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Facilitating choice, framing choice: the experiences of staff working in pre-implantation genetic diagnosis

Investigators: C.Williams*, B.Farsides, P.Braude, K.Ehrich, R.Scott, J.Sandall.
Project Funding: Wellcome Trust Biomedical Ethics Programme

With its ability to choose the genetic characteristics of potential children, pre-implantation genetic diagnosis (PGD) has been described as a ‘central ethical turning point’. Amongst the dilemmas that have recently attracted public debate are the selection of embryos on the grounds of sex alone, and in order to provide therapy for a sick sibling. The project was primarily a case study of staff at two English teaching hospitals, working in closely linked PGD and Assisted Conception teams. PGD offers technological promise of increased reproductive choice and arguably heralds a new era of predictive medicine. However, the application of PGD is replete with ethical problems and it can be envisaged that increasingly complicated cases will present themselves as new technologies emerge.

Ehrich, K., Williams, C., Scott, R., Sandall, J., Farsides, B. (2006) ‘Social welfare, genetic welfare? Boundary work in the IVF/PGD clinic’, Social Science & Medicine 63:1213-1224.

Ehrich, K., Williams, C., Farsides, B., Sandall, J and Scott, R. (2007) Choosing embryos:  Ethical complexity and relational autonomy in staff accounts of PGD, Sociology of Health & Illness 29:7: 1091-1106.

Scott, R., Williams, C., Ehrich, K., Farsides, B.  (2007) The appropriate extent of PGD: health professionals’ views on the requirement for a ‘significant risk of a serious genetic condition’. Medical Law Review 15:3:320-356.

Ehrich, K., Farsides, B., Williams, C., Scott, R. (2007) Testing the embryo, testing the fetus. Clinical Ethics 2:4:181-186.

Williams, C., Ehrich, K., Farsides, B, Scott, R. (2007) Facilitating choice, framing choice: staff views on widening the scope of PGD. Social Science and Medicine  65:1094-1105

Williams, C.,Wainwright, S., Ehrich, K. and Michael, M.  (2008) Human embryos as boundary objects? Some reflections on the biomedical worlds of embryonic stem cells and preimplantation genetic diagnosis. New Genetics and Society Vol 27, 1, March, 7-18

Ehrich, K., Williams, C., Farsides, B. (2008) The embryo as moral work object: PGD/IVF staff views and experiences.  Sociology of Health & Illness 30:5:772-787

Ehrich, K., Williams, C. (2010) A ‘Healthy Baby’: The double imperative of pre-implantation genetic diagnosis.  Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 14(1): 41–56 
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