A Health Policy Ethics Approach Developing Recommendations for Regulation of Preimplantation Genetic Diagnosis in Canada

This dissertation provides ethically informed policy recommendations for the regulation of Preimplantation Genetic Diagnosis (PGD) in Canada. It tackles three interrelated policy questions: (1) PI: Should parents be permitted to use PGD in order to avoid implanting embryos found to be carrying disabling traits? (2) P2: Should parents be permitted to use PGD in order to intentionally implant embryos found to be carrying disabling traits? (3) P3: Should parents undergoing IVF be required to use PGD to avoid implanting embryos found to be carrying disabling traits?;Reproductive freedom in Canada is found to have both a firm ethical foundation and strong legal standing such that it should be understood by policy makers as a strong, though not inviolable, negative right. A rough threshold for determining when an ethical concern is of significant weight to require the state to restrict reproductive freedom is developed through an analysis of existing legal limits and protections. Disability is found to be best understood as an interaction between biomedical factors and the social environment, resulting in a rejection of purely medical and social models of disability. Non-person affecting harm to potential future persons is found to be insufficient grounds for restricting the rights of living persons. The maximizing principle is found to be incompatible with justice as fairness, reinforcing society and social institutions as the proper domain of justice.;This dissertation concludes that the ethical concerns raised by screening on the basis of disability status fail to meet the threshold for restricting reproductive freedom. It is recommended that the state allow parents to use PGD to select between embryos on the basis of disability status, and that it refrain from imposing coercive genetic screening.;In answering these questions, this dissertation explores four keys areas of philosophical inquiry: the scope of reproductive freedom, the nature of disability, the nature of harm to future persons, and the demands of justice in the genetic age.