Dessislava Fessenko discusses the moral permissibility of genetic selection for non-disease traits and highlights some of the ultimate considerations that should define it.

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Recent news about the successful creation of experimental synthetic human embryos from stem cells made some of us, bioethicists, consider the possible ethical implications of such a technology if it advances to the point of having a wider application and replaces in-vitro fertilization. One potential concern is if stem cell-based human embryo development would allow for selection for non-disease traits, such as intelligence and sex. Such elective selection practices have emerged in IVF. While their cumulative social effects appear less pronounced for the time being due to the overall low rates of IVF-conceived newborns, this may not be the case with more tractable reproductive technologies that also facilitate selection for non-disease traits. This prompts questions about the moral justifiability of elective selection.

Some claim that improving individual and collective well-being makes such genetic selection morally permissible. However, arguments about everyone’s equal moral worth and respect for humanity potentially negate the moral permissibility of genetic selection for non-disease traits. Ethical tensions arise when the conception of well-being threatens to undermine respect for persons. Addressing these tensions requires a broader substantive debate about the essence of these values, and suggest considerations that could inform this debate.

Photo Credit: Christoph Bock/wikimedia. Image Description: The picture shows the crystal structure of a short DNA helix with sequence “accgcCGgcgcc”.

One possible justification for genetic selection for non-disease traits lies in its potential for improvement of individual and collective well-being. Some think that selecting for traits that predetermine intelligence levels or social behavior could enable better social outcomes for the individual and the family. When done at scale such selection might turbocharge social progress and civilizational achievements. Pursuing such a line of reasoning entails adopting a utilitarian conception of “right”. Under this conception, genetic selection for non-disease traits would be morally justified if its aggregate positive consequences for all concerned (child, family, society) outweigh the negative ones. This justification centers on the perceived social or personal utility of genetic selection for non-disease traits.

The disability rights critique of prenatal genetic testing advances a host of counterarguments to such utility considerations with respect to children with disabilities. Additional counterarguments address certain non-disease traits such as sex and could apply by analogy to non-disease traits generally because of their broader social relevance. The first such counterargument is that utility considerations for genetic selection reduce a person to her traits and effectively judge her moral worthiness on that basis. Utility considerations essentially devalue a child’s personality and ability to have a meaningful life and relationships even if that child does not possess an “optimal” set of genes. Furthermore, perceiving a child as a “means” to attaining ends, such as social utility, dehumanizes the child. Moreover, gene selection reinforces social discrimination based on stereotypes about traits. All these concerns render gene selection for non-disease traits morally problematic. These critiques effectively draw on everyone’s equal moral worth and respect for humanity.

These two lines of reasoning situate the moral debate about gene selection for non-disease traits along the continuum of two moral values: well-being and personhood or humanity. They potentially align if a quest for a better life nurtures one’s personality and respects one’s humanity. Yet, adopting a purely utilitarian conception of well-being may come in tension if its pursuit sidelines one’s individuality and uniqueness. Resolving these issues involves a decision, first and foremost, as to what these values entail. Such determinations are typically predisposed by a society’s culture and religious traditions and require broader substantive debate as to what belief system a society cherishes and wishes to uphold (as J. Haidt, as well as M. Sandel argue)

Besides these justifications and counterarguments, three further considerations should inform this debate. First, gene selection for non-disease traits may have unintended consequences and trigger inhumane social practices. For example, the one-child-policy in China prompted de facto selection for sex (male) through selective abortion. This led to overall gender imbalance and spurred social practices that undermined fundamental human rights, such as trade in women, forced marriages, and the associated violence. Second, allowing gene selection for non-disease traits may set a society on a slippery slope towards considering the wider use of gene selection for any traits (including disease) as a health prevention or even promotion measure and, thus, towards a form of eugenics. Third, promoting genetic diversity may be morally requisite for a society if it wishes to substantiate and practice broader social fairness and equality.

The moral permissibility of gene selection for non-disease traits hinges on the meaning assigned to collective and personal well-being and respect for personhood and humanity. Such value determinations are culture-dependent and require substantive public debate as to the values and social practices a society embraces and wishes to promote. The debate needs to give careful consideration to the pivotal role of respect for personhood and humanity for personal and societal thriving, especially in the context of emergent reproductive technologies with potential significant impact on personal autonomy, as well as on social justice.

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Dessislava Fessenko is a Master of Bioethics candidate in the Center for Bioethics at Harvard Medical School. She is also a technology lawyer and a policy researcher working on AI policy and governance. @DessiFessenko