Simone Bateman

Much more than a gene: hereditary breast and ovarian cancer, reproductive choices and family life

This article presents the results of a study that investigates the way in which carriers of a mutation on the BRCA1 or the BRCA2 gene, associated with a high risk of breast and ovarian cancer, make their reproductive decisions. Using semi-structured interviews, the study explored the way in which these persons reflected on the acceptability of taking the risk of transmitting this mutation to the next generation, the arguments they used in favor or against taking that risk, and in the light of these arguments, their opinion on the acceptability of preimplantation genetic diagnosis (PGD) as a reproductive option. The findings suggest that when carriers are planning to have a(nother) child, they are mainly concerned by the risk of transmitting ‘much more than a gene’: essentially painful experiences not only with respect to health, such as undergoing cancer surveillance or combatting one’s own illness, but also with regards to family life, such as witnessing the illness and death of a close relative, encountering difficulties in finding a partner or reconsidering one’s plans to have a family. As for opinions concerning the acceptability of PGD as a reproductive option, opinions about personal recourse were varied but all expressed the understanding that PGD should be made available to those persons who consider it their best option.

The Concept and Practices of Human Enhancement: What Is at Stake?

Human enhancement has generated a considerable amount of debate, with little concern as to what precisely is meant by this term and to what concrete practices it refers. Some authors, mostly philosophers, have offered formal definitions of the term; many others have often simply provided working definitions or based their reflections on an implicit understanding of the term (Menuz et al., 2013). We do not intend here to propose yet another definition, but to identify and characterize the contexts in which new uses of the term enhancement have emerged and to provide, on this basis, some points of reference as to what is at stake.