Most of us would do anything to help our children have the best future possible. We would make sure they had the best prenatal environment, the best diet and be sent to the best schools, all so that they could have the best possible future opportunities. But what would we do if we could, before they were born, alter our child’s genes in order to guarantee that advantage? The choice of genetically engineering our children is rapidly becoming a scientific reality, and we are faced with the question: If we are able to safely engineer a child at the genetic level… should we?
Genetic engineering is a topic that is greeted with a combination of curiosity, skepticism and apprehension. Those in favor of genetic engineering have been accused of “playing God”, whereas those opposed have been characterized as being against scientific progress. Many people view genetic engineering as something confined to the domain of science fiction; something so far in the future that it needn’t be worried about. However, with the advance of modern technology, this attitude towards genetic engineering is not only misguided, but can be dangerous.
Nearly every advance in technology comes with unanswered questions, and genetic engineering is no different. What should we do? What will happen if we make certain decisions? How will our decisions affect society? If we have the ability to do it safely, is it ethically permissible to genetically engineer our children? Is there an ethical difference between genetic enhancement and genetic therapy? As people living in the time where genetic engineering is a real possibility, it is vital that we address the bioethical issues surrounding this controversial topic. If we procrastinate in this area and do not address these issues before they come up, we will inevitably make poor decisions that could have been avoided. Like many advancements in science and technology, genetics provides us with an opportunity to be good stewards with what we have. But it also offers us a unique opportunity as well; “… we can begin to determine not simply who will live and who will die, but what all those who live in the future will be like” (Harris & Burley, 2004)
This article is designed as a form of philosophical preventative maintenance, with very real ramifications for the near future. Because it is meant to address issues of genetic engineering specifically, other issues will be avoided. I will assume that genetic engineering will not destroy human embryos and will not result in any unintended changes. These issues need to be addressed by scientists, doctors and ethicists today, but will likely be circumvented with the advance of technology. The purpose of this paper is to ask, “What philosophical issues arise from genetic engineering itself?”
Many moral philosophers and ethicists, when approaching complex ethical issues, have attempted to lay out a principle of moral reasoning that is designed to answer the question, “What ought I to do?” It seems reasonable, therefore, to follow a basic principle of moral reasoning, and philosopher Kurt Baier explores a fairly simple one in his book, The Moral Point of View. According to Baier, “The best course of action is… the course of action which is supported by the best reasons. And the best reasons may require us to abandon the aim we actually have set our heart on.” Baier’s two-step approach involves looking at the relevant facts surrounding an issue and determining the relative weight of those considerations “to decide which course of action has the full weight of reason behind it”. (Baier, 1969) Following this approach, it is our job to critically examine the arguments for and against genetic engineering and to support the most reasonable conclusion, given the strongest available arguments on both sides.
Enhancement vs Therapy
One important distinction in this discussion is the difference between genetic enhancement and genetic therapy. Therapy can be defined as “… an intervention designed to maintain or restore bodily organization and functioning states that are typical for one’s species, age and sex” and enhancement can be defined as an “alteration to improve upon normal organization, appearance, health and functioning” (Lagay, 2001). This distinction is not new to the medical community and has been used in a variety of different contexts, so applying it to the topic of genetic engineering is not without precedent.
While there may be some obvious examples of therapy and enhancement (steroids may be used for either), is there a line that can be neatly drawn to distinguish between therapy and enhancement? Much has been written on this issue (Colleton, 2008; Kamm 2005; Jeungst 1998), and while the distinction may not exist de jure, a de facto line certainly exists. As Colleton explains, our society certainly is “… making a distinction, drawing a line. Its placement may be arbitrary, but that does not mean that no one is making it” (Colleton, 2008). And this distinction is important to make, because therapies are generally considered to be “medically necessary” (and indicate medical obligation), whereas enhancements are superfluous (Jeungst, 1998). “… The line between therapy and enhancement is the line where medical necessity stops and optional or elective procedures begin” (Colleton, 2008).
If a strict line between therapy and enhancement can be defined, it is inconsequential to the ultimate conclusion of this paper. My goal is to argue for the moral and legal freedom to genetically engineer our children, regardless of whether or not it is considered to be for therapeutic or enhancement purposes.
