It is only a matter of time before germline genetic engineering is applied to humans. The advent of technologies such as CRISPR has forced the scientific community’s hand in making rules and regulations on the topic. There are many arguments for and against human germline genetic engineering, and many scientific communities as well as countries disagree. Researchers in China have already begun editing the genomes of non-viable human embryos, so the question has become, how long before we have a “Build-A-Baby” workshop in every major city? The answer to this question really depends on who you ask. There are currently three schools of thought on human germline genetic engineering. The first sees any kind of genetic engineering at the embryonic or germ level to be unnatural and therefore impermissible. The second position acknowledges the merits of genetic engineering for gene therapy but not for gene enhancement. The third wishes to utilize genetic engineering to its full extent and allow it to be used for both therapy and enhancement.
Perhaps the most widely accepted theory is the second. Most people, regardless of their competency in the subject, if asked outside of a religious context will be all for removing genetic diseases such as Huntington’s disease or cystic fibrosis. However, they lose their support for genetic engineering when it comes to choosing hair color, eye color, athletic dispositions, or anything that is deemed unnecessary for a healthy human life. This approach is commonly referred to as the therapy-enhancement distinction. While I agree that upon first glance it is the most favorable approach of the three, the line between therapy and enhancement is often not as clearly defined as it needs to be. The issue lies within therapy itself. Therapy implies there is a norm that all humans want to attain. When you are sick with the flu you go see a doctor so that you can hopefully feel normal again. Very few will argue that Huntington’s disease is a norm and therefore shouldn’t be treated, but what about obesity?
Officially obesity is classified as a disease much like Huntington’s, and although it is not purely genetic there are indubitably genetic predispositions, or propensities. Now the question for those who subscribe to a therapy vs. enhancement approach is whether or not treating obesity genetically is a therapy or an enhancement. Ultimately genetic engineering allows humans to play god. It allows humans to determine what others deserve to have or not have. It is clear to most that no human deserves to have Huntington’s disease. But do some humans deserve to have a higher likelihood to fall victim to childhood obesity? Do some humans deserve to be below average intelligence? Do some humans deserve to be considered less attractive in their society? No parents wish any of those things upon their children, so if we have the power to produce only healthy, fit, intelligent, attractive humans, is it not a therapy to provide them the best normal life possible?
The first and third responses essentially say do nothing at all, or do everything available, and both responses are of sound logic. However, they still feel wrong. So what is left to do? Therapy vs. enhancement appears to be the only compromise, though its machinery is not powerful enough to truly make the distinction between the two. Ultimately, there is no overarching answer or solution. There is no one theory for every gene that could be edited. Therefore, the best possible solution would be a gene specific approach. Instead of attempting to categorize any kind of gene editing as either therapy or enhancement, why not create a governing body to examine each proposed gene that is to be edited, and determine whether or not the benefits of this edit would outweigh the detriments. A gene specific approach is the only way that human germline genetic engineering can be used to help to its fullest extent, while its greatest harms are actively avoided. Hopefully a “Build-A-Baby Workshop” will be on your nearest street corner soon, but not without a meticulously created list of design options.