The Mediating Powers of Reproductive Technologies: An ethical technology assessment of Preimplantation Genetic Diagnosis, Non-Invasive Prenatal Testing, Sperm sorting and CRISPR/Cas9

Abstract

This thesis is an ethical technology assessment of the reproductive technologies Preimplantation Genetic Diagnosis (PGD), Non-invasive Prenatal Testing (NIPT), sperm sorting and CRISPR/Cas9. It analyzes the mediating effects of these four technologies on the experience and actions of prospective parents, and on (1) the concept of reproductive autonomy, (2) the goals of medicine and (3) the slippery slope arguments. This is done with the use of the technology mediation approach, which is based on a post-phenomenological perspective that understands an intertwined relation between technology and human beings and between technology and ethics. By means of this approach, it becomes possible to understand the impact of technology on our ethical reflection, and it allows for insight which is useful for the evaluation and (re)designing of technologies. This thesis extracted eight mediating effects of the four reproductive technologies on both the experience and actions of prospective parents, namely four mediations of experience: (1) perception of the unborn, (2) reproduction as a decision-making process, (3) perception on diseases and disabilities, and (4) experiencing risks. And four mediations of praxis: (5) the praxis of choosing, (6) having to choose a child, (7) decisions about what lives are worth living, and (8) weighing risks. These mediating effects have both an increasing and decreasing effect on the concept of reproductive autonomy, they put pressure on the concepts of health and disease in the goals of medicine, and they show how the decision-making mechanism contributes to the idea of a slippery slope towards ‘eugenics’ and ‘designer babies’. These results show a shift in perceptions and actions regarding reproduction and are useful as content for the evaluation and (re)designing of the reproductive technologies.