We Have Always Designed Babies But Are The Moral Fashions Really Changing?

by Dr. Nileema Conlon Vaswani in

If we thought that Alzheimer's disease was one that we could worry about later in life, Charl and Danielle de Beer have shown us that it is a disease that deserves consideration at the very beginning. The couple, who is undergoing fertility treatment, has asked that their embryos be screened for early-onset Alzheimer's disease. Only those embryos that do not carry the gene for this disease will be implanted. The couple has a family history of early onset Alzheimer's from Charl's side of the family and, although, he does not know whether or not he has been affected, both he and his wife would like to prevent the disease from being passed on to their children. The HFEA (Human Fertilisation and Embryology Authority) in the UK has allowed the clinic in London where the couple is receiving fertility treatment to screen the embryos for this rare type of Alzheimer's disease. So is it morally permissible to choose one's embryos and, via that process, one's children as well?

Traditional methods of having children may not rely on an active selection of characteristics about the child to come but they do still depend on passive methods of selection. We choose our partners and if we have children with them we do, in some sense, choose what the children will look like. A mixed race couple will, for example, produce a mixed race child. While the reason for their relationship may not be to produce a mixed race child, it is a passive choice nonetheless. Pregnant women are encouraged by the State to produce the healthiest baby possible and, for this reason, discouraged from doing anything that might compromise the health of the foetus. Even in cases of adoption, couples specify criteria for the children they want to adopt. Some people specifically ask to adopt children of a certain race or gender. These criteria or preferences are considered socially acceptable and are generally not labelled as moves towards designer babies.

In the case of the embryos in question, we are not trying to maintain the health of a chosen embryo as one might be encouraged to maintain the health of the foetus in a pregnancy but are choosing an embryo that is healthy. At the very least, it will be free from the gene for early onset Alzheimer’s disease. If we were to extend the argument, we would be choosing a child who was free from developing this form of Alzheimer's disease. However, this difference is not necessarily morally problematic.

Imagine that technology had progressed to the point where instead of having to screen embryos for inheritable diseases, markers to indicate the probability of these diseases, revealed themselves. Under this system, when an embryo was created, we would be able to see how healthy it was, what genetic diseases were present, and so on. When deciding which embryos to implant, we would most likely choose the ones that were more likely to have a future with less disease than those who were likely to remain unhealthy. If our decision to choose healthy embryos is morally permissible, perhaps even morally obligatory, when the embryos reveal their own features, then why would it be morally impermissible to choose healthy embryos when we have to use screening to reveal the very same features?

The fear that allowing screening for an inheritable disease such as Alzheimer's will lead to the creation of "designer babies" with choices such as eye colour and hair colour being made, is somewhat unwarranted. For as long as screening is regulated, each case can be considered on the basis of its own merits. The point about screening for Alzheimer's is that it is just that, i.e., a debilitating disease, and lies in a category that is quite different from eye colour or hair colour.

It is, of course, true that even a healthy embryo could grow into an unhealthy child and eventually into an unhealthy adult. Screening for one inheritable disease is just that; it does not preclude the individual's developing other unknown inheritable diseases or even from developing a disease because of external conditions. Attempts to prevent one's child from developing this rare form of Alzheimer's disease does not prevent the child from developing another medical condition that would alter his or her quality of life in the same way as would early onset Alzheimer's disease. For this reason, critics of the screening process might ask whether it is even worth selecting an embryo that is free from the gene for early onset Alzheimer's disease.

We can only do what lies within our control to ensure the best for our children. The de Beers are doing just that. They don't want their children to suffer and for their lives to be cut short in their thirties. These intentions are morally praiseworthy even if, for reasons unrelated to Alzheimer's disease, their children's quality of life is compromised at the same time as would have been had they developed Alzheimer's disease. Although technology can often be misused, in cases such as this, it can help rather than hinder a morally appropriate course of action. If we are designing babies in cases like this one, we are only doing so to the right moral specifications.