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| The promise of gene editing and designer offspring may prove irresistible |
Posted by Keith Tidman
It’s an axiom that parents aspire to the best for their children — from good health to the best of admired traits. Yet our primary recourse is to roll the dice in picking a spouse or partner, hoping that the resulting blend of chromosomes will lead to offspring who are healthy, smart, happy, attractive, fit, and a lot else. Gene editing, now concentrated on medical applications, will offer ways to significantly raise the probability of human offspring manifesting the traits parents seek: ‘designer offspring’. What, then, are the philosophical and sociological implications of using gene editing to influence the health-related wellbeing of offspring, as well as to intervene into the complex traits that define those offspring under the broader rubric of human enhancement and what we can and ought to do?
‘All the interests of my reason, speculative as well as practical, combine in the three following questions: What can I know? What ought I to do? What may I hope?’
— Immanuel KantThe idea is to alter genes for particular outcomes, guided by previous mapping of every gene in the human body. To date, these selected outcomes have targeted averting or curing disorders, like cystic fibrosis, Huntington’s, and sickle-cell disease, stemming from gene mutations. As such, one of the central bioethical issues is for parents to freely decide which disorders are ‘unacceptable’ and thus to prevent or fix through gene editing. The public, and the medical field, already make similar medical decisions all the time in the course of treatments: stem cells to grow transplantable organs, AI-controlled robotic surgery, and vaccinations, among innumerable others. The aim is to avoid or cure health disorders, or minimally to mitigate symptoms.
As a matter of societal norms, these decisions reflect people’s basic notions about the purpose of health science. Yet, if informed parents knowingly choose to give birth to, say, an infant with Down syndrome, believing philosophically and sociologically that such children can live happy, productive lives and are a ‘blessing’, then as a matter of ethics, humanitarianism, and sovereign agency they retain that right. A potential wrinkle in the reasoning is that such a child itself has no say in the decision. Which might deny the child her ‘natural right’ not to go through a lifetime with the quality-of-life conditions the disorder hands her. The child is denied freely choosing her own destiny: the absence of consent traditionally associated with medical intervention. As a corollary, the aim is not to deprive society of heterogeneity; sameness is not an ideal. That is not equivalent, however, to contending that a particular disorder must remain a forever variation of the human species.
‘We are going from being able to read our genetic code to the ability to write it. This gives us the … ability to do things never contemplated before’
— Craig Venter, writing in ‘Heraclitean Fire: Sketches from a Life Before Nature’.Longer term, people won’t be satisfied limited to health-related measures. They will turn increasingly to more-complex traits: cognition (intelligence, memory, comprehension, talent, etc.), body type (eye and hair colour, height, weight, mesomorphism, etc.), athleticism (fast, strong, agile, endurance, etc.), attractiveness, gender, lifespan, and personality. The ‘designer offspring’, that is, mentioned above. Nontrivially, some changes may be inheritable, passed from one generation to the next. This will add to the burden of getting each intervention right, in a science that’s briskly evolving. Thus, gene editing will not only give parents offspring that conform to their ideals; also, it may alter the foundational features of our very species. These transhumanist choices will give rise to philosophical and sociological issues with which society will grapple. Claims that society is skating close to eugenics —a practice rightly discredited as immoral — as well as specious charges of ‘playing God’ and assertions of dominion may lead to select public backlash, but not incurably so to human-enhancing programs.
Debates will confront thorny issues: risk–reward balance in using gene editing to design offspring; comparative value among alternative human traits; potential inequality in access to procedures, exacerbating classism; tipping point between experimentation and informed implementation; which embryos to carry to term and childhood; cultural norms and values that emerge from designer offspring; individual versus societal rights; society’s intent in adopting what one might call genetic engineering, and the basis of family choice; acceleration and possible redirection of the otherwise-natural evolution of the human species; consequences of genetic changes for humanity’s future; the need for ongoing programmes to monitor children born as a result of gene editing; and possible irreversibility of some adverse effects. It won't be easy.
