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How will we regulate genetic enhancement?

Genetic enhancement technologies present difficult and novel regulatory issues, including the problem of measuring and comparing risks and benefits and dealing with the impact of these technologies on social values. This Article describes and evaluates the potential approaches that may be taken to regulate these technologies. The author concludes that a variety of approaches will be necessary, involving self-regulation, government restrictions on access and use, licensing, and a national lottery.

American Medical Association↗

Germ-line genetic enhancement and Rawlsian primary goods.

Genetic interventions raise a host of moral issues and, of its various species, germ-line genetic enhancement is the most morally contentious. This paper surveys various arguments against germ-line enhancement and attempts to demonstrate their inadequacies. A positive argument is advanced in favor of certain forms of germ-line enhancements, which holds that they are morally permissible if and only if they augment Rawlsian primary goods, either directly or by facilitating their acquisition.

Ethical Analysis↗

Genetic enhancement: plan now to act later.

All three main articles in the issues of the Kennedy Institute of Ethics Journal endorse the view that genetic enhancement should be permitted, including human germ-line genetic enhancement. However, unregulated, wealth-based access to genetic enhancement in general, and germ-line enhancement in particular, would create intolerable risks for society. Although there are a number of practical problems raised by proposals to regulate or restrict access to genetic enhancement, which will make it difficult if not impossible to muster support for any effective restrictions until we begin to experience the societal problems that genetic enhancement will create, it is important to consider now what restrictions would be appropriate, how they would be imposed, and what changes would be needed in existing laws and institutions to facilitate them. Without this type of groundwork, there is no way society will be in a position to act in time.

Ethical Analysis↗

Can human genetic enhancement be prohibited?

This article seeks to reframe the ethical discussion of genetic enhancement, which is the use of genetic engineering to supply a characteristic that a parent might want in a child that does not involve the treatment or prevention of disease. I consider whether it is likely that enhancement can be successfully prohibited. If genetic enhancement is feasible, it is likely that there will be demand for it because parents compete to produce able children and nations compete to accumulate human capital in skilled workers. If some parents or nations begin using genetic enhancement, this will change these competitions in ways that increase the incentives for others to use it. Therefore, a ban on genetic enhancement would be unstable, because once the ban was breached by defectors the motivation of others to uphold it would weaken, making the ban liable to collapse. The argument provides a new perspective on slippery slopes to dangerous technology.

Adult↗

Genetic enhancement in the twenty-first century: three problems in legal imagining.

By what method should we resolve the ethical and public policy issues surrounding genetic enhancement: a utilitarian calculus, appeal to Scripture, application of neo-Kantian principles? In this Article, the author claims that, despite the diversity of our basic methodological commitments, we can advance our shared understanding of the issues surrounding genetic enhancement and come to agree upon certain central features as essential to any adequate method for resolving those issues. The author attempts to make modest headway on both fronts by engaging in "legal imagining." Legal imagining consists of examining hypothetical problems from the lawyer's perspective, the perspective of a caring, professional friend. This Article examines and discusses three problems in legal imagining.

Adult↗

Does justice require genetic enhancements?

It is argued that justice in some cases provides a pro tanto reason genetically to enhance victims of the genetic lottery. Various arguments--both to the effect that justice provides no such reason and to the effect that while there may be such reasons, they are overridden by certain moral constraints--are considered and rejected. Finally, it is argued that justice provides stronger reasons to perform more traditional medical tasks (treatments), and that therefore genetic enhancements should not play an important role in a public health care system.

Adolescent↗

When norms normalize: the case of genetic "enhancement".

As the possibility of genetic intervention becomes more concrete, defining and regulating ethically permissible interventions must include a consideration of the implicit as well as explicit consequences. These include the moral implications of defining "enhancement" by reference to a standard of normality. Some authors have called into question the standard ethical concerns about genetic enhancement, but the distinction between enhancing and therapeutic interventions is still structured as relatively unproblematic. However, determining the boundary between therapy and enhancement will have feedback effects on the socially implemented definitions of what counts as normal in human embodiment. Positioning the interface between permissible and nonpermissible interventions at the same place as the boundaries between therapy and enhancement, and between normal and abnormal embodiment, (1) uses biology to justify a moral evaluation, (2) privileges the single standpoint of the genetically canonical person, and (3) enhances the dichotomy between "normal" and "not normal". Assuming that the limit of permissibility along the interventional continuum is coterminous with the definitions of enhancement and of normality, distracts from the work of uncovering the real grounds to setting limits to genetic manipulation.

Ethics, Medical↗

Thinking theologically about reproductive and genetic enhancements: the challenge.

Current philosophical and legal bioethical reflections on reprogenetics provides little more than a rationalization of the interests of science. There are two reasons for this. First, bioethicists attempt to address ethical issues in a "language of precision" that characterizes science, and this works against analogical and narratological modes of discourse that have traditionally provided guidance for understanding human nature and purpose. Second, the current ethical and legal debate is framed by a public/private distinction that banishes robust norms to the private realm, and leaves a minimalist public discourse of harm avoidance that is insuffucient for regulating the science. In this essay, I argue that Mark Hanson's account of anxiety provides a valuable starting point for addressing deficiencies in the current philosophical and legal debate, and it highlights the need for a theological discourse on genetic enhancements. Through an assessment of Joel Shuman's criticism of the public/private distinction, I show how the needed theological discourse should be situated in the context of robust communities, and how such a communitarian inter-ethic is compatible with a variant of liberalism. Finally, I critically assess James Keenan's account of virtue and perfection, in order to outline what a sufficient discourse on reproductive and genetic enhancements requires.

