Approach one: ‘My choice my right’

Mothers / parents should have the right to decide:

• whether or not to use IVF with PGD in order to choose a particular embryo
• to select any embryo they wish to transfer to become pregnant
• whether or not to have screening and testing during pregnancy
• whether to continue or terminate a pregnancy.

Decisions whether to begin or continue a pregnancy involve the woman’s right to control her own body, the father’s interests, and the rights of the whānau / family. Mothers / parents are in the best position to know whether a decision is right for them and their whānau / family.

Reproductive autonomy

Current law and practice allows women / parents considerable freedom to make their own choices with regard to pregnancy.

Women / parents can generally choose whether or not to have screening, diagnostic tests or both, and decide whether or not to continue the pregnancy based on the results.

However, currently there are some limits on reproductive freedom:

• Using PGD for sex selection (choosing to have a boy or a girl by selecting a particular embryo) is prohibited unless it is done to prevent or treat a genetic disease. Supporters of approach one think that mothers / parents should be able to choose either a girl or a boy. Supporters argue that there is no noticeable preference for a particular sex in New Zealand, so allowing sex selection would make little difference to the overall number of boys and girls

• Women / parents can only use PGD to avoid a genetic condition if the fertility clinic, together with a clinical geneticist, decides that the child is likely to seriously impaired. Supporters of approach one say that women / parents should be able to use PGD for whatever purpose they wish, as they are best equipped to decide what will be serious in their particular circumstances

• Use of PGD to create a ‘saviour sibling’ needs the approval of an ethics committee. Supporters of approach one say that it is a private matter for them to decide, if they had a sick child and wanted to use PGD to select an embryo. They do not believe that an ethics committee should have the power to interfere in what is an intensely personal matter

• Another limit at present is that PGD may not be used to select embryos with a genetic impairment seen in a parent, for example, deaf parents who want a deaf child. Supporters of approach one say that if parents are using PGD they should be free to select whatever embryo they wish to transfer to the mother, even if the embryo carries some genetic condition. They point out that most embryos have some genetic differences and it is not always clear whether these will affect the child. They consider this is a choice that should be left to the women / parents.

Supporters of approach one: ‘my choice my right’ say that testing regimes cannot give us definite answers. There is always some level of uncertainty. Mothers / parents who support approach one say that they and their families are most affected and so they are in the best position to make these complex decisions. They do not accept that these are matters that should be controlled by the government or overseen by ethics committees.

Healthy child

People supporting approach one: ‘my choice my right’ argue that most parents want a healthy child. They point out that it distresses parents if their child suffers pain, needs to undergo invasive medical treatments or may die. They say that parents are in the best position to assess whether they would have the financial and emotional resources to raise a disabled child. The considerable costs involved in supporting a child with a chronic illness or disability might include harm to parental well-being, employment, career, earnings, savings and relationships, including relationships with their other children.

Less government interference

Supporters of approach one: ‘my choice my right’ believe in the protection of individual rights. They believe that regulating reproductive decisions means that the government is eroding personal freedoms, allowing the government to increase its control over individuals. If the government regulates reproductive decisions, it disregards personal choice and personal responsibility by making the decisions for women / parents.

Supporters argue that if women / parents are able to pay for tests they should be able to have them. They point out that they would, in any event, be able to get any tests they want overseas. Some say that with unlimited choice mothers / parents should be personally responsible for funding the costs of the tests.

What can be done?

• remove all restrictions on PGD, pre-birth testing and abortion.

For and against the approach ‘my choice my right’

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