Are current genetic screening technologies the gateway to a genetically elitist society? Ellie Houghton

Are current genetic screening technologies the gateway to a genetically elitist society?

Ellie Houghton Upper Sixth

Genetic code

Designer babies and genetically optimized humans are generally perceived to be an ethical debate of the future, but the rise of the enhanced human being could be just around the corner. It may even already be a reality in the USA.

The rise of Crispr Cas-9 (a new gene editing technology) drew the attention of the general population to of genetic engineering. But what about the world of genetic screening? While Crispr Cas-9 and other genetic editing technologies are currently forbidden for use in embryos to prevent the development of ‘designer babies’, it is common now for couples at high risk of having a baby with an inherited genetic disease such as Tay sach’s or cystic fibrosis to conceive a baby via IVF and have the embryos screened using preimplantation genetic diagnosis (PGD).

PGD involves checking the genes of an embryo for a specific genetic condition. PGD can screen for over 600 genetic conditions and helps many families avoid having a child with a devastating disease. It is currently provided by the NHS for parents at high risk of having a child with inherited genetic disease. PGD can only screen for single gene disorders, whereas most traits that define who we are, such as intelligence and athletic ability, are controlled by many different genes and are influenced by the environment in which we are brought up. This means that PGD has limited use in creating enhanced children as it cannot be used to predict which embryos possess more ‘desirable’ traits, as it can only be used to screen for specific genetic diseases and the sex of the embryo.

Whilst PGD does not necessarily provide an advantage over the general population, and is accepted on the basis that it improves the chance for life, technology has now advanced to the point that the firm Genomic Prediction in the US has now developed a method PGD can screen for over 600 to screen for low IQ. It involves analysing many DNA regions genetic conditions. at once to calculate what’s known as a polygenic risk score. This risk score can predict how likely someone is to develop a certain condition. The company’s polygenic test for ‘mental disability’ identifies embryos with IQ scores significantly below average. Technology such as polygenic testing could easily become the gateway to creating a genetically enhanced human race, particularly in countries with for-profit healthcare systems such as the USA. The technology used to detect low IQ can also be used to select the embryo with the highest IQ for implantation. Understanding of human genomes is now so great we can test for traits such as eye colour, and with The Fertility Institutes in the USA already offering this ‘treatment’, tests for qualities such as sexuality and athletic ability cannot

testing is currently not optimised for nonwhite groups as they are underrepresented in the genetic databases from which the scores are derived. This means that the tests may be less accurate for ethnic minority groups, potentially introducing a racial division to the socio-economic and ethical issues of genetic screening.

Screening for polygenic traits is currently illegal in the UK and embryos may only be screened for chromosomal abnormalities (e.g. Down’s syndrome) or single gene disorders through PGD. However, the UK faces great pressure to widen the use of polygenic risk scores as they are able to predict likelihood of an embryo developing diseases such as breast cancer and heart disease. This would be a huge step in developing preventative medicine and could potentially save many lives and NHS money. Matt Hancock, the British Health Secretary, has even said: “We must get predictive testing into the NHS as soon as we possibly can.”

be far behind. We are rapidly approaching a world in which it will be possible to design and optimise our children. On the surface, some of these tests may be seen as a benefit to society, but where will this end?

According to a survey conducted in 2013, 14.6% of 1006 Americans surveyed supported the use of techniques such as PGD to screen for physical traits and 18.9% for personality traits. This demonstrates that the majority of those surveyed view genetic screening as a threat, sharing the view that evolution should be left to nature, not to science. However, a small percentage were in favour of these screening technologies. This may be because many people see these screening techniques as a new form of evolution and we have the potential to develop a stronger, better adapted human race.

But to what extent is polygenic screening really advancing the human race? Some would argue that, as each embryo has the same biological parents, they should not have a huge difference in genetic makeup and each embryo should have similar polygenic risk scores for each trait. So would it really make a difference choosing the best out of a select few?

Those that consider genetic screening to be the future of evolution often fail to consider the cost of PGD and the IVF treatment that must go along with it. In the UK, whilst Once polygenic testing has been introduced the NHS will fund families at a high risk of to the UK, where will the line be drawn as having a child with a genetic disorder, for to which tests are allowed to be carried out? a family that does not qualify, PGD costs Given that polygenic screening is already around £8,000 for available in the USA for a single course of treatment and each We need variation traits such as IQ and eye colour, if an embryo cycle of IVF costs in society to help is being screened for around £5,000. IVF also has low success promote equality. the risk of developing cancer, why not screen rates of around for the likelihood of 20-35% per cycle, meaning it is highly likely developing depression at the same time? a couple will require more than one round NHS mental health services are also of IVF. Costs such as these are far too high overwhelmed, so a polygenic test to reduce for the majority of the population to be the number of children growing up with able to undergo these treatments, meaning depression would help lessen the burden these treatments would be exclusively on the NHS. What about testing your child available to the wealthy, leaving the general for athletic ability or the ability to gain population behind. muscle? A wave of stronger, fitter children could also be seen as a benefit to society The lack of accessibility of these procedures in light of the UK’s increasing obesity to the majority of the population due to epidemic. But should parents really be costs would hugely increase the socio- allowed to make these kinds of decisions, economic divide. Furthermore, polygenic potentially influenced by prejudice or their own personal bias as to what they

Matt Hancock believe constitutes the ‘perfect child’? We need variation in society to help promote equality and understanding.

PGD, polygenic testing and other genetic screening techniques can certainly be seen as the gateway towards a genetically elitist society. It is down to our government to decide which tests are allowed to be carried out. However, the world must collectively make a decision as to just how far to open the gateway.