Ethical issues associated with preconception genetic screening: historical experience and current trends
The discovery of molecular markers for hereditary diseases and the development of technologies that made genetic diagnosis accessible to a wide range of people have created prerequisites for the primary prevention of many diseases. The identification and objective analysis of ethical problems associated with preconception screening for monogenic diseases for the primary prevention of hereditary diseases through genetic testing of potential partners. Based on the published data, the authors have analyzed in detail problems and contradictions when implementing various programs aimed at eradicating hereditary diseases. The influence of these programs on the gene pool and demography has been studied. The high efficiency of genetic screening for the prevention of autosomal recessive hereditary diseases has been shown. At the same time, the wide practical application of genetic technologies is hampered by the suppression of ethical issues. One of the possible ways to solve this problem may be the incorporation of local ethics committees into the medical diagnostic process.Donnikov A.E.
Keywords
hereditary diseases
genetic diagnosis
preconception screening
genetic screening
ethics
primary prevention
clinical genetics
References
- Власов В.В., Реброва О.Ю. Оценка популяционной эффективности медицинских технологий. Медицинские технологии. Оценка и выбор. 2012; 3: 33-41. [Vlasov V.V., Rebrova O.Yu. Criteria for population efficacy of medical technologies. Meditsinskie tekhnologii. Otsenka i vybor. 2012; (3): 33-41. (in Russian).]
- Commonwealth Fund Publications. Vol. 1. Prevention of chronic illness. Harvard University Press; 1957.
- Ассаэль Б.М. Дьявольский ген. СПб.: Благотворительный фонд «Острова»; 2017. 284 с. [Accael’ B.M. D’yavol’skii gen. Sankt Petersburg: Blagotvoritel’nyi fond #Ostrova#; 2017. 284 p. (in Russian).]
- Евгеника: генетический отбор. [Электронный ресурс]. Доступно по: https://medium.com/eggheado-science/28eb65226ca6 Ссылка активна на 04.03.2019. [Evgenika: geneticheskii otbor. Available at: https://medium.com/eggheado-science/28eb65226ca6 Accessed 04.03.2019. (in Russian).]
- Запрещенные направления в науке: Евгеника. [Электронный ресурс]. Доступно по: http://ychenik.gorod.tomsk.ru/index-1181959135.php Ссылка активна на 28.02.2019. Available at: http://ychenik.gorod.tomsk.ru/index-1181959135.php Accessed 28.02.2019.(in Russian).]
- Cao A., Galanello R., M.C. Rosatelli M.C. Prenatal diagnosis and screening of the haemoglobinopathies. Bailliere’s Clin. Haematol. 1998; 11(1): 215-38.
- Angastiniotis M., Modell B. Global epidemiology of hemoglobin disorders. Ann. N.Y. Acad. Sci. 1998; 850: 251-69.
- Cao A., Kan Y.W. The prevention of thalassemia. Cold Spring Harb. Perspect. Med. 2013; 3(2): a011775. https://doi.org/10.1101/cshperspect.a011775.
- Li C.K. New trend in the epidemiology of thalassaemia. Best Pract. Res. Clin. Obstet. Gynaecol. 2017; 39: 16-26. https://doi.org/10.1016/j.bpobgyn.2016.10.013.
- Cowan R.S. Heredity and hope: the case for genetic screening. Harvard University Press; 2009.
- «Еврейская болезнь» Тея-Сакса среди израильтян почти исчезла. [Электронный ресурс: Новости]. Доступно по: https://www.newsru.com/world/18jan2005/ill.html Ссылка активна на 03.04.2019. #Evreiskaya bolezn’# Teya-Saksa sredi izpail’tyan pochti ischezla. Available at: https://www.newsru.com/world/18jan2005/ill.html Accessed 03.04.2019.
- Kind P., Lafata J.E., Matuszewski K., Raisch D. Применение QALY в клинической практике и при принятии административных решений: проблемы и перспективы. Качественная клиническая практика. 2015; 2: 92-7. [Kind P., Lafata J.E., Matuszewski K., Raisch D. Primenenie QALY v klinicheskoi praktike i pri prinyatii administrativnykh reshenii: problemy i perspektivy. Kachestvennaya klinicheskaya praktika. 2015; (2): 92-7. (in Russian).]
- Spriggs M. Lesbian couple create a child who is deaf like them. J. Med. Ethics. 2002; 28(5): 283.
- Levy N. Deafness, culture, and choice. J. Med. Ethics. 2002; 28(5): 284-5.
- Bauman H.-D.L. Designing deaf babies and the question of disability. J. Deaf Stud. Deaf Educ. 2005; 10(3): 311-5.
