The benefits of these techniques can prevent suffering, but imagine futures literally written in DNA before birth. All it would take is an ethical hop, and lots of money.
Sometime in the not-too-distant future, Marie and Antonio Freeman step into a doctor’s office to design their next child.
“Your extracted eggs, Marie, have been fertilized with Antonio’s sperm,” the doctor says. “After screening we’re left with, as you see, two healthy boys and two very healthy girls.”
A monitor displays what looks like soap bubbles that bumped into each other on a green background.
“Naturally, no critical predispositions to any of the major heritable diseases,” the doctor says. “All that remains is to select the most compatible candidate. We might as well start with gender—have you given it any thought?”
“We would want Vincent to have a brother, you know, to play with,” Marie says, referring to her first child.
Acknowledging this, the doctor continues: “You have specified hazel eyes, dark hair and fair skin. I have taken the liberty of eradicating any potentially prejudicial conditions: premature baldness, myopia, alcoholism and addictive susceptibility, propensity for violence and obesity—”
“We didn’t want—I mean, diseases, yes,” Marie interrupts.
“Right, we were wondering if it’s good to leave a few things to chance,” Antonio says.
“You want to give your child the best possible start,” the doctor replies. “Believe me, we have enough imperfection built-in already. Your child doesn’t need any additional burdens. And keep in mind, this child is still you, simply the best of you. You could conceive naturally a thousand times and never get such a result.”
The Freemans are characters in the science fiction film Gattaca, which explores liberal eugenics as an unintended consequence of certain technologies meant to assist human reproduction. Although Antonio and Marie do not exist outside the movie’s imaginary universe, their real-life counterparts could be walking among us sooner than we think—and, in a sense, they already are.
When Gattaca premiered in 1997, doctors had been using laboratory techniques to help women and men overcome infertility for more than a decade. In 1978, Louise Brown of the U.K. became the world’s first “test tube baby”—the first person conceived through in vitro fertilization (IVF), a procedure in which sperm and eggs are combined in the lab to create several viable embryos that are subsequently implanted in a woman’s womb. The first IVF clinic opened in the U.S. in 1980. Today, hundreds of fertility clinics in the country offer IVF and more than one percent of children born in the U.S. are conceived this way.
In the years surrounding Gattaca’s release, doctors were also talking about how to responsibly use another, more controversial technique to help people have children: preimplantation genetic diagnosis (PGD). In this procedure, clinicians vacuum up one of eight cells in a three-day-old embryo created through IVF and analyze the DNA within to find genes associated with debilitating and potentially fatal diseases. Sometimes, doctors wait two more days, when the embryo has become what is known as a blastocyst—a mostly hollow ball of around 100 cells—and collect between 5 and 20 cells for DNA analysis. In most cases, this extraction does not significantly disturb the embryo’s development. PGD can identify embryos that will almost certainly develop disorders caused by a mutation in a single gene, such as cystic fibrosis, sickle cell disease, Tay-Sachs and Huntington’s, as well as disorders that result from an extra chromosome, such as Down syndrome. From its earliest days, PGD has been principally intended for people who have a high risk of conceiving a child with a particular disorder, because it runs in the family or because they happen to harbor a certain genetic mutation.