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This appeared in the Oct. 11 Philadelphia Inquirer. The e-mail address for responding is [log in to unmask] Editorial Ready or not Human embryo selection is here, raising questions that have no easy answers. Lisa and Jack Nash of Colorado recently pitched the world into the future. And what they've done shows us we're just not ready for that future yet. The Nashes have a daughter, Molly, who suffers from a condition called Fanconi's anemia. She needs healthy bone-marrow cells, or she will die. (It's a genetic disease; both parents carry the gene.) The Nashes used in-vitro fertilization to create 15 embryos that were then genetically screened to find one compatible with Molly's blood type and free of the gene. Welcome to the world, Adam Nash - the first case in history of successful human genetic selection. Some of Adam's cord blood was used to treat Molly. In choosing Adam's genetic traits, the Nashes were, on a small, personal scale, selecting for the best possible human. That verges toward eugenics, the practice of creating a master race of human beings, editing out drawbacks until you get a line of supermen and superwomen. But the Nash case is probably as close as you'll get to likable eugenics. The Nashes did not have this baby only to service an existing child. They wanted another child anyway and are committed, loving parents. Lisa Nash has spoken of her abhorrence of abortion. In other words, these are good people, people who honor life, who used new technologies in a bid to save their daughter. Even those with misgivings may feel a tide of sympathy. But the Nash case also unleashes a tide of questions. It is right to create a person as a therapy? What about the 14 embryos that didn't make it? The Nashes are pioneer consumers of new services that can help us orchestrate birth and regulate the future. When people see what science can offer us in the next generation, they're going to want those services. Market pressures - from the demand side - will be tumultuous. Now at hand, the biotechnological revolution will allow us to go much further than in this case. Many might feel fairly OK about what the Nashes did - but this is just the start, and there's no end in sight. Our institutions have not kept up with the onslaught of products, services and issues produced by the new science: genetically altered foods; cloning (scientists just cloned the endangered gaur in an effort to save the species - right? wrong? why or why not?); gene therapy; genetic selection (welcome, Adam) and much more. So we must start talking, deliberating and legislating about the changes science hath wrought. Start at the top, with a national ethics council made up of eminent men and women from the human and natural sciences, constitutional law, philosophy and religion, and begin a long-term conversation before the world. Did we say "long-term"? Make that "permanent." Such ethics tribunals exist at many hospitals, universities and places of worship, but we need a big one to make it a world roundtable. Eventually it will be our legislators' turn. Good luck to them, for the work that awaits will be difficult, disturbing, divisive. The law is a practical expression of our common values. As such, it must someday lay down pathmarks for the biotech highway. National ground rules can guide state legislators. What will those laws say? They may say that anything goes, as long as the procedure does not harm the child. They might forbid all crafting or selection of embryos, or they might set limits on those steps. We don't want people to make and break embryos like chicken eggs. We don't want women to offer themselves as baby, fetus or embryo factories. We may, however, find genetic selection allowable when life itself is at stake, as it is for Molly Nash. Perhaps we can find a principle to steer by. Or, perhaps, principles failing us, we may simply stipulate what can and can't be done. It'll be a patchwork job at first, becoming subtler and more finely tuned as our minds and spirits grow into these challenging realities. Pressure will focus on the labs and hospitals in which this miraculous, ambiguous work is done. More than ever, these institutions are becoming responsive to the values of the communities around them. They will need to set and advertise the ethics of their work as clearly as they can, for their practitioners will be answerable, as they are now, to the rest of us. For now, what we have are two lives - Adam and Molly Nash - and 14 embryos that didn't make the cut. Reasons for joy, for puzzlement, for distress. Reasons, most of all, for beginning the hard work of imagining the future before it passes us by.