The Ethics of Designer Children

Some time ago I happened to record an interview on NPR with Michael Sandel, a Harvard philosopher about the ethics of genetic engineering (he recently published a book The case Against Perfection). It got me thinking, and I thought I might share some ... thoughts.


In the last two decades, our rapidly developing biotechnology has brought us into the realm of human genetic engineering. We are now able to not only screen for many diseases and a few genetic characteristics, but are on the verge of being able to select characteristics of a child. So far this has been limited to the sex of the unborn (for $10-20K), but these will soon expand.

The ethics of this new technology has - as is traditionally been the case – lagged behind the scientific capability. Despite the engagement of prominent intellectuals -- Jurgen Habermas, probably the most important living Continental philosopher wrote a short tract on it a few years ago (The Future of Human Nature), and now so has Michael Sandel -- a truly public debate has not materialized, aside from brief flashes over Dolly the sheep and stem-cell research.

In his discussion, Sandel brings up several fundamental issues: the role and importance of choice as such, the distinction between medical treatment and enhancement, and perfection of species as such. These slippery topics will hopefully make the following discussion more interesting.

Genetic alteration of children remains the locus of the discussion with Sandel, and there are two big points there:

1) in a classically Marxist line, Sandel argues from the point of view of the parents - if they can choose the characteristics of a child they will treat it no different than produce – as a commodity. According to him, such an attitude is simply inappropriate when it comes to children, who, like other relatives (say, parents) should be loved for the relation, not their qualities. As an example of this view taken to the extreme, he points to parents who choose to bring to term a child with Down's syndrome.

But Sandel has to fudge a lot here, blurring together relatively neutral cosmetic characteristics -- hair, eye color -- and 'merit qualities' - (predisposition to) intelligence, musical talent, height, build, etc. While customizing a child like a weekend sports car seems ethically dubious, one can't condemn parents for choosing a smarter or taller than average child on these grounds, for they can reasonably say they are doing it entirely for the child's good. We are assuming fairness does not enter the picture here – that everyone would have equal access to these technologies.

So instead, Sandel is forced to rely here on his distinction between medical treatment and 'enhancement', which distinguishes ensuring a child has higher intellectual potential as reprehensible, while screening for diseases is ok. I will address this distinction below; at this point, we should just note that the moral status of genetic engineering will hinge on this distinction for Sandel.

2) Jurgen Habermas, on the other hand, argues against human genetic engineering because of the effect on the child - the awareness of having been engineered by another person, rather than just fate. Now, rather then a purely philosophical question as he characterizes it, it is in fact an empirical psychological one, similar in nature to the effect of discovering that one is adopted. However, its not a priori clear what effect a revelation of genetic tampering would have, especially in a society where that is fairly commonplace. In fact, not having had good genes arranged in a society where that is common would likely prove even more psychologically damaging. In any case, I'm insisting the question is empirical rather than an abstractly metaphysical.

In contrast to the two philosophers, I would say my position is more practical, which brings me back to Sandel's distinction of medical and enhancement (negative and positive) treatment.

“Treatment vs. Enhancement”

Is there a real (moral) distinction between medical treatment and enhancement? Sandel argues yes – medical treatment restores 'natural human functioning' (for example, growth hormone deficiency resulting in exceptionally short height) while enhancement is more like a consumer good. But how does one define ‘natural human functioning’? The condition of the average human? This widely depends on the environment – what is a 'natural human environment' – savannas? Jungles? Certainly not the living conditions of 99% of contemporary humans.

Ultimately such a distinction can only refer to the below/above average human condition in a given society - from which it is much more difficult to extract a moral argument. What is the significance of this? Well, when it comes to practical policy issues, it's not too great. So, for Sandel, plastic surgery is a 'non-medical consumer good', not a public good like regular medical services, hence they should be treated differently. This may include decreased health insurance coverage, forcing (non-reconstructive) plastic surgeons to repay any federal grants/scholarships they received while in medical school, etc. Overall not particularly controversial, because it addresses a compromiseable, ‘linear’ issue.

Choice

However, if we deny moral weight to the “treatment vs. enhancement” distinction, Sandel is on shakier ground when it comes to parents selecting genes of their children. And this is the case because another moral factor comes in – choice. A reasonable (in America) rejoinder to Sandel is that choice is a fundamental right, of parents among other instances. In the radio program that I refer to, Sandel brilliantly replied that while choice is important, it is not absolute or even a self-standing good (“choice is not an altar we should all worship at”). This is a particularly appropriate response for him, given his communitarian concept of freedom, which emphasizes context and social links over absolute notions and rights like a naked ‘right to choose’.

One problem with allowing such choice for parents is that it inhibits them (and society more generally) from learning to accept things about children – it takes away the ‘gift of human nature’. In this case, according to Sandel, the right to choose would be trumped because, given the enhancement distinction, choice for enhancement is morally lower than choice for medical treatment and doesn't place it above other considerations (those discussed above). But if the distinction doesn’t hold as a sharp line, his reply is no longer valid, especially when we acknowledge the difference between neutral “customization” gene selection -- or something like abortion conditional on genetic quality -- and enhancing the genetic stock of one’s child to improve their potential in life. In that case, it would be difficult to justify restraint on the latter opportunity from the point of view of a single family. Choice is no longer obviously morally less important. So perhaps at this juncture we should widen our scope to consider the policy for society as a whole – i.e. eugenics.

