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Background: In Germany, preimplantation genetic diagnosis (PGD) is currently not legal, but there is still a controversial debate about legalization. Studies about the attitudes of infertile couples towards PGD are rare., Methods: A survey was conducted with 265 German infertile couples about knowledge, attitudes and prospective use of PGD. The influence of independent variables associated with approval of PGD is analysed by binary logistic regression., Results: Sixty percent of respondents have heard about PGD. Eighty-seven percent support a general legalization of PGD in Germany for severe, early-onset genetic diseases. Seventy-four percent consider PGD morally acceptable. Sixty percent supported legalizing PGD for HLA-matching. But only a minority approved PGD to test for non-health-related traits. Respondents with a higher education level were the least supportive to all uses of PGD., Conclusions: Our results suggest that German infertile couples are as liberal towards PGD for health-related uses as in other western countries. They would legalize and use PGD to raise the rates to get pregnant and to avoid severe diseases of the offspring. Taking the opinions of German infertile couples into consideration could help redefine and reframe the public debate towards legalization of PGD and the moral status of the embryo in Germany.

In Germany the public awareness on ethical problems of the application of medicine and life sciences on human beings is very high. It can be observed that German Society is rather sensitive concerning bioethical issues. Politics supports this attitude. Many articles in professional journals as well as in newspapers cover bioethical issues. Conferences and workshops on a professional and an educational level deal with topics on ethics of life sciences and ethics in general. Moreover, in the case of bioethics many different disciplines contribute with relevant considerations to the process of opinion and judgment formation. This paper summarizes the main ethical and legal debates on bioethical issues in Germany, specifies the focus of leading German centres of bioethics and biolaw, and explains the tasks, services and networking of the German Reference Centre for Ethics in the Life Sciences (DRZE) which was founded by the Federal Government.

Current and proposed laws regarding the practice of assisted conception and preimplantation genetic diagnosis (PGD) in Germany are discussed in this paper. Strict limits on scientific and clinical studies into assisted conception that were imposed by legislators are analysed in response to modern trends. New laws are in prospect, and discussions on their form are attracting much debate. Ethical issues cover donor insemination and surrogate motherhood, and increasingly involve intracytoplasmic sperm injection. The limit of three fertilized oocytes, and cryopreservation of pronucleate eggs only, will probably be retained in any new law. Proposals for PGD are still attracting considerable opposition, in relation to the concept of totipotency that underlined earlier legislation. These attitudes are examined and criticized in this review, and comments that such techniques infringe personal dignity are questioned in some detail. So too are proposals to limit clinicians' liability for a child being born following failure of sterilization, with a recommendation to avoid performing this surgery on the grounds of avoiding future financial burdens for the couple. Possible future legislation is considered briefly at the conclusion of the article.

Preimplantation genetic diagnosis makes it possible to detect some genetic disorders in embryos in vitro before they are transferred to the uterus. Using this technique, there is an opportunity for couples who have an increased risk of transmitting severe genetic disorders to their offspring to reduce this risk by >95%. By doing PGD, abortions at a later stage can be avoided.

Preimplantation genetic diagnosis (PGD) has not been performed in Germany. Existing German laws do not explicitly permit or prohibit PGD. German law does forbid the wasting of totipotent embryonic cells, fertilizing oocyctes without transferring them in the same cycle, and the use of micromanipulations that later may harm embryonic development. German law also limits the number of oocytes allowed to be fertilized in each in vitro fertilization (IVF) cycle to three and prohibits research on embryos. The existence of these laws may impede but not prevent the development of PGD programmes in Germany. In contrast, the liberal regulation of pregnancy termination coupled with the development of ethical guidelines specific to PGD may facilitate the introduction of PGD in Germany. Because of these contradictions, legislation is required to clarify the legal status of PGD in Germany., (Copyright 2000 John Wiley & Sons, Ltd.)