Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies
- 2nd Edition - August 14, 2023
- Imprint: Academic Press
- Editor: Sorin Hostiuc
- Language: English
- Paperback ISBN:9 7 8 - 0 - 4 4 3 - 1 9 0 4 5 - 2
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 1 9 0 4 6 - 9
**Selected for 2025 Doody’s Core Titles® in Medical Ethics**The Human Genome Project has triggered a technological revolution that has influenced nearly every field of medicine, i… Read more
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The Human Genome Project has triggered a technological revolution that has influenced nearly every field of medicine, including reproductive medicine, obstetrics, gynecology, andrology, prenatal genetic testing, and gene therapy. This second edition of Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies offers a thorough, timely discussion of ethical issues raised by the latest genetic and genomic technologies applied in human reproductive and prenatal medicine, providing practical recommendations, guidelines, and algorithms to support ethical clinical practice. Here, international experts consider the ethics of technologies from preconception carrier screening to genetic engineering, CRISPR gene editing, mitochondrial gene replacement therapy, sex selection, predictive testing, secondary findings, embryo reduction, and the moral status of the embryo, genetic enhancement, and the sharing of genetic data. Throughout the book, contributors adopt a global, holistic perspective on applied challenges and the moral questions around the implementation of genetic reproductive technologies. The book is an ideal resource for practitioners, regulators, lawmakers, clinical researchers, genetic counselors, and graduate and medical students.This fully updated second edition examines new developments in the field, tackling ethical aspects of organoid development, recent advances in pharmacogenomics, direct-to-consumer genetic testing, and genetic engineering.
- Provides practical analysis of the ethical issues raised by cutting-edge techniques and recent advances in prenatal and reproductive genetics
- Contains contributions from leading bioethicists and clinicians who offer a global, holistic perspective on applied challenges and moral questions relating to genetic and genomic reproductive technology
- Discusses preconception carrier screening, genetic engineering, and the use of CRISPR gene editing, mitochondrial gene replacement therapy, and ethical issues, among others
- Considers ethical aspects of recent advances and new technologies in the field, from organoid development to pharmacogenomics and direct-to-consumer genetic testing
Active researchers, basic and translational scientists, clinicians, and students in the areas of human genetics, medical genetics, genomics, reproductive medicine, gynecology, obstetrics, andrology, embryology, prenatal testing, and genetic testing, genetic counselors, bioethicists, fertility specialists, lawmakers and regulators, medical students and residents, pharmacologists, Students
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- Chapter 1: Genomic editing: From human health to the “perfect child”
- Abstract
- 1: Introduction
- 2: Ethical issues in clinical genome editing
- 3: Conclusions
- References
- Chapter 2: Ethics of mitochondrial gene replacement therapy
- Abstract
- 1: Introduction
- 2: What is mitochondrial disease and mitochondrial donation?
- 3: The UK timeline
- 4: The international position
- 5: Are the techniques safe?
- 6: Ethical issues
- 7: “Three parent babies” and identity
- 8: Genetic modification and the “slippery slope”
- 9: Risks for egg donors
- 10: Ethical differences between PNT and MST
- 11: Mitochondrial disease as complex: Diagnosis, predicting risk, and genetic counseling
- 12: Alternative reproductive options
- 13: Polar body transfer and gene editing
- 14: Conclusion
- References
- Further reading
- Chapter 3: Reproductive technologies used by same-gender couples
- Abstract
- 1: Introduction
- 2: Procreative autonomy
- 3: Gamete and embryo donation
- 4: Surrogacy agreement
- 5: Trans parenthood
- 6: Conscience clause
- 7: Conclusions
- References
- Further reading
- Chapter 4: Ethical issues raised by multiparents
- Abstract
- 1: Introduction
- 2: Multiparents of children born through ARTs
- 3: Where do all these parents come from?
- 4: Ethical issues
- 5: Secondary ethical issues
- 6: Final considerations
- References
- Chapter 5: Revisiting the nondirective principle of genetic counseling in prenatal screening
- Abstract
- 1: Introduction
- 2: Genetic counseling: An overview
- 3: The nondirective principle in genetic counseling
- 4: Does the nondirective principle compromise genetic counseling in prenatal screening?
