Ethics of Genetic Enhancement
For future generations, genetic engineering might all but eliminate the predisposition to serious disease and disability. It is not difficult to imagine a future where parents routinely select genetic enhancement to “improve” not only the health and longevity, but the physical features, behavioral traits, and aptitudes of their children. I want to discuss several ethical issues involving genetic enhancement, especially as applied to improve behavioral traits and aptitudes. The ethical issues, while similar to those of cloning, lead to different complexities and, I think, different answers. The issues I will discuss are: (a) the ramifications on quality of life; (b) the effect on individuality; (c) the impact on human dignity; (d) the problem of free will; (e) the problem of fairness; (f) the problem of equal distribution in a market driven economy; (g) the problem of wide scale eugenics.
The American Medical Association’s Council on Ethical and Judicial Affairs issued a policy statement in 1994 stating that efforts to enhance “desirable” characteristics through the insertion of a modified or additional gene, or efforts to “improve” complex human traits, are contrary not only to the ethical tradition of medicine but also to the egalitarian values of our society. (1) Science is both a public and social enterprise. Clearly, scientific technology, even if it involves great benefits to society, is subject to moral constraints. (2)
Society recognizes that the freedom of scientific inquiry is not an absolute right, and scientists are expected to conduct their research to widely held ethical principles. There are times when limits on scientific freedom must be imposed, even if such limits are perceived as an impediment by an individual scientist. (3)
On the other hand, Supreme Court precedent has elevated reproductive choice to a constitutional right, which suggests that genetic selection is simply a new reproductive right devised by technology, with the same constitutional protection as “natural” reproductive rights. (4) It would seem unlikely that the Court would limit reproductive rights to “natural” procreation, and the public already presumes that artificial techniques such as in vitro fertilization, surrogate motherhood, or artificial insemination, are constitutionally protected. (5) Medical ethics track public opinion, and if society has a permissive attitude towards genetic engineering, this may tilt the balance in the opposite direction for those who formulate medical ethics policy.
The technology of reprogenetics involves germ line therapy, or genetic manipulation of early embryos, resulting in genetic alterations that become part of the individual’s germ line, and may be transmitted to future generations. (6) Reprogenetics for genetic enhancement means the selection of “desirable” traits for one’s offspring. Future technology will allow parents to alter genes of their children to provide them with increased longevity, intelligence, health, happiness, (7) or to provide children with “innate” talents, desires, and abilities (8) such as perfect pitch (9) or athletic prowess, or an increased ability to learn multiple languages (10) or an extrovert personality. (11)
First we may see genetic “vaccines” given to embryos to place an AIDS resistance gene or other disease-resistant genes in that baby. (12) Later, as technology expands, we will be able to provide children with good health and increased longevity, predetermined vocational and physical aptitudes and personality traits, and perhaps even a state of well-being or euphoria.
(a) The ramifications on quality of life.
Genetic enhancement would make life easier for people. Bruno Bettelheim, the child psychologist, in his study, “The Uses of Enchantment,” said that a struggle against severe difficulties in life is unavoidable, that it is an intrinsic part of human existence. In other words, life is difficult. Many people wonder if it’s fair to bring children into a world fraught with so many difficulties and painful experiences, all ending in death. (As Hobbes put it, life in a state of nature is nasty, brutish, and short.). Just growing up and acquiring good habits of behavior can be very demanding. Parents often have an arduous time raising children or getting their children to do what parents want. Imagine a world in which children would readily learn to share their toys, to wait their turn, to not have tantrums–and so on. Genetic engineering could provide children with settled habits of honesty, fair play, diligence, perseverance, concern for others, and many other traits people generally agree are important for a civil society.
Reprogenetics for behavioral traits would allow a shift in the parent-child relationship so that parents would no longer need to exert intense personal authority over their children. Genetic engineering itself would inculcate personality traits, so that children would have the predisposition and innate desire to develop good behavior. Children would develop “naturally” with little need for moral inculcation. (13) Parents would be happier and undergo less stress in their parenting experience. Parents would have more quality time with their children and for other projects. And even though no one denies that environment is a big factor in shaping human behavior, it is not unreasonable to suppose that future technology might create “super” genes that could inject a very strong orientation towards any given trait so that children would turn out as spelled out in their engineered genes, even if they grow up in a contrary environment.
