*** Fantastic evolution of the Tom-B'Elanna relationship. You wouldn't think it would get much better after "Drive," but it does. The way they face the conflict is perfectly in line with their traits and comes across as believable and easy to follow.
*** While parenthood has always been a major theme in Star Trek, this is one of way too few times ST has faced issues of pregnancy, so it's quite welcome.
*** Great role for the Doctor as well as B'Elanna and Tom. It would have been easy to reduce this story to a redundant parental soliloquy and to forget (as usual) the third, chiefly important party in such ethical decisions: the physician.
*** Excellent writing all-around, sensational direction, and very good music (especially in the key scene) to boot. One of the best Voy episodes also from a technical point of view.
*** As reported in the Trivia section of this episode's main page, there are some inconsistencies with what was previously affirmed in ST about genetic procedures. This is, however, quite forgiveable.
*** The actual ethical implications of genetic resequencing could have used a little more developing, but the authors chose to focus more on the emotional/human side of the characters. It is an understandable choice, albeit a somewhat bitter one for the ethicists among us.
Considering that this whole plot line was written in order to justify actress Roxann Dawson's real-life pregnancy, this is a superb episode. Usually such ploys end up being disgustingly out-of-character and painful to watch (see DS9), but Lineage was just amazingly well done.