February 23, 2024

Should Singapore embrace human enhancement via germline genome editing?

Recent years have witnessed the emergence of a “New Eugenics” movement by highly-educated technopreneurs and white-collar professionals in Western countries, who believe that it is their natural right (based on individual reproductive autonomy) to screen, select or genetically engineer non disease-related socially-desirable traits in their offspring, such as high IQ, athletic prowess and physical beauty traits such as height, skin complexion, eye and hair colour.

The advent of the Nobel prize-winning CRISPR-Cas9 technology thus provides such opportunities for human genetic enhancement.

The “new eugenics” and a close cousin “pronatalism” are predominantly rooted in Western secular liberalism with little or no religious overtones, based on the concept of “procreative beneficence”. This holds that parents have significant moral reasons to select, of the possible children they could have, the child who is most likely to experience the greatest well-being – that is, the most advantaged child, the child with the best chance at having the best life.

Many new eugenicists believe that they are being socially responsible by not only committing to reproduce prolifically to compensate for declining birthrates in their respective countries, but also by enabling the world to be increasingly populated by their “genetically superior” offspring, who will lead longer, healthier, better and more fulfilling lives, and contribute more to the advancement of human civilization through their superior intellect.

Nevertheless, instead of altruism and civic consciousness, this appears to smack more of egoism and narcissism in the misguided belief of the superiority of their own upper middle-class family values and genetic heritage.

One prominent proponent of pro-natalism is the billionaire Elon Musk. He currently has 11 children by three different women, most of whom were artificially conceived by IVF. After the birth of one of his many children, he had previously tweeted “Doing my best to help the underpopulation crisis. Population collapse due to low birth rates is a much bigger risk to civilization than global warming.”

There is a very real danger that such misguided ideals could find traction and take root in East Asian Confucian societies such as Singapore, which by their very nature are hyper-competitive and obsessed with material success, social status and academic excellence.

Disabled people with physical or intellectual handicaps are heavily stigmatized in these societies and are often scorned as a burden to society and as a shame and embarrassment.

Moreover the demographic transition of East Asian Confucian societies to ultra-low fertility rates, with most families having only one child due to high living costs and educational stress, may in turn motivate prospective parents to utilize new assisted reproductive technologies to beget children with the “best” or “most optimal” genetics, rather than leaving it to chance via the natural fertilization process that involves the mixing and recombination of genes in a random manner.

Indeed, indigenous eugenics movements have also sprung up in East Asian Confucian societies. Take, for instance, the “uterine morality” (zigong daode) movement in mainland China amongst feminists, which argues that because women bear the brunt of birthing and caring for children, they should only accept only the very best genetic material into their wombs. In essence, for a woman to have good “uterine morals”, she must take responsibility for her future children by selecting a good-looking, intelligent, strong, financially-sound man with no family history of genetic disorders, so as to ensure that future generations evolve into healthy, beautiful, and intelligent beings.

One drawback to this is that realistically, there are simply not enough of such “good men” to go around. A recent book published by Yale professor Marcia Inhorn pointed out that increasing numbers of educated women worldwide are freezing their eggs because there are simply not enough suitable men that can match them in terms of education and income levels, as women tend to graduate from universities at higher rates than men.

Nevertheless, if Singapore were to subscribe to these narratives, and permit the application of germline genome editing for human enhancement, it must beware of the following consequences:

  • Damage to Singapore’s reputation as an international hub for biomedical research and industry, if this contravenes global consensus and widely accepted ethical norms. Public sentiment worldwide is overwhelmingly against germline gene editing for human enhancement.
  • Unnecessary use of expensive, invasive and risky assisted reproduction techniques by fertile and healthy couples, just to avail themselves of the opportunity to genetically modify their offspring for amplifying non-disease related socially desirable traits, rather than as treatment for infertility or as cure for genetic diseases. This would be tantamount to clinical malpractice by fertility doctors and clinics.
  • Further decline in Singapore’s already low fertility rates by increasing the financial costs of having a child. Germline genome editing for human enhancement will not come cheap. Moreover, there are also additional medical fees for complex assisted reproduction procedures that are required for germline genome editing. If human genetic enhancement becomes a fad in Singapore, many prospective parents desiring two or more children, may eventually decide on having just one superior “genetically enhanced” child due to the high costs involved.
  • Increased social inequality and tensions between rich and poor. Only the rich can afford to use such expensive techniques on their offspring. This could in turn lead to further amplification and exaggeration of socially desirable traits such as high IQ, athletic prowess and physical beauty among the more affluent sections of society.
  • Reinforcement of racial discrimination and social bias against ethnic minorities. Many Asian women use skin-whitening cream, dye their hair blonde and wear contact lenses that make their eye pupils look blue, because they consider these traits to be beautiful and desirable. Why not genetically-engineer these traits into their offspring? Would this not imply that certain races are more beautiful and desirable than others? Such reinforcement of social biases in beauty standards would obviously be inimical to efforts by local policymakers to build a more inclusive and cohesive society.
  • Contrary to the concept of a level playing field in society, analogous to the ban on sports doping. Athletes do not always start out equal nor are they given the same opportunities. Some athletes may be advantaged by their superior physique conferred by genetics, others from richer countries may receive much better training and nutrition compared to those from poorer countries. But yet all major international sporting organizations ban doping, most commonly anabolic steroid use, to ensure a level playing field and same starting point among athletes. Should not Singapore ban human genetic enhancement to ensure a level playing field in society?
  • Disruption of family harmony, due to parents having unrealistic expectations of their genetically modified children after spending so much money. There may also be jealousy and resentment between siblings if only some of them had received genetic enhancement, while other had not.
  • Aim of enhancement does not justify medical risks incurred. Genome editing with CRISPR-Cas9 technology is neither completely error-free nor without potential safety risks. These include unintended on-target and off-target gene editing errors, and insufficient editing resulting in mosaicism, whereby only some but not all cells within the embryo have the correctly edited genes. There have also even been reports of entire chromosomes being unintentionally deleted during gene editing.
  • Trespass and violation of the individual autonomy and rights of the unborn child, who had never consented to being genetically modified in the first place. This is particularly significant if substantial medical risks are incurred during germline genome editing.
  • Unexpected and unintended detrimental effects of germline genome editing may manifest in offspring much later in life, for example certain types of cancer or neurodegenerative disease. We can expect lawsuits against biotech companies, government regulatory agencies and even parents for harms of conception.

What kind of country does Singapore want to become? A more inclusive and cohesive society, or a more competitive “cut-throat” and social status-conscious one?

Alexis Heng