Bad things happen because they're good. That's Human Nature's first law. But how does it work? How does a good technology—preimplantation genetic diagnosis, for example—turn bad? Are the good and bad related? Should we never have created the technology in the first place?
Two exchanges from the last couple of weeks shed some light on the paradox. The first comes from my friend Jeremy Manier. Jeremy and I have been exchanging thoughts about the impending arrival of PGD for aesthetic traits—hair, eye, and skin color—in humans. I had cited dog breeding as a precedent. But Jeremy points out that we "already have done a version of the dog trick with the now-defunct 'Nobel Prize sperm bank'—the moral equivalent of breeding a former dog show champion." He continues:
The Nobel bank was creepy, but it remained something of a fringe practice, even though it offered an easy route to instant eugenics. One reason it stayed a fringe phenomenon may have been the lack of control prospective parents had over the outcome. You couldn't really be sure your Nobel offspring would be an Einstein, and the child might lack good looks and social graces altogether. The Nobel bank may have boosted the odds that your child would have the desired traits, but it still relied on old-fashioned, largely unsupervised egg-sperm unions.
Pre-implantation screening of traits gets you more control, and that kind of control is what worries me most. … Reproduction the old way amounted to an honest roll of the dice. Now the dice could be loaded to prevent novelty.
I think that's exactly right: PGD gets you more control. That's what makes it such a blessing when you're trying not to pass on a fatal disease: You don't have to accept the guesswork of "Well, I'm asymptomatic, and so is my husband, so the odds are that our child won't get it." But that's also what makes it troubling when you're aiming for aesthetic traits: It eliminates novelty and surprise (Jeremy's beef), and it lowers the threshold for discarding embryos as unfit (my beef). Using sperm from a blond donor doesn't guarantee you a blond kid. But in theory, if you screen your embryos for hair-color genes, you can eliminate all the brunettes. The good and bad effects of increased precision go hand in hand.
Well, almost. That brings me to the second exchange I had recently, with Dr. William Kearns of the Shady Grove Center for Preimplantation Genetics. Following up on a story by Gautam Naik in the Wall Street Journal, I wrote an item about Dr. Jeffrey Steinberg, a Los Angeles fertility doctor who's advertising PGD to achieve "a preselected choice of gender, eye color, hair color and complexion." Steinberg's practical problem is that it's hard to spot aesthetic gene combinations using PGD. But Naik reports that Kearns
has made headway in cracking the problem. In a presentation made at a November meeting of the American Society of Human Genetics in Philadelphia, he described how he had managed to amplify the DNA available from a single embryonic cell to identify complex diseases and also certain physical traits. Of 42 embryos tested, Dr. Kearns said he had enough data to identify [genes] that relate to northern European skin, hair and eye pigmentation in 80% of the samples.
That's where Dr. Steinberg enters the picture:
Dr. Kearns' talk attracted the attention of Dr. Steinberg, the head of Fertility Institutes, which already offers PGD for gender selection. The clinic had hoped to collaborate with Dr. Kearns to offer trait selection as well. … Dr. Kearns says he is firmly against the idea of using PGD to select nonmedical traits. He plans to offer his PGD amplification technique to fertility clinics for medical purposes such as screening for complex disorders, but won't let it be used for physical trait selection. "I'm not going to do designer babies," says Dr. Kearns. "I won't sell my soul for a dollar." A spokeswoman for Dr. Steinberg said: "The relationship between them is very amicable, and this center looks forward to working with Dr. Kearns."
In Kearns and Steinberg, I saw a familiar dynamic: one man leading with one purpose, another following with a different purpose. "Kearns isn't offering his method for aesthetic PGD," I wrote. "He doesn't have to. He's just the trailblazer who's inadvertently showing less scrupulous followers how they could make it work."
When Kearns read this description of himself, he cried foul. He pointed out, rightly, that I had omitted his explicit moral rejection of aesthetic PGD. But he went further. "By focusing so heavily on the potential abuses of the technology, I wonder whether you really understand what [PGD] is and the ethical responsibilities the medical community bears in offering this technology," he wrote. "Your article focuses on the sensational aspects of choosing children with non-medical traits and ignores the important medical advances our new technology provides couples trying to have a child free of a genetic disease."
That's part of the paradox: Bad things may come from good, but does that mean we should ignore the good? Kearns is right: We can't. But we can't ignore the bad, either. Good and bad applications of technology often rely on precisely the same breakthrough—in this case, the ability to detect complex genetic combinations. And one man's motives don't control another's. Every Kearns has his Steinberg. It's not fair, but it's the way of the world.
Part of our challenge as readers and writers of history is to see differences between individuals, even as we weave them together in a collective story. I first learned this lesson when I was writing about a political strategy that went awry. I don't think I can capture it better now than I did then: An idea passes from one person to another to another, changing shape with every transaction. No one controls the outcome. Everyone in the chain knows what the idea means to him, but no one knows how the idea will turn out.