[tt] Dissent: Designer Babies and the Pro-Choice Movement

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Designer Babies and the Pro-Choice Movement
http://dissentmagazine.org/article/?article=861
[Linked by Arts & Letters Daily.]
2007 Summer

By Rebecca Tuhus-Dubrow

OVER THE LAST century, the link between sex and reproduction has
weakened. Feminist activism, aided by technological advances, has
given middle-class women in the United States widespread access to
effective contraception and safe, legal abortion. Although far too
many exceptions persist, for large numbers of women, sex today has
no necessary relationship to childbearing. Meanwhile, a burgeoning
fertility industry has, for thousands, taken baby-making from the
bedroom to the laboratory.
In vitro fertilization (IVF) does not merely help the infertile to
procreate; increasingly, it allows parents to determine the genetic
makeup of their offspring. Initially, preimplantation genetic
diagnosis (PGD) targeted severe childhood diseases, such as
Tay-Sachs and sickle cell anemia. Now, more parents use it to screen
out genes for late-onset, treatable diseases, such as colon cancer;
sex selection is also popular. According to a 2006 survey conducted
by the Genetics and Public Policy Center at Johns Hopkins
University, 42 percent of 137 IVF-PGD clinics allowed parents to
select for gender. Scientists predict that parents will be able to
choose such characteristics as blue eyes or curly hair. Less
certain, but plausible, is that scientists will be able to identify
genes for more complex traits, such as intelligence and
homosexuality. Genetic engineering, which will enable not merely the
selection but the insertion of desired genes, is on the horizon. In
the United States, this rapidly advancing technology is unchecked by
any regulatory mechanism.
It will emerge as an important political issue, complicated by
competing values, such as individual liberty and social equality.
Nowhere will this tension be more conspicuous than in the
reproductive rights movement. There is a lot of messy overlap
between reproductive rights and what could emerge as a neo-eugenics:
both benefit from the separation of sex and reproduction and both
entail increased choice. Pro-choice advocates already find
themselves associated with advocates of this reprogenetic
technology, who often appropriate pro-choice language. Its about
Reproductive Rights, Stupid, reads the title of an article on the
Web site betterhumans.com, which promotes the use of biotechnologies
to improve the human species.
Even without the borrowed buzzwords, the pro-choice movement would
be uneasily close to the issue. Historically, pro-choice arguments
have focused on the right to privacy and freedom from government
interference. Legally, those are the terms that define reproductive
rights. The landmark Supreme Court cases Connecticut v. Griswold
(1965) and Roe v. Wade (1973) recognized the right of individuals to
control their reproductive destinies. Legal scholars predict that
when the question of selecting the traits of offspring inevitably
arrives in court, it will be considered in this framework.
Like it or not, pro-choice groups, then, will be compelled to take a
stand. They will have to distinguish their concept of reproductive
rights from that advanced by neo-eugenicists and to decide whether
and how to endorse regulation of reproductive technologies without
jeopardizing already tenuous rights. But along with these challenges
come opportunities. By incorporating concerns about the abuse of
reproductive technologies into a pro-choice platform, the movement
can shift away from an individual-liberties paradigm toward a social
justice orientation; move away from a single-issue focus on abortion
toward a more comprehensive agenda; and form coalitions with other
segments of the left.

