- Email: [email protected]
Germinal choice technology and the human future
RBMOnline - Vol 10. Supp 1. 2005 27–35 Reproductive BioMedicine Online; www.rbmonline.com/Article/1639 on web 6 January 2005
Germinal choice technology and the human future Gregory Stock is director of the Program on Medicine, Technology and Society at UCLA’s School of Public Health in Los Angeles, USA. Dr Stock is also the CEO of Signum Biosciences (www.signumbiosciences.com) in Princeton, NJ. He explores the topics raised in this essay more fully in his book published in spring 2002 and now available in paperback from Mariner Press: Redesigning Humans: Choosing our Genes, Changing our Future (http://research.mednet.ucla.edu/pmts/redesign.htm). This book won the Kistler prize for science books. More details about the author can be found on the Internet at http://research.mednet.ucla.edu/pmts/Stock.htm.
Gregory Stock UCLA School of Public Health, Los Angeles, USA Correspondence: e-mail: [email protected]
Abstract This paper examines the likely impacts of emerging technologies that will give prospective parents the potential to directly influence the genetics of their offspring. My primary focus is on advanced prenatal genetic diagnosis (PGD) for both disease and non-disease traits, since this is likely to emerge before such possibilities as direct germline engineering. I place these technologies within the larger context of today’s revolution in the life sciences and consider the progress likely to occur in this realm in the next few generations. I take a common sense look at the types of screening choices people are likely to make once these possibilities become possible, their broad consequences for human society, and the advantages and disadvantages of plausible regulatory paths in this realm. I also reflect upon today’s debate about cloning and other such issues in the life sciences, looking at the driving forces behind these discussions and the tensions likely to develop in the next few decades.
Keywords: cloning, designer babies, eugenics, germline engineering, human evolution, PGD
Introduction When we look into the future to consider the challenges that technology will bring us, we typically think of global warming, pollution, terrorism, globalization or even the loss of personal privacy. But such issues pale beside the matter of how we will ultimately alter ourselves, using advancing technology in the life sciences. The idea that humans might somehow transform their very biology seems strange and disturbing if not downright preposterous, but genetics and biology are our core and our substance, and as we learn to understand and adjust them, we are learning to manipulate and change ourselves. To see the degree to which we have used technology to transform our external world, you need only take a walk through the heart of any major city. The valleys of glass, concrete and steel through which you stroll will hardly be the habitat of our Pleistocene ancestors, and as our technology has achieved greater power and precision, we have begun to swing its focus back upon our own selves. Ultimately this may transform our internal world as profoundly as our external one, revolutionizing medicine and health care, altering huge swaths
of the global economy, changing the way we have children and how we manage our emotions, even altering our lifespans. Such developments will make us look anew at the question of what it means to be human.
The big picture Two revolutions that are unprecedented in the history of life are underway today (Stock, 1993). The first is the silicon revolution: the telecommunications, computers, artificial intelligence and related technology that are ever more shaping our lives. We are breathing into inert sand – the silicon at our feet – a level of complexity rivalling life itself, and our world will never be the same. The second revolution, a child of the first, is that in molecular biology. As we plumb the workings of life to untangle our very substance, we are beginning to adjust and manipulate its underlying processes to take control of our evolutionary future. Today is but the calm before the storm, for our science has slammed evolution into ‘fast forward’, and no one can say where the process will ultimately carry us.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005 © 2005 Reproductive Healthcare Limited Published by Reproductive Healthcare Limited
27
Ethics - Germinal choice technology and the human future - G Stock
The human genome project is the poster child of this second revolution. We have a list of the human genes, and libraries of their common variants. We have micro-array technology to screen for these variants at ever lower prices, and we have the bioinformatics capabilities to make sense of the tsunami of such information about to wash over us. The impact will be enormous, because genes do matter. They are not our destiny, but they carry tremendous information about our predispositions and vulnerabilities in life, about who we are. For the childhood environments typical in today’s developed world, between a quarter and three-quarters of the variation in most traits across the human population can be explained by genetics, so our genes are a huge window into who we are, and we are beginning to draw back the curtain.
Cloning brings nothing novel into being, because it attempts merely to copy a previous genetic constitution. The procedure may take some years to realize, as it is technically difficult, of dubious safety and without broad appeal, but it already has provoked major legislation and inflamed passions. The strong reaction stems from the fact that cloning is a symbol of the coming insertion of sophisticated technology into human reproduction, because unlike IVF, cloning creates an outcome unachievable by biology alone: the birth of a delayed identical twin. Given recent research progress in Korea on embryonic stem cells (Hwang et al., 2004), which must overcome the same technical hurdles of nuclear transfer and embryo manipulation, a human clone will probably be born within a decade or so.
The widespread and inexpensive personal genetic testing that will arrive during the next decade will challenge us deeply by pushing medicine towards more preventive and personalized interventions, but this hardly warrants the angst about biotech evident today. Our deeper fears come from three more distant possibilities.
When such a birth occurs, however, it will not be nearly as momentous as observers seem to imagine. The arrival of a delayed twin may strike us as strange, but it hardly threatens civilization. Moreover, so expensive and difficult a clinical procedure will not come into widespread use rapidly. Twentyfive years after the arrival of IVF, a procedure that promised to fill a deeply felt absence in the lives of millions of childless couples, IVF still accounts for only 1% of live births in the US and Britain, and the desire to clone a child is far less widespread and far less passionately held.
The first is the reworking of our underlying biology. If we unravel the process of ageing and learn to substantively retard critical aspects of it, all of human society will be affected (de Grey et al., 2002). Family relationships, educational structures, the passage of wealth and power between generations, and the shapes of most social institutions will shift profoundly. The second is the power of psychopharmacology to manage our emotions. Ritalin, Viagra and Prozac are only clumsy baby steps. The potential is now emerging to short-circuit the evolutionary programmes that direct human behaviour. It is no accident that we like sugar, that sex feels good, that we are strongly attached to family, or that success brings a sense of fulfilment. Would we be able to resist a cocktail of drugs that made us feel contented and fulfilled without physiological sideeffects? and if we did not, who would we be and what would motivate us? Finally, there is reproduction, the passage of life from one generation to the next. As we come to understand the constellations of genes that influence our identities, potentials, vulnerabilities and temperaments, we will want to use this knowledge to influence the constitutions of our children.
Children by design Coming changes in human reproduction in the decades ahead will give people three primary ways of choosing their kids’ genes. These germinal choice technologies (GCT), each building on a foundation of in-vitro fertilization (IVF), will greatly extend less potent present methods of influencing the biology of children, for example mate selection and amniocentesis followed by abortion. Coming GCT technologies, ranging from reproductive cloning, which, notwithstanding the controversy it provokes, is highly conservative, to germline engineering, a radical embodiment of conscious human design, are not distant. Each is already in use in a rudimentary form, either with livestock, laboratory animals or humans.
28
Germline engineering, the most potent GCT, sits at the other pole of coming reproductive possibilities because it embodies the direct design or alteration of embryos. Germline engineering is geared not towards duplication, but enhancement and the creation of novelty. Like cloning, it embodies great symbolism, representing the advent of intentional human design, but it is even more technically challenging than cloning and of more dubious safety. The basic outline of how it might be effected in humans through artificial chromosome technology, however, has already been described along with early potential design targets like anti-ageing interventions (Campbell and Stock, 2000; Capecchi, 2000). It will probably be several generations before the balance of risks and rewards favours the broad use of germline engineering, and the technology seems unlikely to be used even narrowly in humans in any meaningful way for at least 40 or 50 years, but worry about ‘designer children’, as with cloning, has already provoked fascination and hand wringing in the print and broadcast media. Between these two extremes – cloning and germline engineering – lies the real challenge for humanity in this realm in the immediate decades ahead: preimplantation genetic diagnosis (PGD). PGD is already broadly used in a rudimentary form. Significant refinements to it are in progress and advanced PGD could be in broad use within a decade or two, applied to the large numbers of children already being conceived routinely by IVF. The major enabling developments required for the arrival of advanced PGD are (i) breakthroughs in methods of oocyte maturation and handling to allow the easy freezing of immature eggs rather than mature oocytes or embryos, (ii) completion of broad genomic population studies to establish the linkages between diverse constellations of gene variants and aspects of human vulnerability, potential, personality and temperament, and (iii) progress on comprehensive genomic testing of single cells.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
All three are straightforward extensions of current research, so advanced PGD could emerge in full force in the next generation (Stock, 2002). Moreover, such embryo screening would be extremely difficult to regulate, much less ban, given that it will be feasible in thousands of laboratories throughout the world, is viewed as desirable by large numbers of people (Macer et al., 1995), and cannot be detected after the event. There is no way of examining a child to determine if he or she is the product of embryo screening.
Embryo selection of this sophistication would be human enhancement as surely as germline engineering. Indeed, no one could later figure out whether an embryo with a particular genome had been selected to obtain that genome or modified to produce it. A natural question is whether such intervention would eventually partition humanity into the ‘enhanced’ and the ‘unenhanced’ (Silver, 1997). The answer hinges on which enhancements become feasible, how much they cost and who has access to them.
Any national ban would merely raise the price of the procedure, drive it underground, shift it to more hospitable environments, and reserve it for the wealthy, who could easily circumvent such a restriction, since borders are permeable. Advanced embryo screening will soon be with us, and it seems destined eventually to become the foundation for other, more provocative GCT.
When bioethicists use the term enhancement, they usually grapple with the challenge of defining ‘normal’ human functioning because they wish to differentiate between therapy and enhancement (Parens, 1998). Such a distinction, however, is arbitrary for many interventions. To retard ageing, for example, would be an enhancement of our vitality, but a therapy for age-related decline. It is a therapeutic enhancement, and this is so, whether the outcome is achieved through screening embryos or through sophisticated genetic interventions.