- Романов Г.П., Барашков Н.А., Терютин Ф.М., Лашин С.А., Соловьев А.В., Пшенникова В.Г., Бондарь А.А., Морозов И.В., Сазонов Н.Н., Томский М.И., Джемилева Л.У., Хуснутдинова Э.К., Посух О.Л., Федорова С.А. Брачная структура, репродуктивные параметры и мутации гена GJB2 (СX26) у глухих людей в Якутии. Генетика. 2018; 54(5): 547-55. [Romanov G.P., Barashkov N.A., Teryutin F.M., Solovyev A.V., Pshennikova V.G., Sazonov N.N., Fedorova S.A., Tomsky M.I., Lashin S.A., Posukh O.L., Morozov I.V., Bondar A.A., Dzhemileva L.U., Khusnutdinova E.K. Marital structure, genetic fitness, and the GJB2 gene mutations among deaf people in Yakutia (Eastern Siberia, Russia). Genetika/Russian Journal of Genetics. 2018; 54(5): 554-61. (in Russian)]
- Enns E.E., Boudreault P., Palmer C.G.S. Examining the relationship between genetic counselors’ attitudes toward deaf people and the genetic counseling session. J. Genet. Couns. 2010; 19(2): 161-73. https://doi.org/10.1007/s10897-009-9272-6.
- Carrieri D., Farrimond H., Kelly S., Turnpenny P. Families dealing with the uncertainty of genetic disorders: the case of Neurofibromatosis Type 1. Sociol. Health Illn. 2016; 38(5): 753-67. https://doi.org/10.1111/1467-9566.12401.
- Pradhan E., Pearson E., Puri M., Maharjan M., Maharjan D.C., Shah I. Determinants of imbalanced sex ratio at birth in Nepal: evidence from secondary analysis of a large hospital-based study and nationally-representative survey data BMJ Open. 2019; 9(1): e023021. https://doi.org/10.1136/bmjopen-2018-023021.
- Население Китая. [Электронный ресурс: База данных по народонаселению]. Доступно по: http://ru.worldstat.info/Asia/China Ссылка активна на 07.03.2019. [Naselenie Kitaya. Available at: http://ru.worldstat.info/Asia/China Accessed 07.03.2019. (in Russian).]
- Фадеев А. Страна женихов. [Электронный ресурс: Демография]. Доступно по: https://rg.ru/2013/07/31/neravenstvo.html Ссылка активна на 07.03.2019. [Fadeev A. Strana zhenikhov. Available at: https://rg.ru/2013/07/31/neravenstvo Accessed 07.03.2019. (in Russian).]
- World Population Prospects. The 2015 Revision. Key findings and advance tables. New York; 2015. 59 p.
- World abortion policies, 2013. New York: Dept. of Economic and Social Affairs, Population Division; 2013.
- Куракин П.И. Рождаемость и смертность в капиталистических государствах Европы. М.: В/О «Союзоргучет» Редакционно-издательское управление; 1938. 87 с. [Kurakin P.I. Rozhdaemost’ i smertnost’ v kapitalisticheskikh gosudarstvakh Evropy. Moscow: Soyuzorguchet; 1938. 87 p.(in Russian).]
- Рашин А.Г. Население России за 100 лет (1811–1913 гг.). Струмилин С.Г., ред. М.: Государственное статистическое издательство; 1956. 351 с. [Rashin A.G. Naselenie Rossii za 100 let (1811–1913). Strumilin S.G., ed. Moscow: Gosudarctvennoe statisticheskoe izdatel’stvo; 1956. 351 p. (in Russian).]
- Hanevik H.I., Hessen D.O., Sunde A., Breivik J. Can IVF influence human evolution? Hum. Reprod. 2016; 31(7): 1397-402. 10.1093/humrep/dew089.
- Посух О.Л., Бады-Хоо М.С., Зыцарь М.В., Михальская В.Ю., Лашин С.А.,Барашков Н.А., Романов Г.П. Роль социально-демографической структуры сообществ глухих людей в распространенности наследуемых форм потери слуха. Вавиловский журнал генетики и селекции. 2016; 20(1): 7-15. [Posuh O.L., Bady-Khoo M.S., Zytsar’ M.V.,Mikhal’skaya V. Yu., Lashin S.A., Barashkov N.A., Romanov G.P. Impact of socio-demographic structure of the deaf people communities in prevalence of hereditary hearing loss. Vavilovskii zhurnal genetiki i selektsii. 2016; 20(1): 7-15.(in Russian)]
- Arnos K.S., Welch K.O., Tekin M., Norris V.W., Blanton S.H., Pandya A., Nance W.E. A comparative analysis of the genetic epidemiology of deafness in the United States in two sets of pedigrees collected more than a century apart. Am. J. Hum. Genet. 2008; 83(2): 200-7. https://doi.org/ 10.1016/j.ajhg.2008.07.001.
- Payne M., Rupar C.A., Siu G.M., Siu V.M. Amish, mennonite, and hutterite genetic disorder database. Paediatr. Child Health. 2011; 16(3): e23-4. https://doi.org/ 10.1093/pch/16.3.e23.
- Ferreira C.R., Regier D.S., Hadley D.W., Hart P.S., Muenke M. Medical genetics and genomic medicine in the United States of America. Part 1: history, demographics, legislation, and burden of disease. Mol. Genet. Genomic Med. 2017; 5(4): 307-16. https://doi.org/ 10.1002/mgg3.318. eCollection 2017 Jul.
- Ekstein J., Katzenstein H. The Dor Yeshorim story: Community-based carrier screening for Tay-Sachs disease. Adv. Genet. 2001; 44: 297-310.
