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February 27, 2002

Ethics of Preimplantation Diagnosis for a Woman Destined to Develop Early-Onset Alzheimer Disease

Author Affiliations

Author Affiliations: Department of Obstetrics and Gynecology (Dr Towner) and Bioethics Program (Dr Loewy), University of California, Davis, Sacramento.

JAMA. 2002;287(8):1038-1040. doi:10.1001/jama.287.8.1038

Since the birth of the first child conceived by in vitro fertilization more than 20 years ago, the applications of assisted reproduction have expanded rapidly. A single sperm can be injected directly into a single ovum to overcome severe male-factor infertility. An ovum from a young donor can be fertilized and implanted in a postmenopausal woman so she can carry the fetus. In vitro fertilization, in combination with DNA or karyotype analysis of a single cell from the developing embryo (preimplantation diagnosis), allows implantation of embryos that are free of genetic defects in couples without infertility. At every new step along the evolving pathway of assisted reproduction, ethical concerns have been raised. However, thus far, the techniques have been permitted—in part because of a widespread but tacit assumption that promotion of reproductive freedom, or in today's language, reproductive autonomy—is an unqualified interest or good. But is reproductive freedom an unqualified good to society, the individuals undergoing the procedure, the medical profession, the businesses sponsoring such technologies, or the offspring thus produced?