Gene therapy is an advanced technique
Gene therapy is an advanced technique, where genes are used as a mean for curing diseases. It involves replacing the mutated gene with a healthier copy or inserting a new gene and knocking off the older faulty gene. A vector is used as a carrier of the gene, in most cases modified viral vectors such as adenovirus or retrovirus are used. Sometimes the genes are targeted directly to cells. The two type of gene therapies are somatic cell therapy and the germ line therapy. The astounding difference between them is somatic cell only affect individuals whereas, germline therapy since are performed on reproductive cells are passed onto future generation. Usually germline therapies are more successful than somatic therapy since it only targets the cells of the individual and reduce some symptoms unlike germline which works in the genetic level in gene pool. Despite being the only available treatment approaches in some of the complicated multifactorial disorders like Alzheimer’s and neurodegenerative disorders like Huntington’s Chorea, the process of genetic alteration raises several ethical questions in broader context where genetic makeup could be completely manipulated to create “Designer Babies”. This can be related to George Annas thinking where genetic therapy and diagnosis might incline the parents towards treating their children as products. They would want to use this germline therapy as a weapon to create future child with desirable traits. (Burley and Harris, 2002) This will lead to lack of care and love relationship between children and parents since they are simply a product of their desire. Also, this would lead to difference in genetic class in society which would have catastrophic social and ethical effects like eugenesis. I personally believe that using the germline option would be misused beyond the treatment approach.
If someone would oppose the use of germ cell for both genetic treatment and other purposes I think the many reasons may play a part in their decision making like the “playing god” objection where most people believe that there is a higher power who know more than us and it would be wise to leave this decision to themselves. It would be unwise to alter a genetic makeup and go against the nature provided later effects are not known. Also, when germ line therapy may be used for physical enhancements such as for tallness, extra muscles or blue eyes. And according to French Anderson adding a normal gene for treatment purposes is quite different than adding gene for enhancement. This may imbalance the metabolic and natural balance. (Teays and Purdy, 2001) Also, this would be like changing the natural gene pool and decreasing the diversity and not appreciating the natural value pluralism.
Some scientists believe that germline gene therapy should be approved since it is the only way of reducing the suffering of people affected by genetic disorder that can not be cured by other means. To be honest there would be people who would use the techniques for enhancement. We live in a world where currently lot of people are using cosmetic surgeries to promote impressive characteristics. There would be people with such thought who would want the gene enhancement for themselves and the future generation. Think about a future with a proportion of people with good look and characteristic gene and there is this genetically underclass population who decided to go against the germ line enhancement or who simply could not afford it. Does not this scene idealize most theory of eugenic, to create a better race. Which has led to various discrimination and even heinous acts like natural studies being conducted on a particular race thought to be unfit. The whole scenario would be repeated where people with gene enhancement such as higher intelligent, good look, good muscle and taller would be favoured more in case of jobs, sports and in many other contexts. When people whose gene has not been enhanced face this sort of crisis they may blame the past generation, parents may blame themselves and all these would cause impact on family bonding. People with unchanged genes may be subjected various discrimination and violation of human rights.
I think I will be more favourable towards somatic therapy despite knowing the drawbacks of the treatment where one major reason is somatic cell therapy does not have a long-lasting permanent effect and their efficacy is severely low. Where as germ line therapy, the cure is permanent however the trait can be passed onto future generation and can be used for genetic enhancements. (Richter and Bacchetta, 1998) Therefore I disagree with this.
People supporting germline therapy may state that they are supporting this simply because they believe it can lessen suffering. But it cannot be made certain that people would go on using the germline therapy just for treatment. There will be some who would try to use it beyond that, for enhancement and creating designer babies with desirable traits. I think that genes should not be tampered and agreeing with Nelkin and Lindee who said gene represent human identity and it should not be manipulated and changed because the person would no longer stay same. Also, they believed that manipulation would produce clones with no mind and soul. Gene is a sacred entity and as Noonan stated it gives us a value. (Burley and Harris, 2002)
I have several questions about the treatment approaches. Even if it the germline therapy is used for treatment it raises several questions in account of safety and efficacy. First, not many clinical trials have been established regarding germline therapies and not much success rates were seen in terms of outcome. Then why peruse something which has this low rate of success. The common form of vector to introduce the target DNA is a virus, there is no guarantee that this virus would not switch back to its virulence state and lead to Immunosuppressant infections. It can be accounted that suppose the transformation of gene is successful but what if a mutation occurs as such dangerous that this will be passed onto generations leading to catastrophic disabilities.