‘It is an important point to realize that the genetic programming of our lives is not fully deterministic. It is statistical … not deterministic’
— Richard DawkinsThe promise of gene editing and designer offspring (and by extension, human enhancement writ large) may prove irresistible and irreversible — our destiny. To light the way, nations and supranational institutions should arrange ongoing collaboration among philosophers, scientists, the humanities, medical professionals, theologians, policymakers, and the public. Self-regulation is not enough. Oversight is key, where malleable guidelines take account of improved knowledge and procedures. What society accepts (or rejects) today in human gene editing and human enhancements may well change dramatically from decade to decade. Importantly, introducing gene editing into selecting the complex traits of offspring must be informed and unrushed. Overarching moral imperatives must be clear. Yet, as parents have always felt a compelling urge and responsibility to advantage their children in any manner possible, eventually they may muse whether genetic enhancements are a ‘moral obligation’, not just a ‘moral right’.
7 comments:
"To light the way, nations and supranational institutions should arrange ongoing collaboration among philosophers, scientists, the humanities, medical professionals, theologians, policymakers, and the public."
Would this light the way? I'm not so sure... clealry the different groups have different perspectives... scientists may be in opposition to not only theologians but philosophers too (not to say that the latter groups necessarily have a monopoly of wisdom!!)
Nonetheless, I wonder if there might be a hierarchy needed of views... that getting the policy ethical should come before, say , consdierations of utility?
I would think it is impossible today to 'get the policy ethical'. While ethics is not devoid of reason, it is not based on reason either. In the words of theologian Deane Galbraith, where autonomy was once said to be grounded in reason, it is now seen to be 'grounded arbitrarily'.
There comes a point, also, where the application of reason is dangerous. The human genome has about 3 000 000 000 base pairs. We have very little idea how changing even one or two might ultimately distort the world for better or for worse (in our nature, we always think for better).
Today we are more aware than ever that seemingly innocent things we do may threaten our very existence. A photo went viral on the Internet: birds swarming over Rome. 5G had upset them, it was said. It hadn't, but it shows how jumpy we have become about products of our own reason.
My suggestion, Martin, that society take a collaborative approach to tackling the future of gene editing as it relates to the consequential topic of human development is my conviction in the effectiveness of multidisciplinary teams to complex problem-solving. Yes, it’s about the ‘different perspectives’; but it’s also about energetically challenging each other’s cherished assumptions, confirmation biases, and occasional tunnel vision. Multidisciplinary teams require good people with good leadership; but for certain sets of problems, they do work.
So, to these ends, one objective would be for diverse specialists to raise the awareness of each other regarding the full set of issues the team should be weighing — historical, current, and future — and sorting out how those issues might impinge on society going forward in maturing gene-editing capabilities. As well as appropriate applications. To that purpose, I see the specialists as complementing, not impairing, each other.
You make a good point about ‘getting the policy ethical’. But equally, we have to get the science right and the ‘sociology’ right; there's too much at stake not to. I anticipate that advances among the universe of factors related to gene editing within humans will in some instances lead to simultaneous enlightenment among the fields listed in the essay, and in other instances their leapfrogging each other, in turns. That's okay. In both models, the aim is to play off and challenge each other, spurring creative sparks among the specialists. After all is said and done, isn't the subject too consequential for humankind to leave to just a few?
I would venture, Thomas, that it is possible to ‘get the policy ethical’ — at least, ‘ethical’ to some (and even perhaps most) minds. Admittedly, what’s ‘ethical’ is not uncommonly quite squishy, jiggled by culture, time in history, dominant creeds, upbringing, political suasions, one’s place in society, experiences, and so on. It’s the nature of the beast. It's situational. And it's contentious, as we see all the time — from animated televised debates to people demonstrating in the streets. But doesn’t society, amidst all that roiling, eventually have to arrive at decisions, choices, and actions? The alternative, it seems to me, is inertia.
