Screening Embryos for Psychiatric Conditions: Public Perspectives, Ethical and Social Issues
Collection Editor(s):
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Introduction
The number of genomic loci identified to be associated with psychiatric disorders have substantially increased over the last decade. Alongside developments in polygenic embryo screening (PES; or PGT-P), the use of polygenic risk scores (PRS) to predict the genetic likelihood of polygenic traits (e.g., height, skin tone) and conditions (e.g., psychiatric disorders), it is now possible to screen embryos intended for invitro fertilization for genetic risk of psychiatric conditions such as schizophrenia or autism spectrum disorders. Private companies have started to offer PES for some psychiatric conditions; however, many ethical issues have been raised in the academic literature.
Concerns about the use of PES broadly have included little evidence of clinical utility, limited portability of the PRS used in PES to populations underrepresented in the genome-wide association studies (GWAS) on which they are based, potential for exacerbating healthcare disparities, and impacts on patient autonomy. In addition to these issues, PES for psychiatric disorders may bring forth additional ethical matters that warrant careful consideration given the potential for exacerbating stigma…
- Lázaro-Muñoz, G., Pereira, S., Carmi, S., & Lencz, T. (2021). Screening embryos for polygenic conditions and traits: Ethical considerations for an emerging technology. Genetics in Medicine, 23(3), 432-434.
- Lencz, T., Sabatello, M., Docherty, A., Peterson, R. E., Soda, T., Austin, J., Bierut, L., Crepaz-Keay, D., Curtis, D., Degenhardt, F., Huckins, L., Lázaro-Muñoz, G., Mattheisen, M., Meiser, B., Peay, H., Rietschel, M., Walss-Bass, C., & Davis, L. K. (2022). Concerns about the use of polygenic embryo screening for psychiatric and cognitive traits. Lancet Psychiatry, 9(10), 838-844.
- Turley, P., Meyer, M. N., Wang, N., Cesarini, D., Hammonds, E., Martin, A. R., Neale, B. M., Rehm, H. L., Wilkins-Haug, L., Benjamin, D. J., Hyman, S., Laibson, D., & Visscher, P. M. (2021). Problems with using polygenic scores to select embryos. New England Journal of Medicine, 385(1), 78-86.
- Barlevy, D., Lencz, T., Carmi, S., Kostick-Quenet, K. M., Mukherjee, M., Pereira, S., & Lázaro-Muñoz, G. (2022). Capacities and limitations of using polygenic risk scores for reproductive decision making. American Journal of Bioethics, 22(2), 42-45.
- Murray, G. K., Lin, T., Austin, J., McGrath, J. J., Hickie, I. B., & Wray, N. R. (2021). Could polygenic risk scores be useful in psychiatry? A review. JAMA Psychiatry, 78(2), 210-219.
- Pereira, S., Carmi, S., Altarescu, G., Austin, J., Barlevy, D., Hershlag, A., Juengst, E., Kostick-Quenet, K., Kovanci, E., Lathi, R. B., Mukherjee, M., Van den Veyver, I., Zuk, O., Lázaro-Muñoz, G., & Lencz, T. (2022). Polygenic embryo screening: Four clinical considerations warrant further attention. Human Reproduction, 37(7), 1375-1378.
- Lencz, T., Backenroth, D., Granot-Hershkovitz, E., Green, A., Gettler, K., Cho, J. H., Weissbrod, O., Zuk, O., & Carmi, S. (2021). Utility of polygenic embryo screening for disease depends on the selection strategy. eLife, 10, Article e64716.
- Karavani, E., Zuk, O., Zeevi, D., Barzilai, N., Stefanis, N. C., Hatzimanolis, A., Smyrnis, N., Avramopoulos, D., Kruglyak, L., Atzmon, G., Lam, M., Lencz, T., & Carmi, S. (2019). Screening human embryos for polygenic traits has limited utility. Cell, 179(6), 1424-1435.e8.
- Soda, T., Merner, A. R., Small, B. J., Torgerson, L. N., Muñoz, K., Austin, J., Storch E. A., Pereira, S., & Lázaro-Muñoz, G. (2023). Child and adolescent psychiatrists' use, attitudes, and understanding of genetic testing and pharmacogenetics in clinical practice. Psychiatry Research, 325, Article 115246.
- Pereira, S., Muñoz, K. A., Small, B. J., Soda, T., Torgerson, L. N., Sanchez, C. E., Austin, J., Storch, E. A., & Lázaro-Muñoz, G. (2022). Psychiatric polygenic risk scores: Child and adolescent psychiatrists' knowledge, attitudes, and experiences. AJMG Part B: Neuropsychiatric Genetics, 189(7-8), 293-302.
- Meyer, M. N., Tan, T., Benjamin, D. J., Laibson, D., & Turley, P. (2023). Public views on polygenic screening of embryos. Science, 379(6632), 541-543.
- Furrer, R. A., Barlevy, D., Pereira, S., Carmi, S., Lencz, T., & Lázaro-Muñoz, G. (2024). Public attitudes, interests, and concerns regarding polygenic embryo screening. JAMA Network Open, 7(5), Article e2410832.
- Barlevy, D., Cenolli, I., Campbell, T., Furrer, R., Mukherjee, M., Kostick-Quenet, K., Carmi, S., Lencz, T., Lázaro-Muñoz, G., & Pereira, S. (2024). Patient interest in and clinician reservations on polygenic embryo screening: a qualitative study of stakeholder perspectives. Journal of Assisted Reproduction and Genetics, 41, 1221–1231.
- Furrer, R., Carmi, S., Lencz, T., & Lázaro-Muñoz, G. (2023). Nurtured genetics: Prenatal testing and the anchoring of genetic expectancies. American Journal of Bioethics, 23(3), 42-44.
- Brannan, C., Foulkes, A. S., & Lázaro-Muñoz, G. (2019). Preventing discrimination based on psychiatric risk biomarkers. AJMG Part B: Neuropsychiatric Genetics, 180(2), 159-171.
- Palk, A. C., Dalvie, S., de Vries, J., Martin, A. R., & Stein, D. J. (2019). Potential use of clinical polygenic risk scores in psychiatry – ethical implications and communicating high polygenic risk. Philosophy, Ethics, and Humanities in Medicine, 14, Article 4.
Suggested Citation
Lázaro-Muñoz, G., & Merner, A. (2023). Screening embryos for psychiatric conditions: Public perspectives, ethical and social issues. In ELSIhub Collections. Center for ELSI Resources and Analysis (CERA). https://doi.org/10.25936/zesc-f326
About ELSIhub Collections
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ELSIhub Collections are essential reading lists on fundamental or emerging topics in ELSI, curated and explained by expert Collection Editors, often paired with ELSI trainees. This series assembles materials from cross-disciplinary literatures to enable quick access to key information.