Clinical trials for such treatments ought to be established properly but this will need human trials which is completely unethical, so the alternative would be animal trials. Insertion of mutated gene into animal may lead to early death and abnormalities in animal causing them to suffer provided that the data coming from them may not be relevant to human trials. (Dresser, 2004) So, without established data I think it would be unwise to go with germline therapy. Also, the concerns about the GMO we usually have is what if a new strain of germ or a new mutation leads to destruction of such organism completely. Similar concerns can be raised against germline therapy where a change such a new strain of virus or mutation affecting the germline enhanced individuals might lead to death.
Dworkin has talked about the responsibilities towards our future generation where he mentioned that by future we have no way of knowing their identity. (Burley and Harris, 2002) Truly people who are not here and about people whom we even do not know will exist or not, I cannot think of any duties can we have towards them. Certainly, some may argue that we might have several other duties towards our future generation, but approving germline therapy is not one of them where they would use it for enhancement purpose to create a win win situation for them raising more room for discrimination and leaning back to that scenario of past eugenics. Plus, we do not know whether the decisions such as germline therapy might be beneficent to them it can also have the negative impact like introducing harmful traits and abnormality.
Even if a healthy child is born even after germline therapy I however think that their autonomous right is breeched where they might not have agreed in the same way in such situation. This in the coming future might cause emotional trauma. There may be a question put in their identity that whether the child is the same person after its gene has been altered. According to Harris in his book Wonderwoman and Superman that identity begins during gametic phase of an individual.(Launis, Pietarinen and Ra?ikka?, 1999) And Bernard Williams has put forward the zygotic principle where the zygote as a developed individual in the future would grieve about that they could be someone else without their genome altered and their existence become questionable in terms someone else might have existed instead of them. (Kuhse and Singer, n.d.)
Many may argue with me with applications based on distributive genetic justice. For example, in the second aspect of the two variants of the level playing field concept, ‘the brute luck view’ which was described by Scanlon that a person should not be excluded from available opportunities in society due to factors which they have no control over like poverty, or maybe disadvantage in the natural gene pool lottery. So according to him I suppose it includes genetic modification as well if that is the case to get access to equal opportunity. The brute luck view was expanded more by asking the question on basis of what equality can be defined and “resource egalitarian” view seemed to answer this by saying that any kind of resources would be distributed equally among every person like intervening in the natural lottery to promote individual liberty. Or they may put an example forward about the equal opportunities should be provided to everyone based on right to health care just like Norman Daniels or Rawl has talked about, but they have not stated anything about genetic intervention as an example of the healthcare. (Buchanan et al., 2000)
I am not saying I am against these concepts, but I will disagree with people those would use these examples to prove justification about germline therapy. All these theories were based on providing social equality but lacked concerns when it came to extensive use of genetic modification.
I would like to highlight about the healthcare factors where it is very essential to consider to what extent genetic disorder be considered as disease and I think it should be highly regulated and constricted rules should be made against the use of such therapies to genetic enhancement. There should be equal right to healthcare, but it should not be put forward in case of germline genetic therapy used in case of genetic enhancement.
If I consider the resource egalitarian and brute luck view, I can clearly see people misusing germline modification to create perfect human being fit for the society or with preferred characteristic to get a job which would lead to more inequality rather than equality. People who cannot afford the germline therapy or people who are against the therapy would be at greater loss. All these can lead to breaching of the value pluralism and failing to appreciate the natural diversity and create a different definition of “Perfect human”, this would be quite similar to thoughts of past eugenicist who wanted a better race and getting rid of the unfit and leading to stigmatizing them from various aspects.
According to reproductive autonomy a parent has the freedom to decide whether to have children or not, but I do not think this can be elaborated to what type of traits they want in their children or can decide what sort of children to have. Reproductive right certainly gives them the freedom to decide about whether to conceive a child but certainly draws the line when “Designer Babies” created by them are concerned.
In conclusion I would like to say that germ line therapy can certainly be misused and introduce threats like introduction of eugenics and breeching of values and ethics. It would create socioeconomical uproar and in some cases if mutation accidentally is introduced can have catastrophic effect on the mankind. Such treatment should therefore not be considered.