limitations Will Mitigate Discrimination Resulting From PGD
In a recent study of assisted reproductive technology clinics throughout the United States,
researchers collected data from more than 3,000 PGD cycles.10 According to the analysis, 75%
of the examined PGD cycles were for detection of chromosomal abnormalities (including
aneuploidy and rearrangements), 15% were for detection of X-linked disorders (e.g., Duchenne
muscular dystrophy) and autosomal disorders (e.g., Huntington’s disease, hereditary breast
10
Susannah Baruch, David Kaufman, & Kathy L. Hudson, Genetic Testing of Embryos: Practices and Perspectives
of U.S. In Vitro Fertilization Clinics, 89 FERTILITY AND STERILITY 1053 (2008).
3
4. cancer, and Alzheimer disease), and 9% were for sex selection.11 The remaining 1% were for
HLA typing.12 The study thus suggests that currently, approximately 90% of PGD cycles are
used to screen for serious medically-relevant genetic disorders.
As PGD embraces the rapidly advancing knowledge of the genetics underlying non-
medical traits such as eye color, height, or minor medical traits such as anti-arteriosclerosis
propensity, for example, embryo selection will potentially include a number of these traits. As is
discussed below, this increase in information will likely have a strong mitigating impact on the
potential for PGD-induced disability discrimination.
Figure 1 is a chart showing the cross of two individuals who are the biological parents of
a group of embryos. Each parent in the cross possesses the autosomal-dominant mutation that
causes Huntington’s Disease (black circle), and each possesses one gene involved in a
cooperative mechanism to increase lifetime resistance to arteriosclerosis (red or green circle);
offspring must possess both cooperative genes to effectively possess the resistance. As the chart
shows, if the embryo selection is based on PGD analysis of just the autosomal-dominant
mutation for Huntington’s Disease, then 4:16 (or 25%) of embryos on average will not inherit the
mutation from either parent.
However, if the embryo selection is based on both the absence of the autosomal-dominant
mutation and the presence of the two cooperative alleles, then just 1:16 (or 6.25%) of embryos
on average will satisfy those criteria (boxed in yellow). With every new trait that is added to the
selection criteria, the possibility of obtaining the desired outcome is significantly lowered.
Indeed, rather than this simple cross, a diagram that examines the inheritance of 5, 10, or 50
potentially serious genetic disorders from two biological parents would be incredibly complex,
11
Id.
12
Id.
4
5. and the chances of obtaining a “perfect” embryo that satisfies all criteria are vanishingly small.
Screening for this many serious genetic disorders is not as unlikely as it may seem, considering
recent suggestions that every human being harbors a genetic propensity for between 5 and 50
disorders.13
13
This statement is generally attributed to Francis Collins, M.D., Ph.D., former director of the National Human
Genome Research Institute. See, e.g., Press Release, Rep. Slaughter, Author of Genetic Information
Nondiscrimination Act, Applauds Bill’s Passage in House of Representatives, May 1, 2008,
http://www.louise.house.gov/index.php?option=com_content&task=view&id=964&Itemid=1 (“each one of us is
estimated to be genetically predisposed to between 5 and 50 serious disorders.”); Roseann Gumina, The Human
Genome Project and the Next Medical Revolution, MEDSCAPE TODAY, 1998,
http://www.medscape.com/viewarticle/431916 (citing Dr. Collins for the proposition that “each human being has 5
to 50 genetic flaws.”); Nicholas Wade, Gene Mutation Tied to Colon Cancers in Ashkenazi Jews, N.Y. TIMES, Aug.
26, 1997 (quoting Dr. Collins directly as saying that “[w]e are all flawed, we all carry 5 to 50 serious genetic
misspellings.”).
