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01 / 05
The Potential of Embryonic Screening

Blog Post | Pregnancy & Birth

The Potential of Embryonic Screening

A new frontier in reproductive freedom rekindles old ethical questions.

Summary: New genetic screening technologies may soon allow parents to select embryos based on predicted risk for hundreds of diseases, potentially reducing the incidence of severe childhood conditions like Tay–Sachs and SMA I. This has sparked ethical debates about reproductive freedom, disability rights, and inequality. Philosopher Jessica Flanigan defends access to embryo information, arguing that ethical drawbacks don’t outweigh the benefits of empowering parents to promote well-being in future generations through genetic screening.


Starting with an inability to crawl, sit up, or turn over, infants with Tay–Sachs disease soon experience seizures, severe hearing loss, and paralysis—and can expect to live no more than five years before the neurons in their spinal cord and central nervous system give out.

Because of congenital heart defects and fatal respiratory problems, only 60 to 75 percent of infants born with Edwards syndrome live past the first week of life, and only 10 percent live past their first year. 

Without medical interventions, such as the $2 million gene therapy Zolgensma, infants with spinal muscular atrophy type 1 (SMA I) often die from respiratory failure within the first two years of life, making SMA I the most common genetic cause of death for infants. 

On June 4, 2025, Nucleus Genomics announced that it will offer preimplantation genetic disorder screening for in vitro fertilization embryos, which can predict 900 conditions, including genetic abnormalities and propensities for Alzheimer’s, heart disease, and various cancers. Although the accuracy of polygenic screening is contested, Nucleus’s founder, Kian Sadeghi, argues that prospective parents ought to be privy to what genetic variants will predispose their children to diseases.

For instance, although heart disease is in large part determined by one’s lifestyle choices, parents may prefer an embryo without a genetic predisposition for heart disease if they’ve lost loved ones to heart attacks and strokes. Thus, Nucleus’s screening, if accurate, would not only prevent tragic premature deaths from fatal genetic disorders but also increase potential well-being and longevity for individuals well into their adult lives. 

Nucleus Genomics plans to charge $5,999 for the service. As of July 2025, no other preimplantation screening of a similar scope is offered at a price that low—other companies’ prices often range from $15,000 to $20,000. Thus, there may be a future where extensive genetic prescreening is more affordable for couples undergoing in vitro fertilization (IVF). Nucleus also intends to include prediction of physical characteristics such as height, hair color, and eye color for the given embryos.

What are we to think of this innovation? The philosopher Jessica Flanigan from the University of Richmond is finishing her book, The Ethics of Expecting, in which she argues that an important aspect of reproductive freedom is the freedom to access information on the embryos being implanted in your body. In an interview with Flanigan, I raised some common objections to embryonic screening. Here are her responses.  

Some bioethicists worry that selection based on certain traits in embryonic screening expresses to the world that people with certain traits are less valuable (“the expressivist objection”). This is particularly pertinent for members of disabled communities, such as people who are deaf or blind, traits that may be routinely selected against.

Flanigan acknowledges that one can feel hurt that some of their particular traits are not selected for by other people. However, this harm is not too different from the harm one may feel when selected against in dating.  

Furthermore, this harm does not oblige other people to select the traits the offended people have. Flanigan recognizes that the ableist discrimination some disabled people face is a serious injustice. “We should focus more on supporting existing disabled people, but this does not obligate us to create more disabled people so that the existing disabled people can feel supported,” says Flanigan.  She adds that when it comes to reproductive rights, “disabled people are not entitled to limit the freedom of nondisabled people.”

Some worry that even at Nucleus’s lower price, only the rich will be using embryonic screening, and thus their offspring will be even more advantaged compared with low-income children.

As Flanigan argues, the US health care market drives innovation for the whole world. Its market incentives encourage more companies to invest in research and development and in quickly producing new drugs and medical technologies. When these drugs and technologies are first introduced to the market, they are often available only to those who can afford them and thus necessarily create short-term health inequalities.

Once a technology or drug is publicly recognized as effective, however, insurers begin to cover that innovation, and the treatment becomes more widely available to the public. Even if these short-term inequalities do harm, it’s hard to justify restrictions given the potential for long-term equality. “You would never say we should have never made the computer because early on only rich people had access to computer processing and that wasn’t fair. Because now you can get a laptop on Amazon for $65,” Flanigan notes.

Furthermore, Flanigan argues that assisted reproduction at large can create greater social equality—for example, helping gay couples start families. Embryonic screening will also allow couples with genetic predispositions to severe diseases to ensure that their future children lead healthier lives than their ancestors.  

A compelling argument against advanced embryo selection of this kind is that the world would lose an important diversity of human experience if all embryos were selected for the most advantageous qualities. In Denmark, for instance, only 23 to 35 children per year were born with Down syndrome between 2004 and 2020 as a result of increases in prenatal screening, despite nearly all individuals with Down syndrome reporting high life satisfaction. 

