Chapter 19, Problem 3CS

A couple well informed about the epigenetic effects of nutrition and dietary supplements such as choline and folate decided to take supplements before trying to get pregnant. Their first child was born with hair and eye colors very different from the parents and has been consistently praised by teachers for learning ability and memory. The couple attributes these characteristics to their intake of epigenetic supplements. Now they wish to have another child and have informed their physician that they intend to greatly increase the amount of supplements they take to increase the epigenetic effects in their child. The physician cautioned them that studies available in human trials show no effect of choline on learning and that excess intake of folate during pregnancy may be associated with an increased risk of autism spectrum disorder in the child. The couple is convinced that these studies are not conclusive, and while more research is needed, they intend to pursue their plan of increasing their intake of supplements.

What ethical issues should the physician address with the parents about the use of supplements at high dose levels?