#polygenictesting — Public Fediverse posts
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DATE: September 15, 2026 at 02:00PM
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-------------------------------------------------TITLE: Public treats risks for low intelligence and heart disease similarly when selecting embryos
People often report feeling more comfortable using genetic screening to avoid medical conditions than to select for non-medical traits. However, new research suggests that when prospective parents actually choose which embryo to implant, they tend to weigh non-medical traits just as heavily as medical ones. These findings, published in Nature Human Behaviour, indicate that the distinction between medical and non-medical traits becomes blurry when people make concrete reproductive choices.
Preimplantation genetic testing is a medical procedure used during in vitro fertilization. Before an embryo is transferred to a uterus, doctors extract a small number of cells and analyze the genetic material. Polygenic testing is a specific type of this analysis that looks at thousands of genetic variations at once.
Rather than identifying a single genetic mutation that causes a disease through a direct biological mechanism, polygenic testing relies on statistical models. It calculates a risk estimate by comparing an embryo’s DNA against population-level data. The resulting scores do not reveal an innate genetic predisposition or a fixed biological destiny. Instead, they provide a statistical estimate of the chances a person might develop complex characteristics, ranging from heart disease to intelligence.
Initial surveys established that the public is surprisingly open to screening embryos using these complex statistical scores. For instance, a 2023 study found that the American public is broadly willing to consider screening embryos for complex physical and behavioral traits.
Subsequent work revealed that non-Western populations might be even more accepting of selecting for non-medical traits. A 2025 survey indicated that people in Singapore were more receptive to using embryo screening for educational and cognitive outcomes than Americans were.
The new study takes the next step by testing whether people’s stated moral attitudes match how they act when weighing medical risks against personal traits. The research, led by Edmond Awad, a senior lecturer at the University of Exeter and senior research fellow at the University of Oxford, along with Julian Savulescu and Dominic Wilkinson, sought to understand if providing these statistical estimates shapes prospective parents’ choices, even if they initially express reluctance to test for non-medical traits.
“I have argued for a long time that when parents are choosing between embryos they have reason to choose the one expected to have the best life, and that the medical label is the wrong place to draw the line,” Savulescu, the Chen Su Lan centennial professor in medical ethics and director of the Centre for Biomedical Ethics at the National University of Singapore, told PsyPost. “This study was about what people actually do.”
“My hunch was that people would not sort attributes into medical and non-medical once a real choice was in front of them, and that they would go instead by how much an attribute would affect the child,” Savulescu explained. He noted that Awad had previously run the Moral Machine, which guided millions of people through online moral dilemmas about automated vehicles, making a similar approach ideal for this question. “Those pilots turned up a gap between what people said they wanted tested and what they did with the information once they had it.”
The authors noted a psychological phenomenon known as deliberate ignorance, where people might avoid learning about non-medical traits to sidestep ethical dilemmas. However, if a clinic provides that statistical information anyway, those same people might still use it to make reproductive decisions. The team recruited 1,467 adults in the United States for an online experiment. They focused on four specific attributes that a polygenic score might estimate. Two of these were medical conditions: heart disease and vision impairment. Two were non-medical traits: low cognitive ability and antisocial behavior.
The US participants were split into two separate groups. The first group was asked if they would be willing to use polygenic testing to calculate risk estimates for each of the four attributes. Participants simply answered whether they would say yes, no, or not sure to receiving this statistical information.
The results from this first group indicated that 66.7 percent of participants were willing to test for the medical conditions. A slightly lower portion, 61.4 percent, were willing to test for the non-medical traits. Though the preference for medical testing was higher, well over half of the participants still supported screening for intelligence and behavioral tendencies.
“This was a Registered Report. Our hypotheses and our analysis plan were reviewed and accepted by the journal in October 2025, before we collected any data, so the results could not be shaped after the fact,” Awad explained. “On the basis of our own pilot studies, and of other recent work, we registered a prediction that most people would not want testing for low IQ or antisocial behavior. The opposite happened. Sixty-one percent said they would.” He suggested this could be due to wording—asking about avoiding negative traits rather than selecting positive ones—or a general shift toward greater willingness to test.
The second group of US participants faced a different task. They were presented with hypothetical scenarios where genetic testing had already been completed on two viable embryos. The participants had to choose which embryo to implant based on statistical estimates for two of the four attributes. In these scenarios, the statistical models predicted that the embryos had either an average chance, a 5 percent above-average chance, or a 5 percent below-average chance of developing the assigned traits.
When forced to make a choice, participants avoided embryos with an above-average chance of undesirable non-medical traits just as strongly as they avoided those with medical conditions. “What we found was that in the US sample, an embryo with a higher-than-average chance of developing heart disease in later life was about 40 percentage points less likely to be chosen than one with an average chance,” said Wilkinson, a professor of medical ethics at the University of Oxford and consultant neonatologist. “For antisocial behavior the gap was 36 points, for low IQ 32 points, and for vision impairment 19 points.”
