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Abstract
The Human Genome Project has triggered a technological revolution that has influenced nearly every field of medicine, including reproductive medicine, obstetrics, gynecology, andrology, prenatal genetic testing, and gene therapy. This second edition of Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies offers a thorough, timely discussion of ethical issues raised by the latest genetic and genomic technologies applied in human reproductive and prenatal medicine, providing practical recommendations, guidelines, and algorithms to support ethical clinical practice. Here, international experts consider the ethics of technologies from preconception carrier screening to genetic engineering, CRISPR gene editing, mitochondrial gene replacement therapy, sex selection, predictive testing, secondary findings, embryo reduction, and the moral status of the embryo, genetic enhancement, and the sharing of genetic data. Throughout the book, contributors adopt a global, holistic perspective on applied challenges and the moral questions around the implementation of genetic reproductive technologies. The book is an ideal resource for practitioners, regulators, lawmakers, clinical researchers, genetic counselors, and graduate and medical students.This fully updated second edition examines new developments in the field, tackling ethical aspects of organoid development, recent advances in pharmacogenomics, direct-to-consumer genetic testing, and genetic engineering
Intro -- Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies -- Copyright -- Contents -- Contributors -- Chapter 1: Genomic editing: From human health to the ``perfect child´´ -- 1. Introduction -- 1.1. Beginnings -- 1.2. Definitions and context -- 1.3. Recombinant DNA technology: The basis for DNA modification -- 1.4. Genome editing -- 1.4.1. Meganucleases -- 1.5. Zinc finger nucleases (ZFNs) -- 1.5.1. Transcription activator-like nucleases (TALENs) -- 1.6. CRISPR/Cas9 technology -- 1.7. Base editing technology -- 1.8. Principles of using genome editing in research and clinical practice -- 2. Ethical issues in clinical genome editing -- 2.1. Nonmaleficence and risk/benefit assessment -- 2.1.1. Risk-to-benefit analysis -- 2.2. Beneficence in gene editing therapies -- 2.3. Respect for autonomy -- 2.4. Confidentiality -- 2.4.1. Germline editing -- 2.4.2. The He Jiankui affair and the aftermath -- 2.5. Applying the principle of justice in clinical genome editing -- 2.6. Eugenics, enhancement, and ``designer babies´´ -- 3. Conclusions -- References -- Chapter 2: Ethics of mitochondrial gene replacement therapy -- 1. Introduction -- 2. What is mitochondrial disease and mitochondrial donation? -- 3. The UK timeline -- 4. The international position -- 5. Are the techniques safe? -- 6. Ethical issues -- 7. ``Three parent babies´´ and identity -- 8. Genetic modification and the ``slippery slope´´ -- 9. Risks for egg donors -- 10. Ethical differences between PNT and MST -- 11. Mitochondrial disease as complex: Diagnosis, predicting risk, and genetic counseling -- 12. Alternative reproductive options -- 13. Polar body transfer and gene editing -- 14. Conclusion -- References -- Further reading -- Chapter 3: Reproductive technologies used by same-gender couples -- 1. Introduction -- 2. Procreative autonomy.
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Front Cover -- Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies -- Copyright -- Contents -- Contributors -- Chapter 1: Genomic Editing-From Human Health to the "Perfect Child -- 1. Introduction -- 1.1. Definitions and Context -- 1.2. Recombinant DNA Technology-The Basis for DNA Modification -- 1.3. Genome Editing -- 1.3.1. Meganucleases -- 1.4. Zinc Finger Nucleases (ZFNs) -- 1.4.1. Transcription-Activator Like Nucleases (TALENs) -- 1.5. CRISPR/Cas9 Technology -- 1.6. Base Editing Technology -- 1.7. Principles of Using Genome Editing in Research and Clinical Practice -- 2. Ethical Issues in Clinical Genome Editing -- 2.1. Nonmaleficence and Risk/Benefit Assessment -- 2.1.1. Risk to Benefit Analysis -- 2.2. Beneficence in Gene-Editing Therapies -- 2.3. Respect for Autonomy -- 2.4. Confidentiality -- 2.4.1. Germline Editing -- 2.5. Applying the Principle of Justice in Clinical Genome Editing -- 2.6. Eugenics, Enhancement, and "Designer Babies -- 3. Conclusions -- References -- Further Reading -- Chapter 2: Ethics of Mitochondrial Gene Replacement Therapy -- 1. Introduction -- 2. What Is Mitochondrial Disease and Mitochondrial Donation? -- 3. The UK Timeline -- 4. The International Position -- 5. Are the Techniques Safe? -- 6. Ethical Issues -- 7. "Three-Parent Babies" and Identity -- 8. Genetic Modification and the ``Slippery Slope´´ -- 9. Donating Eggs (Risks and Benefits) -- 10. Differences Between PNT and MST -- 11. Mitochondrial Disease as Complex: Diagnosis, Predicting Risk, and Genetic Counseling -- 12. Alternative Reproductive Options -- 13. Polar Body Transfer and Gene Editing -- 14. Conclusion -- References -- Further Reading -- Chapter 3: Reproductive Technologies Used by Same Gender Couples -- 1. Introduction -- 2. Procreative Autonomy -- 3. Gamete and Embryo Donation -- 4. Surrogacy Agreement
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