/>iImagine a couple undergoing in-vitro fertilization with the option to select embryos based on their predicted IQ scores. Embryo 1, 2, or 3? Which one will be smarter? According to a recent Wall Street Journal article, startups Nucleus Genomics and Herasight are offering IQ predictions based on genetic tests to help parents select which embryos to use. Inside Silicon Valley’s Growing Obsession With Having Smarter Babies - WSJ
These genetic tests look at polygenic traits, meaning a characteristic that is influenced by two or more genes. Polygenic scores represent individualized predictions of health and other outcomes derived from genome-wide association studies. These studies started in 2005, so we are talking about a technological advancement that is barely 20 years old.
One of the known risks of using polygenic scores is pleiotropy - the tendency of genetic variants to affect multiple phenotypes. In other words, an embryo picked for a polygenic score for one trait may have an unusually high (or low) polygenic score for another trait that parents did not intend to target. For example, if an embryo is chosen based on a polygenic score for educational attainment, the risk of bipolar disorder is increased. This unintended correlation between traits highlights the complexity and potential risks associated with polygenic scoring. Using Polygenic Scores - NEJM As polygenic scoring improves and reproductive technology advances, the magnitude of unintended consequences may also increase.
Currently, there is a lack of comprehensive regulation surrounding polygenic embryo screening in many countries, including the U.S. Bill of Health blog - Harvard Companies offering these services operate in a largely unregulated environment, raising concerns about the reliability and accuracy of their claims as well as the potential for unintended consequences. Smarter baby? - The Economic Times
Over time, scientific discoveries and advancements have shaped the evolution of legal theory and practice. So where might we be headed?
These companies could face liability if predictions are inaccurate or there are unintended consequences. Parents picked embryo 1 because her IQ was predicted to be higher, but it turns out she is on the bipolar disorder spectrum. Potential legal claims could include negligence, breach of contract, and misrepresentation (negligent or fraudulent). How does a company defend itself?
- Comply with guidelines existing in the then-current regulatory framework
- Follow industry standards in technology and scientific research to ensure accuracy of services
- Take all necessary precautions to minimize liability, including having robust procedures in place to address any unintended consequences
- Obtain informed consent from parents -- consent forms and service descriptions are key
- Provide thorough counseling about the limitations and potential inaccuracies of the technology
- Provide thorough counseling about potential risks and benefits of selecting embryos based on predicted traits
In addition to facing these potential liability issues, these companies could be teeing up a potential conflict between the rights of parents to make decisions about future children and the rights of the children themselves. Companies can argue that they respect the rights of parents to make decisions about their future children, while also ensuring that parents are fully informed about the potential implications of their choices.
An additional risk is creation of genetic "classes," which raises equal protection concerns. Such concern has led to the passage of laws like the Genetic Information Nondiscrimination Act (GINA), briefly described by the American Society of Human Genetics as establishing a baseline of protection for all Americans against genetic discrimination. GINA protections
The hypothetical scenario we describe highlights the complex legal and ethical landscape surrounding the use of genetic technologies in reproductive decision-making. It underscores the need for careful consideration and regulation to ensure that these technologies are used responsibly and equitably.
