The case for genetic augmentation of humans

A few days ago the world was informed of the birth of the first children who were .genetically engineered through the use of CRISPR/Cas9 technology. This has proven to be very controversial. People are very upset about it, including a lot of scientists involved in genetic engineering. They tend to phrase their offense in terms that exclude the responsibility of the technology they themselves helped introduce. HIV/AIDS they say, is easy to prevent or treat with medication.

Another argument made by prominent scientists is that CRISP/Cas9 makes a lot of off-target mutations. In other words, you might make a child immune to AIDS, but the child will have random damage to its genome. This idea seems primarily based on a retracted paper made by scientists who didn’t realize that every generation of new mice will be born with new genetic mutations.  This whole incident shows to me how science isn’t genuinely value neutral. We have a horror scenario in our head of “designer babies”, because it violates an ideal we hold sacred, the ideal of equality. When we take a step towards the horror scenario, excuses are sought that suggest the measures taken are not a logical outgrowth of the previously introduced technology.

The response we see today reminds me of the drama surrounding IVF when it was first introduced. IVF is a logical outgrowth of microbiology. If you understand how to isolate and nurture human cells outside of the human body, it’s logical that humans will seek to use that knowledge for their own benefit. When the procedure was first introduced, we thought of IVF as a method to help couples suffering infertility problems. Today of course it’s also a method used by fifty year old Hollywood actresses who want to wait with having children until their career is over. This is a logical self-evident outgrowth of the technique as it was originally introduced.

The world we live in today is governed by 195 different countries, a number that seems to increase rather than decrease as a consequence of decolonization. Even if Western governments agreed tomorrow that certain medical procedures are morally unacceptable, it would be relatively easy to find radically different cultures in different nations that have no such concerns. Scientists willing to perform procedures for people that most scientists consider taboo are not just rewarded with infamy, they’re likely to be rewarded with huge sums of money.

I’ve seen it argued that ethics should prohibit scientists from giving birth to genetically engineered children. However, if we expect certain things to be avoided by appeals to ethics, please consider a few examples of ethically dubious procedures happening today:

Here we see Martina Big, the woman with the largest breast implants in Europe. She has started injecting substances that darken her skin and now proclaims to be a black woman. She also went to America, to receive butt implants that match the size of her breast implants. Apparently she is capable of finding doctors who don’t fear violating medical ethics.

Here we see Rajo Devi Lohan, a woman who gave birth to her first child at age 70 after undergoing IVF treatment. They took an egg from another woman and injected the husband’s sperm into it, as his old age prohibited his sperm from fertilizing the egg on its own. Both parents are illiterate.

 

Some people want to have their tongue split in two, a procedure that can cause irreversible nerve damage. Many go out and split their own tongue, or hire a buddy to do it for them. Some plastic surgeons are willing to carry out the procedure too, for around 2000 dollar. The procedure can cause speech problems too, but presumably the reason these people focus on looking interesting is because they don’t have the ability to say anything interesting. Rather than referring them to a psychologist, cosmetic surgeons are willing to split their tongue in two for them.

Ethical standards and a scientific education that lasts six years or more seem insufficient to prohibit some professionals from mutilating people’s bodies and bringing children into the world in far from ideal circumstances. It seems self-evident to me that our access to genetic technology will similarly lead to a number of scientists willing to elevate their own judgement above that of everyone else and engage in experiments the rest of us would consider morally reprehensible. In India, some surgeons are willing to amputate healthy limbs of children, in exchange for a payment from the gangs that use these children for begging. It seems self-evident to me that when the technology makes it possible, wealthy parents who are eager to have children with genetic enhancements will be capable of finding fertility specialists willing to assist them in this endeavor.

Designer babies

Doctors who are afraid that parents might choose to use genetic procedures to give their children blue eyes or a high IQ are not speaking from their role as medical professionals, but rather, from their own sociological perspective. They fear a society where wealthy people can make their own children genetically superior to the children of those who are poor. This is not a new phenomenon, but it’s a response that’s seen to every technology. New technologies tend to start out only accessible to wealthy individuals. Given enough time, access spreads into the general population. It took eighty years since their invention until half the American population had an automobile.

In the case of designer babies, the same thing is going to happen. Elites will choose to make their children intelligent, beautiful and healthy. To oppose such progress is popular, but it’s also difficult to defend. If you condemn the development of designer babies, you’re thereby implicitly also suggesting that our children should eventually die painful deaths. We know of genetic procedures that can be carried out in mice, that allow us to effectively remove the aging cells from their bodies when they’re old, thereby dramatically increasing their life expectancy. On what basis would you be able to reject such procedures in humans? If you choose to prohibit such a procedure, you’re effectively condemning newborn children to premature deaths.

