PID auf Aneuploidie des Embryos? Ethische Überlegungen zur Auslegung von § 3a des Embryonenschutzgesetzes in Deutschland

Definition of problem: At least in some cases, testing for aneuploidy as part of preimplantation genetic diagnosis (PGD) can be medically useful for pregnancy care. The current legal situation in Germany seems to not generally exclude PGD to detect a maldistribution of chromosomes in an embryo, but testing would require approval by a PGD ethics committee on a case-by-case basis and a well-reasoned application by the concerned woman. This article examines ethically and legally whether fundamental reasons prevent PGD commissions from admitting requests to perform aneuploidy tests as part of PGD. Arguments: Three constellations – each with differing ethical implications – can be distinguished in which testing for aneuploidy could be considered or could occur: Testing for aneuploidy can (i) be the main reason for in vitro fertilization (IVF), which in itself is not medically indicated; (ii) IVF is done as infertility treatment in which case PGD and aneuploidy testing could be done additionally; or (iii) PGD with IVF is indicated in order to prevent a congenital disease or chromosomal aberration leading to a diagnosis of aneuploidy as an incidental or additional finding. Ethical arguments which could lead to a general rejection of aneuploidy testing are the prevention of discrimination against people with aneuploidy, as well as the protection of embryos. These concerns oppose constellation (i), but do not apply to (ii) and (iii). Yet there are at least three ethical arguments in favour of an admissibility of a request for aneuploidy testing: the “good practice” of IVF, the duty to the emerging child and the parent’s right to have a voice in the discussion. Conclusion: Aneuploidy testing as part of PGD is not ruled out by legal or ethical reasons and should be openly discussed by the relevant German ethics commissions.