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This is one of my undergrad (BA Phil) essays, a few of which I share on this website. This particular essay was for a Practical Ethics subject.

On the Limitation of Genetic Intervention: a Reply to Agar

Nicholas Agar, in his paper ‘Designing Babies: Morally Permissible Ways to Modify the Human Genome’, argues that while therapeutic genetic engineering is generally regarded as morally acceptable, it is a mistake to regard all forms of eugenic genetic engineering as morally abhorrent. I disagree with this position of Agar’s and in the following paper I illustrate where his paper is weak and I present an argument why any form of genetic intervention, except in the most extreme circumstances, is morally impermissible.

The last section of Agar’s paper deals with circumstances in which he thinks genetic intervention is morally impermissible. He argues that there is somewhat of an analogy between the abilities, desires, and capacities of genetic engineers and those of the process of natural selection; and important differences too. Agar illustrates that the changes in an individual’s genotype, and consequently their phenotype, are naturally ‘engineered’ via the process of natural selection. Natural selection has a ‘goal’ in this process, that individuals find and reproduce with the best genetic matches to ensure a successful consequent generation (Agar 1995, p. 11). Likewise, genetic engineers have goals in their pursuits of genetic modification, but these goals are not nearly as broad and inclusive as those of the process of natural selection. The goals of genetic engineers may by constrained by many external forces, be they social, religious, political, or economical. Selecting and enhancing a gene for a particular trait that is desired in 21st century Australia may result in a socially, politically, or economically specific generation of people that is not suited to the world as a whole. Such active discrimination, argues Agar, is a clear boundary for the exclusion of genetic modification (Agar 1995, pp. 10 – 15).

This position is something that is largely agreeable, and consequently something that I will not argue against in this paper. Where Agar falls short is his failure to see that this particular argument of his extends to most forms of genetic intervention, even some forms of therapeutic genetic engineering.

Agar focuses upon one main counter claim to the position against eugenic genetic intervention (EGI), the claim that EGI is too expensive and therefore exclusive. Agar argues against this claim by attempting to show that EGI does not interfere with the individual’s phenotype and is therefore less harmful than many think. Agar is wrong in both regards.

Agar (1995, p. 5) makes the uncontroversial claim that ‘[e]arly eugenic intervention is likely to be very expensive. This means it will only be available to the wealthy’. Agar uses an example first used by Jerry Bishop and Michael Waldholz, which I’ll reproduce below, to illustrate that this line of thinking is not really important. What does it matter if a few genes are modified if one’s environment is a major influencing factor too? The argument by Bishop and Waldholz (in Agar 1995, p. 5) is as follows:

It wouldn’t take many generations of this discriminatory genetic selection to produce an ever- widening gap between the upper and lower strata of society. …[A] society in which a butcher’s son has little opportunity to be anything but a butcher and an executive’s child is born to be an executive may not seem unreal as it might seem today.

Agar’s error in dealing with this statement is that he focuses solely upon genetic determinism in its refutation. Agar dedicates a great deal of verbosity illustrating the differences between an individual’s genotype and their phenotype (something that I luckily don’t need to explore in detail here) in an attempt to show that there are few traits that can be effectively controlled in the modification of the genotype alone. Traits such as whether or not one is a butcher or one is an executive have a great deal of reliance upon the phenotype so their engineering at the genetic level is problematic, if not impossible.

But genetic determinism is not the only conclusion that can be drawn from the Bishop and Waldholz argument. It may very well be true that engineering an executive is problematic, if not impossible, but the process of selectively modifying the genomes of particular individuals (the rich) over a number of generations will result in two distinct classes of individuals; those with EGI and those without. The social and moral implications of this fact are entirely overlooked by Agar. Admittedly, this is a grey area for we are talking about some possible generation of people, and perhaps the executive and butcher argument above is too strong, but it remains that those who can afford EGI will posses genetic differences to those who cannot afford similar, or any, EGI. It is too strong, as Agar correctly illustrates, to claim the presence of an ‘executive’s gene’, but this is not the main concern. The main concern is that those who can afford EGI have the potential to receive some sort of social benefit. Discriminating against future social inclusion based upon one’s present financial state is not a morally praiseworthy decision.

