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1. Making decisions
Equipping the Next Generation for Active Engagementin Science
This resource was developed with, and funded by, the NHS Sickle Cell and Thalassaemia Screening Programme (part of Public Health England)

2. 2
Objectives
To explain how IVF with PGD can be used
to help a couple with an inherited
condition to have a healthy child.
Recognise ethical, social and economic
arguments and use them to make an
informed choice.

3. 3
Engage Explore Explain Extend Evaluate
Meet Mr and Mrs Yusuf
What is it like to live with thalassemia?

4. Meet the genetic counsellor and
find out about your options…
What will
you choose to
do?
Engage Explore Explain Extend Evaluate
4

5. First thoughts:
Options
1 Take no
action
2 Use pre-natal
screening
3 Use IVF and
PGD
4 Use donor
sperm
Engage Explore Explain Extend Evaluate
5
Which option will you
take and why?
Why is this a difficult
decision to make?
Would anything make it
easier?

6. This approach looks
at the outcomes of
people’s actions.
Get into pairs.
You will be given an Option
Card – this is the decision you
have made as a couple.
Goal-based ethics
Engage Explore Explain Extend Evaluate
SS1 6
Options
1 Take no
action
2 Use pre-natal
screening
3 Use IVF and
PGD
4 Use donor
sperm

7. Engage Explore Explain Extend Evaluate
7

8. Use
pre-natal
screening
Take no
action
Use donor
sperm
Use IVF and
PGD
Choice Outcomes
Engage Explore Explain Extend Evaluate
SS2-3 8

9. Meet specialist Alison
Lashwood and learn
about the procedure
Find out more about IVF
with PGD
Check your understanding
Is it the right
choice for you?
Engage Explore Explain Extend Evaluate
SS4
9

10. Meet Dr Allison
Streetly who will
talk about how to
make an ethical
decision.
This approach examines the
intentions behind people's
actions.
Duty-based ethics
Freedom to choose
Rights of the child
Playing God
There are three main
principles:
Engage Explore Explain Extend Evaluate
10

11. Every woman
has the right
to have a
child if she
wishes. If the only way I
could have a healthy child
is to use IVF and PGD I
would use it. C
Each of the
embryos
created by
IVF is a
potential life. It should
not be our decision
which lives and which
dies.
It is our duty
to prevent a
child being
born with a
serious genetic condition
that will only bring it pain
and suffering.
A
Playing
God
Freedom
to choose
Rights of
the child
Watch the video clips about each ethical
principle and match the views to each one.
B
Which ethical principle do you think is most
important in making this decision?
Engage Explore Explain Extend Evaluate
11

12. Making a decision
Work in a group of 3-4. Use the decision making
lifeline.
To make a balanced decision you also need to consider:
Listen to the social and economic effects of
IVF with PGD.
Complete the lifeline.
Write in the ethical arguments for and against IVF
with PGD.
Get more information about the success rates and
costs.
Economic argumentsSocial arguments
Engage Explore Explain Extend Evaluate
SS5
SS6
12

13. Your decision:
will you choose IVF with PGD?
Work in your group. Each person should say which
factor (ethical, social or economic) is the most
important to them, what their decision would be
and why.
The rest of the group should question why they
think this and try and change their mind about their
decision.
Work alone. Make your final decision: will you
use IVF with PGD? Explain why.
Did anyone’s argument change your mind?
If so, what was it?
Engage Explore Explain Extend Evaluate

14. Get students talking and thinking

15. © Sheffield Hallam University 2014 This page may have been changed from the original
This resource was developed with, and funded by, the NHS Sickle Cell and Thalassaemia Screening Programme (part of Public Health England)
Student sheets
Making decisions
Sheet no. Title Notes
SS1 Option cards Reusable, one per class, cut up into cards
SS2a Birth cards Reusable, one per class, cut up into cards
SS2b Birth cards Reusable, one per class, cut up into cards
SS3 Outcomes table
Consumable, cut into two tables, one table per
student.
SS4 IVF with PGD
Reusable, one per pair or students can access on
computer.
SS5 Decision making lifeline
Consumable, one per group or students can access
on computer and print out.
SS6
Costs and success rates of IVF
with PGD
Reusable, one per pair or students can access on
computer.

