Natalie Frank, a Ph.D. in clinical psychology, specializes in pediatric psychology and behavioral health.
Human beings have always endeavored to better themselves, wanting to be healthier, faster, more attractive, and brighter, always dreaming of attaining perfection. This ideal has been especially focused upon by parents who want to give their children the most advantages possible.
Hundreds of years before test-tube babies came about, alchemists believed that small, flawless humans could be formed artificially with a variety of substances. These included sperm, human blood, powdered minerals, excrement, and the sap of white willows. Sometimes animals served as surrogates for the developing homunculus; other times, a large glass or lead container was believed to suffice. There are even reports of the use of pumpkins for the “growing” of one of these small beings, which were believed to develop into a baby that could be educated and trained. Paracelsus, a prominent physician and alchemist, published a “recipe” for creating a homunculus, which included the suggestion that all steps of the procedure be carried out in secret.
While there are no credible reports of any actual pumpkin children being created, four centuries later, we were able to develop real medical capabilities that allowed conception to occur outside the human body. With the birth of Louise Brown, the first “test-tube baby” in 1978, couples with fertility problems were given new hope regarding their ability to have a child.
In the wake of this innovation, new reproductive technology has emerged. This has included more advanced methods for conducting in vitro fertilization (IVF), recombinant genetics, and now genetic engineering. But these developments have also led to struggles regarding the ethics and future of this technology. Some of the issues that have resulted in controversy include state and federal power, professional standards, and women’s reproductive rights. Another major issue has involved selective breeding on the basis of race, gender, sexual orientation, maternal age, and genetic risk for a variety of diseases.
The year Louise Brown turned 11, researchers progressed past the ability to create life in a laboratory petri dish. They found a way to gaze into the embryo’s genetic makeup and predict what life might be like for that individual. These predictions were, of course, laden with value judgments of what is good and bad, which attributes most people would choose for their children if given the chance, and which attributes they would select out, if possible. As technology developed further, the ability to choose a child’s characteristics became a real option, and potential parents were given a never before realized power—the power to preview and choose the genetic traits of their future children.
Just as Paracelsus believed that his procedure for creating a homunculus worked best if done in secret, science is quietly handing humans the ability to direct our own evolution by willingly altering our genetic makeup. The potential exists to select out the genes that make us sick and kill us, those that predispose us to develop cancer, heart disease, depression, addictions, and obesity. In the near future, it will likely become possible to choose to retain only those genes that could make us healthier, stronger, more intelligent, or even better looking.
But just because we can, does that mean that we should?
Dr. Jeffrey Steinberg, Genetic Engineer of Designer Babies
Dr. Jeffrey Steinberg of The Fertility Institutes has worked for more than a decade to improve the ability to genetically engineer the physical features of babies. He employs a procedure known as preimplantation genetic diagnosis (PGD) to sort and select embryos based on gender and eye color. He intends to try to select for other traits in the coming year, including skin color and hair color.
After announcing this, he and his clinic drew widespread outrage. “Screening embryos for skin color isn’t about reproductive choice,” said Osagie Obasogie, CGS Senior Fellow and University of California professor. “It’s about leveraging social prejudices to try to give your kid a leg up. This is the tip of the iceberg in terms of how reproductive and genetic technologies could fundamentally reshape race relations.”
Steinberg routinely uses the media to promote his efforts, which many have said are akin to eugenics, in order to increase revenue. And the revenue resulting from his work is definitely high. In 2007, an Australian couple with three sons paid Steinberg $40,000 to have a daughter. This is a single patient.
PGD can cost $20,000 or more per attempt, and most attempts fail. Many people try again, sometimes several times, before giving birth to a healthy baby. This obviously means only the most affluent parents can use PGD procedures to select the traits of their babies.
Social sex selection has been gaining acceptance in the U.S., even when it means IVF and PGD are marketed to people with no fertility problems and no heritable genetic conditions. Most fertility practitioners who offer gender selection justify it as “family balancing” in families who have more than two children of the same sex and none of the other sex.
However, Steinberg is marketing PGD to couples with no genetic risk factors regardless of family makeup. In fact, the majority of couples undergoing in vitro fertilization at Steinberg’s clinic do so only in order to choose the gender. They are not required to even have a first child before requesting the gender of their baby.