But, as I mentioned above, this applies to much therapeutic genetic intervention (TGI) too. Agar simply brushes over the issue of TGI in the beginning of his paper claiming that TGI is the kind of process that is generally considered morally acceptable (Agar 1995, p. 2). This is certainly not sufficient, even more so since many arguments against EGI can be applied to TGI too. Perhaps the main concern with TGI is that a ‘normal’ human has to be defined before any particular genetic abnormality is identified and rectified. Since humans are so diverse, and what we all deem valuable is almost certainly subjective, defining some set of ‘normal’ traits is problematic. If, for example, we say that Downs Syndrome is a candidate for TGI we are devaluing the life experiences of persons with Downs Syndrome, we are saying that our life, our genome, is superior. Rather than modify the social world to be more inclusive, TGI seeks to be exclusive and remove those ‘defects’ deemed undesirable. This is not to say, of course, that some medical conditions, particularly life threatening medical conditions, would not be a candidate for TGI, but the motivation of both the patient and the genetic therapist, and also the wider social world, would need to be carefully considered.

Consider the following thought experiment I’ve adapted from a similar one presented by Rob Sparrow (2008).

  1. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the single embryo that they have available to implant. The embryo carries a gene for bowel cancer that can be fixed with TGI. The embryo is fine in all other regards.

    Should the couple choose to have TGI? Yes, No, or toss a coin?
  2. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the single embryo that they have available to implant. The embryo carries a gene associated with life expectancy X that can be increased via TGI. The embryo is fine in all other regards.

    Should the couple choose to have TGI? Yes, No, or toss a coin?
  3. A mixed race couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the single embryo that they have available to implant. They live in a racist society in which white individuals have a longer life expectancy, and other health and social advantages compared to those with dark skin. The embryo carries a gene for dark skin that can be altered via TGI to become a gene for white skin. The embryo is fine in all other regards.

    Should the couple choose to have TGI? Yes, No, or toss a coin?
  4. A couple are having in-vitro fertilisation, and undertake pre-implantation genetic diagnosis of the single embryo that they have available to implant. The embryo carries a gene for Mayer-Kuster-Rokitansky-Hauser (MKRH) syndrome that can be fixed via TGI. The embryo is fine in all other regards.
    MKRH is an (imaginary) syndrome in which infants are born without a uterus. They can only reproduce using a surrogate. The gene for MKRH is also associated with a life expectancy 5 years less than individuals who do not have this gene.

    Should the couple choose to have TGI? Yes, No, or toss a coin?

In all of these cases, except number 3, it seems to be, prima facie, morally acceptable to decide to accept TGI. The individual in question, if given TGI, will live a longer, happier, and more productive life. Number 3 is a little uncomfortable even though it seems logical to opt for TGI. I’m not interested in number 3 here though, I’m interested in number 4. Here we have an individual without a uterus, can only reproduce via a surrogate, and lives on average five years less than those who don’t possess the MKRH gene. Again, prima facie, it seems that opting for TGI in this case is morally acceptable. But what if MKRH is simply a nice euphemism for what we now call maleness? We become instantly uncomfortable as in case number 3. My point here is that even TGI is aimed at treating conditions based upon our social, religious, political, and/or economic desires. Without some sort of complicated moral equation, the sort that can effectively balance maleness with life expectancy for example, TGI becomes just as morally problematic as EGI.

Agar’s paper is semi-successful; it provides a very good position to argue against genetic intervention. Unfortunately he doesn’t extend it far enough for his argument is just as valid against TGI as it is against the undesirable instances of EGI that he illustrates. The use of genetic intervention is too problematic, and full of inherent arbitrariness, that there are only a handful of cases where a successful moral argument can be constructed for its use.

References

Agar, N 1995, “Designing Babies: Morally Permissible Ways to Modify the Human Genome”, in Bioethics, Vol. 9, No. 1, pp. 1 – 16

Sparrow, R 2008, “Better than men? Sex and the therapy/enhancement distinction”, Conference Presentation, James Martin Advanced Research Seminar, University of Oxford, November 12.

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