Medical Sociology and the Issue of Designer Babies

Many reproductive possibilities are exponentially increasing due to recent advances in genetics. In the United States, prenatal testing and screening are used as a routine regime; therefore, broadening the world of general obstetrics and leaving the tapering confines of genetics. As biotechnology and genomics have gained more prominence in public discourse, inevitable concerns have been raised about the implications of reproductive advancements. Techniques such as invitro fertilization – allow embryos to be tested through preimplantation genetics in order to detect genetic defects and gene therapy – used in the treating of diseases, present tremendous opportunities to address human disease. Future advancements of biotechnology and the uncertainty it holds regarding implementing gene therapy in cloning, producing artificial animals, human cloning, and genetic enhancements, such as in the case of “designer babies” have given rise to many ethical questions. In this research paper I will explore to what extent is it ethical to improve the human genome, and whether society should allow couples to produce “designer babies”.

Many have condemned the widely accepted biotechnological research in the form of scientific experiments and theoretical practices in reproductive genetics. Research in this area have even been viewed by some as a form of eugenics. It is believed that Gene transfer may open the door to positive eugenics, where the focus would be on improving births rather than preventing undesirable births. Theoretically, the technology could be used to enhance certain desirable qualities-not merely to treat disease. At the extreme, the distinction between treatment and enhancement can be easily blurred. The former aims to eradicate disease, such as to provide a genome editing to prevent a child from inheriting a form of immune deficiency.

The genetic modification of babies, “designer babies” have been an ongoing debate of ethical and moral values and it is important that there are more benefits than detriment before invoking this idea into society. A designer baby refers to a baby whose genetic makeup has been artificially selected by genetic engineering combined with in vitro fertilization to ensure the presence or absence of certain genes or characteristics. Robert Nozick’s, “Anarchy, State, and Utopia”, contended that the government should not have the ability to interfere with market forces matters because it could have a devasting impact on procreation (Nozick, 1974). Some believe that striving to alter the human genome is in violation of human freedom engendering a path leading to political, social, and biological peril. Others, however, proclaimed that the government should create regulations to preserve and consider certain values, including the overall welfare of unborn babies and social justice. Considerable research has been done to gain a better understanding of both the ethics and overall future benefit to society of creating designer babies.

The procedure for the creation of designer babies via genome editing involves the use of the CAS-9 CRISPR system. This system allows the Cas9 enzyme to cut the DNA double helix. A guide-RNA then directs Cas9 to specific sites in the genome. If a cut is made in a gene, DNA repair machinery in the cell silences the gene. The main advantage of this technology is that it can be guided to very specific genetic sequences and ignore other sequences that are not meant to be targeted.  By introducing a new DNA fragment with the Cas9-gRNA complex, the DNA repair machinery repairs the DNA by incorporating the new DNA where the cut was made. This way a specific mutation can be introduced into a gene, or a mutated gene can be replaced with a healthy one, or an entirely new gene can even be introduced into the cell DNA. Essentially, CRISPR-Cas9 allows scientists to manipulate cell DNA in an infinite number of ways (Khan & Hayat, 2019). Many scientist and geneticist agree that it is fallacious to “create” a child. It is believed that this act can create further social woes as related to social bias, superiority, discrimination, standardization of beauty and the inevitable distinction between perfection and imperfection (Baylis, 2019).

According to Baylis, genetic modification and genetic determinism can be fundamentally explained as “gene G” almost always leads to the development of “trait T”. (G increases the probability of T and the probability of T, given G, is 95% or greater)”. This can also loosely be viewed as “genes (genotypes) cause traits (phenotypes)” (2019). Genetic determinism is aberrant because traits are generally moderately or weakly determined by genetics. For example, diseases that in theory would be easiest to prevent—those caused by only a single genetic mutation—affect relatively few people, therefore, many of the reproductive technologies developed, will overcome many of the barriers that currently prevent some people from choosing to select against disease.

One technique, which is still in the experimental stages, is to analyze fetal cells that have been isolated from maternal blood. This form of prenatal testing eliminates the risks of complications associated with amniocentesis and CVS and may therefore make prenatal testing more desirable to some. However, it does not overcome the difficult reality that most prenatally diagnosed diseases cannot be treated, but only prevented through pregnancy termination. Another option available to couples who want to select against disease, but do not want to terminate a pregnancy, is “preimplantation genetic diagnosis (PGD) of embryos created through in vitro fertilization (IVF) In time, we are likely to learn about genes associated with, if not determinative of, various traits and behaviors”(Ly, 2011). Not only will we have knowledge about the genetics of more diseases and traits, but our capacity to genetically analyze biological samples (whether from amniotic fluid, maternal serum, or IVF embryos) will exponentially increase. The technological imperative to learn as much as possible about our future children with respect to disease, and genetic traits, may similarly increase. Soon, DNA chips and next-generation technologies will allow for the analysis of thousands of genetic variants, gene therapy, or transfer, may also create pressures toward neo-eugenics. However, despite their initial optimism, scientists have been disappointed at how little gene transfer has progressed since the 1990s.

