Creating Humans: Ethical Questions, part 9.3

~Today I conclude my discussion of germ line modification, an inheritable form of genetic enhancement/engineering (G.E.), from the audio course Creating Humans: Ethical Questions Where Reproduction and Science Collide.  Previously, I’ve discussed some of the scientific, legal, and social consequences of this technology.  Now, I come to some philosophical thoughts about the implications of genetic enhancement.

What I find most interesting of all about germ line modification, the thing that makes it the most interesting reproductive technology from the course, is that it forces us to confront some of the deepest questions of human existence.  We all want what’s best for our children, but if we choose to make use of this technology, we must ask what exactly that means.  What do people really want out of life?  Why are we here?  Can direct genetic changes make life “better” for our children and humanity as a whole? 

The answers, if there are answers, are more complex (and interesting) that you might think.  As with all of the technologies I’ve discussed so far, the question is the same: where do we draw the line?  Most of us would likely not have a problem with engineering out fatal genetic disorders (e.g. Tay-Sachs).  But what about nonfatal but crippling genetic diseases (e.g. Lou Gehrig’s Disease)?  Again, I think most people would think it’s ok to prevent those.  Going farther, is it ok to remove obviously “bad” but not necessarily fatal or disabling problems, such as an increased likelihood of Alzheimer’s or breast cancer?   …again, I think most people would not really have a problem with altering the DNA of their unborn children to prevent them from suffering this, even if the fix in question concerns one’s mental capabilities (again, such as Alzheimer’s), rather than purely physical problems.

It’s when we move from the realm of “cure” or “prevention” to “enhancement” that people get squeamish.  While I think many of us are rightly uncomfortable with allowing parents to use genetic engineering to create specific physical traits such as height or hair and eye color, can we really object to parents altering an embryo’s DNA to be, say, resistant to HIV or other diseases?  Or to have less likelihood of developing diabetes?  Or to have teeth that won’t require braces?  Or to not develop severe acne? Or to be less likely to have poor eyesight?  To have more balanced cholesterol levels?  Or, if we colonize the Moon or Mars, to be more resistant to radiation?

I could go on and on, of course, but you get the idea.  Personally, I don’t really have a fundamental ethical problem with genetic enhancements like the ones I describe; the problem as I see it is societal, as I discussed previously.  I think people see germ line engineering, rightly or not, as an unavoidable slippery slope from small changes (removing the chance of a fatal genetic diseases) to overwhelmingly bad changes (creation of an oppressive genetic “master race” that will enslave us all!).  Genetic engineering, like the other technologies examined in the course, is merely a tool, one we would be foolish to outright ban or ignore.  Instead, making decisions about what can and can’t be done, what is and isn’t morally, ethically, and legally allowed, will be a long, complicated, and international effort.

But where use of this technology veers into the realm of mind-bending philosophical speculation is when we consider its power (not yet, but in the future), to affect not only our descendant’s physical traits, but their mental ones.  It’s from these that we recoil (consider my discussion of genetics vs. mind control from the previous post), but if that’s also your reaction, take a moment to ask yourself exactly why you find the idea so disturbing (“from the gut” is not an acceptable answer).  For example, consider the list of physical genetic alterations I listed two paragraphs ago.  Now ask yourself, is it ok for parents to genetically engineer their offspring to be less likely to develop severe depression?  Why or why not?  What about ensuring that one’s child is not born with severe retardation?  What about making sure the child is, in fact, highly intelligent?  Or has a perfect sense of musical pitch?  Or, for that matter, has a cheerful disposition?  I mean, we all want our children to be happy, right?  Right??

Consider the extremely disturbing implications of this research paper.  Here’s the abstract (colors added for emphasis):

• “Happiness or subjective wellbeing was measured on a birth-record based sample of several thousand middle-aged twins using the Well Being (WB) scale of the Multidimensional Personality Questionnaire (MPQ). Neither socioeconomic status (SES), educational attainment, family income, marital status, nor an indicant of religious commitment could account for more than about 3% of the variance in WB. From 44% to 53% of the variance in WB, however, is associated with genetic variation. Based on the retest of smaller samples of twins after intervals of 4.5 and 10 years, we estimate that the heritability of the stable component of subjective wellbeing approaches 80%.”

