Prenatal Gene Therapy: Playing God or Playing Doctor?

In recent years new tests, such as amniocentesis and chorionic villus sampling, have been developed to determine if unborn children have a genetic disease. In the past there has been no way to help an unborn child with a genetic disease such as Down syndrome. But we are now developing germ line gene therapy, which are manipulations on the genetic level, in order to prevent such diseases. If a disease is prevented in unborn children, it may eventually be wiped out in future generations. Germ line gene therapy also may be used to determine the sex, hair color, eye color, and other traits of a child. There are arguments for and against these therapies, but my belief is that prenatal engineering is detrimental to the individuality of mankind except to promote the well being of an unborn child.

Prenatal testing has been made possible through advances in genetics that allow parents to know if their children have genetic diseases. Amniocentesis, which is performed during the second or third trimester, is when amniotic fluid is drawn from the amniotic sac with a long needle through the pregnant woman’s stomach (Ettorre 27). This test can detect Down syndrome, blood type, and metabolic or neural problems. Chorionic villus sampling is another test made available through advances in genetics. This test is done during the tenth or twelfth week of pregnancy by removing a tiny sample of chorionic tissue with a small tube that is inserted into the vagina through the cervix to collect, by suction, a tiny sample at the edge of the placenta (Ettorre 28). This test can detect the same things as amniocentesis, except neural tube defects, but it can be done sooner. For amniocentesis and chorionic villus sampling there is respectively a 1% and a 3% chance the woman will miscarry as a result of the testing (Ettorre 28). Another disadvantage of the testing is that as of now there is no cure for a child who tests positive for a disease, and many women choose to have a spontaneous abortion rather than keep a diseased child (Ettorre 29).

Now that genetics is more fully understood and new technology is available to manipulate genes, there soon may be ways to cure some genetic diseases detected during prenatal testing. One way gene therapy can be used is to treat an unborn child for a genetic disease. Gene therapy may be able to remove the harmful gene and insert a healthy replacement gene directly into the child through an injection, inhalation, retroviruses, or pills (Barbour 111).

There are many reasons people believe why this technology should and many why it should not be used. One reason people should not use gene therapy is that the human body tends to reject anything foreign, like a virus carrying a corrective gene into a diseased cell (Barbour 175). Some see gene therapy as "playing god" and condemn it as an arrogant and illegitimate intervention into the natural order (Hildt 110). Others believe that removing a disease gene from the genome may unintentionally remove the hidden collateral benefits that these genes may have (Hildt 110). Another disadvantage is that the procedure is irreversible, so if a side effect is discovered as a person who received this treatment grows older it is not possible to reverse what was done. The effects of gene transfer in recent gene therapy trials were either not enough to reverse clinical abnormalities or were limited by rapid extinction of the trans gene extinction (Tournier-Lasserve 2). Trans gene extinction means that the inserted gene doesn’t survive and the trait disappears.

Another problem with this practice is that it amounts to non-consented therapy for not-yet-existing people; it does what we think is good for them, not necessarily what they think is good for them (Hildt 112). Gene therapy also can be seen as discriminatory to disabled people, due to their potential decrease in numbers, hence their political power, and the implicit devaluation of their lives (Savulescu 2). This practice may make the disabled feel as if the general population wants to get rid of them.

One very important advantage to gene therapy is that people may be able to stop some diseases from occurring in future generations. Families that may know they carry a gene for sickle cell anemia, or other diseases, may decide to have that gene replaced in their unborn children, so their future generations do not get the disease (Caplan 2). Parents would not have to give up their children and would be free of the stress of losing any of their children. Children who are diagnosed with a disease in the womb will have the chance to live a normal life once they are born. It has always been a goal of doctors and scientists to use medicine to help cure diseases and keep people healthy; gene therapy is just another way for them to help the general population.

Another way gene therapy can be used is to choose certain traits of a child such as sex, eye color, intelligence in some subjects and so on. One advantage of using gene therapy in this way is that if a person really wants a blonde hair blue-eyed baby girl they could have one. Many people have a larger number of children because they would like to experience having both a boy and a girl or one or the other. With gender selection people would be able to have fewer children to experience a boy and girl, which could be an opportunity to help with our population crisis (Moran 3). Also if a family carries a sex-linked disease, such as hemophilia, the parents may avoid passing the disease onto their children by choosing their gender (Moran 2). This procedure of choosing a child’s sex would also prevent the gene from being passed onto the future generations of the family.

There is also risk to using gene therapy in this way. In the gender selection procedure seven of twenty-nine pregnancies resulted in a spontaneous miscarriage (Moran 3). Most women take more than one menstrual cycle before they become pregnant. The procedure would cost $2,500 per menstrual cycle, which can get very expensive (Moran 2). Gender selection also could result in an imbalance in the sex ratio. Overall variety in the gene pool may be significantly and possibly irreversibly reduced if significant numbers of people choose the same traits in their children (Hildt 122). If selection according to a widely shared criterion becomes an established practice then those who have the unwanted characteristics would take this practice as an offense and may have a lower self-esteem because they would think they don’t have desirable traits (Hildt 123). Also children who have their traits chosen before they are born, may feel that more is expected from them than is not expected from children produced by the free play of "reproduction roulette" (Hildt 122). They may have additional stress in trying to live up to the image that their parents made for them. People who are engineered for superior intelligence in some subjects, such as math or science, may have an unfair advantage over those who are not genetically enhanced. Genetically enhanced people may also have superiority complexes and make others feel less confident or less worthy.

Overall I believe that if gene therapy is available to unborn children who have a disease, it should be used so that the child has a chance at a normal, happy life. The only time I think sex selection should be used is if one of the parents carries a sex-linked disease that can be stopped from passing onto to the family’s next generation. When it comes to choosing the traits of a child I believe people should love their children whether male or female, blonde or brunette, or blue or brown-eyed.

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Works Cited

Ettorre, Elizabeth. Reproductive Genetics, Gender and the Body. London: Routledge, 2002.

Hildt, Elisabeth, and Sigrid Graumann, eds. Genetics in Human Reproduction. Vermont: Ashgate, 1999

Moran, Mark. "Sex Selection Seems Successful." American Medical News 41.37 (1998): 42