Given the messy complexities and uncertainties of human reproduction, today’s polished media images of future parents shopping for designer babies are a caricature of things to come, but GCT will bring prospective parents many difficult choices about the genetics of their future kids. The logistics of reproduction seem poised to shift towards a process that starts when a young woman freezes and cryogenically banks large numbers of immature oocytes collected by ovarian biopsy. Later, when she has a partner and wants kids, she will thaw, mature and fertilize these eggs, screening the resultant embryos using advanced PGD, so that she and her partner can implant the ones they choose. Moreover, the focus of embryo screening will probably progress from protecting against genetic disease to avoiding lesser vulnerabilities like manic depression, to identifying non-disease attributes like personality, temperament, athleticism and appearance. The users of such screening will also shift as it spreads from the infertile who see it as an adjunct to the IVF they are already undergoing, to the wealthy who wish to avoid the risks and uncertainties of traditional reproduction, to just about everyone else as pressures mount to include the procedure in basic healthcare packages.
The enhanced and the unenhanced In light of the potential widespread availability of advanced PGD even a few decades from now, it is worth looking at the choices people might gravitate towards, given access to such technology. Importantly, such PGD will probably be potent enough to offer meaningful enhancement well before direct germline manipulation further extends the choices available to parents. Consider what would happen, for example, if parents wishing to enrich their offspring for some trait substantively shaped by genetics were to create 100 healthy embryos, test them using PGD, and implant only the most predisposed towards that trait. If such embryos were selected, for example, for the gene variants responsible for most of the genetic contribution to high IQ (Tambs et al., 1989), the average score of the resultant kids would be 120, some 20 points above the general population average and higher than 90% of population (Stock, 2002). Moreover, this shift would take place in only a single generation.
Thus, I use the term enhancement to mean any augmentation of attributes or overall functioning, whether or not it moves a person beyond what is typical for humans. People generally want to be healthier, smarter, stronger, faster and more attractive, but in essence enhancements are simply the modifications that people think serve their goals and purposes. A useful way of categorizing enhancements is by their magnitude and by the degree to which they are health related. Targeted qualities will range from reducing disease risks like cancer and diabetes, to adjusting cosmetic and idiosyncratic traits like hair colour, musical talent, height or curiosity. We’d all want our children to be at low risk for leukaemia, but we’d probably disagree about how tall or outgoing we’d like to see them. We can best gauge the magnitude of a modification by comparing it to the typical range of human functioning. At one extreme are partial restorations of lost capacities – hearing for the deaf or improved immune responses for those with compromised immune systems. In the middle are improvements that make people a little smarter, stronger or taller, lifting under-performers to average levels and average performers to elite levels. At the other extreme are enhancements that carry a person beyond typical human ranges, reaching levels beyond even today’s elite performers – superhuman endurance, intellect, strength or vitality. Clearly, this latter group would be impossible to accomplish through embryo screening alone, so it will not be available anytime soon, but the other two could readily be accomplished by choosing among sibling embryos. Enhancements positioned differently for these two measures will differ substantially in how they challenge us socially, morally, and politically. Many people have no problem with either enhancements that are health related or those that avoid subnormal attributes. We generally call them ‘therapies’. Modest enhancements or alterations of idiosyncratic traits are troubling to some but are generally tolerated. Enhancements to elite or superhuman levels are usually condemned.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
29
Ethics - Germinal choice technology and the human future - G Stock
The key to understanding the future trajectory of human enhancement is to realize that deeper enhancements will be more difficult technically. Modest improvements will be easier to accomplish (Stock, 2002), so early GCT will offer far less to those seeking elite or superhuman performance than to those trying to avoid impairments or raise performance a bit. Broad use of GCT would not only raise average human performance and health in coming generations, it would narrow the spread between those with the highest and lowest potentials. This levelling would arise not from imposed restrictions on the technology, but from the nature of technological advance, the complexity of deeper enhancements, and people’s risk avoidance. We may eventually come to enhance human physiology substantively so as to live longer or function better in meaningful ways, but we are not on the verge of this. To improve average or below-average performance is another story. Here, all we have to do is copy or select what nature already has achieved. As GCT becomes more potent, we will face difficult decisions about what tradeoffs will be best for our children. Humanity will agree that certain manipulations are wrong, just as we agree that certain parental behaviours constitute abuse. We will also agree that certain enhancements should be required, just as we agree that kids should enhance their immunity by getting vaccinations. But large realms will be contentious. Consider deaf parents who wish to select embryos destined for deafness. Difficult as it may be for someone with normal hearing to accept this choice, preventing it would be dangerously close to coercive eugenics targeting the handicapped. Germinal choice will force us to confront our attitudes about what constitutes a meaningful life, our responsibilities to others, our prejudices, and what we mean when we say that all potential lives are equal and deserve protection.
The tensions of living together Humanity’s manipulation of canine evolution has produced an incredible diversity of breeds and served as an unwitting pilot project for our coming manipulation of our own evolution (Wayne, 1993; Vila et al., 1997). In the early phases of human self-modification, the social constraints will be entirely different, and the methods much more sophisticated, but scientists no doubt will encounter some of the same biological limits and possibilities (Lyudmila and Trut, 1999).
30
choice we face will be our handling of advanced PGD, IVF and egg banking. If tests to screen for almost all genetic diseases, for example, become feasible but are available only to the affluent, genetic disorders will turn into diseases of the disadvantaged. Our policies will become even more critical when we can screen embryos for deeper aspects of genetic potential and vulnerability. As class barriers break down and society continues to advance towards meritocracy, the most talented from all ethnicities and backgrounds will be able to achieve success and associate, partner and mate with similarly talented and successful others. Over time, such self-sorting will divide society, increasingly distancing the more gifted from the less gifted. Narrowly available genetic screening and enhancement technology would accelerate such division and reinforce privilege, whereas broadly available technology would counteract it. Not long ago, restricting access to education was a way of reinforcing class divisions, but governments work so hard now to provide every child with the education to reach his or her potential that in many countries society is already being repartitioned by talent and intellect rather than family and position. In the US, student populations at elite institutions are ethnically and culturally more diverse, but draw from a narrow segment of humanity. In 1990, Yale and Harvard together enrolled only 1 in 400 of the freshmen at four-year colleges, but had 10% of all students scoring more than 700 on the verbal portion of their scholastic aptitude tests (SAT). Clustering the intellectual elite together this way is a new phenomenon; in 1950, these schools were 10 times less selective (Cook and Frank, 1991). Kids soon learn how competitive the world is and where their talents do and do not lie. We have each been through this. If we were astute, lucky, or found good mentors, we ended up doing what we were best at. Some of our aptitudes emerged from our experiences; others – those innate talents that come so naturally we took them for granted – came straight from our biology. People without the special talents and attributes that our society values – those who are clumsy, inarticulate, unattractive, slow-witted, those who would find it wonderful just to be average – are at a great disadvantage. Their hopes and aspirations may have always matched their lesser potentials, but it is more likely that their dreams had to shrink painfully, one disappointment at a time.
Reproductive fitness has always been nature’s metric for gauging individual worth, but as it becomes less prominent in our lives, we may want to amplify more peripheral aspects of who we are. Our choices will shape the human future, and we will discover them not in the proclamations of United Nations committees, but in our actual behaviour. Moreover, what we say we want will matter less than what we actually choose, which will reflect fashion and taste as well as utility.
Perhaps a mother who is unattractive remembers what it was like to suffer the teasing of her classmates and recalls her struggle for acceptance. Perhaps a father remembers being short and weak, and being picked on as a child. Perhaps a young man remembers watching others easily answer questions he could not fathom and remembers the humiliation of being dropped to the ‘slow’ group. Maybe a young woman wanted to be a writer, but could never bring any magic to her words. Maybe we were plagued with a punishing shyness, could not concentrate, or were stumbling and awkward. Such wounds heal but do not entirely disappear.
As GCT advances and begins to offer parents possibilities they find truly meaningful, our regulatory policies will begin to have significant consequences for society. The first major
We have no choice, of course, but to play the hand we are dealt. But at the same time, we strive to protect our children and give them the breaks we never had: the education we could
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
not afford, the family stability we wanted, the wealth we dreamed of, the guidance we needed. Society applauds such efforts but will be far more wary of parents who try to help their children with genetic interventions. Why, though, should we not try to give our future children talents that we did not have, or eliminate deficiencies that plagued us? If we could make our baby brighter or more attractive, or give the child more raw talent, or keep him or her from being overweight, why would we not? One social problem that might attend interventions that gave our children raw talents would be that such talents would become less special. To the extent that talent and good health are heritable, children from some parents have an edge. What brilliant intellectual does not expect his child to be near the top of the class? What sports superstar does not expect his child to have athletic gifts? Such kids may not meet such expectations, but they will probably do fairly well. Genetics is not the whole story, but it is important. Adopted children tend to resemble their biological parents more than their adoptive ones for a reason: life does not start from scratch each generation; it takes from the past. With the completion of our sequencing of the human genome, pointing out that we differ from one another in only 1 in 1000 of our DNA bases, the individual letters in the code that constitutes our genome, has been fashionable. We are 99.9% the same as our fellow humans – virtually identical to them – whoever they may be. This interpretation is reassuring but misleading. We only have to look around us to see the extraordinary differences among us. Biological diversity is real. We come in different shapes and sizes. We have distinct personalities and temperaments. We possess different talents and vulnerabilities. We draw much of this from our genetic constitutions. How can this be when our genetics are 99.9% the same? The answer is clear when we see that our DNA sequence is more than 98.5% the same as a chimpanzee’s, 80% the same as a mouse’s. Open up a mouse and you find a heart, lungs, intestines, bones, nerves, muscles. Mice are very close cousins to us, and when it comes simply to having homologous genes rather than exact sequences, the similarity between all life is clear. Some 98% of the mouse’s genes are ours too, some 95% of the cow’s, 60% of the fruit fly’s, and 50% of those of even a banana. All life has cells. These cells divide in the same ways. They regulate their DNA, manage their metabolism and cellular communication. They have the same basic biochemistry. Our genetic similarities come from the fundamentals we all share. Of course you and I are nearly the same. We are both animals, vertebrates, primates, humans. The differences between us are subtle, but that does not mean we do not care about them. A difference of 1 in 1000 bases comes to 3,000,000 differences. Sure, the vast majority are scattered through the so-called junk DNA between our genes, and most of the 150,000 or so differences in our actual genes will not lead to functional differences. But a single base can be the difference between vibrant health and early death. Parkinson’s comes from a single changed base. So do sickle-cell anaemia, haemophilia and other diseases.
