08 December 2014
ByAppeared in BioNews 783
Although the word was not actually used (or at least I did not hear it), this was a polemic making the case for 'eugenics'. That is, the improvement, even 'perfection' perhaps, of humanity by actively intervening in its inherited biology.
In its pursuit, Professor Julian Savulescu, presenting the first session of the Progress Educational Trust's 2014 annual conference, The Commercialisation of Life, made a good case for parents being given more of a choice in the attributes of their children. After all, what's not to like in the idea of preventing inherited genetic diseases? Preventing diseases is what public health is all about, isn't it?
Genetic screening, followed by the discarding of unwanted embryos (perceived as 'flawed') and implanting unflawed ones, denies life to an individual with a genetic disease in favour of an individual who does not have it. Health is better than disease. The life that does result is arguably a better life than the life (or lives) denied. That argument is the pivot on which the moral imperative of the title turns.
Not that it stops there. A life could be made better not only by preventing negative attributes, like diseases, but by enhancing positive ones - a capacity for happiness, perhaps? Are there genes for a pervasive feeling of wellbeing? Some scientists think there are (or might be). Acceptance or rejection of an embryo could be made on the basis of its 'well-being genotype'.
Cunningly, Professor Savulescu got us to connive with him on this extrapolation, asking for a show of hands on whether we would like to live longer, particularly if we could avoid the downsides of age. We mostly stuck our hands up − not that surprisingly. Of course, what we would like as being advantageous for ourselves, or our children (higher IQ for instance), is not necessarily what we would like to see for others (or their children). Evolutionary theory reminds us that once an adaptive trait has spread through an entire population any competitive advantage its gene once had is lost; and not only that, any concomitant disadvantage for individuals it carries is what remains. A high IQ seems to carry more risk of unhappiness than a lower one.
Extreme cases make for bad laws. It is as true in medical science as it is in the laws needed to enshrine the introduction of choice by parents of what traits they would like to see realised in their children. Avoiding the expression of cystic fibrosis genes in people, for example, is a poor illustration of the possible consequences of a parental free-for-all in choosing the qualities they would prefer their children to possess.
There is a decidedly unpleasant whiff of 'Black Friday' in a possible scenario of adults seeing children merely as things that they have bought and own, and scrambling for the limited resources available to achieve it. And never forget that this was after all a conference on 'the commercialisation of life'. Commercialisation is above all about commodification and your own value being judged, not so much by what you are, but by what you own.
Chairing the session, Baroness Ruth Deech, former chair of the Human Fertilisation and Embryology Authority, reminded the audience of potential human rights issues. When it comes to aspiring parents and future children, whose rights trump whose? And what rights does commerce have to make claims for (and to offer) the genetic sieving of embryos for implantation. The opportunity to choose the sex of your, as yet unborn, child overseas is advertised by a fertility clinic on the tube train I come into London on (sex-selection for 'social reasons' is illegal in this country). Baroness Deech pointed out the centrality of the law in providing the country's moral benchmarks.
For their part, the audience viewed the moral imperative for parents to 'design' their babies as somewhat less self-evident than did Professor Savulescu. They expressed more scepticism about unqualified claims of the benefits of choice based on screening and drew attention to its drawbacks.
It was pointed out by an audience member that screening had not only increased prejudice against children and adults with Down's syndrome, but had led to reduced services for them - the implementation of screening and a 'choice', informed by counselling, had led to the devaluation of people with Down's syndrome as human beings and that it was contributing to a loss of respect for their humanity.
Concern was also in the air about what attributes parents might opt for. The question was floated of whether profoundly deaf parents had the 'right' to choose to have a child also profoundly deaf. In other words in a conflict between moral obligation and autonomy of choice, is there a clear winner? Would the law and ethics be on the same side? Where would the issue of human rights sit?
That genetic screening, followed by a choice of an embryo to implant, represents the new eugenics is barely refutable. If it differs from earlier manifestations it is because they largely stemmed from fears of the better off and better educated that society was becoming swamped by the poor and poorly educated, who were seen paddling in in the shallow end of national gene pools. In other words, social problems could be solved by interfering in human reproduction, rather than by changing social structures. As ever the poor are still with us. Where does the new eugenics leave them?
The Progress Educational Trust (PET) is grateful to the conference's sponsors - Merck Serono, the Anne McLaren Memorial Trust Fund, the Edwards and Steptoe Research Trust Fund, Ferring Pharmaceuticals, the London Women's Clinic and the Medical Research Council.
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