Breakthroughs in genetics present us with a promise and a predicament. The promise is that we may soon be able to treat and prevent a host of debilitating diseases. The predicament is that our newfound genetic knowledge may also enable us to manipulate our own nature—to enhance our muscles, memories, and moods; to choose the sex, height, and other genetic traits of our children; to make ourselves "better than well." When science moves faster than moral understanding, as it does today, men and women struggle to articulate their unease. In liberal societies they reach first for the language of autonomy, fairness, and individual rights. But this part of our moral vocabulary is ill equipped to address the hardest questions posed by genetic engineering. The genomic revolution has induced a kind of moral vertigo.
Consider cloning. The birth of Dolly the cloned sheep, in 1997, brought a torrent of concern about the prospect of cloned human beings. There are good medical reasons to worry. Most scientists agree that cloning is unsafe, likely to produce offspring with serious abnormalities. (Dolly recently died a premature death.) But suppose technology improved to the point where clones were at no greater risk than naturally conceived offspring. Would human cloning still be objectionable? Should our hesitation be moral as well as medical? What, exactly, is wrong with creating a child who is a genetic twin of one parent, or of an older sibling who has tragically died—or, for that matter, of an admired scientist, sports star, or celebrity?
Some say cloning is wrong because it violates the right to autonomy: by choosing a child's genetic makeup in advance, parents deny the child's right to an open future. A similar objection can be raised against any form of bioengineering that allows parents to select or reject genetic characteristics. According to this argument, genetic enhancements for musical talent, say, or athletic prowess, would point children toward particular choices, and so designer children would never be fully free.
At first glance the autonomy argument seems to capture what is troubling about human cloning and other forms of genetic engineering. It is not persuasive, for two reasons. First, it wrongly implies that absent a designing parent, children are free to choose their characteristics for themselves. But none of us chooses his genetic inheritance. The alternative to a cloned or genetically enhanced child is not one whose future is unbound by particular talents but one at the mercy of the genetic lottery.
Second, even if a concern for autonomy explains some of our worries about made-to-order children, it cannot explain our moral hesitation about people who seek genetic remedies or enhancements for themselves. Gene therapy on somatic (that is, nonreproductive) cells, such as muscle cells and brain cells, repairs or replaces defective genes. The moral quandary arises when people use such therapy not to cure a disease but to reach beyond health, to enhance their physical or cognitive capacities, to lift themselves above the norm.
Like cosmetic surgery, genetic enhancement employs medical means for nonmedical ends—ends unrelated to curing or preventing disease or repairing injury. But unlike cosmetic surgery, genetic enhancement is more than skin-deep. If we are ambivalent about surgery or Botox injections for sagging chins and furrowed brows, we are all the more troubled by genetic engineering for stronger bodies, sharper memories, greater intelligence, and happier moods. The question is whether we are right to be troubled, and if so, on what grounds.
In order to grapple with the ethics of enhancement, we need to confront questions largely lost from view—questions about the moral status of nature, and about the proper stance of human beings toward the given world. Since these questions verge on theology, modern philosophers and political theorists tend to shrink from them. But our new powers of biotechnology make them unavoidable. To see why this is so, consider four examples already on the horizon: muscle enhancement, memory enhancement, growth-hormone treatment, and reproductive technologies that enable parents to choose the sex and some genetic traits of their children. In each case what began as an attempt to treat a disease or prevent a genetic disorder now beckons as an instrument of improvement and consumer choice.
Muscles. Everyone would welcome a gene therapy to alleviate muscular dystrophy and to reverse the debilitating muscle loss that comes with old age. But what if the same therapy were used to improve athletic performance? Researchers have developed a synthetic gene that, when injected into the muscle cells of mice, prevents and even reverses natural muscle deterioration. The gene not only repairs wasted or injured muscles but also strengthens healthy ones. This success bodes well for human applications. H. Lee Sweeney, of the University of Pennsylvania, who leads the research, hopes his discovery will cure the immobility that afflicts the elderly. But Sweeney's bulked-up mice have already attracted the attention of athletes seeking a competitive edge. Although the therapy is not yet approved for human use, the prospect of genetically enhanced weight lifters, home-run sluggers, linebackers, and sprinters is easy to imagine. The widespread use of steroids and other performance-improving drugs in professional sports suggests that many athletes will be eager to avail themselves of genetic enhancement.
Suppose for the sake of argument that muscle-enhancing gene therapy, unlike steroids, turned out to be safe—or at least no riskier than a rigorous weight-training regimen. Would there be a reason to ban its use in sports? There is something unsettling about the image of genetically altered athletes lifting SUVs or hitting 650-foot home runs or running a three-minute mile. But what, exactly, is troubling about it? Is it simply that we find such superhuman spectacles too bizarre to contemplate? Or does our unease point to something of ethical significance?
It might be argued that a genetically enhanced athlete, like a drug-enhanced athlete, would have an unfair advantage over his unenhanced competitors. But the fairness argument against enhancement has a fatal flaw: it has always been the case that some athletes are better endowed genetically than others, and yet we do not consider this to undermine the fairness of competitive sports. From the standpoint of fairness, enhanced genetic differences would be no worse than natural ones, assuming they were safe and made available to all. If genetic enhancement in sports is morally objectionable, it must be for reasons other than fairness.
Memory. Genetic enhancement is possible for brains as well as brawn. In the mid-1990s scientists managed to manipulate a memory-linked gene in fruit flies, creating flies with photographic memories. More recently researchers have produced smart mice by inserting extra copies of a memory-related gene into mouse embryos. The altered mice learn more quickly and remember things longer than normal mice. The extra copies were programmed to remain active even in old age, and the improvement was passed on to offspring.
Human memory is more complicated, but biotech companies, including Memory Pharmaceuticals, are in hot pursuit of memory-enhancing drugs, or "cognition enhancers," for human beings. The obvious market for such drugs consists of those who suffer from Alzheimer's and other serious memory disorders. The companies also have their sights on a bigger market: the 81 million Americans over fifty, who are beginning to encounter the memory loss that comes naturally with age. A drug that reversed age-related memory loss would be a bonanza for the pharmaceutical industry: a Viagra for the brain. Such use would straddle the line between remedy and enhancement. Unlike a treatment for Alzheimer's, it would cure no disease; but insofar as it restored capacities a person once possessed, it would have a remedial aspect. It could also have purely nonmedical uses: for example, by a lawyer cramming to memorize facts for an upcoming trial, or by a business executive eager to learn Mandarin on the eve of his departure for Shanghai.