The Twentieth Century

The link between reproductive rights and eugenics is not new; in
fact, it has dogged the movement since its early days. Margaret
Sanger, the tireless pioneer of birth control in the United States,
started out in the early twentieth century as a radical socialist
and feminist. A nurse with working-class origins, she saw firsthand
the travails of poor women drained physically and financially by
endless births. Sanger believed that birth controllegally restricted
at the timewas all but a panacea for societys ills. She launched a
crusade, even subordinating other values to the cause: during World
War I, for example, she kept quiet about her pacifist beliefs out of
fear that her unpopular opinion would undermine support for birth
control.
By 1919, Sangers far-left political background was a liability in a
climate hostile to radicalism. At the same time, the eugenics
movement was seen as socially responsible and forward-thinking by
the public and many intellectuals. Eugenicists argued that society
would benefit if families with good genes reproduced prolifically,
while the unfit refrained from procreating.
To advance the latter goal, some eugenicists advocated
sterilization, by force, if necessary. This option was presented as
a humane alternative: the dysgenic would not have to be permanently
institutionalized or even remain celibate to avoid propagating their
undesirable genes. Forced sterilization received Supreme Court
approval in Buck v. Bell (1927). Justice Oliver Wendell Holmes, Jr.,
famously wrote, It is better for all the world, if instead of
waiting to execute degenerate offspring for crime, or to let them
starve for their imbecility, society can prevent those who are
manifestly unfit from continuing their kind . . . . Three
generations of imbeciles are enough. Numerous state laws were
enacted to authorize forced sterilization.
In an attempt to gain the imprimatur of science, and in a move that
has since haunted her legacy, Sanger became associated with the
eugenics movement. She had promoted birth control for the poor
because she saw that they suffered most for the lack of it. The
well-off always managed to procure means for controlling their
fertility; Sangers poor patients begged her for the secrets of the
rich. When she embraced eugenics, her rhetoric adapted easily to the
values of the movement. While I personally believe in the
sterilization of the feeble-minded, the insane and the syphiletic
[sic], she wrote in 1919, I have not been able to discover that
these measures are more than superficial deterrents when applied to
the constantly growing stream of the unfit. . . . Birth control, on
the other hand, not only opens the way to the eugenist [sic], but it
preserves his work.
This early association, along with certain government policies,
helped to taint birth control and abortion in the eyes of many
minorities. Plenty of poor white people suffered under eugenic
policies, but black, Hispanic, and indigenous women were targeted
disproportionately. (In the rural South, sterilizations of black
womenoften performed without their knowledge following childbirth,
abortion, or other operationswere known as the Mississippi
appendectomy, a term coined by Fannie Lou Hamer to describe her
own.) In the 1960s and 1970s, the Black Panther Party and the Nation
of Islam both denounced birth control as genocidal. Other groups,
such as the National Association for the Advancement of Colored
People and the Student Non-violent Coordinating Committee, also
harbored suspicions. When the government funded birth control rather
than health care or child care in poor communities, some activists
angrily pointed out that reducing the number of poor people was not
the same as reducing poverty. Fears ran deep that contraception and
abortion, as well as sterilization, were means of controlling, if
not eliminating, these communities.
Meanwhile, the mainstream pro-choice movement was operating from a
vastly different perspective. Mainstream feminists wanted the choice
not to have children, to be emancipated from the constraints of the
traditional female role. Rarely did white women have to fight to
have children; the struggle was to avoid having them. In the 1960s
and 1970s, abortion rights activists framed the debate in terms of
feminism and sexual liberation. The movement triumphed with Roe v.
Wade.
In the following decades, some strands of the mainstream pro-choice
movement, notably NARAL (then known as the National Abortion Rights
Action League), modified their approach in the face of changing
political realities. In the aftermath of the Webster v. Reproductive
Health Services Supreme Court decision (1989), which upheld a