Our major competitors for just about everything in life are other people, so we are fine-tuned by evolution to be highly sensitive to the minute differences among us. All people might look pretty much the same to a space alien or a mosquito – or an evolutionary biologist – but not to a coach trying to build a winning sports team or to someone looking for a mate. As we untangle our genes and learn to select and alter them, some parents will want to give their children endowments they themselves could only dream of. If such interventions become broadly available, first through PGD and later through actual germline engineering, the result will be revolutionary, because it will be such a major step toward equalizing life’s possibilities. The gifted of today may not welcome such a levelling, because it would diminish the edge their children enjoy, but there can be little doubt that universal access to enhancement technology would equalize and spread talent, not concentrate it.
Competition unleashed Because kids must draw from environment and experience to realize their full biological potentials, a flood of children with high genetic potential would make the achievement of success far more challenging. Society would get very competitive, even for the best endowed. For those whose children would have great ‘natural’ talent anyway, such a development is threatening. For those who would have been less fortunate, just being in the game will be an improvement. As germinal enhancements become feasible, the mass of humanity is bound to insist on enriching its children’s natural endowments. Strong voices may oppose this, but most of the warnings about eugenics and human manufacture will flow from those with the talent and position to voice them – the elite with the most to lose. After all, their children are the ones who will ultimately suffer from the arrival of a wild genetic bazaar where all parents can gain similar talents and potentials for their children. Today’s intellectual elite might not want to live in a world as aggressive, competitive, and uncontrolled as the one that would emerge from universal access to potent GCT, so their distaste for the technology may deepen once its true implications become clear. Such resistance, however, would be reminiscent of the fears of earlier elites who liked society the way it was and wanted to retain their advantages. The wellborn were right to fear the political reforms that broke down class divisions, and today’s new elite should wince as well, because if the God-given gifts of talent and intelligence that have raised them above the throngs are laid out for everyone to grab, their children’s futures will not look nearly as bright. That concern about preserving the ideals of an egalitarian society and preventing the formation of a genetic elite (Krimsky, 2000) inspires much of the philosophical distaste for GCT among intellectuals is ironic, both because they are among the elite and because any meaningful effort to block these technologies will compound rather than alleviate such biological advantages.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
31
Ethics - Germinal choice technology and the human future - G Stock
To look at the possible implications of advanced GCT more concretely, let’s imagine that scientific progress and public policy combine to make meaningful enhancement technologies widely available, relatively commonplace, and largely under the control of individual parents. This is not far-fetched; laboratory-mediated conception using advance PGD may one day seem no more foreign than medically assisted birth does today. Parents will want to do what they think is best for their children, and even those uninterested in enhancement may come to see it as reckless and primitive to conceive a child without prior genetic testing. After all, in 1900 few thought of giving birth in a hospital as ‘natural’. Only 5% of births took place there. Today almost all do in the USA, and some 30% are by Caesarian section, a frequently avoidable procedure that is nonetheless readily accepted (Wertz and Wertz, 1989). In such a world, people’s genetics over time would become a manifestation of their parents’ values and predilections. Initially, the differences between the ‘enhanced’, who use these technologies, and the ‘unenhanced’, who do not, would be only statistical, in that those with enhancements would tend to do better than many, but not all, of those without enhancements. But as the technology became more potent, less overlap would exist between these populations. As this became clear to parents, many of the children of those who had shunned the technology would probably opt to enhance their own children to keep them from being at a disadvantage. A similar story would play out in the global arena, as countries that initially blocked GCT gradually felt forced to revise their laws and accept it. Access to advanced technology typically flows with national wealth, but adoption of GCT might hinge more on the religious and cultural traditions in different regions. China and the rest of Asia, for example, seem much less troubled by these technologies than Europe, so some of the wealthiest nations could easily be the most resistant to enhancement technology. Eventually, however, they probably will have no choice. What, after all, would a country that bans advanced embryo diagnosis do if other nations were to embark on popularly supported eugenic programmes poised to raise the average IQ of their next generation by 20 points?
Breeds apart As we increasingly manifest our aptitudes, temperaments and philosophies in our children through our decisions about their genetic constitutions, a self-reinforcing channelling of human lineages will probably develop. Family names once denoted family professions that persisted for generations. The Cooks, Fishers, Smiths, Taylors, and Bakers of the world no doubt would uncover the corresponding trades among their ancestors. Perhaps in the future clusters of genetic predispositions, lifestyles and philosophical orientations will arise that are equally persistent. Such families of musicians, politicians, therapists, scientists and athletes, however, would not be locked in by social constraints and limited opportunities, but by a tight feedback loop between complex genetic selection and the values, philosophies and choices that bring that selection and flow from it.
32
Over time, such specialization might become far deeper than
that which has occurred historically without reproductive reinforcement. Ideally, the resultant partitioning of the social landscape would be according to individual predisposition and desire rather than some pre-existing template imposed upon unwilling populations. But the possibilities of abuse either by governments or by individual parents who breed children for their own purposes are significant. Tyranny and child abuse require no advanced technology, though, and whether either would be changed much by the presence of GCT is highly debatable. Even disregarding outright abuse, though, scenarios of human design are jarring, because they evoke troubling images of freakish human forms. We should not dismiss such images, but neither should we allow them to grow in our imaginations to the point where they oversimplify and distort a future landscape bound to be exceedingly complex. Rare special potentials may become more dramatic and less unusual, but parents will be even more drawn to genetic predispositions that avoid the genetic handicaps and vulnerabilities that afflict us today. This will narrow the human diversity around us, but so did polio vaccinations and seatbelts, and they provoked no outcry. As self-reinforcing clusters of human attributes begin to crystallize, however, human diversity will expand. Today, when a rare combination of genetic and environmental factors comes together to create genius in one of its many guises, the combination usually disappears in the next generation. This happens not only because contributing environmental influences do not recur, but because the particular genetic constellation dissipates during genetic recombination. In the future, parents might preserve or even extend key aspects of such genetic influences through embryo selection and germline engineering. As particular attributes are boosted or diminished in children, their predispositions will come to reflect their parents’ philosophies and attitudes, so children will also come to manifest the cultural ethos and values that influence their parents. Consider gender. Many couples would choose different attributes for boys and girls. So, GCT would translate cultural attitudes about gender into the biology of children. If a society believes that women are (or should be) more empathetic and supportive, and boys more aggressive and independent, then whether or not these gender specificities are true, they will become true, and if society believes that such gender distinctions do not (or should not) exist, they will diminish. Even aspects of personal identity that are specific to a particular culture at a particular time could become embedded in biology to deepen the differences among human populations. Cultures differently value education, athletics, intelligence, calmness, obedience, curiosity and other personality traits. To the extent that genes influence these cultural differences, GCT might reinforce and heighten them, particularly if the biological predispositions that elicit these cultural patterns engender selection of the same predispositions. This is not to say, however, that the cultural landscape brought about by GCT will soon become unfamiliar. We are used to
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
broad human diversity that ranges from 80-pound models to 400-pound Sumo wrestlers, from tiny gymnasts to towering basketball players, and from deaf-mutes to concert pianists. The added differences brought by GCT will not soon sweep us into a realm anyone would notice during a ride on a crowded subway.
Genes and dreams To know what traits we will want to give our children, we need to reflect upon who we are. Our evolutionary past speaks to us through our biology to fashion our underlying desires and drives (Wilson, 1978; de Waal, 1998). Our urges are those that best enabled our ancestors to have as many children as possible and ensure that they’d grow up to do the same. Simplistic interpretations of what evolution tells us about who we are and how we should live are frequently misleading and politically self-serving, but when general human preferences are relatively consistent across different cultures and lands, they are probably tied to our biology, whatever their local accents and nuances. At the risk of landing in trouble, I will make a few extreme generalizations about men and women. These statements have many exceptions and inadequacies, but nonetheless are useful in understanding some of the underlying forces operating in our culture. We humans focus much of our energy on sex, our families and homes, and our relative status. Both men and women are largely monogamous but not entirely. We favour those more related to us over those less related. We are social creatures, and are most comfortable within groups of a few people to a few dozen. We are highly competitive. Men tend to be more aggressive and violent than women (Edwards, 1987). Men compete more for status, power and wealth – key ingredients in attracting women – and are drawn to beautiful women, which in almost all cultures means women having attributes that signal youthfulness and health, just the qualities needed to bear and rear children. Women tend to care more about how they look – a key ingredient in attracting men – are more socially adept, care more about commitment, and are drawn to men with status, power, and wealth – the qualities needed to provide for children. The importance we attach to sex, beauty, status, power and the success of our children comes from deep within us. We do not have to act upon these urges, but we cannot escape them. It is no fluke that advertisements so frequently play on these themes. They work. Automobile ads for men stress status, power, money, and getting women, so do ads for computers, vacations, cigarettes, beer and just about everything else. Fashion ads for women focus on beauty, appearance, sex and attracting and holding the right men. Many parents-to-be, if they could use germinal choice technology to shape their children, would seek the very attributes that advertisers push. Not everyone would follow stereotypes of beauty, strength and intelligence, but many would, and we might find ourselves surprised at how much we would be drawn in these directions if given a smorgasbord of possible qualities to choose from.
