Characterizations of the post-PGD embryo -- the laws and policies of four countries.

New technical possibilities, clinical considerations and research purposes are influencing both how we look at the embryo and what we look for. The characterization of human embryos is influenced by and plays an important role in determining the possible uses and non-uses of an embryo by women undergoing IVF, clinicians and scientists. Through PGD, embryos created by IVF are selected for transfer based on particular characterizations, including the presence of genetic markers or a tissue match for a sibling. Most legislation regarding assisted reproductive technologies does not regulate directly with respect to PGD, therefore governments and professional bodies have undertaken policy analyses to determine the appropriate regulatory framework for PGD. We examine the precise language used in the recent policy and regulatory documents of four jurisdictions (the UK, Australia, Canada and New Zealand) that in any way characterizes the post-PGD embryo. We then explore the mutually constructed relationship between how that embryo is characterized and the purposes for which PGD is applied, as well as the types of uses to which the post-PGD embryo is ultimately relegated. As our analysis indicates, based on the information provided through PGD, a number of possible categorizations of the post-PGD embryo emerge depending both on the outcome of PGD and the initial intention behind the procedure. In the context of this examination we reveal how understandings of embryo 'health' are being produced through the clinical practice and scientific application of PGD. This paper introduces and analyses five overarching categories that have emerged from our analysis of the documents: (i) the affected embryo; (ii) the unaffected embryo; (iii) the sex-selected embryo; (iv) the human leukocyte antigen-typed embryo; and (v) the carrier embryo. Through our analysis of these categories and their implications for use and non-use of the post-PGD embryo, we conclude that the legal and policy-based characterizations raise important social and ethical questions that must be examined as the regulation of assisted reproductive technology develops internationally. Driven by imperatives such as reproductive autonomy, the desire for children of particular characteristics, 'disease' prevention and the need for new sources of embryos, particularly 'fresh' embryos, for research purposes, clinicians, patients, researchers and policy makers are circumventing debates about the social dimensions of using PGD for a growing number of genetic indications. We suggest that assumptions behind the characterization of human embryos in both law and policy must be exposed and examined to ensure that reproductive technologies benefit all members of society. [ABSTRACT FROM AUTHOR]