Missouri statute prohibiting the use of public facilities for
abortions, NARAL launched its successful Who Decides? campaign,
which toned down the womens liberation language and focused on the
right to freedom from government intervention. As Kate Michelman,
until recently NARALs president, recalls in her 2005 book, With
Liberty and Justice for All, The issue was not whether abortion was
morally right or wrong; that was a matter of individual conscience.
The question was, who had the right to decidewomen or the
government? On the defensive against a passionately committed (and
sometimes murderous) anti-abortion movement, many feminists focused
more intensively on abortion, shifting energy away from other goals,
such as child care, maternity leave, and support for alternative
sexual lifestyles. All of these had once been integral parts of the
feminist pro-choice agenda, as Carole Joffe discussed in these pages
(Its Not Just Abortion, Stupid, Winter 2005).
Although arguably a political necessity at the time, focusing on
abortion and adopting an individual liberties paradigm had its
costs. (William Saletan has analyzed the campaign in his book
Bearing Right: How Conservatives Won the Abortion War.) One was the
loss of a compelling moral narrative, which left a vacuum for the
anti-abortion side to fill. Another was the alienation of poor
minority women. Abortion was less of a priority for women struggling
with multiple reproductive challenges: environmental hazards, lack
of health care and child care, the fear of coerced sterilization.
Some of those who wanted abortions couldnt afford to pay for them,
so the freedom from government intervention was inadequate. The
racial component of reproductive politics has been analyzed by
scholars such as Dorothy Roberts in Killing the Black Body and
Jennifer Nelson in Women of Color and the Reproductive Rights
Movement.
Currently, the pro-choice movement is under siege to a greater
degree than any time since 1973, a situation that has led it to
reassess its strategy. Now, some supporters of abortion rights want
to move beyond the stagnant terms of the debate. Efforts to rethink
the conventional approach are evident in the work of Frances
Kissling, former president of Catholics for a Free Choice;
reproductive justice advocates, including Loretta Ross; mainstream
players in the Democratic Party, such as George Lakoff, a linguist
and consultant; and would-be presidential nominee Hillary Clinton;
as well as many other feminists and activists. The term choice
itself has come under scrutiny, often criticized as a problematic
concept and a weak and morally flaccid competitor with life. Recent
documents, such as Beyond Choice, a 2004 book by Alexander Sanger,
grandson of Margaret and chair of the International Planned
Parenthood Council, and More than a Choice, a 2006 paper by the
Center for American Progress, reflect this attitude.
Choice rhetoric has seeped into other aspects of feminism as well,
with mixed results. Linda Hirschman caused a stir in 2005 with an
article in the American Prospect decrying choice feminismthe notion
that staying home with the kids is as feminist as working, provided
that its the womans choice. Her article focused on the mommy wars
debate, but the same rationale can apply to other aspects of female
life. Some women assert that anything from wearing lipstick to
topless dancing can be a feminist act, because a woman is empowered
by her choice to perform it. (Ariel Levy discusses this phenomenon
in her book Female Chauvinist Pigs.) Hirschman argued that women,
with the goal of collective advancement in mind, ought to
aggressively pursue high-power, high-paying positions.
Although I dont agree with everything Hirschman wrotefor instance,
that we should eschew low-paying, socially beneficial work in favor
of cutthroat corporate successI think she was onto something. Choice
feminism is uncomfortably close to the ethos of consumer culture. A
feminism that consecrates individual choices, endorsing them all as
equally valid, has lost its mission and its soul. (Indeed, choice
feminism is Hirschmans term, not a movement with an agenda; but some
women do subscribe to the idea.)
And here is where the reprogenetic technologies fit in. What is a
designer baby but a new consumer choice? When a vague, distorted
feminism is conflated with enthusiastic consumerism, when choice is
the catchword of both, designer babies can easily emerge as the
natural, if not inevitable, next step in the evolution of our
liberated, capitalist society, in which choices will continue to
multiply for consumersespecially for those consumers par excellence,
women.

