Genie in the bottle

Progress in eugenics poses ethical questions

The early 20th-century debate on is best exemplified by an apocryphal story. George Bernard Shaw was propositioned by Isadora Duncan. Ms Duncan suggested that they could do humanity a favour by having a baby which would inherit her looks and Mr Shaw’s brains. Mr Shaw demurred, “Ah, but what if the child inherits my looks and your brain?” Imagine that you could create a baby with the exact attributes you desired, picking genes from two, three, or more individuals. This super-baby might have high intelligence, disease resistance, athletic prowess, etc. Further, imagine that such a super-baby could be cloned. Now, this eugenic fantasy is close to hard reality.

 
The world has taken giant strides in tweaking how we look at birth. Cloning already existed in nature since identical twins are clones, but, in 1996, The Roslin Institute in Scotland cloned Dolly the sheep. At least 20 mammalian species have been cloned since. In-vitro fertilisation (IVF) — the mixing of genetic material from two individuals to create a baby — was first demonstrated in 1978. At least 5 million IVF babies have since been born and now even “three-parent” babies are possible.
 
In this regard, the last five years have witnessed the development of precise genetic editing technologies. The CRISPR CAS-9 technique can cut and paste specific genes into (and out of) a genome. Another set of technologies might make it possible to generate reproductive cells even from the skin cells of adults. Intriguing options such as “one-parent” babies and babies with two male (or two female) parents can now be contemplated.

 

Beyond personal choice, these advancements provide huge potential benefits. A wide range of genetic conditions such as multiple sclerosis, muscular dystrophy, diabetes and sickle-cell anaemia might be eliminated by excising specific genes. Genetic resistance to other diseases, including HIV and malaria, could be introduced. Bereaved parents could clone a dead offspring. LGBT couples could have children that are their genetic descendants. Organs could be grown in labs for transplants. Extinct species such as the woolly mammoth might be revived.
 
But along with such wonders come several ethical questions. Should experimentation on human embryos be allowed? If so, to what purpose? The medical benefits must be weighed against the potential harm, given the endless frightful possibilities such as dictators cloning themselves and the super-rich perpetuating dominance by having super-babies. Also, what constitutes an “embryo”, given that a few skin cells may be converted into reproductive material? What legislation is needed to guard the fundamental rights of individuals to control their own DNA and to prevent it from being misused?

 
The American National Academy of Sciences (NAS) has just released a report that considers some of these questions. It makes recommendations about what may and may not be acceptable. The NAS report tries to balance potential benefits with unintended risks while paying heed to societal values. The report recommends that editing the DNA of a human embryo to prevent disease could be ethically allowable in rare circumstances and with safeguards in place. But editing for enhancements should be banned. In practice, this line is blurred: curing genetic predisposition to asthma or muscular dystrophy could lead to the creation of babies with massive lung capacities or big muscles, respectively.

 
Obviously, the NAS recommendations cannot be binding. And what complicates such ethical dilemmas further is that different nations have different laws and different religions (and rationalists, for that matter) with widely varying stances on these matters. But the recommendations will clearly influence research directions in the US, and thus could be useful signposts, given that legislation everywhere has to catch up with the science. We may well see situations where “medical tourists” gravitate to regimes with more lax laws in this regard. It's a Brave New World out there, 85 years after Aldous Huxley wrote his classic, as genetically modified individuals are grown in bottles.