What's the difference between using erythropoietin—a biosynthetically produced hormone that stimulates the production of red blood cells—and training at high altitude, which also can increase the concentration of circulating red blood cells? This is an important criticism. The answer is not a simple one. The criticism conflates two things. First, we must acknowledge that it can be difficult sometimes to know, precisely, where to draw the line between what is permissible and what is not.
The criticism errs when it collapses this often difficult task of line-drawing into the much more radical conceptual claim there are no differences to be noted, no distinctions worth making at all. Yes, drawing lines can be a difficult and imperfect enterprise at best.
Where we draw the line and on what grounds we draw it will be very important choices—ones that must be well defended. But we cannot escape the task of drawing lines as best we can.
We can, I hope, see the difference between the two and the practical need to draw a line somewhere between them. There is a difference worth noting. A second criticism of any effort at drug control in sport is that enforcing a prohibition against performance-enhancing drugs is very difficult, if not impossible, without intruding on the privacy of the athletes.
The current schemes of drug control, at least the effective ones, do exact a price. Athletes must provide samples of urine—usually while being observed—or blood, or both. To discourage the use of performance-enhancing drugs that are taken during training rather than just before competing, no-advance-notice testing programs have been established.
These programs require knowing where the athlete is at all times—another intrusion on privacy. Perhaps the best defense of such invasions of privacy is that the great majority of athletes welcome them as the most effective methods to ensure that their opponents are not cheating. More recently, commentators have emphasized the possibility of genetic manipulation to enhance performance in sport.
Direct genetic manipulation in this sense is altering a person's genes via gene transfer or the like. Although gene transfer research directed at therapy has experienced some dramatic recent successes, the use of similar techniques to enhance athletic performance remains in the future—perhaps not as far into the future as we might have thought until very recently, but in the future nonetheless.
Gene transfer is not a widely available, well-understood, safe technology. Indirect genetic manipulation, on the other hand, has been in use for a good 15 years or more, ever since biosynthetic hGH was first made available. By indirect genetic manipulation, I mean using the fruits of genetic knowledge to manipulate human physiology or anatomy.
In the case of hGH, scientists were able to identify the gene that specifies hGH, clone it, and put it into a cellular production system to produce as much growth hormone as was wanted or could be sold. Indirect genetic manipulation will become increasingly available in the future. Biosynthetic hGH marks one of the first attempts at indirect genetic manipulation. The evidence we now have suggests that injecting hGH in physiologically normal amounts may accelerate the growth rate of a child who makes endogenous hGH with normal activity and within the normal quantitative range, but will not increase the final height such children reach.
In other words, it will not enhance height. That fact, however, was not known when biosynthetic hGH first became available. Parents have tried to use growth hormone to make their otherwise normal children taller.
There is nothing intrinsically wrong with parents seeking advantages for their children. However, heightism, like ageism, sexism, or racism, involves treating people differently as a function of an attribute that is irrelevant to the judgment in question. Whether a person is taller or shorter should make no difference as to what you would think of the quality of his or her writing, speaking, or teaching; it has nothing whatsoever to do with his or her worth as a human being.
Yet there is some evidence indicating that being taller in the United States confers certain advantages. For the record, I am about 5 feet 11 inches tall. I should note when I wrote about this many years ago for a magazine that was owned by the Time-Life Corporation, the editor, who liked the article very much, called me to say he had a problem.
His boss, the publisher, was very short. Obviously, he is good enough at what he does that he has overcome the heightism that otherwise would have been an obstacle to his success. As the magazine was paying me by the word, of course I agreed. What might have happened if hGH did increase the height of otherwise normal, healthy children?
Two scenarios are worth considering. In this scheme, hGH would be available to those who wished to purchase it for their children and who could afford it.
This last point is not trivial, as a course of hGH can last for years and cost tens of thousands of dollars. What would be the result of leaving hGH-mediated height enhancement to the market? Simply put, instead of a culture roughly divided into the poorer and less well-educated on the one hand, and the wealthy well-educated on the other, we would now have the poorly educated short and the wealthy well-educated tall.
We would have added one additional, very visible form of inequality onto other, somewhat less visible forms of inequality. I believe that is a very disturbing scenario to anyone committed to social justice and equal opportunity.
In that scenario, we make growth hormone available to everyone: Every child in the United States gets all the growth hormone they or more accurately, their parents want. Who benefits from the egalitarian scenario? Not the children, certainly. Every child would be taller, but still some people would be taller than others.
If anything, differences in height might be treated as even more significant than they now are. After all, we would be spending enormous sums to make children taller, so height must be crucially important, right? In this scenario children don't benefit; parents don't benefit. Instead, the benefits go to people who own stock in the companies that make growth hormone and, perhaps, to those who manufacture fabric, because we'll all need to wear clothing in larger sizes.
