Million Dollar Baby

The danger of a slippery slope is that you never know when you’re going to fall. As medicine makes further advancements in the realm of pre-natal screening, we must remain aware of the point at which the fight against diseases progresses into an unnatural quest for perfection.

Earlier this year, in vitro fertilization was used to screen for a faulty BRCA1 gene that increases one’s susceptibility for breast cancer, while researchers at Cambridge University claim that a pre-natal screening for autism will soon be possible. Although both steps seem to represent an innocuous effort to prevent devastating medical conditions, the extended use of pre-natal screening raises many serious ethical questions.

Autism, for example, should be distinguished from disorders that are currently screened, such as Down syndrome and Huntington’s diseases. It is not a disease, but a spectrum condition that does not necessarily entail suffering. Indeed, autism is often related to remarkable talents—it is believed that both Newton and Einstein were autistic—and selection against the condition can be viewed as a sinister form of eugenics that discriminates against those who are not typical.

Meanwhile, pre-natal screening against cancer susceptibility presents deviation from the standard practice, as screening has previously only been used against diseases with a 90-100 percent chance of causing a disease that affect the child from birth. BRCA1, however, only raises the risk of the disease from 50-85 percent, while breast cancer itself does not affect the child from birth and has the potential to be cured.

Both these examples of extended pre-natal screening raise a critical question: At what point does the mitigation of flaws develop into a cultivation of inhuman immunity?

Although screening for autism leads to worries over the removal of all eccentricities from society, autism is nevertheless a condition that affects a child from birth and causes many difficulties. To condemn the screening of autism due to its links with unusual talents, but not screening of diseases such as Down syndrome, essentially values an autistic person’s life above that of someone with Down syndrome.

Thus, in keeping with current policies on the issue, screening for autism is morally acceptable. Nevertheless, the act is another step towards the sinister world where every abnormality, up to depression, is removed before birth, and as such it should not be taken lightly.

Screening for breast cancer susceptibility is advancement in the same direction. The previous legal boundaries for appropriate screening (a 90-100 percent chance of the disease affecting the child) were violated in this case. As advances allow us to screen for smaller and smaller susceptibilities, firm boundaries must be drawn to keep science in check. Policymakers must consider the range of genes that cause the same level of susceptibility as BRCA1 and evaluate the implications of permitting such extensive use of pre-natal screening. Ultimately, a level of susceptibility for which it is permissible to screen must be determined, and this level should remain fixed. Such limits may be arbitrary and may eventually deny screening for BRCA1, but, at some point, policymakers must draw a line in the sand.

Furthermore, extensive use of pre-natal screening presents a worrying situation in which those with wealth are able to purchase an objectively higher level of descendants than others. Selection of the most attractive traits presents a significant genetic advantage to the wealthy—more so than simply being able to afford a higher standard of medical treatment—and threatens to irrevocably exaggerate the divide between rich and poor.

In order to preserve the ideals of our society, the cultivation of this super-race should be deterred, and purchasable pre-natal screening and IVF treatment in the name of health should be covered by health insurance by law. Failure to make pre-natal screening practices publicly available has worrisome and immoral implications for the future of society.

Pre-natal screening presents a valid opportunity to combat many diseases, and we are still significantly far from the sinister world of designer babies outlined by cynics and satirists. However, as science allows us to advance further and further in pursuit of perfection, we should be aware of the implications of each medical achievement. Safety checks must be imposed to prevent a loss of balance, as tumbling to the bottom of this particular slippery slope would be disastrous.


Olivia M. Goldhill ’11, a Crimson editorial writer, is a government concentrator in Pforzheimer House.