Friday, September 19, 2014
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The Mixed Blessing of Genetic Choice

The advance of knowledge is often a mixed blessing. Over the past 60 years, nuclear physics has been one obvious example of this truth. Over the next 60 years, genetics may be another.

Today, enterprising firms offer, for a fee, to tell you about your genes. They claim that this knowledge will help you live longer and better. You might, for example, have extra checkups to detect early signs of the diseases that you are most at risk of contracting, or you could alter your diet to reduce that risk. If your chances of a long lifespan are not good, you might buy more life insurance, or even retire early to have enough time to do what you always wanted to do.

Defenders of privacy have worked, with some success, to prevent insurance companies from requiring genetic testing before issuing life insurance. But if individuals can do tests from which insurance companies are barred, and if those who receive adverse genetic information then buy additional life insurance without disclosing the tests that they have taken, they are cheating other holders of life insurance. Premiums will have to increase to cover the losses, and those with a good genetic prognosis may opt out of life insurance to avoid subsidizing the cheats, driving premiums higher still.

We need not become too alarmed yet. The United States Government Accountability Office sent identical genetic samples to several of the testing companies, and got widely varying, and mostly useless, advice. But as the science improves, the insurance problem will have to be faced.

Selecting our children raises more profound ethical problems. This is not new. In developed countries, the routine testing of older pregnant women, combined with the availability of abortion, has significantly reduced the incidence of conditions like Down syndrome. In some regions of India and China where couples are anxious to have a son, selective abortion has been the ultimate form of sexism, and has been practiced to such an extent that a generation is coming of age in which males face a shortage of female partners.

Selection of children need not involve abortion. For several years, some couples at risk of passing a genetic disease on to their children have used in vitro fertilization, producing several embryos that can be tested for the faulty gene and implanting in the woman’s uterus only those without it. Now couples are using this technique to avoid passing on genes that imply a significantly elevated risk of developing certain forms of cancer.

Since everyone carries some adverse genes, there is no clear line between selecting against a child with above-average risks of contracting a disease and selecting for a child with unusually rosy health prospects. Thus, genetic selection will inevitably move towards genetic enhancement.

For many parents, nothing is more important than giving their child the best possible start in life. They buy expensive toys to maximize their child’s learning potential and spend much more on private schools or after school tutoring in the hope that he or she will excel on the tests that determine entry to elite universities. It may not be long before we can identify genes that improve the odds of success in this quest.

Many will condemn this as a resurgence of “eugenics,” the view, especially popular in the early twentieth century, that hereditary traits should be improved through active intervention. So it is, in a way, and in the hands of authoritarian regimes, genetic selection could resemble the evils of earlier forms of eugenics, with their advocacy of odious, pseudoscientific official policies, particularly concerning “racial hygiene.”

In liberal, market driven societies, however, eugenics will not be coercively imposed by the state for the collective good. Instead, it will be the outcome of parental choice and the workings of the free market. If it leads to healthier, smarter people with better problem-solving abilities, that will be a good thing. But even if parents make choices that are good for their children, there could be perils as well as blessings.

In the case of sex selection, it is easy to see that couples who independently choose the best for their own child can produce an outcome that makes all their children worse off than they would have been if no one could select the sex of their child. Something similar could happen with other forms of genetic selection. Since above-average height correlates with above-average income, and there is a clearly a genetic component to height, it is not fanciful to imagine couples choosing to have taller children. The outcome could be a genetic “arms race” that leads to taller and taller children, with significant environmental costs in the additional consumption required to fuel larger human beings.

The most alarming implication of this mode of genetic selection, however, is that only the rich will be able to afford it. The gap between rich and poor, already a challenge to our ideas of social justice, will become a chasm that mere equality of opportunity will be powerless to bridge. That is not a future that any of us should approve.

But avoiding this outcome will not be easy, for it will require that selection for genetic enhancement is either available to no one or accessible to everyone. The first option would require coercion, and – since countries will not accept that others should gain a competitive edge – an international agreement to forego the benefits that genetic enhancement can bring. The second option, universal access, would require an unprecedented level of social assistance for the poor, and extraordinarily difficult decisions about what to subsidize.

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