by Jamie Metzl
The dignity of being human, rooted in the dignity of life itself and flourishing in a manner seemingly issuing only in human pride, completes itself and stands tallest when we bow our heads and lift our hearts in recognition of powers greater than our own. The fullest dignity of the god-like animal is realized in its acknowledgement and celebration of the divine.3
Harvard philosopher Michael Sandel made a similar point in his Atlantic article and then book, The Case Against Perfection. “To believe that our talents and powers are wholly our own doing,” he writes, “is to misunderstand our place in creation, to confuse our role with God’s.”4
This isn’t just a philosophical position. We’ve already seen how early-stage embryos can be mosaics of different types of cells that make it difficult to determine whether a potentially harmful mutation will wind up a real problem for a future child or not. We’ve seen how even the most seemingly determinative of single-gene mutations don’t always cause the disease they usually do. With so much at stake, why wouldn’t we just take the safer route of trusting nature and our own biology—even with all of its bugs, shortcomings, and sometimes dangerous mutations—that’s evolved over billions of years?
Because we are humans, that’s why.
The moment our ancestors made tools, they were challenging the environment as they found it. The moment we started planting crops, clearing fields, and creating medicines to fight off the terrible, natural diseases afflicting us, we were giving the middle finger to nature as it was. Although we have good reasons to not want to cut down our forests, poison our air and oceans, and kill off the other species sharing our planet, our history with nature as we found it is a history of war. Nature conspired to kill us through hostile weather, predation, starvation, and disease, and we fought back with everything we had. We didn’t live in harmony with nature; we balanced respect for nature with outright war against it.
We would all agree that ants are part of nature and so are anthills. Birds are part of nature and so are nests. Humans, too, are part of nature. What else could we be? If so, are not our shopping malls, nuclear bombs, and CRISPR edits also part of nature?
We would have no need to “play god” if the world we found ourselves inhabiting was less hostile. Darwin described nature as “clumsy, wasteful, blundering, low, and horribly cruel.”5 If god exists and is benign, it’s fair to ask, why is god not playing god? If the world is in god’s image as it is, why do we fight natural diseases like cancer at all? If it is not, why would we impose limits to what we might do to continue making the world a better and safer place for us? If god, for those who believe in the concept, didn’t want us to live in caves fighting off disease, starvation, predators, and the elements, isn’t everything from stone tools to fire to editing our genome part of doing our bit to complete god’s unfinished business? But if, on the other hand, this god is agnostic about us, shouldn’t we do what we can to defend and promote our species while protecting the ecosystems around us?
This leads to the logical conclusion not that we should never “play god” but that we must—but wisely and in balance with our surroundings. We will never have perfect knowledge of the genome just like we never had perfect knowledge of fire before we started harnessing it, cancer before we started treating it, or domesticated crops before we started eating them. In each case, we balanced the costs and benefits and moved forward with imperfect information and a hunger to learn and do more. The same is true with genetic technologies.
The bigger the step we consider taking to advance the genetic revolution, the more the potential costs will and should weigh on us. Continuing to conduct research is clearly the right thing to do. Making nonheritable genetic changes in people to help fight disease is also well on the path to widespread acceptance. Selecting and gene editing embryos will be bigger steps and rightly engender more conversation and scrutiny. But it would be folly to suggest that our species needs to wait for perfect knowledge to move forward. We can’t and we won’t. We are the hominins who climbed down from the trees and then conquered the world. We’re filled with optimism and hubris. It’s built into our operating system.