- 5: Does genetic counseling in prenatal screening compromise the nondirective principle?
- 6: The concept of nondirectivity vs the role of genetic counseling
- 7: Activating the conscience clause in genetic counseling in prenatal screening?
- 8: Genetic counseling in prenatal screening in ethnic and cultural minorities
- 9: Medical tourism for abortion after genetic counseling
- 10: Issues of genetic counseling in prenatal screening
- 11: Final considerations
- References
- Chapter 6: Sex selection, gender selection, and sexism
- Abstract
- 1: Introduction
- 2: The roots and reasons for sex selection
- 3: From politics on reproduction to biopolicy
- 4: Missing girls: Why and how many?
- 5: Legal and ethical questions
- 6: Conclusion
- References
- Chapter 7: The impact of “Big Data” on beginning-of-life issues
- Abstract
- 1: Introduction: First, what is really “Big Data”?
- 2: “Big Data” and healthcare: An expanding universe
- 3: “Big Data” and Beginning-of-life issues: A field in its infancy
- 4: Conclusion: Work in progress
- References
- Chapter 8: The moral status of the embryo and its uses: Bioethics and social perceptions
- Abstract
- 1: Introduction
- 2: The empirical perspective in bioethics and public perceptions of science studies
- 3: The notion of moral status
- 4: Contrasting narratives on the moral status of the embryo
- 5: The status of the embryo frame and the beginning of individual human life
- 6: Views on the status of the embryo, religious beliefs, scientific literacy, and gender
- 7: Moral status and attitudes to embryo research
- 8: Conclusions
- References
- Chapter 9: Fetal reduction
- Abstract
- 1: Bioethical issues of fetal reduction: Why words matter
- 2: The moral status of embryo and fetus
- 3: Fetal reduction: “A soft cover for hard choices”
- 4: Parental autonomy and parental responsibility
- 5: Conclusion
- References
- Chapter 10: Stem cell therapies for neurodegenerative disorders: An ethical analysis
- Abstract
- 1: Introduction
- 2: An overview on stem cell therapies for neurodegenerative disorders
- 3: Risk-to-benefit analysis for stem cell therapies in neurodegenerative disorders
- 4: Induced pluripotent stem cell therapies for neurodegenerative disorders
- 5: Moral status of IPSCs
- 6: Conclusions
- References
- Chapter 11: Predictive genetic testing in multifactorial disorders
- Abstract
- 1: Introduction
- 2: Respect for autonomy
- 3: Nondirectiveness in predictive testing for multifactorial disorders
- 4: Direct-to-consumer genetic testing
- 5: When to recommend predictive genetic testing?
- 6: Nonmaleficence and risk assessment
- 7: Confidentiality and family sharing of the genetic results
- 8: Predictive genetic testing in children
- 9: Genetic exceptionalism and multifactorial disorders
- 10: Conclusions
- References
- Chapter 12: Whole-genome sequencing as a method of prenatal genetic diagnosis: Ethical issues
- Abstract
- 1: Introduction
- 2: From the standard of prenatal diagnosis to whole-genome sequencing
- 3: Whole-genome sequencing as a prenatal diagnostic tool
- 4: Ethical problems surrounding whole-genome sequencing
- 5: The importance of pre-WGS test and post-WGS diagnostic counseling
- 6: Conclusion
- References
- Chapter 13: Noninvasive prenatal genetic diagnosis
- Abstract
- 1: Introduction
- 2: High- versus low-risk populations
- 3: Reproductive autonomy
- 4: Counseling for NIPT
- 5: Should parents be allowed to get tested “for information only”
- 6: NIPT and discrimination
- 7: Eugenics, procreative beneficence, and NIPT
- 8: Conclusions
- References
- Chapter 14: Prenatal testing in low-risk populations: After routinization
- Abstract
- 1: Introduction
- 2: Background on offering the test to low-risk women
- 3: Diagnostic test versus screening test
- 4: Reduced penetrance and variable expressivity
- 5: Negative test and healthy baby assumptions
- 6: Incidental findings: Maternal conditions
- 7: Ethics of testing just for information
- 8: Practical issues: Who will counsel patients?
