A design for our future

October 5, 2001

<P style="MARGIN-RIGHT: 0px"> Mary Warnock looks at how far we should go to create a 'perfect' child

We are told that this is David Galton's first book "for a general audience"; and it shows. He has not quite decided who his readers will be, and, especially at the beginning when he is tracing the history of eugenics back to the ancient Greeks, he seems to be telling it to children who can take in only short sentences and who have never heard of Plato or Aristotle. His tone seems patronising and his jokes, which are numerous, inserted to make the subject matter less rebarbative for the slow learner. When he gets into his stride, however, the stilted style is replaced by something more sure-footed, and the central arguments concerned with genetic modification and cloning (therapeutic and reproductive) are clear and original.

Galton is convinced that genetic modification of human beings, not only to prevent the birth of babies with severe monogenetic diseases by embryo selection but by gene replacement or gene enhancement, is about to become part of medical reality and must be accepted. It is the new form of eugenics, and he argues that we should face that fact and decide how to deal with it. The horror we tend to feel at the thought of eugenics is largely political. Galton reminds us not only of the outrages perpetrated by Nazi biologists and geneticists after 1933, but of less well-documented programmes such as that in Sweden, where between 1935 and 1976 60,000 young women were compulsorily sterilised on the grounds that they were mentally defective or had "no obvious concepts of ethics". The new eugenics, on the other hand, need not be politically motivated. It may be a matter of individual decision. If a couple were to demand as a right that they have a healthy child rather than one afflicted by a heritable disease, or a child who was the clone of one of them if they themselves suffer from intractable infertility, it is conceivable that they might use the Human Rights Act to overturn any ban on genetic engineering or reproductive cloning that was in place. Galton argues that there should be as little legislative or regulatory interference with such decisions as possible.

However, he is realistic about the unpredictability of the outcome of gene replacement or gene enhancement; and especially about the dangers to the child of reproductive cloning. Not only is the procedure itself hazardous (Dolly the sheep was the only successful outcome from 7 attempts to fuse an adult nucleus with an enucleated egg), but the resulting child might be more prone to suffer somatic mutations such as cancer or immune deficiency than a child who receives a random mix of genes from two parents. A cloned child would be like an extreme version of the offspring of first-cousin or brother-and-sister marriages. Since the results of human cloning cannot be known without trial, and since it would generally be deemed immoral to experiment with the future of a child, it is quite likely that no human clones will be produced, in spite of the plans and promises of Severino Antinori, or at any rate not for many years. The consideration of the risks involved is quite enough. I need no further arguments against attempts at human reproductive cloning, and indeed I find it hard to understand the metaphysical questions about personal identity that it seems to raise in people's minds, let alone the assertions, many quoted by Galton, that cloning would be an affront to "human dignity".

Leaving cloning on one side, in reading Galton's account of the possibilities, we are compelled to consider what the objections to so-called designer babies are. Most people are happy with the idea that one could "design" one's baby so that it did not suffer from a heritable disease. This seems a proper extension of the purpose of medicine, to minimise human suffering and to concentrate on prevention of diseases for which there is no cure. It is true that there are those who object to even this degree of "design". These are mostly those who themselves have been born with some degree of disability, and who nevertheless live worthwhile lives, and who believe that disabled people are degraded by the assumption that it is better to be born without a disability. But these objectors, in the nature of the case, are the less severely affected; they are not those who live a short, painful life, nor those who are acutely mentally retarded, nor those who live with the threat of a disease such as Huntington's or Alzheimer's developing as they grow to be adults. Nor is it true that in wishing to diminish the number of people born with disabilities, one is down-grading those who have or acquire disabilities. A disability is an impairment, however much those who suffer may claim that the concept is nothing but a social construct. It is not surprising that parents should want their children to be unimpaired.

When one moves on, however, to what Galton refers to as the "grey area between disease and personality trait", difficulties abound. Seeking to avoid a tendency to obesity, to alcoholism, to aggression or to homosexuality may seem little less acceptable than seeking to avoid disease. But what about positively seeking to improve intelligence, or mathematical or musical talent? All these characteristics are to a certain extent genetic, as a casual glance at ordinary families will show. Nevertheless, attempting to design babies to possess these characteristics may well fail; and then the disappointment of the parents and the disaffection of the children may produce bad blood between them. Most reasonably ambitious parents hope that their children will inherit their tastes. It is bad enough when they do not, without the parents having taken special steps to ensure that their children will turn out as they want.

No one is nothing but their genes, and Galton recognises this. In speaking of the possible genetic background of criminal behaviour, he says: "The new genetics is unlikely to undermine the traditional theories of justice. Many criminal lawyers believe individual responsibility to rest on the principle of capacity and fair opportunity to act otherwise. The argument that fair opportunity is compromised by genetic predisposition runs up against the difficulty that not everyone possessing the predisposition resorts to criminal behaviour. Actions have to be treated as intentional simply because a coherent social order demands it... In the final analysis, the law judges people and not genetic or other scientific criteria."

This is rare good sense. For my own part, I have always valued the element of chance in the birth of children. Unless there had been a good medical reason to know, I would never have wanted to know even the sex of my child before it was born. The moment of birth is like the unwrapping of a Christmas present that has been kept a secret. Equally, though one may come to it the hard way, in the end I believe that one comes to like and respect one's own children the more, the more unexpected their personalities and abilities turn out to be. But these seem to be rather childish reasons for putting up elaborate legal barriers to prevent the choice of genes.

There is another problem that Galton discusses, but to which he offers no practical solution. And this brings the question of eugenics back into the political arena. The screening of embryos and the enhancement or replacement of genes will always be expensive. Galton states that, as a matter of principle, such treatments should be available to everyone who wants them. But this is almost certainly an unattainable ideal. It is more likely that those who can pay will do so, and those who cannot will not be able to design their babies (except, with luck, for the remedying of gross genetic defects). Will this not widen the gap between the rich (and their descendants) and the poor? Will the underclass begin to suffer not only from the cycle of poverty, but from the cycle of genetically inherited defects, physical and intellectual? The same pool of people will, it seems likely, win all the glittering prizes and not even the most improved education system in the world will be able to lift the poor out of their genetic slum. It is only because I am generally sceptical about the extent to which we are determined by our genes that I am not horrified by such a picture.

Many other questions arise out of our new genetic knowledge that Galton discusses, among them confidentiality, insurance and discrimination in the workplace. In all these fields his book is enriched by excellent instances of legal cases and appeals, not only in this country but in the United States, where in some ways things have moved faster than in Europe. He is also concerned with decision-making in the field. He is (sadly) scornful of committees of inquiry set up to advise governments, regarding them as out of touch and arbitrary. He is equally scornful of the pious platitudes that emanate from the Council of Europe. He is anxious for more democratic involvement of a larger number of people in decision-making and advocates wide consultation and even referendums to settle what is or is not to be permitted in the way of research and genetic intervention.

He blames the sensation-seeking press for the low level of understanding of the issues among the general public. I personally think that not nearly enough use is made of outlets such as women's magazines for presenting the issues clearly; only when people become better aware of what is possible now and what is already within sight can they be expected to take a rational view of what is, after all, an extremely complex subject. We should be grateful to Galton, however terrible some of his jokes, for contributing to such rational understanding.

Baroness Warnock chaired the Committee of Enquiry into Human Fertilisation and Embryology, 1982-84.

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