Human Genetic Engineering

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Ethics and genetic engineering have been inseparable since the emergence of the technologies that allowed scientists to manipulate the genetic codes. Ethics has always followed the scientific breakthroughs and often cast a shadow on the most daring and promising of them. Among such breakthroughs, there are animal cloning (Dolly) and inter-species genetic manipulations - GMOs (for example, transgenic frost-resistant "Fish tomato"). Both aforementioned cases are highly controversial and have aroused an international debate on their ethical implications. Animal advocates considered the cloned sheep Dolly an instance of inhumane treatment while scientists saw it as a scientific front-pager - the first animal cloned from an adult cell. General public had the third angle on this situation and worried about the possibility of living in the world where people could clone themselves and raise the younger selves as their children or, even worse, see cloning as an opportunity to live forever. As for GMOs, the technology was viewed as a panacea to the world hunger at first, but now it is discussed more in terms of the negative side effect on the human organism, namely the alleged ability to change the DNA of the living organisms and affect future generations.

As early as in the 1980s, when genetic engineering was making its first steps as a serious and promising science (the science of the future), society has backfired with a religious vision of what was going on, and Congress and the Commission of the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research had to react with a statement. The final report "Splicing Life" was presented to the public at a congressional hearing on human genetic engineering in 1982. Even at that distant time, the Commission concluded that, genetic engineering already demonstrated a great potential value for human well-being, and qualified the rising concerns as exaggerated. The Commission admitted,

Genetic engineering techniques are not only a powerful new tool for manipulating nature - including means of curing human illness - but also a challenge to some deeply held feelings about the meaning of being human and of family lineage. But as a product of human investigation and ingenuity, the new knowledge is a celebration of human creativity, and the new powers are a reminder of human obligations to act responsibly. (Jonsen, Veatch, & Walters, 1998)

In other words, even in the 1980s, the government recognized the power of the new science and called to challenging old religious beliefs and social norms and developing new vision, in which there would be a place for such breakthroughs as gene modification. The Commission did not find enough ground or ethical precepts to preclude the clinical use of gene splicing (Jonsen, Veatch, & Walters, 1998). Nowadays, thirty years after this report was made public to label ethical concern as exaggerated and to ask people to revise their worldview, the world is still the same. Genetic engineering is still a major driving force of progress, and it still triggers heated debates on morality and ethics. Sandel (2007) asserts, "Breakthroughs in genetics present us with a promise and a predicament" (p. 5).

Technologies that allow people to alter the human germ line raise multiple ethical, moral, scientific, and social issues. Researchers believe that the debate, as heated and extensive as it is, is still not enough to generate a proper attitude toward this kind of genetic engineering. Many aspects, such as genetic counseling, patients, and the application of the technology have not yet been adequately discussed and brought to the general public. Safety is among the most important issues. Safety can be an ethical justification from at least a technical standpoint that means, if or when the technology is a one hundred percent safe and efficient, scientists have a moral right to agitate for or allow its practical application. However, there is a strong possibility that scientists will never know for sure that the side effects of some alterations on the genetic level will not manifest themselves in some distant progeny (Scott, 2006).

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The American Association for the Advancement of Science suggests that, in case of incorporating foreign genetic material into the human genome, there should be evidence on the level of molecular certainty (up to the sequence level) that the change will have the desired effect and no side effect in the short or long run. In order to preclude a slowly developing undesired change or damage, multiple subsequent generations should be studied and monitored. The problem is that there are no guarantees or measurements of safety in regard to, inter alia, inheritable genetic modification, as there is no point at which the monitoring should stop. The next generation or the generation after that could always be the breaking point. Another case is altering an already present mutation in genes. If no foreign material is involved and the inheritable genetic modification is targeted exclusively on the mutant sequence and aimed to correct it precisely, the Association suggests that the analysis for negative changes is carried on the level of the full genome sequence. If no changes are located, the manipulation should be regarded as successful, and no further multigenerational monitoring is needed. Particular suggestions on technical approaches to inheritable genetic modification include the technique of the so-called clean replacement of genes so that the inserted gene functions where/as appropriate, resulting in a normal gene expression. Unfortunately, such a method, although being ethically tolerable and even welcome, has not been yet developed or honed to the degree of perfection. Another approach centers on the idea of adding genes into the embryo genome by means of artificial chromosome. At this point, the opponents of radical manipulation with genes appeal to the lack of informed consent of the recipient - a child. In this regard, scholars and scientists suggest engineering the chromosome in such a way that it keeps the inserted genes in a "sleeping mode" until the recipient is grown up enough to make a conscious decision whether to activate them or not. Despite solving the aforementioned ethical issue, this sophisticated technique arouses new practical issues, for example, at what age a child has to make this choice, whether there will be technologies to do it, or whether such complex engineering project on the human genome is at all possible or not (Scott, 2006).

