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A commentary on the 2024 article "Reasons and Reproduction: Gene Editing and Genetic Selection," by J. McMahan and J. Savulescu is presented. Topics covered include the authors' aims in their article, how in choosing gene-editing, prospective parents create person-affecting reasons and the moral reasons to prefer gene-editing to embryo selection.

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including "non-medical" traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as "non-medical"; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. [ABSTRACT FROM AUTHOR]

The article informs the genetic expectations are anchored by prenatal testing. It mentions parents will place disproportionate importance on that genetic information if polygenic scores for attributes are presented as the first pieces of information about a child. It reports "Genetic expectancies" will be developed by parents who are educated about a potential child's genetic predispositions before to birth.

The article explores the role of autonomy in decision-making for prenatal testing. It highlights the many genetic counseling codes of practice and ethics emphasize the importance of supporting patients' autonomous decisions. It mentions the autonomy is considered especially important in prenatal testing due to historical concerns about eugenics and coercion. It explore the arguments for and against non-medical trait NIPT.

The article suggests that the field of non-invasive prenatal testing (NIPT) needs to focus on practical implementation questions rather than non-medical traits. It mentions the expanded NIPT becomes more widely available, women and couples will face complex and ethically challenging decisions about which genetic information to learn about their fetuses. It highlights the need for clinicians to grapple with how to present these choices to patients.

The article discusses the use of noninvasive prenatal testing (NIPT) and polygenic scores to identify non-medical traits in embryos, such as heightened cognitive ability, and the discrepancies in how one assess the morality of selecting embryos with such traits. It argues one should not rely solely on the current lack of scientific evidence regarding the predictive accuracy of these genetic tests and their clinical applications.

The article informs the consistency of using polygenic testing in pregnancy is under debate. It mentions that some argue prenatal selection should be allowed based on likely cognitive ability within the normal range, others argue against. It highlights the prenatal selection against fetuses with sex chromosome anomalies is allowed in the context of fetal sex determination by noninvasive prenatal testing (NIPT) on social grounds.

The article discusses the potential expansion of noninvasive prenatal testing (NIPT) to include "non-medical traits. It mentions the arguments for and against the use of NIPT for non-medical traits, a commentary suggests that the field needs to shift focus towards practical questions about the implementation of expanded NIPT. It emphasizes the importance of presenting clear and accurate information to patients about the choices they will face regarding expanded NIPT.

The article discusses the regulatory approach of anticipatory governance concerning the issue of non-invasive prenatal testing (NIPT) for non-medical traits. It mentions the text emphasizes the importance of a regulatory approach based on lessons learned from the regulation of medically assisted reproduction. It highlights the governance recommendations for NIPT for non-medical traits and illustrate the necessity of such an approach for anticipatory governance.

The article suggests that empirical data can be utilized to provide practical guidelines for providers who offer non-medical trait screening technologies. It mentions the data can also help weigh the ethical considerations associated with such screening methods. It highlights the text goes on to discuss the different methods that may be used for screening non-medical traits, including testing for specific variants or chromosomal changes and using polygenic risk scores.

The article discusses the importance of appropriate implementation and use of noninvasive prenatal testing (NIPT) as decisions related to having children have ethical significance. It mentions the argue that consistency in decision-making about seeking information through NIPT is crucial but not being achieved currently. It discusses the importance of the phenotype itself is more relevant than the distinction between medical and non-medical traits.

The article discusses the significant transformation in the presentation of prenatal development due to the advancement of biotechnologies and prenatal diagnosis examinations. It mentions the ability to understand biological processes and intervene in them is closely connected and has amplified this impact. It explores the possibility of modifying the characteristics of offspring has emerged due to these advancements.

The article presents the arguments both for and against the potential use of non-invasive prenatal testing (NIPT) for "non-medical" traits. It mentions that ethical decision-making regarding prenatal screening should not be solely based on biomedical criteria. It highlights the need for more careful consideration of the use of NIPT for non-medical traits and suggests that decision-making should not solely focus on what is medically possible or on the criterion of pathology.

