GENETIC SCREENING
Purpose
To consider the ethical issues raised by genetic screening.
Genetic screening
There may be sensitive issues involved if any students have personal experience of prostate, ovarian or breast cancer, or have relations or friends with these diseases. It is worth asking, at the start of the activity or topic, to ascertain if this is the case and perhaps drawing on their experience to inform the rest of the class, if they are willing to talk about it.
Alternative articles could be used, for example Gene Screening ‘could cut cystic fibrosis by half’ published in July 2000 in The Guardian links directly to the context of the topic.
The Student Sheet presents two articles that appeared in The Guardian. The students have questions associated with each article.
Q1 The students’ first task is to write a response to the first article in the form of a letter to The Guardian, either supporting or opposing the establishment of national genetic screening programmes for common forms of cancer.
There is no correct answer for this; students should present a view and then justify that view. The ethical frameworks presented in Topic 2 (pages 99–100) of the Student Book can help them structure their arguments. The first activity in the Staff development module on Ethical debate provides examples of arguments that students might use. That activity could be used as an alternative to Activity 2.20. The Staff Development modules can be found on SNAB Online in the Teaching SNAB section. The Learning Skills for Science support on SNAB Online includes useful guidance on extracting information from articles.
See the weblinks for a Channel 4 News article about the ethics of genetic screening and a link to the Sanger Centre who have been undertaking research into public views on what happens to genomic information.
Some suggested answers for the question associated with the second article are given below for guidance, but any valid points may be credited.
Q2 a The Human Fertilisation and Embryology Authority is the UK’s independent regulatory body for overseeing safe and appropriate practice in fertility treatment and embryo research. It also licences and monitors centres carrying out IVF, donor insemination and human embryo research.
b Possible points could include:
New knowledge needs to be validated.
Any decisions made are likely to have a large impact on the lives of people who may pass on the genetic risk of breast cancer, so the decision has to be the best one possible, so time might be needed to consider all aspects with care.
The final decision may result in legal changes. The decision therefore has to be legally enforceable.
Experts may have conflicting opinions and a range of ethical viewpoints, so it might take time to get a majority agreement.
A number of different experts may need to be consulted from different areas to ensure that the ethical issues as well as the science are considered. It might take time to find, consult, analyse and interpret all the responses.
The long-term effects of this new step in embryo selection need careful consideration.
format of a table is suggested to encourage students to write concisely. They should also aim to use appropriate terminology.
Reasons for and against screening out human embryos with a mutation that gives a high risk of breast cancer:
For Against
● Embryo screening has successfully been used since 1990, so it is not a new technology.
● Embryo screening has worked for a number of diseases, for example muscular dystrophy
● Being able to select a child without a disease will reduce the number of parents who feel that they cannot have children due to the risk of passing on a disease.
● It will also reduce the need for abortions during pregnancy, which can cause distress as well as introduce moral and ethical dilemmas.
● It will benefit society in the long term, for example health services will save money.
● Embryo screening, by preventing the birth of a person who is likely to get breast cancer, will prevent a lot of pain and suffering not only for the person with the disease, but for their family and friends.
● Knowing that you carry the gene that will increase your risk will make you more aware of possible development of the disease resulting in earlier diagnosis and treatment.
● It is only a risk of having breast cancer that is being screened for. Even if the risk is a high one, it does not definitely mean that the embryo will develop into a person who will have breast cancer.
● Every individual has the right to life.
● The technique involves creating more embryos than will be needed. Those with the mutation will be destroyed. Some people feel that this is ethically unacceptable.
● No one would argue that the prospect of dying from breast cancer at the age of, for example, 30 is pleasant, but who can tell what that individual might do with 30 years of life? Many people have made remarkable achievements before they reach 30 years of age.
● Removing gene mutations is narrowing the human gene pool.