Mark Henderson
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The smiling young woman in a red dress who stared out from the front page of The Times yesterday does not much look like the face of eugenics. Yet to her critics, she is about to cross an ethical boundary.
If the fertility watchdog grants permission to her doctor – and it has already agreed in principle – she will soon start IVF treatment, even though she is fertile. Her embryos will then be screened for a gene that heightens the risk of breast cancer. This gene killed her mother, her grandmother and her great-grandmother, and she carries it herself. Now she has an opportunity to spare her daughters this devastating heirloom.
For some, though, this is no cause for celebration. They fear instead that we are treading the path towards designer babies, created to feed pushy parents’ fantasies of raising the next Cristiano Ronaldo or Scarlett Johansson.
Their concern is that embryo screening, which uses a technique called pre-implantation genetic diagnosis (PGD), is being used for an ever-widening range of inherited conditions. It was originally licensed only for rogue genes that invariably cause an incurable and life-threatening disease, such as cystic fibrosis. Now, it has been deemed acceptable when the risk of illness is just 80 per cent, and for a cancer that can be prevented, albeit with mutilating surgery.
From here, the argument goes, it is a short jump to testing for DNA that is more loosely linked to disease, or to no disease at all. Doctors might screen for the recently discovered gene that raises the risk of obesity, even though diet and exercise play more important roles. Selection of socially desirable traits such as intelligence and good looks could follow. The parallels drawn are with the Nazis, Huxley’s hatcheries and the biological underclass of the science-fiction movie Gattaca.
It is easy, though, to get carried away by cliché. Talk of designer babies, slippery slopes and brave new worlds adds little to constructive debate about PGD, because its dystopian potential is firmly limited by science. It is certainly a powerful technology that has helped hundreds of families to have a healthy child. But it is entirely unsuitable for mass production of babies-to-order.
To begin with, PGD is impossible without IVF. To test an embryo’s genetic make-up, it is first necessary to grasp it with a pipette and extract a cell. This can be done only with an embryo fertilised in the laboratory. The procedure also requires a reasonable supply of embryos to test: if a single embryo conceived naturally is faulty, there would be no others to implant instead.
This necessarily knocks straight out of the game many couples who might like a designer baby. For all its undeniable benefits, IVF holds little appeal for the naturally fertile. Success rates are poor, and it involves invasive and gruelling gynaecological procedures. There are also side-effects for the prospective mother: menopausal symptoms such as hot flushes, and on rare occasions ovarian hyperstimulation syndrome, which can be fatal. Natural conception is a more efficient option for those who can manage it, not to mention more fun.
Then there is the matter of what to look for. At present, scientists know of about 200 single genes that cause or predispose to disorders for which it is reasonably simple to test. The kind of traits that parents would wish for in a true designer baby, however, are not much influenced by solitary genes.
Intelligence, height, good looks, athletic ability – all have a heritable element, but this is determined by a complex array of genes, with relationships that are poorly understood. Each trait will also be affected by environment, both in the womb and childhood: there is no guarantee that the designer baby will do what it says on the tin. It is one thing to expect PGD to detect cystic fibrosis, quite another to identify an Oxbridge first waiting to happen.
Some of these hurdles, of course, may eventually be overcome. Our understanding of how genes affect one another is progressing all the time, and it is not implausible that a genetic suite that enhances intelligence might eventually be pinned down. “Gene chips” that can test for thousands of genes at once are improving in sophistication.
But there is still the raw material to contend with. Embryologists performing PGD can work only with what nature provides. No matter how many embryos are produced, each will inherit all its genetic material equally from its parents. It is all very well ordering a designer baby with the brains of Stephen Hawking and the looks of Kate Moss. If mum and dad are thick and ugly, it isn’t going to happen. Create a thousand embryos if you like – you’ll be testing away in vain. PGD is incapable of making genetic haves of the offspring of have-nots.
Improved technology could actually make matters worse for would-be parents of a designer baby. In genetic screening, there is such a thing as too much information. Even when looking for a single, catastrophic mutation, such as the one that triggers Huntington’s disease, all the embryos that are created sometimes test positive. Add in the thousands of defects that a gene chip might one day reveal, and it will become nigh on impossible to find one that has nothing wrong with it. Do you select the embryo with “clever” genes but a propensity to schizophrenia? Or the athletic one likely to develop type 2 diabetes later in life?
Knowing about the natural limits to the utility of embryo screening is fundamental to informed debate about its place in medicine. To oppose embryo screening on the basis of implications that are largely imagined is to elevate implausible thought-experiment over proven potential to transform life and health. PGD is a great tool for preventing genetic diseases that cascade down the generations, blighting whole families with misery and suffering. For the eugenic design of superhumans, it is essentially useless.
Mark Henderson is science editor of The Times
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Adoption is not preferable for me. I prefer to give birth to my child.
That is why we are doing IVF. We don't feel obligated to adopt any children.
