10.1.3 Human Augmentation and Genetic Modification

Human augmentation refers to attempts to enhance or increase human capabilities through technological, biomedical, or other interventions. While the notion of enhancement is broad, philosopher Eric Juengst and psychiatrist Daniel Moseley define it as “biomedical interventions that are used to improve human form or functioning beyond what is necessary to restore or sustain health” (Juengst and Moseley 2019). Human augmentation, then, refers to interventions sought not for individual health but for the sake of improving an individual’s capabilities and functioning. For example, the cyclist Lance Armstrong famously won the Tour de France seven years in a row (1999–2005). Armstrong became infamous, however, when he was later stripped of his titles after it became clear that he had practiced “blood doping” to improve his performance when competing in the Tour de France. He used illegal and banned interventions to enhance his performance and gain an unfair edge over competition. There are many potential biomedical interventions (e.g., pharmacological) that can be used to improve or enhance capabilities in certain areas, and it can often be difficult to clearly define why some raise moral concerns and others do not. Many people, for instance, ingest caffeine on a regular basis. Caffeine is a mild stimulant that may enhance capabilities, but caffeine use is accepted and generally does not raise moral concerns. In contrast, using Adderall, a pharmaceutical amphetamine salt, not as prescribed for medical and health reasons but to enhance energy levels and memory is the sort of intervention that is often viewed as ethically problematic.

Advancements in human biotechnology have created an opportunity for some people to exercise genetic choices that could yield potential therapeutic benefits and make it possible to augment human capacities through genetic modification. Developments in gene editing technologies like CRISPR (clustered regularly interspaced short palindromic repeats), for example, have made genetic modification easier, faster, and more affordable. New technologies have also demonstrated the potential of gene editing.

The characteristics of an organism can be deliberately modified and altered through genetic engineering. Genetic modification has been practiced in agriculture to intentionally alter the characteristics of certain crops (e.g., rice and corn) so that plants, for example, produce higher yields, are more robust, and have increased nutritional properties. Human augmentation through genetic engineering raises numerous ethical concerns. If genetic information is altered to promote certain traits, then how we define “positive” and “negative” genetic traits could have far-reaching consequences. Positive genetic traits will naturally be ones that are promoted and reinforced, whereas negative genetic traits will be reduced and eliminated. In the future, if human genetic modification becomes widely practiced, it is possible that a focus on “positive” genetic traits will decrease human genetic diversity, making us less adaptable and more vulnerable.

A Utilitarian Approach to Genetic Engineering

Whether a utilitarian would find the practice of genetic engineering morally permissible when applied to humans would depend, as it so often does, on how it is used. Utilitarians would likely find human augmentation through gene editing a morally worthwhile endeavor if it improved overall human welfare and happiness. For instance, utilitarians would support the use of genetic modification to eliminate disease and disability. If it turns out to be an extremely costly intervention, however, utilitarians might not support it on the grounds that only the very wealthy would be able to access it.

New advancements in biotechnology often come with high costs, making it so only the wealthiest can afford them. If the costs of human genetic modification are too high, many people won’t be able to access such interventions, and it will worsen the inequality gap. Imagine if prospective parents were able to access gene editing technologies to modify their offspring’s genetic traits. If these services are only accessible to the very wealthy, then naturally only the select few and their offspring will benefit from them. Such a scenario would no doubt have negative social implications. The inequality gap would widen, the children of wealthy parents would have numerous advantages over other children, and it might even lay the groundwork for new forms of discrimination and oppression.

Utilitarians argue that conduct is morally right if it promotes the greatest happiness for the greatest number. Human augmentation through genetic engineering has the potential to increase quality of life by curing or preventing illness and eliminating certain forms of disability, but it could also negatively impact society by, for example, widening the inequality gap, benefiting only a very small percentage of the population, and laying the groundwork for new forms of discrimination. Whether utilitarians support the use of gene editing technologies on humans depends on how such technologies are used and whether their use promotes the greatest good for the greatest number. There are numerous ethical quagmires ahead in the arena of gene editing, but at the same time, this technology holds the promise of eradicating the most terrible of human diseases and thus eliminating unnecessary suffering and improving quality of life. Utilitarians argue that all potential benefits and harms need to be carefully considered and weighed to determine whether gene editing technologies are used in a morally responsible way.

