David King
The main debate around human genetics currently centres on the ethics of genetic testing, and possibilities for genetic discrimination and selective eugenics. But while ethicists and the media constantly re-hash these issues, a small group of scientists and publicists are working towards an even more frightening prospect: the intentional genetic engineering of human beings. Just as Ian Wilmut presented us with the first clone of an adult mammal, Dolly, as a fait accompli, so these scientists aim to set in place the tools of a new techno-eugenics, before the public has ever had a chance to decide whether this is the direction we want to go in. The publicists, meanwhile are trying to convince us that these developments are inevitable. The Campaign Against Human Genetic Engineering, has been set up in response to this threat.
Currently, genetic engineering is only applied to non-reproductive cells (this is known as 'gene therapy') in order to treat diseases in a single patient, rather than in all their descendants. Gene therapy is still very unsuccessful, and we are often told that the prospect of reproductive genetic engineering is remote. In fact, the basic technologies for human genetic engineering (HGE) have been available for some time and at present are being refined and improved in a number of ways. We should not make the same mistake that was made with cloning, and a**ume that the issue is one for the far future.
In the first instance, the likely justifications of HGE will be medical. One major step towards reproductive genetic engineering is the proposal by US gene therapy pioneer, French Anderson, to begin doing gene therapy on foetuses, to treat certain genetic diseases. Although not directly targeted at reproductive cells, Anderson's proposed technique poses a relatively high risk that genes will be 'inadvertently' altered in the reproductive cells of the foetus, as well as in the blood cells which he wants to fix. Thus, if he is allowed to go ahead, the descendants of the foetus will be genetically engineered in every cell of their body. Another scientist, James Grifo of New York University is transferring cell nuclei from the eggs of older to younger women, using similar techniques to those used in cloning. He aims to overcome certain fertility problems, but the result would be babies with three genetic parents, arguably a form of HGE. In addition to the two normal parents, these babies will have mitochondria (gene-containing subcellular bodies which control energy production in cells) from the younger woman.
Anderson is a declared advocate of HGE for medical purposes, and was a speaker at a symposium last year at UCLA, at which advocates of HGE set out their stall. At the symposium, which was attended by nearly 1,000 people, James Watson, of DNA discovery fame, advocated the use of HGE not merely for medical purposes, but for 'enhancement': 'And the other thing, because no one really has the guts to say it, I mean, if we could make better human beings by knowing how to add genes, why shouldn't we do it?'
In his recent book, Re-Making Eden (1998), Princeton biologist, Lee Silver celebrates the coming future of human 'enhancement', in which the health, appearance, personality, cognitive ability, sensory capacity, and life-span of our children all become artifacts of genetic engineering, literally selected from a catalog. Silver acknowledges that the costs of these technologies will limit their full use to only a small 'elite', so that over time society will segregate into the "GenRich" and the "Naturals":
"The GenRich - who account for 10 percent of the American population - all carry synthetic genes... that were created in the laboratory ...All aspects of the economy, the media, the entertainment industry, and the knowledge industry are controlled by members of the GenRich cla**...Naturals work as low-paid service providers or as labourers, and their children go to public schools... If the accumulation of genetic knowledge and advances in genetic enhancement technology continue ... the GenRich cla** and the Natural cla** will become...entirely separate species with no ability to cross-breed, and with as much romantic interest in each other as a current human would have for a chimpanzee."
Silver, another speaker at the UCLA symposium, believes that these trends should not and cannot be stopped, because to do so would infringe on liberty.
The safety charade
Most scientists say that what is preventing them from embarking on HGE is the risk that the process will itself generate new mutations, which will be pa**ed on to future generations. Official scientific and ethical bodies tend to rely on this as the basis for forbidding attempts at HGE, rather than any principled opposition to the idea.
In my view, we should not allow ourselves to be lulled into a false sense of security by this argument. Experience with genetically engineered crops, for example, shows that we are unlikely ever to arrive at a situation when we can be sure that the risks are zero. Instead, when scientists are ready to proceed, we will be told that the risks are 'acceptable', compared to the benefits. Meanwhile, there will be people telling us loudly that since they are taking the risks with their children, we have no right to interfere.
What for?
One of the flaws in the argument of those who support the possibility of HGE for medical purposes is that there seem to be very few good examples where it is the only solution to the medical problem of genetic disease. The main advantage of HGE is said to be the elimination of disease genes from a family. Yet in nearly all cases, existing technologies of prenatal and preimplantation genetic testing of embryos allow the avoidance of actual disease. There are only a few very rare cases where HGE is the only option.
Furthermore, there is always another solution for those couples who are certain to produce a genetically disabled child and cannot, or do not want to deal with this possibility. They can choose not to have children, to adopt a child, or to use donor eggs or s**m. Parenthood is not the only way to create fulfilment through close, intimate and long lasting relationships with children. The question we have to ask is whether we should develop the technology for HGE, in order to satisfy a very small number of people.
Could we control it?
Although the arguments for the first uses of HGE will be medical, in fact the main market for the technology will be 'enhancement'. Once it was available, how would it be possible to ensure that HGE was used for purely medical purposes? The same problem applies to prenatal genetic screening and to somatic gene therapy, and not only are there no accepted criteria for deciding what constitutes a medical condition, but in a free market society there seems to be no convincing mechanism for arriving at such decision. The best answer that conventional medical ethics seems to have is to `leave it up to the parents', ie. to market forces.
Existing trends leave little doubt about what to expect. Sophisticated medical technology and medical personnel are already employed in increasingly fashionable cosmetic surgery. Another example is the use of genetically engineered human growth hormone (HGH), developed to remedy the medical condition of growth hormone deficiency. Because of aggressive marketing by its manufacturers, HGH is routinely prescribed in the USA to normal short children with no hormone deficiency. If these pressures already exist, how much stronger will they be for a technology with as great a power to manipulate human life as HGE?
Time to Act
Germ line manipulation opens up, for the first time in human history, the possibility of consciously designing human beings, in a myriad of different ways. I am not generally happy about using the concept of playing God, but it is difficult to avoid in this case. The advocates of genetic engineering point out that humans constantly 'play God', in a sense, by interfering with nature. Yet the environmental crisis has forced us to realise that many of the ways we already do this are not wise, destroy the environment and cannot be sustained. Furthermore, HGE is not just a continuation of existing trends. Once we begin to consciously design ourselves, we will have entered a completely new era of human history, in which human subjects, rather than being accepted as they are will become just another kind of object, shaped according to parental whims and market forces.
In essence, the vision of the advocates of HGE is a sanitised version of the old eugenics doctrines, updated for the 1990s. Instead of 'elimination of the unfit', HGE is presented as a tool to end, once and for all, the suffering a**ociated with genetic diseases. And in place of 'improving the race', the 1990s emphasis is on freedom of choice, where 'reproductive rights' become consumer rights to choose the characteristics of your child. No doubt the resulting eugenic society would be a little less brutal than those of earlier this century. On the other hand the capabilities of geneticists are much greater now than they were then. Unrestrained, HGE is perfectly capable of producing Lee Silver's dystopia.
In most cases, the public's function with respect to science is to consume its products, or to pay to clean up the mess. But with HGE, there is still time to prevent it, before it becomes reality. We need an international ban on HGE and cloning. There is a good chance this can be achieved, since both are already illegal in many countries. Of course it may be impossible to prevent a scientist, somewhere, from attempting to clone or genetically engineer humans. But there is a great difference between a society which would jail such a scientist and one which would permit HGE to become widespread and respectable. If we fail to act now, we will only have ourselves to blame.