Fertility Centers of New England, Preimplantation Genetic Diagnosis (PGD)
Preimplantation genetic diagnosis (PGD) involves screening single cells from embryos for genetic diseases and chromosomal disorders. This testing is performed with in-vitro fertilization (IVF) and occurs prior to embryo transfer, before a pregnancy is established. PGD offers at-risk couples the opportunity to select embryos for transfer based on their genetic and chromosomal status. The goal of PGD is to identify abnormal embryos so they will not be transferred, leaving unaffected embryos to be selected for transfer that are more likely to make healthy, disease-free babies.
PGD can identify the presence of chromosomal translocations (rearrangements of parts of chromosomes) and single-gene disorders (genetic diseases that are the result of a single mutated gene). There are over 4,000 single-gene disorders. The most common diseases tested for are Cystic Fibrosis, Tay Sachs, Fragile X, Myotonic Dystrophy and Thalassemia.
PGD technology can also be used to determine the sex of the embryo prior to the transfer into the uterus. Sex selection is offered to couples interested in family balancing who already have at least one child.
National Institute of Health
What are genome editing and CRISPR-Cas9?
Genome editing (also called gene editing) is a group of technologies that give scientists the ability to change an organism's DNA. These technologies allow genetic material to be added, removed, or altered at particular locations in the genome. Several approaches to genome editing have been developed. A recent one is known as CRISPR-Cas9, which is short for clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9. The CRISPR-Cas9 system has generated a lot of excitement in the scientific community because it is faster, cheaper, more accurate, and more efficient than other existing genome editing methods.
Genome editing is of great interest in the prevention and treatment of human diseases. Currently, most research on genome editing is done to understand diseases using cells and animal models. Scientists are still working to determine whether this approach is safe and effective for use in people. It is being explored in research on a wide variety of diseases, including single-gene disorders such as cystic fibrosis, hemophilia, and sickle cell disease. It also holds promise for the treatment and prevention of more complex diseases, such as cancer, heart disease, mental illness, and human immunodeficiency virus (HIV) infection.
Human Cloning: Position Paper of the Catholic Medical Association, reprinted in Issues of Law & Medicine 15:323, pp. 323-324 (2000)
The cloning of human beings would be a violation of the natural moral law. Research in cloning as it applies to man is degrading. It destroys the dignity of human nature by treating the human person as a material commodity to be manipulated according to whim and fancy.
The BMJ. 2001 Nov 24, 323 (7323): 1240–1243.
Ethics of using preimplantation genetic diagnosis to select a stem cell donor for an existing person, Robert J Boyle
Who is harmed by allowing PGD to be performed solely for the benefit of a relative? Not the couple who wish to produce an embryo. Nor the child who would not otherwise have existed. Nor the person who receives the stem cell transplant that might save his or her life. We must avoid the trap of interfering with individual liberty by preventing such procedures for no good reason, simply out of the “genophobia” that grips much of society today. Some people object to using PGD along with in vitro fertilisation for any indication. But if these procedures are acceptable, as they are in many countries, it is reasonable to use them to both bring a new person into the world and to help save an existing life.
Wolowelsky, J.B. and Grazi, R.V. (2007). Sex Selection and Halachic Ethics: A Contemporary Discussion. Tradition 40:1
R. Yitzhak Zilberstein, who regularly contributes responsa to the Israeli Medical Halakha Group, rejects IVF for sex selection: “[Normally] God joins with man and wife [in creating a child],” he writes “but here it is the doctor’s hand [instead].” It is simply absurd, he maintains, to consider putting aside the general halakhic concerns to allow one to bring into the world an infant which, according to some halakhic authorities has doubtful halakhic status as the father’s legal child, has doubtful status as the legal heir, and whose only certain status is that of a male or female baby. That notwithstanding, he continues, “one cannot close the door in the face of despondent people who suffer mental anguish in fear of giving birth to sick children, pressure which can drive the mother mad. Therefore, in the case of a serious genetic disease which affects the couple, it is difficult to forbid the suggestion [for genetic screening through PGD]...”
The medical use of sperm sorting for sex selection in cases of sex-linked genetic diseases such as hemophilia was confirmed by R. Shlomo Zalman Auerbach. He opposed sex selection for family balancing. Rabbinic aversion to sex selection for non-medical purposes was confirmed recently when the Israeli Ministry of Health would allow sex selection for family balancing for a couple with four children of the same sex if an ethics committee including a psychiatrist concludes that withholding such approval would cause damage to the metal health of at least one of the parents or the future child. Rabbinic authorities were quoted as condemning sex selection for personal parental satisfaction as antithetical to traditional Jewish values.
Wolowelsky, J.B. and Grazi, R.V., Ibid.
Two idiosyncratic cases regarding sex selection offer examples of when Halakha would take a more lenient approach than the secular medical society. Both concern cases of donor sperm and each emerged from the fact that the social father is not considered the halakhic father of the child.
One case concerned the halakhic consideration of yihud, which prohibits unrelated men and women from being alone together in a closed room unobserved by a third party. Adopted children are halakhically unrelated to their social parents, and therefore some halakhists consider the prohibitions of yihud as applicable to them. For this reason, some halakhists discourage adoption in general. Other authorities argue that the deep psychological sexual taboos that exist in normal families are to be found in those families where the child was adopted at birth and therefore waive yihud considerations in such families.
In the case of donor sperm, the child is halakhically related to the mother but not to the social father. The mother has no yichud prohibitions with either a male of female child. But those who apply yihud prohibitions to adoptive families would impose them on living relationships between the social father and a female child—but not a male one. The halakhic authority who had allowed the donor sperm also insisted on sex selection for a male child to avoid yihud problems and allow for the regular social interaction common to biological families.
The second case concerned a child would not have the same status as a Kohen that the social father had. A Kohen has special public duties and rights in the synagogue. Within a religious community, it is obvious who is a Kohen and who is not. The social father here was concerned that every member of the community would thereby know that the child was not his genetic son, destroying his privacy in the matter. He therefore requested PGD to guarantee a daughter...
Rav Soloveitchik, The Lonely Man of Faith
"The brute's existence is an undignified one because it is a helpless one... Man of old who could not fight disease and succumbed in multitudes to yellow fever or any other plague with degrading helplessness could not lay claim to dignity. Only the man who builds hospitals, discovers therapeutic techniques and saves lives is blessed with dignity." (pp.16-17)