Generic consistency in the reproductive enterprise: ethical and legal implications for exclusion testing for Huntington's disease.

Abstract

This paper applies Alan Gewirth's Principle of Generic Consistency (PGC) to assess the morality of exclusion testing for Huntington's Disease (HD). Part 1 presents the PGC and outlines ways in which its use may be justified. Part 2 considers how the PGC might grant protection to potential agents as such (the moral status of which is problematic under the PGC). Part 3 contends that the morality of exclusion testing rests not only on its implications for the fetus (at most a potential agent), but also on the intended relations between the possibly affected parent and the future “child-when-agent” (CA) (born after a negative test) that are intrinsic consequences of the central motivation for exclusion testing. Part 4 argues that the PGC renders it immoral, all things being equal, to permit exclusion tests on the fetus unless CA is granted (under specified circumstances) a right to find out whether the at risk parent is carrying the mutation for HD, with the implication that it is morally wrong for the at risk parent to be provided with the results of an exclusion test unless a legally binding duty is imposed on him or her to undergo a mutation test at CA's request. This right and its correlative duty might, however, be overridden by conflicting rights-considerations. The complexities of such an assessment are indicated.