Assessing the New Eugenics

Eugenics is a bad word, and designer baby is a term the media use to
conjure science fiction dystopias, but is it really wrong to use new
technologies to improve the human species?
Theres no easy answer. Many people instinctively react against the
idea of tinkering with genetics. It evokes fears of playing God, of
technological experimentation gone horribly awry, even of the end of
humanity as we know it. If only, or primarily, out of pure
nostalgia, a lot of us bristle at the prospect.
Approached on the level of specifics, however, the questions appear
more complicated. A couple profiled in the New York Times underwent
elective in vitro fertilizationeven though they could likely have
conceived without itin order to choose an embryo without a gene that
would predispose their child to colon cancer. There are several
possible criticisms of their decision. Colon cancer is a late-onset,
treatable disease. By the time the child is an adult, a cure may be
found. The gene is not even certain to cause the disease. How can
they justify the expenditure and the godlike control theyve assumed?
On the other hand, their family has suffered immensely from this
disease, and they want to ensure that their child avoids that
suffering. If the technology is available, and they choose to spend
their money on it, how can we deprive them of that option?
This example leads us down the slippery slope. Where, and how, do we
draw the line between acceptable and unacceptable? Many people
condone health-related genetic tinkering, but not a cosmetic kind.
Or, we may feel comfortable with treatment, but not enhancement.
Yet, in a culture in which health and beauty are increasingly
conflated, as are treatments and enhancements (as more natural
variation is pathologized), these distinctions are exceedingly
difficult to make. It is even more difficult to imagine how they
would be regulated.
The new eugenics is in many ways the opposite of its predecessor.
The original eugenics was largely negative: its goal was to curtail
the population growth of the unfit, often through involuntary,
state-sanctioned, sometimes state-funded sterilization. Todays
version is positive: it allows for the creation of more desirable
babies. (Granted, it could be interpreted as negative because, at
this stage, it involves discarding unfit embryos. And the original
eugenics also included a positive element: encouraging fit families
to breed.) The more meaningful distinction is that the original
eugenics involved coercion, depriving people of their rights and
liberties. Todays variety technically does the opposite: the
technologies offer more choices. Indeed, some proponents of their
use accuse bio-Luddites of being the true descendants of
eugenicistsfor proposing state interference in the arena, for
seeking to circumscribe the full range of available reproductive
choices.
But individual choices can have larger social consequences.
Princeton professor Lee Silver has outlined a nightmarish scenario
in which an essentially new species evolves: The GenRich class and
the Natural class will become entirely separate species with no
ability to crossbreed, and with as much romantic interest in each
other as a current human would have for a chimpanzee. Others, such
as bioethicist George Annas, have worried that such a scenario could
undermine the notion of human rights, which is based on a concept of
our shared humanity. On a less existentially threatening but
disturbing note, Annas and others have also predicted an arms race
among relatively affluent parents: added to pressure to enroll kids
in the most prestigious preschools will be pressure to provide them
with the best genes. The result could be an increased tendency to
see children as commodities and status markers; on the other hand,
parents who choose to forgo these measures could be seen as
negligent.
Clearly, there is great potential for good as well as harm in these
technologies. They shouldnt be left, as they currently are, entirely
to the market. Its time for a society-wide conversation about their
use and abuse. The United States is lagging in this regard. Many
countries, mostly in Europe, but also Canada, Australia, and
Trinidad and Tobago have passed laws or regulations restricting or
proscribing various kinds of genetic modifications. The United
Kingdom has the Human Fertilization and Embryology Authority (HFEA),
which licenses and monitors all fertility clinics.

