Center for Clinical Ethics, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Bioethics. 2021 Jun;35(5):487-495. doi: 10.1111/bioe.12871. Epub 2021 Apr 2.
Assisted reproductive technologies have greatly increased our control over reproductive choices, leading some bioethicists to argue that we face unprecedented moral obligations towards progeny. Several models attempting to balance the principle of procreative autonomy with these obligations have been proposed. The least demanding is the minimal threshold model (MTM), according to which every reproductive choice is permissible, except creating children whose lives will not be worth living. Hence, as long as the future child is likely to have a life worth living, prospective parents may be allowed to use preimplantation genetic diagnosis (PGD) to select embryos with genetic diseases or disabilities. Assuming a consequentialist person-affecting view of morality, this paper investigates whether the MTM is an appropriate tool to guide procreative decisions given the continuous development of reproductive genetic technologies. In particular, I consider germline genome editing (GGE) and I argue that its application in human reproduction, unlike PGD, should be conceived as person-affecting towards future progeny. I claim that even if we assume the plausibility of the MTM within PGD, we are committed to accepting that a greater moral obligation towards progeny should guide procreative decisions if GGE were available. In this case, the MTM should no longer be considered an appropriate instrument to guide procreative choices. Finally, I investigate when we face this greater moral obligation, concluding that it applies only when prospective parents have already engaged in the in vitro fertilization process.
辅助生殖技术极大地增加了我们对生殖选择的控制,导致一些生物伦理学家认为,我们对后代负有前所未有的道德义务。已经提出了几种试图平衡生殖自主权原则和这些义务的模型。要求最低的是最小门槛模型(MTM),根据该模型,除了创造生命不值得活下去的孩子之外,每个生殖选择都是允许的。因此,只要未来的孩子有可能过上有价值的生活,准父母就可以被允许使用胚胎植入前遗传学诊断(PGD)来选择有遗传疾病或残疾的胚胎。本文基于后果主义的人际影响道德观,探讨了在生殖遗传技术不断发展的情况下,MTM 是否是指导生殖决策的适当工具。特别是,我考虑了种系基因组编辑(GGE),并认为与 PGD 不同,它在人类生殖中的应用应该被视为对未来后代的人际影响。我主张,即使我们假设在 PGD 中 MTM 的合理性,我们也应该接受,如果 GGE 可用,我们应该对后代承担更大的道德义务,以指导生殖决策。在这种情况下,MTM 不应再被视为指导生殖选择的适当工具。最后,我探讨了何时我们面临这种更大的道德义务,得出的结论是,只有当准父母已经参与体外受精过程时,这种义务才适用。