often by their appearance. These ‘cosmetic’ interventions will probably be for clusters of alleles that in the case of women soften features and bring more symmetry to them (Thornhill and Gangestad, 1993), or in the case of men, add to stature and strength. Eventually self-modification of this sort might lead to moderately less physical diversity, but we must remember that quite a spread exists in what we find attractive. Moreover, the most superficial features such as hair type, eye colour, nose shape and general appearance may be easier to modify through clothing, hair dyes, cosmetic surgery and even coloured contact lenses. Today, when parents buy donor eggs or sperm, the most important qualities they seek in a donor – since health can be assumed – are ethnicity and basic physical features that match their own. Recipients want to be sure that the child seems to be theirs. Beyond those limitations, couples seek the same underlying qualities they might seek in a mate. Indeed the catalogue listings in sperm and egg donor banks strongly resemble singles ads. Here is an ad for sperm (Schmidt and Moore, 1998): ‘He has wavy dark brown hair and eyes. He’s 5’ 10” tall and weighs 156 lbs on a medium frame. . . . His ancestry is Eastern European. . . . He is currently studying law with a GPA of 3.4. Other interests include music . . . iceskating, and juggling’. Sociability will be a valued trait for future selection, I suspect, because it is so important to positioning ourselves within groups, and intelligence will be as well, since it is a critical ingredient in equipping us for a complicated world that includes complex social dealings we have with one another. It enables us to entertain each other, to play social games effectively, to compete more successfully with one another (Ridley, 1993). However imperfect the measures of genetic predisposition toward ‘intelligence’ turn out, many prospective parents will probably use them in selecting embryos. Grade point average and SAT scores are important pieces of information on the biographical profiles of egg and sperm donors, because they serve as a surrogate for these genetic markers. In contrast, there will probably be less agreement on choices of temperament and personality. Whether it is better to be introverted or extroverted, cautious or bold depends on circumstances. Parents may well moderate their choices in this realm to avoid extremes, and psychopharmacology, with its antidepressants, mood stabilizers, sedatives and anti-anxiety agents, would push in this direction as well. But the inclination to give our children skills and traits that align with our own temperaments and lifestyles will push the other way. An optimist may feel so good about his optimism and energy that he wants more of it for his child. A concert pianist may see music as so integral to life that she wants to give her daughter even greater talents than her own. A devout individual may want his child to be even more religious and resistant to temptation. To the extent that trait enhancement of this sort engenders mindsets disinclined to attenuate the trait in their own children, such traits may reinforce themselves from generation to generation and push toward the limits of genetic possibility and technical know-how.
Physical attributes will be an enticing target for potential adjustment, because people, particularly women, are judged so
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
33
Ethics - Germinal choice technology and the human future - G Stock
Our feelings and emotions play a large role in regulating our behaviour, so we need to consider their nature as well in thinking about our likely future choices with germinal technologies. Biology uses emotion to channel behaviour in ways that have been evolutionarily fruitful. We do things because they gratify our desires, calm our fears, stop our pains, feed our hungers, satisfy our curiosities or make us feel happy. If we largely seek various flavours of pleasure and avoid various kinds of pain, we have a good shot at feeding ourselves, having kids, taking care of them, and being the best biological creatures we can be, which means leaving the most kids behind. As to how rapidly GCT will be embraced, our infatuation with health suggests that broad screenings of embryos to avoid diseases and other unwanted traits will spread rapidly as soon as they become readily available. Similarly, we are almost certain to embrace the germinal enhancement possibilities of added longevity when they begin to emerge. But assessing which modifications to a child’s temperament will appeal to parents or which enhancements toward talents such as music, art, or athletic ability, they might choose is mere guesswork. I am suspicious of simplistic interpretations of the impacts of germinal choice. We can discern some broad outlines, but our reactions to its possibilities will probably be as complex and unpredictable as the rest of life, and equally driven by the specifics of individual temperament, personality and circumstance. The only real way to gauge our distant choices may well be to observe our immediate ones as GCT begins to expand, and we will need to extrapolate from these without forgetting that both our individual expectations and our social environment will shift substantially in the years ahead as the technology evolves.
Looking at our fears One certainty about GCT and the other emerging possibilities of biotechnology is that no matter how much debate and discussion takes place, no consensus about them will emerge. These possibilities speak too directly to our vision of the human future, our notions of who we are and will become. They touch us too deeply. Our perceptions of them depend too much on religion, philosophy, culture and politics. To some, this is the invasion of the inhuman, and we are heading towards disaster by violating the most sacred aspects of our humanity. To others, this is our flowering, enabling us to transcend aspects of our biology that other generations could barely dream of. In light of this, it is worth thinking about what the various critics of germinal choice and other technologies of the biotech revolution are most afraid of. They are not particularly concerned that these technologies will fail or prove unsafe, because if that occurred, the technologies would probably fade away. Their real worry is that these technologies will succeed, and succeed so gloriously that they create seductive possibilities we cannot resist. They fear that people will see so much benefit in them that they will embrace them, in which case critics will have to face their real fears.
34
The first fear is of ourselves. They worry that we will abuse these technologies. And, of course, we will. We abuse every technology. But this does not mean that we should stop developing GCT or that their costs outweigh their benefits. A second fear is of the philosophical implications. Critics fear that these technologies will change our sense of who we are. Again, they will. But if we could stop all biotechnology dead in its tracks, other technologies would still reshape our society. We may not be comfortable with the world we are creating for our great-grandchildren, but so what. Our great-grandparents would probably find our world jarring as well if they could see it, yet few of us would choose to return to their era, and our great-grandchildren will be no more eager to exchange their world for ours, which will seem primitive indeed to them. A third fear of critics is that we will be forced to make difficult choices. Again, they are right. Coming choices about both the end of life and its beginning are going to be excruciating. It is not easy to decide when to pull the plug on someone or which embryo to implant and which to discard. But these choices are part of growing up. Humanity is leaving its childhood and moving into its adolescence as its powers infuse into realms hitherto beyond our reach. The time has come for us to accept the responsibility that comes with our new understandings and powers. The next frontier is not space, it is our own selves. Do we really want to pull back and relinquish the exploration to other braver souls in other regions of the world?
References and further reading Campbell J, Stock G 2000 A vision for practical human germline engineering. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York, pp. 9–16. Capecchi M 2000 Human germline gene therapy: how and why. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York, pp. 31–42. Cook P, Frank R 1991 The growing concentration of top students at elite schools. In: Clotfelter C, Rothschild M (eds) The Economics of Higher Education. NBER-University of Chicago Press, Chicago, pp 121–140. de Grey A, Baynes J, Berd D et al. 2002 Time to talk SENS: critiquing the immutability of human aging. In: Harman D (ed.) Increasing Healthy Life Span: Conventional Measures and Slowing the Innate Aging Process; Proceedings of the 9th Congress of the International Association of Biomedical Gerontology. Annals of the New York Academy of Sciences 959 (special release), 452–462. de Waal F 1998. Chimpanzee Politics: Power and Sex among Apes. Johns Hopkins University Press, Baltimore, USA. Edwards A 1987, Male violence in feminist theory: an analysis of sex/gender violence and male dominance. In: Hanmer J, Maynard M (eds) Women, Violence and Social Control. Macmillan Press, London, pp. 13–29. Hwang W, Ryu Y, Park J et al. 2004 Evidence of a pluripotent human embryonic stem cell line derived from a cloned blastocyst. Science 303, 1669–1674. Krimsky S 2000 The psychosocial limits on human germline modification. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
Press, New York, pp. 104–107. Lyudmila N, Trut R 1999. Early canid domestication: the farm fox experiment. American Scientist Magazine 87, 160–169. Macer D 2000 Universal bioethics for the human germline. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York, pp. 139–141. Macer D, Akiyama S, Alora A et al. 1995 International perceptions and approval of gene therapy. Human Gene Therapy 6, 791–803. Parens E (ed) 1998 Enhancing Human Traits: Ethical and Social Implications. Georgetown University Press, Washington DC. Ridley M 1993. The Red Queen: Sex and the Evolution of Human Nature. Penguin, Harmondsworth. Schmidt M, Moore L 1998 Constructing a ‘good catch,’ picking a winner: the development of technosemen and the deconstruction of the monolithic male. In: Davis-Floyd R, Dumit J (eds) Cyborg Babies: from Techno-Sex to Techno-Tots. Routledge Press, New York, pp. 21–39. Silver L 1997 Remaking Eden: How Genetic Engineering and Cloning will Transform the American family. Avon Books, New York. Stock G 1993 Metaman: Humans, Machines, and the Birth of a Global Superorganism. Simon and Schuster, New York.
Stock G 2002. Redesigning Humans: our Inevitable Genetic Future. Houghton Mifflin, New York. Stock G, Campbell J (eds) 2000. Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York. Tambs K, Sundet J, Magnus D et al. 1989 Genetic and environmental contributions to the covariance between occupational status, educational attainment, and IQ: a study of twins. Behavior Genetics 19, 202–222. Thornhill R, Gangestad S 1993. Human facial beauty: averageness, symmetry, and parasite resistance. Human Nature 4, 237–269. Vila C, Savolainen P, Maldonado J et al. 1997 Multiple and ancient origins of the domestic dog. Science 76, 1687–1689. Wayne R 1993 Molecular evolution of the dog family. Trends in Genetics 9, 218–224. Wertz R, Wertz D 1989 Lying-In: a History of Childbirth in America. Yale University Press, New Haven, USA. Wilson EO 1978 On Human Nature. Harvard University Press, Cambridge, Massachusetts, USA.
Received 22 November 2004; refereed and accepted 9 December 2004.
