Chapter 9: Genetic Choices – Testing, Therapy, Stem Cells & Enhancement

Genetic Choices – Testing, Therapy, Stem Cells & Enhancement outlines various forms of genetic testing—including newborn screening, predictive testing for disorders like Huntington's disease, prenatal diagnosis, and preimplantation genetic diagnosis (PGD)—and highlights the ethical challenges of uncertainty, the psychological impact of results, and the tension between individual autonomy, confidentiality, and the duty to warn family members about inherited risks. The discussion proceeds to gene therapy, distinguishing between non-inheritable somatic cell intervention (aimed at treating existing individuals) and inheritable germ-line modification (which affects future generations and remains highly controversial due to safety concerns). A central moral debate revolves around the distinction between using genetics for medical "repair" versus using it for "enhancement" of normal traits, raising serious questions about justice, fairness, and the potential for new forms of eugenics. Additionally, the chapter examines the intense moral scrutiny directed at embryonic stem cell research, where the immense potential for treating major diseases conflicts with concerns regarding the moral status of the human embryo and its deliberate destruction for research purposes. These bioethical issues are analyzed through major theoretical frameworks, revealing how principles like utilitarianism, Kantian ethics, and natural law offer competing guidance on genetic decision-making, particularly concerning reproductive choices and the philosophical problem of the "wrongful handicap" when selecting against disability.