Society would not be better off. We would simply have wasted enormous social resources for no good end whatsoever. Neither the market nor the egalitarian scenarios are at all appealing. The overall impact of one or the other would be to reinforce heightism. These scenarios would also reinforce the idea that we should pursue technological solutions to address the problems of social inequality and prejudice, rather than attacking those problems at their roots.
Fortunately, we've been saved from this predicament because of studies that show that growth hormone does not affect the final, adult height of children who make normal growth hormone. But we will not always be so fortunate. Another possible challenge may come from cognitive-enhancing drugs. The caffeine in a person's morning coffee or tea can enhance alertness and, hence, one's cognitive abilities.
The concept, then, of a cognitive-enhancing drug is not new. But more highly tailored pharmaceuticals, designed to improve one or more domains of cognitive function, are coming along. The first one available in the United States, known as Tacrine or Cognex, was marketed as a drug to help ameliorate the symptoms of Alzheimer-type dementia.
Its effects are quite modest at best, and it does not work in all persons with Alzheimer's. But for some people with dementia, it may slow the progression of symptoms. Other compounds are in the drug development pipeline. Some of these may be more effective than Cognex; some may target other aspects of cognitive functioning.
One or more of these drugs may improve cognitive functioning in persons whose cognitive abilities are not impaired—and would be considered, therefore, an enhancement. What would be the impact of widely available cognitive-enhancing drugs? Imagine a law firm that hires 10 new young lawyers. Could it be morally defensible or even morally required? Karpin, I. Choosing disability: preimplantation genetic diagnosis and negative enhancement. Kendal, E. The perfect womb: promoting equality of Fetal opportunity.
Kim, N. Gene-editing: interpretation of current law and legal policy. Kirk, E. Embryo selection for complex traits is impracticable. BMJ , Krutzinna, J. Beyond an open future: cognitive enhancement and the welfare of children.
Ethics 26 2 , — Levine, S. Stem Cell Res. Liao, S. Designing humans: a human rights approach. Bioethics 33 1 , 98— Lock, M. An Anthropology of Biomedicine. Lyon, J. Bioethics panels open door slightly to germline gene. JAMA 17 , — MacKay, C. Ethics 6 1 , — Mackenzie, R. Reprogenetics and pharmacogenetics: in whose best interests?
Law 24 2 , — Macpherson, I. Commentary: grand challenge: ELSI in a changing global environment. Malek, J. Deciding against disability: does the use of reproductive genetic technologies express disvalue for people with disabilities? Ethics 36 4 , — Malmqvist, E. Mameli, M. Reproductive cloning, genetic engineering and the autonomy of the child: the moral agent and the open future.
Ethics 33, 87— Marden, E. Displaced agendas: current regulatory strategies for germline gene therapy. McGill Law J. Mason, P. Personal genomic testing, genetic inheritance, and uncertainty. Massmann, A. Studies in Christian Ethics.
McKanna, T. Gene doping: the hype and the harm. Mehlman, M. Wondergenes: Genetic enhancement and the future of society.
Bloomington, Indiana: Indiana University Press. Genetic enhancement: plan now to act later. The Price of Perfection. Individualism and Society in the Era of Biomedical Enhancement. Millum, J. Munsie, M. Ethical issues in human organoid and gastruloid research. Development , — Murphy, T.
Genetic modifications for personal enhancement: a defence. Neil, D. Skene, L. Newman, S. Averting the clone age: prospects and perils of human developmental manipulation. Health Law Policy. Braverman, I. London: Routledge , — Nicholson, S. Ethical and regulatory issues in gene therapy. Niklas, K. Rethinking gene regulatory networks in light of alternative splicing, intrinsically disordered protein domains, and post-translational modifications. Nordberg, A. Nunes, R.
Deafness, genetics and dysgenics. Human dignity and the creation of human—nonhuman chimeras. Multiplex parenting: IVG and the generations to come. Ethical aspects of creating human-nonhuman chimeras capable of human gamete production and human pregnancy.
Pattinson, S. Regulating germ-line gene therapy to avoid sliding down the slippery slope. Law Int. Pergament, E. Preimplantation genetics: a case for prospective action. Persson, I. Could it be permissible to prevent the existence of morally enhanced people? Ethics 38 11 , — Polkinghorne, J. The person, the soul, and genetic engineering. Powell, R. Evolution, genetic engineering, and human enhancement. Philosophy and Technology 25 4 , — Qiu, R. Debating ethical issues in genome editing technology.
Asian Bioeth. Reagan, J. Taming our brave new world. Regalado, A. Retrieved November 25, Resnik, D. Debunking the slippery slope argument against human germ-line gene therapy. Genetic modification and genetic determinism.
Ethics Humanit. Richter, G. Interventions in the human genome: some moral and ethical considerations. Rippe, K. The idea of precaution: ethical requirements for the regulation of new biotechnologies in the environmental field. Plant Sci. Roache, R. Clarke, S. Ethics 42 12 , — Robert, J. Crossing species boundaries. Roberts, J. Customizing conception: a survey of preimplantation genetic diagnosis and the resulting social, ethical, and legal dilemmas.