Assuming the aforementioned technical issues are met, the remaining issues would include the candidates, settings and circumstances for such operations, counseling issues, comparative analysis of risks and benefits, as well as inheritable genetic modification versus alternative methods. It is believed that the first candidates for inheritable genetic modification should be couples at risk of giving birth to a child with serious genetic condition. The argument against this idea is in the fact of availability of other methods and less risky options. The alternatives include adoption, sperm or egg donors, in vitro fertilization, and termination of pregnancy with diagnosed mutations (Scott, 2006). However, each of the options can be also subject to heavy criticism in terms of being ethically right and clear, especially the last mentioned alternative. It is doubtful that there is more ethicality in killing an embryo than in altering its genetic material.

Even if the technical and ethical sides are met, there remains the factor of creating a specific regulatory climate for inheritable genetic modification, namely the setting and oversight mechanisms. People engaged in the debate agree that, most probably, the first setting should take the form of a research setting. The specifics of the regulatory mechanism should and will vary among countries in accordance with the laws and social norms in them. In addition, there will be a need for public discourse regarding the studies on gene transfer or alteration. Not only the directly involved people must be informed on all the aspects and receive counseling, but also the general public should know at least general facts and aims of inheritable genetic modification. One should pay attention to country-specific morality, mainstream religion, traditions and customs, as well as other manifestations of the social consciousness and mentality of a particular nation. Along with the already existing disputes in the scientific circles, outbursts of public indignation can happen and further complicate the issue (Scott, 2006). Perhaps, it would be reasonable to consider the public reaction and, if the latter bans the technology, it would be better to either refuse or postpone its application. Nevertheless, the individuals who are for it and in need of it would suffer because of their minority report.

The points of view of researchers and health care practitioners are also of great value. According to the data retrieved by the American Society of Human Genetics, the majority of respondents (about 64 percent) were positive about the use of inheritable genetic modification but under a few conditions: it needs to be proved safe, efficient, and be used, not for the enhancement purposes, but for preventing serious mutations and diseases (Scott, 2006). Therefore, a new stipulation leads to a new conceptual ambiguity. It is not quite clear where therapy ends and enhancement begins. Sandel (2007) states, "The distinction between curing and improving seems to make a moral difference, but it is not obvious what the difference consists in" (p. 12). For example, the borderline between fixing a future child's harelip and fixing droopy ears is not exactly clear. The latter may be regarded as both an attempt at removing a genetic defect and simply perfecting a child. On the other hand, the idea of the parents choosing and "programming" the color of their child's eyes or hair, or the child's intellectual abilities seems to be clearly unacceptable. However, maybe, it does not. Recently, a couple was searching for an egg donor with a set of peculiar characteristics, for which they were ready to pay $50,000. The egg donor's height had to be five feet, ten inches, body athletic, a combined SAT score of minimum 1400, and there had to be no health problems throughout the family bloodline. Whereas the latter is a reasonable demand, the former qualities and their exact parameters may be puzzling. The parents' motives are unclear and discrepant: they wanted either a child who would bear resemblance to themselves or a child with better qualities and characteristics than their own (Sandel, 2007).

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Here is another case. A few years ago, a deaf lesbian couple decided to have a deaf child. They considered deafness a cultural identity and not a disability. Therefore, instead of assuring that their child would not inherit the gene for deafness or altering this gene, they did the opposite. The couple found a sperm donor with five generations of inherited deafness. The baby was born deaf, as expected and wanted. The deaf couple's decision was met with social indignation. Many people saw this situation as deliberately inflicting a disability on a child. The parents defended themselves by saying that they simply wanted a child like themselves to be able to share the benefits of the deaf community with him/her. The author of the book, in which this controversial case is reported, raised an interesting question, "Is it wrong to make a child deaf by design? If so, what makes it wrong - the deafness or the design?" (Sandel, 2007, p. 2).

