Genetic Reproductive Freedom
It's illiberal to deny women the right to choose their embryo
According to a recent survey,1 more bioethicists think abortion is permissible than judge it permissible to select a healthy embryo (even to avoid a painful medical condition). Incredibly, only 22% allow that selection for non-medical traits is generally permissible. I find this strikingly illiberal.
Inconsistent-seeming, too (when 87% support abortion). “Trust women,” they say, except when it comes to choosing the genetic makeup of their future children—at which point we should suddenly expect a random roll of the dice to do better? I really want to ask these people: Why don’t you trust women more? Why are you depriving them of reproductive choices? When you oppose such interference from others, why do you now demand that the government step between a woman and her doctor, imposing your values and preferences over her body?
Most of all, I find the reported combination of views substantively unreasonable. To see why, imagine a woman who is feeling on the fence about her pregnancy. She’s thinking about termination. But if she keeps the baby, she’s determined to give it the best start in life that she can. Supposing that gene editing technology exists that could (in expectation) improve her future child’s cognitive capabilities, empathy, grit, resilience, ambition, etc., she would avail herself of that opportunity—for her child’s sake. Or, again, she could abort it. Between these two options, do most bioethicists really want to say it would be morally better to terminate the pregnancy?2 (Would they try to pressure her in that direction?) I sure hope not.
Putting aside sheer superstition about “playing God”, I’ve heard two main objections to genetic reproductive freedom (or “enhancement”) that seem worth addressing: (1) concerns about unequal access exacerbating social inequality, and (2) concerns that parents could make bad choices. Both objections are deeply illiberal. I’ll discuss each in turn.
Unequal Access
There are few things that make my blood boil as reliably as Harrison Bergeron-style “leveling down” (e.g., depriving gifted children of advanced math classes for fear that helping them to reach their full potential would “exacerbate inequality”). It’s perhaps the one form of outright evil that is routinely tolerated on the political left. I find it deeply distressing.
Of course, no one is a consistently authoritarian egalitarian. That would require banning books, because children in wealthier households are advantaged by having more books around the home. And it would require totalitarian government control over mating choices, because assortative mating results in highly skilled and capable people autonomously choosing to pair up, giving their future children both genetic and environmental advantages compared to others.3 The costs of such interference are surely too great to countenance.
Still, plenty of people seem willing enough to be haphazardly illiberal, restricting some reproductive choices from fear of inegalitarian outcomes. The problem with this may be seen most clearly via parity reasoning. If egalitarianism leads you to deprive women of access to genetic improvements during pregnancy, why not also (unequally-distributed) environmental improvements? Should pregnant women privileged with clean air be forced to chain smoke, to better equalize fetal outcomes? Or should pre-natal vitamins, folic acid, and choline supplements be banned, because they are disproportionately taken by wealthier, more educated women to help with fetal development?
Good things are good. We should want more children, not fewer, to have access to the improved life prospects that privilege (sometimes) affords. Depending on the details (of cost and benefit), it may turn out to be worth subsidizing parents’ access to gene editing or embryonic selection technologies, to broaden access to this good thing.4 (A more capable citizenry has plenty of social value, after all. That’s part of why child poverty relief and subsidized education are such good ideas.) Crucially, the value of access to this technology cannot possibly be a reason to ban it. That gets things morally backwards.
The Risk of Bad Choices
The trickier issue is what to do about “bad” choices. The constant illiberal temptation is to use the force of government to prevent other people from making decisions that you disagree with. But unless a parental choice would constitute clear-cut child abuse (e.g., gratuitously selecting for a painful medical condition), my inclination is to bang the table with my liberal hammer and insist that it’s none of our damn business what children other people choose to have.
We may anticipate that some groups—even groups we generally support—will not be happy with the results that follow from women fully exercising their reproductive autonomy. So be it. Disability activists already object to selective abortion based on pre-natal screening, for example. Genetic selection would predictably make genetic diseases and disabilities even rarer than they already are. But unless you think Fetal Alcohol Syndrome activists, distressed by their dwindling numbers, should be allowed to force vodka down the throats of pregnant women, I don’t see how you can reasonably believe that disability groups should be allowed to interfere in others’ reproductive decisions.
The same goes for LGBTQ+ advocates who fear that many parents would opt to increase the odds of their children being straight, cis, etc.5 Others would remain free to make the opposite choices for their own families, of course. A liberal social compact should not ban (or compel) either option. We can try to persuade others of our views,6 but the ultimate power of decision must lie with each individual for themselves.
