Côté Stéphanie, Ravitsky Vardit, Hamet Pavel, Bouffard Chantal
J Int Bioethique Ethique Sci. 2015 Dec;26(4):137-50, 160.
Over 30 years ago, preimplantation genetic diagnosis (PGD) was developed to help couples at risk of transmitting a serious genetic disease to their offspring. Today, the range of medical and non-medical uses of PGD has expanded considerably and some raise much controversy. This is the case, for example, with In-Vitro Fertilization to select embryos as 'saviour siblings' or to screen for susceptibility and predisposition to late onset diseases or conditions of variable penetrance. The situation is even more problematic in the case of sex selection or selection of traits that are culturally valued or discredited (such as deafness, behavioral traits, or height). The debate surrounding PGD has been employing terms to describe these particular uses that have contributed to a focus on the negative effects, thus preventing a distinction between the abuses and the benefits of this reproductive technology. In this context, this paper proposes a terminological clarification that would allow distinguishing medical and non-medical use and, therefore, the issues relevant to each. A more accurate and less generic nomenclature could prevent a conflation of different levels of ethical, clinical and social issues under the single term 'PGD'. For the vast majority of medical uses, we propose to keep: 'preimplantation genetic diagnosis (PGD)', which emphasizes that it is a genetic diagnosis. For non-medical uses, we suggest: 'preimplantation genetic trait selection (PGTS)'.
30多年前,植入前基因诊断(PGD)应运而生,旨在帮助那些有将严重遗传疾病遗传给后代风险的夫妇。如今,PGD的医学和非医学用途范围已大幅扩大,其中一些用途引发了诸多争议。例如,通过体外受精来选择作为“救星同胞”的胚胎,或者筛查迟发性疾病或可变外显率疾病的易感性和易患性,情况就是如此。在性别选择或选择具有文化价值或不被认可的特征(如耳聋、行为特征或身高)的情况下,问题更为棘手。围绕PGD的争论一直使用一些术语来描述这些特殊用途,这导致人们将重点放在了负面影响上,从而无法区分这种生殖技术的滥用和益处。在此背景下,本文提出了术语上的澄清,以便区分医学用途和非医学用途,进而区分与之相关的问题。更准确、更具体的命名法可以防止在“PGD”这一单一术语下混淆不同层面的伦理、临床和社会问题。对于绝大多数医学用途,我们建议保留“植入前基因诊断(PGD)”,该术语强调这是一种基因诊断。对于非医学用途,我们建议使用“植入前基因特征选择(PGTS)”。