June 2012 saw scientists controversially predicting the entire genetic code of a foetus, information which could be used to prevent the birth of a child suffering from a disorder [Ref: Telegraph]. One method, alongside screening foetuses, called preimplantation genetic diagnosis (PGD), involves the extraction of a cell during IVF treatment and analysing the DNA for the presence of disease-associated genetic alterations. Only embryos without mutation are then selected, and doctors now commonly prevent serious disorders like cystic fibrosis [Ref: Nature]. However, some see this procedure being increasingly trivialised by the possibility of identifying cancer disposition and late-onset diseases and so fear doctors may attempt to alter genes to create ‘perfect’ humans in the future. Many scientists are doubtful of this being a realistic prospect as human traits are significantly influenced by environmental factors and proponents, like Dartmouth College’s Professor Green, argue this may not be as ethically-troublesome as critics suggest [Ref: Nature]. Perhaps these techniques are tools of empowerment rather than manipulation and recent developments in the scope of prenatal screening suggest scientists may soon be able to screen unborn babies for 3,500 genetic disorders [Ref: Telegraph]. Whilst some celebrate this breakthrough in potentially reducing suffering from disability, others predict that this may lead to increased abortions which, they say, could devalue the lives of disabled people and undermine respect for the human condition [Ref: Daily Mail]. Fundamentally, those critical of these developments fear a slippery slope, at the bottom of which lies a damagingly utilitarian conception of the value of human life. Proponents of the procedures strongly dispute this, asserting that there is greater moral value in a child being born free from disability and suffering.

Where are we now?
In recent years there has been a rapid development in the scope and availability of screening embryos for genetically-inherited diseases. PGD can already be used to identify more than 200 inherited defects, the most common being Down’s Syndrome (the only defect routinely screened for on the NHS), spina bifida, and some forms of cystic fibrosis. In the UK regulation of screening is tightly controlled by the Human Fertilisation and Embryology Authority (HFEA), when compared to the USA, but critics fear an ever-liberalising approach by the HFEA which has recently seen controversial clearance given for scans for breast cancer and Alzheimers disease which often only affect sufferers well into their adult lives [Ref: Daily Mail]. In the UK sex selection is currently permitted for medical reasons, like the gender-specific disease haemophilia, but is banned for physical, social, or psychological reasons. With the predicted expansion of genetic mapping, and the identification of ‘de novo’ mutations,  doctors could even be able to identify potential sufferers of autism and schizophrenia [Ref: Telegraph]. It is thought by some that such non-invasive genetic screening may be much more widely available over the next 5 years at an approximate cost of $50,000 per child [Ref: BioNews]. This predicted expansion of not only specific techniques but of the scope of genetic screening has raised serious ethical dilemmas, particularly given predictions that parents may be able to deselect, abort, or specifically select an embryo or foetus based solely on that child’s future sexual orientation for example [Ref: Bioedge]. Some even fear the rapid expansion of these techniques, and a liberalising approach to ethical issues, may one day result in the existence of ‘Designer Babies’ where parents may select embryos on the basis of intelligence, athleticism, hair or eye colour.

Preventing disability: rebranded eugenics or laudable goal?
Embryonic screening proponents argue they are ending sufferance at the hands of disability and consider it unjust that parents would opt to impose avoidable genetic disorders upon their children. Some have gone so far as to assert that the parents of a child have a moral duty to screen for genetic disorders, not merely a right to do so [Ref: Opposing Views]. Critics counter that it would be more beneficial for society to accept each other as we are and that to encourage the reduction of the number of disabled people in society would be to send a negative, and potentially harmful, message to disabled people themsevles. For some, the relatively recent normalisation of conditions like autism [Ref: Progress] strongly supports the view that human variance should be celebrated and not eliminated [Ref: Guardian]. Some point to pledges like that of the Danish governments to eliminate Down’s Syndrome by 2030 as evidence of a drive to prevent any deviation from biological ‘normality’ and question how we can celebrate the Paralympic Games whilst also promote the view that disability is something to be actively eliminated [Ref: Globe and Mail].

A slippery slope or the yellow brick road?
The prospect of detecting thousands of genetic disorders prior to birth, which can then be used as the basis for an abortion or the deselection of an embryo raises serious ethical dilemmas [Ref: New York Times]. Some question what is to be meant by ‘disability’ when in recent years conditions like deafness have been categorised as a disability less readily [Ref: spiked]. Further questions are raised about how severe a disability must be to justify termination or deselection and strong opposition exists about the future possibility of conditions like autism being used to justify an abortion. If there are to be limits on which disabilities are sufficiently severe, the question is posed as to whether anyone has the authority or the means to make such an inevitably arbitrary distinction. It’s argued that this devalues human life by turning people into commodities [Ref: BBC News]. But proponents of embryo screening emphasise that abortion is already widespread in the UK and that to further impose limits on a woman’s right to choose in this way is highly illiberal.

Devaluing human life?
Critics argue that all human life should be valued equally, and they ask if we can value the life of a non-disabled person who cannot speak multiple languages, play sport, write novels, or do handstands just as much as we value the life of a non-disabled person who can do these things, in which case how can the singling out of disability be justified? This has led to harsher critics branding genetic screening ‘modernised eugenics’ - gradually eliminating the weak in society on the basis of their physical or mental capabilities [Ref: Journal of Medical Ethics]. However, proponents attack this comparison, pointing out that whilst eugenics is state-sponsored and coercive, genetic screening merely provides information to prospective parents. Scientists continue to face accusations that they are attempting to ‘play God’ using these procedures, but is this a sensationalistic appeal to emotion or does it have merit [Ref: Telegraph]? Is this a push towards the devaluation of human life or a laudable scientific breakthrough providing an opportunity for the prevention of suffering for thousands of people every year?