5
6. Figure 1. Representation of a Three-Trait Cross14
14
The first allele (black circle) is an autosomal-dominant genetic disorder. The second allele (red circle) and third
allele (green circle) represent a cooperative multiallelic genetic trait; in this example, two genes are working
together to cause a particular phenotype. If embryo selection is based on analysis of just the autosomal-dominant
allele, 4:16 (25%) of embryos on average will be suitable for implantation. If the embryo selection is based on the
absence of the autosomal-dominant allele and the presence of both cooperative multiallelic genes, then just 1:16
(6.25%) of embryos on average will be suitable for implantation (boxed in yellow). This figure is adapted from
Figure VIII.c in German National Ethics Council, Genetic Diagnosis Before and During Pregnancy: Opinion 162-
63 (2003), available at www.ethikrat.org/_english/press/Opinion_Genetic_Diagnosis.pdf.
6
7. The problem of multiple trait selection is further complicated by the relatively high rate
of chromosomal abnormalities in IVF embryos. A 2003 study suggested that – in high-risk
groups, at least – as many as 68% of embryos possess chromosomal abnormalities.15 Thus, even
if these embryos possess no allelic disorders, the chromosomal abnormalities render them unfit
for implantation. The opportunity for selection is further reduced by the simple fact that most
fertility centers only harvest an average of 6 to 15 eggs for in vitro fertilization.16
It is logical to assume that in a complex screen that tests thousands of genetic traits, the
limited number of selections based on random assortment and the limited number of embryos
created will most likely result in the most serious traits being selected against rather than the
most desirable traits being selected for; the majority of parents are undoubtedly more likely to
choose against serious genetic disorders regardless of the presence or absence of desirable non-
medical traits than to choose for favorable non-medical traits despite the presence of a serious
genetic disorder. However, less threatening genetic disorders – which themselves are termed
disabilities under the current broad definition – will be less likely to be selected against because
there are so many to choose from and only a limited number of embryos with which to make the
choice; it is slightly more likely that in this situation parents will select desirable non-medical
traits over less threatening genetic disorders. Thus, the negative discriminatory impact of PGD
will likely be limited to the most serious life-threatening genetic diseases simply because those
are the ones most likely to be consistently selected against.
15
Lawrence Werlin, et al., Preimplantation Genetic Diagnosis as Both a Therapeutic and Diagnostic Tool in
Assisted Reproductive Technology, 80 FERTILITY AND STERILITY 467 (2003).
16
Fertility Specialists of Dallas, In Vitro Fertilization Overview,
http://www.fertilitydallas.com/IVF_fertility_dallas_IVF_overview.html (last visited Mar. 26, 2009) (“[t]he average
number of eggs retrieved at IVF is between 8 and 15.”); G. David Adamson, The Stumbling Blocks to IVF,
http://www.medicinenet.com/script/main/art.asp?articlekey=54431 (last visited Mar. 26, 2009) (“[t]he average
number of eggs retrieved is about 10 to 12 eggs for each retrieval.”); Advanced Fertility Center of Chicago, IVF
overview and general information about the in vitro fertilization process and procedures,
http://www.advancedfertility.com/ivf.htm (last visited Mar. 26, 2009) (ranging from 6.8 to 10.3 eggs per retrieval).
7
8. Limiting negative selection – and therefore potential discrimination – to the most serious
genetic disorders is arguably little comfort to those who suffer from those disorders or indeed
anyone concerned about the potential for discrimination. However, understanding this limitation
to PGD selection will allow government agencies and society at large to focus anti-
discrimination efforts on those limited most likely to suffer the potential discriminatory impact
of PGD.
III. The Limited Use of PGD Will Mitigate Potential Discriminatory Effects
In 1990, for the first time, a child was born from an embryo subjected to PGD.17 As a
result of the preimplantation screening, the girl was born free of the ΔF508 deletion associated
with cystic fibrosis.18 Just 16 years later in 2006, 4-6% of the 138,000 IVF cycles in the United
States – roughly 7,000 cycles – included PGD.19 Although these figures represent a rapid rise in
the frequency of PGD since its first use, PGD is currently used in only about 0.1% of all
pregnancies in the United States.20
The low frequency of PGD testing associated with IVF cycles has significant
ramifications on the ability of PGD to affect discrimination against the disabled. If concerns
about increased discrimination due to PGD are based on either (i) a lower overall frequency of a
genetic disorder in the human population (or some subpopulation) due to selection against that
17
A.H. Handyside, et al., Birth of a Normal Girl After In Vitro Fertilization and Preimplantation Diagnostic Testing
for Cystic Fibrosis, 237 NEJM 905, 905 (1992).