- Grazi R.V., Wolowelsky J.B. Cultural concerns when counseling Orthodox Jewish couples for genetic screening and PGD. J. Genet. Couns. 2015; 24(6): 878-81. https://doi.org/10.1007/s10897-015-9860-6.
- Traeger-Synodinos J. Pre-implantation genetic diagnosis. Best Pract. Res. Clin. Obstet. Gynaecol. 2017; 39: 74-88. https://doi.org/10.1016/j.bpobgyn.2016.10.010.
- De Rycke M., Belva F., Goossens V., Moutou C., SenGupta S.B., Traeger-Synodinos J., Coonen E. ESHRE PGD Consortium data collection XIII: cycles from January to December 2010 with pregnancy follow-up to October 2011. Hum. Reprod. 2015; 30(8.): 1763-89. https://doi.org/10.1093/humrep/dev122.
- David B.E., Weitzman G.A., Hervé C., Fellous M. Genetic counseling for the Orthodox Jewish couple undergoing preimplantation genetic diagnosis. J. Genet. Couns. 2012; 21(5): 625-30. https://doi.org/10.1007/s10897-012-9502-1.
- Романов А.Ю., Ладыгин С.С., Долгушина Н.В., Макарова Н.П. Проблемы донорства эмбрионов. Медицинский оппонет. 2019; 1(2): 19-23. [Romanov A.Yu., Ladygin S.S., Dolgushina N.V., Makarova N.P. Problemy donorstva embrionov. Meditsinskii opponent. 2019; 1(2): 19-23. (in Russian)]
- Приказ Минздрава России от 30.08.2012 № 107н (ред. от 01.02.2018) «О порядке использования вспомогательных репродуктивных технологий, противопоказаниях и ограничениях к их применению». [Prikaz Minzdrava Rossii 30.08.2012 No. 107n (editor 01.02.2018) # O poryadke ispol’zovaniya vspomogatel’nykh reproduktivnykh tekhnologii, protivopokazaniyaknh i ogranicheniyakh k ikh primeneniyu#. (in Russian)]
- Александрова Н.В., Шубина Е.С., Екимов А.Н., Кодылева Т.А., Мукосей И.С., Макарова Н.П., Кулакова Е.В., Левков Л.А., Барков И.Ю., Трофимов Д.Ю., Сухих Г.Т. Сравнение результатов преимплантационного генетического скрининга, проведенного методами CGH и NGS. Молекулярная биология. 2017; 51(2): 308-13. [Aleksandrova N.V., Shubina E.S., Ekimov A.N., Kodyleva T.A., Mukosey I.S., Makarova N.P., Kulakova E.V., Levkov L.A., Barkov I.Y., Trofimov D.Y., Sukhikh G.T. Comparative results of preimplantation genetic screening by array comparative genomic hybridization and new-generation sequencing. Molecular Biology. 2017; 51(2): 269-73. (in Russian)]
- Bleich J.D. Genetic screening: survey of recent Halakhic periodical literature. Tradition. 2000 Spring; 34(1): 63-87.
- Mendes Á., Metcalfe A., Paneque M., Sousa L., Clarke AJ., Sequeiros J. Communication of information about genetic risks: putting families at the center. Fam. Process. 2018; 57(3): 836-46. https://doi.org/10.1111/famp.12306.
- Palmer C.G., Boudreault P., Baldwin E.E., Fox M., Deignan J.L., Kobayashi Y. et al. Deaf genetic testing and psychological well-being in deaf adults. J. Genet. Couns. 2013; 22(4): 492-507.
- Palmer C.G., Boudreault P., Baldwin E.E., Sinsheimer J.S. Impact of genetic counseling and Connexin-26 and Connexin-30 testing on deaf identity and comprehension of genetic test results in a sample of deaf adults: a prospective, longitudinal study. PloS One. 2014; 9(11): e111512. https://doi.org/10.1371/journal.pone.0111512. eCollection 2014.
- Frumkin A., Raz A.E., Lieberman S. “The Most Important Test You’ll Ever Take”?: Attitudes toward confidential carrier matching and open individual testing among modern-religious Jews in Israel. Soc. Sci. Med. 2011; 73(12): 1741-7. https://doi.org/10.1016/j.socscimed.2011.09.031.
- Awad E., Dsouza S., Kim R., Schulz J., Henrich J., Shariff A. et al. The moral machine experiment. Nature. 2018; 563(7729): 59-64. https://doi.org/10.1038/s41586-018-0637-6.
Received 17.04.2019
Accepted 19.04.2019
About the Authors
Andrey E. Donnikov, PhD, head of the laboratory of molecular genetic techniques, a doctor of clinical laboratory diagnostics, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow. Е-mail: a_donnikov@oparina4.ru ORCID: 0000-0003-3504-2406 Reasearcher ID: E-7178-2015 ScopusID: 6505485697117997, Russia, Moscow, Ac. Oparina 4.
For citations: Donnikov A.E. Ethical issues associated with preconception genetic screening: historical experience and current trends.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 11: 46-54.(In Russian).
https://dx.doi.org/10.18565/aig.2019.11.46-54