Friday, August 1, 2014

The Reproductive Technology Quagmire OR Genetic Engineering Bye Other Name?

KHAN_STAR_TREK In other words the world may end up with the ultimate genetically engineered humans like this guy from the movies: Ricardo Montalbán portrays Khan Noonien Singh, a genetically enhanced superhuman who used his strength and intellect to briefly rule much of Earth in the 1990s  in Star Trek II: The Wrath of Khan

Embryo Screening and the Ethics of Human Genetic Engineering

In April 2008, Dartmouth College ethics professor Ronald M. Green's essay, "Building Baby from the Genes Up," was published in the Washington Post. Green presented his case in support of the genetic engineering of embryos, arguing that tinkering with genes could eliminate disease or confer desirable features onto our future progeny. "Why not improve our genome?" he asked. Two days later, Richard Hayes, executive director of the Center for Genetics and Society, rebutted, warning of a "neo-eugenic future" and "the danger of genetic misuse."

These practically polar opposite opinions are two sides of a debate taking place around the world. The controversy revolves around what scientists are calling reprogenetics: the combined use of reproductive and genetic technologies to select, and someday even genetically modify, embryos before implantation—not for health reasons, but for the sake of "improvement."

Following Western cultures’ devaluation of babies in the 1970s and 80s, babies became scarce and, consequently, desirable once again.  Now, any means used to make babies is seen as good, as long as pregnancy occurs at a convenient time. 

Some cannot conceive naturally.  The prevailing view is that those who cannot do so should have free access to such reproductive technologies as in vitro fertilization (“IVF”) or the purchase of gametes, i.e., sperm and eggs.  Reproductive technology has become a fait accompli with a large, affluent and profitable constituency and it receives inflationary insurance subsidies.  Yet, reproductive technology both reflects and facilitates serious problems.

For example, the growing demand for reproductive technology is largely a response to Western cultural changes.  First, childbearing has been widely postponed.  Deferring parenthood into the mid-thirties and beyond worked for some, but has created many fertility clinic users.  Further, serial sexual partnering has enabled nearly twenty million new cases of sexually transmitted infections (“STIs”) each year, which scar reproductive organs and also impair fertility.  IVF is often used to bypass these blockages.  IVF and the effectuation of the Brave New World

Such academic commentators as Francis Fukuyama 

Such  IVF and the effectuation of the Brave New World

Such academic commentators as Francis Fukuyama and Bill McKibben have observed that human genetic engineering will demoralize individuals and damage human community.  They write, for example, of futuristic highly-skilled classical pianists or athletes who know that their parents used reproductive technology to provide their offspring with strong musical or athletic genes, and of the existential crises caused regarding the source of, and credit for, their respective accomplishments.  They observe that democracy will become untenable if some use these technologies to create a biological elite

These warnings are, at once, an exaggeration and an understatement.  They are an exaggeration because, although genomic research has enabled scientists to identify the effects of many DNA sequences, we are still years away from knowing which genes influence many other traits.  They are also an exaggeration because many have observed that, to date, gene manipulation efforts reveal that genes cannot often be simply cut and pasted, especially without causing serious unanticipated effects. 

In the interim, IVF enables efforts to clear these technological hurdles.  It uses the same lab equipment and provides cumulating knowledge, techniques and an oversupply of embryos needed to advance genetic engineering.  IVF is to genetic engineering as breeder reactors are to nuclear weapons proliferation.

The commentators understate reproductive technology’s effects in another important way.  The same ethic of reproductive control that animates IVF also allows egg and sperm shopping, genetic screening and embryo selection -- and its companions, sex-selection or eugenic abortion.  One may maintain that the embryo is not a person but one cannot dispute that the embryo at seven days tells us much about the person at 27 years.  With its multi-embryo production, IVF already enables parents to select between embryos for numerous lifelong traits, including sex and disability.  Despite their backgrounds, sperm and egg shoppers display distinct preferences for gametes from tall, conventionally attractive gamete sellers with much formal education.  These choices are clearly design and they not prospective; they occur every day. 