18
Id.
19
See, e.g., Baruch et al., supra note 10 (4-6% of IVF cycles); CDC, Assisted Reproductive Technology Success
Rates: National Summary and Fertility Clinic Reports, http://www.cdc.gov/ART/ART2006 (last visited Mar. 26,
2009) (138,198 ART cycles in 2006).
20
American Pregnancy Association, Pregnancy Statistics, http://www.americanpregnancy.org/main/statistics.html
(last visited Mar. 26, 2009) (approximately 6,000,000 pregnancies per year).
8
9. disorder by PGD; or (ii) on society’s adoption of a “culture of prevention and perfectionism”21
(that is, that people with the most serious genetic disorders are unfit or inferior),22 then arguably
there must first be widespread adoption of the technology. On the other hand, if PGD is only
routinely used by a limited number of individuals – such as those facing fertility problems or
life-threatening inheritable diseases, for example – it is much more difficult to support the
argument that PGD could result in disability discrimination; there would arguably not be enough
of an impact on either disability frequencies or societal/cultural views to promote discrimination.
A. Parents Who Reject PGD Testing
A primary limitation on the widespread adoption of PGD (and therefore on the ability of
PGD to negatively affect discrimination against the disabled) is the acceptance of the technology.
To “promote further stigmatization of and discrimination against people with genetic
impairments,”23 PGD must be widely accepted; if society rejects either PGD as a whole or rejects
specific uses of the technology, the ability of PGD to influence stigmatization or discrimination
will be severely limited. Arguably, widespread rejection of PGD or specific uses thereof could
actually result in the opposite effect; there could be increased support for and awareness of the
disabled because of widespred disfavor with the technology.
In 2006, the Genetics and Public Policy Center (“GPPC”) at The Johns Hopkins
University published one of the largest analyses of public opinion regarding PGD.24 Based on
surveys and/or interviews with over 6,000 people, the results suggest that 42% of Americans
21
Krahn, supra note 8 at 1445.
22
The President’s Council on Bioethics, Beyond Therapy: Biotechnology and the Pursuit of Happiness, October
2003, http://www.bioethics.gov/reports/beyondtherapy/ (last visited Mar. 26, 2009).
23
Krahn, supra note 8 at 1445.
24
Kathy L. Hudson, Preimplantation Genetic Diagnosis: Public Policy and Public Attitudes, 85 FERTILITY &
STERILITY 1638 (2006).
9
10. disapprove of using PGD to select against adulthood diseases such as cancer, and 32% of
Americans do not approve of using PGD even to prevent fatal childhood disease.25 Additionally,
fully 72% of Americans disapprove of using PGD to select embryos based on non-health
characteristics (such as intelligence, height, etc.).26
The survey provides evidence that a significant percentage of individuals in the United
States disapprove of using PGD for any use, while still a larger percent do not approve of using
PGD to select for or against less serious traits (such as adulthood diseases, behavior, and
appearance). The anti-PGD views of millions of adults will significantly limit the widespread
adoption of the technology and any resultant negative impact on discrimination against the
disabled.
B. Unintended Pregnancies
There are number of factors that may significantly limit widespread adoption of PGD and
thus potentially mitigate the impact of PGD on discrimination of the disabled. One example of a
potentially mitigating factor is the number of unintended pregnancies in the United States.
Unintended pregnancies can be the result of such things as lack of contraception, contraceptive
failure or misuse, or involuntary sex. Since unintended pregnancies are by definition unplanned,
they are completely in vivo and thus there is no opportunity for PGD testing.
Unintended pregnancies represent a significant percentage of all pregnancies in the
United States.27 In 1994, there were approximately 3.95 million births and 1.43 million
25
Id.
26
Id.
27
Stanley K. Henshaw, Unintended Pregnancies in the United States, 30 Family Planning Perspectives 24, 26
(1998) available at http://www.guttmacher.org/pubs/journals/3002498.html (this data does not include
miscarriages).
