8.2 Reproductive Ethics and Genetic Engineering

Reproductive ethics grapples with the complex issues surrounding assisted reproduction and genetic technologies. From in vitro fertilization to gene editing, these advancements raise questions about procreative rights, access to care, and the moral status of embryos.

Genetic engineering adds another layer of ethical complexity. While it offers potential benefits like disease prevention, it also sparks concerns about designer babies, eugenics, and unintended consequences. Balancing individual autonomy with societal interests remains a key challenge in this rapidly evolving field.

Ethical Considerations in Reproduction

Assisted Reproductive Technologies (ART)

• Assisted reproductive technologies (ART) help individuals or couples conceive a child when natural conception is difficult or impossible
  • ART procedures include in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and surrogacy
• Principle of procreative liberty argues that individuals have a fundamental right to make decisions about their own reproduction, including the use of ART
  • Based on the idea of personal autonomy and self-determination
• Issues of access and equality arise with ART due to high costs of these procedures
  • Can make them inaccessible to many individuals and couples
  • Raises questions about whether access to ART should be considered a right and whether society has an obligation to provide financial assistance

Ethical Challenges in Third-Party Reproduction

• Use of third parties in ART (sperm donors, egg donors, surrogates) raises ethical questions
  • Rights and responsibilities of these individuals
  • Potential psychological impact on the resulting children
• Cryopreservation of embryos for later use raises ethical questions
  • Moral status of embryos and whether they should be treated as persons with rights
  • Concerns about the fate of unused embryos
    • Whether it is permissible to donate them for research or to other couples
• Principle of procreative beneficence suggests prospective parents have a moral obligation to select the child expected to have the best life
  • Raises questions about the permissibility of using ART to select for certain traits

Ethics of Genetic Technologies

Genetic Screening and Testing

• Genetic screening involves testing individuals or populations for genetic markers associated with certain diseases or traits
  • Preimplantation genetic diagnosis (PGD) allows for screening of embryos created through IVF before implantation
• Genetic testing can provide individuals with information about their risk of developing genetic diseases or passing them on to offspring
  • Can lead to difficult decisions and potential discrimination
• Principle of genetic privacy holds that individuals have a right to control access to their genetic information
  • This information should not be used to discriminate against them in areas such as employment or insurance
• Concerns about eugenics, the idea of using selective breeding or genetic engineering to "improve" the human population
  • Worries that widespread genetic screening could lead to stigmatization or elimination of certain traits or disabilities

Gene Editing and Modification

• Gene editing technologies (CRISPR-Cas9) allow for precise modification of DNA sequences
  • Holds promise for treating genetic diseases
  • Raises concerns about unintended consequences and potential for misuse
• Germline gene editing, which involves making changes to DNA of embryos that will be passed on to future generations, is particularly controversial
  • Concerns about safety and long-term effects of these modifications
  • Ethical implications of altering the human genome
• Somatic gene editing, which involves modifying genes in non-reproductive cells, is less controversial
  • Still raises questions about accessibility, regulation, and potential unintended consequences

Genetic Enhancement vs Designer Babies

Arguments for Genetic Enhancement

• Genetic enhancement refers to the use of genetic technologies to improve human traits and capabilities beyond what is necessary for health
  • Could include enhancing intelligence, physical abilities, or even moral dispositions
• Proponents argue that genetic enhancement could lead to significant benefits for individuals and society
  • Increased productivity, creativity, and well-being
  • See it as a continuation of other forms of enhancement (education, medical interventions)
• Principle of procreative beneficence suggests parents have a moral obligation to select for traits that will give their child the best life possible
  • Genetic enhancement could be seen as an extension of this principle

Concerns about Designer Babies

• "Designer babies" refers to the use of genetic technologies to select for specific traits in offspring
  • Often associated with non-medical traits (appearance, abilities)
  • Could also be used to reduce the risk of genetic diseases
• Critics worry that genetic enhancement could exacerbate social inequalities
  • Only the wealthy would have access to these technologies
  • Could create a "genetic divide" and undermine principles of equality and fairness
• Concerns that genetic enhancement could lead to a narrowing of human diversity and loss of appreciation for different ways of being
  • Could create pressure for individuals to conform to certain standards of perfection
• Arguments against designer babies worry about the commodification of children and erosion of unconditional love
  • Also concerns about unintended consequences of manipulating complex traits influenced by multiple genes and environmental factors

Reproductive Autonomy vs Societal Interests

Reproductive Autonomy

• Reproductive autonomy refers to the idea that individuals should have the freedom to make decisions about their own reproduction without interference
  • Includes decisions about whether to have children, when to have children, and how many children to have
• Policies that limit reproductive autonomy (forced sterilization, restrictions on access to contraception and abortion) have historically been used to target marginalized groups and perpetuate social inequalities
  • Raises concerns about reproductive justice and disproportionate impact on certain communities
• In the context of assisted reproduction and genetic technologies, overly restrictive regulations can be seen as a violation of procreative liberty

Balancing with Societal Interests

• Societal interests in reproduction can include concerns about population size, public health, and well-being of future generations
  • In some cases, these interests may conflict with individual reproductive autonomy
• Concerns about overpopulation have led some to argue for policies that encourage or incentivize smaller families
  • However, these policies can be seen as coercive and a violation of reproductive rights
• Idea of procreative responsibility suggests individuals have a moral obligation to consider societal impact of their reproductive decisions
  • Could involve considering environmental impact of having children or potential burden on public resources
  • Controversial idea that can be seen as a form of reproductive shaming
• Balancing reproductive autonomy with societal interests requires careful consideration of specific context and commitment to reproductive justice and equality
  • Involves striking a balance between individual rights and common good
  • Must be attentive to ways in which policies can perpetuate or alleviate social inequalities