I don't know why society thinks infertile people are especially obligated to adopt children. We don't have to any more than anyone else does.
Hermione Lane, Houston, TX
This article states the following obstacles to "designer babies":
1) You're stuck with your own genes as a basis.
- true, but we have 2 of each. If I'm fat and short it is still likely that one gene is "longer and slimmer" than the other. This means there is a lot of room for improvement in any person.
2) genes work in combination, so screening is difficult.
- true, but this problem decreases quickly with time, as knowledge increases.
3) IVF is a tough/expensive/painful procedure.
- this is the strongest obstacle, but the procedure is steadily improving - i.e. lower cost, higher rate of success. Besides, it does not get more complex or painful by scanning for more genes than one (you only need more embryos to choose from).
"Superhuman design" is a stupid phrase, but if each generation can throw away the worst of what we've inherited, will it not bring us the right way? It is a logical choice for the individual who wishes the best for his children.
R.E., Oslo, Norway
Excellent article and finally a voice of reason in a field where many are intent on fostering fear. The scaremongering couldn't be anymore blatent with reference to Nazis to evoke the most fear to those without even the smallest modicum of scientific knowledge. Associate it with "evil" and you stir the ill informed to stop progress, maybe burning books is next on the agenda. One cannot be afraid of technology and its potential, or the progress of human kind will be severly limited. People are afraid of what they dont understand and with the lowering rate of people even taking up sciences how can people expect to grasp these concepts and have a well formed opinion?
Manu, Oxford,
Maybe (in the future) each embryo in the whomb of the mother can be given a profile of probalities of characteristics per gene . If there are really disappointing probabilities for certain characteristics, it could be aborted (choice of parents). E..g. The embryo has 3 genes that contribute to his intelligence, all 3 have an expected IQ, each determined by looking at the average IQ of a known sample of children with one of the 3 genes. 2 of which have a low *expected* IQ of 67 and 78, the third an expected IQ=97. The parents may decide to abort the child and try it again. It's not a designer baby. But there is 'quality control'. This may perhaps be feasible?
Betrand, Gr., NL
Mark, what do you mean "just 80%"? Such a weasel phrase! Does "just" diminish such a high percentage?
80% is a HUGE risk. Have five female children and ONLY FOUR will either die or need mutilating surgery to survive. Cheer up, ONE will probably be OK! You only wanted one? That's OK then!
For some perspective. Her chance of winning £10 on the lottery from one line is just 2%. (That's the right place for "just".) Oh, and three times as many people die from breast cancer as die on the roads.
However, other than that minor nit-pick, this is a very good article, well done.
Peter Dunford, Bournemouth, UK
Designer babies will happen. It's inevitable. This article just poses potential problems. So how will the path be tread? The same as before, always with break-through medicines. First, tell the world this could be the cure for cancer. Then pick some poor, hillbilly family to undergo treatment for a 'heartbreaking' condition. The scientists practice, perfect. Then the treatment goes to market. The high price tag excludes all but those at the top, who, being ultra-competitive on behalf of their children, will happily pay the price. As for the Kate Moss/Stephen Hawking conundrum - who knows? Maybe they'll discover that every person's genes has these potentials, which can be unlocked. Or maybe Moss, Hawkings, et al, can sell their DNA strands, to be incorporated into others' biology. All it takes is imagination, money, poor suckers of guinea pigs, practice, good marketing, and the human competitive spirit. I loved Gattaca, a very human story that seemed to say "F*ck you!" to all this.
Daniel Clee, London,
Amazing how lunatic ideas, which underline the reality that George Orwell's "Nineteen Eighty Four" dealt with social fact rather than fiction, make it easier for oldies to accept their status of being on the way out. Dictatorship doesn't necessarily come with machine-guns and barbed wire. The selective approach to the permissible cradle is equally dictatorial in deciding whether innocent and defenceless human infants are allowed to live or not. The Holocaust of the Unborn is starting now, in our own society, and we are doing nothing whatever to stop it. Stephen Hawkings should be celebrating the fact that he was allowed to live at all before he celebrates his prospective flight into space.
Edmund Burke, Kingston upon Thames, England
What a fantastic, straight-forward article. I have often wondered how one selects embroyos for their "good-looking-ness". But then science is wonderful thing...
G, London,
It is a relief to know that unnatural selection wont ever be a feasible option. I dont think the ordinary person would have been interested, but we know what some organisations can be like, given half a chance.
Henry Percy, London, UK
Brilliant - you have just won the rights to serve as my AIM away message ----> Go Demography!
cmm, Florida, USA
Isn't it true, though, that there are private IVF clinics in the US supplying donor gametes for those who can't have children naturally, and that will only accept the eggs and sperm of college-educated, intelligent and attractive men and women? Is this not another route to 'designer babies' that is facilitated by IVF?