Many common conditions such as heart disease, Alzheimer’s disease, schizophrenia—are polygenic. Height alone is influenced by at least 400 genes. How these genes interact with one another or influence other traits is still not fully understood, as is the relationship between genes and the environment. The notion of Genetic determinism of designer babies allow people to presume that society is a fragile interwoven web of many deciding factors adjudging what is normal and abnormal based on an abundance of factors that influences what is considered abnormalities (Sutter, 2007). Norms are expected ways of behaving in a society according to the majority. “Functionalism interprets each part of society in terms of how it contributes to the stability of the whole society” (Catalano, 2019). Society is more than the sum of its parts; rather, each part of society is functional for the stability of the whole.

The French sociologist, Emile Durkheim, was especially interested in how social order is possible or how society remains relatively stable. Durkheim theorized that it is the macro-level of social structure, rather than the micro-level that creates the stability of everyday life. He envisioned society as an organism, and just like within an organism, each component plays a necessary part, but none can function alone. If one-part experiences a crisis or fails, other parts must adapt to fill the void in some way. The social argument against designer babies is that if this technology becomes a possibility soon it would cause disunity between those that can afford the service and those that cannot (Begley, 2016). Each social group experiences health and illness differently. Health tends to dynamically correlate with social status. Social epidemiology is the distribution of disease based on social rather than biological factors and these forces affect the likelihood of health and illness, patient personal experiences of illness, health care providers, and the entire health care system. The genetic engineering of designer babies is ultimately expected to upset the delicate balance of these symbiotic societal relationships.

Moreover, Begley believe that the wealthy would have the greatest advantage. This belief is due to wealthiest individuals’ ability to afford the selection of the most desirable traits in their offspring, while those of lower socioeconomic status would not be able to access the same options. As a result, economic divisions may grow into genetic divisions, with social distinctions ultimately becoming delineated, according to STAT-Harvard telephone poll of 1,000 US adults conducted January 13 – 17, 2016 that addressed the ethical, social, and legal implications of genome editing. This depicted that many people who participated in the poll did not agree with the alteration of physical and athletic attributes, appearance, intelligence, or even the changing of genes to reduce the risk of developing genetically inherited diseases in newborn babies.

The STAT-Harvard poll had a series of 10 questions. However, in evaluating three relative questions out of 10, it is quite clear how strongly the study subjects viewed genetic engineering. The first question of the poll asked, “Do you think the federal government should fund scientific research on changing the genes of unborn babies that aim to improve their characteristics such as intelligence physical traits such as athletic ability or appearance?” 14% said yes, 82% said no, and 4% said they don’t know. The next question states, “Do you think that changing the genes of unborn babies to improve their intelligence or physical characteristics should be legal?” 11% said yes, 83% said no, and 6% don’t know. The last question asked, “Do you think that changing the genes of unborn babies to reduce their risk of developing certain serious diseases should be legal?” 26% said yes, 65% said no, and 9% don’t know. Based on the survey responses, the trend of this statistical data is that most people do not agree with the alteration of genes of unborn babies. enhanced individuals from unenhanced individuals. 

Overall, I believe that the future of designer babies is immanently near. The conversation of biotechnology, genetic engineering, and designer babies will be an ongoing debate as technology advancements continue to emerge. There will always be differences in opinion concerning what should and should not be allowed and what is and is not ethical. Genetic modification can be dangerous if not used ethically for earnest and noble intents. It is imperative that the decision on whether to allow genetic modification results in the correct utilization of it, such as fighting disease and curing disabilities. The technology to create a better society is within reach, but the question remains if we are using these resources for the right things. Traditional eugenics was an effort to select parents in order to improve population through selective breeding and birth control. Modern eugenics is an effort to selectively, “design” children. As a society, in making this critical decision, we must continue to improve our understanding of the scientific consequences and ethical aspects of genetic engineering. The platforms for these technologies are improving every day, with a plethora of new data appearing due to technology miniaturization and automation and newer discoveries to improve the yield and specificity of an edited product. Alongside the developmental improvement in genome-wide engineering the regulatory work-up, standardization protocols need to be devised to reduce inter and intra-method imprecision, defining the indications and contraindications of every technique to help improve the concept of personalized medicine.

Works Cited

• Begley, Sharon. “STAT-Harvard poll: Americans say no to ‘designer babies.” Feb. 2016, www.statnews.com/2016/02/11/stat-harvard-poll-gene-editing/. Accessed 12 April 2019.
• Catalano, Michael. “The Prospect of Designer Babies: Is it Inevitable?” Pit Journal, 2012, www.pitjournal.unc.edu/article/prospect-designer-babies-it-inevitable.hmtl. Accessed 14 April 2019.
• Baylis F, Robert JS. “The inevitability of genetic enhancement technologies”. NCBI, 2004, https://www.ncbi.nlm.nih.gov/pubmed/15168695/. Accessed 24 April 2019
• Nozick, R. (1974). Anarchy, state, and utopia. New York: Basic Books.
• Suter, Sonia M. “A Brave New World of Designer Babies.” Berkeley Technology Law Journal, Mar. 2007, www.scholarship.law.berkeley.edu/cgi/viewcontent.cgi?article=1704&context=btlj. Accessed 1 May 2019.
• Ly, Sarah. “Ethics of Designer Babies”. The Embryo Project Encyclopedia, 2011, https://embryo.asu.edu/pages/ethics-designer-babies. Accessed May 1 2019
• Khan, Sikandar Hayat. “Genome-Editing Technologies: Concept, Pros, and Cons of Various Genome-Editing Techniques and Bioethical Concerns for Clinical Application”, NCBI, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454098/. Accessed 20 April 2019