Opponents of any heritable genetic modifications warning of the “slippery slope,” where each step leads to the next, are in this sense not wrong.6 Each small step that scientists, doctors, or governments take in the direction of human genetic engineering will justify the next small step. If it’s okay to incorporate another woman’s donated mitochondria to help parents prevent a child from being born with mitochondrial disease, why couldn’t heritable genetic changes be made to eliminate other terrible diseases? If it’s okay to select an embryo who won’t die young from Huntington’s disease or doesn’t have disrupted copies of the APOE4 gene that significantly increases its chances of getting early onset Alzheimer’s, why couldn’t we select one likely to live an extraordinarily long and healthy life? If we can mix and match genetic materials to make pigs with human hearts for transplant, why can’t we mix and match genes from multiple humans to ensure our future children have the strongest human heart or other organ or capacity we can provide them?7
“Genetic illness and genetic wellness [are] not discrete neighboring countries; rather,” Siddhartha Mukherjee beautifully writes in The Gene, “wellness and illness [are] continuous kingdoms, bounded by thin, often transparent, borders.”8 There is nothing inherently wrong with a slippery slope; we just need to be mindful of the direction in which we are sliding.
Decisions about whether or not to genetically select or alter preimplanted embryos are made by adults, but their real impact is on future children. Genetic conservatives, some of whom are political liberals, make the case that actively deciding the genetics of future children takes agency away from those children. But how much choice do children have about their mother’s prenatal nutrition or stress levels during pregnancy, or whether they are sent, like many young South Korean kids, to cram schools from an early age to increase their chances of admission to the best universities and later success? While genetic conservatives argue we have a moral obligation to not alter future generations because they have no say in the matter, others contend just the opposite.
Oxford bioethicist Julian Savulescu is a key voice asserting that parents have a “moral obligation to create children with the best chance of the best life.” He argues that “couples who decide to have a child have a significant moral reason to select the child who, given his or her genetic endowment, can be expected to enjoy the most well-being.”9 Oxford’s Nick Bostrom arrives at the same conclusion when he suggests we deploy what he calls the “reversal test” when figuring out whether it is morally justified to make a given genetic alteration to a future human.10
Bostrom’s argument is that if some people feel that making a change in one direction is bad—say, genetically engineering a person to eliminate a genetic disease—they would have to articulate why doing the opposite, that is, genetically engineering a person to add a genetic disease, would be justified, because this is in effect what they would be doing. Because no one could logically argue for genetically engineering humans to add diseases, this logic structure implicitly favors human enhancement.
Arguments like Savulescu’s and Bostrom’s have been attacked as morally repugnant by opponents who believe this justifies valuing one life more than another, denigrates disabled people, misunderstands what constitutes a “good life,” conflates genetic therapies and enhancements, and commodifies future offspring. In his 2018 book She Has Her Mother’s Laugh, science journalist Carl Zimmer warns against what he calls a “genetic essentialism” that reduces the complexity of humans and humanity to mere genetics.11 All of these criticisms raise the specter of modern-day eugenics.12
The eugenics claim is not a spurious one. It hovers, in fact, over the entire prospect of human genetic engineering like a dark cloud.
The term eugenics combines the Greek roots for good and birth. Although coined in the nineteenth century, the concept of selective breeding and human p
opulation culling has a more ancient history. Infanticide was written into Roman law and practiced widely in the Roman Empire. “A father shall immediately put to death,” Table IV of the Twelve Tables of Roman Law stated, “a son who is a monster, or has a form different from that of the human race.”13 In ancient Sparta, city elders inspected newborns to ensure that any who seemed particularly sickly would not survive. The German tribes, pre-Islamic Arabs, and ancient Japanese, Chinese, and Indians all practiced infanticide in one form or another.
The 1859 publication of Darwin’s The Origins of Species didn’t just get scientists thinking about how finches evolved in the Galapagos but about how human societies evolved more generally. Applying Darwin’s principles of natural selection to human societies, Darwin’s cousin and scientific polymath Sir Francis Galton theorized that human evolution would regress if societies prevented their weakest members from being selected out. In his influential books Hereditary Talent and Character (1885) and then Hereditary Genius (1889), he outlined how eugenics could be applied positively by encouraging the most capable people to reproduce with each other and negatively by discouraging people with what he considered disadvantageous traits from passing on their genes. These theories were embraced by mainstream scientific communities and championed by luminaries like Alexander Graham Bell, John Maynard Keynes, Woodrow Wilson, and Winston Churchill.