It’s arguable, perhaps, that for society to work — to work effectively, efficiently, productively, and creatively, with some reasonable measure of momentum — it must make the hard decisions. I see gene editing, as it relates to human development, as one such decision. As you know, this is not virgin territory; medicine has long been using these techniques to avert and cure diseases, as the essay briefly mentions. But as with other such human endeavours, there’s always a next step, right? Getting the next step right — ‘getting the policy ethical’ — is, I suggest, achievable, even if exquisitely difficult.
Ah, Keith, your vision seems one of scientists working patiently towards the truth, with the highest of motives. But what if they are corruptible and indeed corrupted? Surely the test is how the science will develop given that people with evil motives will sooner or later be using it? Maybe you've seen it already, but our readers may be curious too: this is 'nightmare' vison that Jennifer Doudna, one of the US's top biotechnologists, had not long after discovering a powerful new gene editing technique:
"DOUDNA: I had a dream in which I was working away — I think I was in my office actually — and a colleague of mine came in and said, “I’d like to introduce you to someone, and I’d like you to explain the CRISPR technology to him.” And he led me into a room. There was a light in the room and there was someone sitting in silhouette in a chair with his back to me. He turned around, and I realized with this horror — and I can feel it right now as I’m telling you the story, I feel this chill in my body — I realized that it was Adolf Hitler. And he was looking at me with very intent look on his face, an eager look. He wanted to know about this technology.
I felt this incredible sense of fear; both personal fear, but also a profound existential fear that if someone like that were to get a hold of a powerful technology like this, how would they deploy it? And when I woke up from that dream — and thinking about it subsequently — it was really scary to think about. I thought, “We have to proceed responsibly here.” We cannot just — or at least for myself — I can’t just carry on with my next experiment at my lab. I really have to get involved in a broader discussion about this. It’s just too important a subject."
( more at http://freakonomics.com/podcast/evolution-accelerated-rebroadcast-2/ )
Thank you, Martin, for introducing this viewpoint.
What Doudna describes, however, strikes me as arguably the hyperbolic, even surreal imaginings that can typify dream states. I’m perplexed why she didn’t wake up and accept the unreality of the scenario dreamt. Even if the nightmare, in spurring unease, were to lead to sincere, understandable soul searching. I might add that, even if explained as the product of Doudna’s dream, resort to ‘Hitler’ as a rhetorical device to demonize something — anything — is a terribly blunt instrument, no? Comparisons to Hitler, in any context, in order to create a narrative and condemn (especially if couched as the product of a dream-cum-nightmare), strain credulity, I feel.
The ‘existential fear’ referred to, as emotionally colouring the dream, has unfortunately and, to my mind, unnecessarily muddied discussion of all sorts of other rapidly emerging developments, including AI. This can’t be proved, of course, but I suspect these developments will come to fruition over the course of time, even if the entire course isn’t yet fully discernible, and despite pushback in the form of provisional pauses. All that said, I enthusiastically welcome one apparent outcome of Doudna’s dream: Her decision to ‘get involved in a broader discussion’ about the ‘powerful technology’ represented by gene editing. Underscoring this point, the world as a whole should increasingly engage in the multidisciplinary due diligence that the essay proposes.
By way of brief follow-up, Martin, I found this comment by Jennifer Doudna, also from the 'freakonomics' podcast link you referred readers to, as quite a reasonable and encouraging forecast of the promise of human (what she calls 'not medically essential') gene editing down the road ...
DOUDNA: "I’ve seen an evolution in my own thinking, quite frankly. I have gone from feeling very uncomfortable with the idea of making changes to human embryos, especially for anything that would be considered not medically essential, to thinking that there may come a time — I don’t think we’re there now and I don’t think it’s right around the corner — but I think there may come a time when that application is embraced and it’s going to be deployed. For me, the important thing is not to reject it. It’s actually to understand it and really think through the implications."
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