Many people prefer the idea of leaving such things up to chance. That’s fine—it may not be what I’d recommend, but they’re free to follow that preference for themselves. I just don’t think it’s reasonable to force others to roll nature’s dice, if they have different preferences and the opportunity to do better than chance. Let people make their own decisions. Trust people to make their own decisions. That’s what principled liberalism demands of us.
Inevitably, some people will make bad decisions. (And many will make defensible decisions for bad reasons.) That’s life. At least any one person’s reproductive choices are pretty low-stakes in the grand scheme of things. It’s when you introduce a coercive policy, forcing your views on everyone—even those who find your views terribly misguided—that you really raise the stakes. That’s a recipe for moral disaster, if the uniform coercive policy imposed turns out to be wrong (as seems likely).
If we (eventually) have the technical capability for cognitive, moral, and personality genetic enhancement, and coercively prevent anyone from taking advantage of it, the opportunity costs could be mind-boggling. Just imagine environmental analogues: banning books, poisoning pregnant women with lead, and so on. Even if you believe in an impairment/enhancement distinction—which I doubt has any principled basis—most education presumably lies on the “enhancement” side of the boundary. (Folks living before the invention of calculus weren’t thereby cognitively impaired.) So just think how terrible it would be to outright ban education, across the entire population. Coercively reducing the cognitive capabilities and life prospects for future generations is really bad! This “moral risk”—disaster, really—is so much more severe than anything that could realistically result from diverse individuals independently exercising their full reproductive autonomy.
Conclusion
We should take the risk of bad decisions into account. But by far the gravest such risk is that of an illiberal policy-maker forcing their bad (in)decision on the entire population, depriving everyone of better options. If you’re still not on board with full-blown liberalism (or reproductive freedom), let’s at least take care to minimize the scope of interference. Banning some limited list of “bad choices” would be more moderate than banning every non-random option whatsoever. We should strongly want people to have the opportunity to provide their kids with genetic benefits, just as with environmental benefits. I don’t see how any reasonable person could deny this.7
I’m guessing that most opponents of embryonic selection will also be opposed to gene editing of this sort.
“If you’re an egalitarian, how come your spouse is so brilliant?” is a much more pressing challenge than the traditional “how come you’re so rich?” version.
Though I kinda doubt that subsidies would be all that necessary. Unless artificially propped up by competition-restricting regulations, it doesn’t usually take all that long for prices to fall and a new technology in high demand to become more widely accessible. Then again, the medical sector is rather notorious for its byzantine, competition-restricting regulations, so…
We can sympathize and support these groups when they’re targeted by hateful, intolerant segments of society, without giving them a blank check to indulge in illiberal tendencies themselves. I worry that some on the left treat “ally-ship” the way some on the right treat patriotism, where unlimited in-group favoritism erodes all moral boundaries.
Though, contrary to those who insist that “traditional” preferences here must stem from bigotry, I actually think it’s perfectly reasonable for parents to (moderately) prefer that their kids have traits that make it easier and (moderately) more likely for those kids to eventually give them grandkids. If there turns out to be a “strongly desires biological children” gene-cluster, I would expect it to be in similarly high demand.
I understand that some people see the word “genetic” and start panicking. Presumably, they’re implicitly conflating technologically-aided genetic reproductive freedom with coercive eugenics (i.e., technologically-aided reproductive coercion). The two opposites are not the same, just because both involve technology and goal-directedness in relation to reproduction! Anyone making this conflation seems far from reasonable to me.
Yes. I suspect a pretty deep divide here is whether you tend to see zero sum or positive sum interaction as the default. If you see zero sum interaction as the default, then you'll either be a leveling down egalitarian (left) or an immigration/trade restrictionist (right). Or maybe both (see, eg, the new magazine Compact, which combines elements of both left and right zero sum thinking).
By contrast, if you see positive sum interaction as the default, you're less bothered by inequality (it needn't be hurting the worst off) and less worried about free movement of goods/labor making your compatriots worse off. This is why I see much more in common between the Trumpian and progressive worldviews than their supporters tend to; it seems to me they make the same starting mistake, and just develop it in different directions.
I agree with everything you said here but I'd like to mention too important other points.
First, in practice if someone's concern really is equality of opportunity the very last thing they should do is push for strict regulation. I think we can guarantee that worldwide effective bans just won't happen so they very rich and powerful will have access. The question is just do we open it up so the price can fall like it did with cell phones or keep it locked away for the ultra-rich?
Second, everyone tends to get stuck on things like intelligence and sure many people want a successful child but I think the real action here is with happiness. Some people really do seem essentially an order of magnitude more happy (hypomanic) and equally if not more functional. The possibility for reduction of human suffering just by choosing less unhappy genes is amazing.