Therapeutic Genetic Engineering
We currently have the ability to identify genetic defects in utero, and if our technology were advanced enough, we could genetically engineer gametes and/or embryos and return the DNA back to normal functioning. For example, sickle-cell anemia is an inherited disorder that causes the red blood cells to develop into sickle (or crescent) shapes, instead of the normal, healthy disk shape. Those with sickle cell anemia can have a variety of symptoms, including poor circulation, increased risk of infection, and a decreased life span. (Mayo Clinic Staff, 2011 and NIH, 2012) With the advance of modern genetics, we now know that HBB, “the gene associated with sickle cell anemia” is found in “region 15.5 on the short arm of human chromosome 11” and is “1600 base pairs long”. (DOE, 2003) If we know exactly where the gene is, it is very likely that we will be able to modify the genome in a way that will cure sickle-cell anemia before a child is born.
When considering the obvious examples of genetic therapy, some have argued that “… gene therapy for the treatment of severe disease is considered ethical because it can be supported by the fundamental moral principle of beneficence: It would relieve human suffering. Gene therapy would be, therefore, a moral good” (Anderson, 1989). Others, like Munson & Davis, have argued that “[t]here is no moral reason… not to develop and employ germ-line gene therapy” and that “…medicine has a prima facie moral obligation to do so.” (Munson and Davis, 1992). After considering the social and economic factors, “…far more reasons exist to commend fetal gene therapy than to reject it.” (Fletcher and Richter, 1996) We ought to embrace safe genetic therapy as something we should do if given the opportunity.
There are several arguments for and against genetic enhancement that must be considered, as well as various responses to those arguments. I will attempt to address two arguments in favor of genetic enhancement, two arguments against it and then construct a case for the moral and legal freedom to safely genetically enhance our children.
Arguments for Genetic Enhancement
One of the primary arguments in favor of genetic enhancement deals with the idea of the “natural lottery”, or traditional child-development with no enhancement. The natural lottery, as John Rawls explains in A Theory of Justice, has to do with the biological inheritance a child is born with. In the absence of any genetic modification by the parents, the child’s genetic traits are determined largely by chance. Julian Savulescu, the editor-in-chief of the Journal of Medical Ethics, argues that genetic enhancement may be a “moral obligation” because “if we have the power to intervene in the nature of our offspring – rather than consigning them to the natural lottery – then we should.” Chris Seck, former editor of The Stanford Review, says, “It is true that genetic engineering may limit children’s autonomy to shape their own destinies. But it is equally true that all people’s destinies are already limited by their natural genetic makeup, a makeup that they are born with and cannot change.” (Seck, 2007)
Many advocates in favor of genetic enhancement point to the fact that parents already select for and against certain conditions, with the end goal of producing better children. Many expecting mothers alter their diet and behavior, in addition to taking specially designed pre-natal vitamins. It is often considered the hallmark of “good parenting” when the child goes to a good school, is encouraged to be involved in sports, and the parents do whatever they can to help their child get good grades and get into a good college. Considering this, how is genetic engineering any different? It is true that genetic modification is designed to change things at a much more fundamental level than altering the environment, but the goals are the same: to provide the child with the best possible future. And many experts argue that genetic enhancement does just that. “Most parents want to improve the lot of their children. Providing a safe environment, a healthful diet, a good education, exposure to diverse experiences are some of the more conventional means of enhancing the health and opportunities of children” (McGee, 1997).
Arguments Against Genetic Enhancement
Many people are concerned that genetic enhancement will infringe on the child’s autonomy in a way that makes it more difficult to shape her own destiny. As Dinesh D’Souza writes, “If parents are able to remake a child’s genetic makeup, they are in a sense writing the genetic instructions that shape his entire life. If my parents give me blue eyes instead of brown eyes, if they make me tall instead of medium height, if they choose a passive over an aggressive personality, their choices will have a direct, lifelong effect on me.” D’Souza holds personal autonomy in very high regard, including the personal autonomy of children, saying “children are not our property.” In response to the idea that we should be free to manipulate the genetic makeup of our children, he asks, “What greater violation of individual autonomy is even conceivable?” D’Souza concludes this argument from personal autonomy of the child with this:
“The greatest danger of genetic engineering is that we might become arrogant enough to believe that we can not only remedy nature’s defects but also improve on human nature itself. We should not have the right to try such experiments out on other people, even our own offspring. The children are human persons, and to tamper with their structure in the absence of a clear need — such as to avoid a specific disease — is a fundamental and impermissible violation of their integrity.” (Bailey & D’Souza)
If a parent decides to genetically engineer a child with the goal of being tall, many would argue that the parents’ decision is preventing the child from being fully autonomous. If the height of the child works out in her favor, do the parents deserve some (or all) of the credit? What if her height works against her in some way? Are the parents to blame? If the child was allowed to develop without any genetic enhancements (“natural lottery”), her personal autonomy would never have been violated, her decisions would have been hers alone, and her accomplishments/failures would have fallen on her shoulders.