35 Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Germinal choice technology and the human future Gregory Stock is director of the Program on Medicine, Technology and Society at UCLA’s School of Public Health in Los Angeles, USA. Dr Stock is also the CEO of Signum Biosciences (www.signumbiosciences.com) in Princeton, NJ. He explores the topics raised in this essay more fully in his book published in spring 2002 and now available in paperback from Mariner Press: Redesigning Humans: Choosing our Genes, Changing our Future (http://research.mednet.ucla.edu/pmts/redesign.htm). This book won the Kistler prize for science books. More details about the author can be found on the Internet at http://research.mednet.ucla.edu/pmts/Stock.htm.
Gregory Stock UCLA School of Public Health, Los Angeles, USA Correspondence: e-mail: [email protected]
Abstract This paper examines the likely impacts of emerging technologies that will give prospective parents the potential to directly influence the genetics of their offspring. My primary focus is on advanced prenatal genetic diagnosis (PGD) for both disease and non-disease traits, since this is likely to emerge before such possibilities as direct germline engineering. I place these technologies within the larger context of today’s revolution in the life sciences and consider the progress likely to occur in this realm in the next few generations. I take a common sense look at the types of screening choices people are likely to make once these possibilities become possible, their broad consequences for human society, and the advantages and disadvantages of plausible regulatory paths in this realm. I also reflect upon today’s debate about cloning and other such issues in the life sciences, looking at the driving forces behind these discussions and the tensions likely to develop in the next few decades.
Keywords: cloning, designer babies, eugenics, germline engineering, human evolution, PGD
Introduction When we look into the future to consider the challenges that technology will bring us, we typically think of global warming, pollution, terrorism, globalization or even the loss of personal privacy. But such issues pale beside the matter of how we will ultimately alter ourselves, using advancing technology in the life sciences. The idea that humans might somehow transform their very biology seems strange and disturbing if not downright preposterous, but genetics and biology are our core and our substance, and as we learn to understand and adjust them, we are learning to manipulate and change ourselves. To see the degree to which we have used technology to transform our external world, you need only take a walk through the heart of any major city. The valleys of glass, concrete and steel through which you stroll will hardly be the habitat of our Pleistocene ancestors, and as our technology has achieved greater power and precision, we have begun to swing its focus back upon our own selves. Ultimately this may transform our internal world as profoundly as our external one, revolutionizing medicine and health care, altering huge swaths
of the global economy, changing the way we have children and how we manage our emotions, even altering our lifespans. Such developments will make us look anew at the question of what it means to be human.
The big picture Two revolutions that are unprecedented in the history of life are underway today (Stock, 1993). The first is the silicon revolution: the telecommunications, computers, artificial intelligence and related technology that are ever more shaping our lives. We are breathing into inert sand – the silicon at our feet – a level of complexity rivalling life itself, and our world will never be the same. The second revolution, a child of the first, is that in molecular biology. As we plumb the workings of life to untangle our very substance, we are beginning to adjust and manipulate its underlying processes to take control of our evolutionary future. Today is but the calm before the storm, for our science has slammed evolution into ‘fast forward’, and no one can say where the process will ultimately carry us.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005 © 2005 Reproductive Healthcare Limited Published by Reproductive Healthcare Limited
27
Ethics - Germinal choice technology and the human future - G Stock
The human genome project is the poster child of this second revolution. We have a list of the human genes, and libraries of their common variants. We have micro-array technology to screen for these variants at ever lower prices, and we have the bioinformatics capabilities to make sense of the tsunami of such information about to wash over us. The impact will be enormous, because genes do matter. They are not our destiny, but they carry tremendous information about our predispositions and vulnerabilities in life, about who we are. For the childhood environments typical in today’s developed world, between a quarter and three-quarters of the variation in most traits across the human population can be explained by genetics, so our genes are a huge window into who we are, and we are beginning to draw back the curtain.
Cloning brings nothing novel into being, because it attempts merely to copy a previous genetic constitution. The procedure may take some years to realize, as it is technically difficult, of dubious safety and without broad appeal, but it already has provoked major legislation and inflamed passions. The strong reaction stems from the fact that cloning is a symbol of the coming insertion of sophisticated technology into human reproduction, because unlike IVF, cloning creates an outcome unachievable by biology alone: the birth of a delayed identical twin. Given recent research progress in Korea on embryonic stem cells (Hwang et al., 2004), which must overcome the same technical hurdles of nuclear transfer and embryo manipulation, a human clone will probably be born within a decade or so.
The widespread and inexpensive personal genetic testing that will arrive during the next decade will challenge us deeply by pushing medicine towards more preventive and personalized interventions, but this hardly warrants the angst about biotech evident today. Our deeper fears come from three more distant possibilities.
When such a birth occurs, however, it will not be nearly as momentous as observers seem to imagine. The arrival of a delayed twin may strike us as strange, but it hardly threatens civilization. Moreover, so expensive and difficult a clinical procedure will not come into widespread use rapidly. Twentyfive years after the arrival of IVF, a procedure that promised to fill a deeply felt absence in the lives of millions of childless couples, IVF still accounts for only 1% of live births in the US and Britain, and the desire to clone a child is far less widespread and far less passionately held.
The first is the reworking of our underlying biology. If we unravel the process of ageing and learn to substantively retard critical aspects of it, all of human society will be affected (de Grey et al., 2002). Family relationships, educational structures, the passage of wealth and power between generations, and the shapes of most social institutions will shift profoundly. The second is the power of psychopharmacology to manage our emotions. Ritalin, Viagra and Prozac are only clumsy baby steps. The potential is now emerging to short-circuit the evolutionary programmes that direct human behaviour. It is no accident that we like sugar, that sex feels good, that we are strongly attached to family, or that success brings a sense of fulfilment. Would we be able to resist a cocktail of drugs that made us feel contented and fulfilled without physiological sideeffects? and if we did not, who would we be and what would motivate us? Finally, there is reproduction, the passage of life from one generation to the next. As we come to understand the constellations of genes that influence our identities, potentials, vulnerabilities and temperaments, we will want to use this knowledge to influence the constitutions of our children.
Children by design Coming changes in human reproduction in the decades ahead will give people three primary ways of choosing their kids’ genes. These germinal choice technologies (GCT), each building on a foundation of in-vitro fertilization (IVF), will greatly extend less potent present methods of influencing the biology of children, for example mate selection and amniocentesis followed by abortion. Coming GCT technologies, ranging from reproductive cloning, which, notwithstanding the controversy it provokes, is highly conservative, to germline engineering, a radical embodiment of conscious human design, are not distant. Each is already in use in a rudimentary form, either with livestock, laboratory animals or humans.
28
Germline engineering, the most potent GCT, sits at the other pole of coming reproductive possibilities because it embodies the direct design or alteration of embryos. Germline engineering is geared not towards duplication, but enhancement and the creation of novelty. Like cloning, it embodies great symbolism, representing the advent of intentional human design, but it is even more technically challenging than cloning and of more dubious safety. The basic outline of how it might be effected in humans through artificial chromosome technology, however, has already been described along with early potential design targets like anti-ageing interventions (Campbell and Stock, 2000; Capecchi, 2000). It will probably be several generations before the balance of risks and rewards favours the broad use of germline engineering, and the technology seems unlikely to be used even narrowly in humans in any meaningful way for at least 40 or 50 years, but worry about ‘designer children’, as with cloning, has already provoked fascination and hand wringing in the print and broadcast media. Between these two extremes – cloning and germline engineering – lies the real challenge for humanity in this realm in the immediate decades ahead: preimplantation genetic diagnosis (PGD). PGD is already broadly used in a rudimentary form. Significant refinements to it are in progress and advanced PGD could be in broad use within a decade or two, applied to the large numbers of children already being conceived routinely by IVF. The major enabling developments required for the arrival of advanced PGD are (i) breakthroughs in methods of oocyte maturation and handling to allow the easy freezing of immature eggs rather than mature oocytes or embryos, (ii) completion of broad genomic population studies to establish the linkages between diverse constellations of gene variants and aspects of human vulnerability, potential, personality and temperament, and (iii) progress on comprehensive genomic testing of single cells.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
All three are straightforward extensions of current research, so advanced PGD could emerge in full force in the next generation (Stock, 2002). Moreover, such embryo screening would be extremely difficult to regulate, much less ban, given that it will be feasible in thousands of laboratories throughout the world, is viewed as desirable by large numbers of people (Macer et al., 1995), and cannot be detected after the event. There is no way of examining a child to determine if he or she is the product of embryo screening.
Embryo selection of this sophistication would be human enhancement as surely as germline engineering. Indeed, no one could later figure out whether an embryo with a particular genome had been selected to obtain that genome or modified to produce it. A natural question is whether such intervention would eventually partition humanity into the ‘enhanced’ and the ‘unenhanced’ (Silver, 1997). The answer hinges on which enhancements become feasible, how much they cost and who has access to them.
Any national ban would merely raise the price of the procedure, drive it underground, shift it to more hospitable environments, and reserve it for the wealthy, who could easily circumvent such a restriction, since borders are permeable. Advanced embryo screening will soon be with us, and it seems destined eventually to become the foundation for other, more provocative GCT.
When bioethicists use the term enhancement, they usually grapple with the challenge of defining ‘normal’ human functioning because they wish to differentiate between therapy and enhancement (Parens, 1998). Such a distinction, however, is arbitrary for many interventions. To retard ageing, for example, would be an enhancement of our vitality, but a therapy for age-related decline. It is a therapeutic enhancement, and this is so, whether the outcome is achieved through screening embryos or through sophisticated genetic interventions.
