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Picking the Best Baby

Posted by Jesse Reynolds on December 2nd, 2008


Better Babies contestants at the Indiana State Fair, 1929

The leading newspaper in Canada's capitol city published an essay by ethicist Margaret Somerville on the social implications of widespread genetic screening. In "A New Eugenics," she asserts that the clear message is that certain groups of people don't make the genetic grade, and should not have been born:

As harsh as the language is, we must ask ourselves: "Are we on a search-and-destroy mission to wipe out certain groups of people?"...

[A]re we implementing a new eugenics and, if so, what are its dangers? To respond we need to take heed of history....

Whether or not we like it, the message we will be delivering at the societal level is: "We don't want you in our society unless you measure up to a certain genetic standard. You are only a potential member, until you've passed the admission test that we are willing to pay for with our tax dollars and implement."

The unavoidable collective impact of these decisions is the implementation of negative eugenics with respect to disabled people and it's disingenuous to deny that.

Negative eugenic practices have historically taken various forms, from infanticide, on to prenatal testing and selective abortion, and then to preimplantation genetic diagnosis (PGD) in the last two decades. With the price of genetic sequencing plummeting, the next step becomes apparent. The technology behind the wide genetic scans offered by companies such as 23andMe could feasibly be used on an entire batch of blastocysts in a fertility treatment, enabling prospective parents and clinicians to pick the genetically "best." Such a process was just described by the assisted reproduction and stem cell company Reprogenetics, at a recent meeting of the American Society for Reproductive Medicine.

What might be the cost of a wide-scanning PGD? Traditional PGD presently costs a few thousand dollars over the price of basic in vitro fertilization, and has been used to select against a single gene at a time, generally one related to a serious disease that is known to be carried by one or both of the parents. As a baseline for some "back of the envelope" calculations, the service of 23andMe, which tests for 91 genetic variations, currently costs $400. At this price, applying it to an entire cohort of a dozen blastocysts, even with additional costs for extracting a single cell from each and amplifying their DNA, may become competitive.

If the additional cost of such a procedure were just a few thousand dollars, then prospective parents who already are using IVF may find it hard to resist. But could this become even more widespread? I would not rule out the future use of wide genetic scans for natural pregnancies. This would sometimes be followed by selective abortion, just as it now sometimes is for sex selection. In fact, there's a good chance genetic testing could be done using a pregnant woman's blood at just five or six weeks gestation, as is currently done with prenatal sex determination and possibly soon for monogenetic diseases such as cystic fibrosis.

But wide adoption may hinge on the cost-benefit analyses of insurance providers. In jurisdictions where a new baby is likely to have the same insurer for much of its life, such as nations with single payer health care, some may argue that the cost of a wide genetic scan plus IVF would warrant coverage in order to ensure a "genetically healthy" baby, even if there is no indication of genetically-related disease in the parents.

Of course, IVF remains a physically unpleasant process, and many parents would decline the service, even if free. At what point, though, might they face pressure from their insurer, government, or society at large to be sure their child will be the healthiest possible?

Previously on Biopolitical Times:





Posted in Biotech & Pharma, Eugenics, Genetic Selection, Jesse Reynolds's Blog Posts


Comments

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  1. Comment by John Mayger, Feb 24th, 2011 4:17pm

    Negative eugenics for small abnormalities is rejected by most people but for gross deformities such as Spina bifita is it not kind to abort them to prevent their suffering. Where do we draw the line or is that the right of the parent?

    Positive eugenics is widely practiced by most of the customers of all the IVF clinics for both sperm and egg donation. A premium is paid for top eugenic donors and their popularity is also dependent on eugenic markers such as Intelligence as measured by University results) as well as height, ethnicity and social virtues a sense of humour or musical ability.

    Single mothers by choice and lesbians are able to and choose to "Breed Up" to a perceived better DNA source than they would have been able to do by marriage or sleeping around.

    I would like to see more discussion on Positive eugenics!


 


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