How Much Can We Decide About Baby's Genes?

A Slippery Slope?

But, while there are not many objectors to screening for a deadly breast cancer gene, the concern is where this will lead.

This case is part of a shift from genes known to cause diseases to genes which simply raise their risk. It may very well move on to conditions that many do not consider diseases, said Arthur Caplan, a bioethicist at the University of Pennsylvania.

Caplan sees the real ethical questions beginning when testing moves to diseases like Alzheimer's.

"It's bad, but it won't affect you until ... later in life," he said, adding,"Sixty years from now, we might cure it."

Finally, Caplan said, testing may move to conditions like shyness, obesity and homosexuality, which some may find undesirable. But many people, if not most, would find it repugnant to treat those as diseases.

"People will say, 'those aren't diseases, those are just differences,'" he said.

Caplan also thinks more genetic testing will shift peoples' views on in vitro fertilization.

"I think we're on the brink of a shift in how we treat IVF," he said. "I think, in the future, it's going to be used to create healthy babies in fertile people."

Given the ability to prevent children from having certain diseases, Caplan sees a rising demand, and that demand changing how in vitro fertilization is covered by insurance companies (it's typically not covered now) and how affordable the expensive treatment becomes.

"More people than just the infertile are going to want a chance to do this testing," he said.

But Silber said that such concerns are unfounded, given the current state of gene testing and in vitro fertilization.

And while he believes insurance companies should cover in vitro fertilization, "I don't see that happening," he said.

"Insurance companies have been rather stupid about that, because they only care about how much they save this year. There's no question, in the long haul, they would save a lot of money."

But, Silber doesn't see "designer babies" as a concern in the near future, if ever.

The reason, Silber said, is that tests can only pick out problems that stem from a single gene. Personality traits, like shyness, are complex, and can't be traced to the work of a single gene.

"I don't see that being possible or conceivable," he said. "You could worry about it if you really didn't understand the genetics of it. ... [Pre-implantation diagnosis] will be restricted to certain defects or diseases, because that's all we have."

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