- 9: OB/Gyn counseling
- 10: Information access outside of the United States
- 11: Problematic solutions
- 12: Linear model of information transmission
- 13: Justice issues: Access to testing
- 14: Conclusion
- References
- Chapter 15: Using genetics for enhancement (liberal eugenics)
- Abstract
- Acknowledgments
- 1: Introduction
- 2: Genetic enhancement
- 3: Liberal eugenics
- 4: Regulation, health coverage, and public opinion
- 5: Conclusion
- References
- Chapter 16: Should incidental findings arising from prenatal testing be reported indiscriminately to patients?
- Abstract
- 1: Introduction
- 2: Incidental findings in the prenatal setting
- 3: Reporting incidental findings in the prenatal setting
- 4: Handling incidental findings: Informed consent procedures and pretest counseling in genetic testing
- 5: Conclusion
- References
- Chapter 17: Third-party sharing of genetic information
- Abstract
- 1: Introduction
- 2: Disclosure of genetic data to relatives
- 3: Disclosure of genetic information to employers
- 4: Disclosure of genetic data to health insurance companies
- 5: Third-party sharing of genetic data in the context of biomedical research
- 6: Disclosure of data resulting from DTC genetic tests
- 7: Disclosure of data resulting from genetic interpretation services
- 8: Third-party sharing for forensic purposes
- References
- Chapter 18: Cerebral and noncerebral organoids
- Abstract
- 1: Stem cells applications: Organoids and brain organoids
- 2: Ethical issues
- 3: Final remarks
- References
- Chapter 19: Cognitive enhancement: Bioethical aspects
- Abstract
- 1: Introduction
- 2: Libertarian and utilitarian theories
- 3: Personalist and egalitarian theories
- 4: Hidden risks of enhancement
- 5: Possible future regulation about enhancement
- 6: Conclusion
- References
- Chapter 20: Risks and benefits of direct-to-consumer genetic testing in the reproductive context
- Abstract
- 1: Introduction
- 2: A brief history of DTC genetic testing
- 3: Current status of DTC genetic testing relevant to reproductive decisions
- 4: Limits and risks
- 5: Benefits
- 6: Ethical issues
- 7: Conclusion
- References
- Chapter 21: Genetic immunization: Enhancement or public health measure?
- Abstract
- 1: Introduction
- 2: Public health and ethics
- 3: Moral concepts from public health ethics
- 4: Ethical analysis of genetic immunization
- 5: Conclusions
- References
- Index
- Edition: 2
- Published: August 14, 2023
- No. of pages (Paperback): 554
- No. of pages (eBook): 480
- Imprint: Academic Press
- Language: English
- Paperback ISBN: 9780443190452
- eBook ISBN: 9780443190469
SH
Sorin Hostiuc
Sorin Hostiuc, MD, PhD, is Professor in the Department of Legal Medicine and Bioethics at Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, and Senior Physician at the National Institute of Legal Medicine, Bucharest, Romania. Dr. Hostiuc has written extensively on topics such as informed consent, research ethics, history of medical ethics, and reproductive ethics, with more than 200 published articles in The Lancet, New England Journal of Medicine, PLOS ONE, Journal of Translational Medicine, and Frontiers in Neuroscience, among other journals. He has also published four monographs in Romanian dealing with bioethical issues: A Treaty of Medical and Dental Bioethics, Ethics of Scientific Research, Ethics of Scientific Publishing, and Informed Consent as well as a book about the history of informed consent in Europe. Dr. Hostiuc received his PhD in medicine and MD from Carol Davila University of Medicine and Pharmacy.
Affiliations and expertise
Professor, Department of Legal Medicine and Bioethics, Department 2, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Medical Manager, National Institute of Legal Medicine, Bucharest, RomaniaRead Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies on ScienceDirect