Parents want their children to be happy and successful, with all possible advantages in life. It seems that many parents even want their children to be better than they were in some way. Based on these considerations, what interest could society possibly have in restricting technology that could easily eliminate the need to inculcate children into good habits?
(b) The impact on individuality.
John Stuart Mill said that because of the need for self-expression that follows upon the capacity for thought and reflection, human beings simply cannot be made happier by external restrictions on their development and spontaneity, however benevolent these external constraints might be. (14) If children’s personalities have been predetermined by reprogenetics, children might be “wholly subject to parental will.” (15) These children may encounter a loss of a normal sense of individuality and self, or the freedom to create their own identity. Some children might feel “inauthentic”–that there is no real “self” for him or her to be because his or her personality was predetermined.
(c) The impact on human dignity.
If parents can select personality traits and aptitudes, sets of interests and ideologies, or the profession that their child will want to pursue-children will be treated as mere means to parental ends, instead of unique individuals worthy of being ends in themselves. Further, this could lead to a market model that would put a price on all human characteristics, thereby commodifying the children with these characteristics.
In the annals of child psychology, people often disagree about what constitutes the best interests of children. Many people have children for less than ideal reasons, including instrumental purposes such as to live vicariously through them, to provide companionship in old age, to create an heir who will carry on the family name and give one a sense of immortality, or to produce a being who will love you unconditionally. In short, even without reprogenetics, many children are brought into the world to serve as an instrument of the parent’s will.
Parents already have the constitutional right to exert near virtual control over their children’s development, (16) while children have a limited spectrum of legal rights. Children have the legal duty to comply with their parents’ legal control. Parents can decide how their children look, what they eat and wear, where they sleep, what toys they play with, who will play with their children, religious upbringing, when they can start dating, curfews, attendance at school and maintaining of grades. Parents make decisions according to their own principles and standards, whims, predilections, herd instinct, and purely selfish reasons without running afoul of the law or raising many moral eyebrows. As a society we tolerate or even endorse the choices parents make which, at times, are clearly instrumental in nature.
Parental selection for personality traits is nothing more than a technological means of developing traits instead of having to inculcate the same traits. If parents have the right to inculcate various character traits in their children, if parents already control nearly every aspect of their children’s lives from the time they are born until they attain majority-it is difficult to understand how a legal argument against reprogenetics could pass constitutional muster. Parental choice could be elevated by genetic engineering to foster traits that not only would enhance the quality of children’s lives, but would do so with scientific precision and at the same time free parents of the arduous inculcation phase they often must endure.
(d) The problem of free will.
It is a fundamental notion of liberty that human beings make their own decisions about their lives. This theory is expressed in the Constitution, (17) and it is a principle found in Locke’s proposition that everyone has the “equal right…to his natural freedom, without being subjected to the will or authority of any other man.” (18) This underscores the importance of liberty in our capacity for self-expression. (19) If an agent could not have done otherwise – if children are programmed to automatically develop a set pattern of character traits – this could undermine the conception that individual choice has real meaning. What is to be said of the status of free will if a child is born programmed to behave in a particular way, or to desire pursue a particular course or study and work? If certain predispositions are inbred, including the inclination and desire to act on these predispositions – if a person’s life projects as well as his or her personality traits are causally determined, we will need to reexamine traditional notions of free will.
