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Ethical Considerations of Pre-implantation Genetic Diagnosis of Embryos Created via
In Vitro Fertilization
Introduction
Philosophical views on assisted reproductive technologies exist on a spectrum
where one extreme advocates avoiding conception through any means outside of natural
copulation, while the other extreme asserts that humans have the right to use all
developed assisted reproductive technologies regardless of the situation. Because new
assisted reproductive technologies are constantly being developed, the philosophical
views and the respective ethical concerns regarding their use vary based on the nature of
how specific technologies control different aspects of reproduction. Common assisted
reproductive techniques include those related to donor gametes and surrogacy, in vitro
fertilization, embryo culturing techniques, and pre-implantation genetic diagnosis. In
vitro fertilization is a technique that involves fertilization of the female oocyte with the
male sperm in a laboratory setting, as opposed to within the female reproductive system,
and is integral to pre-implantation genetic diagnosis because the embryo must be outside
of the body in order to undergo testing. Pre-implantation genetic diagnosis consists of a
cluster of assisted reproductive techniques that enable sex determination as well as an
evaluation of the cellular and genetic health of the embryo, which allows for the detection
of certain diseases before the embryo is inserted into the mother or surrogate. The term
pre-implantation refers to the fact that the testing is done before the embryo implants into
the uterine wall of the mother, which is prerequisite for embryonic development and
subsequent fetal development. These techniques allow women with certain reproductive
issues or couples with predispositions to genetic diseases to bear healthy children, as well

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as ensuring that a healthy embryo is implanted into a surrogate for couples where an
individual is incapable of sustaining pregnancy, whether heterosexual or homosexual.
Embryos have a complete set of genetic information required for life and growth,
unlike a single egg or sperm cell. Ethical considerations of pre-implantation genetic
diagnosis vary based on the degree of moral standing appropriated to the embryo and
based on the reproductive freedom of adults. Philosophies that illustrate a more
conservative ethical extreme on the use of pre-implantation genetic diagnosis typically
consider the moral standing of embryos equal to that of adults and tend to resist
subjugating embryos to the tests involved in pre-implantation genetic diagnosis.
Conversely, philosophies with a more liberal approach to the use of pre-implantation
genetic diagnosis usually argue the limitations to the moral standing of embryos and how
their freedom to live imposes on the reproductive freedoms of adults. Since pre-
implantation genetic diagnosis is a type of assisted reproductive technology, whether a
given philosophy permits the use of assisted reproductive technologies as a whole is
generally correlated to the philosophy’s view on the use of pre-implantation genetic
diagnosis. Philosophical fundamentals of Bonnie Steinbock, John Robertson, and
Christopher Tollefsen vary in their approach to treating embryos and reproductive
freedoms, which lends to their classification based on whether they allow for the use of
pre-implantation genetic diagnosis.
Overview of Philosophical Literature
Christopher Tollefsen’s philosophy allows extremely limited use of assisted
reproductive technologies and represents an extreme perspective on the ethical debate of
the use of pre-implantation genetic diagnosis. Tollefsen describes the nature of human

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beings and animals as being virtually the same in all respects except for the human
capacity for rational choice. He describes how animals and humans are temporal beings,
such that characteristics typical of an organism change throughout the organism’s
lifespan. For example, a human being is not born with the ability to walk and talk, which
are typical characteristics of the species; however, nobody disagrees that an infant is in
fact a human being. Tollefsen extends this concept to embryos and views them as
humans with a set of traits characteristic of their age, which grants them the moral
standing of human beings. In Tollefsen’s philosophy all members of a species have the
same moral standing, thus embryos should be treated with the same considerations as any
adult human being. However, the ability to make rational decisions is a distinguishing
feature of human beings that is incorporated into human nature, while the driving
motivations behind such decisions are external and variable. Since humans are rationally
able to predict future consequences of current actions, Tollefsen argues that humans tend
to make rational decisions for the common good and mutual fulfillment with other human
beings. Tollefsen views the sexual union involved in natural conception as being an
integral part of human nature by representing a logical and critical decision for human
social fulfillment, regardless of the external forces that drove the decision.
Consequentially, he fundamentally disagrees with in vitro fertilization and argues that
fertilization should only occur in the body of a female, as anything that circumvents in
vivo conception goes against the rational nature of human beings by avoiding sexual
fulfillment and involves the mistreatment of embryos. Furthermore, Tollefsen disagrees
with research used to develop new assisted reproductive technologies due to the inherent
improper treatment of embryos, since embryos have the moral status equivalent to adults