Genetic screening also works the other way.  If prospective parents don't like their unborn's genes, they can, and often do, end the life tested.  For example, over 90% of fetuses diagnosed with Down Syndrome are aborted.  Not in some futuristic hell, but today, we are ending disability through a medically-mediated rendering of Jonathan Swift’s A Modest Proposal, by purging the disabled. 

Consider further the effects of genetic screening on the self-perception of the able-bodied.  How does it feel to know you were born because you met a quality control inspector’s, and your parents,’ standards?  In place of unconditional love, reporoductive technology allows the introduction of discrimination without regard to human dignity based on health or performance-related criteria. 

Some have suggested that embryo selection could be legislatively limited to those with genes for "life-or-death" diseases. That proposal does not inspire confidence. 
First, who can say that a disabled or a relatively brief life -- even one with much suffering -- is not worth living?  Second, most reproductive technology users will de-select embryos or abort fetuses whose genes suggest they will someday have MS, ALS, breast cancer or Huntington’s.  These conditions seldom kill, or even afflict, the young. 

Further, as many have observed, the lines between disease and trait or cure and enhancement are quite blurry.  What will be the legislative status of embryos that have genes for schizophrenia?  Deafness?  Depression?  Obesity?  Below average intelligence or height?   As the number of people with imperfections decreases, society’s acceptance of, and support groups and services for, the imperfect will shrink and the pressure to have “perfect” kids will intensify.  Stanford Law Professor Hank Greely has predicted that, given these competitive pressures, within 50 years, 50% of Americans will be the product of IVF.  Thus, genetic screening could cause the social stratification and personal alienation that the commentators fear, even without the genetic manipulation they foresee. 
All we have to do to advance this dystopia is more of what is already done: embrace reproductive technology, screen gametes/embryos and use/implant those with the traits the parents want.  Even if we could agree on and proscribe what constituted abuses of these practices, regulation of these micro-scale technologies, which involve high stakes to their demanding consumers and the clinics that compete for their business, and which occur behind closed doors in hundreds of office parks, is impracticable. 

Reproductive technology’s impact on self-perception
Apart from creating a genetically privileged class, reproductive technology already affects the perception of other beings and basic kinship or solidarity.  Despite vast demographic, ideological and personality differences, until about thirty years ago humans shared a common, mysterious origin in the union of a woman and a man.  This is no longer universally the case.  In its place, reproductive technology, applies a corporate model, not only in its technical practices, but in its marketing and competition for market share.  Increasingly, as life is manufactured and sold, it becomes less awesome and more like other possessions. 

While reproductive technology is the ultimate reductionist activity -- sperm plus egg plus gestation equals human -- it cannot be reduced into its component parts; like all things, we must take its benefit and harm as a unitary whole.  As children have become products of subjective desires and labs, not creations of God or nature, life has been radically altered in ways unreported by the TV news.  Relativism and utilitarianism have taken firm hold.  Marriage is postponed and eschewed and is increasingly separated from child-bearing and raising.  The perception and treatment of children have also changed:  many are prenatally frozen, their births are scheduled, they are formula-fed, placed in day care, micro-managed and overscheduled. 

Social scientists report numerous indicia of sharply diminishing social cohesion since the 1970s.  Has reproductive technology singlehandedly caused each of these changes?  No, but they fit squarely within a cultural context that makes everything, even human life, bend to individual sovereignty, engineering principles and ultimately, commerce.  With more to follow, skids greased.  As Waclav Havel wrote, “The tragedy of modern man is not that he knows less and less about the meaning of his life but that it bothers him less and less.”

Fundamentally, reproductive technology places the interests of the individual above those of the community.  Using it is like building one’s home on the beach at Normandy or in Yosemite Valley.  It pleases the consumer and their family and friends.  But it costs the culture something far more precious and universal, namely the notion of the sacred and the continuation of a society where genetic advantage cannot be purchased.  Reproductive technology has generated many offspring.  But with its effects on human perception and community, reproductive technology users should not expect the emerging world to resemble the one their grandparents or parents grew up in, or be much of a place to raise kids.

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