Ethical Challenges of Germline Genetic Enhancement

Abstract

The new reproductive technologies have opened the door to different processes of germline genetic enhancement by which the characteristics of an individual according to the interests of the agents involved could be selected during its gestation. Although the initiative is apparently oriented towards developing individuals that would excel in society, critical voices raise the concerns about that this approach would generate and need for a reflection on the ethical, social and legal implications of these techniques and their implementation in society. We reviewed the literature about these issues throughout their historical records to date, focusing on the moral arguments and non-clinical aspects that affect the legal and social environment. We have observed various trends of thought with divergent positions (proactive, preventive, and regulatory) as well as a large number of articles that try to reconcile the different approaches. This review illustrates a series of concepts from the ethics and philosophy fields which are frequently used in studies that evaluate the ethical implications of germline genetic enhancement, such as dignity, benefit, autonomy, and identity. In addition, amongst the many unresolved controversies surrounding genetic enhancement, we identify procreative beneficence, genetic disassociation, gender selection, the value of disability, embryo chimerization, and the psychosocial inequality of potentially enhanced individuals as crucial. We also develop possible scenarios for future debate. We consider especially important the definition and specification of three aspects which are essential for the deployment of new reproductive technologies: the moral status of the embryo undergoing enhancement, the legal status of the enhanced individual, and the responsibility of the agents executing the enhancement. Finally, we propose the precautionary principle as a means to navigate ethical uncertainties.

Fresh Umbilical Cord Blood—A Source of Multipotent Stem Cells, Collection, Banking, Cryopreservation, and Ethical Concerns

“…However, studies have shown that using private banks has several difficulties, including a high economic cost. Public banking services are useful; however, the waitlist may be longer, putting people’s lives in jeopardy [ 118 ]. Another recurrent issue addressed in studies reviewed is the disclosure of the donor and recipient’s names, which are frequently published in government banks.…”

Ethical challenges of cord blood banks: a scoping review

“…These concerns led to the emergence of movements on the theme of patients' rights as well as the right of society to participate in medical decision-making [ 41 ]. Addressing ethical issues related to these technologies seems to be one of the basic requirements that must be considered in the comprehensive health system [ 42 ]. One of these issues is respect for the autonomy and independence of individuals (sick or healthy) who are entitled to choose/reject a special treatment [ 43 ].…”

“…Different studies indicate that umbilical cord blood cells should not be used without parents' permission. This moral concern is right and reasonable; cord blood bank managers are required to give parents serious moral and legal guarantees about this concern [ 42 ].…”

Healing the Fundamental Unit of Heredity (Gene Therapy): Current Perspective and What the Future Holds

“…However, despite its potential to prevent congenital disease, germline therapy is highly controversial and there has been little research in its field for technical or ethical reasons. 1,[13][14][15] In germline gene therapy, stem cells such as sperm and eggs are modified by inserting updated genes into the genome. Modifications in this way can be made from generation to generation to create the next generation.…”

“…In this therapy, any side effects are limited to these patients and are not passed on to the next generation. 13 In general, the individual genetic makeup is not affected by the corrected changes, but this therapy can be repaired and contribute to the normal function of the damaged organ. 16 Somatic cell gene therapy is considered the only therapy that can be accepted by society, this is because this therapy can affect cells, tissues, or organs that are targeted by sufferers and are not passed on to the next generation.…”