Perhaps these concerns are exaggerated. Human beings are much more than their genes. We are a product of the constant interplay between our nature (genes) and nurture (environment), not merely the sum of the two. There may be a limit to the level of precision available in reprogenetics. Identical, or monozygotic, twins who have the same genetic information nonetheless develop quite differently when exposed to different environments. The environment in which we each develop has a unique differential. Random events, luck and chance, as well as life choices and divergent life experiences all play a role in the development of an individual’s personality, behavior, character and intellectual capabilities. Add to this peoplesâ€™ physical, social, political, historical, and religious environments, the pressure of peer groups, and we have an even more complex differentiation that interplays with a person’s genes. Thus, genetic enhancement is more likely to be no more than a “blueprint.” (20) As such, children would be born with a genetic factor that predisposes them to a set of behavior traits and temperament, but how these traits play out will vary depending on the environmental factors and experiences of each individual. Still, even uncertain predictions can have tremendous impact on the way a child perceives his or her will power, and on how his or her life actually turns out. (21)
(e) The problem of fairness.
A system of reprogenetics could promote various types of athletic prowess or musical or scientific genius, or great beauty. Would sporting and beauty contests have rules to prohibit some or all genetically enhanced contestants? If so, this would be unfair to people who had worked their way towards these goals, because it was not their choice to be enhanced and the choice made for them cannot now be undone. Should the government ban such procedures outright? The integrity of sports, where attainment of athletic prowess comes from hard work, concentration, perseverance, determination, and so many other skills might simply give way. Moreover, children who, because of genetic enhancement, might not develop such virtues as perseverance, determination and so on may be disadvantaged in other areas of life when these skills come into need.
Perhaps genetically enhanced athletes are the inevitable wave of the future. As the ranks are filled with this new breed of player, the level of play likely would ratchet up quite dramatically, and the popularity of various sports might increase as well. One can imagine a genetic battle of sorts, with parents pushing for stronger genetic prowess in each new generation. On the other hand, if a large number of parents opted to select for athletic prowess, musical talent and the like, there could be an overabundance of super athletes and child prodigies. If so, we would live in a strange new world in which everyone could or would be a highly virtuosic concert artist or an equally highly developed athlete.
(f) The problem of equal distribution.
As some parents start using reprogenetics to produce children who have intellectual, behavioral and physical advantages, people who are not able to afford its use could become severely disadvantaged. This could pose grave risks to our political and social structure, with a group of privileged individuals and families perpetuating enhancements from generation to generation, creating a hereditary aristocracy or “genobility.” People would no longer believe that they have just as good an opportunity to succeed as the next person. The enhanced would tend to monopolize desirable occupations and fill high status social roles. The disadvantaged would no longer be able to count on traditional methods of social advancement, such as education and intermarriage, to improve the quality of their lives.
By giving an unfair advantage to enhanced individuals, we would undermine the principle of social equality, and the idea in the Declaration of Independence that “all men are created equal” would seem to be simply false.
If health insurance coverage of today’s technology is any indication, genetic enhancement will not be covered by most insurance policies. Cosmetic surgery, in vitro fertilization, fitness centers, performance enhancing drugs, and other technological advantages in life are paid for by the individuals involved. Thus, reprogenetics can exacerbate social and economic inequalities unless this technology is made available to everyone at an affordable cost. (22)
But the fear of unequal distributional consequences of any new technology ought not be used to limit scientific progress. We already accept a marketplace system in which affluent parents give their children greater advantages in life that less affluent parents are unable to afford – from summer camps to the latest computers, from music lessons to a first rate college education. If one accepts the disparity in the distribution of wealth, it is difficult to see this as a basis for rejecting the use of reprogenetic technologies intended to provide children with further and greater advantages.
(g) The problem of wide-scale eugenics. (23)
Government has a legitimate concern for the well-being of children, and has an important role in deciding
“what the country’s norms and practices ought to be, and how the institutions and arrangements throughout society ought to be structured to facilitate the right kinds of development of the best kinds of new persons. The flourishing of children ought to be at the very center of moral and social and political and economic and legal thought, rather than, as at the present, at the periphery, if attended to at all.” (24)
We know that some degree of government regulation will need to go into genetic engineering. Public policy will be concerned about the equitable distribution of genetic technology, and of possibly banning harmful or offensive uses of genetic technology, such as out-and-out cloning. Public policy might dictate that genetic vaccines be given to growing embryos in the womb to instill immunity to many diseases. Perhaps the government might have an interest in genetically altering the genes of adults who are violent offenders, so that their offspring will not have a genetic disposition towards violence. The likelihood of governmental controls could be a slippery slope down the road to full scale eugenics, something many people view with queasiness.
