The Stanford Center for Law and the Biosciences officially launched on February 27 with its inaugural conference Unnatural Selection: Should California Regulate Pre-implantation Genetic Diagnosis. Dr. Mark Hughes, one of the pioneers of pre-implantation genetic diagnosis (PGD), wasted little time in vividly portraying the issues at hand. Dr. Hughes bolstered his remarks about his work with photos of the devastating ailments that PGD has been used to avoid. Dr. Hughes also allowed the audience a view of the remarkable process by which a cell is removed from a human embryo so that scientists can screen it for various genetic disorders. Combining powerful images with narratives from his own career, Dr. Hughes conveyed a sense of the high stakes surrounding biomedical interventions in human reproduction.

Pre-implantation genetic diagnosis, developed by British and American researchers during the early 1990s, represents a merger of two distinct areas of biotechnology. The first is in-vitro fertilization, a well-established practice of using external fertilization to overcome infertility problems. The second is genetic testing, methods which detect the presence or absence of genes. For would-be parents who are carriers of harmful genes, and thus risk having children with severe genetic disorders, PGD allows an opportunity to systematically select an embryo that lacks the harmful genetic abnormality.

The conference brought together a range of experts, each with a unique approach to the issue of biotechnology and human reproduction. John Robertson and Radhika Rao, both law professors, discussed constitutional questions arising from the new technology. Professor Robertson made the case that there was most likely not a constitutional right to access to PGD services, and Professor Rao considered the constitutional implications of allowing PGD for some purposes (gender selection intended to avoid sex-linked genetic defect) but not others (gender selection intended to create “balanced” families).

Dr. Kate Hudson, founder and director of the Genetics and Public Policy Center at Johns Hopkins University, presented research attempting to gauge public opinion on issues of reproductive biotechnology. Dr. Hudson’s extensive efforts provided a rare glimpse at our nation’s attitudes, and revealed disparities based on gender, age, and religious outlook. Joe Leigh Simpson, a representative from the American Society of Reproductive Medicine, offered analysis of the efficacy and potential pitfalls of self-regulation in this industry.

Several key issues emerged from the discussions with these and other speakers. Consensus emerged about the need for quality control, further research, and regulation of false advertising. Less clear is where, if anywhere, the line should be drawn between legitimate uses of PGD to avert severe genetic illnesses and more problematic uses of PGD for gender selection, for the selection of non-severe traits, or for the selection of certain disabilities which the parent feels are actually beneficial.

The conference was well attended, and the questions of many in the audience revealed that they had personal involvement in an aspect of human reproductive technology. The conference was enhanced by an audience both willing and capable of probing the conclusions of the various panelists. Stanford CLB looks forward to many more engaging events!

Stanford CLB is grateful to the generous sponsors of the conference: Affymetrix, Paul Hastings LLP, and the Stanford University Bio-X Program.

— Pablo Arredondo

Photo: PGD Procedure. Photo courtesy of Dr. SHerman J. Silber, M.D., infertile.com