A Roundtable Discussion on the Ethics of Genetic Enhancement
An Overview of the Foundational Paper and Its Core Concepts
The roundtable discussion was centered on the chapter "The Ethics of Genetic Enhancement: Key Concepts and Future Prospects" by Jonny Anomaly and Tess Johnson, published in The Routledge Handbook of the Ethics of Human Enhancement. The paper provides a conceptual framework for navigating the complex moral landscape of technologies that aim to improve human capacities, with a specific focus on genetic interventions like embryo selection and gene editing.
At its core, the paper situates genetic enhancement within the long history of human efforts to improve survival and flourishing, from the control of fire to the development of literacy. However, it acknowledges that modern genetic technologies, particularly CRISPR-based systems, represent a profound leap in power and precision, enabling intentional, heritable changes to the human germline. This capability forces a confrontation with fundamental questions about human nature, parental responsibility, social justice, and collective welfare.
The concepts presented in the paper directly impact everyday life by reframing choices that are already becoming reality for prospective parents. Technologies like in vitro fertilization (IVF) coupled with preimplantation genetic testing (PGT) allow for selection against disease, but the line between preventing illness and selecting for desirable traits is becoming increasingly blurred. As our understanding of the genetic underpinnings of traits like intelligence, physical ability, and even personality grows, the choices parents face will become more complex and morally fraught. The paper asks us to consider the societal implications of these individual choices. For example, if height is a valued trait, and affluent parents can select for taller children, what does this mean for social equality? If enhancing cognitive ability could lead to scientific breakthroughs that benefit everyone, is there a moral imperative to pursue it?
Contention around these concepts exists because they touch upon deeply held, and often conflicting, values. There is a tension between individual reproductive freedom and the collective good; between the desire to give one's children the best possible start in life and the fear of creating a genetic class divide. The historical shadow of "classical" eugenics—state-led, coercive programs rooted in racism and ableism—looms large, creating profound skepticism towards any project aimed at improving the human gene pool, even if pursued through the lens of individual choice or "liberal" eugenics. Furthermore, the discussion engages with the disability rights movement, which challenges the very premise that certain genetic variations constitute a harm to be eliminated, arguing instead that society should adapt to human diversity. The paper by Anomaly and Johnson does not seek to resolve these debates but rather to provide the analytical tools—drawn from ethics, economics, and political science—necessary for a more structured and coherent discussion.
Introduction to the Panelists
The roundtable brought together eight distinguished experts from diverse fields to discuss the issues raised by the paper:
Dr. Alina Cortez is an evolutionary economist and public policy scholar. Her work focuses on the institutional and market dynamics of enhancement technologies, particularly the challenges posed by positional goods, collective action problems, and the unintended consequences of regulation, such as the emergence of black markets.
Professor Malik Rahman is a religious ethicist specializing in Islamic jurisprudence. He evaluates genetic technologies through the lens of stewardship, humility, and the moral distinction between therapy and enhancement, advocating for a precautionary approach that prioritizes safety and equity.
Dr. Sienna Okafor is a clinical geneticist and implementation scientist working in West Africa. She offers a pragmatic, welfarist perspective grounded in the realities of resource-constrained health systems, emphasizing the importance of equitable access, community engagement, and focusing on all-purpose goods like disease immunity.
Professor Linh Nguyen is a disability studies scholar and activist. Her work is centered on the social model of disability and the expressivist critique, arguing that genetic selection against disability can reinforce social stigma and that societal resources should be directed toward inclusion and accessibility rather than normalization.
Dr. Rafael Dominguez is a bioethicist and a proponent of liberal eugenics. He argues from a framework of procreative beneficence and reproductive autonomy, suggesting that parents have strong moral reasons to use enhancement technologies to provide their children with the best possible life, while also considering the welfare of others.
Judge Keiko Tanaka is a comparative law scholar specializing in the global governance of genomic technologies. She examines the practical challenges of regulating a borderless technology, focusing on creating adaptive legal frameworks that prevent medical tourism, ensure safety, and protect individual rights from coercive state action.
