Because I’m such an expert on everything, most of my articles end with an emphatic period. This one ends with a troubled question mark.
We heard some fabulous news last week. Scientists in Ohio reported success in using gene therapy to treat newborns with a horrific disease called “spinal muscular atrophy,” that essentially turns them into jelly before they die, normally within twenty months. I attended a funeral for a baby like this a number of years ago—one of the saddest things I’ve ever seen. But now scientists have figured out how to use a benign virus to carry a better version of a defective gene to the right spot in the body so it can start cranking out more of the right kind of muscle-control protein. The results are “very striking” according to one neutral expert. All of the infants tested are still alive after more than two years—a feat in itself—and several of them are speaking, swallowing, and even rolling over.
Can you beat that? Actually, someone can. Scientists at Sun Yat-sen University in China have demonstrated how to fix a gene in a human embryo, long before a baby is even born. Victims of the blood disorder called beta-thalassemia need repeated blood transfusions and specialist care for their entire lives to deal with their heart problems, lung problems, and weak and misshapen bones—all because of a single error in one of the three billion “letters” that make up our genetic code. Now researchers have been able to go into the embryo and essentially correct the typo, to prevent that particular problem from ever arising.
This has only been done in a lab. No such “edited” embryo has yet been used to produce a human baby. The editing process itself may cause other problems no one understands yet. Still, it appears that beta-thalassemia may someday join smallpox on the list of diseases we don’t have to think about anymore.
Now let’s darken the picture a bit. CBS News reported last summer that if you live in Iceland, the list of vanishing conditions now includes Down Syndrome. Not because anyone invented a pill, or a post-birth gene therapy, or a pre-birth gene edit, but by the simpler expedient of prenatal testing and then aborting fetuses likely to have the condition. The trend is even stronger in Denmark.
I am not an expert on Down Syndrome. I don’t want to become one. I do know, at least a little bit, one fellow in his forties who has it, from visiting with him and his family at holiday gatherings over the years. There’s an awful lot I don’t know about this guy, but I have to tell you, he and his family don’t strike me as being particularly miserable. They seem downright normal, other than the surface expression of the condition itself. When I consider the question, “Would it have been ok to kill this guy off in the womb just because he turned out like this?” my needle tilts toward no. That may put me in a minority, but so does being a humanist.
Not every choice should be regulated by law. Filling jails with women and/or their doctors who chose to abort a Down Syndrome fetus—as recent laws enacted in Indiana and North Dakota seek to do—is not a good idea. But not everything that’s legal is necessarily moral or good.
If I haven’t raised your worry antennae yet, try this one: What about fetuses that will grow up to be gay? Gay people insist they are “born this way,” and I don’t doubt them. If that’s true, there is probably a gene or set of genes that’s associated with it. Rightly or wrongly, scientists are busy looking for this gene, and my money says they’re going to find it—or some other effective prediction tool. (It’s possible they already have.) Once they find it, the whole panoply of gene editing, gene therapy, and abortion options will come into play. Whatever the proportion of same-sex attracted people there is in the population now, it’s likely to shrink once prenatal testing for it kicks in.
Which condition is likelier to induce torment: Down Syndrome or same-sex attraction? There’s a question for some bright young psychology PhD candidate to research. Certainly, being gay in a straight world creates a lot of anguish. There wouldn’t be a need for an “It Gets Better” project if it didn’t. Why subject your child to that if you don’t have to?
Another status that millions of people believe justifies abortion is the curse of being female. China is notorious for a female abortion rate high enough to throw its whole population balance out of whack, but sex-selective abortion is happening more and more in Europe and the US as well. Tammy Wynette sang, “It’s hard to be a woman.” Why subject your child to that if you don’t have to?
Let’s twist the worry ratchet one more time. Abortion can be traumatic, especially for a woman who wanted to have a healthy, so-called “normal” child in the first place. Gene editing and gene therapy options are barely off the ground yet and probably have quite a few years of polishing to go before they’re ready for prime time. But there’s another tool in the kit that’s available, right now, and is already being used.
The in vitro fertilization process produces lots of embryos, only one of which gets implanted and, with a little luck, produces a baby. Say there are twenty embryos to choose from. The doctor tells you: “Well, #4 probably has Down Syndrome, and #9 is probably gay. You definitely don’t want the blood disorder you’ll get in #16. Then there’s … etc., etc. … all of which leaves you with six excellent candidates for a healthy, normal child—two of them boys!”
Do you consciously choose, or do you flip a coin? “Why didn’t your mother fix you when she could have?” will be an interesting playground taunt for gay and other “abnormal” kids to respond to.
According to the MIT Technology Review, a publication not known for outlandish claims, we’re inches away from a world where we can predict which little embryos will become smart, athletic, attractive children, if you spend enough money. A whole world of Ivanka Trumps. Is this a good thing?
Back when I followed the NFL, I used to start every Monday morning with Peter King’s “Ten Things I Think I Think” column. I liked both the writing and the title. Here are a few of mine:
I think I think that the research on gene editing and gene therapy to cure disease is fantastic, even though the Catholic Church disagrees.
Islam has an interesting five-part hierarchy of desirability for different actions, translated loosely as “compulsory,” “desirable,” “neutral,” “disliked,” and “forbidden.” I think I think that aborting fetuses because they will probably develop conditions like Down Syndrome, same-sex attraction, or a uterus belongs in the “dislike” box.
I think I think that if the proportion of gay or Down Syndrome people drops in society, the level of toleration for those who remain may drop as well, in the kind of feedback loop that makes microphones hurt your ears.
I think I think that gene editing, gene therapy, or IVF selection to produce a similar result belongs in the same “dislike” category. I clock in at a 50.01% level of certainty on this one.
Quite a bit higher on the certainty level, I think I think that no one really cares what I think, and that a great many women are going to do this anyway—not just for Down Syndrome and same-sex attraction but for whatever else the gene-scanners tell them they can select for.
I think I think that trying to stop the development of these technologies would have as much success as King Canute trying to stop the tide. Even if US laws tried to shut the research down, it would flourish elsewhere.
I think I think that baby-design is going to be far more readily available for rich people than for the rest of us. The story goes that F. Scott Fitzgerald once remarked, “The rich are different from you and me,” and Ernest Hemingway replied, “Yes, they have more money.” Our baby-design future will start to make the rich different in far more profound ways than that. The notion in ages past that the upper class deserved its privileges because of its “noble blood” has been largely discredited for the last century or so. I think I think it may come roaring back. And I’m short on good ideas about how to deal with it. Raising my taxes so that everyone can afford the same baby-designing that rich people can is definitely not on my list. What’s on yours?