Given the messy complexities and uncertainties of human reproduction, today’s polished media images of future parents shopping for designer babies are a caricature of things to come, but GCT will bring prospective parents many difficult choices about the genetics of their future kids. The logistics of reproduction seem poised to shift towards a process that starts when a young woman freezes and cryogenically banks large numbers of immature oocytes collected by ovarian biopsy. Later, when she has a partner and wants kids, she will thaw, mature and fertilize these eggs, screening the resultant embryos using advanced PGD, so that she and her partner can implant the ones they choose. Moreover, the focus of embryo screening will probably progress from protecting against genetic disease to avoiding lesser vulnerabilities like manic depression, to identifying non-disease attributes like personality, temperament, athleticism and appearance. The users of such screening will also shift as it spreads from the infertile who see it as an adjunct to the IVF they are already undergoing, to the wealthy who wish to avoid the risks and uncertainties of traditional reproduction, to just about everyone else as pressures mount to include the procedure in basic healthcare packages.
The enhanced and the unenhanced In light of the potential widespread availability of advanced PGD even a few decades from now, it is worth looking at the choices people might gravitate towards, given access to such technology. Importantly, such PGD will probably be potent enough to offer meaningful enhancement well before direct germline manipulation further extends the choices available to parents. Consider what would happen, for example, if parents wishing to enrich their offspring for some trait substantively shaped by genetics were to create 100 healthy embryos, test them using PGD, and implant only the most predisposed towards that trait. If such embryos were selected, for example, for the gene variants responsible for most of the genetic contribution to high IQ (Tambs et al., 1989), the average score of the resultant kids would be 120, some 20 points above the general population average and higher than 90% of population (Stock, 2002). Moreover, this shift would take place in only a single generation.
Thus, I use the term enhancement to mean any augmentation of attributes or overall functioning, whether or not it moves a person beyond what is typical for humans. People generally want to be healthier, smarter, stronger, faster and more attractive, but in essence enhancements are simply the modifications that people think serve their goals and purposes. A useful way of categorizing enhancements is by their magnitude and by the degree to which they are health related. Targeted qualities will range from reducing disease risks like cancer and diabetes, to adjusting cosmetic and idiosyncratic traits like hair colour, musical talent, height or curiosity. We’d all want our children to be at low risk for leukaemia, but we’d probably disagree about how tall or outgoing we’d like to see them. We can best gauge the magnitude of a modification by comparing it to the typical range of human functioning. At one extreme are partial restorations of lost capacities – hearing for the deaf or improved immune responses for those with compromised immune systems. In the middle are improvements that make people a little smarter, stronger or taller, lifting under-performers to average levels and average performers to elite levels. At the other extreme are enhancements that carry a person beyond typical human ranges, reaching levels beyond even today’s elite performers – superhuman endurance, intellect, strength or vitality. Clearly, this latter group would be impossible to accomplish through embryo screening alone, so it will not be available anytime soon, but the other two could readily be accomplished by choosing among sibling embryos. Enhancements positioned differently for these two measures will differ substantially in how they challenge us socially, morally, and politically. Many people have no problem with either enhancements that are health related or those that avoid subnormal attributes. We generally call them ‘therapies’. Modest enhancements or alterations of idiosyncratic traits are troubling to some but are generally tolerated. Enhancements to elite or superhuman levels are usually condemned.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
29
Ethics - Germinal choice technology and the human future - G Stock
The key to understanding the future trajectory of human enhancement is to realize that deeper enhancements will be more difficult technically. Modest improvements will be easier to accomplish (Stock, 2002), so early GCT will offer far less to those seeking elite or superhuman performance than to those trying to avoid impairments or raise performance a bit. Broad use of GCT would not only raise average human performance and health in coming generations, it would narrow the spread between those with the highest and lowest potentials. This levelling would arise not from imposed restrictions on the technology, but from the nature of technological advance, the complexity of deeper enhancements, and people’s risk avoidance. We may eventually come to enhance human physiology substantively so as to live longer or function better in meaningful ways, but we are not on the verge of this. To improve average or below-average performance is another story. Here, all we have to do is copy or select what nature already has achieved. As GCT becomes more potent, we will face difficult decisions about what tradeoffs will be best for our children. Humanity will agree that certain manipulations are wrong, just as we agree that certain parental behaviours constitute abuse. We will also agree that certain enhancements should be required, just as we agree that kids should enhance their immunity by getting vaccinations. But large realms will be contentious. Consider deaf parents who wish to select embryos destined for deafness. Difficult as it may be for someone with normal hearing to accept this choice, preventing it would be dangerously close to coercive eugenics targeting the handicapped. Germinal choice will force us to confront our attitudes about what constitutes a meaningful life, our responsibilities to others, our prejudices, and what we mean when we say that all potential lives are equal and deserve protection.
The tensions of living together Humanity’s manipulation of canine evolution has produced an incredible diversity of breeds and served as an unwitting pilot project for our coming manipulation of our own evolution (Wayne, 1993; Vila et al., 1997). In the early phases of human self-modification, the social constraints will be entirely different, and the methods much more sophisticated, but scientists no doubt will encounter some of the same biological limits and possibilities (Lyudmila and Trut, 1999).
30
choice we face will be our handling of advanced PGD, IVF and egg banking. If tests to screen for almost all genetic diseases, for example, become feasible but are available only to the affluent, genetic disorders will turn into diseases of the disadvantaged. Our policies will become even more critical when we can screen embryos for deeper aspects of genetic potential and vulnerability. As class barriers break down and society continues to advance towards meritocracy, the most talented from all ethnicities and backgrounds will be able to achieve success and associate, partner and mate with similarly talented and successful others. Over time, such self-sorting will divide society, increasingly distancing the more gifted from the less gifted. Narrowly available genetic screening and enhancement technology would accelerate such division and reinforce privilege, whereas broadly available technology would counteract it. Not long ago, restricting access to education was a way of reinforcing class divisions, but governments work so hard now to provide every child with the education to reach his or her potential that in many countries society is already being repartitioned by talent and intellect rather than family and position. In the US, student populations at elite institutions are ethnically and culturally more diverse, but draw from a narrow segment of humanity. In 1990, Yale and Harvard together enrolled only 1 in 400 of the freshmen at four-year colleges, but had 10% of all students scoring more than 700 on the verbal portion of their scholastic aptitude tests (SAT). Clustering the intellectual elite together this way is a new phenomenon; in 1950, these schools were 10 times less selective (Cook and Frank, 1991). Kids soon learn how competitive the world is and where their talents do and do not lie. We have each been through this. If we were astute, lucky, or found good mentors, we ended up doing what we were best at. Some of our aptitudes emerged from our experiences; others – those innate talents that come so naturally we took them for granted – came straight from our biology. People without the special talents and attributes that our society values – those who are clumsy, inarticulate, unattractive, slow-witted, those who would find it wonderful just to be average – are at a great disadvantage. Their hopes and aspirations may have always matched their lesser potentials, but it is more likely that their dreams had to shrink painfully, one disappointment at a time.
Reproductive fitness has always been nature’s metric for gauging individual worth, but as it becomes less prominent in our lives, we may want to amplify more peripheral aspects of who we are. Our choices will shape the human future, and we will discover them not in the proclamations of United Nations committees, but in our actual behaviour. Moreover, what we say we want will matter less than what we actually choose, which will reflect fashion and taste as well as utility.
Perhaps a mother who is unattractive remembers what it was like to suffer the teasing of her classmates and recalls her struggle for acceptance. Perhaps a father remembers being short and weak, and being picked on as a child. Perhaps a young man remembers watching others easily answer questions he could not fathom and remembers the humiliation of being dropped to the ‘slow’ group. Maybe a young woman wanted to be a writer, but could never bring any magic to her words. Maybe we were plagued with a punishing shyness, could not concentrate, or were stumbling and awkward. Such wounds heal but do not entirely disappear.
As GCT advances and begins to offer parents possibilities they find truly meaningful, our regulatory policies will begin to have significant consequences for society. The first major
We have no choice, of course, but to play the hand we are dealt. But at the same time, we strive to protect our children and give them the breaks we never had: the education we could
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
not afford, the family stability we wanted, the wealth we dreamed of, the guidance we needed. Society applauds such efforts but will be far more wary of parents who try to help their children with genetic interventions. Why, though, should we not try to give our future children talents that we did not have, or eliminate deficiencies that plagued us? If we could make our baby brighter or more attractive, or give the child more raw talent, or keep him or her from being overweight, why would we not? One social problem that might attend interventions that gave our children raw talents would be that such talents would become less special. To the extent that talent and good health are heritable, children from some parents have an edge. What brilliant intellectual does not expect his child to be near the top of the class? What sports superstar does not expect his child to have athletic gifts? Such kids may not meet such expectations, but they will probably do fairly well. Genetics is not the whole story, but it is important. Adopted children tend to resemble their biological parents more than their adoptive ones for a reason: life does not start from scratch each generation; it takes from the past. With the completion of our sequencing of the human genome, pointing out that we differ from one another in only 1 in 1000 of our DNA bases, the individual letters in the code that constitutes our genome, has been fashionable. We are 99.9% the same as our fellow humans – virtually identical to them – whoever they may be. This interpretation is reassuring but misleading. We only have to look around us to see the extraordinary differences among us. Biological diversity is real. We come in different shapes and sizes. We have distinct personalities and temperaments. We possess different talents and vulnerabilities. We draw much of this from our genetic constitutions. How can this be when our genetics are 99.9% the same? The answer is clear when we see that our DNA sequence is more than 98.5% the same as a chimpanzee’s, 80% the same as a mouse’s. Open up a mouse and you find a heart, lungs, intestines, bones, nerves, muscles. Mice are very close cousins to us, and when it comes simply to having homologous genes rather than exact sequences, the similarity between all life is clear. Some 98% of the mouse’s genes are ours too, some 95% of the cow’s, 60% of the fruit fly’s, and 50% of those of even a banana. All life has cells. These cells divide in the same ways. They regulate their DNA, manage their metabolism and cellular communication. They have the same basic biochemistry. Our genetic similarities come from the fundamentals we all share. Of course you and I are nearly the same. We are both animals, vertebrates, primates, humans. The differences between us are subtle, but that does not mean we do not care about them. A difference of 1 in 1000 bases comes to 3,000,000 differences. Sure, the vast majority are scattered through the so-called junk DNA between our genes, and most of the 150,000 or so differences in our actual genes will not lead to functional differences. But a single base can be the difference between vibrant health and early death. Parkinson’s comes from a single changed base. So do sickle-cell anaemia, haemophilia and other diseases.
