Mehlman’s book begins with a
thrilling anecdote and ends with a chilling proposal. He begins by having us
imagine a mountain rescue team of genetically enhanced superheroes who have
specially designed fingers that let them cling to cliff faces while aiding
stranded climbers and who pop pills made from genetically enhanced bacteria that
heighten their senses and speed up their reasoning skills. He ends by proposing
that a databank be set up containing the complete DNA sequence of every
American citizen and that we all be subjected to routine genetic analysis to be
sure that we have not altered our genes in any way not authorized by the
government. He suggests that people with unauthorized enhancements should be "handicapped"
in some way that will prevent them from competing unfairly with normal
citizens.

The proposal is so outlandish it is
hard to believe Mehlman understands the implications of his ideas. He wants the
government to regulate our bodies at the molecular level and create a lifetime
surveillance regime to enforce that regulation. The contents of your womb may
be between you and your doctor, but the contents of your cell nucleus and mitochondria
would be matters for the federal government. He freely admits that the
surveillance scheme he advocates resembles the society of the dystopian science
fiction movie Gattaca and the handicapping scheme resembles Vonnegut’s
dark satire "Harrison Bergeron." He tries to mitigate the former
comparison by pointing out that his surveillance program is designed to catch
the enhanced, while the program in Gattaca was meant to catch the
unenhanced. He tries to mitigate the latter comparison by admitting that there
may be some circumstances in which handicapping is inappropriate. Neither
remark makes a lifetime of bodily control seem more palatable.

How on earth did Mehlman get to the
point where this idea seems plausible? His book divides neatly into three sections.
The first explains the genetic technologies he is concerned about. The second
places these technologies in the context of some basic values, and the third
contains his proposal. In the first two sections of the book Mehlman betrays a
lack of understanding of both genetic science and human values. His genetically
enhanced people are comic book superheroes, and his picture of human life
assimilates everything to a competitive sporting event. Life is like the
Olympics, and we need a governing body constantly on the lookout for cheaters.

The book opens with a sequence of
short chapters, often beginning with a lively anecdote, that explain genetics
at the most basic level. He lets the readers know that they have 23
chromosomes, and the last is the sex chromosome. He makes a few useful points
here. He defines enhancement as any technology that changes the way people’s
bodies work but is not designed to fight disease. He defines genetic technology
broadly to include not just alterations made directly to someone’s DNA, but
also drugs created by genetically altered microorganisms. By this standard
genetic enhancement is rampant in athletics. These definitions are reasonable,
but he quickly moves to describing the potential of genetic technology with
wide-eyed, gee-whiz naiveté. He casually talks about genes for vague,
culturally defined traits like "charisma" (67). He asserts without
evidence that genetic technology will improve people’s ability in all aspects
of their lives (61) and will be approved for sale over the counter (81). By the
end of the book he claims that genetic technology will enable people to fly or to
live and breathe underwater or in space (123).

A reality check is useful here.
When I started working on this review, I took the book out to my back porch
along with a cup of coffee. When I did this, I sat down with two of the most
effective enhancement technologies humans have ever devised. Writing is a
social technology that can transmit the collective knowledge of our species to
an individual, and a book is the most durable, convenient, and beautiful way to
store writing. Coffee is a chemical technology, so its effects are immediate,
as are its side effects. Nevertheless, coffee offers a clear enhancement: it
has been shown to improve both short-term recall and general IQ. The
really nice thing about these technologies is how well they work together. You
prepare your brain to learn, and then present it with high-quality information.
Future enhancement technologies, even those derived from genetics knowledge,
are likely to resemble a good book and a cup of coffee. As a teacher, I already
spend a great deal of time giving PowerPoint presentations to teenagers on
Ritalin, although whether this improves on books and coffee remains to be seen.
In the near future, you might be able to take a drug that dramatically
increases your working memory—Mehlman rightly suggests that such drugs will
come out of Alzheimer’s research—and play around with software that graphically
represents multivariate statistical problems. Mehlman mentions the comparison
between future enhancement technologies and education but dismisses it offhandedly.
Genetic technologies, he says, are infinitely more powerful because they are
only limited by cost, production problems, and unimagined side effects. He
seems to think that this is a trivial list, and that these impediments are somehow
different than the factors that hold back any technology that improves people’s
lives.

The real problem with Mehlman’s
treatment, though, is that he focuses entirely on competitive situations where
enhancements simply lead to an arms race that no one really benefits from. He
talks a lot about people competing to have taller children who can play better
basketball. His chapter on the value of authenticity is entirely about performance-enhancing
drugs in sports. This narrow focus on competition leads him to say that all
enhancements are self-defeating. "What good is a performance enhancing
product that adds five miles an hour to a sprinter’s speed…or adds twenty IQ
points to a person’s intelligence, if it does so for everybody and everybody
uses them?" (89). The only time he considers activities that are not zero-sum
games is a (perfectly reasonable) dismissal of trickle-down economics. But most
of life is not a zero-sum game, or even an economic positive-sum game. Most
people benefit directly from being around other people who are intelligent and
creative. I benefit directly from having a spouse who is a caring parent to our
children and wise partner in decision making. I benefit directly from
colleagues who are brilliant conversation partners on philosophical issues. I
benefit directly from having curious students who are a joy to teach. Asking "What
good are twenty points of IQ if everyone has them?" is like asking "What
good is literacy if everyone is literate?" We all benefit from living in a
literate society. He doesn’t even seem to understand that intelligence might be
valuable to the intelligent person, even if she doesn’t lord it over her
competitors. The simple pleasure of knowing one’s world does not figure into
his calculations.