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The percentage of PGD procedures carried out at Steinberg’s clinics is extraordinarily high. According to the annual Centers for Disease Control (CDC) report (2015), almost 90 percent of all IVF procedures conducted at Steinberg’s clinics are PGD procedures. Comparatively, the national average is 5 percent, and out of 464 U.S. clinics, only four others use the technique in 50 percent or more of procedures. This suggests that while the websites for Steinberg’s clinics underscores how he aims to provide the highest levels of infertility care available, the vast majority of patients are not seeking help for infertility problems.
An Early PGD Pioneer Has a Change of Heart
Twenty-five years ago, Dr. Jeffrey Nisker, one of the leading PGD developers, was helping to push the boundaries of reproductive technology. He saw the PGD procedure as a triumph, allowing infertile couples to have children and those carrying the genes for disorders to have healthy children. But when ethics became an issue, he felt morally bound to stop pursuing this line of research altogether.
"I was enamoured by the science. But, you know, I had never really thought about where it was going,” Dr. Nisker said.
That soon changed when news of his use of the procedure was publicized, leading to non-stop calls. The problem, as he saw it, was that almost none of these calls came from those wanting to prevent the child from being born with a disease. He was stunned to find that almost all of these couples were seeking to choose the gender or physical characteristics of their child. He was even more surprised to realize that the majority of those seeking his help were fertile. “I never thought for one minute this would be used by fertile couples," he said.
As soon as he realized where this all was going, he gave back a huge amount of grant money and closed his clinic. Nisker’s position is best summed up in his play, Orchids (1994), where a doctor teaching medical students says, "In a perfect world, exploration of the ethical and social implications of genetic science should precede research. Without careful constraints, the rapid pace may be harmful."
Hoping for greater public debate and discussion, Nisker remains concerned about the direction genetic testing is taking. "This is scary to me because I'm one who doesn't believe in social engineering. If we strive for perfection, we are going to blame people with disabilities. We're not going to accommodate them, or support them with tax dollars."
Will Genetic Engineering Usher in a New Era of Eugenics?
Critics ranging from certain religious leaders to political conservatives to advocates for the disabled are fearful that a new age of eugenics may be around the corner. Instead of being motivated by racists, despots, or elitists, it is believed this era will instead be generated by parental aspirations and the quest for the perfect child. The issue which the controversy centers around is embryo disposal. The embryos that are not implanted because they don’t possess the characteristics being selected for are destroyed. This is obviously unacceptable for many, particularly those who believe that life begins at conception.
Discarding embryos because of certain characteristics is problematic enough when screening occurs to eliminate a heritable disease. Additionally, there continues to be much disagreement regarding which conditions it should be permissible to screen and select for. The majority of people agree that screening should be allowed for deadly diseases. Yet for other conditions, there is more argument, with those on one side saying that even mild conditions can seriously affect a person’s life and those on the other side saying this is a slippery slope.
For example, doctors were strongly criticized in 2007 for allowing a couple to use PGS so their child could avoid an inherited squint. Questions being considered include whether these types of procedures should be permitted for mild or manageable conditions, those that only increase disease risk but don’t determine it, or those that only develop later in life. Clearly, given that these questions regarding how serious a condition must be to warrant screening for it are still hotly debated, screening for cosmetic reasons such as hair and eye coloring would create a major dispute.
NASA Believes Future of Genetically Engineered Babies Plausible
In 2011, NASA compiled a list of the most plausible science fiction films (Zielinski, 2011). The film rated as most credible was Gattaca (1998). The name of the movie alludes to its theme of genetics engineering as it is an acronym for Guanine, Adenine, Thymine, Thymine, Adenine, Cytosine, a DNA sequence made up of the four nucleotide acids. The movie tells the story of a man born “naturally” in a time when almost all people are genetically engineered, which greatly limited his life options due to the status of being considered “invalid.”
NASA’s assertion that the dystopian world portrayed in Gattaca could become a reality before long is echoed by others. Dr. Roger Pierson, a fertility specialist at the University of Saskatchewan, says. "Twenty years from now, you have to wonder if all babies will be conceived by IVF." He goes on to say, "We are not going to slow the technology, so the question is, how do we use it?"
While considering people who are not produced through embryo selection and enhancement techniques invalid is a frightening prospect for many, there are those in the academic and medical communities who argue that individuals who procreate are morally obliged to improve the species.
The Moral Obligation to Use Genetic Screening and Selection Techniques
Julian Savulescu, the controversial Oxford University bioethicist, believes that society should do more than merely allow such screening. He claims parents have a moral obligation to select embryos that are "most likely to have the best life, based on the available genetic information." Termed procreative beneficence, he states that the argument against his position, primarily that he is advocating a world with little diversity, is false.
