- The Washington Times - Tuesday, March 5, 2002

A medical milestone divided the science community and raised weighty ethical questions last week as genetics technology took a step that some see as progress but that alarmed others who fear the advent of "designer babies."

A test-tube baby girl was born free of her mother's early onset Alzheimer's disease after doctors performed a genetic screening of the woman's embryos for the unwanted gene.

The news, published Wednesday in the Journal of the American Medical Association, ratcheted up what has become an increasingly passionate dialogue on gene manipulation.

After a typical in vitro fertilization was performed, doctors examined the embryos and selected four out of 15 that did not contain the Alzheimer's gene to produce a baby. Without that screening, the woman's child would otherwise have had a good chance of becoming hopelessly senile around the age of 30.

The new technique, called preimplantation genetic diagnosis (PGD) or preimplantation diagnosis (PID), was performed by Dr. Yury Verlinsky at Chicago's Reproductive Genetics Institute.

While many celebrated the news and don't find it "particularly problematic," others maintain it is a step toward a troubling "ethical cliff."

Will such methods be used only to cure the sick, or will parents use the procedure for custom-ordered children? Is this a step toward a new eugenics?

"We're really on the precipice of a time in which we will not unconditionally love our babies," says Wesley Smith, author of "The Culture of Death."

"It's a deal with the devil motivated by desire to get the good, but you're going to get the evil," he says. "We're not a species known for self-restraint."

Karen Rothenberg, dean of the Law and Health Care Program at the University of Maryland, says PID could allow "a society where we have not only an economic and social underclass but a genetic underclass."

"Who's qualified to be a parent and who's qualified to be born?" Miss Rothenberg asks.

Many geneticists call such concerns hysterical. "The tone [of media coverage] has been, 'Oh my God, this is the beginning,' and 'What's the next step going to be?'" says Dr. Gregory Stock, director of the program on medicine, technology and society at UCLA's school of medicine. "And I would say, 'What in the world is wrong with what those parents did?'"

Miss Rothenberg says there won't be a demand for designer babies. "Most of us cherish the opportunity to try to have a baby the natural way. That's our first goal," she says.

Proponents of gene screening say that PGD can be confined to disease-specific situations in which lives can be saved, and that it will never get to the point of "designer babies." Mr. Smith calls that position "astonishingly naive" and "willfully ignorant."

If the procedure can be used to prevent a dreaded disease, Mr. Smith asks, won't scientists and parents, emboldened by this success, naturally start to screen for intelligence and athletic ability?

Dr. Stock doesn't necessarily think that is a bad thing.

"What if we move toward predispositions that are not so serious or not fatal?" he says. "I don't find that particularly problematic."

Few criticize the case reported in JAMA, which may have spared a child from a debilitating hereditary disease. But PGD's science-fictionlike implications are, to some, terrifying.

In his 2001 essay "Redesigning Life," Dr. David King writes, "It will soon become common sense that sex is for fun, but having a baby is a serious matter, not to be left to chance."

Perhaps the next question is how we will, as a society, respond to those who do and don't have PGD, should it become widely available.

"I think it will be seen as reckless to not have genetic screening of one kind or another the idea that every child should have the right to start off with a healthy genetic constitution," says Dr. Stock, author of "Redesigning Humans."

"What worries me is when is it going to go from being an option to being a duty?" Miss Rothenberg asks. As long as it remains parents' choice, "society will whisper behind the back" of families who choose not to get PGD, she says.

"I think the greater pressure is not what social feelings will be, but what will happen with health care decisions," Dr. Stock says. "If you were going to cover a child and the parents were willing to undergo a genetic test, insurance would be cheaper."

It's difficult to know timetables on these new technologies. Science that once seemed like science fiction is here now, and no one knows this more than the scientists at the forefront of the debates.

"This whole discussion that we're having is part of society's attempt to come to grips with these new technologies, the possibilities that are brought about by this revolution in genetics," Dr. Stock says.

This discussion isn't premature, but preliminary, he says: "It doesn't even touch the harder issues."


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