Selecting for Disabilities: Selection Versus Modification

Abstract

This essay considers one argument used to defend parents who use preimplantation genetic diagnosis (PGD) to select for deafness and other disabilities. Some bioethicists have argued that a distinction should be drawn between genetically modifying embryos to possess disabilities and using PGD to select embryos that already present markers of them, and that the former is unethical because it inflicts avoidable harms onto the resulting children, whereas the latter is permissible because it allows children with potentially impaired abilities to exist. This essay raises doubts about whether a meaningful moral distinction can be drawn between modification and selection. Arguments which distinguish modification from selection can be understood in two ways. One is to read them as presenting a No Harm, No Foul argument. Another is to read them as presenting a Harming Versus Letting Be argument. Neither succeeds, however, either in establishing a meaningful moral distinction between modification and selection, or in showing that the second is morally permissible in contradistinction to the first.

KEYWORDS:

• Genetic modification
• genetic selection
• assisted reproductive
• technology
• disabilities
• parenthood
• nonidentity problem

Notes on contributor

Dr Joshua Shaw received his B.A. in philosophy from Bard College, an M.A. in humanities from University of Chicago, and a Ph.D. in philosophy from Indiana University, Bloomington. He joined the faculty of the School of Humanities and Social Sciences at Penn State Erie, The Behrend College, in 2004. He is the current Program Chair for the General Arts and Sciences Major (GAS) and the Associate Degree in Letters, Arts, and Sciences (2LABC). Dr Shaw's most recent publications are on ethical dilemmas raised by reproduction, parenthood, and assisted reproductive technology.

Notes

1 See Melissa Seymour Fahmy’s ‘On the Supposed Moral Harm of Selecting for Deafness’ for a superb overview of the debate over selecting for disabilities.

2 Derek Parfit is often credited with introducing the nonidentity problem in Reasons and Persons. See Parfit 1987, p. 359. For his part, he credits Greg Kavka as his inspiration. See Kavka 1981, pp. 93–223 for what Kavka calls ‘the paradox of future individuals’.

3 Seymour Fahmy tacitly acknowledges this point. At one point in her essay, she addresses the criticism that selecting for deafness violates the resulting child’s right to an open future. She rejects this criticism. However, she notes in her reply that in ‘the absence of gene therapy, there is no possible future in which the child in question could exist without also being deaf’ (Seymour Fahmy 2011, p.130, my italics). This reference to gene therapy is telling, for it indicates that a child’s right to an open future would be violated if parents did not use medical technologies to treat deafness, such cochlear implants or gene therapy should it become possible. However, this casts doubt on whether a meaningful moral distinction can be drawn between modifying embryos to possess disabilities and using PGD to select for them. Were it possible to treat deafness through gene therapy, both would equally violate the right to an open future.

4 See Davis 2001, p. 64 for this criticism. See Feinberg, p. 126 for more on the right to an open future.