Recently, Lars Fjosne, Ethics Professor at Oxford, threw down a gauntlet, suggesting that we have a moral obligation to genetically screen for and disfavour gene permutations that have been shown to be prone to various kinds of misbehaviour. Over the last decade, we've heard a number of philosophers explore similar ideas; another common topic of discussion is whether we have an obligation to screen out Downs Syndrome, Autism, Aspergers, Diabetes, and a variety of other defects of varying severities). Likewise, there are some communities that do not wish to apply specific (or any) modern medicines to themselves (including their children), such as the anti-vaccine movement, or the Christian Scientists. These problems being related, we should be able to consistently explain our positions on each issue and how it turns on the specifics if it differs between them. Consider this my current considerations on these matters and an effort towards positions over them.
The broad goal we're trying to serve in any policy is to promote the general welfare, broadly construed. That broad construment is not just broad enough to consider the health of members of society; it must be versed enough in human nature to consider dignity, happiness, and a certain amount of autonomy that is necessary to preserve that; in short, it must be a society in which a reasonable person, absent strong political positions demanding they reject the society we should build (e.g. theocrats or libertarians), would be happy living in with only the usual reasonable inculturation, absent a focus on national pride. There is a natural tension between the needs of civilisation and the way human nature came to be in the EEA (see Freud's 「Das Unbehagen in der Kultur」); we neither dream this tension could be eliminated nor do we desire a system with an unaceptable level of it. We mention the general welfare then not as a single value that can be simply judged on these matters, but rather as a required foundation for its components in this judgement; for those focused on another style of analysis, I expect this analysis not to sway.
To approach the issue, let's ask a number of questions:
- Is genetic engineering differently acceptable than genetic filtering?
- Is a mandate for medical treatment differently acceptable than either of the above?
- Would different availability of any of these treatments based on funds be dangerous/damaging-to-society or acceptable?
- Would private choice over the specifics of these treatments lead to more problematic results than mandated specifics?
- Are there risks inherent in these practices that cannot be mitigated sufficiently?
- Is there a damage to dignity or reasonable pluralism in these practices?
- Would the specifics of Fjosne's proposal lead to other harms?
Let's recognise the viscerality of these treatments, and the potential body horror involved in nonvoluntary treatment, and recognise as well that parents usually extend their feelings on those matters over their immediate family, particularly when they have custody over those children. I temper that with the idea that that viscerality should not be entirely respected (nor entirely disregarded) as I hold that:
- The health of others can virtually demand nonvoluntary treatment in the case of an epidemic
- Parental custody, in my existing political philosophy, is paired with a similarly strong (but with different specifics) societal custody, and I expect both to have significant weight in the upbringing of a child (and if the parents are sufficiently incompetent, for their custody to end)
While there are few necessarily universal notions of the good for humanity, good health is close enough to one that I believe we can be comfortable treating it as a universal good; the good sought by Fjosne, by contrast, is not so clearly a good thing, either directly or in consequence. In my use of the term "defect" above and mentioning of unusual advocacy groups, I recognise that there is some potential fluidity over these matters, but most of those advocacy groups are operating from positions of pain and their advocacy is understandable in that light; the pain is not (usually) a result of any oppression they have felt so much as the basic condition, but usually the condition is not even theoretically solvable in the general case while motion on the perception of defect is movable; transferring the pain from an insolvable problem to a solvable one is understandable as a simple emotional/logical flaw. As such, I dismiss those groups (to the extent that they hold the recognition of their status as a defect to be a problem; if they do not hold this and instead want reasonable accomodation/help for their problems, I am generally for them) as having misunderstood their pain and situation. As such, I think of Fjosne's treatment as potentially very differently from illness/disability-focused matters.
For now, I choose not to address the issues of access; I don't want to trivialise those matters at this time, but I want my thinking to happen within the context of what should happen with universal public healthcare as I see it as a necessity for a decent society and its lacking in the United States at the present time as an outrage rather than a situation to be dealt with; consequences of its lacking are not *that* uniquely problematic for this issue compared to a lifetime of effectively no access to healthcare.
The values involved remain reasonably open, but I think I've narrowed them enough to feel out a judgement; I reject Fjosne's claim of moral obligation. The good is not persuasive, the body horror is a reasonable concern, and I worry that behavioural shaping through genetic shaping would lead to a variety of other harms when the other harms we would (theoretically) want to mitigate could be mitigated through less hazardous means; a good upbringing and suitable education, I think, would produce good results for almost all of humanity.
I bend the other way on most mind/body defects; I accept genetic screening for moderate-to-strong physical defects and most mental defects, and am comfortable considering screening and filtering there to be a moral obligation, although the metric of "being able to live a reasonably normal and happy life" strongly figures into my judgement on both, and I recognise that defects can easily come about by accident after birth and those defects should see reasonable accomodation.