The rights and wrongs of designer humans
Designer babies - their gender, personality traits and skin colour potentially chosen by genetic testing - are a looming reality. But are we ready to confront this minefield of ethical issues?
You are going to be a parent. Modern science is your guide, IVF your chosen method - the aim being multiple foetuses for maximum choice. Clutching the Book of Life - as the map of the human genome is known - you ponder your ideal child. There's Foetus A, which even as a mere mass of cells already has a bad report card: a genetic disposition to criminal behaviour. Select or dispatch? What of Foetus B? Music to your ears, it has an excellent chance of being born with perfect pitch - but the gene map also points to depression. Move along. Foetus C? You're in luck: gene markers for exceptional athleticism, and high marks for brain power to boot.
This is an exaggeration, but it is not science fiction - and nor is it too far removed from the debates we face as we confront the choices scientific advances are delivering: gender selection of human beings, with selection for birth based on screening for not just major diseases or a preference for a particular gender, but also for personality traits and other skills or weaknesses, from long-distance running ability to a dangerously short fuse.
These are ethical and moral notions that will confuse most of us, and horrify many, but for expatriate philosopher Julian Savulescu, director of Oxford's Institute for Science and Ethics, this is a debate whose time has come. It is one in which he is a fierce advocate for letting science speak for itself and for leaving individuals to decide for themselves how they use the information.
"[We are] starting to identify things associated with personality and with cognitive capacities," he says. "Everyone has different limitations and capacities and it's pretty obvious that a lot of that, at least some of it, we are born with. And if we're born with it, we can influence it. And that's the point of the argument - that we should make decisions over that, rather than leaving it to nature to decide."
In Melbourne this week, the professor will deliver the Latrobe University Centre for Dialogue's 2013 annual lecture at St Michael's church in Collins Street. Savulescu says he will call for Australians to begin a debate on laws governing the issue, which are determined at state level. (A federal government advisory panel, the Human Genetics Advisory Committee, offers national guidelines. At present, it is legal to test only for certain diseases. Tests for personality traits are banned.)
Savulescu says local laws are too conservative - more so than in the US but in keeping with European attitudes. He warns that among the reasons for Australians to focus on genetic selection are China's ambitions. "China is investing hundreds of millions of dollars looking for the genes that are associated with intelligence and they're going to be doing this sort of testing in the future. There won't be any of the sort of constraints that we have in Australia and Europe."
Of Victorian law, he is scathing: "With the current situation in Victoria, everything is legislated, except for major diseases - and I think that's more like a fascist system where people's freedom is controlled by the state."
Savulescu describes what sounds a relatively benign discovery: that singers with perfect pitch may have a musical marker on their genetic map. He also details what he calls compelling cases that already exist for genetic influence over behaviours such as "poor impulse control".
Of this gene and its effects, he says the science is robust enough to warrant offering the test now. It relates to a variant of a gene on the X chromosome which, combined with environmental factors such as child abuse or neglect, means "you're very likely to end up with poor impulse control and be a criminal ... So you've got this gene that in certain environments [results in] a disposition that's bad for the individual and also bad for society. These are the sorts of things people should be told and make decisions over."
In a discussion of more confronting scenarios - assuming the discovery of a gay gene, or of genetic signposts responsible for different traits in racial groups - Savulescu is adamant the rights of the individual to choose must be paramount.
"If people who are fundamentalist Christians want to have a child that isn't disposed to being gay then they should be free to do that. They're not harming the child. They're selecting between different children that they could otherwise naturally have had. If gay people want to have a child that's got the gay gene and have someone more like themselves they should also be free to do so." Savulescu doubts this situation will ever arise: "[Homosexuality is] not something I think you'll be able to reliably select for, there's not a sufficiently well-understood basis for that. I don't know if there ever will be."
On the race question, he says a mixed-race couple, for example, should be free to favour or reject racial characteristics such as a dominant skin colour. "Once you get more and more information about the genetic basis of different racial characteristics, you'll of course be able to select to have more or less of that trait. So if you've got a mixed-race couple ... you will be able to select embryos out more or less [for] one of those that you want.
"Again, I think people should be free to make those sorts of choices. The objection then is that if you're in a racist society, people will select the privileged race - so if you've got a mixed-race couple they'll select to have a white baby. Just like in a sexist society they'll select boys. The problem there is that it's the racism or sexism in society that should be corrected. Couples shouldn't have their reproductive liberty basically controlled in order to engineer a certain society."
Savulescu knows the standard reaction to these bold and blunt views, having already stirred up debate in Britain. "People immediately say, 'that's what the Nazis did and that's eugenics'. It is indeed eugenics but so is testing for Down Syndrome or cystic fibrosis or any disease. That's also eugenics."
He says religious beliefs are behind much of the criticism - and are most to blame for conservative laws. He respects people's right to practise their faith, but not to impose it on others.
"I think the debate that needs to happen, particularly in Australia now they have Tony Abbott, is to put religion in its place ... [which is] in the home.
"If it were the case that Tony Abbott's personal Catholic views started to influence public policy, it would be a kind of moral outrage and completely inappropriate. If, however, he keeps his views to himself and participates as a responsible player in the debate, then everyone's got different views and we should respect that. Let's just hope that he pulls his ethical head in."
But Savulescu's views also worry experts closer to him in stature, expertise and knowledge of genetics and ethics than do religious leaders and their flocks. Victoria Palmer, an ethicist and research fellow at Melbourne University, says advocates such as Savulescu have an absolutist view that "choice and autonomy" trump all - that "people have the information to decide, and therefore it's ethical to make things available".
"It really overlooks questions of justice and benefit," she says. "And then there are questions of the benefits to society, in terms of designer babies or even of predictive testing for depression and other mental illnesses. It can lead to the idea that some lives are more worth living than others, or that some conditions have stigma and shame associated with them. It creates divisions."
Kate Dunlop, who heads the NSW government's Centre for Genetic Education, concurs. "I think most people have concerns about allowing people to choose non-health related traits for their baby and I think our focus is that it's important that benefits outweigh harm in implementing any of these new technologies.
"We don't have enough evidence at this stage to say that the benefits outweigh the harms by any stretch of the imagination," she says.
"It's difficult to get an accurate prediction of a lot of the traits that [Savulescu] talks about. We know a lot of traits have a genetic basis but the environment also often plays a significant role in the expression of them. So at this stage we're cautious with the technology, we're cautious about saying these traits could be measured or chosen and we have to be careful not to mislead people. Technology is moving rapidly and we may get better evidence or we may be able to predict more accurately in time - but at this stage it's not the case."
Both Dunlop and Palmer emphasise their respect for Savulescu, and agree that a debate is important. The professor himself says that in his Melbourne speech on Thursday, he will be trying to give that debate some spark and perspective.
"I'm going to show how we're really confused at the moment," he says, noting what he calls the "medicalisation of normality, cosmetic surgery in children, kids taking cognitive enhancers, people wanting drugs to improve their love life".
"We're taking part in an enhancement revolution. It's not just that our cars are better, or computers are better - we're able to enhance ourselves and we don't know what to do with that. Where to draw the lines based on science and ethics? What are the guiding principles? And the guiding principle in all this is that people should be free to do these things unless they're harming other people."