Eugenics

If gene selection is not objectionable for a given parent within society, it implies society as a whole accepts genetic selection of children and its likely outcome (given social pressure) – accelerated genetic drift in a steady direction, i.e. uncoordinated eugenics. What is the problem with making explicit and coordinated? As Sandel notes, we often object to eugenics because it has historically been bound up with coercion, so perhaps there is nothing wrong with it if is voluntary (for the moment treating the choice of a parent considering whether to assure his child high intelligence in a society that discriminates against the unintelligent as still voluntary). But he argues that such a program would be pure hubris – we would presume to know what is best for humanity. We would be playing God. Not to mention (as Sandel does), the danger of ‘inscribing in genes' present prejudices, something bound to happen when genetic engineering is done on a wide scale.

Clearly, organized (or wide-scale) endeavors in human genetic engineering is quite hazardous. There is also the possibility that (international competition aside) there is little to be gained from genetic improvement on a national scale. What do we gain if the US population becomes a little stronger on average, a little taller, or even a little more predisposed to intelligence? “Subjective welfare” studies clearly show that growth of per capita GDP in Western societies does not correspond to growth in subjective well-being. This is in part because many characteristics we hold important are inherently relative – they are “positional goods” (basically, goods whose value derives from factors external to the good itself). Just as the benefits of wealth above some threshold are relative to one’s peers, so would be genetic endowment.

Midway conclusions

Based on the considerations so far, I would argue along with Sandel that programs that encourage genetic enhancement in a particular direction are a bad idea. Private ventures, like a recent attempt to propagate the genes of Nobel laureates, are less censurable largely because of their smaller scale. But when it comes to individual parents and doctors, I would disagree with Sandel. The argument so far shows there is nothing morally wrong with parents selecting their children’s genes as such, at least when it would not reasonably seem to be against the child’s interests. While enhancing a child’s height or intellectual potential may not improve their life, it is unlikely to be any more damaging than myriads of other choices parents currently make for their children, from the music lessons they force on them, to their diet, to their schools.

In practice, certain limits would need to be placed on the types of genetic choices allowed, but social rather than legal means, acting both on the doctor and the parent, should minimize the more shady genetic meddling, like choosing hair or eye color, to prevent the commodification of children. This is not the domain for hard government regulation. Rather, these choices should be guided by how we understand the nature of the person, and it is in this respect that a discussion of enhancement in sports is timely.

Enhancement in Sports

On this issue, Sandel finally leaves abstract categories, and says we must consider this issue on purely functional grounds. As he says, the deciding criteria when considering the morality of enhancements in sports (whether chemical like steroids or physical like bionic limbs) is the purpose and ultimate goal of the sport. The legitimate enhancements ones are those that perfect rather than obscure the qualities and talents that the sport is meant to demonstrate – and is thus sport-dependent. Racket improvements in tennis or running shoes for runners (his example) do not interfere or obviate the participants’ skills but rather allow more fine-tuned performance. In no sense do they corrupt the sport. On the other hand, field and track athletes who are thus able to achieve unprecedented feats are distinctly less interesting. A shotputter on steroids is much like a drag race – perhaps an interesting show, but hardly a sport as such. The distinction is subjective but rooted in what we imagine to be the purpose of sports in general and a given sport in particular: exercise of skill, elegance, determination, endurance, etc.

Returning to the case of the parents, most crudely put, what is the purpose of children or particular characteristics for them? Or, rather, how do we think about character traits and other human qualities – to what extent do they impact on our self-image? Is musical ability just a ‘faculty’ (as Plato would put it) or is it part of our very self?

In Conclusion

So the moral outcomes rest on a fine distinction – are we adding characteristics – say mathematical talent – to a given child? Or are we creating a child to spec, like playing SimChild, with intelligence x, height y, language ability z? We have to think about the nature of self, how we construct our identity. The former primarily engages the eugenics question and I think only becomes problematic on the grand scale, while the latter is potentially subject to most of Sandel’s and Habermas’s objections… but how convincing are they?

On the one hand, the idea that parental participation in determining their children’s genes will have terrible effects on the child’s self-image (a la Habermas) blithely ignores the tremendous role parental influence in all its forms already plays in a child’s growth. Habermas in particular seems to be completely oblivious to the widely accepted role ‘nurture’ plays in the process, as if living in a 19^th century pre-Freud world that imagines genetics to be uniquely indelible. On the other hand, now that we know genetic factors have similar influence to childhood environment, his insight might instead suggest that we should curb already existing parental influence through childhood rather than allowing that influence to extend into the child’s genetic make up.

My point here is that there are no a priori philosophically deducible answers to be had on this question for the individual. It is not morality which should guide us here but empirical psychological data which illuminates how the self-image and child-parent relationships are affected by the application of these new technologies. If we find that parents fundamentally view their children differently (for the worse) as a result, this would be a decisive argument against them. If nothing of the sort manifests itself, I argue we have no philosophical reason to hold back. Of course, the necessary experimental data may be difficult to obtain, but the point is that any limitation should be justified on practical, psychological grounds, not mere speculation; we’re dealing with a question of discipline competency, as it were. So, for one, in regard to Sandel’s point about commodification of children, as much as I agree that choice is at times harmful, so many other factors are to be considered that this effect may entirely disappear. And if I was in that position, I would push for the best damn genes money can buy.