Genetics and Ethics Book (... in the final stretch!)

I am working on the final chapter of my forthcoming textbook titled Genetics and Ethics for Polity Press. It is expected to be published in 2018 and I have cleared my summer schedule to ensure I have time to make the final revisions to make this book so it will be as up-to-date and relevant as possible. Here is the substantive blurb I sent the publishers which gives you an overview of the topics covered and conclusions reached in the book:

Advances in the biomedical sciences, especially our understanding of the role genes play in health, disease, happiness and human behaviour, might help societies advance important moral aspirations. These aspirations range from preventing and treating specific diseases, to realizing greater equality of opportunity, expanding the scope of reproductive freedom and the promotion of the healthy aging of a population. New technological advancements, like genetic screening and testing, gene therapy and genome editing raise a host of ethical questions. Is the idea of “genetically engineering” humans a morally objectionable form of “eugenics”? Would it be ethical to alter the rate of human aging if doing so would increase the number of years humans can expect to live on a warming planet with a global population already exceeding 7 billion people? Should parents undergoing IVF be permitted to screen for the sex of their offspring? What plays a more important role in human health and happiness, heredity or environment? And how does the answer to latter question influence what we consider morally sound science policy to be in the twenty-first century? These and other pressing societal concerns are addressed in Genetics and Ethics.

The book is designed to help students and scholars in the humanities and life sciences think rationally and cogently about the ethical and social challenges raised by the genetic revolution. Some philosophers have urged caution about expanding the domain of human control to include directly influencing the “genetic lottery of life”. Michael Sandel, for example, has argued that the quest to perfect our biology threatens to erode our appreciation for life as a gift. While Jürgen Habermas has defended the position that parents selecting the genetic constitutions of their offspring threaten the self-understanding of the affected person as an autonomous and responsible agent. Other authors make the idea of “normal species functioning” a central focus of their normative analysis of the demands of genetics and justice. In From Chance to Choice: Genetics and Justice, Allen Buchanan, Dan Brock, Norman Daniels and Daniel Wikler conclude that there is a principled presumption that genetic intervention to prevent or ameliorate serious limitations on opportunity due to disease is a requirement of justice. And finally the bioethicist Julian Savulescu has gone so far as to endorse what he calls the “principle of procreative beneficence” which maintains that couples should select the child who is expected to have the best life based on the relevant information, including genetic information.

Farrelly proposes we pause and hit the “reset” button on the ethical debates about genetics and genetic engineering. The ethical analysis developed in this textbook is not deferential to “normal species functioning” or the therapy/enhancement distinction. Nor does it address the ethics of procreative decisions in a fashion that ignores the different burdens that may be placed on women vs men. And finally, the ethical analysis advanced in the book does not treat genetic interventions as one monolithic type of intervention. Like different types of social engineering (e.g. patriarchy, capitalism, democracy, education, etc.), genetic engineering could be both good or bad. The devil is really in the details. So rather than develop an ethical analysis of genetics that prioritizes one particular value or moral ideal to guide our deliberations about the prospect of genetically engineering humans, Farrelly advances instead a provisional moral analysis. He contends that public discourse and debate should be informed by important empirical insights concerning the role heredity plays in different traits, as well as the risks, benefits and costs of genetic intervention to individuals and societies vs the risks, benefits and costs of the “biological status quo” yielded by the blind process of evolution by natural selection.

The chapters of the book address issues as varied as eugenics, infectious and chronic disease, evolutionary biology, epigenetics, happiness, reproductive freedom and longevity. The book emphasizes why the virtue ethics tradition is particularly helpful to address the complexity of ethical and social issues raised by advances in our understanding of human genetics. The virtuous polity, argues Farrelly, is one that aspires to ensure that both individuals and populations can flourish. By integrating an account of the moral virtues of benevolence and justice with the epistemic or intellectual virtues- the ability to recognise the salient facts and have a sensitivity to details, intellectual humility, adaptability of intellect and the detective’s virtues- Farrelly helps illuminate some of the ethical challenges raised by the genetic revolution. This distinctive methodology of the book, coupled with the timeliness of its applied focus, should appeal to both philosophers and those interested in advances in the biomedical sciences more generally.

An empirically-informed virtue ethics analysis of genetics and ethics, concludes Farrelly, yields five general, substantive moral convictions. Firstly, a virtuous polity would see genetic intervention, whether it be gene therapy, genome editing or a drug that modulates the expression of specific genes, as a possible extension of the duty to aid provided such interventions prove to be reasonably safe and cost-effective ways of preventing or treating morbidity. Secondly, virtuous agents would avoid the folly of both genetic determinism and environmental determinism. Thirdly, a virtuous polity would not necessarily eschew eugenics, where that term is taken to mean, as Bertrand Russell (1934) defines it, as “the attempt to improve the biological character of a breed by deliberate methods adopted to that end”. Eugenic aspirations can be morally defensible, even morally obligatory, when they pursue empirically sound and morally justified aims (e.g. promotion of health) through reasonable and morally justified means that treat all persons as free and equal moral agents. Fourthly, a virtuous polity would take a purposeful approach to determining the scope and limitations of reproductive and parental freedom. Such an approach will give due consideration to three different moral values (without ascribing a primacy to any one of these values)- autonomy, wellbeing and equality. And finally, a virtuous polity would aspire to promote the healthy aging of its population, including pursuing interventions that retard the aging process if doing so increases the healthspan or “biological warranty period” of humans. Any such aging intervention should be pursued in a responsible manner so that considerations of equity, population size, intergenerational justice and environmental impact are also taken seriously.