The Price of Perfection: Individualism and Society in the Era of Biomedical Enhancement

9. The War on Enhancements

u Chapter 9 The War on Enhancements Despite the tremendous tangible and intangible costs of trying to prevent people from using biomedical enhancements outside of sports, including the loss of substantial societal benefits to the extent that these efforts would have been successful had they proceeded unhindered, a campaign against enhancement use in general is in fact under way. A major enemy in this campaign is genetic enhancement. The NIH officially refuses to fund research on genetic engineering for enhancement purposes.1 Although this stance might be chalked up to a conviction that preventing, curing, or mitigating disease is a more worthy way of expending scarce research resources, the NIH position is undoubtedly also an attempt to mollify critics of genetic enhancement. The American Medical Association regards genetic enhancement as unethical . An opinion of its Council on Ethical and Judicial Affairs proclaims that “efforts to enhance ‘desirable’ characteristics through the insertion of a modified or additional gene, or efforts to ‘improve’ complex human traits—the eugenic development of offspring—are contrary not only to the ethical tradition of medicine, but also to the egalitarian values of our society.”2 As noted earlier, the AMA also opposes using gene transfer technology to enhance children unless certain conditions can be 176 the price of perfection met: There must be “clear and meaningful benefit to the fetus or child; no trade-off with other characteristics or traits, [and] equal access . . . irrespective of income or other socioeconomic characteristics.”3 (The second of these conditions is indefensible. Exactly how can a body of physicians rule out the possibility that a significant gain in one ability— say, high-level cognitive functioning—can ever be justified if it is accompanied by a minor degradation of some other, arguably less important, trait, like a loss of half an inch in height?) Nevertheless, the reasons that genetic enhancement is singled out as a major foe are understandable. As described in chapter 1, the science of human genetics is full of surprises, like the much smaller number of genes than had been expected and the stretches of DNA that previously were thought to be superfluous but turn out to have important regulatory functions. The techniques for genetic manipulation are new and poorly understood. Just when scientists think they’ve licked a major technical problem, like how to deliver modified genes to the right place in the body, their methods turns out to have hidden dangers. A good example, mentioned earlier, is the French effort to use gene therapy to cure a disease in infants called X-linked severe combined immunodeficiency syndrome (X-SCID). With the aim of producing white blood cells with a proper immune response, the French researchers took stem cells from the children’s bone marrow, used a standard retrovirus to insert corrected DNA into the cells, and returned the modified cells to the children’s bone marrow. At first, the procedure seemed to have succeeded : ten boys developed functioning immune systems. But it turned out that the retrovirus that the researchers had used to insert the corrected DNA into the stem cells had lodged in a position in the children’s DNA that was too near a gene that, if stimulated, can cause leukemia, a form of cancer. Three of the boys contracted the cancer. Caution when dealing with genetic enhancement thus stems from a legitimate fear of making mistakes. That a mistake involves genes also gives rise to the concern that it could spread out of control. Remember that it was this risk from Paul Berg’s recombinant DNA E. coli experiment that led to the voluntary moratorium on recombinant DNA research . In the case of genetic engineering, the apprehension is that the mistakes could become so widespread that they corrupt the human gene pool itself, in the same way that it is feared that a failed experiment with genetically modified plants or animals could infect and destroy entire ecosystems. At the extreme, humanity might become infertile or inca- pable of surviving some new environmental insult, such as a previously unknown disease. But Courtney Campbell, director of the Program for Ethics, Science, and the Environment at Oregon State University, points out that failure itself is not the problem: “Failure, after all, is an integral learning occasion in the trial-and-error methodology of science.”4 The real fear is that scientists will succeed—but not in the way they anticipated. As Campbell explains, Willard...