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and freely conducting experiments and tests on adults is illegal. Tollefsen only accepts
the use of already available techniques that aid instead of replacing reproduction, which
explains his disagreement with in vitro fertilization as it replaces natural conception.
Tollefsen’s philosophy clearly prohibits pre-implantation genetic diagnosis by
disagreeing with in vitro fertilization, which is prerequisite for the techniques involved in
pre-implantation genetic diagnosis.
John Robertson’s philosophy permits the use of pre-implantation genetic
diagnosis while still posing limits on theoretical future assisted reproductive
technologies; his philosophy represents a moderate perspective on the ethical debate of
the use of pre-implantation genetic diagnosis. Robertson argues that all humans have a
widespread fundamental right to have a child, termed procreative liberty, and asserts that
the only limit to an individual’s procreative liberty occurs when it infringes upon the
freedoms of others. Procreative liberty explains why no human beings under normal
circumstances are subjected to compulsory sterilization, even in cases where individuals
are mentally handicapped. Robertson’s philosophy of procreative liberty ethically
permits the use of assisted reproductive technologies for parents; however, with the onset
of various genomics technologies comes the need to clarify the extent of the parents’
procreative liberty. Parents bearing a child through natural conception are unaware of the
genetic makeup of their child, as no technologies to manipulate reproduction are used.
Through the use of assisted reproductive technologies such as pre-implantation genetic
diagnosis, parents may discover the genetic makeup of an embryo before implantation
and can make decisions accordingly. Robertson asserts that the procreative liberty of
parents includes the use of assisted reproductive technologies to bear children, but only

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those technologies that mitigate the potential of harming the organisms that are products
of such technologies. This explanation reflects his view on the moral standing of
embryos, specifically that embryos have a certain degree of moral standing that may be
overcome by the procreative liberties of the parents, so long as the embryo is not harmed
or set up for detrimental circumstances during development. Robertson gives embryos a
seemingly small but significant amount of moral standing by virtue of their ability to
develop into a fetus if implanted under appropriate conditions. He describes embryos as
being symbolic of life, leading to his assertion of the importance of minimizing harm to
embryos through various technologies. Robertson’s philosophy permits the use of pre-
implantation genetic diagnosis because the techniques involved pose little harm to the
embryo and actually help assess the embryo’s overall health, while simultaneously
helping a couple bear a child as per their procreative liberty. Pre-implantation genetic
diagnosis identifies genetic diseases that may cause harm to the person that develops
from the embryo later in life, if the embryo were to be implanted, without causing harm
to the embryo during the testing. Robertson does not completely agree with research on
developing new assisted reproductive technologies due to their potential to harm
embryos; however, he acknowledges that limiting harm to embryos across the board is
more feasible in practice than in research.
The philosophy of Bonnie Steinbock permits a widespread yet conditional use of
pre-implantation genetic diagnosis and represents a more extreme view on the ethical
debate of its use. Steinbock proposes that humans have a moral right to reproduce
contingent on the whether the individuals involved have the intention of properly raising
the conceived child. She refers to this concept as procreative responsibility and extends it

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to encompass the responsible use of assisted reproductive technologies by those with the
intention of creating a family. Steinbock addresses the moral status of embryos through
her philosophy that only entities with invested interests can have significant moral
standing. For example, a mother whose child passed away due to a car accident has
invested interests in teenagers driving safely and thus has moral standing in a high school
event related to safe driving. According to Steinbock, entities without invested interests
cannot put forth any claims that reflect their interest and thus have no moral standing.
Embryos are an example of entities with no invested interests due to their lack of
sentience and inability to suffer, which seems to indicate that embryos have no moral
standing. In spite of this, Steinbock designates a small amount of moral standing to
embryos because they will eventually acquire invested interests after a period of time
spent developing. Steinbock poses no limitations on research towards developing new
assisted reproductive technologies or on other research involving embryos due to the
diminished moral standing appropriated to the embryos. Moreover, Steinbock’s
philosophy allows for the use of pre-implantation genetic diagnosis because the
reproductive freedoms of the parents outweigh the embryo’s moral standing, so long as
the parents have the capacity and intention to raise the child appropriately.
Ethical Analysis
A superior approach to ethical considerations of the use of pre-implantation
genetic diagnosis involves extending the ability to have children to people who cannot do
so naturally, including to infertile and homosexual couples, while safeguarding the health
of embryos selected for implantation. Every human individual has the right to bear a
child, regardless of any defining characteristic such as having an inadvertent biological

