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Engineering Ourselves
Redesigning Humans: Our Inevitable Genetic Future
by Gregory Stock

Reviewed by
Adam Marcus

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China isn't known as the vanguard of biotechnology, but the world's most populous nation appears to be leading the way in at least one area. The Chinese reportedly have invested heavily in assisted reproductive technologies, and there are now dozens of infertility clinics in a country vilified for its one-family-one-child policy.

What is more, genetic counselors in China are much more likely than their Western colleagues to recommend that a pregnancy be terminated if prenatal testing reveals genetic defects like those that cause Down syndrome, dwarfism or a cleft palate.

This behavior is logical, says Gregory Stock in his book Redesigning Humans. After all, when parents are allowed to have but one offspring, they have powerful incentives to make that child as 'fit' as possible. "If it means screening for genetic vulnerabilities and diseases, they will do that. And if they could make their children smarter or stronger through genetic testing and manipulation, they'd probably do that too," Stock writes.

The world is headed irrevocably toward the genetic engineering of humans, predicts Stock, who directs the Program on Medicine, Technology and Society at the School of Medicine at the University of California, Los Angeles. But unlike many of his peers, Stock is hardly upset by the prospect of genetic engineering. In fact, the opposite is true.

The 'birth' of genetic engineering, he says, "may prove messy and painful, but it carries the wonder of new life and new possibilities, the promise of growth and achievement." He continues: "Humanity has been building toward this moment for tens of thousands of years."

True or not, his premise seems sound: The genetic genie is out of the bottle, and there's no corking it. His view, however, of what genetic engineering can achieve ignores the scientific literature on human traits and their genetic complexity. He suggests that knowing the identity of a handful of genes involved in cancer and diseases like Alzheimer's is the basis for engineering healthy cells. If only this were true.

Eventually, Stock predicts, today's relatively primitive tinkerings around the margins of the genome will yield to far more sophisticated advances like artificial chromosomes bearing a slate of desirable genes, including genes that protect against disease.

Stock writes about a technology called 'preimplantation genetic diagnosis'—the burgeoning practice of probing new embryos for known disease genes. Preimplantation genetic diagnosis is but one example of the kind of 'germinal choice technologies' Stock argues will soon guide many, if not most, pregnancies.

"Pure and simple, we are poised to make conscious, highly specific choices about the genetic constitutions of our children and to inject our preferences into the next generation using methods far beyond those previously available," writes Stock.

‘Eventually, caution may lead parents toward embryo selection.’

Since preimplantation genetic diagnosis and embryo selection are already being used, Stock's projections have a solid base. And he helps resolve any doubt about why they will become even more common—and more aggressive. Stock's answer is a single word: competition.

"As their reach and power grow, these procedures will spread. Eventually, caution may lead parents toward embryo selection and germline manipulation, not away from it, because they may worry about placing their children at a disadvantage," Stock argues. How many parents would willingly doom their child to life below the mean when the competition is so fierce?

The key here, of course, is cost. As Stock points out, left to designs of the free market, germinal choice technologies will further widen the gap between rich and poor. That's where governments come in. Rather than throw sand bags against an unstoppable flood, governments, Stock believes, should step in to ferry these technologies in an equitable and reasonable way.

"The challenge facing those who…worry about unequal access to these technologies isn't how to ban them, but how to ensure that they become cheap enough for everyone to afford." Ultimately, Stock adds, "if germline technology can bring meaningful enhancement, the greatest divisions will not be between rich and poor but between generations."

Stock neatly punctures the arguments often served up against fiddling with the human genome: it's dangerous, anti-democratic, spiritually disruptive, playing "God." Take the last, for example. While it's true that genetic engineering is unnatural intervention in the life of our organism, so, too, are vaccinations and in vitro fertilization.

As for the notion that future germinal choice technologies might be perilous, Stock has this to say: "Given our disinclination to injure our children, it is hard to come up with believable scenarios in which foolhardy use of these technologies would persist long enough to be as big a health hazard as alcohol, cigarettes, automobiles, lack of exercise, or poor diet."

Redesigning Humans clearly comes from an author with broad perspective, as Stock's biography illustrates. He has a doctorate in biophysics, an MBA from Harvard, and several books to his credit, including Metaman: The Merging of Humans and Machines into a Global Superorganism and The Book of Questions, a treatise on ethics. He holds several patents, including one for a shaping dental filler and one for a tooth spacer that's pending. He even ran for Congress, unsuccessfully, as a Democrat.

Perhaps it's not surprising, then, that Redesigning Humans is at times awkwardly organized, and Stock's reasoning occasionally smacks of circularity: Germinal choice technologies will be the future because it is the future. Furthermore, the slim book often reads like a lecture series or magazine article stretched into a hardback.

Even so, readers interested in our biological future may find it worth ignoring these flaws to glimpse one person's view of the future. As Redesigning Humans makes the case, this future may be closer than we think.

Stock, Gregory. Redesigning Humans: Our Inevitable Genetic Future. Houghton Mifflin Company, Boston, Massachusetts, 2002.

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