The power of heredity and the relevance of eugenic history

Lombardo, Paul A.

doi:10.1038/s41436-018-0123-4

Cited by 12 publications

(11 citation statements)

References 29 publications

(20 reference statements)

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“…These issues include stigmatization (McCabe & McCabe, 2011), autonomy (including "choice overload" (Hadar & Sood, 2014)), and equity (Sueoka, 2016). In addition, the ever-present specter of eugenics (Lombardo, 2018) may be especially salient in the context of the LRP strategy. These thorny issues, as well as the difference between relative and absolute risk reduction, may also be difficult to communicate to couples seeking assisted reproductive technologies (Cunningham et al, 2015;Wilkinson et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…These difficulties are expected to exacerbate the already profound ethical issues raised by PES (as we have recently reviewed (Lázaro-Muñoz et al, 2020)), which include stigmatization (McCabe & McCabe, 2011), autonomy (including “choice overload” (Hadar & Sood, 2014)), and equity (Sueoka, 2016). In addition, the ever-present specter of eugenics (Lombardo, 2018) may be especially salient in the context of the LRP strategy. We thus call for urgent deliberations amongst key stakeholders (including researchers, clinicians, and patients) to address governance of PES and for the development of policy statements by professional societies.…”

Section: Resultsmentioning

confidence: 99%

“…(Sueoka, 2016). In addition, the ever-present specter of eugenics (Lombardo, 2018) may be especially salient in the context of the LRP strategy. How to juxtapose these difficulties with the potential public health benefits of PES is an open question.…”

Section: Discussionmentioning

confidence: 99%

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Utility of polygenic embryo screening for disease depends on the selection strategy

Lencz

Backenroth

Green

et al. 2020

Preprint

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As of 2019, polygenic risk scores have been utilized to screen in vitro fertilization embryos for genetic liability to adult diseases, despite a lack of comprehensive modeling of expected outcomes. In this short report, we demonstrate that a strong determinant of the potential utility of such screening is the selection strategy employed, a factor that has not been previously studied. Minimal risk reduction is expected if only extremely high-scoring embryos are excluded, whereas risk reductions are substantially greater if the lowest-scoring embryo (for a given disease) is selected. We systematically examined the relative contributions of the variance explained by the score, the number of embryos, the disease prevalence, and the parental scores on the utility of screening. We discuss the results in the context of relative vs absolute risk, as well as the potential ethical concerns raised by such procedures.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Utility of polygenic embryo screening for disease depends on the selection strategy

Lencz

Backenroth

Green

et al. 2020

Preprint

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“…These difficulties are expected to exacerbate the already profound ethical issues raised by PES (as we have recently reviewed [ Lázaro-Muñoz et al, 2021 ]), which include stigmatization ( McCabe and McCabe, 2011 ), autonomy (including ‘choice overload’ [ Hadar and Sood, 2014 ]), and equity ( Sueoka, 2016 ). In addition, the ever-present specter of eugenics ( Lombardo, 2018 ) may be especially salient in the context of the LRP strategy. How to juxtapose these difficulties with the potential public health benefits of PES is an open question.…”

Section: Discussionmentioning

confidence: 99%

Utility of polygenic embryo screening for disease depends on the selection strategy

Lencz

Backenroth

Granot‐Hershkovitz

et al. 2021

eLife

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Polygenic risk scores (PRSs) have been offered since 2019 to screen in vitro fertilization embryos for genetic liability to adult diseases, despite a lack of comprehensive modeling of expected outcomes. Here we predict, based on the liability threshold model, the expected reduction in complex disease risk following polygenic embryo screening for a single disease. A strong determinant of the potential utility of such screening is the selection strategy, a factor that has not been previously studied. When only embryos with a very high PRS are excluded, the achieved risk reduction is minimal. In contrast, selecting the embryo with the lowest PRS can lead to substantial relative risk reductions, given a sufficient number of viable embryos. We systematically examine the impact of several factors on the utility of screening, including: variance explained by the PRS, number of embryos, disease prevalence, parental PRSs, and parental disease status. We consider both relative and absolute risk reductions, as well as population-averaged and per-couple risk reductions, and also examine the risk of pleiotropic effects. Finally, we confirm our theoretical predictions by simulating ‘virtual’ couples and offspring based on real genomes from schizophrenia and Crohn’s disease case-control studies. We discuss the assumptions and limitations of our model, as well as the potential emerging ethical concerns.

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“…A concept that "became concrete in a variety of ways, from political movements to voluntary social programs" and beyond into restricting reproduction of the unfit, eugenics came to mean different things to different groups. 14 For eugenic reformers, they speculated on various (and often competing) theories about the relationship between alcohol and soft and hard heredity. Discussion about the dysgenic effects of liquor on women and children proliferated, as newspapers and journals trumpeted the results of eugenic family studies in which hordes of unwanted children were born to drunkard parents.…”

mentioning

confidence: 99%

“The Offspring of Drunkards”: Gender, Welfare, and the Eugenic Politics of Birth Control and Alcohol Reform in the United States

Thompson¹

2021

J. Law. Med. Ethics

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The power of heredity and the relevance of eugenic history

Cited by 12 publications

References 29 publications

Utility of polygenic embryo screening for disease depends on the selection strategy

Utility of polygenic embryo screening for disease depends on the selection strategy

Utility of polygenic embryo screening for disease depends on the selection strategy

“The Offspring of Drunkards”: Gender, Welfare, and the Eugenic Politics of Birth Control and Alcohol Reform in the United States

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