If life is a race and genetic
technology can give you superpowers, Mehlman would be right to predict a dire
future that can only be headed off by a massive curtailment of civil liberties.
"Succeeding generations [of enhanced individuals] will capture all that is
worth having" he warns, unless we act now to stop this menace. The measures he proposes are severe. Forced
sterilization should be visited on those who acquire germ-line enhancements,
which are passed on to children. Justice Holmes famously tried to justify the
forced sterilization of Carrie Buck by saying "three generations of
imbeciles is enough." Mehlman would rob someone of their right to children
with the even more preposterous "three generations of geniuses is enough."
Mehlman initially proposes a ban on all genetic enhancement, which leads him to
describe a "war on genes" explicitly modeled on the war on drugs. He
modifies this to allow for some individuals, like rescue personnel, to have
licensed enhancements, but the idea of a "war on genes" seems to
carry over. At the very least, he suggests that we will have to go literally to
war against countries that do not cooperate in the enhancement licensing scheme
(152). Mehlman acts as if opposition to his proposal will come only from
economic libertarians, who want to see a perfectly free market on genetic
enhancement, but most of his ideas involve curtailing civil
liberties–including really basic ones like the right to one’s body. Adding
another perpetual war against an undefined enemy–on top of the war on drugs
and the war on terrorism–should not be welcomed by anyone who values civil
society.

One may be legitimately worried
that genetic enhancement will exacerbate inequality, but there are obvious
solutions to this problem that Mehlman only deals with cursorily. Rather than
banning or restricting access to enhancement technology, we could subsidize its
distribution to those who can’t afford it. Mehlman briefly considers this
option, but dismisses it as too expensive. This is illogical, because his
program of universal surveillance and war won’t be cheap, either in terms of
money or basic liberties. The argument becomes incoherent when one considers
his accounting. Although the enhancement technologies he considers vary from
simple drugs to the direct manipulation of embryos, he uses the cost of in
vitro fertilization (IVF) to estimate the cost of subsidized enhancement:
$10,000 per individual, or $2.5 trillion for the nation. But subsidized
enhancement does not need to take the form of universal surgery. We may simply
be talking about a drug, developed originally for Alzheimer’s patients, which
could be distributed to kids who are performing poorly in school. In fact, this
is a more likely population to benefit from such a drug than, say, lawyers who
are already operating at peak performance. The program wouldn’t even have to be
called enhancement. More likely, it will be called a federal program for
children with learning disorders. Although if the learning disorders fall
within what is currently considered the normal range of human variation, it
will be a genetic enhancement in Mehlman’s terms. Alternately, drugs that
promote cognitive development could be given at birth. Again, although this
would be an enhancement in Mehlman’s terms, it would probably be greeted as a
treatment by the public, another part of the odd regimen of procedures that now
accompany hospital births.

One reason Mehlman can’t seriously consider
subsidizing genetic technology for people who need it is that he never
considers problems in the way health care is delivered in the United States, even though the book is aimed only at Americans. Health care costs are
rising out of control, particularly for drugs. A national, single-payer system
of insurance would not only save administrative costs and allow the government
to negotiate lower pharmaceutical prices, it would allow us to identify and
subsidize simple procedures to help people who are functioning at the low end
of the normal spectrum. The basic effect of a national health care system is to
focus energy on simple measures that are broadly effective: prevention rather
than treatment, general practitioners over highly paid specialists. A national
health care system would also draw the medical community’s attention away from
exotic enhancements that would benefit a few and turn it toward pedestrian
boosts that benefit many and could easily be relabeled as treatments simply by
raising standards for normality. These procedures on the borderline between
treatment and enhancement are also far more likely to be developed than any cheaper,
more convenient genetic alternative to SCUBA gear.

Mehlman can be very slipshod in the
way he handles sources and technical language. At one point he suggests that it
should be illegal to transport germ-line enhancement across state lines for
purposes of sale or distribution. What could this mean? Germ-line enhancement
is a technique, not an object. If he means to say that individuals with the
knowledge of how to enhance the germ line should not be allowed to cross state
lines in the course of providing this service, he should say so. His use of
sources is lazy and credulous. To back up the claim that enhancement via
preimplantation genetic diagnosis will not cause significant changes in the
species, he cites the personal communication of a colleague who was himself referring
to the personal communication of another colleague. Mehlman also repeats a
story about Ted Turner going off drugs for manic depression right before
selling his company to Time Warner, and then gives as his source the personal
communication of a colleague. The story may well be true, but shouldn’t an
academic publication have better citations than office gossip about
celebrities? Most telling for his credulity: Mehlman chooses to illustrate the
ease of acquiring technologies on international markets by citing Pentagon
reports on Saddam Hussein’s supposed success in acquiring weapons of mass
destruction.

I can recommend this book only to
people with a professional interest in looking at how not to discuss
genetic technology and society. The problem isn’t simply that Mehlman’s
proposals are dangerous: a good reviewer should be able to recommend a book she
disagrees with. The problem is that he arrives at his proposals by
fundamentally mischaracterizing the technologies and the values at stake. The
last thing in the world we need is another trumped up war against a distorted,
mischaracterized, and exaggerated enemy.

© 2006 Robert Loftis

Rob Loftis, Ph.D., Department of
Philosophy, St. Lawrence University

Categories: Genetics, Ethics