In other words, whether or not one is “happy” most of the time is, believe it or not, largely a matter of genetics.  Now, I’m sure that many people, perhaps almost all people, are uncomfortable with the idea of altering the genetic code of their unborn children to ensure that said children are happy.  But why, exactly?  Because the child should be able to make their own choices?  But…what if they’re genetically predisposed towards being unhappy (or worse, severely depressed)?  We might say that civilization is built on unhappy people wanting to improve their lot in life, or expound on the brilliant art, etc. created by “tortured genius” types.  But is that enough of a reason to leave “sad” genes intact?  I mean, the whole point of civilization and so forth is to make us happier…right?  Can you really fault parents for not wanting their children to start life with this sort of genetically predetermined burden?

That’s why I find the philosophical dimensions of germ line modification so fascinating.  It makes us ask what we (speaking through our unborn descendants) really want out of this life that we’ve all been thrust into without our consent.  Why are we here?  What’s the point?  Is it to suffer, endure our lot, and take what we can get?  To worship and praise a deity? To free ourselves from suffering?  To find meaning in suffering?  Is it to enjoy each moment as best we can?  To learn things?  To help others (…to enjoy themselves?)?  To uncover the secrets of the universe?  To perpetuate our genes by having children?  To rebuild a shattered God?  To find True Love?  To just make it to the weekend??

…because if any of the above reasons sounds like a good, or even acceptable, meaning for life, I think it’s intellectually dishonest to dismiss germ line engineering, even for…no, especially when it comes to influencing the mental and personality traits of our descendants.  If you think we’re here to enjoy life & control our suffering, and have the capability via G.E. to make it even a little bit more likely that your children, grandchildren, etc. are more likely (and remember, this is all tinkering with probability, not certainty) to enjoy their lives regardless of external circumstances, is it your duty to do so?  Should it not, in fact, be one of your top priorities if you could do it?  And if you think we’re here to learn more about the world, then shouldn’t you ensure that your child is smart?  But if you increase your child’s intelligence, are you possibly decreasing their happiness?  Does making them more likely to be happy make them less likely to be productive/ambitious?  Should we strive for ambitious children?   …I could go on for hours!

Honestly, the only real objection I can ultimately see (assuming we actually acquire a reliable, non-experimental understanding of this technology) is religious: that we shouldn’t mess around with human DNA because God, etc. etc.  And I think that’s the position that a lot of people will take, but not for the same reasons.  Some people that feel this way will, I hope, actually take the time to think about why their religious/philosophical beliefs prohibit such alterations.  But I think that a lot of people will retreat into religious objections (not only for G.E. but for many of the other reproductive technologies from the course), simply because it’s easy to do so.  Although I find these sorts of ethical dilemmas fascinating, I know that most people don’t; they just want simple, easy-to-understand solutions to challenging ethical problems.

With it’s strong, almost overwhelming religiosity (especially in politics), the United States is especially prone to this, and I think that will make it difficult for us to have a real, national dialog to decide on these and other important bioethical issues.  It will make it even more difficult to involve America in an international framework to regulate and enforce the decisions we are able to make.  Because, like all the other reproductive technologies, regulation of them is useless without international conventions; otherwise, those with the means to do so will simply travel to genetic clinics in nations or other areas (or perhaps hospital ships in international waters?) where G.E. and so forth is legal or uncontrolled.