Dr. Maya Whitfield is a feminist bioethicist whose work explores reproductive autonomy in the context of structural power and intersectional justice. She critiques the market and patriarchal forces that define "desirable" traits and advocates for robust, community-informed consent processes that protect marginalized groups.
Dr. Viktor Petrov is a neuroscientist and genomic engineer. He provides a crucial scientific perspective on the complexities and risks of genetic enhancement, emphasizing the polygenic nature of complex traits, the potential for off-target effects, and the need for rigorous, incremental research and post-market surveillance.
The Roundtable Discussion
The discussion was structured around the key themes presented in the Anomaly and Johnson paper, beginning with the foundational distinctions and moving toward broader societal and regulatory implications.
The Treatment-Enhancement Distinction: A Blurry Line with Practical Weight
The panel began by dissecting the distinction between "treatment" and "enhancement," a concept the paper identifies as central to public and regulatory attitudes. Professor Malik Rahman opened the discussion by defending the moral significance of this distinction. Drawing on a theological framework of stewardship, he argued that using genetic technology to restore a person to a species-typical level of functioning—treating a disease—is a permissible act of healing. However, attempting to transcend normal human capacities constitutes enhancement and risks hubris. He stated, "The ethical tradition of medicine, as the AMA code cited in the paper notes, is grounded in therapy. When we move beyond that, we move from being stewards of creation to its redesigners, a role for which we are ill-equipped and which invites unforeseen and potentially catastrophic consequences." He argued that this line, while not always perfectly sharp, provides a vital precautionary boundary.
Dr. Rafael Dominguez immediately challenged this view, deploying the "reversal test" developed by Bostrom and Ord and highlighted in the paper. He posed a hypothetical: "If we consider a genetic intervention that would lower an individual's intelligence from average to below-average, we would almost universally consider this a harm. If we consider an intervention to raise it from below-average to average, we call it a treatment. But if we consider raising it from average to above-average, we suddenly become hesitant and call it a morally suspicious 'enhancement.' The reversal test forces us to ask: why is the status quo of 'average' the immovable moral optimum? Without a strong reason, this looks like status quo bias." He argued, in line with David Resnik's position in the paper, that the focus should be on an intervention's effect on welfare and autonomy, not on whether it crosses an arbitrary line of normality.
Dr. Maya Whitfield added a critical feminist lens to this debate. She argued that the treatment/enhancement distinction is often socially constructed to serve existing power structures. "Historically, what is considered 'normal' functioning for a woman's body has been defined by patriarchal systems," she noted. "For example, is menopause a disease to be treated or a natural part of aging? Is using reproductive technology to have a child at 45 a treatment for infertility or an enhancement of reproductive capacity? The line is drawn and redrawn based on social norms, not objective biology. This distinction can become a tool for controlling bodies, especially those of women and marginalized people."
Providing a pragmatic counterpoint, Dr. Sienna Okafor drew on Norm Daniels' argument, as cited in the paper. "In my clinical reality in a resource-limited setting, the treatment/enhancement distinction is incredibly useful, even if it's imperfect," she explained. "When allocating scarce public health resources, we must prioritize. Daniels' concept of 'fair equality of opportunity' compels us to focus on interventions that address significant deprivations—treating severe genetic diseases like sickle cell anemia—before we consider enhancements that provide marginal benefits. For policy and public health, the distinction, however blurry philosophically, has practical bite."
Positional Goods, Inequality, and Collective Action Problems
The discussion then shifted to the economic and social consequences of enhancement, focusing on the paper's concepts of positional goods and network effects. Dr. Alina Cortez framed the central problem. "The paper rightly identifies the danger of positional arms races," she began. "Height is a classic example. If wealthy parents can pay to make their children taller, they gain a relative advantage. But if everyone does it, no one's relative position changes, and we've all expended resources in a collectively self-defeating exercise. This is a classic collective action problem." She argued that policy should actively discourage such arms races, perhaps through taxation, while incentivizing enhancements that are "all-purpose goods" with positive externalities. "Contrast height with what the paper calls 'genetic immunization,'" she continued. "Enhancing immunity to infectious diseases is an all-purpose good; it benefits the individual regardless of what others do. Moreover, it creates a massive positive externality—herd immunity. A society of more immune individuals is better for everyone. These are the enhancements we should subsidize."