Eugenics is the idea that the government, with the purpose of promoting the general welfare, might require that a genetically approved “serum” be given to all expectant mothers, to make certain traits uniform in the society. A well-intended government might use eugenics to make society uniform, so as to make everyone truly equal and eliminate class distinctions. Genetic engineering could result in a utopian society in which there is no crime, everyone is trustworthy and kind, etc. We know that political rulers have in the past attempted to shape the composition of the human race one way or another. Once a particular gene pool is “preferred” over others – once traits are established to produce a superior group of people, and attempts are made to eliminate “undesirable” gene pools – we allow a dangerous political machinery to turn people into pawns for the ruling elite. Widespread eugenics could result in a population of automatons so well described in Aldous Huxley’s Brave New World. In that story, the government divided a single embryo into ninety-six identical copies, and gestated them under conditions to yield five classes of hierarchical workers. Some groups were conditioned to love performing specified tasks. Eugenics embodies the ultimate fear that the government might develop and exploit clones who are explicitly created for their low intelligence and ability to do boring and low-paying work. (25)
But we cannot let fear of science fiction scenarios cloud our vision. To do so would be unwise, possibly blocking potentially valid uses of genetics technology.
While eugenics is an effort by government to improve the “gene pool” by control over a society’s reproductive practices, (26) reprogenetics is practiced on the level of each individual or couple in deciding what genes a single child will receive. Reprogenetics, unlike eugenics, which would lead to a restriction of reproductive freedom, would expand reproductive freedom by giving people the opportunity to have children who will be healthy, happy, and loving. The worry that eugenics would become a reality seems misplaced because advocates of reprogenetics presuppose reproductive freedom free of undue governmental constraints.
In a society that places a high value on individual freedom, it is hard to find any legitimate basis for restricting the use of reprogenetics. Roscoe Pound suggested that law should reflect the “received ideals” of the “time and place.” (27) In view of our time and place and the “received ideals” of our constitutional law, genetic engineering would seem to be a technology that society will endorse.
We have developed into a society in which the constitutional protection of reproductive choices has expanded, not contracted, with technological innovations – ranging from medical treatment of infertility, in vitro fertilization, surrogate motherhood, and so on.
The law favors respecting the rights of parents to make important decisions regarding procreation. Genetic engineering seems to have traveled an irreversible path in which we will discover how to control birth defects, disease, regenerate damaged spinal cords, develop super athletes, and super geniuses.
At the same time, it may be disquieting to think that the evolution of mankind would end up being reduced to a marketplace agenda in which parents clamor for more and better genetic enhancements to expand the potential of their children.
When science enters a new domain, it becomes necessary for the language of rights to likewise undergo a paradigm shift or else explain how its theory is consistent with technological advances, and I believe philosophers are doing just that. Technology is a tool for expanding human potential, to permit greater freedom, not the limiting of freedom. (28)
(1) See, â€œReport on Ethical Issues Related to Prenatal Genetic Screening,â€ 3 Arch Fam. Med. 633, 637-39 (1994).
(2) See, Christine L. Feiler, â€œHuman Embryo Experimentation: Regulation and Relative Rightsâ€ 66 Fordham L. Rev. 2435, 2457 (1998).
(3) See, 1 National Bioethics Advisory Comm’n, Cloning Human Beings: Report and Recommendations of the National Bioethics Advisory Commission 6 (1997)
(4) See, John A. Robertson, â€œLiberty, Identity, and Human Cloning,â€ 76 Tex. L. Rev. 1371, 1374 (1998).
(5) See, Stephanie J. Hong, â€œAnd â€˜Cloningâ€™ Makes Three: A Constitutional Comparison Between Cloning and Other Assisted Reproductive Technologies,â€ 26 Hastings Const. Law Quarterly 741, 784 (Spr. 1999).