“In our studies we told participants that ‘above average’ meant 5 percentage points above the average chance,” Wilkinson added. “So a fairly small change in the odds for the future child produced a very large change in the choice. That will be familiar to anyone who counsels parents. People are not weighing probabilities the way a statistician would.” Savulescu agreed, noting that people care deeply about small probabilities when the stakes are high, and a “child’s life, how good it is, is a high stake.”
Participants penalized embryos for having a higher statistical risk of low intelligence or antisocial behavior to the same degree as a higher risk of heart disease. All three attributes were avoided much more strongly than a higher chance of vision impairment. The researchers also set up direct trade-off scenarios, forcing participants to choose between an embryo with a higher statistical risk for a medical condition and one with a higher statistical risk for a non-medical trait.
In these head-to-head comparisons, vision impairment was consistently tolerated more than any other attribute. Participants frequently chose to implant an embryo with a higher chance of vision issues if it meant avoiding a higher chance of low intelligence, antisocial behavior, or heart disease. The findings suggest that when genetic information is already available, the dividing line between medical and non-medical traits fades.
To see if these patterns held across different cultures, the researchers ran a similar experiment with 623 participants in China. These participants completed the embryo selection task without the initial willingness survey. The results were largely similar to the American group, demonstrating a widespread tendency to avoid non-medical traits when the statistical estimates are available. However, Chinese participants showed an even stronger aversion to embryos with a higher chance of low intelligence compared to the American group.
The researchers also asked participants to rate the four attributes on several dimensions, such as how controllable they are and how much they affect a person’s life. The team initially predicted that people would avoid traits that seemed harder to manage. Instead, the data suggests that perceived seriousness drove the decisions. If an attribute was seen as having a severe impact on a person’s life, participants avoided it, regardless of whether it was categorized as a medical condition or a non-medical trait.
“What people say they want tested does not tell you what they will do with the answer,” Savulescu said. “The label on an attribute is doing less work than people assume. What guided the choice was how serious the outcome seemed for the child. Doctors and regulators care about disease; people care about well-being, of their child and others.”
Wilkinson emphasized that this behavior shouldn’t be misconstrued: “This study does not show that people want designer babies,” he said. “What we found is that people want to avoid their children having genetic risk factors that might affect how well their life will go in the future. It is important to note that these were hypothetical scenarios and we don’t know what people would do in real life, especially when there are risks or financial costs involved.”
As with all research, there are a few things to keep in mind. The study relied on hypothetical scenarios that presented a flat 5 percent change in risk for all traits. In reality, polygenic scores for complex behavioral traits are currently less exact than scores for medical conditions. Presenting a uniform 5 percent shift in predictability might overstate the current capabilities of the technology for behavioral traits, making the choice seem simpler than it would be in a clinic.
“We do realize that our dilemmas are simplified versions of the trade-offs real parents face,” Awad said. “In a clinic the average chances differ from one attribute to the next, the numbers arrive with a margin of error, and how much each score is worth varies a great deal between attributes. We stripped all of that out on purpose, so that the only thing separating our four attributes was the attributes themselves rather than the way they were dressed up. That is what let us test the category question cleanly.”
Wilkinson also cautioned that “within a family, where the embryos share the same parents, polygenic prediction for behavioral traits such as cognitive ability is much weaker than our scenarios imply, so the real gains from selecting on them would be far smaller.”
Additionally, participants in the selection task were forced to make a decision based on the information provided to them. In a real clinical setting, prospective parents might choose not to look at certain genetic information at all. The act of opting out of genetic results could completely change the outcome of an embryo selection process. Future studies might explore how actual clinic patients navigate these decisions when they have the freedom to reject certain trait predictors.
“I’d like to note that one of the practical points is about consent,” Wilkinson said. “Some clinics today hand parents a panel of scores they never asked to see, laid out in a uniform way whatever each score is actually worth. It is important to be aware that the way that information is arranged may shape the decision that prospective parents make. Signing a consent form is not the same as making a considered choice.”
The research is part of ANTITHESES, a Wellcome Trust-funded project examining deep value disagreements. “We wanted to identify tools to reveal what people’s values are that drive disagreement,” Savulescu said. “What we saw was that people value some non-medical aspects of well-being nearly as much as they value medical aspects. This shows people do not draw a sharp line between medical conditions and non-disease traits.”
“What the public prefers does not settle what is right. Colleagues and I have argued before that public preferences are an input to ethical policy rather than a verdict on it,” Savulescu added. “What this study shows is that one of the categories the current rules are built on, medical against non-medical, does not describe how people actually reason when they have to choose. That is a reason to look again at the categories.”
To expand on these findings, Awad noted the team has launched Tinker Tots, an open online experiment that presents embryo selection dilemmas across a wider range of traits and countries. “After that we want to get closer to the clinic,” he added, “and study people who are actually going through IVF.”
The study, “Public perceptions of polygenic testing and embryo selection for non-medical traits,” was authored by Edmond Awad, Clara Colombatto, Joanna Demaree-Cotton, Brian D. Earp, Jim A. C. Everett, Peng Liu, G. Owen Schaefer, Ilina Singh, Dominic Wilkinson, and Julian Savulescu.
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