Germ-line gene therapy, in which genetic flaws are corrected in the DNA of externally fertilized human embryos, lies in the distant yet foreseeable future. Worries about germ-line therapy have prompted international bodies to craft guidelines that are unusual for their anticipatory nature. Motivating these guidelines is the idea that a “transnational harmonization” of principles should be reached before national policies are developed. This article reviews selected national policies and international recommendations, and it concludes that national policies should be precedents for, rather than descendants of, international normative codes. The inclination to develop morally-based codes, which is implicit in transnational harmonization, will be more useful if grounded in empirically-based medical technologies and politically-tested policies rather than on abstract principles developed well in advance of technological feasibility.

Preimplantation genetics describes a newly-emerging field in medical genetics, the consequence of the implementation of clinical preimplantation diagnosis and the likely future development of germ-line gene therapy. Given the existing clinical and laboratory difficulties already demonstrated in preimplantation diagnosis and the sensitive ethical issues surrounding genetic manipulation of human embryos, there is a need for 1) critical and objective evaluation of developments in this field by human and medical geneticists and 2) development of guidelines for research and clinical practice in the years ahead. We propose a course of prospective action for preimplantation genetics implemented through the newly-formed American College of Medical Genetics in order to address the ethics, safety, accuracy, cost, and overall merit of preimplantation genetics.

In 1993, investigators from George Washington University (GWU) Medical Center separated the cells of 17 human embryos and produced 48 embryos, an average of three embryos for each original. The method, variously called twinning, cloning, embryo splitting, and blastomere separation, demonstrated that human embryos could be split to create genetically identical entities during conception. When publicized, however, the experiment brought to mind a different view of cloning repeated since the beginning of the new reproductive technologies. In the early 1970s, when research onin vitrofertilization (IVF) was in its infancy, commentators worried that cloning–defined as the duplication of persons–would be next, leading to a scenario of “boys genetically exactly like the father, girls like the mother, or individuals like some true or false hero of art, science, or sports, or like some demagogue or some saint.”

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