Although his work was partly in the spirit of the Victorian England times, Galton was then and even more now what we would call a racist. “The science of improving stock,” he wrote, “takes cognizance of all the influences that tend in however remote degree to give the more suitable races or strains of blood a better chance of prevailing speedily over the less suitable than they otherwise would have had.”14 In 1909, Galton and his colleagues established the journal Eugenics Review, which argued in its first edition that nations should compete with each other in “race-betterment” and that the number of people in with “pre-natal conditions” in hospitals and asylums should be “reduced to a minimum” through sterilization and selective breeding.15
Galton’s theories gained increasing prominence internationally, particularly in the New World. Although eugenics would later accrue sinister connotations, many of the early adopters of eugenic theories were American progressives who believed science could be used to guide social policies and create a better society for all. “We can intelligently mold and guide the evolution in which we take part,” progressive theologian Walter Rauschenbusch wrote. “God,” Johns Hopkins economic professor Richard Ely asserted, “works through the state.” Many American progressives embraced eugenics as a way of making society better by preventing those considered “unfit” and “defective” from being born. “We know enough about eugenics so that if that knowledge were applied, the defective classes would disappear within a decade,” University of Wisconsin president Charles Van Hise opined.16
In the United States, the “science” of eugenics became intertwined with disturbing ideas about race. Speaking to the 1923 Second International Congress of Eugenics, President Henry Osborn of New York’s American Museum of Natural History argued that scientists should:
ascertain through observation and experiment what each race is best fitted to accomplish… If the Negro fails in government, he may become a fine agriculturist or a fine mechanic… The right of the state to safeguard the character and integrity of the race or races on which its future depends is, to my mind, as incontestable as the right of the state to safeguard the health and morals of its peoples. As science has enlightened government in the prevention and spread of disease, it must also enlighten government in the prevention of the spread and multiplication of worthless members of society, the spread of feeblemindedness, of idiocy, and of all moral and intellectual as well as physical diseases.17
Major research institutes like Cold Spring Harbor, funded by the likes of the Rockefeller Foundation, the Carnegie Institution of Washington, and the Kellogg Race Betterment Foundation, provided a scientific underpinning for a progressive eugenics movement growing in popularity as a genetic determinism swept the country. The American Association for the Advancement of Science put its full weight behind the eugenics movement through its trend-setting publication, Science.18 If Mendel showed there were genes for specific traits, the thinking went, it was only a matter of time before the gene dictating every significant human trait would be found. Ideas like these moved quickly into state policies.
Indiana in 1907 became the first U.S. state to pass a eugenics law making sterilization mandatory for certain types of people in state custody. Thirty different states and Puerto Rico soon followed with laws of their own. In the first half of the twentieth century, approximately sixty thousand Americans, mostly patients in mental institutions and criminals, were sterilized without their acquiescence. Roughly a third of all Puerto Rican women were sterilized after providing only the flimsiest consent.19 These laws were not entirely uncontroversial, and many were challenged in courts. But the U.S. Supreme Court ruled in its now infamous 1927 Buck v. Bell decision, that eugenics laws were constitutional. “Three generations of imbeciles,” progressive Supreme Court justice Oliver Wendell Holmes disgracefully wrote in the decision, “are enough.”20
As the eugenics movement played out in the United States, another group of Europeans was watching closely. Nazism was, in many ways, a perverted heir of Darwinism. German scientists and doctors embraced Galton’s eugenic theories from the beginning. In 1905, the Society for Racial Hygiene was established in Berlin with the express goal of promoting Nordic racial “purity” through sterilization and selective breeding. An Institute for Hereditary Biology and Racial Hygiene was soon opened in Frankfurt by a leading German eugenicist, Otmar Freiherr von Verschuer.