Interestingly and strangely, the former case caused much less condemnation than the case of the deaf child. Perhaps, it is considered morally acceptable to want a child with qualities that mainstream society cultivates as positive, such as mental and physical capabilities, and it is considered wrong to want a child with what the general public considers a disability. Nevertheless, even if no damage is involved, the issue of perfecting one's child is somehow unsettling. Maybe, it is nothing more than choosing the lesser of two evils. Either way, as these cases show, even the concepts of ethics and perfection, can be relative.

Another ambiguous issue is sex selection. On the one hand, on the level of a family, it is beneficiary for parents who may want to know or choose the baby's sex. On the other hand, on the social level, this seemingly harmless possibility of choosing a child's sex can transform into a real problem. Let alone the debate on the moral status of the embryo, each of such decisions may contribute to the unnatural distribution and prevalence of one sex over the other. Based on the culture-specific norms and gender statuses of males and females, the preference may be given disproportionally to either boys or girls. At this point, sex selection might be used as a tool of gender discrimination (as in China and India). Some people believe that societies where males dominate in terms of status and number will be less stable and more prone to crime (Sandel, 2007). Although it is impossible to either prove or refute such beliefs, there is a rational in this speculation.

Somatic enhancements that will not be transferred to offspring can also raise moral questions. Paradoxically, people are generally OK with plastic surgeries aimed at changing physical features, but they are skeptical and judgmental about similar manipulations on the genetic level. Therefore, Botox injections or breasts surgery are now common operations that are integral parts of the Hollywood culture and life. Nevertheless, the idea of enhancing a body via genetic manipulations in order to make it stronger or aesthetically appealing is still a taboo in many societies and for many people, the USA included. It is reasonable to assume that, since the surgical manipulations are relatively skin-deep and genetic ones are carried on the invisible level of the human genome, the latter seem more disturbing and unnatural (Sandel, 2007).

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Between physical and intellectual enhancement, the former is, probably, perceived with less opposition. The reason of why it is so can be hidden in the understanding that physique is a relatively yielding part of a human being. Unlike intellect (not memory or other elements that can be trained), body can be trained relatively easy so that nearly everyone who wants to do it, will do it. For example, if the family trait is a tendency to corpulence, a human can overcome its effect by physical exercises and diet plan, as well as by means of genetic interference. The options are not the same or at all nonexistent for the intellect. Maybe this is what makes the difference. Maybe people subconsciously envy or prejudge some superiority that they cannot get, more so if this superiority is artificially induced. The ethics of cognitive enhancement is complicated. Mental superiority brings by far more potential and benefits to its owner, especially in the modern world of the information age. Some speak of the danger of creating two classes of human beings: those with enhanced IQ and memory and those with unaltered, natural inclinations and memory that are not brilliant and fade away with years. In case these alterations are not somatic but inheritable, the vision of the future becomes an anti-Utopian movie where humans are divided, not into classes, but into subspecies based on this single trait. Moreover, the poor unenhanced will have to access the technology; thus, they will be unable to change their status (Sandel, 2007). In other words, there are fears that such manipulations with the genetic material will further deepen the inter-class gap and social inequality. Some people go even further and [reasonably] fear, "Genetic intervention has the potential to improve inborn traits to the ultimate advantage of the race" (Dyson & Harris, 2003).

Considering all the above information and the magnitude and multi-faceted nature of the issue, it is impossible to generate a comprehensive, objective and the only true conclusion on what is moral and what is immoral about human genetic engineering. Perhaps a more appropriate way to conclude this discussion is to determine the most morally permissible and ethically justified cases for genetic modification. Summing up, the overriding moral considerations are cases when genetic engineering is aimed at treating instead of enhancing, when the alteration cannot be passed to future generations, and when there are elaborate and sophisticated methods of conducting and controlling gene interventions. At this point of human evolution and social development, these considerations can and should be taken as etalons of a safe, positive, and beneficiary use of the technology, with the rest of cases requiring individual approach and discussion. Among the suggestions on how to overcome the current status quo of genetic engineering, one can mention the recommendations of the Commission of the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, which are still valid despite being three-decade old. Another suggestion can be found in Sandel's studies. Unlike the Commission that suggested redefining the vision of Homo Sapiens, Sandel (2007) says people need to redefine the "moral status of nature" and its role in the current life of humans.

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