Slippery slope in reproductive medicine?

Along with the wonders of globalization comes the various stumble blocks in healthcare – unequal access to healthcare, rising cost of healthcare, privatization and transformation of healthcare into a privatized profit-generating business. All these are already happening. However, last year, a highly sensationalized legislation which allowed the co-creation of a 3-parents embryo presented a new growing challenge. 

GM babies; an inevitable goal in reproductive medicine?'

Image via toonpool

Prima facie, this technology appears at best, beneficial and at worst, innocuous. It provides an alternative means for female sufferers of mitochondrial disease to conceive genetically related babies without passing down their disease.  However, the implications may very well reach beyond the lives of these parents-to-be. These include the welfare of the children born and the integrity of the society in the long run.

It is undeniable that one of the most important evolutionary purposes of reproduction is to ensure the continuity of our species. In the process, as part of Darwin's theory of evolution, nature selects for the genes that confer offsprings with survival advantages. Thus, it would seem that this technology has not yet breached the essence and the very purpose of reproduction. Just as nature selects for genes most favourable to our species survival, it seems that this technology is harmless or in fact beneficial in sieving out 'bad' disease genes. However, scientists may run the risk of tampering with the natural process of evolution by taking matters into their own hands. 

Obviously, there are multiple uncertainties – both ethical and technical - accompanying this conceiving method. At best children born will live a highly stressful and scrutinized life given the need for lifetime scientific monitoring and studies. It would not be surprising (though this is unlikely) if some of them born in this way suffer from debilitating conditions. At worst, the interconnecting effects of globalization would facilitate the spread of this technology eventually leading to misuse of technology, and the contamination of the human gene pool. Besides, the availability of donor eggs should prompt us to question the value of such a trial and think if the end justifies the means -are we essentially creating a biological experiment with such huge risk to society in order to fulfill the self-serving interests of an incredibly small proportion of the community (predicted to be 5-10 couples a year)? Besides, by doing so, have we breached an International law prohibiting inheritable genetic alterations?

The line has been crossed and to dismiss a slippery slope on the grounds that NHS could implement tight regulations would be totally unreasonable.  Why? A slippery slope is in fact unfolding in front of our very eyes. It had started off with the desire of subfertile parents or those with genetic defects to conceive a baby. This was met by the introduction of in-vitro fertilization (IVF). While IVF certainly has a positive impact on those desperately wanting a baby, its introduction possibly has an unintended effect of making laboratory breeding technique more palatable to society. Continuing from this, a proposal for 3-parents babies might have appeared to be more permissible that it previously was. In the absence of IVF technology, the idea of generating a 3-parent babies in the lab would have seemed so bizarre and outrageous that such a proposal would have been met with stronger resistance. 

The issue here is whether scientists would stop at tampering human genetics at mitochondrial level. There is a great chance that the very next technique proposed would be far more tempting and more fiercely fought for by the scientific communities that it would be even more difficult to reject. 

The Human Fertilisation and Embryology authority (HFEA) recently approved genetic modification of IVF embryos for research purposes. What separates this from a typical genetic therapy that is being researched on to treat single-gene disorders is the fact that gene therapy is targeted to somatic cells and thus, such genetic modification is not heritable and does not pose a risk to our human genome. With this slippery slope unfolding before our very own eyes, it would then be too late when (or if) we realize that our ethics have degraded and it would be a matter of time before the first GM babies arrive.

The challenge this presents to healthcare is to resist the tempting offer made by scientific communities. Granted, there are many innovations that have improved the outcome of care without crossing any ethical boundaries. We should be welcoming and in fact encouraging those.

The duty of care of healthcare would be to act in the best interest of patients – in this case, the couples wanting to have genetically related babies. Besides, a bigger role healthcare plays is in regulating scientific communities; this is done by only taking in innovation which are ethically sound and medically important. Healthcare should not be tolerating any technology which carries ethical mines. As such, it appears that the challenge of the future would be to manage the conflicting interests of helping patients and safeguarding the integrity of today’s mankind including their genetics and (medical) ethics. Finding ways to go around ethical mines, to search for safe and ethically sound ways of conducting experiments in tricky situations becomes more important than ever. 

" is slippery slope merely a logical fallacy?"