The Lockhart review is currently touring the nation seeking the views of experts and interested parties for its report to the Government “ due in December “ on the Human Cloning Act 2002 and the Research Involving Humans Act 2002. What better time to ponder the big, moral questions raised by biotechnological discoveries, and their conversion into medical technologies with the capacity to profoundly change how we partner, reproduce, parent, compete and generally go about the business of being human?
It goes without saying that reproductive and genetic – or reprogenic – technologies will continue to offer people valuable information and options to improve the quality of their lives and those of their children. The younger brother of a friend has cystic fibrosis (CF). When he was diagnosed, my friend’s parents decided against having any more kids: the only way, back then, to avoid the birth of another affected child. More than thirty years later, my friend’s brother has used reprogenic technologies to conceive an embryo genetically related to him and his wife and to screen it to ensure it would neither carry nor be affected by CF.
But if not properly regulated, reprogenic technologies have the capacity to increase social inequality; entrenching the disadvantages already suffered by the poor. Research repeatedly demonstrates that as family incomes fall, the risk of poor developmental outcomes for children increases.
Thanks to Fiona Katauskas |
One little-recognised problem concerns the anticipated development “ through the use of stem cell therapies “ of replacement tissues and organs. Many of us have been led to expect that ‘therapeutic cloning’, will primarily enable the creation of say, pancreas and heart muscle cells for the treatment of diabetes and cardio-vascular disease, with DNA identical to that of the intended recipient. However, such technology can also be used to create a ‘bank’ of human embryonic stem cells matched to “ and so able to treat “ the majority of people.
But to create this bank, you need to have DNA that is representative of the different segments of the population. In particular, if only excess embryos from IVF clinics are used to create embryonic stem cells, there may not be matched cell lines for those unable to afford such reproductive treatments in the first place. Sadly, social discrimination will ensure that a disproportionate number of those unrepresented will be ethnic and racial minorities.
Having first missed out on having any or the number of children they wanted due to their inability to afford any or enough IVF treatment, it may be that in the future the poorest 10 per cent of the population may also be unable to benefit as much as the rich from the best medical treatment science can provide.
Embryo selection techniques may also lead to the creation of future populations in which the economically deprived suffer genetic disadvantages. Currently, the motive for diagnosing embryos created in the lab is to discover which are most likely to implant and develop into a baby, or to identify embryos unaffected by an inherited condition. However, parents are also allowed to select against embryos that carry, rather than are affected by, particular genetic defects and one Sydney-based clinic allows parents with a child of one sex to select an embryo of the other in order to ‘balance’ their family.
The present worry is that the disproportionate access the wealthy have to screening and selection techniques are “ at the margins “ enabling them to improve the health of their genetic lines in ways unavailable to the poor. The future worry is that this genetic advantage will expand to non-disease characteristics and predispositions if and when we gain the knowledge to screen and select for such things in the future.
What if, for example, scientists eventually isolate the constellation of genes that will predispose a child to have a high IQ? It seems unlikely that some parents at least, particularly those already screening to eliminate a disease-trait or to have a child of the right sex, might not want to know if any of their embryos has this constellation and “ if it were possible “ to implant an embryo both free of disease and enhanced with high IQ genes.
The problem would be that, insofar as such genetic selection actually did cash out for the resulting child in higher IQ, it would be the children of the rich who would be disproportionately rewarded. Indeed, wealthy children in such a brave new world might be doubly advantaged when it came to developing valued human characteristics like IQ compared to the poor. Firstly because, as is currently the case, they have the environmental advantages that contribute to IQ like quality schooling and secondly, because they will have been genetically predisposed to develop a high IQ.
How can we ensure biotechnology continues to enrich all our lives, but doesn’t exacerbate existing disadvantages suffered by the poor? One suggestion, made by high-profile ethicist Peter Singer, is that the state should subsidise genetic enhancement services so they are equally available to everyone.
What matters is that we “ ethicists, scientists, politicians and the public “ get our head around the problem now. Not, as has so often been the case in the past, after the reprogenic horse has bolted.