Stem cell derived gametes : a slippery slope towards designer babies?

Study question: Is the fear for designer babies a convincing argument against the development of stem cell derived (SCD-) gametes? Summary answer: Although SCD-gametes can facilitate the creation of designer babies, this need not undermine the entire enterprise of in vitro gamete derivation. What is known already: The dawn of new reproductive techniques is often accompanied by fears for eugenic practices, the creation of so-called designer babies in particular. The reproductive use of SCD-gametes feeds similar worries, in view of the possibility to select and design embryos with desired nondisease related traits. While such practices have a negative moral connotation, it should be investigated whether or not this moral worry is justified, both in terms of the scientific possibilities (state of the art), and the moral wrongness of selecting and or editing embryos in function of non-disease related traits. Study design, size, duration: A literature study was performed to delineate how the terms 'eugenics' and 'designer baby' are used and how they relate to each other. Next, claims in the scientific and ethical literature about how SCD-gametes may be used for eugenic purposes were inventoried. These claims were critically evaluated for scientific accurateness. Finally, we question whether the claimed possibility of selecting or genetically designing future offspring based on non-disease related traits is necessarily a morally bad thing. Participants/materials, setting, methods: Literature study, conceptual analysis, normative analysis. Main results and the role of chance: A first possibility is to produce large numbers of gametes (especially oocytes) and embryos to select genetic traits. Second, stem cells could be edited via CRISPR/Cas9 and differentiated into gametes. Third, SCD-gamete technology could be used to recombine SCDgametes with other gametes and derive gametes from the resulting embryos (and so on) to shape the genome through selective breeding, by combining desirable traits that arise in different embryos. Fourth, at present somatic cell nuclear transfer (SCNT) is hindered by the short supply of human oocytes. This could be overcome by means of SCD-gametes. By facilitating SCNT, SCD-gamete technology could ease the creation of embryos with the same genome as someone with a desirable genotype. A last possibility would be to create gametes from persons with desired traits (e.g. via induced pluripotent stem cells) and make these available via gamete banks. Each of these scenarios is premised upon further scientific developments. Given the rapid advance in CRISPR/Cas9, it might become possible to edit embryos so that SCD-gamete technology will be neither a sufficient nor a necessary condition to genetically design offspring. If SCD-gamete technology would become safe, it might nevertheless facilitate eugenic purposes, of which the moral wrongness remains contested. Limitations, reasons for caution: Gamete derivation from human stem cells is still in the research phase. The question of the moral wrongness of enhancement and eugenics is explored but not 'answered', as it is a fundamentally normative question. Similarly, 'designer baby' is a stipulative concept, as it is contested which interventions amount to 'designing'. Wider implications of the findings: The causal link between SCD-gamete technology and eugenics/designer babies is weak and speculative. Moreover, the wrongness of such an evolution is contested. Trial registration number: n/a.

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