Many arguments against genetic enhancement deal with what would happen if genetic enhancement becomes a normal societal occurrence. Those who argue in this way warn us about social problems that may arise because of genetic enhancement, and they make comparison between genetic enhancement and eugenics. In his paper, The Case Against Enhancement, Michael Sandel argues against enhancement by appealing to humanity’s moral conscience. Allowing genetic enhancement “represent[s] a kind of hyperaency – a Promethean aspiration to remake nature, including human nature, to serve our purpose and satisfy our desires. The problem is not the drift to mechanism but the drive to mastery.” His concern is primarily how this technology will change humanity’s view of itself, and he concludes his paper with the idea that genetic enhancement will threaten to “banish our appreciate of life as a gift, and to leave us with nothing to affirm or behold outside our own will.”
Another potential social problem is the issue of inequality; a problem very well expressed in the movie Gattaca, where there are obvious differences between those who are genetically engineered (the valids) and those who are not (the in-valids). In this movie, certain jobs are available only to the “valids”; jobs that the in-valids would never be able to get because of their un-engineered genetic code. The in-valids, complete with all of their genetic “imperfections” were given the less-respected positions in society, such as janitors and maintenance workers. In one scene, Vincent (the “in-valid” main character) told his father of his dream to become an astronaut, to which his father responded, “The only way you’re going to see the inside of a spaceship is if you were cleaning it.” (Gattaca, 1997) This is because companies in this future society, on which this movie is based, hire people based on genetic screening, not their performance. And this is exactly the type of social inequality that many people in opposition to genetic engineering are concerned about. “To many, Gattaca is a dystopia where vast gaps between the haves and have-nots will become intolerable, due to the existence of not just material, but also genetic inequalities.” (Seck, 2007)
And finally, no discussion of genetic enhancement would be complete without a discussion of eugenics. Eugenics is the view that “advocates the use of practices aimed at improving the genetic composition of a population”, and the Nazi promotion of eugenics has been nearly universally condemned. In Nazi Germany, specific people were targeted as “Lebensunwertes Leben” (Life Unworthy of Life) because of certain characteristics, including genetically based diseases and heredity. (Stein, 2007) Many people opposed to genetic enhancement will compare the selection of specific genes in the human genome to what was done during the time of the Nazis. “The logic behind this argument is that human genetic enhancement perpetuates discrimination against the disabled and the ‘genetically unfit,’” (Seck, 2007) and if genetic enhancement discriminates against the disabled and genetically unfit, then it is a form of eugenics. According to those opposed to genetic enhancement, the manipulation of genetics in an attempt to create “designer babies” has essentially the same outcome as eugenics. Because of this, we should stay away from anything that puts humanity in the “driver’s seat” of human genetics. They argue that eugenics is nothing more than humanity’s attempt to “play God”, because there are some things that we, as a species, should not touch. These things should be ultimately left up to God to decide.
Responding to the Arguments Against Enhancement
The personal autonomy argument, advocated by D’Sousza and others, essentially says that the child has the right to determine her future, and unnecessary genetic enhancement will violate her personal autonomy. What D’Sousza fails to recognize is that parents make choices regarding the life and welfare of their children all the time, yet no one claims the autonomy of the child is being violated. Expectant mothers will regularly take vitamins (to enhance the prenatal environment), read or play music to the developing child and alter her diet, all in an attempt to give the child the best environment possible. After birth, parents deliberately choose the child’s nutrition, education, entertainment and health. In fact, to neglect these things is often seen as inappropriate parenting. These alterations are certainly not a violation of the child’s autonomy; they are the hallmark of a good parent. In the same way, selecting for certain traits is not a violation of personal autonomy; it is an attempt to give the child the best possible opportunities in life. Modern genetics research has shown that many traits are determined by both genetics and environment, so to alter the environment may be more, less or equally integral in the development of specific traits.