The article discusses the significant transformation in the presentation of prenatal development due to the advancement of biotechnologies and prenatal diagnosis examinations. It mentions the ability to understand biological processes and intervene in them is closely connected and has amplified this impact. It explores the possibility of modifying the characteristics of offspring has emerged due to these advancements.

The article highlights the privacy concerns associated with the genetic data generated by cell-free noninvasive prenatal testing (NIPT), which includes maternal and fetal genomes. It mentions that while data security protection is necessary, excessive security measures may limit data sharing and hinder the development of NIPT. It highlights the challenges of NIPT data security and sharing need to be considered when developing an ethical framework.

This article explores the limitations of using noninvasive prenatal testing (NIPT) for non-medical trait prediction. It focused on the probabilistic nature of polygenic scores, which establish a statistical association rather than a direct causal relationship between genetic variants and the development. It suggestions that varying predictive value of polygenic scores can lead to information overload and pose practical problems for reproductive decision-making after NIPT.

The article discusses the argument against using Non-Invasive Prenatal Testing (NIPT) for non-medical traits. It highlights the benefits of polygenic risk scores for individual decision-making by parents. It mentions the also acknowledge the potential burden on the healthcare system that may result from additional testing needed to confirm NIPT results. It explore also includes a collectivist perspective on the issue.

The article presents the discussion on establishing three categories of genetic conditions and approaching differently in the clinical encounter. Topics include recommending screening for rare conditions in populations with a low risk a priori significantly increasing the likelihood of false positives; and recommending screening means potentially encouraging or pushing more women in a path leading to invasive diagnostic testing.

Prenatal genetic testing is becoming available for an increasingly broad set of diseases, and it is only a matter of time before parents can choose to test for hundreds, if not thousands, of genetic conditions in their fetuses. Should access to certain kinds of fetal genetic information be limited, and if so, on what basis? We evaluate a range of considerations including reproductive autonomy, parental rights, disability rights, and the rights and interests of the fetus as a potential future child. We conclude that parents should be able to access information that could be useful during pregnancy, but that testing for non-medical information should be limited. Next, we argue that the government lacks a compelling state interest in regulating prenatal genetic testing and propose that regulation should occur through medical professional organizations. Finally, we present a framework for determining what testing physicians should recommend, offer neutrally, or not offer at all. [ABSTRACT FROM AUTHOR]

The article presents the discussion on implementing expanded prenatal genetic testing. Topics include professional organizations limiting the access to fetal genetic information where few patients making questionable reproductive decisions; and providing patients with a practical, digestible testing framework will overall decrease in the autonomy.

The article presents the discussion on favor of evidence-based policy development for expanding prenatal genetic testing. Topics include "severe" medical conditions categorized as such according to "actual patient goals and desires;" and beliefs regarding family planning laying the foundation for shared decision-making before, during, and after pregnancy.

The article presents the discussion on determining biological sex providing increasingly realistic 3D and 4D ultrasound images of the fetus. Topics include expanding prenatal genetic testing (ePGT) using whole genome sequencing (WGS) or large gene panels; and interferencing with shared decision-making processes between parents and the chosen care providers.

The article presents the discussion on noninvasive prenatal testing (NIPT) being implemented as a first-trimester prenatal screening modality in healthcare systems around the world. Topics include using NIPT for detecting copy number variants, single-gene disorders, and microdeletion syndromes; and being useful for reproductive decision-making providing reasons for women or couples considering the termination of pregnancy.

The article discusses the ethical concerns related to prenatal testing for non-medical genetic traits. It suggests that these concerns could become more widespread as this type of testing becomes more common, potentially impacting every pregnancy. It highlights that genetic testing results are often probabilistic, and the role of genetics in determining certain traits is not always clear or definitive.

The article discusses the rapid evolution of techniques to screen and analyze the fetal genome, some of which are already available commercially. It highlights the advances will enable the testing of virtually any trait with a genetic contribution, including non-medical traits. It explores the some inconsistencies in current prenatal screening programs and argue that the inclusion of non-medical traits is not entirely incompatible with current screening approaches.