Gene Editing and Biodiversity

Some ethicists argue that we should distinguish between somatic cell interventions and germ-line interventions when discussing the morality of human genetic modification. In somatic cell interventions, genetic changes cannot be inherited or passed to a patient’s offspring. In germ-line interventions (inheritable genetic modification), however, genetic changes can be passed down to future generations (Gannett 2008). Any genetic modifications that result from germ-line interventions are inheritable and therefore have the potential to become part of the larger human gene pool. Ethicists have identified numerous ethical issues and concerns related to inheritable genetic modification. For example, it is unclear what long-term effects would result from gene modification, future generations cannot consent to genetic modification, and germ-line interventions may have a negative effect on biodiversity.

Some ethicists also argue that the distinction between therapy and enhancement is morally relevant when considering genetic modification. A gene editing therapy (or negative genetic modification) is an intervention that is pursued to “restore normal function,” whereas a gene editing enhancement (or positive genetic modification) is an intervention that is pursued to enhance or increase normal capacities and functioning (Gannett 2008). Ethicists argue that genetic modification is morally permissible when it aims at therapy and morally impermissible when it aims at enhancement. A therapy only aims to return an individual to a normal state of health, but an enhancement aims to go beyond an individual’s normal capabilities. In cases of enhancement, however, interventions are pursued because patients possess a desire to go beyond their current capacities. The latter run a greater risk of having unknown and long-term effects on the gene pool and genetic diversity.

Genetic diversity is important for any species to thrive, evolve, and adapt. If genetic engineering is widely practiced, it is possible that modification will focus on certain favored traits. This would result in less biodiversity within the species and would threaten humanity in unforeseen ways. For instance, it is possible that a less diverse gene pool would make the human species vulnerable to some unknown future illness. The concern is that the more homogenous and narrow our gene pool becomes, the less adaptable we become as a species. Like all technologies that are new and that push the boundaries of what’s possible, it is hard to imagine all the possible (positive or negative) consequences that exist on the horizon until we use them and are able to gather data to help us better understand the implications of their use.

Patenting of Genetic Material

Before 1980, the United States did not consider living organisms patentable because they were considered naturally occurring entities. This changed in 1980 when the US Supreme Court issued its decision in Diamond v. Chakrabarty, which found that a genetically modified bacterial strain could be patented because “it was ‘man-made’ and not naturally occurring” (Gannett 2008). The court’s decision opened a door that allowed individuals, institutions, and private entities to patent organisms that they genetically modified and even patent specific genes when they were first to identify them. This made it possible for private entities to gain the exclusive rights to develop diagnostics for specific genes. Myriad Genetics, for example, “patented BRCA1 and BRCA2 breast and ovarian cancer genes and granted Eli Lilly exclusive rights to market applications based on the BRCA1 sequence” (Gannett 2008). Eli Lilly’s exclusive rights allowed it to charge patients thousands of dollars to get tested for cancers resulting from the BRCA mutations, as well as charge researchers who worked to develop a deeper understanding of these genes and their role in the development of cancer.

Philosophers debate whether patenting genetic material is an ethical practice. Some philosophers think gene patents are generally beneficial and not morally problematic. They argue, for example, that patents are an important reward and help motivate researchers, they incentivize progress and scientific advancement, and gene patents benefit society because they lead to the development of better, more affordable medical testing and intervention. Other philosophers, in contrast, raise doubts about the morality of gene patents. They argue, for example, that gene patents impede scientific progress by encouraging secrecy, they reward the pursuit of commercial interests, they award private entities the exclusive right to develop market applications and embolden them to drive up the costs of medical testing and treatment, and genes are naturally occurring and not the sort of thing that should be patentable.

An ethical position on gene patenting depends on what factors and outcomes are considered to be morally relevant. Ethicists debate whether gene patents are generally beneficial or not, whether they produce more good or harm. They explore how they impact scientific progress and development, question whether they create conflicts of interest that harm patients or contribute to higher medical costs, and debate what makes something intellectual property.