As for myself, I’m terribly torn on the issue of germ line engineering.  Part of me sees this technology as one of the great hopes for humanity’s future, bringing with it the eventual promise of freeing humanity from a great deal of painful evolutionary baggage that we’ve accumulated over millions of years, but which now weighs us down.  It’s a vision of a world in which people don’t die from fatal genetic diseases, or are born with diabetes, or get Alzheimer’s and thousands of other health issues, and where people don’t need to get braces for their teeth or backs or legs, or wear eyeglasses, or get zits (…but would that be considered beautification?), or die from cancer in their 30s, or take drugs for genetically-induced depression, anxiety, blood problems, and so forth.  A world where people are healthier, happier, and live longer even without expensive pharmaceuticals or therapies, even if we all went back to living in caves.  Such modifications to the human genome are certainly “unnatural”, but is the world I describe really so bad?

However, with so many emerging technologies, science fiction has a half-century advantage on us.  Genetic engineering is a time-tested staple of speculative fiction.  In general, owing to the need to create dramatic plotlines, it’s generally depicted as a bad thing.  Star Trek, for example, postulated “Eugenics Wars” in the near future (i.e. the 1990s) led by genetically engineered “Augments” such as KHAAAAAAAN!, leading the outlawing of genetic enhancement in the Federation.  S.M. Stirling’s Domination novels take the use of G.E. to create a “master race” to a horrifying conclusion, with humanity divided between the “Draka” rulers and their “Servus” slaves.  The Japanese show Gundam Seed depicts a world divided between genetically-enhanced “Coordinators” and unaltered “Naturals” mostly on Earth, with massively destructive wars (which, naturally, involve giant robots) waged between the two groups. I think these scenarios speak from our visceral fear against altering the fundamental nature of humanity.

Although the worlds they depict are extreme, I think they make some good points about the social and legal dimensions of G.E. If we allow free, or even limited use of this technology, will we have to keep track of who’s been enhanced?  Should people whose physical capabilities (such as strength, speed, etc.) have been genetically enhanced be barred from the Olympics?  What about the Tour de France?  What about professional sports?  College sports?  High school swim teams?

And what of those whose brains have been enhanced, giving them, say, a better memory or savant-level math skills?  Should they be forced to disclose this on college applications?  What about job applications?  Should there be a box that you have to check if you’ve received G.E. (whether in the germ line or in a somatic cell line sense), and if so, disclose exactly how?  Will non-enhanced people need some sort of affirmative action law?  Or is that too much government intervention?  Should those who can afford it be free to use G.E. on themselves or their children?

As you can see, the ethical, legal, social, and even philosophical implications of genetic enhancement are mind-boggling.  But the genetic genie may very well have already left the bottle.  As a society, we can’t simply stick our heads in the sand and pretend this technology doesn’t exist; nor, I believe, will we be able to effectively ban it entirely even if we wanted to.  It’s going to be used, one way or another, but exactly how we decide to use it will be one of the most important issues facing humanity over the next century.

So what do you think about all this?  Should we allow G.E. or not?  To what degree?  Would you use it if it were available?  Why or why not?

Creating Humans: Ethical Questions, part 9.2

~A far more controversial form of genetic engineering is germ line modification, also called germline engineering.  This is a catch-all term for any changes in a person’s DNA that will affect their descendants regardless of use of any other genetic engineering.  If the genetic engineering affects a patient’s reproductive system (i.e. their gametes), it would be considered germ line modification.  Another example would be if the DNA of an in-vitro fertilized embryo is altered in a lab prior to implantation into a womb; the resulting child would then carry the engineered changes, and pass them on to his or her offspring.

Germ line modification is not yet technologically feasible, but as biotechnological research progresses it will quickly become so.  Understandably, this type of technology, although it remains theoretical for now, is highly controversial.  First of all, there’s an inherent concern that it will provide an unfair advantage to children whose parents have them enhanced.  As I’ve mentioned before, most of the reproductive technologies in this course are and will be the domain of the wealthier people and nations of the world, and modifying the DNA of offspring seems, to many, to create an even more unbalanced playing field in the arena of life.  Some fear this will lead to a genetic aristocracy or hierarchy; for example Aldous Huxley’s novel Brave New World features hatchery-raised children genetically slotted into genetically-determined roles within society, with the brilliant “Alpha-double-plusses” ruling at the top and the “Epsilon semi-morons” doing manual labor.  The film GATTACA also features a society divided on the basis of genetics, with genetically “inferior” humans relegated to menial roles.

