State Intervention in Couples’ Reproductive Decisions: Socioethical Reflections Based on the Practice of Preimplantation Genetic Diagnosis in France

Abstract

Adopting socioethical and anthropological perspectives, this article addresses the impact of state intervention in the reproductive life of couples who consult for preimplantation genetic diagnosis (PGD) in France. Our main objective is to identify and analyze the socioethical problems flowing from French legislation as related to PGD and from its implementation. Methods included review and analysis of the relevant literature, ethnographic research in the three centers accredited to perform PGD, and participant observation (990 hours), with 79 semistructured interviews. Ethical problems identified were: (1) discrimination based on sexual orientation and the requirement for adherence to a traditional model of the couple and the family; (2) inequities in access to PGD; (3) restrictions on couples’ autonomy; and (4) breaches of respect for private life. We conclude that the state could improve the ethical conditions in which PGD is practiced by: (1) establishing educational programs in ethics to support members of multidisciplinary centers for prenatal diagnosis; (2) conducting empirical studies on the social acceptability of PGD; and (3) conducting empirical studies on the extent of state intervention in the reproductive life of couples likely to have recourse to reprogenetic services.