Critics of genetic enhancement (or any other contentious issue; cloning for example) will assert that those in favor of it are “playing God”, and we should rely on nature, or God, to determine genetics. It is obvious that “playing God” is something that we should not do, according to the critics, but what does it actually mean to “play God”? When people use the term “playing God”, it is meant as a precautionary principle, meant to express some kind of discouragement from a specific action. The actions associated with “playing God” are usually new technologies that alter something about the human condition. In this case, genetic engineering is seen as playing God, but couldn’t the same argument be used as a “catch-all” for anything that makes us uncomfortable? I would never say that we shouldn’t take the proper precautions when it comes to new technologies, but preventing the advancement of science and technology by an appeal to discomfort does not adequately justify abstaining from it.
And finally: social inequality as a result of genetic enhancement. As portrayed in the movie Gattaca, genetic enhancement has the potential to encourage a wider division of the classes. It could create a social division between those who are not genetically enhanced and those who are. This is one of the more rhetorically powerful arguments against genetic engineering, not because it makes enhancement something that we should avoid, but because it highlights a pre-existing problem in modern society. There are many things that we currently embrace that seem to encourage a gap between the “haves” and the “have-nots”; education, access to health care and access to computers, just to name a few. However, if we want to do something to solve the social division, is it reasonable to ban the technology? Those who are against genetic enhancement are suggesting that we ban it, and that doesn’t seem like a reasonable solution. If we banned everything that might cause a social division in society, that would require that we ban other things that are thought to be good for society, such as access to education. How we solve this problem is up to us, according to the policies that we put in place. But banning technologies like genetic engineering is not the correct solution.
In response to the eugenics comparison, genetic enhancement may be a form of gene-selection, but Nazi eugenics and Genetic engineering, just like any other new advancement in technology, comes with a wide variety of unanswered questions, and this paper has certainly not addressed every single question. There is a distinction that needs to be made between therapy and enhancement, which has a direct impact on some of the unanswered questions above (such as insurance considerations). However, that distinction does not imply that genetic enhancement should be opposed; it suggests that safe genetic therapy should be whole-heartedly embraced. Because of the potential benefits of genetic engineering, we should not allow our discomfort to prevent our society from exploring it. We should most certainly embrace a precautionary attitude, but we should embrace genetic engineering for its positive benefits. We need to be extremely careful as we proceed, but we should definitely proceed. One of the most important things to recognize is that we will not be able to outright design a child. We will not be able to say, “My daughter will be able to play piano like Beethoven”. All that we will be able to do is alter the chances of a wide variety of outcomes; something we already do through environmental manipulation. Genetic engineering technology is currently in its infancy, and it would be irresponsible to engage in that kind of unsafe behavior right now. But, if our technology continues to advance in a way that makes genetic engineering safe, then our response should be to use that technology to enhance the opportunities of future generations.genetic enhancement are different in every morally relevant way. The Nazis would exterminate the “unfit” living people, whereas genetic enhancement is in the business of creating the best life possible for people. Nazi eugenics was attempting to create a “perfect race” by killing and sterilizing people, but genetic engineering is attempting to select for certain traits by altering the DNA, not killing anyone or selecting for a “perfect race.” In general, the comparison between Nazi eugenics and genetic enhancement conflates the similarities while completely ignoring the obvious differences. The Nazis pursued a eugenics outcome by means of death; genetic enhancement pursues a eugenics outcome by means of life.
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Kurt Baier. The Moral Point of View, Problems in Moral Philosophy: An Introduction to ethics. (Dickenson Publishing Company, 1967)
Laura Colleton, “The Elusive Line Between Enhancement and Therapy and Its Effects on Health Care in the US.” Journal of Evolution and Technology, Vol. 18, Issue 1 (2008)
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This paper is the result of a semester long independent research project, headed by biology professor at Buffalo State, Dr. Amy McMillan. It was then reviewed (several times) by Buffalo State philosophy professor, Dr. Jason Grinnell. It was then modified for Ball State University’s undergrad philosophy journal “Stance” and submitted. Unfortunately, the administrator at Ball State never received it, and I graduated.