The Ethics of Genetic Choice
By Ronald M. Green
Yale University Press. 279 pp. $26
Ethics in the Age of Genetic Engineering
By Michael J. Sandel
Harvard University Press. 162 pp. $18.95
Consider some new definitions for the 21st century.
Little girl? Sugar and spice and everything nice - plus an exact genetic blueprint, like the how-to sheet that comes with your new cyber-era thingamajig.
Little boy? Snakes and snails and puppy-dog tails - in addition to precociously muscled arms (Why wait until baseball camp?), a psychology programmed away from dopey cigarette smoking and binge drinking, and maybe freckles if you like them.
We sit on the cusp of a new world in which the ability to genetically engineer our children, as well as reupholster our own organs, promises to become routine rather than exotic. Just as old definitions of life proved ethically problematic once medicine understood pregnancy better (would people fight over abortion if everyone agreed a child before birth is not conscious?), our traditional ideas of how we should control our bodies and those of our children look increasingly fragile in the face of "reprogenetics," the new medical field that unites reproductive and genetic technology.
Among the smartest and best-equipped thinkers to address these issues - despite no known manipulation of either's genes by their parents - are Ronald M. Green, director of Dartmouth College's Ethics Institute and cofounder of the Office of Genome Ethics at the National Institutes of Health, and Michael J. Sandel, the Harvard government professor who served on President Bush's Council on Bioethics that published the 2003 report "Beyond Therapy" (a document that opposed various uses of genetic intervention for human "enhancement").
Green and Sandel come at the subject from sharply different angles, making reading them together particularly useful.
You should read Green's book first because it's enormously more detailed, reportorial, imaginative and precise in explaining the science involved and the options we face. Green visits crucial researchers in Philadelphia, Salt Lake City and elsewhere, plumbs popular culture treatments of the issues from H.G. Wells'
The Time Machine
through the film
(1997) and the fiction of Octavia Butler, and integrates philosophical perspectives from his onetime teacher John Rawls as well as Jewish and Christian theologians.
Green even responds to an earlier version of Sandel's book - the article in the Atlantic from which Sandel's book grew. Agree with Green or not,
Babies by Design
consistently and brilliantly offers a persuasive brief for carefully and wisely moving forward.
Whether it's extending our life spans, genetically prescreening our babies, expanding tissue regeneration, or any of a number of other avenues, Green believes we must make "deliberate interventions into our own and our children's genetic makeup - to both prevent disease and enhance human life." He foresees engineer-parents reducing family fighting (by preselecting for less aggressive behavior) and argues it's normal for gene wizardry to evolve from therapeutic uses to sheer enhancement, just as plastic surgery did. He urges the reader to distinguish today's science from the discredited eugenics of the 19th and 20th centuries because today's technologies arrive as choices for the individual, not state-directed programs.
We have, Green concludes, always tried to make ourselves healthier, better and better looking (largely succeeding over the centuries), and nothing's going to stop us from doing so in the imminent age of the "$1,000 genome." When genetic profiles come down far enough in price, everyone and his or her doctor will have to confront these choices. "The time to start talking about this challenge," Green warns, "is now."
By contrast, in
The Case Against Perfection
, Sandel argues against Western science's bent since Francis Bacon to control nature whenever it can. Choosing our children's qualities, he contends, may not only impair their autonomy and skew our desired egalitarian social landscape, but will - this is Sandel's most distinctive point - deny us our sense of life as a "gift," an "endowment" that should exceed our control.
Sandel prefers that we reject a "stance of mastery and dominion that fails to appreciate the gifted character of human powers and achievements," that treats children as "objects of our design." He extrapolates from this into criticism of "hyperparenting," the intense management of one's children for success.
Like Green, Sandel ponders a phenomenon at the top of the news last week - the use of enhancement drugs and gene "therapies" in sports. Like Green, Sandel points out that the history of sports is full of activities once thought to alter fair competition into unfair competition - e.g., the use of shoes by runners - but later judged perfectly natural, the way munching an energy bar is today.
Unlike Green, who asks - in a chapter titled "Creating the Superathlete" - "What's wrong with gene doping, and why shouldn't we regard it as just another tool, like better food or innovative training techniques, to improve competitiveness?" Sandel sees a difference between what enhances a sport and what turns it into "spectacle."
Still, they share the view that bans on particular substances or practices in sports are just conventions of a particular time. That implies a useful guideline for analysts of last week's Mitchell Report: Distinguish ethical issues about following current rules from future issues about the relation of "enhancement science" to athletic performance. What's happening in baseball just shows what an impact new science can have on settled ways of life.
Is Green right that we always fear change and exhibit a "status-quo bias"? Should we heed Sandel's warning that the future of human solidarity is at stake? Green, with a greater grasp of the science, emphasizes medicine's many victories for humankind. Sandel, a savvy student of political history, notes how often exploitation of new science has led to disaster through pollution, global warming, industrialized genocide and nuclear proliferation.
Both, however, agree on one crucial truth: We all need much greater literacy in the ethical concepts and scientific information necessary to make informed decisions about these choices, especially given, as Green reports, "how fast the science is moving."
One solution is as old as Gutenberg. Before you plan that baby or fit together the crib, pick up these genetically engineered progenies, so to speak, of
Dr. Spock's Baby and Child Care