Our major competitors for just about everything in life are other people, so we are fine-tuned by evolution to be highly sensitive to the minute differences among us. All people might look pretty much the same to a space alien or a mosquito – or an evolutionary biologist – but not to a coach trying to build a winning sports team or to someone looking for a mate. As we untangle our genes and learn to select and alter them, some parents will want to give their children endowments they themselves could only dream of. If such interventions become broadly available, first through PGD and later through actual germline engineering, the result will be revolutionary, because it will be such a major step toward equalizing life’s possibilities. The gifted of today may not welcome such a levelling, because it would diminish the edge their children enjoy, but there can be little doubt that universal access to enhancement technology would equalize and spread talent, not concentrate it.
Competition unleashed Because kids must draw from environment and experience to realize their full biological potentials, a flood of children with high genetic potential would make the achievement of success far more challenging. Society would get very competitive, even for the best endowed. For those whose children would have great ‘natural’ talent anyway, such a development is threatening. For those who would have been less fortunate, just being in the game will be an improvement. As germinal enhancements become feasible, the mass of humanity is bound to insist on enriching its children’s natural endowments. Strong voices may oppose this, but most of the warnings about eugenics and human manufacture will flow from those with the talent and position to voice them – the elite with the most to lose. After all, their children are the ones who will ultimately suffer from the arrival of a wild genetic bazaar where all parents can gain similar talents and potentials for their children. Today’s intellectual elite might not want to live in a world as aggressive, competitive, and uncontrolled as the one that would emerge from universal access to potent GCT, so their distaste for the technology may deepen once its true implications become clear. Such resistance, however, would be reminiscent of the fears of earlier elites who liked society the way it was and wanted to retain their advantages. The wellborn were right to fear the political reforms that broke down class divisions, and today’s new elite should wince as well, because if the God-given gifts of talent and intelligence that have raised them above the throngs are laid out for everyone to grab, their children’s futures will not look nearly as bright. That concern about preserving the ideals of an egalitarian society and preventing the formation of a genetic elite (Krimsky, 2000) inspires much of the philosophical distaste for GCT among intellectuals is ironic, both because they are among the elite and because any meaningful effort to block these technologies will compound rather than alleviate such biological advantages.
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
31
Ethics - Germinal choice technology and the human future - G Stock
To look at the possible implications of advanced GCT more concretely, let’s imagine that scientific progress and public policy combine to make meaningful enhancement technologies widely available, relatively commonplace, and largely under the control of individual parents. This is not far-fetched; laboratory-mediated conception using advance PGD may one day seem no more foreign than medically assisted birth does today. Parents will want to do what they think is best for their children, and even those uninterested in enhancement may come to see it as reckless and primitive to conceive a child without prior genetic testing. After all, in 1900 few thought of giving birth in a hospital as ‘natural’. Only 5% of births took place there. Today almost all do in the USA, and some 30% are by Caesarian section, a frequently avoidable procedure that is nonetheless readily accepted (Wertz and Wertz, 1989). In such a world, people’s genetics over time would become a manifestation of their parents’ values and predilections. Initially, the differences between the ‘enhanced’, who use these technologies, and the ‘unenhanced’, who do not, would be only statistical, in that those with enhancements would tend to do better than many, but not all, of those without enhancements. But as the technology became more potent, less overlap would exist between these populations. As this became clear to parents, many of the children of those who had shunned the technology would probably opt to enhance their own children to keep them from being at a disadvantage. A similar story would play out in the global arena, as countries that initially blocked GCT gradually felt forced to revise their laws and accept it. Access to advanced technology typically flows with national wealth, but adoption of GCT might hinge more on the religious and cultural traditions in different regions. China and the rest of Asia, for example, seem much less troubled by these technologies than Europe, so some of the wealthiest nations could easily be the most resistant to enhancement technology. Eventually, however, they probably will have no choice. What, after all, would a country that bans advanced embryo diagnosis do if other nations were to embark on popularly supported eugenic programmes poised to raise the average IQ of their next generation by 20 points?
Breeds apart As we increasingly manifest our aptitudes, temperaments and philosophies in our children through our decisions about their genetic constitutions, a self-reinforcing channelling of human lineages will probably develop. Family names once denoted family professions that persisted for generations. The Cooks, Fishers, Smiths, Taylors, and Bakers of the world no doubt would uncover the corresponding trades among their ancestors. Perhaps in the future clusters of genetic predispositions, lifestyles and philosophical orientations will arise that are equally persistent. Such families of musicians, politicians, therapists, scientists and athletes, however, would not be locked in by social constraints and limited opportunities, but by a tight feedback loop between complex genetic selection and the values, philosophies and choices that bring that selection and flow from it.
32
Over time, such specialization might become far deeper than
that which has occurred historically without reproductive reinforcement. Ideally, the resultant partitioning of the social landscape would be according to individual predisposition and desire rather than some pre-existing template imposed upon unwilling populations. But the possibilities of abuse either by governments or by individual parents who breed children for their own purposes are significant. Tyranny and child abuse require no advanced technology, though, and whether either would be changed much by the presence of GCT is highly debatable. Even disregarding outright abuse, though, scenarios of human design are jarring, because they evoke troubling images of freakish human forms. We should not dismiss such images, but neither should we allow them to grow in our imaginations to the point where they oversimplify and distort a future landscape bound to be exceedingly complex. Rare special potentials may become more dramatic and less unusual, but parents will be even more drawn to genetic predispositions that avoid the genetic handicaps and vulnerabilities that afflict us today. This will narrow the human diversity around us, but so did polio vaccinations and seatbelts, and they provoked no outcry. As self-reinforcing clusters of human attributes begin to crystallize, however, human diversity will expand. Today, when a rare combination of genetic and environmental factors comes together to create genius in one of its many guises, the combination usually disappears in the next generation. This happens not only because contributing environmental influences do not recur, but because the particular genetic constellation dissipates during genetic recombination. In the future, parents might preserve or even extend key aspects of such genetic influences through embryo selection and germline engineering. As particular attributes are boosted or diminished in children, their predispositions will come to reflect their parents’ philosophies and attitudes, so children will also come to manifest the cultural ethos and values that influence their parents. Consider gender. Many couples would choose different attributes for boys and girls. So, GCT would translate cultural attitudes about gender into the biology of children. If a society believes that women are (or should be) more empathetic and supportive, and boys more aggressive and independent, then whether or not these gender specificities are true, they will become true, and if society believes that such gender distinctions do not (or should not) exist, they will diminish. Even aspects of personal identity that are specific to a particular culture at a particular time could become embedded in biology to deepen the differences among human populations. Cultures differently value education, athletics, intelligence, calmness, obedience, curiosity and other personality traits. To the extent that genes influence these cultural differences, GCT might reinforce and heighten them, particularly if the biological predispositions that elicit these cultural patterns engender selection of the same predispositions. This is not to say, however, that the cultural landscape brought about by GCT will soon become unfamiliar. We are used to
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
broad human diversity that ranges from 80-pound models to 400-pound Sumo wrestlers, from tiny gymnasts to towering basketball players, and from deaf-mutes to concert pianists. The added differences brought by GCT will not soon sweep us into a realm anyone would notice during a ride on a crowded subway.
Genes and dreams To know what traits we will want to give our children, we need to reflect upon who we are. Our evolutionary past speaks to us through our biology to fashion our underlying desires and drives (Wilson, 1978; de Waal, 1998). Our urges are those that best enabled our ancestors to have as many children as possible and ensure that they’d grow up to do the same. Simplistic interpretations of what evolution tells us about who we are and how we should live are frequently misleading and politically self-serving, but when general human preferences are relatively consistent across different cultures and lands, they are probably tied to our biology, whatever their local accents and nuances. At the risk of landing in trouble, I will make a few extreme generalizations about men and women. These statements have many exceptions and inadequacies, but nonetheless are useful in understanding some of the underlying forces operating in our culture. We humans focus much of our energy on sex, our families and homes, and our relative status. Both men and women are largely monogamous but not entirely. We favour those more related to us over those less related. We are social creatures, and are most comfortable within groups of a few people to a few dozen. We are highly competitive. Men tend to be more aggressive and violent than women (Edwards, 1987). Men compete more for status, power and wealth – key ingredients in attracting women – and are drawn to beautiful women, which in almost all cultures means women having attributes that signal youthfulness and health, just the qualities needed to bear and rear children. Women tend to care more about how they look – a key ingredient in attracting men – are more socially adept, care more about commitment, and are drawn to men with status, power, and wealth – the qualities needed to provide for children. The importance we attach to sex, beauty, status, power and the success of our children comes from deep within us. We do not have to act upon these urges, but we cannot escape them. It is no fluke that advertisements so frequently play on these themes. They work. Automobile ads for men stress status, power, money, and getting women, so do ads for computers, vacations, cigarettes, beer and just about everything else. Fashion ads for women focus on beauty, appearance, sex and attracting and holding the right men. Many parents-to-be, if they could use germinal choice technology to shape their children, would seek the very attributes that advertisers push. Not everyone would follow stereotypes of beauty, strength and intelligence, but many would, and we might find ourselves surprised at how much we would be drawn in these directions if given a smorgasbord of possible qualities to choose from.