Of course on the other side of the curve, people are less conservative. If I were to take a child who would die from progeria and implement a stem-cell treatment with genetically altered cells that allow the child to live a normal healthy life, I’m not a monster, I’m a saint. It’s alright to lift people up from disaster to mediocrity. It’s taboo to lift people up from mediocrity to excellence. Consider another example: Preventing Huntington’s disease. Very few people today would oppose procedures that prevent children from being born with Huntington’s disease. Similarly, we don’t mind the elimination of hereditary breast cancer, sickle cell disease and other tragedies. People whose siblings suffer severe mental illness, like bipolar disorder, are probably capable of convincing the general public to let them prevent their own children from suffering the same disease.

But what happens if you take a group of average people and eliminate the shortest ten percent every generation? You end up, given enough time, with very tall people. The question that seems to have no good answer however, is why it needs to take so long. If we’re perfectly content eliminating mutations that lead you to die young, or suffer severe cognitive impairment, after a few generations we will all live longer and healthier. But why do today’s children have to be condemned to mediocrity? Where is the moral justification that allows you to say that a child born today doesn’t have a right to live to be 200 through genetic engineering, if the medical procedures that enable such a thing are available to us today? There is no real proper moral justification that can be given to prohibit the genetic engineering of fertilized eggs.

The mentality towards genetic engineering that we have is the egalitarian bucket of crabs mentality that we have in general. We want Jeff Bezos to have less money because we feel threatened by him and we want children in Sudan to have more because we feel sorry for them. In a similar manner we want Kim Kardashian to be uglier and children born with cleft lips to be prettier, so we publish pictures of the prior with cellulite in the magazines and perform expensive surgeries on the latter.

This is what happens to a tribe of animals who evolved under conditions of stagnation. If no genuine improvement is possible, our instincts lead us to seek out redistribution, from the most successful to the least successful. The very idea that stagnation is now a thing of the past, that all of us can become prettier, happier, more intelligent and wealthier, is alien to our brains that evolved under such conditions of permanent stasis.

And yet it’s possible. We can all benefit. If I genetically engineer my children to be more intelligent, longer lived and prettier, how does it hurt your children? At a young age your children will interact with children who read books and understand the world around them, rather than children who bully other children and get arrested. As they mature, these intelligent children become capable of fulfilling a meaningful role in society. Consider the societal impact of an eighty year old Alzheimer’s patient. Now compare this societal impact to that of an eighty year old genius, who continues to participate in society. How would it hurt you personally, if we had more of the latter and fewer of the prior?

Mediocrity is not perfection

The human body is flawed, because it came about through incremental improvement. We had to be good enough to pass on our genes, but more than that was not necessary. When you’re done reproducing, evolution has no genuine interest in you any longer. This leads us to a body that sets us up for misery. The human body isn’t broken when something goes wrong, it’s broken from the moment we come into existence, as it is filled with design flaws.

What do I mean with design flaws? Well, please tell me, why can an eleven year old girl become pregnant? What’s the point to that, when we know it causes endless misery for the new parent as well as the infant?

Mainumby, now 14, suffers chronic pain in her hips and waist, the result of her pregnancy drawing calcium and vitamins from her growing body.

More painful still are the psychological scars. Her daughter, now nearly four, is a constant reminder of the traumatic end to her own childhood. Mainumby regularly self-harms, said Rosana.

“She’s taking medication, her anti-depressants, pills to help her sleep,” said Rosana. “She has panic attacks … several times, she’s wanted to commit suicide.”(Source)

If this is the design of a God, then it is the design of a flawed God. Another example to consider: In your early twenties your cognitive abilities and physical beauty peak. Wars are fought over women in their early twenties. They’re not fought over women in their forties. This is the reality you live in, the reality you grew used to. You’re born into a flawed bag of meat, a bag of meat barely good enough to let you pass on your genes.

If you’re lucky it functions properly at birth, rather than immediately casting you into pain from the first moment you see the light of day. If you’re unlucky your first breath is a breath of pain. Your skin might crack, your eyes may be red and swollen. You might be born permanently blind as a consequence of a single mutation in a gene supposed to synthesize a form of collagen. A single wrong codon in your genetic code can reduce you to a monstrosity, a human being faced with gasps and crying children when you leave your house during the day.

Even if you’re lucky it’s guaranteed to fall apart however. Your body is going to start causing you pain and suffering as it gradually ceases to function. Your back will start to hurt, your growing prostate will cause you to pee in your pants and make you afraid of leaving your house. Your skin will start to sag, lines will develop around your face that signal the decay of your body and overall vitality. You’ll be forty or fifty and attracted to people in their twenties, but they will not be attracted to you. You’ll resign yourself to a boring office job, where you struggle to comprehend new situations and innovations. Eventually you will have decayed far enough to become unable to participate in society, transformed from a strong man into a burden.

