Προεμφυτευτική διάγνωση : ηθικά ζητήματα που προκύπτουν από την εφαρμογή της μεθόδου

Progress in biomedical and genetic technology now offers the possibility for screening the embryo since the earliest stages of development, largely before the moment of birth. The development of this methodology allowed the discovery of numerous physiological and genetic characteristics of the fetus. Thus, it is possible to diagnose a variety of genetic or developmental causes which are responsible for many serious diseases. For example, both prenatal and preimplantation diagnosis give information about the condition of the embryo, offering in the candidate parents some potential 'choices': either continue with an ongoing pregnancy, or proceed to embryo selection by PGD in order to increase the chance of giving birth to a "healthy" person, or decide to terminate pregnancy if the fetus is predisposed to serious diseases. The following work deals with the ethical and social issues arising from the widespread use of PGD, with the aim of broadening and understanding them. The utilization of the resources offered by modern technology, to prevent pain or distress, or even a person's exposure to social prejudices, is imposed by the respect for human dignity. However, the application of these methods raises a serious moral dilemma: are we eligible to 'prevent' the birth of children with such severe disease, interrupting a pregnancy or by blocking the transfer of embryos in the womb? Moreover, if the answer is yes, which of these choices are morally justifiable and what are precisely the limits of this application? The first chapter of this work sets out the scientific data of the whole discussion. Upon introduction of the process of preimplantation diagnosis, and discussion of the techniques and diagnostic methods used, the benefits and goals of the technique as well as the groups of who profit of PGD are being considered. Moreover, in an attempt to prove that people with disabilities do not constitute medical but rather a social problem, I refer to some genetic syndromes focusing on the characteristics and lifestyles of people, who are born with genetic problems. In the second chapter, the sociological approach is presented. The diachronic course of the concepts of 'health' and disease ', reveals that there is no consensus on what it characterized as healthy or ill. In traditional societies, these [5] concepts are interrelated with the concepts of risk and religious purity, while the modernization of these concepts provides safer examples, attributed to scientific causes. In the same context, the history of disability is described, which is shown to be responsible for the involvement of scientists in the field of reproduction. The sociological survey shows the complexity of managing embryos during PGD and the special relationship developing between the candidate parents and the medical staff. The labeling of the issue of autonomy and socialization of individual, combined with the cultural and institutional background and specialized medical information, are the main issues that will be discussed in this chapter. The use of genetic knowledge in order to improve the living standards of humanity and the selection of the embryo, involve important consequences on the lives of people with disabilities, such as discriminatory tendencies and social isolation. However, these people can live a decent life and is morally wrong to focus only on their defects. Thus, according to the sociological research, disability is not related to illness of the individual, but instead is entirely due to the behavior and attitude of society towards people with disabilities. This proposal is the main place of the social model of disability and therefore, it constitutes a critical duty of society and the State to ensure, specifically to these people, a decent life in an environment of freedom and equality. The third chapter analyzes the ethical concerns arising from the application of methods of prenatal diagnosis which are related with two important issues: the selection of embryos and the value of human life. Specifically, PGD and its applications bring bioethical dilemmas when they violate the regulatory commitment to respect the intrinsic value of human life, irrespective of the form or the stage of the embryo. Therefore, many questions arise as to the definition of a person, the existence of dignity in a human being and the selection between two possible lives: a “normal” one or an “abnormal”. These dilemmas were analyzed through two major philosophical theories, the deontological theory and the utilitarianism theory. The normative commitment that is presented in the moral theory of Kant, suggests that only rational beings have dignity. But what is true for [6] people living with some form of disability, especially if it affects the person's mental state? Therefore, the main points of Kant’s Categorical Imperative are discussed here, while at the same time the theory of Kittay is described, as an alternative approach stating that the rational capacity does not constitute a necessary prerequisite for dignity in a human being. Moreover, the theory of utilitarianism focuses mainly on the consequences arising from the application of the method. Briefly, the refusal of a fetus, as a possibility faced by candidate parents after being submitted to prenatal or preimplantation diagnosis, is a reality. Therefore, the following work describes the need for moral foundation of new biotechnology applications, without rejecting the inherent desire of parents for healthy offspring