From PGS – preimplantation
genetic selection to
PGT - preimplantation genetic
Playing God ?
• Familiar debate !
• Is IVF ethical ? When does life begin? what
are the rights of an embryo?
• Can human embryos be used for harvesting
embryonic stem cell lines ?
• Should cloning be
• Manipulating Nature is
• Triumph of man's ingenuity
which can be used to overcome
Who decides ?
• Top-down – scientists,
• Bottom up - Leave the decision
to each individual couple, who
provide the reproductive
apparatus to create the baby.
• Both technical and ethical
• Assilomar Conference. Recombinant
DNA. 1975. Moratorium , need time to
evaluate the risk reward ratio
• Transhumanism - Logical next step for
human progress . Humans engineer
their own evolution, rather than depend
• Cells are still a black box . Worry about
• Gene Drive
• Gene Flow across species
can lead to interbreeding
• Dare we open Pandora’s
• Unnatural and artificial - Is nothing
• Money - Is everything for sale ?
Knee Jerk Reflex - Ban genetic
• It’s too dangerous, so let's prohibit it !
Easy to do, but will backfire. Throw the
baby out with the bath water.
• Other countries will steal a march on us
and we will be left behind
• Drive it underground ?
• Need sensible guidelines and regulation
• Actions have consequences.
• Inactions have consequences
• Fear of the unknown cannot
paralyse us into inactivity
Should human embryo
research be banned ?
• We are not mad scientists trying to play
• We are doctors trying to do the best for
Doctors are trusted
• If we trust doctors to make life
and death decisions in the ICU,
then why can’t they be trusted
to make decisions about genetic
engineering responsibly in
partnership with their patients ?
• Could set up a multidisciplinary
committee to review each
3 principles of medical ethics
Evolution 2.0 ?
• Human reproduction is not efficient. Hit
and miss affair. Why not improve it ?
• Natural Selection is a biological fact of
• If humans can do a better job, then
why shouldn’t we ?
Human Reproduction v 2.0
• Mother Nature is not always kind -
millions of people die of preventable
diseases, which we can treat today
The problem with regulations
• Rules vary so much from country to
country means there are no right
• Rigid and inflexible. Get outdated
• Isn’t it better to allow doctors the
freedom to select what is best for their
• This conference shows we are
responsible and sensible
• Let patients decide for themselves – it’s
their life and their baby
• A democracy empowers people to make
their own choices
• It’s unethical to interfere in their
personal family-building plans
• Need to individualise and personalise
the care we provide