This diversity concern, Flanigan thinks, is a bit overblown. “The human genome is incredibly rich and diverse.” We live in a gene pool with more and more people reproducing outside of their race, region, and ethnicity. Even if we all select the tallest out of a given set of embryos, Flanigan argues, this would not meaningfully diminish the genetic diversity and randomness of the human genome.

Importantly, “there are some kinds of diversity we don’t experience, and that’s great! Today, there is less variation in how many children die before they’re five.” If we can limit the diversity of infant suffering or painful genetic diseases, this would improve the well-being of future generations.

Perhaps some will decide that they would rather select for rather than against Down syndrome, knowing that their children may be happier. That selection, however, ought not to be decided by anyone besides those procreating. Flanigan predicts that many couples will reject the practice of embryo selection completely and thus there will still be “naturally” genetically diverse embryos. Whether or not you are convinced by these arguments, it is important to note that embryo selection is not the same as a “designer baby” or using genetic tailoring such as CRISPR to control for particular traits. The embryo a couple selects could possibly have been the one that was born naturally; it was one probability among many.

Even if couples were more inclined to pick embryos with particular physical traits, it is unclear that these preferences would be stable across time, as cultural norms and beauty standards shift. For instance, despite a stronger preference for males during China’s one-child policy, The Economist recently reported a preference shift for females among new parents. 

Nevertheless, IVF is still not widely used. It is characterized by high prices ($15,000 to $30,000 for each cycle) and invasive procedures, and we are far from a future where all soon-to-be parents select among embryos. But if preimplantation genetic disorder screenings for IVF do become common and accurate, future generations may be healthier than ever before.

  

Phys.org | Communicable Disease

French Firm Bets on Sterile Mosquitoes

“Inside a factory in southern France, millions of tiger mosquitoes are being bred, not to spread, but to stop them from reproducing—though scaling up such efforts poses a mighty challenge.

At the Terratis facility in Montpellier, male insects grow inside large glass enclosures. In batches of 400,000, they are exposed to X-rays, making them infertile…

The aim is to flood an area with sterile male mosquitoes until the invasive population gradually collapses…

The tiger mosquito (Aedes albopictus), which can transmit diseases such as dengue, the Zika virus and chikungunya, is now present across most of France.

But enhancing efforts to ramp down their numbers remains difficult. Of around 50 industrial projects being developed worldwide, Terratis—founded in 2024—is seen as one of the most promising.

The startup produces 1.5 million sterile mosquitoes per week and aims to reach 40 million within two years.”

From Phys.org.

Blog Post | Mental Health

Behind the Boom in Psychiatric Medication

Recent spikes in anxiety, ADHD, and other diagnoses have more than a little to do with economic incentives.

Summary: Psychiatric diagnoses and medication use have risen sharply in the United States, raising concerns about overdiagnosis and overprescription. Expanded diagnostic criteria and reimbursement incentives are likely contributing to these trends. A recent US Department of Health and Human Services (HHS) initiative—which promotes informed consent, regular reassessment of psychiatric medications, and support for tapering patients off unnecessary drugs—is a step in the right direction, but reducing unnecessary medication use may require broader reforms to the policies and financial structures that shape mental-health care.


Health Secretary Robert F. Kennedy Jr. announced an initiative last week to reduce the overprescribing of psychiatric medications, especially among children. In what’s being called a national mental-health crisis, psychiatric diagnoses in almost every category are reaching all-time highs. The Centers for Disease Control and Prevention reports that autism now appears in 1 in 31 children, a 381% increase since 2000. Childhood attention-deficit/hyperactivity disorder diagnoses nearly doubled between 1997 and 2022. Childhood anxiety diagnoses rose 54% between 2016 and 2022. Past-year prevalence of any mental illness among adults reached 23.1% in 2022, with young adults at 36.2%.

But much of the supposed surge in mental illness can be explained by a broadening of the American Psychiatric Association’s diagnostic criteria in recent decades and financial incentives for diagnosing more. The Mental Health Parity and Addiction Equity Act of 2008, extended by the Affordable Care Act in 2010, required health plans to cover mental-health services at parity with medical and surgical care. That addressed a genuine inequity in coverage, but made it so clinicians are paid more when they diagnose more cases.

The result is what economists call supplier-induced demand. Ideally, increased spending on mental-health care would yield better mental-health outcomes. Instead we have seen the opposite. Between 2000 and 2021, mental-health care spending in the U.S. more than tripled, from $40 billion to $140 billion, while mental-illness rates grew almost as dramatically.

Defenders of mental-health parity argue that spending and diagnoses are rising to meet previously unmet needs. But psychiatry is more subjective than other branches of medicine. No objective cutoff distinguishes ordinary worry from clinical anxiety, or grief from clinical depression. Findings are prone to distortion under the influence of nonpsychiatric factors.