But consider: the children of wealthy families (whether in one’s own nation, or compared to families of poorer nations) are already born with huge advantages over their less-wealthy “peers”.  The Declaration of Independence may assert that All Men Are Created Equal, but strictly speaking that’s only in a legal sense (and only for white male landowners); the moral sense is far more fungible.  Do you think it’s right that some expectant mothers receive excellent prenatal care and nutrition, while other mothers give birth on their own with no medical treatment and babies born half-starved into a life of malnutrition?  That some children receive excellent medical care and educations, while others have nothing? Of course it’s not morally “right”, but the entire history of human civilization is one of inequality.  The question here is, does germ line modification go too far, and if so, why?  What makes it different?

I think a major objection to germ line engineering is suspicion of parental motives, whether for the aforementioned class division or because nudging genes around can unduly influence a child towards a particular course in life, especially if you alter genes affecting personality or mental capabilities.  Most people are uncomfortable with altering the very nature of a child to force them onto a specific path; it seems to much like brainwashing.  Yet consider: human society universally acknowledges the right of parents to intervene in the lives of their children, in many cases strongly influencing (and yes, even forcing) into certain situations, careers, marriages, and so forth.  Is it really any of your business if a family chooses to engage in genetic enhancement to increase the chances of their child doing better in a particular area?  Remember, genetics is not mind control; nature may be stronger than nurture most of the time, but environment still plays a significant role in the development of a person.

Also, consider that humans have been genetically “enhancing” plants, animals, and yes, our own children, since before the invention of agriculture.  We’ve bred docile cattle, loyal bloodhounds, nutritious vegetables, beautiful flowers, prettier children, and more, but until recently, it’s all been mostly haphazard.  We hope that the person we marry and have children with will prove a good genetic match and that our children won’t have genetic disorders.  We hybridize two flowers, hoping the result will be both attractive and viable.  We breed racehorses until we get a winner.  But now, with an exact knowledge of the genetic code, much of the guesswork can be removed or minimized, and we can simply go about what we’ve been doing all along, but with more precision.  Or so the logic goes.

Another argument against germ line modification is vaguely fatalistic, often with religious overtones.  The idea here is that by altering The Very Basis of Life, we are tampering with Things Man Was Not Meant To Know (yes, I enjoy capitalizing clichés).  Some feel that directly altering DNA is “unnatural” and tantamount to meddling with the handiwork of God, saying in effect that we know better than Him and that the lives we are “given” are somehow not good enough. 


While there are many good arguments against germ line modification, I find this argument weak.  I mean, we’ve already altered existing species and driven other species into extinction.  We’ve already altered our environment and living conditions precisely because they weren’t good enough for our needs.  How is altering our genetic code, which is full of evolutionary baggage and problems, any different? 

Also, it’s both callous and ridiculous to take a family whose line is plagued with a particular genetic defect (for example, hemophilia) and say that their affliction is the handiwork of a deity, so their descendants must piously suffer it.  Are the other reproductive technologies discussed in the course (IVF, surrogacy, donation, screening) equally “unnatural”?  What makes them different?

Like so many ethical controversies, this is hardly a new dilemma.  I periodically read or hear about families who refuse vaccinations and/or medical care for their children on religious grounds, saying that only God has the power to heal, etc.  In an era of plane travel and increasingly disease-resistant microbes, society may eventually be force to deal with vaccine refusers who may inadvertently spread diseases.  Do you think it’s ok for a family to refuse medical treatment for an ill child, or refuse to vaccinate them, on religious grounds?  Should the parents be legally culpable if the child dies from a lack of treatment?  Many (including myself) think the parents should be held liable.  Yet vaccinations are an alteration of one’s body.  So is medical treatment.  How is germ line engineering to prevent genetic diseases so different?  And it that’s ok, where do we draw the line from “treatment” to “enhancement”.  Should we draw a line, or leave it up to the parents?

