American Journal of Medical Genetics 66:369 (1996)

Book Review
GENETHICS: TECHNOLOGICAL wide public participation. The current ethical concerns
INTERVENTION IN of geneticists center on rather different topics: for ex-
HUMAN REPRODUCTION ample, privacy and confidentiality of genetic informa-
AS A PHILOSOPHICAL PROBLEM tion, carrier testing when the currently available tests
By Bayertz K. will fail to identify some carriers, and the risk of dis-
Originally published in German as GenEthik crimination if private genetic information falls into the
by Rowohlt Taschenbuch, Verlag GmbH, hands of potential employers or insurance companies.
Hamburg, 1987. As for gene therapy, at present geneticists are frus-
Translated by Sarah L. Kirkby. trated by its difficulties, and the question of whether
Press Syndicate of the somatic cell gene therapy is acceptable, but germline
University of Cambridge, 1994,342 pp. gene therapy not, seems at the moment rather unreal.
One of the chief reasons for concern about new repro-
Molecular genetics has given us new insights into the ductive technologies is the “slippery slope”argument. If
nature of life and has the potential to catalyze great hormonal treatment will allow an abnormally short
medical advances. Not surprisingly, it has caught the child to grow taller, will there be public pressure for
interest of ethicists, who have even coined a new word, the same treatment for shorter-than-average children
genethics, to portray this branch of medical ethics, and within the normal range to add a few inches and gain
have taken a leading role in debating its benefits and the social benefit of greater height? (In American pres-
possible hazards. idential elections, the taller candidate usually wins.)
GenEthics is a 1994 translation of a book originally Will we move on to “designer babies”? Will success in
published in German in 1987. What are its contribu- somatic gene therapy, when it comes, lead us to try
tions to today’s debates? It is a deeply philosophical dis- germline therapy for some devastating disorder? And
cussion centering on such questions as whether there where might that eventually lead? All of us, not just the
are any reasons to reject genetic and reproductive tech- professional philosophers and professional geneticists,
nology on principle, and, if so, whether a decision to have a stake in the answers.
reject it can be justified by its effect in altering human The history of humanity is the history of change, in
nature. what is known and in what values are held. Values and
The author unfortunately reveals his unfamiliarity ethical views are not changeless. The intellectual in-
with genetics when he states that all the offspring of sights of molecular genetics are already affecting our
people with Huntington disease inherit the disease. understanding of our place within nature. Meanwhile,
This error illustrates the failure of geneticists to make our first attempts to apply molecular genetic knowl-
the fundamentals of their science widely understood, so edge are sometimes having unexpected results; for ex-
as to allow informed public discussion. Many geneti- ample, in families affected by Huntington disease, car-
cists have a parallel problem in trying to follow philo- riers of the Huntington gene can now be identified, but
sophical arguments, which too often seem remote from many ethical problems surround this identification.
their own concerns about the appropriateness and Geneticists need a continuing debate on changing val-
safety of applications of current molecular genetic ues. This book may help us understand some of the is-
technology. sues raised by philosophers, even if we do not always
The author discusses a t length the philosophical as- agree with their views.
pects of reproductive technologies such as in vitro fer-
tilization, cloning, and gene therapy. Since the original Margaret W. Thompson
publication of this book, guidelines for dealing with Department of Genetics
these technologies have been drawn up in many coun- The Hospital for Sick Children
tries, including the United States and Canada, with Toronto, Ontario, Canada

0 1996 Wiley-Liss, Inc.