10
11. abortions, totaling 5.38 million pregnancies.28 Of those 5.38 million pregnancies, 3.1 million – a
full 49% – were unintended, a number that is still largely accurate today.29 Of these unintended
pregnancies, a total of 46% ended in births and 54% ended in abortion.30
The fact that 23% of all children – approximately 1.24 million – born in 1994 were not
planned and thus could not have undergone PGD testing has a potentially significant impact on
the concern that PGD will increase discrimination against the disabled. First, the number of
unintended pregnancies suggests that if PGD were in fact to become much more common (and
thus more likely to impact discrimination), the concern about lower frequencies of children born
with genetic disabilities will be significantly reduced by the 50% of pregnancies (and resulting
children) who cannot undergo PGD testing. If, as this Note argues, the ability of PGD to impact
disability discrimination hinges on widespread adoption of PGD and potentially on lower
frequencies of children born with genetic disabilities, then unintended pregnancies will likely
undermine both and thus mitigate the negative impact of PGD on discrimination against the
disabled.
C. Other Aspects of Unintended Pregnancies
Unintended pregnancies might, however, affect discrimination against the disabled in
other ways if PGD testing becomes routine. Although unintended pregnancies will tend to
mitigate overall adoption of PGD, these pregnancies might result in disabilities and any resulting
discrimination being concentrated in lower socioeconomic ranks. At its extreme, this may result
28
Id.
29
James Trussell and L.L. Wynn, Reducing Unintended Pregnancy in the United States, 77 Contraception 1 (2008),
available at http://www.arhp.org/uploadDocs/journaleditorialjan2008.pdf.
30
Henshaw, supra note 28 at 26.
11
12. in a “social underclass”31 that is stigmatized and discriminated against because they did not
undergo PGD as part of their pregnancy.
In 1994, the rate of unintended pregnancies was “highest among women who were aged
18-24, unmarried, low-income, black or Hispanic.”32 Indeed, 25% of all unintended pregnancies
in 1994 occurred below the poverty level (which was then $17,020 for a family of four33), and
another 25% unintended pregnancies occurred in the income bracket between the poverty level
and twice the poverty level.34 Thus, PGD and unintended pregnancies have the potential to
concentrate disabilities and discrimination against the disabled in lower socioeconomic ranks if:
(i) PGD is so widely adopted that it places a societal pressure on parents to undergo PGD testing;
and (ii) the disparate frequency of unintended pregnancies continues to follow historical values
(i.e. a higher percentage of unintended pregnancies occur in lower socioeconomic ranks). Given
the incredibly slow adoption of PGD to date, it is far from clear that it has or will have the
societal support needed to impact disability discrimination.
Alternatively, although unintended pregnancies are likely to mitigate the potential impact
of PGD on disability discrimination, large-scale adoption of PGD testing might in turn have an
impact on the outcome of unintended pregnancies. For example, if society embraces large-scale
PGD testing, there might be increased motivation for parents of an unintended pregnancy to
terminate that pregnancy and thus avoid the risk of disabling genetic disorders. While this Note
has examined PGD separate from the many issues associated with prenatal testing, it is possible
31
Rebecca E. Kopp, Preimplantation Genetic Diagnosis,
http://www.ndsu.nodak.edu/instruct/mcclean/plsc431/students/koop.htm (last visited Apr. 10, 2009).
32
Trussell and Wynn, supra note 29 at 1.
33
Id.
34
Id.
12
13. that there will be increased societal pressure for an individual facing an unintended pregnancy to
undergo prenatal testing as the result of the cultural approval and adoption of PGD.
If the inability to undergo PGD because of an unintended pregnancy ultimately leads to
increased abortion of fetuses with a disability, there is the potential that this increase will
promote discrimination against those who have or are born with those disabilities. Again,
however, this would require that: (i) PGD is so widely adopted that it is able to place this type of
societal pressure on the parents of unintended pregnancies; and (ii) a significant proportion of
parents of unintended pregnancies decide to terminate pregnancies involving disabilities. It
remains unclear that PGD will be so significantly widespread as to possess the degree of societal
pressure required under the current analysis.
