Wondergenes: Genetic Enhancement and the Future of Society
http://www.100md.com
《新英格兰医药杂志》
(Wondergenes is an engaging and readable overview of the potential benefits and harmful effects of genetic enhancement and of what might be done to limit the harm. Although the book raises no major new issues, it brings together, in a vivid and understandable way, probable social consequences that will need consideration as this field of genetic science moves ahead.
The three main sections of the book unfold in a logical sequence. The first chapters describe the "revolutions" in knowledge in the fields of forensic genetics, genetic information, gene therapy, and behavioral genetics, and then the definition of genetic enhancement is approached. First, Mehlman discusses the difficulty of distinguishing between therapy and enhancement and asks what makes an enhancement "genetic." His response is very broad. It includes not only the insertion of genes into human DNA but also such situations as the implantation of male embryos that have been selected by genetic testing, as part of in vitro fertilization, or the use of drugs whose manufacture is made possible by knowledge gained from genetics (for example, human growth hormone or erythropoietin).
The succeeding chapters, which make up the second part of the book, lay out the dilemmas for and challenges to society that are raised by the rapidly growing capabilities of the field of genetics. Mehlman outlines what he sees as the inevitable destruction of democracy and social harmony if genetic enhancement (which is expensive) turns out to be possible, advantageous, and desired by many people yet its use is not controlled. He effectively makes the case for the view that, even if no one were interested in conducting research on genetic enhancement, advances in genetic medicine targeted at diseases would pave the way toward such developments and that economic motivation in a market economy will ensure that entrepreneurs will work to develop applications of enhancement technology that promise a profit. These chapters describe a future in which genetic alterations in some people will lead to diverging populations and to a world in which the resultant genetic inequalities will undermine society. Mehlman considers it possible that eventually the "genobility" may be so genetically different that these intelligent beings will no longer be considered human.
The last part of the book moves toward potential solutions and possible mechanisms to prevent this dystopian future. Mehlman considers the possibility of providing genetic enhancements to all who wish them, but he believes that this would be prohibitively expensive. He then considers banning genetic enhancements and examines the institutions in the United States (such as the Food and Drug Administration and the Drug Enforcement Administration) that might deal with this possibility. The lucid, easy-to-follow description of the current regulatory framework and of the roles of the various agencies and the gaps between them does not inspire confidence that the instruments yet exist to ensure that genetic enhancements will be managed to society's benefit. The difficulty and complexity of regulating this field are convincingly described, and the practical difficulty of stopping the further development and use of genetic enhancement — not only the impediments within the United States but also what might happen if these activities "go offshore" — is clearly laid out. It is plain that limiting the uses of genetic enhancement would require a major overhaul of the current regulatory framework.
Upholding a ban on some or all of the uses of genetic enhancement would depend on whether the dangers to the state's interest appeared clear. Speculation about future harm that seems removed would not be enough, but Mehlman shows vividly that by the time such harm might become clear, a ban might be too late. Many of the scenarios he describes are predicated on the assumption that genetic enhancement will be effective in the foreseeable future. However, human traits that are widely seen as desirable or advantageous (such as intelligence, attractiveness, and strength) are determined in a complex manner, and whether it will indeed prove possible to affect such traits in a reliable and safe way in coming decades is open to question. Nevertheless, scientific advances are sometimes surprising, and this book shows that if genetic enhancement does become possible, humanity will face a problem of major proportions. It will then have been useful to have thought about and explored some of the social consequences and possible responses, as this book does. If genetic enhancement does not become possible, this book will nevertheless have been an interesting one to read.
Patricia A. Baird, M.D.
University of British Columbia
Vancouver, BC V6T 1Z3, Canada(Medical Ethics.) By Maxwe)
The three main sections of the book unfold in a logical sequence. The first chapters describe the "revolutions" in knowledge in the fields of forensic genetics, genetic information, gene therapy, and behavioral genetics, and then the definition of genetic enhancement is approached. First, Mehlman discusses the difficulty of distinguishing between therapy and enhancement and asks what makes an enhancement "genetic." His response is very broad. It includes not only the insertion of genes into human DNA but also such situations as the implantation of male embryos that have been selected by genetic testing, as part of in vitro fertilization, or the use of drugs whose manufacture is made possible by knowledge gained from genetics (for example, human growth hormone or erythropoietin).
The succeeding chapters, which make up the second part of the book, lay out the dilemmas for and challenges to society that are raised by the rapidly growing capabilities of the field of genetics. Mehlman outlines what he sees as the inevitable destruction of democracy and social harmony if genetic enhancement (which is expensive) turns out to be possible, advantageous, and desired by many people yet its use is not controlled. He effectively makes the case for the view that, even if no one were interested in conducting research on genetic enhancement, advances in genetic medicine targeted at diseases would pave the way toward such developments and that economic motivation in a market economy will ensure that entrepreneurs will work to develop applications of enhancement technology that promise a profit. These chapters describe a future in which genetic alterations in some people will lead to diverging populations and to a world in which the resultant genetic inequalities will undermine society. Mehlman considers it possible that eventually the "genobility" may be so genetically different that these intelligent beings will no longer be considered human.
The last part of the book moves toward potential solutions and possible mechanisms to prevent this dystopian future. Mehlman considers the possibility of providing genetic enhancements to all who wish them, but he believes that this would be prohibitively expensive. He then considers banning genetic enhancements and examines the institutions in the United States (such as the Food and Drug Administration and the Drug Enforcement Administration) that might deal with this possibility. The lucid, easy-to-follow description of the current regulatory framework and of the roles of the various agencies and the gaps between them does not inspire confidence that the instruments yet exist to ensure that genetic enhancements will be managed to society's benefit. The difficulty and complexity of regulating this field are convincingly described, and the practical difficulty of stopping the further development and use of genetic enhancement — not only the impediments within the United States but also what might happen if these activities "go offshore" — is clearly laid out. It is plain that limiting the uses of genetic enhancement would require a major overhaul of the current regulatory framework.
Upholding a ban on some or all of the uses of genetic enhancement would depend on whether the dangers to the state's interest appeared clear. Speculation about future harm that seems removed would not be enough, but Mehlman shows vividly that by the time such harm might become clear, a ban might be too late. Many of the scenarios he describes are predicated on the assumption that genetic enhancement will be effective in the foreseeable future. However, human traits that are widely seen as desirable or advantageous (such as intelligence, attractiveness, and strength) are determined in a complex manner, and whether it will indeed prove possible to affect such traits in a reliable and safe way in coming decades is open to question. Nevertheless, scientific advances are sometimes surprising, and this book shows that if genetic enhancement does become possible, humanity will face a problem of major proportions. It will then have been useful to have thought about and explored some of the social consequences and possible responses, as this book does. If genetic enhancement does not become possible, this book will nevertheless have been an interesting one to read.
Patricia A. Baird, M.D.
University of British Columbia
Vancouver, BC V6T 1Z3, Canada(Medical Ethics.) By Maxwe)