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| Book Review:
Better babies for the better off on the possibilities revealed by
the new reproductive technologies Sunday Telegraph (London) Remaking Eden: Cloning and Beyond in a Brave New World by Lee M. Silver Weidenfeld & Nicolson, pounds 20, 317 pp IMAGINE visiting a maternity ward 10 or 50 years' hence. What kind of child, what kind of parents will you visit? Parents happy that they have selected the "perfect" embryo? A gay couple who have had their own child? A mother who has borne her clone, her identical twin? Fast-forward another 300 years - will you be celebrating the birth of a "GenRich" (gene-enriched) baby, evolved by unnatural selection via new reprogenetic technologies? This is the Brave New World that Professor Lee Silver takes us to by the end of his opening chapter and, I have to say, it made my heart sink. Was his book just going to be a scare-story, which would shed little light on the important issues surrounding the new reproductive technologies? Thankfully,Ê Remaking EdenÊ turns out to be an authoritative and thought-provoking analysis by a scientist who is not only at the forefront of research in this field, but also one of the growing group of scientists who actively engage in public debate. We have great need of them. Professor Silver presents a lucid account of recent developments in the science and technology of reproduction, taking us from the very basics - what science has to tell us about the beginnings of life - to the frontiers of reproductive experimentation. His book is enormously helpful in describing the development of techniques such as artificial insemination, IVF and cloning, and the science that underpins them. Professor Silver's concern is not merely to inform, but to alert us all to the potential applications of what he terms "reprogenetic" technologies, which combine techniques for creating and manipulating embryos outside the human body, with other techniques for diagnosing, selecting and altering the embryo's genetic make-up. These will allow us to guide the genetic destiny of our children. And, he writes, "this is what I really fear . . . with genetic engineering it is possible that those who have money will be able to provide genetic advantages to their children and those who do not have money will not be able to use this technology". Unlike Huxley's Brave New World, Silver's future is determined not by governments but by the power of the market. This market, he says, is driven by the instinctive biological need of individuals of our species to procreate, no matter what it takes. A powerful example is IVF. In 1978 the birth of the first "test-tube baby", Louise Brown, was greeted with considerable alarm. Today, how many of us know at least one couple who have been helped by this technique? And how many of us now find the idea so strange or abnormal? Why then, Silver suggests, should it be any different for the other technologies? As long as we yearn for our own children, we will demand whatever will help us to bear them. Two major changes are poised to take us far beyond IVF. The first is cloning from adults - suddenly catapulted from science fiction to science fact with the arrival of Dolly the sheep in February 1997, and more recently by the alarming claims of a maverick research scientist in Chicago. The second is genetic engineering - the ability to manipulate our genetic make-up directly to eliminate or to enhance characteristics. As Professor Silver points out, we already manipulate our genetic make-up indirectly, for example through selective abortion. It is now possible to select out the embryos with particular genes for a few major genetic diseases, such as Huntington's Disease and cystic fibrosis. But, as we identify more and more genes, the possibility of positive selection becomes a greater reality. What if we can select for height, leanness, intelligence or athleticism? What then? And what if we can add new, "better" genetic material? Should we do this? Is it ethically acceptable to do so? Professor Silver takes us all the way down the slippery slope to the designer child, provoking us to consider "what's the problem?", "what's the harm?". He asks repeatedly if there is anything to choose between giving your children a good start genetically and helping them through careful nurturing and a good education? If not, and the market-place prevails, then genetic selection will arrive, whenever it is feasible to do so. For me, his book is a guide to, but not a guide through the moral maze. It is immensely valuable in clarifying the science and painting possible futures, but Silver tends to limit himself to posing challenging questions about the ethical issues raised rather than providing possible answers? If I have a reservation it is that - though the issues this book deals with are vitally important - the science is not always easy to follow. A lay readership would probably be helped by additional appendices on the basics of genetics and embryology. At the very least, we need a clear guide to the voluminous endnotes. Deirdre Janson-Smith is a science consultant at the Natural History Museum.
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