D. Parents Who Are Unable to Afford PGD Testing
In addition to adults who might reject the use of PGD for personal, religious, or other
similar reasons, there are potential biological parents who do not or would not use PGD simply
because the technology is too expensive. Although there is no official data regarding the average
cost of PGD in the United States, most sources suggest that the cost ranges from $3,000 to
$5,000 per PGD cycle.35 This cost is in addition to the costs already associated with IVF.
Additionally, while IVF cycles might be covered by health insurance, it is less clear that PGD
35
Barbara Collura, The Costs of Infertility Treatment, Resolve: The National Infertility Association, available at
http://www.resolve.org/site/PageServer?pagename=lrn_mta_cost (average cost of PGD is $3,550); Fertility
ProRegistry, PGD Sex Selection, http://www.fertilityproregistry.com/content/pgd_sex_selection.asp (last visited
Apr. 15, 2009) (“[t]he cost of Preimplantation Diagnosis and Sex Selection range from $3000 to $5000”); Fertile
Hope, Genetic or Inheritable Cancers, http://www.fertilehope.org/learn-more/cancer-and-fertility-info/genetic-or-
inheritable-cancers.cfm (last visited Apr. 15, 2009) (“[o]n average, the cost of PGD is around $5,000 per cycle.”);
Chelsey Langland, Thinking About PGD, StorkNet’s Infertility Cubby,
http://www.storknet.com/cubbies/infertility/pgd.htm (last visited Apr. 15, 2009) (“[a]verage costs [of PGD] seem to
fall between $2,500 and $5,000.”).
13
14. will be covered.36 Similar to potential biological parents that refuse to adopt PGD for non-
economic reasons, parents who are unable to afford PGD will significantly limit the widespread
adoption of the technology and any resulting negative impact on discrimination against the
disabled. It is, however, possible that PGD will eventually become so inexpensive that cost is no
longer a barrier for individuals, and thus at that point cost will no longer limit the adoption of
PGD.
Unfortunately, the high cost of PGD could potentially add to the social underclass
problem discussed previously. If affluent individuals are more likely to undergo PGD testing
than individuals in lower socioeconomic ranks, disabilities and discrimination against the
disabled could be concentrated in the social underclass.
IV. Conclusion
The concern that PGD could promote a culture of perfection and cause the stigmatization
of and discrimination against the genetically disabled is a valid and troubling one. In an effort to
achieve equality, the disabled have surmounted numerous challenges mounted by both individual
biases and technological developments. Widespread adoption of PGD threatens to mount yet
another challenge for the disabled.
There are, however, a number of factors that will limit the widespread adoption of PGD
and the subsequent effects on discrimination against the disabled. Traditional PGD – that is,
without any genetic modification of the embryo – is severely limited in its ability to select for
more than a few traits; the inheritance of non-linked genetic traits results in genetically complex
36
See, e.g., Randy S. Morris, M.D., PGD – Preimplantation Genetic Diagnosis, http://www.ivf1.com/pgd/ (last
visited Apr. 15, 2009) (“[i]t is very unlikely that PGD will be covered by your insurance [since] [m]ost insurance
companies still consider PGD to be experimental even though we have been doing PGD for more than ten years.”).
14
15. embryos that contain a random mixture of traits from both parents. As a result, it is likely that
parents will use the limited number of embryos gathered during a IVF/PGD cycle to select
against the most serious traits rather than for more benign favorable traits.
Additionally, widespread use of PGD is limited by several factors including unintended
pregnancies, rejection of the technology for a variety of personal reasons, and cost barriers.
Although these factors carry the threat of potentially concentrating disabilities in lower
socioeconomic ranks, they will also significantly limit the widespread adoption of PGD
technology.
Understanding that there are limitations on the adoption of PGD will allow scientists,
ethicists, and legislators to commit resources to further study the reasons behind the limitations
and promote equitable use of the technology. For legislators, this might include diverting
resources to anti-discrimination efforts for those afflictions most likely to be selected against by
PGD. Through a more informed analysis of the many factors limiting the adoption of PGD,
lawmakers will be more prepared to understand the potential applications of the technology and
legislate accordingly.
15