Duke Law Technol. Robertson, J. Liberty, identity, and human cloning. Law Rev. Rodriguez, E. Roduit, J. Human enhancement and perfection. Ethics 39 10 , — Rose, N. Biological citizenship, in Global assemblages: Technology, politics and ethics as anthropological problems. Ong, A. Malden, MA: Blackwell , — Rosoff, P.
Ethics 37 10 , — Rubenstein, D. Germ-line therapy to cure mitochondrial disease: protocol and ethics of in vitro ovum nuclear transplantation. Ethics 4 3 , — Saunders, B. Is procreative beneficence obligatory? Ethics 41 2 , — Savulescu, J. Why genetic testing for genes for criminality is morally required. Human—animal transgenesis and chimeras might be an expression of our humanity. Behavioural genetics: Why eugenic selection is preferable to enhancement. Oxford: Wiley-Blackwell , 3— Schenker, J.
Report of the FIGO committee for the study of ethical aspects of human reproduction. Scott, R. Germline genetic modification and identity: the mitochondrial and nuclear genomes. Oxford Journal of Legal Studies 37 4 , — Scully, J. Selgelid, M. Moderate eugenics and human enhancement. Shakespeare, T. Policy 37 1 , 22— Shapiro, M. The identity of identity: moral and legal aspects of technological self-transformation.
Social Philosophy and Policy 22 2 , — Shapshay, S. Procreative liberty, enhancement and commodification in the human cloning debate. Slatman, J. Sex and enhancement: a phenomenological—existential view. Smith, K. Human germline genetic modification: scientific and bioethical perspectives. Smolin, D. All rights reserved. DMCA and other copyright information. For website information, contact the Office of Communications.
Contact the MU School of Medicine. Informational Alert Close. Learn how to schedule an appointment for vaccination or testing. Read More. Education Research Patient Care. Student Resources Faculty Resources. More Search. Can't find what you're looking for? Pages No Results. Center for Health Ethics. Section Menu. Confusing Terminology If genetic engineering is meant in a very broad sense to include any intentional genetic alteration, then it includes gene therapy. Somatic Cells and Reproductive Cells Two fundamental kinds of cell are somatic cells and reproductive cells.
Techniques of Genetic Alteration Two problems must be confronted when changing genes. Arguments in Favor of Gene Therapy and Genetic Engineering Gene therapy is often viewed as morally unobjectionable, though caution is urged.
Arguments Against Genetic Engineering Ethicists have generally been even more concerned about possible problems with and implications of enhancement genetic engineering than they have been about gene therapy.
Following are some other important objections: Genetic engineering is against the natural or supernatural order. The thought here is that God, or evolution, has created a set of genes for human beings that are either what we should have or that offer us the best survival value.
It is against what God or nature intended to tinker with this genetic code, not to bring it up to normal as in gene therapy , but to create new kinds of beings. Genetic engineering is dehumanizing because it will create nonhuman, alienated creatures. Genetically engineered people will be alienated from themselves, or feel a confused identify, or no longer feel human, or the human race will feel alienated from itself.
People will be alienated even from their radically different genetically engineered children, who could very well be a separate species. Genetic engineered creatures will suffer from obsolescence. However, there are also important debates about the extent to which prenatal screening programmes prejudge the value of disabled people's lives. Genetic research into more complex conditions - such as heart disease - can sometimes help to find clues about the biological mechanisms underlying such diseases.
But genetic research has not delivered the much-promised 'genetic revolution' in health - the prediction and prevention of common diseases in most people - or an explanation of intelligence, criminality, heart disease or schizophrenia. What more and more research has shown is that the underlying assumptions of eugenics - that some people are born genetically superior to others - are simply wrong.
For example, the growing global epidemic of obesity is caused by overeating and lack of exercise, not by an increase in 'genes for obesity'. Of more than obesity genes that have been identified, only a handful have been relevant to just a small number of families with children who are unusually obese. This relative unimportance of genetic factors limits the potential of human genetic engineering to improve our quality of life.
Even for those relatively rare conditions known as genetic disorders, the genetic mutation does not determine a person's quality of life or their other attributes and value as a human being. Genetic research can sometimes help to find new treatments for disease, and today's experimental gene therapy known as 'somatic gene therapy' may one day become safe enough to treat some people with serious conditions - but this is not the same as altering the genetic make-up that an individual passes on to their children and their grandchildren.
Changing genetic make-up known as 'germline gene therapy' would involve enormous risks, experimenting on mothers and unborn babies, and would have unpredictable biological consequences which are passed to future generations.
As most conditions are affected by many complex interactions between our biology and our environment, there is also likely to be little benefit to this approach. Genetic enhancement is a dangerous fantasy, which distracts us from the real issues affecting our quality of life. According to the United Nations, poverty is still the world's biggest killer.
0コメント