Scotsman.com News - Opinion - A skinhead mentality is the wrong approach to genetics

Scotsman.com News - Opinion - A skinhead mentality is the wrong approach to genetics

A skinhead mentality is the wrong approach to genetics

DANI GARAVELLI
ANOTHER development in the field of genetic engineering, another round of predictable screeching.
With reproductive science advancing so quickly that new ethical dilemmas are pitched at us with the relentlessness force of a fast bowler at a Test match, it's a pity the debate on the issues it throws up is stuck in a groove carved out by the passing of the Abortion Act more than 30 years ago.
Take last week's offerings. First, fertility specialists announce they have developed a powerful new way to test embryos for inherited diseases such as Duchenne Muscular Dystrophy (DMD), even when the mutation that causes them is unknown, allowing IVF couples to cherry-pick healthy embryos for implantation. Then, it emerges a London hospital has asked for permission to destroy male embryos conceived by couples with a family history of autism, on the grounds that they are more likely than the female ones to have the condition.
Developments like this are of huge significance and raise profound questions about the way in which we want the world to progress. The manner in which we use the scientific knowledge we accrue impacts not only on individual families, but on society as a whole. And it's important to make the right decisions from the beginning. Reproductive technology has its own momentum. If we get it wrong, there will be no back-tracking.
With this in mind, you would hope that we would be applying ourselves to coming up with sophisticated, 21st-century responses to multi-layered dilemmas. Instead, what we get is a debate with all the subtlety of a group of skinheads on immigration. Vested interests take up entrenched positions: pro-choicers versus anti-abortionists; religious absolutists versus atheists; idealists versus pragmatists. The rhetoric used on both sides is manipulatively emotive and needlessly insulting. But worse still, much of it is deliberately misleading.
I have lost count of the number of newspapers columns that laud genetic screening and IVF for "creating" healthy babies. Yet this is completely erroneous. What the process actually does is to allow them to identify and destroy unhealthy ones. Whether or not this is a good thing is a valid point for argument, but let's at least get the terms of reference right.
On the other side of the argument, opponents of genetic screening refer to it as "the thin end of the wedge", as if termination on the grounds of imperfection was a pernicious new concept. Yet, we have been testing for, and aborting foetuses with, Down's Syndrome for years, despite the fact that babies born with the condition have a reasonable quality of life and often live well into their forties or fifties. If this is already routine, then surely our consciences need not be troubled by the destruction of embryos with far more debilitating conditions.
The difference with IVF of course is the issue of selection: that someone is picking which embryo will be implanted and which destroyed. But since the success of IVF depends on producing surplus embryos, it seems eminently sensible to choose to implant the disease-free ones, and destroy the others, and not the other way round.
In order to move forward we need, first and foremost, to divest the debate of its religious baggage. To suggest concerns over the morality of genetic screening are confined to religious zealots who believe the right to take life resides with the Supreme Being is insulting both to the devout (because it implies faith is incompatible with more sophisticated thinking) and to those without (because it insinuates they place a lower value on prenatal life). You don't need to believe in the existence of a soul to feel uneasy about the destruction of "imperfect" embryos, nor do atheists have a monopoly on rationality.
Once we have done this, and long before we get to the nitty-gritty of actual law-making, there are some huge philosophical questions to mull over: for example, do we really believe it is possible to rid the world of disease, and even if it is, is it something we should aspire to? Is there such a thing as a right to a healthy baby? Is the eradication of pain an inherently good thing, or does pain have its own part to play in moulding humanity?
We also need to address the inconsistency in thinking that welcomes developments which help doctors detect and destroy embryos with debilitating conditions, on the one hand, and uses technological advances to save the lives of extremely premature and often severely brain-damaged babies, on the other.
For my part, I have residual doubts about the wisdom of the genetic screening of embryos, although I remain open-minded. On a human level, it would, of course, be difficult to deny a family, which has already lost two babies to a degenerative wasting disease, the opportunity to ensure their third was free of the condition. But, since the new test can apparently screen for 6,000 diseases - each of which will have a different impact on the sufferer - a blanket approach to genetic screening seems inappropriate.
As the medical ethics expert Sheila McLean once pointed out: to destroy an embryo with the breast cancer gene may be "to apply today's technology to tomorrow's adult." The baby in question may never contract the disease. And even if she does, it will be many years down the line, by which time doctors may have discovered a cure.
Instinctively, too, I feel that to destroy an embryo on the grounds that it is a carrier - rather than a sufferer - of a hereditary condition smacks more of social experimentation than good medicine. And yet, on a logical level it is clear that if hereditary diseases could be eradicated so would the need for genetic screening.
Because of the immense complexity of the issues, I hope the Human Fertilisation and Embryology Authority will continue to proceed cautiously, examining all the potential applications of each new development and ruling on an issue-by-issue basis. In the meantime, it is our duty to raise our game in contributing to the public debate. If we continue to get bogged down in facile name-calling and bitter anti-religious rants, then we will miss the boat. Science will march on regardless, and we will find ourselves in a landscape we scarcely recognise, and which we played no part in shaping.

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