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issue, being a specific race, or having a certain sexual orientation. Pre-implantation
genetic diagnosis offers a method of ensuring that a healthy embryo is implanted into the
female designated to carry the child to term, the significance of which is obvious for the
child’s well being and the lifestyles of the parents. Whether the child is biologically
related to the parents is important to some parents, and the use of available
biotechnologies to bear a biological child should be granted to all couples. Additionally,
the techniques of in vitro fertilization and embryo transfer result in the formation of
multiple embryos to prevent complications in the case of the failure of a single embryo,
but the health of the embryo destined for implantation should be of the most concern.
Any health issues in the implanted embryo will affect the developing organism later in
life, while the embryos that are not implanted will never develop to a point where their
health matters to them or has any external effects, thus the health on the non-implanted
embryos is less important the health of the embryo being implanted.
The philosophy of Christopher Tollefsen does not represent a good ethical
approach towards the use of pre-implantation genetic diagnosis by putting excessive
limitations on the use of assisted reproductive technologies as a whole and by failing to
consider couples that have no possible way of naturally conceiving a child. Tollefsen
views embryos as having the same moral standing as their adult counterparts because of
the transient nature of humans and animals, meaning human embryos and adults should
be treated equally. The inherent injustice in conducting medical tests on adults without
their consent is thus extended to embryos, which prevents the use of assisted reproductive
technologies. Furthermore, his philosophy specifically disagrees with in vitro
fertilization because the technique is used to create embryos in a laboratory, which is

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inconsistent with biological processes, and because the technique eliminates the
copulatory aspect of couples deciding to have a child, which goes against the nature of
humans to make rational choices for fulfillment. While Tollefsen does allow for already
in-place technologies to assist male-female couples in having a child, such as hormone
therapy, he does not account for couples that wish to have a biologically related child but
are unable to do so naturally, such as homosexual couples or heterosexual couples where
the female cannot sustain pregnancy. In other words Tollefsen’s philosophy does not
address the reproductive freedoms of all individuals that make up the human species. On
another note, any couple can achieve sexual fulfillment through rationally deciding to
have intercourse without the intention of conceiving, which invalidates Tollefsen’s
argument against in vitro fertilization due to the consequences of a male-female couple
skipping copulation when attempting to conceive. Tollefsen’s philosophy does not meet
the criteria for representing a solid ethical approach to pre-implantation genetic diagnosis
because the premises give embryos excessive moral standing and only consider a small
subset of couples that desire a child.
Robertson’s and Steinbock’s philosophies represent better ethical approaches than
Tollefsen’s philosophy towards the use of pre-implantation genetic diagnosis; however,
Steinbock’s philosophy best meets the criteria for a superior ethical approach on the
matter. Directly in contrast to Tollefsen, both Robertson and Steinbock have
philosophies that allow for the use of assisted reproductive technologies, including pre-
implantation genetic diagnosis, and encompass a larger range of couples that wish to bear
children. Both philosophies justify the use of assisted reproductive technologies by
explaining how the reproductive freedoms of a couple surpass the moral standing of

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embryos. In particular the philosophies permit the use of pre-implantation genetic
diagnosis to gauge the health of embryos before implantation, which improves the quality
of life for the parents and the child. The main difference between the philosophies of
Robertson and Steinbock is that Robertson’s philosophy does not consider whether a
couple has the intention and capacity to properly rear a child, which represents
Steinbock’s major critique on Robertson’s procreative liberty. Robertson’s philosophy
focuses on the importance of avoiding harm to embryos when employing assisted
reproductive technologies and sanctions the use of in vitro fertilization and pre-
implantation genetic diagnosis because they pose no harm to embryos. Conversely,
Steinbock’s philosophy of procreative responsibility is more focused on ensuring the
lifelong health of the embryo being implanted by taking into account the couple’s
capacity to raise the child, while focusing less on whether embryos are harmed due to
their reduced moral standing. Although Robertson’s philosophy represents a decent
ethical approach towards the use of pre-implantation genetic diagnosis, it is constrained
by its attempts to minimize harm to all embryos. This constraint is not apparent in
Steinbock’s philosophy. The lack of such constraints in conjunction with considering the
lifelong health of the implanted embryo makes Steinbock’s philosophy the best ethical
approach on the use of pre-implantation genetic diagnosis.
Conclusion
Throughout researching and constructing my argument, I learned how to critically
analyze philosophers and apply their arguments without overlaying my own thoughts, but
instead critically thinking about how well my thoughts actually match up with each
philosophy. I learned that a philosopher’s ideas may sound promising until considering

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their downstream implications, and that many viewpoints surrounding one issue are
important because the answer to such philosophical questions is often multi-faceted.
Philosophies that fail to address certain aspects of an issue are bound to be inadequate,
resulting in the need of a philosophy with a more comprehensive perspective on the issue.
Regarding pre-implantation genetic diagnosis, I developed an understanding of how these
techniques benefit the parents and their future child. While establishing a single ethical
viewpoint on the use of pre-implantation genetic diagnosis that satisfies every individual
is clearly impossible, considering the unique situation in which various couples find
themselves helps individuals in disagreement find common ground.
Word Count: 2637

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