Wednesday, April 27, 2016

Hank Greely on future possibilities for human reproduction

One of the 2012 Nobel Laureates in Medicine was Shinya Yamanaka whose work allows stem cells to be generated from skin cells. My Stanford colleague Hank Greely has now written a book, The End of Sex and the Future of Human Reproduction, contemplating some of the possibilities--some of them possibly repugnant transactions--for human reproduction. Here's a Stanford news article: Changes in human reproduction raise legal, ethical issues, Stanford scholar says

"Yet, by the same token, the ability to make gametes from skin cells might have some undesirable consequences. For example, Greely pointed out that someone could take a paper coffee cup that you casually tossed in the trash and turn you into a parent without your knowledge or consent.
“We probably need some laws to deal with that; unconsenting parenthood seems like a bad idea,” Greely said. 

Complicated questions

One possibility he proposes would be to require documentation of the provenance of any cells used to derive eggs or sperm.
“I think there are a lot of complicated questions, and for some of them, there is no particular law book to turn to,” Greely said.
Fairness is a central issue, Greely said. What if some people have access to the technology and others don’t? He predicts that in rich countries this child-making process will be subsidized, making it effectively free for prospective parents.
“In part,” he said, that will happen “because it will save the health care system a lot of money. You don’t need to prevent the births of very many really sick babies to pay for hundreds or thousands of attempts at making babies through easy PGD.”
But even so, there will certainly be international disparities, and possibly national ones as well. 

People with disabilities

Greely also raises challenging issues with respect to people with disabilities.
“If you’ve got a genetic disease and this means far fewer people are going to be born with your disease, well, in one sense that’s a good thing, but in another sense that lowers the research interest in your disease, the social support for your disease, and it kind of says your society thinks you shouldn’t have been born,” he said.
Citing the examples of heritable deafness and dwarfism, he noted that it’s plausible that parents would want a child like them.
“If a parent deafened a living baby, we’d certainly take the baby away and we’d prosecute the parent. If parents choose an embryo because it’s deaf, like themselves, in order to preserve deaf culture from genocide, what do we do then?”
Greely seeks to spark broad discussions about policies regarding these issues.
“I think something that changes the way we conceive babies affects everyone in such basic ways that it’s not a topic that should be left solely to the law professors or to the bioethicists or to the ob-gyns or to the fertility clinics,” he said.

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