Aug 2026· Nature Human Behaviour· 0 citations· 29 references
Medicine
TL;DR
Public views on polygenic embryo testing are examined, suggesting variability in choices across specific traits and conditions, rather than a uniform distinction between medical conditions and non-medical traits.
Abstract
Some advances in reproductive technologies raise substantial ethical and psychological challenges, for example, the use of preimplantation genetic testing to select embryos based on non-medical traits. While studies have explored public willingness to use preimplantation genetic testing for medical or non-medical attributes, stated willingness may not reflect implantation decisions when such information is available. This large cross-national study examined public views on polygenic embryo testing. In a US sample (N = 1,467), participants were more willing to test for medical conditions (for example, heart disease) than non-medical traits (for example, antisocial behaviour or low intelligence), although over half supported testing for non-medical traits. In a forced-choice implantation task, participants used medical and non-medical information to a similar extent when making decisions. Similar patterns were observed in Chinese participants (N = 623). These findings suggest variability in choices across specific traits and conditions, rather than a uniform distinction between medical conditions and non-medical traits. The Stage 1 protocol for this Registered Report was accepted in principle on 7 October 2025. The protocol, as accepted by the journal, can be found at https://osf.io/vb9c2 .
Prior normative and empirical research has identified a gap between how patients and the public conceptualize "serious" conditions eligible for preimplantation genetic testing for monogenic disorders (PGT-M) and how seriousness is defined. Japan represents a highly restrictive regulatory context shaped by its historical experience with eugenics. Although PGT-M has been available since 1998, its use has been tightly limited, with the first birth occurring six years later and approximately 36 conditions approved to date. This study examines how Japanese adults of reproductive age understand "seriousness" in genetic disease and how they view PGT-M in relation to concerns about eugenic selection (inochi no senbetsu, "sorting of lives"). We conducted a cross-sectional online survey of 458 adults aged 18-42 years. Measures included perceived seriousness across clinical parameters (penetrance, survival, daily life impact), willingness to use PGT-M, perceived barriers to access, and attitudes toward eugenic selection. Awareness of PGT-M was low (12%), yet 44% of participants would consider its use. Participants defined seriousness more broadly than current Japanese policy permits: most rated highly penetrant or childhood-lethal conditions as serious, and over half also included conditions associated with mild to moderate functional limitations. Participants distinguished disease prevention from enhancement. Economic burden was the most frequently cited barrier (70%). Many participants who expressed ethical discomfort with eugenic selection nonetheless reported willingness to consider PGT-M. These findings reveal a substantial gap between policy, public reasoning, and reproductive preferences, with implications for European debates on seriousness and proportionality in reproductive genetic testing.
S. Takahashi, R. Iizuka, S. Ong et al.· European Journal of Human Ge...· 0 citations
Preimplantation Genetic Testing for Polygenic Disorders (PGT-P) emerged as a novel application of reproductive genetics. Through polygenic risk scores (PRS), proponents of PGT-P claim to predict a future child's genetic predisposition to multifactorial diseases. However, when probability is marketed as prediction, the ethical foundations of informed decision-making begin to erode. PGT-P relies on PRS to provide probabilistic information, and commercial providers frequently present these risk estimates as predictive, downplaying key limitations. This paper examines how promotional language surrounding PGT-P undermines informed reproductive decision-making and argues that portraying risk as certainty misrepresents scientific evidence and may emphasize narratives of genetic optimization.
Connie Anne Fierro· Journal of Obstetrics and Gy...· 0 citations
Applying a bioethics framework of autonomy, beneficence, nonmaleficence, nonmaleficence, and justice allows these issues to be examined, and current protections to be evaluated for the purpose of instituting change.
Ava Borgess· Journal of healthcare manage...· 0 citations
The advent of massively parallel ("next-generation") DNA sequencing has enabled prenatal testing for any and all diseases at reasonable cost, resulting in the widespread adoption of highly expanded carrier screening. While the size and constitution of these gene panels may be critiqued on various grounds, at least all the diseases selected represent potential risks to the newborn or older child if affected. Thus, the rationale behind the effort falls within ACOG's definition of prenatal care as a preventive health service "designed to improve the health and well-being of pregnant and birthing individuals and their infants through evidence-based services." Nowhere does it promise to improve the health of offspring when they reach adulthood. Here, we argue that testing for adult-onset diseases in the prenatal setting (in the absence of a positive family history) is neither justified nor desirable, based on considerations of equity, scope of practice, downstream burden on the health care system, and psychosocial repercussions.
Wayne W. Grody· Clinical obstetrics and gyne...· 0 citations
Huntington's disease (HD) families face complex decisions about predictive genetic testing and reproductive options, including preimplantation genetic testing (PGT), and particularly PGT for Monogenic Disorders (PGT‐M). We examined attitudes toward genetic testing and reproductive options across affected groups within HD families (e.g., people with HD, spouse/caregivers, and at‐risk family members), in a healthcare system with full funding for genetic services. We conducted semi‐structured interviews with 51 participants (17 people with HD, 20 at‐risk relatives, 14 spouses/partners), recruited from the National HD Clinic in Tel Aviv, Israel. Framework Analysis was employed to enable systematic comparison across groups. Three themes emerged from the analysis: “Surprised by HD” revealed that family members were often unaware of genetic risk despite predictable inheritance, reflecting patterns of nondisclosure and misdiagnosis; “Truth or luck” captured divergent attitudes toward predictive testing, with some participants advocating for early knowledge while others emphasized the psychological burden of knowing in the absence of a cure. Together, these themes formed the context for a central finding: “The recommendation paradox”, a striking pattern where individuals who avoided or regretted personal predictive testing nonetheless strongly endorsed reproductive options for offspring, a tension that manifested differently across groups depending on their relationship to HD. The recommendation paradox reveals ethical tensions between reproductive autonomy and emerging expectations of genetic responsibility. This pattern persists even when economic barriers are removed, demonstrating that psychological factors remain primary determinants of testing uptake. Genetic counseling should explicitly address divergent attitudes toward personal versus offspring testing, recognizing that support for prevention does not necessarily indicate readiness for personal testing.
Noit Inbar, A. Socher, Aya Bar David et al.· Journal of Genetic Counselin...· 0 citations
Critical gaps in public knowledge in genetics are highlighted, emphasizing the need for improved genetic education, including incorporating genetics into school curricula and launching targeted awareness campaigns to promote informed decision-making.
S. Mercier, F. Petit, M. Misrahi et al.· medRxiv· 0 citations
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