Embryo Selection - Brutes or Angels: Human Possibility in the Age of Biotechnology - page 92

ments and cosmetic surgery. As we saw with sex selection, and will exam-
ine later with savior siblings, parental autonomy can even include the use
of Ar technologies to further the interests of unborn children, preexist-
ing children, and the family.
Physicians also have autonomy and responsibilities. The latter are encap-
sulated in documents like the hippocratic oath (2012), which describes the
obligation to benefit the sick and do no harm. The American medical Asso-
ciation (AmA 2001) and the World medical Association (WmA 2007) have
also adopted concise statements describing the proper physician-patient
relationship. The AmA's “Principles of medical ethics” states that a phy-
sician's responsibility to the patient is paramount and that the physician
“shall be dedicated to providing competent medical care, with compas-
sion and respect for human dignity and rights” (2001, Principle i). simi-
larly, the WmA's “international Code of medical ethics” states that the du-
ties of a physician include treating patients compassionately and respecting
their human dignity, rights, and preferences. These documents also speak
of the physician's responsibility to exercise his or her independent profes-
sional judgment (WmA 2006) and to contribute “to the improvement of
the community and the betterment of public health” (AmA 2001, Prin-
ciple vii).
sometimes the autonomy, responsibilities, and personal values of par-
ents and physicians come into conflict. A fascinating example of tension
between parental autonomy and a physician's personal values arises when
PGD is used to genetically test embryos for huntington disease (hD) or
other conditions that normally develop after childbearing years. Carriers
of the hD trait have a 50 percent chance of passing it on to each of their
children, but due to the late onset of the disease, carriers usually do not
know they are carriers when they are ready to have children. 8 however, if
an older sibling of a prospective parent has hD, the parent knows that he or
she may be a carrier. An at-risk parent may have two strong desires: first, to
have a future child free of the disease and, second, to remain uninformed
about her or his own genetic condition for the disease. Both desires can be
satisfied if the couple undergoes ivf and obtains a nondisclosing diagnosis