I’ve barely scratched the surface of genetic engineering controversies, and I’m not done with germ line engineering just yet.  Tomorrow, I’ll go into what I find to be the most interesting aspect of this technology: how it forces us to confront the deepest and most profound questions of our own existence.

Creating Humans: Ethical Questions, part 9.1

~Continuing my course analysis of Creating Humans: Ethical Questions Where Reproduction and Science Collide, the next topic is genetic enhancement.  Of all the topics examined in the course, this is the one that interests me the most in its ethical, social, legal, and scientific implications.  And of all the reproductive technologies we’ve looked at, genetic enhancement is the most fundamental, directly altering the nature of a living creature at the molecular level. 

 

From the discovery of the double-helix structure of the DNA molecule to the completion of the human genome project, researchers have barely begun to scratch the surface of how miniscule changes in our DNA can result in profound changes.  We’ve learned that genes can even be switched on and off in response to other factors (such as hormones).

 

As I discussed earlier, the terms "genetic enhancement” or “genetic engineering” often leave a bad taste in people’s mouths, tainted as they are by the legacy of the eugenics movement, which was largely based on sterilization and pseudoscientific/nationalistic ethnic stereotyping.  It was particularly hard-hit by World War II and the Nazi “Master Race” ideal.  Some people react to the idea of genetic enhancement with scorn, saying that in the hands of a dictator or Nazi-like group it could be devastating.  Although that’s a valid view, recent advances in genetic technology have revived eugenics as an individual choice, rather than a social policy, making the idea of genetic engineering  more acceptable to many people.

 

Broadly speaking, there are two different types of genetic enhancement.  The first is somatic cell line engineering, also called gene therapy, which affects the genetic code of an individual patient.  Trials are still underway regarding the efficacy of gene therapy, and results have been both promising and disappointing in different cases.  An example of a recent promising gene therapy study involved implanting certain genes into the joints of patients afflicted with rheumatoid arthritis.  In response to the genes, the patients’ bodies produced a protein that, in turn, blocked the action of the protein causing the arthritis.

 

In general, somatic cell line engineering for medical purposes is not a morally controversial subject and is therefore ethically acceptable. Think of it as a form of medicine that may help cure genetic diseases or conditions; although the treatment may be dangerous and/or useless, so is taking experimental medicines.  The risk, and resulting changes, affect only the individual.  And so far the changes we can create are small; we’re still a long way from creating syfy mutants with extra arms or super-soldiers with incredible combat skills simply by injecting someone with some genes (although that would be awesome).

 

However, somatic cell line engineering is quickly becoming an issue in athletics, where it is known as “genetic doping”.  Although the efficacy of such “doping” is questionable at best and certainly high-risk, unscrupulous athletes will use any advantage they can get, and genetic doping has the advantage (for now) of being undetectable, unlike testing urine for traces of steroids.  The International Olympic Committee formally banned gene doping in 2003, but it may be only a matter of time until the first genetic doping scandal erupts.  Will it be in baseball?  Swimming?  Perhaps the Tour de France?

 

Tomorrow, I will discuss germ line modification, a far more controversial form of genetic engineering.  For now, here’s a link to the Human Genome Project section on the Ethical, Legal, and Social issues surrounding genetic knowledge and engineering.

San Antonio: Time to Par-tay!

~This is the last set of pictures from last week’s trip to San Antonio, Texas:

^ We were in San Antonio to celebrate my paternal grandmother’s birthday.  Happy 80, grandma!

^ Grandma and her great-granddaughter (my niece…yeah, I’m an uncle, it’s kind of scary). And of course, the cake…

^ ...what cake?? OM NOM NOM.

^ Dad, my nephew, and my sister.  Nice vest & tie, little guy!

^ The cake lid somehow turned into an improvised bongo drum.  I may have had something to do with that.

^ My aunt Hannah, with her cookie-cake and gift: a wine monkey (yes, we’re a strange family).

^ The cookie-cake was discounted at the store.  I wonder why?