Submission to the Committee on the Ethics of Gene Therapy.
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This paper addresses implications of applying the ethical principle of justice to gene therapy. Regarding somatic cell gene therapy as a treatment of last resort for life-threatening or seriously disabling disorders may be inconsistent with subjecting therapy to the preliminary scientific and ethical scrutiny given to research proposals. Emergency care may justify disregarding legal conditions of care, and be governed by different ethical priorities than research. Excluding gene therapy for reasons of enhancement rather than cure is widely agreed, but cosmetic procedures are considered legitimate in private markets. Intergenerational justice is a principle that may justify concentrating therapy on conditions afflicting children rather than older patients.
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Any suggestion of altering the genetic makeup of human beings through gene therapy is quite likely to provoke a response involving some reference to a 'slippery slope'. In this article the author examines the topography of two different types of slippery slope argument, the logical slippery slope and the rhetorical slippery slope argument. The logical form of the argument suggests that if we permit somatic cell gene therapy then we are committed to accepting germ line gene therapy in the future because there is no logically sustainable distinction between them. The rhetorical form posits that allowing somatic cell therapy now will be taking the first step on a slippery slope which will ultimately lead to the type of genocide perpetrated by the Nazis. The author tests the validity of these lines of argument against the facts of human gene therapy and concludes that because of their dependence on probabilities that cannot be empirically proven they should be largely disregarded in the much more important debate on moral line-drawing in gene therapy.
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