Anthropology↗

The inevitability of genetic enhancement technologies.

We outline a number of ethical objections to genetic technologies aimed at enhancing human capacities and traits. We then argue that, despite the persuasiveness of some of these objections, they are insufficient to stop the development and use of genetic enhancement technologies. We contend that the inevitability of the technologies results from a particular guiding worldview of humans as masters of the human evolutionary future, and conclude that recognising this worldview points to new directions for ethical thinking about genetic enhancement technologies.

Capitalism↗

Genetic enhancement technologies and the new society.

So long as procreation continues to remain a central driving force in a marital relationship, and the family the very core of progressive society, efforts will be undertaken to expand the period of fecundity and combat infertility. Genetic planning and eugenic programming are more rational and humane alternatives to population regulation than death by famine and war. Genetic enhancement technologies and the scientific research undertaken to advance them should be viewed as not only aiding (or, sometimes resolving) the tragedy of infertility in family planning, but as a tool for enhancing the health of a Nation's citizens by engineering man's genetic weaknesses out of the line of inheritance. Put simply, healthier and genetically sound individuals have a much better opportunity for pursuing and achieving the "good life" and making a significant contribution to society's greater well being.

Eugenics↗

Bioethics, sport and the genetically enhanced athlete.

This paper begins by acknowledging the interest taken by various international organisations in genetic enhancement and sport, including the US President's Council on Bioethics (July, 2002) and the World Anti-Doping Agency (March, 2002). It is noticed how sporting organisations have been particularly concerned to emphasize the 'threat' of genetics to sport, whereas other institutions have recognised the broader bioethical issues arising from this prospect, which do not readily reject the use of genetic technology in sport. Sports are identified as necessarily 'human' and 'moral' practices, the exploration of which can reveal greater insight into the intuitive fears about genetic modification. It is argued that anti-doping testing measures and sanctions unacceptably persecute the athlete. While there are substantial reasons to be concerned about the use of genetic modification in sport, the desire for policy ought not diminish the need for ethical research; nor ought such research embody the similar guise of traditional 'anti' doping strategies. Rather, the approach to genetics in sport must be informed more by broader social policies in bioethics and recognition of the greater goods arising from genetic technology.

Doping in Sports↗

Genetic enhancement and theosis: two models of therapy.

The author argues that to think theologically about genetic enhancement is to think prayerfully about how to locate all one's uses of medicine, recognizing that they must all be lodged in the Christian struggle to holiness. He is critical of the essays in this issue because they often appear to take on a scholastic life of their own outside of the all-consuming struggle to salvation of Christians across the millennia.

Christianity↗

Human genetic enhancement: is it really a matter of perfection? A dialog with Hanson, Keenan, and Shuman.

The author reviews the arguments made by Mark Hanson, James Keenan, S.J., and Joel Shuman in this issue. In the first section, she argues that they offer a significant contribution toward an understanding of the inner logic of a new trend in contemporary medicine, genetic engineering. However, she criticizes the authors for relying excessively on procedural guidelines and for failing to bring the practical realities of medicine and technology to bear on theory. She argues that more concrete guidelines, which are ultimately grounded in a Christian conception of the person and on the commandment to love, are necessary. Writing from the Roman Catholic perspective, the author argues that the distinction between genetic enhancement and gene therapy is essential, despite the criticisms which have been offered of this distinction. Understanding this distinction will be critical for identifying as licit only those forms of genetic manipulation which respect the dignity of the human person.

Anthropology↗

Targeting tumours with genetically enhanced T lymphocytes.

The genetic modification of T lymphocytes is an important approach to investigating normal T-cell biology and to increasing antitumour immunity. A number of genetic strategies aim to increase the recognition of tumour antigens, enhance antitumour activities and prevent T-cell malfunction. T cells can also be engineered to increase safety, as well as to express markers that can be tracked by non-invasive imaging technologies. Genetically modified T cells are therefore proving to be of great value for basic immunology and experimental immunotherapy.

Adjuvants, Immunologic↗

Reflections on the ethics of genetic enhancement.

The technologies made available by new research in genetics and genomics have been and will be used not only to diagnose and treat disease, but also to attempt to enhance human traits and capacities. A broad definition of genetic-enhancement technologies, not merely gene manipulation, but also indirect genetic technologies, such as biosynthetic drugs, is needed to capture the full range of possible applications. It is difficult, but often possible, to anticipate the enhancement temptations of new therapies. Such anticipation may help us in shaping the marketing, availability, or other aspects of those technologies. Appropriate public and professional policies are needed, and work on them should begin immediately. Most important, we must stimulate public education and dialogue to encourage personal ethical reflection on the appropriate uses and limits of genetic-enhancement technologies.

Body Height↗