Noninvasive, prenatal whole genome sequencing (NIPW) may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation by prospective parents before deciding whether or how to use NIPW. [ABSTRACT FROM PUBLISHER]

The idea that a world in which everyone was born “perfect” would be a world in which something valuable was missing often comes up in debates about the ethics of technologies of prenatal testing and preimplantation genetic diagnosis (PGD). This thought plays an important role in the “disability critique” of prenatal testing. However, the idea that human genetic variation is an important good with significant benefits for society at large is also embraced by a wide range of figures writing in the bioethics literature, including some who are notoriously hostile to the idea that we should not select against disability. By developing a number of thought experiments wherein we are to contemplate increasing genetic diversity from a lower baseline in order to secure this value, I argue that this powerful intuition is more problematic than is generally recognized, especially where the price of diversity is the well-being of particular individuals. [ABSTRACT FROM PUBLISHER]

The article offers insights on the proposal for unrestricted prenatal genome sequencing. Topics covered include the idea that professional organizations and insurance providers should not restrict women from receiving information about reproductive risk, the respect shown by the proposal for individuals with disabilities and the challenge of engaging prospective parents about prenatal testing and parenthood.

The article offers insights on the proposal for unrestricted noninvasive prenatal whole genome sequencing (NIPW). Topics covered include the recommendation to allow parents' access to testing for any known condition, the common concerns about genetic testing of offspring and the obligations that parents accept when they choose to continue a pregnancy involving a fetus with an identified genetic condition.

The article offers insights on the proposal for unrestricted noninvasive prenatal whole genome sequencing (NIPW). Topics covered include the lack of a clear philosophical foundation for the proposal, the traditional justifications for prenatal diagnosis and the way by which prenatal diagnosis benefits society. Also mentioned is the negative impact that line drawing in prenatal diagnosis has for people with the conditions that are explicitly targeted.

The article offers insights on the proposal for unrestricted noninvasive prenatal whole genome sequencing (NIPW). Topics covered include the need to exist in a frictionless health care setting in order for the proposal to function, the huge cost expected for sequencing and the poor decision making about rare genetic conditions.

The article offers insights on the proposal for unlimited whole genome prenatal screening. Topics covered include the intricacies of the ethics of screening, the model for an ethically acceptable way of using unlimited whole genome prenatal screening and the suggested principle for demarcating what health care is to do in the prenatal testing case as when other testing possibilities are considered.

The article offers insights on the strategy proposed to enable informed consent of prospective parents who seek to undergo unrestricted noninvasive prenatal whole genome sequencing (NIPW). Topics covered include the increasing amount of predictive genomic testing becoming available across the life span, the disadvantage of restricting NIPW to severe medical conditions and the reliance of the strategy on a linear transmission model of informed consent.

The article offers insights on the regulation of sequencing a fetus' whole genome. Topics covered include the argument against the idea that prenatal testing should be restricted to some set of disabilities or health conditions, the concern about parents' ability to process information produced by prenatal whole genome sequencing (PWGS) and the commercial pressure that prospective parents will fee to receive the maximum available set of information.

The author offers insights on the framework for unrestricted prenatal whole-genome sequencing. Topics covered include the need for prenatal genetic testing to focus on promoting reproductive autonomy, the measurement of the effectiveness of prenatal testing and the justification of public funding of noninvasive prenatal whole-genome sequencing (NIPW). Also mentioned is the reliance of the framework on a process requiring prospective parents' extended engagement.

The author offers insights on the procedure for managing large amounts of potentially confusing information produced by whole-genome sequencing. Topics covered include the proposal for prospective parents to go through with noninvasive prenatal whole-genome sequencing (NIPW) if the results of testing will be useful to them, the framework proposed which promotes autonomous decision making and the possibility that values are subject to influence by social forces surrounding parents.

