“Should prospective parents seek information about gene variants that increase the risk their children will develop diseases as adults? Should physicians provide that information?”
So asks Ronald Bailey, only just this side of rhetorically, in his similarly named “The Moral Case for Designer Babies: Should parents be allowed to know if their fetus will get Alzheimer’s?”
Regular readers will know that I am a fully qualified (self-awarded) bioethicist, and given my track record of commonsense and non-lunatic judgments—contrasted with, say, Julian Savulescu or those academics who called for “after birth abortions”—I am just the man to speak to this.
Now Bailey doesn’t like dementia or Alzheimer’s, which is fine position to espouse. I don’t like them either. But Bailey would eliminate these maladies by not letting those with genes “for” these diseases live, whereas I would prefer a more traditional cure, say therapy or via drug discovery.
Before we begin our discussion of genes, remember that it is a difficult subject, subject to errors of every kind. Why, just this morning Discover boasts the breathless headline “Couples Share Similar Genetics” over an article which tells us scientists have just “discovered” what everybody else already knew. This form of scientism is acute in academia, where truths are not acknowledged unless they’re accompanied by wee p-values. But let that pass.
Bailey would like wives to remove their eggs and husbands their sperm and give them over to a laboratory, the eggs to be fertilized and then examined for favorable and unfavorable genes. Those embryos with unfavorable genes would be killed, and so would some with favorable genes, though a one or two would be implanted into the mother in the hopes of a successful pregnancy.
Another route is to let the fertilization happen naturally (the Internet is nothing if not a fecund place to discover how this process works), scan the mother sometime after, and then kill those tiny human lives which are genetically unacceptable, and let live those which are acceptable.
The third option, which Bailey labels “genetic ignorance”, is the way he, Bailey himself, and you too, dear reader, arrived on this plant. We thus have good evidence that “genetic ignorance” fashions worthy, morally valuable, if not partially flawed, human beings.
What offends Bailey is the “ignorance” part of this third method. A question perpetually on the lips of the Enlightened is, How could nature function smoothly without central control by high-degreed and well-credentialed, i.e. non-ignorant, experts? You will have heard that question asked in other contexts. It too is rhetorical, meant to be convincing just by its hearing, any opposition put down to stupidity or bigotry.
We really have two ways before us: scan and kill, and naturally natural. The first requires experts and is scientific, and the latter can even be done by Brandeis University graduates. Naturally natural needs no explication. Scan and kill does. There are two scenarios.
Scenario 1: No uncertainty
Suppose there is no uncertainty in the genetic marker. Having the gene (or genes; I’ll write just “gene” for brevity), which we can without error measure, necessarily leads to dementia at age…what, exactly? By 60? 70? Later? Or maybe by as early as 40? You have to suppose something. At any rate, we implant some eggs and we kill those embryos that have this gene. The babies that make it through pregnancy will therefore not—of this we are certain—develop dementia.
They’ll still die, though. (Note to optimists: We all will.) Denying dementia condemns the babies we allow to live to die of something which is not (or is not associated with) dementia. Doubtless these deaths will be from a variety of causes, some less horrible, but some more horrible than dementia. Dying isn’t always pleasant.
Two caveats. Don’t forget that not everybody who would get dementia would live long enough to develop it. And if no babies are allowed to be born with this gene the benefits conferred by it will also be lost to us.
“What’s that? Benefits! Are you crazy?”
Oh, you heard me. Benefits. Perhaps those bearing this forbidden gene are braver than those without, or are better, hardier mothers, or are more creative; or maybe they’re the type that make the best geneticists. Who knows? I certainly don’t, and neither do you.
Maybe dementia, rough as it is on the sufferer, brings families closer together, and therefore creates a healthier society. I don’t know that that is true, but neither do you know it is false. Instead, all we can say is that we do not know what the effects on the whole of society will be. It is rank superstition, pure scidolatry, to say our tinkering will only be positive.
Just think: banning smoking, the nouveau Puritan impulse, causes people to live longer. And to eat more, and to require more of all resources. And maybe that’s good. Then again, maybe it isn’t, because while people who would have smoked will live longer (on average), they’ll have a less interesting and pleasurable life. Smoking is pleasurable to many. I have quoted these words from Mark Twain so many times we should all have them by heart:
There are people who strictly deprive themselves of each and every eatable, drinkable and smokable which has in any way acquired a shady reputation. They pay this price for health. And health is all they get for it. How strange it is. It is like paying out your whole fortune for a cow that has gone dry.
There is always a small subset of us who are certain sure that once program X is implemented, Utopia is right around the corner. But let’s not get too far afield.
Scenario 2: Regular uncertainty
The genetic markers will not be known unambiguously. Complex diseases and traits are not driven by a gene, but by combinations of genes and environment. Identical twins raised apart often develop different personalities and enjoy different levels of health.
Measuring the genes admits one kind of error. Civilians might be amazed to learn that medical tests are far from perfect. Another form is tying the genes to the maladies. This error is huge, simply because the gene-environment interaction is strong and hugely variable. That is, even if we could without error measure the genes of embryos without error, it is only an educated guess whether the genes we let pass are the “right” ones. Some of the babies we let live, in other words, will still develop dementia, perhaps of forms as yet unclassified. Hey. Mistakes happen. And we will wrongly kill many nascent lives which would have lived without the disease.
“Sally says you’re a natural. Is that true?”
“He is! His parents didn’t scan him!”
“Ewww. Don’t touch him! Get away from him!”
One thing never short of supply in the credentialed class is self-esteem. They are continuously discovering ways in which they are superior to those who they would rule over. I therefore am willing to bet any amount short of $1,000 American that once Bailey’s scan and kill becomes routine—for those who can afford it, and there will always be echelons—that having scanned babies will be (a) a status symbol, and (b) treated deferentially. “Little Malcom is a scan? Of course we have a slot for him.”
For it isn’t only dementia-genes that the elite will cull. They’ll also whack those genes said to be related to “aggressive” or “racist” behavior, or they’ll favor those related to “genius” and “creativity.” The error in these judgments, i.e. knowing we have the right gene, goes up exponentially. But uncertainty never stops the purist. “Playing God” was always an apt metaphor, but only in the sense where play is emphasized.
I’ll let readers put in the appropriate Brave New World references. Or maybe it’s The Boys from Brazil?