Perhaps we would be mistaken if we called the body a failure, perhaps it should be thought of instead as an unfinished project. And if we feel hesitant to improve upon ourselves, if we proclaim that we should not play God, how can we go about our day, improving our environment? How can we remove malaria carrying mosquitos from the air around us? How can we eliminate measles, why do we exterminate the parasitic worms in the soil that sometimes crawl out of our eyeballs, why do we extinguish forest fires, why do we put up warning signs against landslides? What is sacred about our bodies, that is not sacred about our environment? If we as conscious actors are free to put the finishing touch on our environment, why can’t we put the finishing touch upon ourselves?

The body is ours, but we are born into it without consent. It is thus our responsibility to turn it into something we can be happy with. We want our children to be happy, strong, healthy, intelligent and long-living, because that’s what all human beings want their lives to look like. The bare minimum we want is that our children don’t die of AIDS, that they are not turned into lifelong pariahs because they happen to carry a contagious disease that could kill you.

If you were to ask me, He Jiankui carried out a sensible first step. He is part of the radical fringe, the kind of people who set a goal in motion by disregarding civility. If this leads to a slippery slope, my suggestion would be to sit down on the ground and enjoy the slide downhill, because the slippery slope leads to people who are happier and healthier than us.

Genetic deterioration

We could decide to avoid genetic enhancement of human beings out of some type of cruel sentimentalism, but that leaves us with another problem: We’re slowly falling apart. We began our existence as a species on the planes of Africa, where we had to flee from predators and hunted animals by running after them until they would collapse. The predators we once feared started dying out in droves around 10.000 years ago and we developed weapons that allowed us to start killing animals from a distance. We had little need left to run. A lot of us today can’t run very well. In this sense, we’re no different from blind fish in a cave. If we don’t need a skill, we’ll slowly lose it over successive generations.

Since the industrial revolution we began to fall apart even faster. A lot of children used to die before adulthood. Infant mortality rates were around 25% throughout most of human history. A lot of those children died from infectious disease, because they carry mutations that made their body more susceptible to the disease. Today those children grow up to be adults, who pass those mutations onto their own children. Scientists believe this may be the cause of a variety of different health epidemics witnessed around the world. A lot of people now get diabetes for example, due to the decline in infant mortality. The obesity epidemic is also thought to be caused by this effect. Another issue involved here is that the difference in reproduction rates between healthy and unhealthy people has declined: How many women do you know who gave birth to sixteen children?

There are different solutions to problems like these. We could stop taking good care of our children. If your baby girl develops a nasty cough, we could leave her outside for a night and check back the next morning, to see whether she was strong enough to survive. Alternatively, we could ban birth control and abortion. Healthy people would start having sixteen or more children again and those children would have to fight each other over the remaining natural resources in our world. Perhaps we should simply implement a eugenics program, that merely allows the smartest, happiest and prettiest people on the planet to reproduce. We could also accept that we’ll gradually fall apart and will need a steady supply of people to replace us, who still have high infant mortality rates and high fertility rates. I think most people don’t like any of these suggestions.

In comparison, the idea of “designer babies” seems relatively benign. One way it could work is as following: We take cells from two parents to be and use them to start producing germ cells, that lead to the production of sperm and eggs. We then decide to check those cells for a long list of rare mutations. If just 0.01% of all human beings have a mutation, it’s rather likely to be a harmful one, especially if it’s located in a gene known to be involved in particular ailments the parent happens to suffer. We would then remove all of those rare mutations from the germ cells and create a baby free from any of the rare mutations their parents carry. In all likelihood, the child would remind us more of the Ancient Greek philosophers than it would remind us of its parents.

Because all of us are flawed, a child born free from our flaws would already seem more like a deity compared to us. The child would live long and would only start to develop ailments like dementia or heart disease at an old age. But to me it is not clear, why we would need to stop at this point. Genetic enhancement can also be used to create children who won’t suffer the kind of ailments we suffer from at all. As mentioned earlier, studies in other animals show us ways of engineering an animal to age much slower than a normal animal would. These interventions are relatively simple and all evidence suggests they would work in human beings too. It seems self-evident to me that this would be thought of as a desirable outcome.

Similarly, I don’t understand what makes people so squeamish about increasing the intelligence of children. Making the dumbest 10% of people smarter every generation, would ensure we will eventually end up with a much smarter population. If it turns out difficult to boost the intelligence of people by removing harmful mutations however, it would be attractive to help them out by introducing new genes, that serve the same effect. If otherwise unintelligent people are given such genes, intelligent parents would then expect the right to introduce such genes into their own children too.

