Dr Calum MacKellar considers eugenics and the ethics of this new technology
The possibility of editing the genetic heritage of living beings has revolutionised biological research.1,2
For the first time, scientists can efficiently, precisely and selectively edit the genes of individuals by removing or inserting genetic material.3
As a result, many commentators are now highlighting the many benefits to humankind arising from the prospect of manipulating the genes of a person.4 For example, it may be possible, in the future, to inactivate disordered genes which may be responsible for serious diseases.
However, there are also some concerns relating to safety. For instance, a certain gene may influence a number of different characteristics, which means that if a gene was modified to influence a particular dysfunction this could give rise to unforeseen consequences.
In addition, during the research stages of human embryonic gene editing it is unavoidable that a significant number of embryos will be destroyed. And because such embryos may be considered as persons, made in the image of God, this means that their destruction can be seen as being just as offensive as the destruction of any other person.5
Another ethical concern is that, if it is eventually possible to alter a person’s genes and those of his or her descendants to address predisposition to disorders, it may also be possible to change just about any other attribute.
Because of this, serious ethical discussion is required as to the possible consequences of gene editing.
Non-inheritable gene editing
To begin with, if the editing takes place to address a genetic disorder on a mature embryo, foetus, child or adult, this could be considered as being similar to existing non-inheritable gene therapy which has already been generally accepted by society.
Such applications of gene editing for therapeutic purposes, therefore, would not raise many new significant ethical problems.
Germline gene editing
On the other hand, using gene editing with the aim of germline gene modifications (intentionally changing the genes of children and descendants), raises significant ethical concerns, because they are inherently eugenic in nature. This describes selection strategies or decisions aimed at affecting, in ways which are considered to be positive, the genetic heritage of a child, a community or humanity in general.6
In fact, eugenic practices were totally rejected after the Second World War as a reaction towards the endorsement of such procedures by Nazi Germany. This was not only because a degree of coercion existed at the time but because unacceptable discrimination, resulting from selection strategies, undermined the equality in worth of all human beings – an equality which is the very basis of civilised society.7
But with the abuse which took place in the first half of the 20th century now becoming an ever older memory, pressures are now returning for a new eugenics. For example, James Watson, American Nobel Prize Laureate and co-discoverer of the structure of DNA, wrote in 1995: ‘But diabolical as Hitler was, and I don’t want to minimize the evil he perpetuated using false genetic arguments, we should not be held hostage to his awful past. For the genetic dice will continue to inflict cruel fates on all too many individuals and their families who do not deserve this damnation. Decency demands that someone must rescue them from genetic hells. If we don’t play God, who will?’8
At this stage, however, it is important to examine which gene editing procedures could be considered as eugenic.
Gene editing of very early embryos
If gene editing takes place on a very early human embryo (such as a two cell embryo), a number of ethical challenges arise. Indeed, if the genetic modification does not give rise to any significant change in the already existing embryo, it would no doubt be seen as similar to standard gene therapy in which the original individual remains.
However, if the gene editing procedure substantially modifies the genetic heritage of a very early embryo, this may actually end the life of the original embryo (a form of death) while creating a new one. As a result, this would have a clear eugenic element since it would mean preferring one new being over another based on the quality of his or her genes.
Gene editing of sperm and eggs during fertilisation
On the other hand, if a genetic modification takes place either on the sperm and egg cells before they are used for conception or during fertilisation resulting in the formation of a one-cell embryo, a new individual, who would not otherwise have existed, is being brought into being. This would happen because any change (no matter how small) of any of the variables in bringing an individual into existence would result in another individual existing in time. In other words, this individual would be a totally different person, in his or her very identity, from the one who would, otherwise, have existed.9
This again has a clear eugenic element since a new individual is being brought into existence in preference to another who may, for example, have had a genetic disorder. What is being proposed, therefore, is not a form of therapy. No existing person is being treated for a disorder. Instead, it is making sure that only certain persons are brought into existence based on the quality of their genes.
Discussion
Of course, it is possible to ask what is ethically wrong in making sure that only healthy children, and not disabled ones who may experience a lot of suffering, are brought into existence.
In response, it is important to recognise that it is difficult to see how parents can decide not to have certain kinds of children without making a value judgment that some children are less desirable.
It follows that when parents make a decision that only a certain kind of child is brought into existence, based solely on genetics factors, this can only mean making a eugenic choice and preferring one possible future child over another. In other words, this decision contradicts the important Christian principle that the lives of all human beings have the same worth, no matter how long or short a person lives or how much suffering or pleasure this person experiences.10 As the Christian physician, John Wyatt explains: ‘Our creation in God’s image implies … a radical equality … In the human community, we are surrounded by other reflections of God who are different, but fundamentally equal in dignity to ourselves.’11
This means that if parents do decide to avoid having a child affected by a serious genetic disorder, based solely on genetics factors, there is a very real sense that such a decision is based on the quality and not on the worthiness and inherent dignity of life. Moreover, the indirect message being given to persons, who have already been born with the same disorder, would be that they should also not have existed.12 This is clearly discriminatory and would undermine the inherent equality of all human persons in society.
Unconditional love
From a Christian perspective, moreover, the unconditional love of parents towards each other and towards God should also expand onto the child. This means that every child brought into existence from this love should, in the same way, be unconditionally loved and accepted by his or her parents.
But if certain genetic preconditions are laid down relating to a possible future child, this can no longer reflect the Christian unconditional procreative love. Moreover, this child will always know that his or her very existence was not unconditional, but conditional on having certain genes – a reality which may give rise to very significant existential anxiety in this child.
Naturally, it is impossible not to have a lot of sympathy towards parents who have children affected by severe disability and suffering. But, if one asks these parents, it is always the disorder and not the very existence of the child with the disorder that has been the cause of so much heartache. They would never say that they wished their specific child had not existed. Moreover, none of the parents would indicate that they would have preferred to exchange their child for another, healthier, one.
Crossroads
In conclusion, society is now at a crossroads with germline gene editing and other forms of prenatal selection procedures. It can either let parents make a eugenic choice in making sure that only certain children are brought into existence based on the quality of their genes. Or it can believe that all lives are equal in worth, without any classification, which is the very basis of a civilized Christian society.
Note: The views expressed in this article are those of the author and do not necessarily reflect the positions of the professional organisations with which he is affiliated.
Calum is Visiting Lecturer in Bioethics at St Mary’s University in London, UK, and Fellow at the Centre for Bioethics & Human Dignity at Trinity International University in Chicago, USA.