On February 3, 2010, a “Letter of Concern from Bioethicists,” organized by fetaldex.org, was sent to report suspected violations of the ethics of human subjects research in the off-label use of dexamethasone during pregnancy by Dr. Maria New. Copies of this letter were submitted to the FDA Office of Pediatric Therapeutics, the Department of Health and Human Services (DHHS) Office for Human Research Protections, and three universities where Dr. New has held or holds appointments. We provide a critical appraisal of the Letter of Concern and show that it makes false claims, misrepresents scientific publications and websites, fails to meet standards of evidence-based reasoning, makes undocumented claims, treats as settled matters what are, instead, ongoing controversies, offers “mere opinion” as a substitute for argument, and makes contradictory claims. The Letter of Concern is a case study in unethical transgressive bioethics. We call on fetaldex.org to withdraw the letter and for co-signatories to withdraw their approval of it. [ABSTRACT FROM AUTHOR]

The article discusses speculation about the author's conduct of research regarding the prenatal diagnosis of congenital adrenal hyperplasia (CAH). The author presents an overview of the methodology she uses for prenatal diagnosis and treatment of CAH, discusses the goal of CAH treatment with the drug dexamethasone, and considers the difficulties of sex assignment of a newborn infant.

This target article considers the ethical implications of providing prenatal diagnosis (PND) and antenatal screening services to detect fetal abnormalities in jurisdictions that prohibit abortion for these conditions. This unusual health policy context is common in the Latin American region. Congenital conditions are often untreated or under-treated in developing countries due to limited health resources, leading many women/couples to prefer termination of affected pregnancies. Three potential harms derive from the provision of PND in the absence of legal and safe abortion for these conditions: psychological distress, unjust distribution of burdens between socio-economic classes, and financial burdens for families and society. We present Iran as a comparative case study where recognition of these ethical issues has led to the liberalization of abortion laws for fetuses with thalassemia. We argue that physicians, geneticists and policymakers have an ethical and professional duty of care to advocate for change in order to ameliorate these harms. [ABSTRACT FROM AUTHOR]

[ABSTRACT FROM PUBLISHER]

The author reflects on the a study by Rob Sparrow concerning the use of prenatal genetic diagnosis (PGD) in preventing the occurrence of sexual development disorders. He comments that the study should be considered ethically suspect and states Sparrow's use of the term eugenics is misleading and provocative. He states that Sparrow didn't successfully argue on the clinical need for PGD in preventing sexual development disorders.

The article examines the changes to prohibitions on abortion especially in cases where fetal abnormality has been detected. It states that medical professionals like physicians, geneticists as well as policy-makers have an ethical obligation to push for changes to prohibitions on abortion especially when the structure of fetus is abnormal. The article also discusses the relationship between abortion and prenatal diagnosis and the legitimacy of the State on the existence of back street abortions.

The article looks at the situation of prenatal diagnosis and abortion in Israel. It states that prenatal diagnosis and abortion in Israel are not in conflict despite the fact that the country's main religion Judaism views abortion as less than ideal. The article also offers several conditions associated with a law legalizing abortion.

The article examines the issue whether prenatal diagnosis morally requires provision of selective abortion. It states that this issue is associated with social justice emphasizing the need to provide prenatal diagnosis to all women. The author also explains that women should exercise meaningful choice when deciding to undergo abortion of fetus with sever abnormalities.

The article examines the morality behind the introduction of prenatal diagnosis and antenatal screening in Iran and Latin American. It states that the morality behind such introduction is associated with the belief that screening and diagnostic testing in pregnancy is to detect genetic abnormalities. The article also explores the various factors which affect people's decision to continue pregnancy despite congenital abnormalities.

In this article the authors comment on the work of bioethicist Angela Ballantyne and her colleagues about an unjustified exception in abortion faced by poor women in developing countries. The author explains that there is an unjust consideration to such claims since women are permitted to test for congenital disabilities but not permitted to abortion. Also investigated is the fact about congenital-abnormalities exception as a misguided response a ban on abortion and challenges of disability.

The author offers insights on a proposed unrestricted framework for the clinical implementation of noninvasive prenatal whole genome sequencing (NIPW). Topics covered include the lack of interest in genome sequencing, the potential use of genetic counseling and informed consent processes for autonomous decision making and the need to consider the tools that can help patients navigate the area of modern pregnancy.

The article offers insights on the strategy proposed to enable informed consent of prospective parents who seek to undergo unrestricted noninvasive prenatal whole genome sequencing (NIPW). Topics covered include the need to consider beneficence for the future child as the principle for anticipated expansion of prenatal genetic testing, the tendency for parents to overestimate the burdens of disability and the suggestion for NIPW to be oriented toward the early diagnosis of medical conditions.