In Praise of Designer Babies

Imagine you knew that you carried a gene for a debilitating illness. But doctors could go into your egg (or your spouse's) and remove that gene, enabling you to have a baby who, whatever other problems they might encounter through their lifetime, wouldn't have to worry about the illness. Would you let them? Most people would say probably yes, provided they were sure the technique was safe and wouldn't produce some kind of two-headed mutant centaur baby. That, after all, is what people were worried about when the first baby conceived via in-vitro fertilization was born in 1978—although in that case, they were worried about cyclops babies (seriously). It turned out in the end that IVF is perfectly safe, and now it's a common procedure, the ethics of which is questioned only by radical anti-choice extremists.

Well we may be approaching the time when doctors can fix certain kinds of inherited diseases before an egg is even fertilized. And naturally, people are worried about "designer babies," the phrase that gets repeated whenever the subject of this kind of genetic engineering comes up. This is a story from NPR yesterday:

The federal government is considering whether to allow scientists to take a controversial step: make changes in some of the genetic material in a woman's egg that would be passed down through generations.

Mark Sauer of the Columbia University Medical Center, a member of one of two teams of U.S. scientists pursuing the research, calls the effort to prevent infants from getting devastating genetic diseases "noble." Sauer says the groups are hoping "to cure disease and to help women delivery healthy normal children."

But the research also raises a variety of concerns, including worries it could open the door to creating "designer babies." The Food and Drug Administration has scheduled an Oct. 22 hearing to consider the issues.

There are legitimate concerns about safety, and just as with any new medical technique, those have to be thoroughly investigated before this kind of thing becomes common. But is a future of designer babies such a bad thing? I suspect it's one of those things we all assume would be terrible, but we seldom ask why it would be so bad.

So let's think about it for a moment. Unless you're a Christian Scientist, a religious sect most of us regard as deranged, no one says to the parents of a sick child, "Well, you just lost the luck of the draw there. It would be against nature to treat your child's illness." So why is it obvious that we should treat the illness after the child is born, but not prevent the illness beforehand?

Perhaps you're concerned about the slippery slope argument—we'll start treating awful diseases, but then quickly move to less critical medical needs, and on to purely elective procedures. But wouldn't the same logic apply? The fact that you might be able to convince a doctor to implant horns on your head isn't a very good argument for not letting a doctor use similar plastic surgery techniques to reconstruct a burn victim's nose. So why is it that we would say that the possibility of genetic engineering being used for something less urgent than preventing a life-threatening illness is a reason to not allow it to be used at all?

And it might be a very good thing to take a few steps down the slope. Genetic engineering of this type is in its infancy, but you could easily foresee a time when we could address all kinds of not life-threatening but still bothersome conditions. If we could free people from things on the order of allergies or myopia, that would be an enormous benefit to them.

One argument you're bound to hear is that technology like this will be distributed unequally, with the rich engineering their superbabies and the rest of of left to have run-of-the-mill children. That's certainly possible, but it depends on the cost of the intervention over the long term, and there's no way to tell yet how expensive it might be in 50 years. Right now we manage to distinguish between necessary medical procedures, which insurance will pay for, and elective ones, which are apportioned on the basis of wealth. Which means that rich people can have more symmetrical noses and perkier breasts and creepily unlined faces than ordinary people do, and that doesn't bother us enough to outlaw plastic surgery. You could envision a time when anyone can get their eggs adapted to remove a slate of harmful conditions and diseases, but only the rich can get the platinum service, which will also give your child shiny, manageable hair. We could probably tolerate that.

I do think we overestimate the degree to which genetic engineering could produce mass inequality. We already have lots of inequality based on genetics. Some people's parents are very smart and some people's parents are extraordinary athletes. Is it unfair that LeBron James' parents gave him the genes that made him six foot eight with loads of natural athletic talent? Not particularly. James himself didn't "deserve" his genetic lottery winnings any more than he would have if his parents were both 5 feet tall and had bought him the body he has through a medical intervention. Furthermore, you could make your next kid that tall, but there are a lot of other variables that would determine whether he actually became the world's best basketball player.

What about intelligence? If we could alter the genes in an egg or a sperm to make a child a bit smarter (which we are a long way from figuring out how to do, by the way), exactly what would be wrong with that? If you had a visceral reaction of opposition when you read that, ask yourself: Why? Try to articulate why it's wrong to use genetic engineering to make a child smarter than they might be if we were just flipping the genetic coin. "Because that's the way it's always been" isn't a persuasive answer. So what is it? Have we violated the free will of the child? Only if you think anyone would choose to be less intelligent than they are; and besides, parents violate their children's free will all the time. The child didn't ask to be smarter, but I didn't ask to have size 10 feet or bad vision; those decisions were made for me. The fact that it was a "natural" process that produced them doesn't make them any more a product of my will.

And it's hard to argue that as a society or a species we have too many smart people. What if a hundred years from now the technology had become safe, cheap, and easy, so a pregnant woman could pop a pill that costs a dollar and would boost her baby's IQ by 20 points—would you think it was wrong then? Keep in mind that parents already do a million things intended to help their developing children become healthier and smarter, some of which begin before the baby leaves the womb.

To repeat, there are serious and complex questions about how safe this kind of genetic engineering would be, and there is a real possibility of unforeseen consequences. But my point is that when we say, "We sure don't want designer babies" as though that's something everyone would naturally agree with, it's worth asking whether our instinctive reaction actually has a rational basis. I'm not a hundred percent sure that we want designer babies. But we might.

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