Niamh Middleton, Dublin, Ireland
Well said Mark :)
Natalie, Hampshire, UK
Right on Mark! But in a world where Marketing, Gossip and Social Credulity always seem to smother Science, Debate and Scepticism what can you do? There is survival value in the herd instinct, so no doubt there is a genetic basis for believing what is generally held to be true, no matter how incredible or unlikely it may be. What can be done? ... How about a rationality gene we can all sprinkle on our cornflakes? Now there's a great story, and just as credible as creating offspring with Kate Moss looks and terrific sumo wrestling skills.
psonic, Wigan,
Democritus (460 - 370 BC) considered that if you really must have children, adoption is preferable since it allows you to make a considered choice whereas if you set about it yourself you are stuck with what you get.
Nicholas Wibberley, Neuvic-Entier, France
Days to come, perhaps a deacde or so later, we shall see the booming of GM-Babies (Genetically modified babies). Much on the lines of GM food etc. the foetus and the DNA configuration of the pre natal stage can be screened and accordingly modified, to suit the traits , personality and external experiences. All one need is a wish list of one's Pa and Mom, with their lineage and pedigree characterstics, thier inherited mapping of dormant and active gene stocks . It may sound like some H.G.Wells sci-fi movie script, but the way bio-technology and genetics are growing , such a day may not be too far away......however the worrying factor is its ramifications on our society and existence. We shall be tinkering with our mother nature, and such violations may lead to some disastrous results. Evey parent may look for an Eistein baby- a whiz kind, or some Arnold Scwzenagger-a brawny blustering 20-stoner child, or some dolly alike Julia Roberts,.....this may go on and on.Are we gaming for it??
Sandy, New Delhi, India
Good review, but as inevitable, too semplicistic.
Mary's comment is right. It is not mathematically determined that ugly parents means ugly children, as the opposite is also true. The complexity of the (genetic) determinants is too big.
It is however true that there is a strong conditioning by a number of genes which possesse a great likelihood to show up if inherited.
On the other way we should not forget that gametes are generated by 'mixing-up' the individual genetic pattern in the process of their formation (meiosis).
This should also sound as a caution for people needing or choosing to select a gamete donor, looking at his/her health and apparent conditions. You can find yourself with a 'normal' child even with a 'supernormal' parent, or worse; or the reverse.
If we refuse the 'Intelligent design' concept by trying to condition our children genetics, we'd better trying not to go too far by behaving as 'gods'. Would be a contradiction in nature!
Gino, Milano, Italia
Good for her and her medics!
Women have hundreds of eggs and men make millions of sperm - there's not much to choose between them genetically I dare say, but if we can pick egg A over egg B and spare the resultant child a hideous and avoidable disease then do so! After all, the parents still end up with 1 child.
Paul, sheffield, u
Nightmare scenario would be a cock-up on the chromosome front resulting in a baby with the physique of Stephen Hawkin and the brains of Kate Moss.
Welcome to the Island of Doctor Moreau.
simon, leeds, u.k.
For this purpose, it can still be viewed as part of nature for humans interfering with nature will always correct itself, not always with a positive result, but whatever is that result, it is still part of nature for we are part of the ecosystem. It just may not be a good thing always and it may not feel like it.
In this case, I cannot see this as a big deal - certainly to the mother involved it will seem that way, but maybe if it were on a bigger scale it would be. Like with engineering mosquitos not to all carry malaria, you then have cause and effect with that. Ie a population explosion for more people now survive that would have died.
Maybe us changing our survival isn't always a good thing as we have now to finance the population created. Then we create others that argue they have the right too. Or they start just finding the odd gene, then replace the odd gene, then looking to give all people blue eyes.
It's not where we should be going - but we have choice to.
Jason Smith, CANTERBURY, UK
We can only hope that the scope and accuracy of this technique can be improved. After all anything that would reduce the number of fat ,ugly and stupid young women with fat, ugly and (presumably) stupid offspring in tow who currently populate our town centres is to be greatly encouraged
P. DOLMAN, WIRRAL, U.K.
"Now she has an opportunity to spare her daughters this devastating heirloom."
That is categorically a false statement with totalitarian dimensions. She may still have daughters who inherit this problem but she has chosen to eliminate them. That is nobody's cure. A large amount of the responsibility for the moral confusion on this subject does indeed lie with the dominance of the "slippery slope" slogan employed by the most organised opponents of child screening. This slogan fails to admit that the slope has already been slipped - four decades ago. Opponents like to raise the spectre of future doom, instead of decrying the assault on man that is taking place now in this country. All that happens is that, with each successive wave of this assault, the prediction of doom has to be modified as the latest immoral development becomes accepted and normalised.
Kevin, London,
I essentially agree with your point of view. However, I'm not certain that "ugly" parents can't create a lovely looking child. I have certainly seen the reverse - two attractive people creating unattractive children who, unfortunately, inherit the least desirable physical characteristics of each parent. But your point is, it's a crap shoot, because we lack the technology, perhaps fortunately, to control every genetic factor - not to mention the environmental ones that help to shape the people we become.
Mary, Pittsburgh, USA