16. You choose to…
You choose to…
You choose to…
You choose to…
Take no action
Use pre-natal screening
Use donor sperm
Use IVF and PGD
You choose to…
You choose to…
You choose to…
You choose to…
Take no action
Use pre-natal screening
Use donor sperm
Use IVF and PGD
SS1
Option cards

17. Your baby does not have
the illness
You choose to take no action…
Your baby does not have
the illness
You choose to take no action…
The result was negative
– you had a healthy baby
You choose to use pre-natal screening
The result was positive –
you had a termination
You choose to use pre-natal screening
Your baby does not have
the illness
You choose to take no action…
Your baby has beta
thalassaemia major
You choose to take no action…
The result was negative
– you had a healthy baby
You choose to use pre-natal screening
The result was positive
– your baby has beta
thalassaemia major
You choose to use pre-natal screening
SS2a
Birth cards

18. You had three attempts and
gave up because of
the cost
You choose to use donor sperm…
You had two attempts then changed
your mind about having a baby who
did not share genes with both of you
You choose to use IVF and PGD…
You had two attempts and gave
up because of the
cost
You choose to use IVF and PGD…
You had two attempts and
had a healthy baby
You choose to use donor sperm…
You had three attempts and
gave up because of
the cost
You choose to use donor sperm…
You had a healthy baby
with one attempt
You choose to use IVF and PGD…
You had three attempts
and gave up because of health and
emotional reasons
You choose to use IVF and PGD…
You had a healthy baby
on first attempt.
You choose to use donor sperm…
SS2b
Birth cards

19. Use pre-
natal
screening
Take no
action
Use
donor
sperm
Use IVF
and PGD
Choice Outcomes
Use pre-
natal
screening
Take no
action
Use
donor
sperm
Use IVF
and PGD
Choice Outcomes
SS3
Outcomes table

20. Mature eggs are collected
from the woman’s ovaries.
The eggs are mixed with the
man’s sperm in a dish.
Fertilisation occurs.
The embryos are left to grow
until they form a ball of cells.
One embryo without the genetic
disease is put back into the
woman’s uterus to hopefully grow
into a baby.
One cell is taken from each
embryo and tested to see if it
carries the genetic disease.
A B C
The woman injects herself
with hormones to increase the
amount of eggs that
mature in her ovaries.D E F
Place the steps in the correct order
SS4
IVF with PGD

21. SS7
Is it scientifically
possible?
The decision ...
Yes Should we?






Can we?
Consider all arguments.
Which is most
important?
Is it the right thing to do?Will it help people?
Social arguments: Ethical arguments:Economic arguments:
Is it worth the costs?
SS5
Decision making lifeline

22. Cost per cycle
£10,000Not all couples that start a PGD cycle end
up having suitable embryos for transfer.
If a couple has a suitable embryo to transplant there can be as
much as a 50% chance that it will become a successful
pregnancy, although this varies from hospital to hospital.
Overall, the chance of a couple having a baby born following
treatment is around 20% per cycle.
The most important factor that can affect the success rate of PGD is a
woman’s age. The chances of success decrease with age, especially over 39.
All couples in the UK can apply for funding from the NHS.
If successful, the NHS will pay for the treatment.
If not, then the couple will have to pay themselves.
Work out how much you think it would probably cost the couple (or the
NHS) to have a baby using IVF with PGD.
How sure can the couple be about how much it will cost before they start?
Discuss any other facts which may influence a couple’s decision to use it.
SS6
Costs and success rates of
IVF with PGD

23. Get students talking and thinking

24. Equipping the Next Generation for Active Engagement in Science