What unnerves me is the fact that governments now have to start making laws about the kind of adjustments we’re free to make to our children. Hereditary breast cancer and Huntington’s disease are free for us to eliminate today through embryo selection, but why not schizophrenia, red hair or a bicuspid aortic valve? How do you go about deciding which type of suffering is severe enough to let you change your offspring? Every individual case for which augmentation is prohibited will seem like an outrage. The government will end up in a position where it decides which disease we should suffer from. How do you explain to your children that they’ll suffer Parkinson’s disease at age 70, because the government thinks it’s not as bad as suffering Huntington’s disease? Average people who witness the “uplifting” of people in a bad position, would similarly feel threatened. If dumb families are turned into average families, why can’t average families be free to turn themselves into smart families?

It seems to me that there is only one position that would be considered defensible: Any procedure carried out with the best interest of the child in mind should be acceptable. In other words, the introduction of synthetic genes that make you more intelligent, longer-lived or prettier would be tolerable, provided there’s sufficient evidence of their safety. I think this is the only logical outcome of the development of genetic technology. If it’s possible to carry out a procedure that will give a child a happier life, we’ll carry it out.

What amazes me is that the same scientists who will condemn those who dare to question the safety of genetic engineering of crops or vaccination of children, tend to be the scientists who condemn the idea of designer babies and germline editing in general. I don’t think this criticism is founded in rational facts or in an emotionally detached observation of the situation. Rather, the academic ideal of an egalitarian society contradicts the scientific possibility of genetically enhancing the human population.

Vaccination and genetic engineering of crops, are ultimately an outgrowth of egalitarian ideals. Genetic engineering of rice is used as a wedge, to force people to abandon their principled opposition to the engineering of crops. Golden Rice makes it possible to feed millions of children who would otherwise suffer from vitamin A deficiency. Vaccination is a medical technology that protects the most vulnerable in society, by immunizing everyone else. These are technologies that carry risks, but the risks are accepted because of the impact they have on the most vulnerable.

I don’t want governments, or experts unaware of the impact their own cultural context has on their moral judgments, to prohibit me or anyone else from using the tools available to us to live better lives. The conservatism and prudence of medical science is what has led to the stagnation in medical progress. The American life expectancy has declined for the third year in a row. That’s not the path we’re supposed to be on. It’s a consequence of what ultimately amounts to a very conservative mentality, of people who prefer subtle tweaks over radical innovations.

Establishments tend to grow gradually more conservative, as they seek to keep out those whose new insights would threaten their own reputation and position. My expectation is that we’re going to witness the emergence of a medical counter-culture, as people collectively lose faith in modern medicine in general. There are two directions in which this clash with the established medical orthodoxy seems to take place. On the one hand exists the emergence of a hyper-rationalist community of people who believe in the empirical scientific method. They do not appear to respect the rationalizations for death that most of us have learned to us accept. There are breakthroughs happening here, but these breakthroughs will have the effect of fundamentally changing what it means to be a human being. If genetic augmentation allows you to live longer, are you willing to sever your ties to nature?

On the other hand, there is an anti-rationalist reaction against modern medicine and its failures. I call it anti-rationalist, because it is ultimately based on a neo-transcendentalist holistic perspective, in which man’s attempts to intervene in nature are fundamentally rejected as abhorrent. This movement follows a simple heuristic, the idea that what is natural is good, that our sickness is a product of our alienation from nature, which is seen as fundamentally good. The heuristic is in many cases of course correct. A simple multivitamin pill in combination with proper nutrition would be sufficient to rob most doctors of the majority of their clientele. Nonetheless, it ultimately asks of man to make peace with death. There is no vitamin pill, no fermented sauerkraut, no paleodiet, no meditative exercise, that’s going to cure Alzheimer’s disease. There is no exercise or antioxidant supplement that allows a woman to have children at age sixty, only Faustian modern medicine allows such a thing.

Are we obliged to operate within the constraints imposed on us by nature, when nature seems fundamentally indifferent to us? To nature, the deformed child born into a hospital is as relevant as the 999 tadpoles out of a thousand that did not grow up to be a frog. They lost the race and so they are discarded in the endless struggle for survival. If their pain is quenched through morphine, they are not treated with mercy by nature, they merely benefit from the side-effects of a hormonal system that sometimes needs successful organisms to bite through pain in the struggle for survival.

And yet, I do not reject the ideas of the neo-transcendentalists completely, for a simple reason. If nature is evil or indifferent, then all hope seems lost. The living world is not synonymous with nature, it is an outgrowth of nature. If nature is cruel to us for no genuine reason, then we are alone in a silent and horrifying universe. Our ability to eliminate suffering would have to be interpreted with caution and skepticism. We can not overcome the laws of physics, we are always inevitably operating within the constraints of nature. All of human progress would have to be interpreted as the attempts of a mouse to escape from the paws of a cat who is merely playing with it.

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