When the National Institute of Mental Health says that half of all American adolescents have experienced mental illness, that isn’t psychiatry advancing as a field. It’s the result of various incentives for pathologizing ordinary struggle.

Wasteful spending and panic over a possibly nonexistent mental-health crisis would be bad enough. But psychiatric overdiagnosis creates an even more serious problem: overmedication. Roughly 1 in 6 American adults, an estimated 44 million people, are now on antidepressants. In young adults, those numbers are even higher. Thirty percent of college students take psychiatric medication, up from 9% in 2007.

For adults with mental conditions resistant to therapy, psychiatric medication can be effective. But we don’t understand the long-term consequences of many psychiatric drugs, particularly on young brains. We are running a large uncontrolled experiment on the developing brains of millions of young people, and we won’t know the full results for decades.

Meanwhile, the reimbursement architecture makes overmedication practically inevitable. Once a patient is on a drug, side effects are often addressed with a second drug rather than with a reassessment of the first. Clinicians call this the “prescribing cascade”: An antidepressant causes insomnia, so a sleep aid is added; a stimulant causes irritability, so a mood stabilizer follows. Each new prescription generates a billable visit, while tapering a patient off an ineffective drug takes time, monitoring and follow-up, which the billing system frequently doesn’t reimburse. Adding a prescription is the fastest, most reimbursable response at every stage of care.

The new HHS initiative rightly recognizes the harms of overprescription and the potential for negative side effects from long-term psychiatric medication in young people. It includes new reimbursement for clinicians who help patients taper off drugs, a “Dear Colleague” letter urging informed consent and regular reassessment, and a technical expert panel to develop formal tapering guidelines this summer.

These are sensible steps, but they don’t address the root cause. The fundamental problem is that federal law created an incentive structure that makes psychiatric medication the default for tens of millions of Americans who might be better served by therapy, lifestyle intervention or no clinical intervention at all.

To get physicians to stop overprescribing, the institutions that shape their choices should offer a greater reward for prescribing sparingly. In addition to new billing codes for deprescribing, what’s needed is a serious examination of whether the coverage mandates and reimbursement structures the ACA put in place are producing the outcomes they promised.

The mental-health system has improved over the past half-century. Effective treatments are more widely available, and people are more willing than ever to seek help. But the same mandates that have increased access to mental-health care have made overdiagnosis and overmedication the path of least resistance for a generation of clinicians and patients.

This article was originally published at the Wall Street Journal on 5/10/2026.

Breastcancer.org | Noncommunicable Disease

FDA Approves drug for Metastatic ER-Positive Breast Cancer

“On May 1, 2026, the U.S. Food and Drug Administration (FDA) approved vepdegestrant (brand name: Veppanu) to treat estrogen receptor-positive, HER2-negative advanced stage or metastatic breast cancer with an ESR1 mutation that grew after being treated with hormonal therapy.

The approval was based on results from the VERITAC-2 trial, which compared vepdegestrant to Faslodex (chemical name: fulvestrant). The results showed that vepdegestrant was more effective for people with metastatic estrogen receptor-positive, HER2-negative breast cancer with an ESR1 mutation that grew while being treated with hormonal therapy and a CDK4/6 inhibitor. The people in the study who took vepdegestrant lived three months longer without the cancer growing than those who received Faslodex. And more of the cancers responded to vepdegestrant than Faslodex — 19% vs. 4%.

Vepdegestrant is a new type of oral selective estrogen receptor downregulator or degrader (SERD) called a PROTAC (proteolosys-targeting chimera). Like other SERDs, vepdegestrant works by blocking estrogen from attaching to cancer cells in the breast. It also destroys the estrogen receptors on the cancer cells and changes the shape of the receptors so they don’t work as well. Because it is a PROTAC, it breaks down the estrogen receptors in a different way than other SERDs.”

From Breastcancer.org.

South China Morning Post | Noncommunicable Disease

Therapy Could Turn Advanced Lung Cancer Into Chronic Illness

“A Hong Kong co-led global study has found that a targeted therapy can keep more than half of advanced lung cancer patients alive without disease progression for at least seven years, marking a step towards turning the deadly illness into a chronic condition.

Researchers from the Chinese University of Hong Kong on Wednesday released the findings of their study, which looked into the efficacy of the third-generation targeted therapy lorlatinib on patients with advanced lung cancer.

The study followed 296 previously untreated patients with advanced ALK-positive non-small cell lung cancer – a type of lung cancer caused by an abnormal rearrangement of the anaplastic lymphoma kinase gene – for seven years from 2019 to 2025. The patients came from multiple regions, such as Hong Kong, mainland China, the United States and Europe.

Among them, 149 patients were given lorlatinib while the remaining 147 received the first-generation agent crizotinib as the control group.

Results showed that 55 per cent of those taking lorlatinib as a first-line treatment experienced no disease progression at seven years, while a rate of only 3 per cent was recorded among those receiving crizotinib.”

From South China Morning Post.