Eugenic theories and U.S. efforts to implement them through state action were also very much on Adolf Hitler’s mind as he wrote his ominous 1925 manifesto, Mein Kampf, in Landsberg prison. “The stronger must dominate and not mate with the weaker,” he wrote:
Only the born weakling can look upon this principle as cruel, and if he does so it is merely because he is of a feebler nature and narrower mind; for if such a law did not direct the process of evolution then the higher development of organic life would not be conceivable at all… Since the inferior always outnumber the superior, the former would always increase more rapidly if they possessed the same capacities for survival and for the procreation of their kind; and the final consequence would be that the best in quality would be forced to recede into the background. Therefore a corrective measure in favor of the better quality must intervene…for here a new and rigorous selection takes place, according to strength and health.21
One of the first laws passed by the Nazis after taking power in 1933 was the Law for the Prevention of Hereditary Defective Offspring, with language based partly on the eugenic sterilization law of California. Genetic health courts were established across Nazi Germany in which two doctors and a lawyer helped determine each case of who should be sterilized.
Over the next four years, the Nazis forcibly sterilized an estimated four hundred thousand Germans. But simply sterilizing those with disabilities was not enough for the Nazis to realize their eugenic dreams. In 1939, they launched a secret operation to kill disabled newborns and children under the age of three. This program was then quickly expanded to include older children and then adults with disabilities considered to have lebensunwertes leben, or lives unworthy of life.
Making clear the conceptual origins of these actions lay in scientifically and medically legitimated eugenics, medical professionals oversaw the murder of an ever-widening group of undesirables in “gassing installations” around the country. This model then expanded from euthanizing the disabled and people with psychiatric conditions to criminals and to those considered to be racial inferiors, including Jews and Roma, as well as homosexuals. It was not by accident that Joseph Mengele, the doctor who decided who would be sent to the gas chambers at Auschwitz, was a former star s
tudent of von Verschuer at the Frankfurt Institute for Hereditary Biology and Racial Hygiene.
By the mid-1930s, the American scientific community was pulling away from eugenics. In 1935, the Carnegie Institution concluded the science of eugenics was not valid and withdrew its funding for the Eugenics Records Office at Cold Spring Harbor. Reports of Nazi atrocities amplified by the 1945–46 Nuremberg trials put the nail in the coffin of the eugenics movement in the West. Although eugenics laws were finally scrapped from the books only in the 1960s in the United States and the 1970s in Canada and Sweden, very few people were forcibly sterilized after the war.
But as new technologies more recently began to revolutionize the human reproduction process and create new tools for assessing, selecting, or genetically engineering preimplanted embryos, many critics raised the specter of eugenics. In his influential 2003 presidential address to the American College of Medical Genetics, and later in a published article, University of California, San Francisco, pediatrician Charles Epstein provocatively asked, “Is modern genetics the new eugenics?” He answered that it had the potential to be, if the scientific community was not self-aware and careful.22
Harvard’s Michael Sandel made a similar point in The Case Against Perfection:
Genetic manipulation seems somehow worse—more intrusive, more sinister—than other ways of enhancing performance and seeking success… This draws it disturbingly close to eugenics… Was the old eugenics objectionable only insofar as it was coercive? Or is there something inherently wrong with the resolve to deliberately design our progeny’s traits… The problem with eugenics and genetic engineering is that they represent a one-sided triumph of willfulness over giftedness, of dominion over reverence, of molding over beholding.23
Leading bioethicist Arthur Caplan argued:
Renegade scientists and totalitarian loonies are not the folks most likely to abuse genetic engineering. You and I are—not because we are bad but because we want to do good. In a world dominated by competition, parents understandably want to give their kids every advantage… The most likely way for eugenics to enter into our lives is through the front door as nervous parents…will fall over one another to be first to give Junior a better set of genes.24