13 - Selective termination of pregnancy and preimplantation genetic diagnosis: some ethical issues in the interpretation of the legal criteria

Summary

Introduction

This chapter considers some of the ethical issues at stake in the legal interpretation of the grounds for selective termination of pregnancy on the one hand and preimplantation genetic diagnosis (PGD) on the other. Termination of pregnancy is legal under section 1(1)(d) of the Abortion Act 1967 (as amended by the Human Fertilisation and Embryology [HFE] Act 1990) if two doctors have formed an opinion in good faith that ‘there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped’. These terms leave considerable scope for interpretation, particularly about what is meant by ‘seriously’, and to date there has been no direct judicial interpretation of this section. In a similar but not identical vein, PGD is legal if there is a significant risk ‘that a person … will have or develop a serious physical or mental disability, a serious illness or any other serious medical condition’. In both cases, then, great reliance is placed on the idea of seriousness. A certain degree of risk is also essential in both cases – a substantial risk in the context of termination of pregnancy and a significant risk in the case of PGD. In this chapter, I focus on some of the difficulties in interpreting seriousness in either context. My analysis will draw on a key and widely endorsed distinction in the bioethics literature between a life that may not be worth living and one that is worth living.