Editorial
Ready or not
Human embryo selection is here, raising questions that have no easy answers.
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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.