Is the era of designer babies finally here?
Every week, it seems, we're told that this discovery or that technology might lead to "designer babies." I've heard this so many times that I've stopped taking it seriously. Genetic engineering always turns out to be more complicated than expected, and our latest technology always turns out to be less capable than advertised.
But now trait selection seems to be coming into view for real.
Two months ago, the Fertility Institutes, an assisted reproduction company headquartered in Los Angeles, began advertising the "pending availability" of genetic tests that would offer "a preselected choice of gender, eye color, hair color and complexion" in artificially conceived children. On Thursday, Gautam Naik of the Wall Street Journal reported that "half a dozen" potential clients had contacted the company to request such tests. As of today, the tests still aren't for sale. But several trends are converging to make aesthetic trait selection an impending business.
1. Embryo screening has become permanently entrenched. By now, tens of thousands of embryos have been screened for quality and potential disease, thanks to preimplantation genetic diagnosis. Culturally and politically, there's no going back.
2. Screening is steadily expanding to traits that are less medically important. We're examining and discarding embryos for flaws that are less lethal, less harmful, less likely to cause disease, and less likely to strike early in life. Two years ago, British regulators approved PGD to get rid of embryos that might become grotesquely cross-eyed. At the time, the head of the clinic that pioneered this use of PGD predicted, "We will increasingly see the use of embryo screening for severe cosmetic conditions."
3. Aesthetic screening is spreading. Once you're screening for "severe" cosmetic conditions, you can no longer rule out other cosmetic criteria. The principal gateway to aesthetic use of PGD is sex selection. Worldwide, the number of embryos and fetuses discarded for being the wrong sex is in the millions. In this country, the number of clients paying for sex-selective PGD is in the thousands and growing. Nearly half of U.S. clinics that offer PGD have used it for nonmedical sex selection, and 40 percent of Americans approve of this practice. The Fertility Institutes explicitly frames eye, hair, and skin color selection as an extension of sex selection.
4. A market for nonmedical trait selection is emerging. Naik points to a New York University survey of patients seeking genetic counseling. In the survey, published three weeks ago, 10 to 13 percent of respondents said they would use PGD to select height, athletic ability, or intelligence. NYU spins this as a tiny minority. But in raw numbers, it's easily enough to attract opportunistic entrepreneurs.
5. Aesthetic trait selection is becoming feasible. This used to be the sticking point in bringing the technology to market. No more. Naik reports:
In October 2007, scientists from deCode Genetics of Iceland published a paper in Nature Genetics pinpointing various [genes] that influence skin, eye and hair color, based on samples taken from people in Iceland and the Netherlands. Along with related genes discovered earlier, "the variants described in this report enable prediction of pigmentation traits based upon an individual's DNA," the company said. … William Kearns, a medical geneticist and director of the Shady Grove Center for Preimplantation Genetics in Rockville, Md., says he has made headway in cracking the problem. In a presentation made at a November meeting of the American Society of Human Genetics in Philadelphia, he described how he had managed to amplify the DNA available from a single embryonic cell to identify complex diseases and also certain physical traits. Of 42 embryos tested, Dr. Kearns said he had enough data to identify [genes] that relate to northern European skin, hair and eye pigmentation in 80% of the samples. Kearns isn't offering his method for aesthetic PGD. He adamantly opposes this application as an unethical abuse of the technology. But his breakthrough inadvertently shows less scrupulous followers how they could serve their own ends.*
6. Doctors have an easy way to talk themselves into offering the service. Dr. Jeffrey Steinberg, medical director of the Fertility Institutes, sees trait selection as a natural extension of the road his profession is already traveling. "This is cosmetic medicine," he tells the Journal. Watch Steinberg's promotional video, and you'll see how easy it is to sell trait selection as just another consumer service. Reproductive technology can "help fertile and infertile couples choose the gender they've always wished for," the video's female narrator promises. Steinberg appears on camera, assuring potential customers that his personnel are experts at "evaluating embryos and making sure that people get their request for a boy or a girl." You want a girl? We'll get you a girl. You want a blonde? We'll get you a blonde.
7. Patients have an easy way to talk themselves into buying the service. You don't have to request PGD just to screen your embryos for eye or hair color. That might feel icky. Instead, Steinberg offers you a package deal:
Patients having genetic screening for abnormal chromosome conditions in their embryos will be able to elect expanded testing that can greatly increase the odds of achieving a healthy pregnancy with a preselected choice of gender, eye color, hair color and complexion, along with screening for potentially lethal diseases, screening for cancer tendencies (breast, colon, pancreas, prostate) and more.
See how smooth the transition can be? You're already screening for diseases. Why not add one more factor while you're at it? So now you'll know which embryos are male and which are female, just in case two of them turn out to be healthy and you're lucky enough to be able to choose which one to put in the womb. And if you're checking sex, why not throw in eye color and complexion? You don't have to do anything with the information yet. Just run the test and find out what your options are.
8. Globalization thwarts regulation. "A large majority of industrialized countries-including Canada, the UK, most of Europe, Japan, Israel, China, and Australia-prohibits non-medical sex selection," notes the Center for Genetics and Society. But the United States doesn't, and according to CGS Associate Director Marcy Darnovsky, Steinberg exploits this gap by "offering travel packages so that people can come to the US to dodge laws in their home nations." CGS wants tougher U.S. laws. Good luck with that: Steinberg already has a satellite clinic in Mexico.
This is how revolutions happen: Technology matures, trends converge, and cultural changes pave the way. By the time Steinberg opens his trait-selection business and does for that practice what he's already doing for sex selection, it'll be too late to stop him. In fact, before you know it, we'll be used to it.
Clarification, Feb. 18, 2009: My original paraphrase of Dr. Kearns' position on PGD for aesthetics-that he wasn't offering it but was "inadvertently showing less scrupulous followers how they could make it work"-failed to convey his strong opposition to the practice. Here is the Journal's full description of Kearns' position:
Dr. Kearns says he is firmly against the idea of using PGD to select nonmedical traits. He plans to offer his PGD amplification technique to fertility clinics for medical purposes such as screening for complex disorders, but won't let it be used for physical trait selection. "I'm not going to do designer babies," says Dr. Kearns. "I won't sell my soul for a dollar."
(Return to the revised paragraph.)
William Saletan is Slate's national correspondent and author of Bearing Right: How Conservatives Won the Abortion War.
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