Ultimately, though, I think the focus will be primarily on relatively rare mendelian traits, where such traits are clearly considered to be and commonly accepted as deleterious. Even then, though, the long-term effect of the procedure will be poorly understood, which may limit acceptance. I don’t think natural variation would come to a halt, and besides, we’ve been interupting human natural selection for a while already (Darwin Awards notwithstanding!).

I think it will be difficult to apply PGD to most of the common complex genetic disorders that are so multifactorial and polygenic (and problematic). In fact, polymorphisms that increase risk for one disease can be protective for another, and the genome is integrative in ways that we barely understand now, so deciding what to select becomes quite difficult! All of this doesn’t even consider the important point you raise about epigenetics, etc.

The proliferation of personal sequenced genomes (thanks for sharing!) should have a profound impact on what we consider to be genetic risks, assuming that this information teaches us about hidden aspects of heritability. When common genetic variation can apparently explain so little, seeing many genomes should be illuminating (again, thanks!)

One final point (and I come with no particular religious ax to grind) - how do we reconcile the notion that we can treat a pre-implantation embryo as a potential patient whom we might diagnose, with the idea that the same (roughly) collection of cells provides a potentially valuable reagent for medical research. Technology can create serious conundrums!

ps. It was nice to speak with you at ASHG. Hope you’re enjoying Durham - I’m still a little envious!

If you would like to learn more, just drop me an email.

Have a look at www.dnapolicy.org - they have done a lot of research about public attitudes regarding PGD. This, in combination with a growing body of literature about the scientific risks and limits, could form the basis for a sane and productive policy discussion. President-elect Obama is interested in these issues - his Personalized Medicine and Genomics Act is in the Senate at the moment. (see www.thomas.gov to read more)

Finally, one last point: The stats can be a bit fuzzy, but somewhere in the order of 1/3 of all U.S. births are thought to be the result of an unintended pregnancy! My point is that the fear of widespread “designer babies” doesn’t much take into account the fact that babies are made by humans, and that human behavior can be difficult to predict.

No ASHG for me this year. In fact, I haven’t been to a meeting in almost 10 years. What a loser….

I happen to think McKibben is way off base–he sounds like Leon Kass. I’m a lot more worried about birth defects and epigenetic problems stemming from PGD than I am about any type of GATTACA scenario.

Speaking as a scientist, I have the same concerns as many of you that the procedure occurs in a milieu that may cause future problems for these children. Even children born of IVF which is a well-accepted technique nowadays may face more health problems than the average population. That’s not to say, however, that they do not enjoy a good quality of life so who’s to say whether IVF or PGD are good or bad in this respect?

With respect to PGD pushing us faster down the road towards genetically engineering our offspring, I’d recommend Enough: Genetic Engineering and the End of Human Nature by Bill McKibben. He thinks that we are already dangerously close to being able to stipulate what traits we want our children to have. McKibben says that any form of genetic engineering could make us wonder who we really are - the product of our genes or the product of our hard work, self-reliance, and inspiration?