(6) See, Dan Seligman, â€œOutlawing DNA,â€ Forbes, July 6, 1998, at 110.
(7) See, Lee M. Silver, Remaking Eden: How Genetic Engineering and Cloning Will Transform the American Family (Princeton University Press, 1998) at 233-47.
(8) See, Lee M. Silver, â€œHow Reprogenetics Will Transform the American Family,â€ 27 Hofstra L.R. 649 (1999).
(9) See, Joseph Profita & T. George Bidder, â€œPerfect Pitch,â€ 29 Am. J. Med. Genetics 763, 766-69 (1988).
(10) See, Dean Hamer & Peter Copeland, Living With Our Genes: Why They Matter More Than You Think at 23l-34 (1998).
(11) See, Seligman, supra note 16, at 110.
(12) Approximately one percent of people with a Western European ancestry carry a gene that provides complete resistance to infection by HIV, the AIDS-causing virus. See, Rong Liu et al., â€œHomozygous Defect in HIV-1 Coreceptor Accounts for Resistance of Some Multiply-Exposed Individuals to HIV-1 Infection,â€ 86 Cell 367, 373 (1996).
(13) Later, as they acquire the habit of virtuous acts, children will come to appreciate the moral reasons behind these moral practices, and will internalized these practices so that they become part of their deliberative will.
(14) See, John Stuart Mill, â€œOn Liberty,â€ in The Utilitarians 483-84 (Doubleday Books 1973).
(15) See, J.L.A. Garcia, â€œHuman Cloning: Never and Why Not,â€ in Human Cloning: Science, Ethics, and Public Policy (Barbara MacKinnon, ed., 1999).
(16) The Supreme Court extended the concept of a right to privacy to child rearing in United States v. Orito, 413 U.S. 139, 142 (1973).
(17) See, David A.J. Richards, â€œThe Individual, the Family, and the Constitution: A Jurisprudential Perspective,â€ 55 N.Y.U.L.Rev. 1, 6, 8 (1980).
(18) John Locke, Second Treatise on Government 54, at 3 (C.B. Macpherson, ed. 1980).
(19) See, John Stuart Mill, â€œOn Liberty,â€ in The Utilitarians 484 (Doubleday Books 1973).
(20) See, Timothy H. Goldsmith, The Biological Roots of Human Nature: Forging Links Between Evolution and Behavior 70-72 (1991) (describing the myth of biological determinism); Michael Ruse, Knowledge in Human Genetics: Some Epistemological Questions, in Genes and Human Self-Knowledge 34, 38-42 (Robert F. Weir et al. eds., 1994) (discussing the dangers of methodological reductionism with the Human Genome Project).
(21) Another issue here is what would be the status of praise for good behavior? It would seem odd to praise a child for good acts when the child could not have done otherwise. On the other hand, there is nothing wrong about heaping praise on children who are inherently good, for this helps to further habituate their behavior so that it eventually becomes internalized.
(22) See, Elliot N. Dorff, â€œHuman Cloning: A Jewish Perspective,â€ 8 S.Cal. Interdisc. L.J. 117 at 117 (1998).
(23) Eugenics is “the strategy of trying to orchestrate human evolution through programs aimed at encouraging the transmission of desirable traits and discouraging the transmission of undesirable ones. See, David Suzuki & Peter Knudtson, Genetics: The Clash Between the New Genetics & Human (Massachusetts: Harvard University Press, 1990).
(24) Virginia Held, “Feminist Transformations of Moral Theory,” Philosophy and Phenomenological Research, Vol. 1, Supp., Fall l990, at 15.
(25) See, Bonnie Stinbock, Cloning Human Beings: Sorting Through the Ethical Issues, in Human Cloning: Science, Ethics, and Public Policy (Barbara MacKinnon, ed., 1999).
(26) See, Silver, supra note 2, at 254.
(27) See, Roscoe Pound, Law and Morals 113 (l924).
(28) â€œChanging Your Genes,â€ The Economist, Apr. 25, l992 at 11, l2.