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TIME THE FUTURE OF MEDICINE Who Gets the Good Genes? BY ROBERT WRIGHT
In the 1932 novel Brave New World, Aldous
Huxley envisioned future childbirth as a very
orderly affair. At the Central London Hatchery and
Conditioning Center, in accordance with orders
from the Social Predestination Room, eggs were
fertilized, bottled and put on a conveyor belt. Nine
months later, the embryos--after
"decanting"--were babies. Thanks to
state-sponsored brainwashing, they would grow
up delighted with their genetically assigned
social roles--from clever, ambitious alphas to
dim-witted epsilons.
Ever since publication of Huxley's dystopian
novel, this has been the standard eugenics
nightmare: government social engineers
subverting individual reproductive choice for the
sake of an eerie social efficiency. But as the age
of genetic engineering dawns, the more plausible
nightmare is roughly the opposite: that a
laissez-faire eugenics will emerge from the free
choices of millions of parents. Indeed, the only
way to avoid Huxleyesque social stratification
may be for the government to get into the
eugenics business.
Huxley's scenario made sense back in 1932.
Some American states were forcibly sterilizing
the "feebleminded," and Hitler had praised these
policies in Mein Kampf. But the biotech revolution
that Huxley dimly foresaw has turned the logic of
eugenics inside out. It lets parents choose
genetic traits, whether by selective abortion,
selective reimplanting of eggs fertilized in vitro
or--in perhaps just a few years--injecting genes
into fertilized eggs. In Huxley's day eugenics
happened only by government mandate; now it
will take government mandate--a ban on genetic
tinkering--to prevent it.
An out-and-out ban isn't in the cards, though.
Who would try to stop parents from ensuring that
their child doesn't have hemophilia? And once
some treatments are allowed, deciding where to
draw the line becomes difficult.
The Bishop of Edinburgh tried. After overseeing a
British Medical Association study on bioethics,
he embraced genetic tinkering for "medical
reasons," while denouncing the "Frankenstein
idea" of making "designer babies" with good
looks and a high IQ. But what is the difference?
Therapists consider learning disabilities to be
medical problems, and if we find a way to
diagnose and remedy them before birth, we'll be
raising scores on IQ tests. Should we tell parents
they can't do that, that the state has decided
they must have a child with dyslexia? Minor
memory flaws? Below-average verbal skills? At
some point you cross the line between handicap
and inconvenience, but people will disagree about
where.
If the government does try to ban certain eugenic
maneuvers, some rich parents will visit clinics in
more permissive nations, then come home to
bear their tip-top children. (Already, British
parents have traveled to Saudi Arabia to choose
their baby's sex in vitro, a procedure that is illegal
at home.) Even without a ban, it will be
upper-class parents who can afford pricey
genetic technologies. Children who would in any
event go to the finest doctors and schools will get
an even bigger head start on health and
achievement.
This unequal access won't bring a rigid caste
system a la Brave New World. The interplay
between genes and environment is too complex
to permit the easy fine-tuning of mind and spirit.
Besides, in vitro fertilization is nobody's idea of a
good time; even many affluent parents will forgo
painful invasive procedures unless horrible
hereditary defects are at stake. But the
technology will become more powerful and user
friendly. Sooner or later, as the most glaring
genetic liabilities drift toward the bottom of the
socioeconomic scale, we will see a biological
stratification vivid enough to mock American
values.
Enter the government. The one realistic way to
avoid this nightmare is to ensure that poor people
will be able to afford the same technologies that
the rich are using. Put that way, it sounds
innocent, but critics will rightly say it amounts to
subsidizing eugenics.
State involvement will create a vast bioethical
quagmire. Even if everyone magically agrees that
improving a child's memory is as valid as avoiding
dyslexia, there will still be things taxpayers aren't
ready to pay for--genes of unproven benefit, say,
or alterations whose downsides may exceed the
upside. (The tendency of genes to have more
than one effect--pleiotropy-- seems to be the rule,
not the exception.) The question will be which
techniques are beyond the pale. The answers will
change as knowledge advances, but the
arguments will never end.
In Brave New World, state-sponsored eugenics
was part of a larger totalitarianism, a cultural war
against family bonds and enduring romance and
other quaint vestiges of free reproductive choice.
The novel worked; it left readers thinking that
nothing could be more ghastly than having
government get into the designer-baby business.
But if this business is left to the marketplace, we
may see that government involvement, however
messy, however creepy, is not the creepiest
alternative.
© 1999 TIME Magazine
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