Abstract

The increasing prevalence of preimplantation genetic testing (PGT) of embryos has led to the identification of couples at risk of transmitting genetically inherited diseases to their offspring. While it is often possible to identify unaffected embryos, situations arise in which the only available embryos are ones whose transfer will certainly lead to the birth of an affected child. Such cases raise complex ethical questions, including: (1) management of situations in which one’s only chance of having a genetically related child is via transfer of affected embryos, (2) the reach of physician autonomy when physicians are morally opposed to the transfer of embryos that will certainly result in affected offspring, (3) the welfare of the resultant children, (4) the permissibility of intentionally transferring an affected embryo, often to have a child who expresses the same genetics as one or both of their parents, (5) the impact of excluding affected embryos on those currently living with that particular disease given the effect such decisions might have on disability rightsDisability rights, (6) distributive justiceJustice concerns given that PGT is currently not available to all those who may stand to benefit due to a lack of access to care.