Abstract
While pre-implantation genetic diagnosis (PGD) is available and legal in Malaysia, there is an ongoing controversy debate about its use. There are few studies available on individuals’ attitudes toward PGD, particularly among those who have a genetic disease, or whose children have a genetic disease. To the best of our knowledge, this is, in fact, the first study of its kind in Malaysia. We conducted in-depth interviews, using semi-structured questionnaires, with seven selected potential PGD users regarding their knowledge, attitudes and decisions relating to the use PGD. The criteria for selecting potential PGD users were that they or their children had a genetic disease, and they desired to have another child who would be free of genetic disease. All participants had heard of PGD and five of them were considering its use. The participants’ attitudes toward PGD were based on several different considerations that were influenced by various factors. These included: the benefit-risk balance of PGD, personal experiences of having a genetic disease, religious beliefs, personal values and cost. The study’s findings suggest that the selected Malaysian participants, as potential PGD users, were supportive but cautious regarding the use of PGD for medical purposes, particularly in relation to others whose experiences were similar. More broadly, the paper highlights the link between the participants’ personal experiences and their beliefs regarding the appropriateness, for others, of individual decision-making on PGD, which has not been revealed by previous studies.
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References
Donnelly, L. S., Watson, M., Moynihan, C., Bancroft, E., Evans, D. G. R., Eeles, R., et al. (2013). Reproductive decision-making in young female carriers of a BRCA mutation. Human Reproduction, 28(4), 1006–1012.
Doolin, B., & Motion, J. (2010). Christian lays understandings on pre-implantation genetic diagnosis. Public Understanding of Science Journal, 19(6), 669–685.
Hershberger, P. E., & Pierce, P. F. (2010). Conceptualizing couples’ decision making in PGD: Emerging cognitive, emotional and moral dimension. Patient Education and Counseling, 81, 53–62.
Hui, P. W., Lam, Y. H., Chen, M., Tang, M. H., Yeung, W. S., Ng, E. H., & Ho, P. C. (2002). Attitudes of at risk subjects toward preimplantation genetic diagnosis of alpha and beta thalassaemia in Hong Kong. Prenatal Diagnosis, 22, 508–511.
Kalfoglou, A. L., Doksum, T., Bernhard, B., Geller, G., LeRoy, L., Matthews, D. J. H., et al. (2005). Opinions about new reproductive genetic technologies: Hopes and fears for our genetic future. Fertility and Sterility, 83(6), 1612–1621.
Lammens, C., Bleiker, E., Aaronson, N., Vriends, A., Ausems, M., et al. (2009). Attitude towards pre-implantation genetic diagnosis for hereditary cancer. Familial Cancer, 8, 457–464.
Nasri, N. W. M., Abdul Jamal, A. R., Abdullah, N. C., Razi, Z. R. M., & Mokhtar, N. M. (2009). Pre-implantation genetic diagnosis for beta-thalassemia using single cell DNA analysis for codons 17 and 26 of beta-globin gene. Achives of Medical Research, 40(1), 1–9.
NorAshikin, M. N. K., Dzulsuhaimi, D., Rajikin, M. H., Abdullah, R. B., Zulqarnain, M., Faizah, S., & Mohamed Said, M. S. (2006). The effects of biopsy and cryopreservation by vitrification on the in vitro development of eight cells mouse embryos. Journal of BioMedical Research, 17(1), 61–66.
Ormondroyd, E., Donnelly, L., Moynihan, C., Savona, C., Bancroft, E., et al. (2012). Attitudes to reproductive genetic testing in women who had a positive BRCA test before having children: a qualitative analysis. European Journal of Human Genetics, 20, 4–10.
Quinn, G., Vadaparampil, S., King, L., Miree, C., & Friedman, S. (2009). Attitudes of high-risk women toward preimplantation genetic diagnosis. Fertility and Sterility, 91(6), 2361–2368.
Savulescu, J., & Kahane, G. (2008). The moral obligation to create children with the best chance of the best life. Journal of Bioethics, 23(5), 274–290.
Schenker, J. G., & Fasouliotis, S. J. (1998). Preimplantation genetic diagnosis principles and ethics. Human Reproduction, 13(8), 2238–2245.
Shkedi, S., & Hashiloni-Dolev, Y. (2007). On new reproductive technologies and family ethics: Preimplantation genetic diagnosis for sibling donor in Israel and Germany. Social Science and Medicine Journal, 65(10), 2081–2092.
Van Rij, M. C., Gielen, M., Lulofs, R., Evers, J. L., Van Osch, L., Muntjewefrr, N., et al. (2011). Profiles and motives for PGD: A prospective cohort study of couples referred for PGD in the Netherlands. Human Reproduction, 26(7), 1826–1835.
Watt, H. (2004). Pre-implantation genetic diagnosis: Choosing the ‘good enough’ child. Health Care Analysis, 12(1), 51–60.
Yaakob, H. (2012). Pre-implantation genetic diagnosis for social sex selection (PGD for SSS) in Malaysia: Analyzing the ‘Wisdom of Repugnance’. Paper presented at 13th Asian bioethics conference, 27th–30th August 2012, Kuala Lumpur.
Acknowledgments
The results of this study come from the research project, Ethical Implications of Pre-implantation Genetic Diagnosis (PGD): A qualitative study on three selected groups in Malaysia’, supported by post-graduate Grant (University of Malaya) [UM.TNC2/IPPP/UPGP/GRANT (PPP)/PS385/2010B] and post-doctorate researcher Grant (UKM) [FRGS/2/2013//SS112/UKM/02/2]. We thank all participants in this study for their time and efforts to make time for the interviews session.
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Olesen, A.P., Nor, S.N.M. & Amin, L. Attitudes Toward Pre-implantation Genetic Diagnosis (PGD) for Genetic Disorders Among Potential Users in Malaysia. Sci Eng Ethics 22, 133–146 (2016). https://doi.org/10.1007/s11948-015-9639-z
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DOI: https://doi.org/10.1007/s11948-015-9639-z