A little to stop individuals undergoing genetic interventions...

Before moving on to this however, it is necessary to point out that with respect to enhancements, if our technology developed in such a way as to allow somatic cell interventions that could be contained within the recipient with a high degree of certainty, then there would be little to stop individuals undergoing genetic interventions that would otherwise by considered unacceptable. There is a caveat on this suggestion however, and that is that in most cases interventions that were of a radical nature, say growing extra arms or having skin that changed colour at varying intervals would and should not be paid for out of the public purse. Anyone who wanted an intervention that was of this nature would have to be willing to pay for the procedures themselves. Public funding for genetic interventions should in my view whether or not they are somatic or germ-line be restricted to those interventions that fall within the boundary of treatment and those that are publicly acceptable forms of enhancement. This position will be further discussed later when the issues of social justice and the effects of germ-line interventions are considered.

Sorts of genetic interventions that are acceptable...

the treatment/enhancement distinction has been seen as a means of deciding between those sorts of genetic interventions that are acceptable and those that are not, it does not fully answer the questions asked about these procedures. With the use of the concept of genetic maladies, the treatment side of the distinction seems able to cope quite well with objections raised against it; it is the other side of the distinction that requires more work. There are a number of reasons for looking further at the enhancement side of the equation. The first of these is that there may be conditions or states of a person that, though not falling within the boundaries of genetic maladies may nevertheless be worthwhile candidates, both in terms of particular persons and for society in general, for genetic intervention. The second reason is that there may be disagreement between differing groups with respect to the status of certain procedures. It may be the case that treatment of certain conditions, such as deafness, which seem to fall within the domain of a malady, may be viewed by other groups, particularly a deaf societal community, as unacceptable both because they do not view it as a necessary treatment, or because they view being deaf vital with respect to their community because they do not regard it as malady. We need a method of determining those conditions, which are not candidates for treatment, but which are nonetheless legitimate targets for enhancement genetic intervention.

Genetic interventions that should overturn this right as a general principle..

This is the correct interpretation of the situation because it holds up the rights of individuals with respect to choice in relation to the type of childbirth they wish to have. If parents wish to have as little medical intervention as is possible then this is a choice that they as autonomous persons have currently and there is nothing specific about genetic interventions that should overturn this right as a general principle. On the other hand this interpretation also respects rights of children to open futures. This is particularly evident in the situation with respect to IVF technologies where these rights should override the more general right the parents possess to choose the level of medical intervention, even though in the situation above it appears to be matter of chance as to whether or not IVF technologies are necessary.

Genetic interventions and correction of such disabilities….

It would also be the case that with respect to genetic interventions that the correction of such disabilities prior to implantation would also be acceptable and in fact should be carried out. The rights expressed earlier of persons to choose to have as little medical intervention as possible in the conception and birth of their child would be overridden in this scenario by the right to an open future of the child that would be produced.. To choose to implant an embryo with a disability, when the options to either implant one without disability or to have disability corrected prior to implantation, would seem to severely impact upon the child’s right to an open future.

Ability of making distinctions between various types of genetic interventions

One further issues needs to be addressed with respect to the ability of making distinctions between various types of genetic interventions, in particular those that relate to the enhancement of complex traits such as intelligence. This is that any attempts to make distinctions between the appropriateness of different interventions is a flawed process because with respect to complex traits in particular it is difficult if not impossible to through the manipulation of a person genetic code make any real changes to these complex traits with any degree of certainty. This is because with traits such as intelligence, it is not the case that the level of a person intelligence is controlled either by the genes of the person in question or by their environment, rather these complex traits are instead the result of the both the actions of the gene and the environment as well as a random developmental noise. This is “in contrast to models of development in which genes or environments are determinative.”[xii] This idea suggests that it is therefore difficult if not impossible to manifest any real directed change in a complex trait via genetic intervention and that as a result procedures aimed at enhancing these complex traits are inappropriate.

Somatic cell interventions will not have unintended effects on the germ-line of recipients….

Some proponents, through application of the principle of double effect have answered the problem of somatic cell interventions designed and intended only to affect the somatic cells, which unintentionally cause alterations to the germ-line. Marc Lappe states that “Germ-line engineering as a direct attempt to change the genotype of future generations cannot ethically be justified. However, when such changes arise as an indirect and otherwise unavoidable consequence of an approved form of somatic cell engineering, they are morally acceptable. The first objection relates to the issue of intention and the unintended consequences of the interventions. Two people, both suffering the same condition attempt to acquire somatic cell intervention to remedy the condition they possess. The intention of the first person is to have the therapy in order to correct the condition, as it is present in them. The second person however knows that there is risk that the procedure will have an effect on their germ-line and this is the major reason for them wanting to undergo the procedure. While they want the condition corrected in them, the major intention in undergoing the procedure is to alter the germ-line so that any progeny will not have to suffer the condition in their life. It seems under the principle of double effect that the first person should be accepted for the therapy while the second should be rejected on the ground that he is more concerned about the effects of the condition on his offspring then on himself. As Moseley suggests, “this would seem to be a morally questionable criterion for a physician to use in deciding whether to proceed with genetic therapy. It is also troubling that all that the second person needs to in order to procure the procedure for them is to lie about their primary intention for wanting to the intervention. Having a situation where people are forced to lie or omit information in order to receive treatment cannot be one that can be said to be good medical practice.

Genetic therapy has distinct in its treatment...

The treatment/enhancement distinction has been seen as a means of deciding between those sorts of genetic interventions that are acceptable and those that are not, it does not fully answer the questions asked about these procedures. With the use of the concept of genetic maladies, the treatment side of the distinction seems able to cope quite well with objections raised against it; it is the other side of the distinction that requires more work. There are a number of reasons for looking further at the enhancement side of the equation. The first of these is that there may be conditions or states of a person that, though not falling within the boundaries of genetic maladies may nevertheless be worthwhile candidates, both in terms of particular persons and for society in general, for genetic intervention. The second reason is that there may be disagreement between differing groups with respect to the status of certain procedures. It may be the case that treatment of certain conditions, such as deafness, which seem to fall within the domain of a malady, may be viewed by other groups, particularly a deaf societal community, as unacceptable both because they do not view it as a necessary treatment, or because they view being deaf vital with respect to their community because they do not regard it as malady. We need a method of determining those conditions, which are not candidates for treatment, but which are nonetheless legitimate targets for enhancement genetic intervention.
[i] S Scales, "Intergenerational Justice and Care in Parenting.," Social Theory and practice 28.4 (2002)