Dr. Dominguez concurred, linking this directly to the ethical principles of procreative beneficence and procreative altruism. "While procreative beneficence directs parents to choose the child expected to have the best life, procreative altruism, as Douglas and Devolder argue, adds a crucial dimension: parents have a reason to choose a child whose existence contributes to the well-being of others. Enhancing for traits that generate positive network effects—like enhanced cognition leading to innovation, or greater cooperativeness leading to better institutions—is a perfect marriage of these two principles. It benefits the child and society."
However, Professor Linh Nguyen offered a sharp critique of this framing. "The very concept of a 'positional good' like height or a 'desirable' trait like high intelligence is built on a foundation of social prejudice," she argued. "We only value height because our society has constructed it as a marker of status, particularly for men. The problem isn't the technology; it's the ableist and hierarchical values that drive the demand for it. Instead of regulating an 'arms race,' we should be dismantling the social structures that make people feel they need to 'compete' on these arbitrary metrics. The discussion of enhancing cognition for 'network effects' is similarly fraught. Who defines what counts as valuable cognition? This often defaults to a very narrow, neurotypical, and culturally specific form of intelligence, devaluing other ways of knowing and being."
Dr. Whitfield echoed this concern, pointing to the market dynamics. "Let's be realistic," she said. "In a capitalist society, the enhancements that will be most heavily marketed and sought after will be those that confer competitive advantage, reinforcing existing social hierarchies. The demand will be shaped by advertising, social media, and biases around race, gender, and class. A 'free market' in enhancement will not magically lead to positive externalities; it will more likely amplify existing injustices."
Autonomy, Eugenics, and the Role of the State
This debate naturally led to the historical and political specter of eugenics, a term the paper carefully distinguishes between its "classical" and "liberal" forms. Dr. Dominguez defended the modern, liberal approach. "The key distinction, as the paper notes, is between coercion and choice. Classical eugenics was a monstrous, state-enforced program. Liberal eugenics is about empowering individuals—parents—to make free and informed choices about the genetic makeup of their children. It is grounded in reproductive autonomy, not state control. To conflate the two is to dismiss the moral significance of individual liberty."
Professor Rahman expressed deep skepticism. "Calling it 'liberal' does not cleanse it of its core aim: the systematic selection of some human traits over others. This will inevitably create social pressure to conform. What begins as a 'choice' for the affluent will become a 'necessity' for the middle class and an impossible burden for the poor. The line between individual choice and societal expectation is thin. Furthermore, the focus on individual autonomy ignores the profound effects these choices have on the community and on our shared understanding of human dignity."
This tension between individual liberty and collective outcomes brought Judge Keiko Tanaka to the forefront. "The legal challenge here is immense," she stated. "How do you protect reproductive autonomy while mitigating the negative collective consequences the paper describes? An outright ban is not a solution. As we've seen with other technologies, a ban in one country simply creates medical tourism and unregulated black markets in another. This would exacerbate inequality, as only the very wealthy could travel to access these services, and it would eliminate any possibility of safety oversight."
She proposed a different path: "We need adaptive, international governance. This could involve creating international registries for gene-editing procedures, establishing clear safety and efficacy standards through a body analogous to the World Health Organization, and creating legal frameworks that distinguish between permissible 'nudges'—like subsidizing enhancements with positive externalities—and impermissible coercion. The goal is not to ban but to channel innovation in a direction that is safe, equitable, and respects fundamental rights."