On the contrary, Savulescu disputes the idea that everyone would select the same option, asserting that there are a number of equally good genomes that exist and would be selected by different couples with different goals. For example, it is often believed that being tall would always be selected over being short since the former is preferable. Yet Savulescu argues that a tall, brilliant rower is not better than a short, brilliant gymnast such that the value of characteristics cannot be assumed apart from an environment. So height is advantageous for some purposes and disadvantageous for others. He states it is impossible to determine if it is better, for example, to be brilliant, creative, and bipolar compared to being of average intelligence and creativity, but free of mental illness (Savulescu, 2015).
Yet, there are several arguments that this position does not address. First is the obvious one, the one of financial resources and socioeconomic status. As has been pointed out, only those with enough money will be able to use PGS to select the characteristics of their children. Since low socioeconomic status is viewed negatively, traits commonly selected out will become much more prevalent in low SES families. This will lead to discrimination based on the association with low SES.
Second, features that provide greater ability such as intelligence, physical strength, stamina, and the like will give those with greater financial resources an even larger advantage.
Third, there’s no support for the argument that people will make different choices ensuring diversity continues. Based on his own example of height, being tall is in fact valued over being short, especially for boys. Parents wouldn’t know whether a child would go on to become a brilliant gymnast or rower or anything else before the fact. So selecting shorter heights because this is advantageous for certain areas isn’t a guarantee that the child will succeed at or even have any interest in trying to succeed at any of those areas.
The suggestion that parents might select a genetic profile that includes a predisposition for bipolar disorder if it also ensured their child would be brilliant and creative over one that would rule out mental illness but lead to other attributes being average seems highly unlikely. For the most part, people value similar attributes regarding many physical and psychological characteristics, so there would be a very real problem of limited diversity being introduced into the gene pool.
Even if genetic engineering techniques became widely accepted, it is improbable that everyone across the world would have equal ability to use it for many years in the future, if ever. This means there would always be those who were born with genetic abnormalities. Because of this, experts continue to demonstrate concern over whether options that permanently alter the human genome might lead to changing public acceptance of people with genetic conditions and disabilities.
Some worry that discrimination may be directed not just at people with certain disabilities but at those who possess physical characteristics viewed as undesirable, such as dark skin, eyes, or hair. If genetics engineering techniques begin to be used, It stands to be seen whether we will accept those who are or choose to remain different or if we come to prioritize a society characterized by physical and psychological perfection.
Recent technological advances now permit us to scan every chromosome in a single embryonic cell to test for genes involved in hundreds of disorders, many of which are clearly life-threatening. And soon, DNA microchips capable of analyzing more than a thousand traits at once, those linked not just to a child's health but to enhancements—genes that influence height, intelligence, hair, skin and eye color, and athletic ability.
While genetic tests were devised to help those suffering from infertility and to help improve the health and well-being of the population, they are now being used for far more than that. Couples fully capable of having babies without aid are opting for IVF and embryo screening and selection, paying huge amounts so that they can have greater genetic control over their offspring.
As Pierson pointed out, scientific advancements are a Pandora’s box of sorts. Once a discovery has been made, it cannot be unmade, and people will find ways to use it even if the scientific community or various political, religious, or other group believes it isn’t ethical to do so. Therefore, the question isn’t how to prevent something from being developed but how best to use it once it is.
It is up to us to spend the time necessary to determine, to the best of our ability, what positive and negative consequences scientific discoveries may have before employing them. This will allow us to use such advances as responsibly as possible for the betterment of society and the human race while preventing potential harm to ourselves and our children.
Bortolotti, L. (2009). Do We Have an Obligation to Make Smarter Babies?.
Centers for Disease Control and Prevention, (2015). ART Success Rates. Retrieve from https://www.cdc.gov/art/artdata/index.html
Savulescu, J. (2015). Procreative beneficence, diversity, intersubjectivity, and imprecision. The American Journal of Bioethics, 15(6), 16-18.
Shanks, P., (2018). Steinberg, Still Starting to Sell Eugenics. Biopolitical Times. Center for Genetics and Society. Retrieved from https://www.geneticsandsociety.org/biopolitical-times/steinberg-still-starting-sell-eugenics-0
Zielinski, S., (2011). NASA Picks Best & Worst Sci-Fi Movies. What Are Yours? Smithsonian Magazine. Retrieved from
This content reflects the personal opinions of the author. It is accurate and true to the best of the author’s knowledge and should not be substituted for impartial fact or advice in legal, political, or personal matters.
© 2018 Natalie Frank