The Wake

Shortly after Christmas, my sister gave birth to her second baby girl. She and her husband are happy parents and very proud of their two girls, but they don’t plan to have any more children. That is, they will never be able to experience having a boy. If they had been given the chance, I imagine they would have gone for it. But wait, duh, it’s the 21st century. We can already do that.

Pre-implantation Genetic Diagnosis, or PGD, allows prospective parents to screen their embryos for genetic diseases, choose the gender of the child and soon choose more characteristics, from stature to eye color to deafness (often a sought-after quality by deaf parents). Sweet! By the time most of us 20-something college students are ready to settle down and have a family, we’ll be able to design our babies from top to bottom and create perfect little families a la Gattaca, a film about a futuristic, genetically-enhanced world where babies are designed with the best qualities in mind and life-expectancy is determined at birth.

Sarcasm aside, the ethical questions alone make this issue a big one. While screening for fatal genetic diseases seems like a wonderful advancement in modern science, it still could be seen as messing with Nature. Or God. I heard a story on National Public Radio about a couple who spent thousands of dollars on the PGD procedure to remove any embryos with a rare genetic disease that had killed their first child. Though costly and time consuming, the woman exclaimed that they would have as many children “as God wants to give us.” But is God giving her these PGD children, or is modern science? I’m not writing about this to take a religious stance, but it is a component of the ethical question.

Despite its being around for the past decade, PGD is not commonly performed. A small number of families use it or similar methods to screen for genetic diseases that run in the family, or choose to select a girl, say, in a family that already has four boys. It has not become enough of an issue to warrant federal regulations, according to www.bioethics.gov, which states, “There is now no direct regulation of either PGD or sperm sorting as such.” Just as well, because then we would be onto another tough ethical question: does the government have the right to regulate our bodies and personal choices in that way? In the UK, for example, they say yes, and have banned use of PGD for gender selection, though it can still be used for medical reasons.

As I see it, where there are users, there will be abusers. Just as there are those who like a glass of wine with dinner, others prefer to drink until they pass out. If PGD remains available and expands its ability to choose characteristics of babies, there will be people who will want to abuse the system and choose everything for their child so it is intelligent, attractive, strong, creative … the list goes on. The stereotypes in my mind run away from me as I imagine a sports-loving father who just wants a son he can play catch with, coach in Little League, and watch in college football games. So he spends the money, gets a son and … oops, the kid has no interest whatsoever in throwing a ball around. Would the father resent his child for not being what he ordered? Would he sue the fertility clinic that promised the child of his dreams? Crazier lawsuits have happened.

While we’re imagining the future consequences of a world where PGD is commonly used, let’s go back to the practice of screening for serious genetic diseases. Embryos that carry genes, say, with an increased risk of breast cancer, are discarded. If this became a common practice, it would lead me to believe that down the road, breast cancer would be simply removed from the gene pool. But unless we completely conquer evolution, new and unknown diseases will arise to take its place, and they could be even scarier.

Then there is the never-ending issue of money: who has it, who doesn’t and what that means for different parts of the population. The high cost of a procedure like PGD keeps it out of reach for a large percentage of the population. Do we want the gap between the rich and the poor widened by the fact that the rich can buy genetically altered children who have a better chance of survival from the get go? Society is already unbalanced and unfair to poorer children once they enter the world, but to create disadvantages at the embryo stage is a whole new level of inequality.

Dear Reader, if this issue fascinates you as much as it did me, do a little of your own research. There are many facets of this issue that I didn’t mention here, from family balancing in different cultures, for example, in countries where boys are more valued than girls, to the safety and reliability of PGD and other techniques to the possibility of PGD partly replacing adoption. Why get someone else’s when you can design your own? Better yet, ask your parents what they think. Their answers might surprise you. Most people will do anything for their child’s happiness and success in life, but how far will we go?