Disability, Identity, and the Expressivist Objection
The most impassioned segment of the discussion revolved around the issue of disability. Professor Linh Nguyen articulated the core of the expressivist objection, as outlined in the paper. "When we use PGT or gene editing to select against deafness or Down syndrome, the act itself sends a powerful and damaging message: that the lives of existing deaf people or people with Down syndrome are less valuable and would have been better prevented. This is not a hypothetical harm; it contributes to real-world stigma and discrimination." She advocated for the social model of disability, arguing that "the primary problem is not the impairment in the individual, but the disabling barriers in society—inaccessible buildings, lack of sign language interpreters, social prejudice. The ethical imperative is to fix society, not to 'fix' the person."
Dr. Sienna Okafor responded with the welfarist perspective, grounded in her clinical experience. "I respect the expressivist argument deeply, but I must also consider the future child," she said. "When a family in a region with very limited medical and social support faces the prospect of having a child with a condition that will cause severe, chronic pain and a drastically shortened life, their choice to prevent that suffering is an act of love. It is not an expression of disrespect for people living with disabilities. The welfarist model in the paper allows for this nuance: it doesn't assume all disability is harm, but it acknowledges that some conditions, in some contexts, will profoundly and negatively impact a person's well-being. To deny parents the choice to prevent that suffering seems, to me, to be a different kind of moral failure."
Dr. Dominguez sought to clarify the position of procreative beneficence. "The principle is about choosing the child expected to have the best life. This is not a judgment on the value of any existing person's life. It is a forward-looking decision about a potential future person. While the social model of disability is correct that society must do more, we cannot pretend that all the challenges associated with certain conditions are purely social. There can be biological realities of pain, discomfort, and limited capacity that are independent of social construction. A responsible parent would have reason to weigh these realities."
Scientific Realities and the Path Forward
The final part of the discussion turned to the scientific and practical realities, guided by Dr. Viktor Petrov. He urged a strong dose of caution and humility. "The public debate often outpaces the science," he warned. "Complex traits like intelligence or morality are not controlled by single genes. They are highly polygenic, involving hundreds or thousands of genes interacting with each other and the environment in ways we barely understand. The idea that we can simply 'edit in' high IQ is, for now, science fiction. The attempt to do so would carry an enormous risk of unintended consequences—what we call off-target effects or pleiotropy, where a single gene affects multiple traits."
He pointed to the case of the CCR5 gene, mentioned in the paper, which was edited in the "Lulu and Nana" experiment in China. "Editing CCR5 may confer HIV resistance, but it is also linked to increased susceptibility to other viruses and may affect cognitive function. This illustrates the immense complexity. We are not editing a simple blueprint; we are tinkering with a delicate, evolved ecosystem." Dr. Petrov advocated for an incremental approach: "We should focus first on monogenic diseases where the cause-and-effect relationship is clear and the therapeutic benefit is unambiguous. Any move toward enhancement, especially of complex traits, must be preceded by decades of research, phased trials, and the establishment of robust, long-term surveillance registries to track outcomes across generations."
Judge Tanaka concluded the discussion by synthesizing the regulatory challenge in light of this scientific uncertainty. "Dr. Petrov's points underscore why a rigid, prohibitory legal framework is inadequate. The science is constantly evolving. Regulation must be adaptive, allowing for research to proceed under strict ethical oversight while being prepared to respond to new data on risks and benefits. International cooperation is not just a nice idea; it is an absolute necessity for safety, equity, and preventing a race to the bottom where rogue actors operate without oversight. The concepts provided by Anomaly and Johnson are not just theoretical; they are the essential building blocks for crafting the wise and humane governance that this powerful technology demands."
The roundtable concluded without consensus, but with a clearer map of the ethical terrain. The discussion highlighted the deep tensions between individual autonomy and collective well-being, progress and precaution, and competing visions of what constitutes a good human life. The panelists agreed that the questions raised by genetic enhancement are among the most profound of our time, requiring ongoing, interdisciplinary dialogue that is as scientifically informed as it is ethically reflective.