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The Case against Perfection: Ethics in the Age of Genetic Engineering (review)
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The Case against Perfection: Ethics in the Age of Genetic Engineering. Michael J. Sandel. Cambridge: Belknap of Harvard UP, 2007.

I often tell my students that my job as their professor is not to give them nice, tidy answers to difficult questions. Rather, my job, I explain, is to give them problems worth having. If I have done my job right, they have more problems when they leave than when they entered. This characterization is also true of Michael Sandel’s The Case against Perfection. Living up to his reputation as a master teacher, Sandel helps his reader recognize and analyze the deeply fraught moral dilemmas created by the advent of genetic engineering. In a world in which the rate of technological development and adoption outpaces the formation of societal mores, the advances in genetic enhancement can easily cause a sense of “moral vertigo” (see 9). This book is written especially for those individuals who feel a deep sense of unease with genetic engineering but who may find it difficult to articulate or defend this sense.

Part of the difficulty with the ethics of enhancement, Sandel explains, is that the same forms of genetic engineering that show such promise in addressing many recalcitrant diseases, also make it possible “to manipulate our [End Page 110] own nature—to enhance our muscles, memories, and moods; to choose the sex, height, and other genetic traits of our children; to improve our physical and cognitive capacities; to make ourselves ‘better than well’” (5–6). Defending a moral line between genetic enhancements that seek to restore health and those that seek to redesign and perfect nature becomes a central task of Sandel’s project.

In the first of the five chapters in this brief volume, Sandel presents an overview of the ethics of enhancement by looking at four specific kinds of modification: muscle enhancement, memory enhancement, height enhancement, and sex selection. This general treatment makes way for a more sustained discussion of genetic enhancement of athletes in the second chapter. He is concerned that as athletes are able to purchase greater speed, height, and strength, sport will degenerate from an activity that honors and cultivates natural talents into an artificial spectacle existing solely for entertainment. Whereas athletes willingly choose to undergo genetic enhancement, chapter three considers the morality of parents who seek to create “designer children.” Sandel defends the therapeutic use of genetic engineering prior to birth to cure or avoid disease, but is sharply critical of those who seek to create the “perfect child.” This theme is further developed in his fourth chapter where he argues that attempts by parents to overcome chance, to “master the mystery of birth” (82), are little more than a non-coercive form of eugenics. Whereas the “old eugenics” sought to control the genetic characteristics of a population by regulating who mated and with whom, sometimes through coercive means, the defenders of the “new eugenics” see in genetic enhancement a way to determine the genetic characteristics of the population through non-coercive means consistent with modern liberal society. Sandel’s own positive argument finally comes fully into view in his final chapter, “Mastery and Gift.” The volume concludes with an expertly written epilogue on “Embryo Ethics: The Stem Cell Debate,” in which he explains how his position against genetic enhancement is consistent with its use in research on embryonic stem cells to cure disease.

In carefully and thoughtfully navigating his reader through the uncertain moral terrain surrounding the ethics of enhancement, Sandel’s little volume provides a great service. Indeed, its scope and tenor would make it ideal for use in the classroom. Though it is little more than a sketch, Sandel’s own position is as important as it is absent from contemporary bioethics scholarship. While consequentalists are right to weigh costs and benefits, and deontologists are right to be concerned to preserve the dignity and autonomy of human beings, Sandel argues “that the moral stakes in the enhancement debate are not fully [End Page 111] captured by [these] familiar categories” (96). The proper moral question is not whether genetic enhancement is safe or fair, or whether it might erode human agency, but...