often by their appearance. These ‘cosmetic’ interventions will probably be for clusters of alleles that in the case of women soften features and bring more symmetry to them (Thornhill and Gangestad, 1993), or in the case of men, add to stature and strength. Eventually self-modification of this sort might lead to moderately less physical diversity, but we must remember that quite a spread exists in what we find attractive. Moreover, the most superficial features such as hair type, eye colour, nose shape and general appearance may be easier to modify through clothing, hair dyes, cosmetic surgery and even coloured contact lenses. Today, when parents buy donor eggs or sperm, the most important qualities they seek in a donor – since health can be assumed – are ethnicity and basic physical features that match their own. Recipients want to be sure that the child seems to be theirs. Beyond those limitations, couples seek the same underlying qualities they might seek in a mate. Indeed the catalogue listings in sperm and egg donor banks strongly resemble singles ads. Here is an ad for sperm (Schmidt and Moore, 1998): ‘He has wavy dark brown hair and eyes. He’s 5’ 10” tall and weighs 156 lbs on a medium frame. . . . His ancestry is Eastern European. . . . He is currently studying law with a GPA of 3.4. Other interests include music . . . iceskating, and juggling’. Sociability will be a valued trait for future selection, I suspect, because it is so important to positioning ourselves within groups, and intelligence will be as well, since it is a critical ingredient in equipping us for a complicated world that includes complex social dealings we have with one another. It enables us to entertain each other, to play social games effectively, to compete more successfully with one another (Ridley, 1993). However imperfect the measures of genetic predisposition toward ‘intelligence’ turn out, many prospective parents will probably use them in selecting embryos. Grade point average and SAT scores are important pieces of information on the biographical profiles of egg and sperm donors, because they serve as a surrogate for these genetic markers. In contrast, there will probably be less agreement on choices of temperament and personality. Whether it is better to be introverted or extroverted, cautious or bold depends on circumstances. Parents may well moderate their choices in this realm to avoid extremes, and psychopharmacology, with its antidepressants, mood stabilizers, sedatives and anti-anxiety agents, would push in this direction as well. But the inclination to give our children skills and traits that align with our own temperaments and lifestyles will push the other way. An optimist may feel so good about his optimism and energy that he wants more of it for his child. A concert pianist may see music as so integral to life that she wants to give her daughter even greater talents than her own. A devout individual may want his child to be even more religious and resistant to temptation. To the extent that trait enhancement of this sort engenders mindsets disinclined to attenuate the trait in their own children, such traits may reinforce themselves from generation to generation and push toward the limits of genetic possibility and technical know-how.
Physical attributes will be an enticing target for potential adjustment, because people, particularly women, are judged so
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
33
Ethics - Germinal choice technology and the human future - G Stock
Our feelings and emotions play a large role in regulating our behaviour, so we need to consider their nature as well in thinking about our likely future choices with germinal technologies. Biology uses emotion to channel behaviour in ways that have been evolutionarily fruitful. We do things because they gratify our desires, calm our fears, stop our pains, feed our hungers, satisfy our curiosities or make us feel happy. If we largely seek various flavours of pleasure and avoid various kinds of pain, we have a good shot at feeding ourselves, having kids, taking care of them, and being the best biological creatures we can be, which means leaving the most kids behind. As to how rapidly GCT will be embraced, our infatuation with health suggests that broad screenings of embryos to avoid diseases and other unwanted traits will spread rapidly as soon as they become readily available. Similarly, we are almost certain to embrace the germinal enhancement possibilities of added longevity when they begin to emerge. But assessing which modifications to a child’s temperament will appeal to parents or which enhancements toward talents such as music, art, or athletic ability, they might choose is mere guesswork. I am suspicious of simplistic interpretations of the impacts of germinal choice. We can discern some broad outlines, but our reactions to its possibilities will probably be as complex and unpredictable as the rest of life, and equally driven by the specifics of individual temperament, personality and circumstance. The only real way to gauge our distant choices may well be to observe our immediate ones as GCT begins to expand, and we will need to extrapolate from these without forgetting that both our individual expectations and our social environment will shift substantially in the years ahead as the technology evolves.
Looking at our fears One certainty about GCT and the other emerging possibilities of biotechnology is that no matter how much debate and discussion takes place, no consensus about them will emerge. These possibilities speak too directly to our vision of the human future, our notions of who we are and will become. They touch us too deeply. Our perceptions of them depend too much on religion, philosophy, culture and politics. To some, this is the invasion of the inhuman, and we are heading towards disaster by violating the most sacred aspects of our humanity. To others, this is our flowering, enabling us to transcend aspects of our biology that other generations could barely dream of. In light of this, it is worth thinking about what the various critics of germinal choice and other technologies of the biotech revolution are most afraid of. They are not particularly concerned that these technologies will fail or prove unsafe, because if that occurred, the technologies would probably fade away. Their real worry is that these technologies will succeed, and succeed so gloriously that they create seductive possibilities we cannot resist. They fear that people will see so much benefit in them that they will embrace them, in which case critics will have to face their real fears.
34
The first fear is of ourselves. They worry that we will abuse these technologies. And, of course, we will. We abuse every technology. But this does not mean that we should stop developing GCT or that their costs outweigh their benefits. A second fear is of the philosophical implications. Critics fear that these technologies will change our sense of who we are. Again, they will. But if we could stop all biotechnology dead in its tracks, other technologies would still reshape our society. We may not be comfortable with the world we are creating for our great-grandchildren, but so what. Our great-grandparents would probably find our world jarring as well if they could see it, yet few of us would choose to return to their era, and our great-grandchildren will be no more eager to exchange their world for ours, which will seem primitive indeed to them. A third fear of critics is that we will be forced to make difficult choices. Again, they are right. Coming choices about both the end of life and its beginning are going to be excruciating. It is not easy to decide when to pull the plug on someone or which embryo to implant and which to discard. But these choices are part of growing up. Humanity is leaving its childhood and moving into its adolescence as its powers infuse into realms hitherto beyond our reach. The time has come for us to accept the responsibility that comes with our new understandings and powers. The next frontier is not space, it is our own selves. Do we really want to pull back and relinquish the exploration to other braver souls in other regions of the world?
References and further reading Campbell J, Stock G 2000 A vision for practical human germline engineering. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York, pp. 9–16. Capecchi M 2000 Human germline gene therapy: how and why. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York, pp. 31–42. Cook P, Frank R 1991 The growing concentration of top students at elite schools. In: Clotfelter C, Rothschild M (eds) The Economics of Higher Education. NBER-University of Chicago Press, Chicago, pp 121–140. de Grey A, Baynes J, Berd D et al. 2002 Time to talk SENS: critiquing the immutability of human aging. In: Harman D (ed.) Increasing Healthy Life Span: Conventional Measures and Slowing the Innate Aging Process; Proceedings of the 9th Congress of the International Association of Biomedical Gerontology. Annals of the New York Academy of Sciences 959 (special release), 452–462. de Waal F 1998. Chimpanzee Politics: Power and Sex among Apes. Johns Hopkins University Press, Baltimore, USA. Edwards A 1987, Male violence in feminist theory: an analysis of sex/gender violence and male dominance. In: Hanmer J, Maynard M (eds) Women, Violence and Social Control. Macmillan Press, London, pp. 13–29. Hwang W, Ryu Y, Park J et al. 2004 Evidence of a pluripotent human embryonic stem cell line derived from a cloned blastocyst. Science 303, 1669–1674. Krimsky S 2000 The psychosocial limits on human germline modification. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University
Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005
Ethics - Germinal choice technology and the human future - G Stock
Press, New York, pp. 104–107. Lyudmila N, Trut R 1999. Early canid domestication: the farm fox experiment. American Scientist Magazine 87, 160–169. Macer D 2000 Universal bioethics for the human germline. In: Stock G, Campbell J (eds) Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York, pp. 139–141. Macer D, Akiyama S, Alora A et al. 1995 International perceptions and approval of gene therapy. Human Gene Therapy 6, 791–803. Parens E (ed) 1998 Enhancing Human Traits: Ethical and Social Implications. Georgetown University Press, Washington DC. Ridley M 1993. The Red Queen: Sex and the Evolution of Human Nature. Penguin, Harmondsworth. Schmidt M, Moore L 1998 Constructing a ‘good catch,’ picking a winner: the development of technosemen and the deconstruction of the monolithic male. In: Davis-Floyd R, Dumit J (eds) Cyborg Babies: from Techno-Sex to Techno-Tots. Routledge Press, New York, pp. 21–39. Silver L 1997 Remaking Eden: How Genetic Engineering and Cloning will Transform the American family. Avon Books, New York. Stock G 1993 Metaman: Humans, Machines, and the Birth of a Global Superorganism. Simon and Schuster, New York.
Stock G 2002. Redesigning Humans: our Inevitable Genetic Future. Houghton Mifflin, New York. Stock G, Campbell J (eds) 2000. Engineering the Human Germline: an Exploration of the Science and Ethics of Altering the Genes we Pass to our Children. Oxford University Press, New York. Tambs K, Sundet J, Magnus D et al. 1989 Genetic and environmental contributions to the covariance between occupational status, educational attainment, and IQ: a study of twins. Behavior Genetics 19, 202–222. Thornhill R, Gangestad S 1993. Human facial beauty: averageness, symmetry, and parasite resistance. Human Nature 4, 237–269. Vila C, Savolainen P, Maldonado J et al. 1997 Multiple and ancient origins of the domestic dog. Science 76, 1687–1689. Wayne R 1993 Molecular evolution of the dog family. Trends in Genetics 9, 218–224. Wertz R, Wertz D 1989 Lying-In: a History of Childbirth in America. Yale University Press, New Haven, USA. Wilson EO 1978 On Human Nature. Harvard University Press, Cambridge, Massachusetts, USA.
Received 22 November 2004; refereed and accepted 9 December 2004.
35 Ethics, Law and Moral Philosophy of Reproductive Biomedicine, Vol. 1, No. 1, March 2005