Human gene transfer: Lessons from our eugenic past
As researchers develop human gene transfer, one recurring issue is whether it may lead to “eugenics,” i.e., a resurgence of an early 20th century movement notorious for the racism it exhibited and the harms it caused. I ask why the American eugenics movement was wrongful, and how ethical guidelines for gene transfer might protect against similar harms.
I explain what gene transfer is, the status of its development, and two distinctions pertinent to the ethical analysis. One concerns uses of gene transfer, either to treat a disease or enhance a trait; the other is between somatic and germline cells. An historical account of the eugenics movement shows that only germline, not somatic, gene transfer, is subject to the eugenics objection. The historical account also highlights eugenic themes in the ethical debate about gene transfer.
One lesson from the eugenics movement is that an ethical paradigm for use of germline gene transfer should seek a definition of “disease” and a public debate about its content. However, the vagueness objection to the treatment/enhancement distinction asserts that “disease” is too vague to define, and implies that we should abandon efforts to do so. I argue this claim conflicts with this lesson of the eugenics movement. Addressing how the disagreement between the value-neutral and value-laden accounts of disease might be resolved, I consider the views of C. L. Stevenson, W. B. Gallie, and Richard Kraut about the nature of disagreements concerning ethical terms. I conclude Kraut's is most applicable to the disagreement concerning “disease,” and use it in analyzing the “malady account” of Bernard Gert, Charles Culver, and Danner Clouser.
The eugenics movement warns that an ethical paradigm for germline gene transfer must protect the interests of those most likely to be affected, i.e., children who will be born using this technology. I claim that John A. Robertson's account of procreative liberty does not furnish such safeguards. I analyze how the interests of future children might affect the permissibility of choices concerning germline gene transfer, i.e., to treat a disease, to enhance a trait, to diminish a trait, or not to prevent a disease.