Responses and Political Possibilities

This issue creates strange bedmates. The common political assumption
is that conservatives would oppose the potentially radical change
promised by reprogenetic technologies, while liberals would embrace
the scientific progress they represent. And indeed, the religious
right, concerned about the embryo and the blasphemy of playing God,
condemns them, while some liberals are more inclined to welcome them
on the grounds of progressand, perhaps, in opposition to culture of
life priorities. At the same time, economic libertarians oppose
regulation of this three-billion-dollar-a-year industry, and a
fringe of neo-eugenicists wants to create a super race. Qualms on
the left include the potential exacerbation of inequalities, the
eugenic overtones, and the environmental implications of meddling
with nature.
Other progressive contingents have their worries. Disability
activists are wary of technologies that essentially aim to eliminate
their community. Gay and lesbian people have an especially complex
relationship to assisted reproductive technology. I spoke to staff
at the GLBT (Gay, Lesbian, Bisexual and Trans-gendered) Community
Center in New York, who said that to the extent that it helps them
have genetically related families, they welcome the technology. But
if a gay gene is ever identified, their communities, too, could be
threatened. Many feminists are troubled by sex selection, but fear
that regulating any aspect of reproduction could jeopardize abortion
rights.
The relevant legal infrastructure adds another complication. The
court decisions that uphold rights valued by progressives could also
afford protection to the right to design babies. This applies to all
of the major cases affirming the right to contraception and
abortion: Griswold and Roe, but also Eisenstadt v. Baird (1972),
which recognized the right of unmarried people to use contraception,
and even Planned Parenthood v. Casey (1992), which allowed some
restrictions on abortion but reiterated the essential right of
people to make decisions regarding reproduction. Further, Lawrence
v. Texas (2003), hailed by the left for striking down sodomy laws,
dramatically limits the ability of government to restrict personal
decisions absent injury to a person or abuse of an institution the
law protects. Although progressives welcome these freedoms, the
implications for the unfettered use of reprogenetic technologies are
disturbing. (Of course, the recent decision in Gonzalez v. Carhart
raises questions about the durability of these liberties under the
current Supreme Court.)
Legal issues aside, in the court of public opinion reproductive
rights may be conflated with a libertarian view on genetic
technologies. University of Texas law professor John Robertson has
defended the use of reprogenetic technologies on the grounds of
procreative liberty. His argument goes like this: people have the
right to procreate; sometimes the choice whether to procreate
depends on the qualities of the prospective offspring; therefore,
enhancement must be permitted (although he endorses limited
restrictions). British author Nicholas Agar, in his recent book
Liberal Eugenics, writes, The eugenics defended here [is] primarily
concerned with the protection and extension of reproductive freedom.
Thus can the concept of reproductive choice be appropriated and
abused.
The first and least controversial task for pro-choice activists,
then, is to make it very clear that the rights for which they have
fought are fundamentally different from the right to determine the
genetic makeup of offspring. Whether the latter right is legitimate
or not, it is not the same as or an extension of the former.
Pro-choice activists have struggled for womens freedom to control
their own lives and bodies, not to control the lives and bodies of
their children.
Drawing this distinction could lead to another step: emphasizing the
morality of abortion rights. Abortion should be legal because women
should have the same rights as men to shape their lives; because
sometimes bringing a child into the world is the wrong thing to do;
because without legal abortion, women suffer and die.
Abortion-rights advocates can frame abortion as a matter of social
justice, not just of freedom from government interference.
As an alternative to choice, women of color have created the concept
of reproductive justice. In the literature of SisterSong Women of
Color Reproductive Health Collective, the national coordinator,
Loretta Ross, defines the term, coined in 1994, as (1) the right to
have a child; (2) the right not to have a child; (3) the right to
parent the children we have . . . . We also fight for the necessary
enabling conditions to realize these rights. This more comprehensive
notion of reproductive justice can be useful in confronting the
issue of designer babies. Although not currently one of the main
items on the reproductive justice agenda, a position on reprogenetic
technologies can easily be added to the list of concerns, which
include environmental hazards and health care. In fact, of the
reproductive rights activists Ive spoken to, Ross was the most
sympathetic to the prospect of regulating these technologies.
As Joffe pointed out in the Dissent article mentioned earlier, the
logic of seeing abortion as just one part of the mosaic of
reproductive and sexual rights and services is not simply that it is
persuasive to others. It is also the most authentic position of the
reproductive freedom movement itself. Reproductive technologies did
not factor into the original movement, because they didnt yet exist.
But now that they do, promoting sensible policies on their use
should fit into a broader platform. Such a platform could appeal to
other factions of the left as well as moderates, who might be turned
off by the focus on abortion but who share concerns about related
issues, including the abuse of reprogenetic technologies.
The concept of reproductive justice has already made inroads into
the mainstream movement. The pro-choice movement eludes
generalization, because different organizations have different
priorities and approaches, but many parts of it have already begun
to shift toward a social justice focus and a broader platform. The
literature of Choice USA, a fifteen-year-old organization founded by
Gloria Steinem, uses the term reproductive justice, and Planned
Parenthood sponsored a conference in 2005 at Smith College titled
Reproductive Justice for All.
Concerns about reprogenetics have also surfaced. The Planned
Parenthood conference devoted a quarter of the agenda to
reproductive technologies. The Center for Genetics and Society,
billed as a pro-choice organization working for sensible policies on
genetic engineering technology, aims to initiate and facilitate
conversations about the subject. One effort was a retreat in October
2006 with representatives from various progressive organizations,
including Planned Parenthood, Choice USA, the ACLU, the disability
rights group Not Dead Yet, and the LGBT Community Center of New
York.
According to Sujatha Jesudason of the Center for Genetics and
Society, the groups that attended that retreat were enthusiastic
about continuing the conversations within their own organizations
and forming coalitions to address the issue. The pro-choice
advocates in particular started a process of reflection on the
tensionsbetween individual liberties and social justicethat are
especially prominent in their movement.
In contemplating regulation, an example from the past might prove
illuminating. In 1975, in New York, a multiracial coalition called
the Advisory Committee on Sterilization helped implement guidelines
for regulating sterilization, including a mandatory waiting period.
The aim was to ensure informed consent, because so many poor
minority women had been sterilized without it, in haste. Planned
Parenthood and NARAL opposed the restrictions, arguing that they
infringed on reproductive freedom. (White women, who frequently
could not persuade doctors to sterilize them, did not want to make
the process more cumbersome.) This conflict was perhaps the clearest
manifestation of the discordant outlooks of different feminists.
The opposition of the mainstream groups was understandable, but it
also reflected a degree of myopia. Likewise, Margaret Sanger was so
single-minded in the promotion of her cause that she endorsed
wrongheaded ideas that she believed would serve it. Now, we who
support abortion rights may fear that regulating reproductive
technologies could endanger our cause. There is no doubt that
maintaining the legality of abortionand fighting to reverse harmful
restrictions of itis paramount. But it is also important for us to
sustain a larger moral vision. We have to find a way to advance that
multifaceted program, including views on reproductive technologies,
while protecting the right to abortion.
It appears inevitable that genetic technologies of all kinds will
become one of the major issues of this century. It appears equally
inevitable that the pro-choice movement will become entangled in the
debate. In this new challenge, Margaret Sanger provides an
instructive exampletodays reproductive-rights advocates should
emulate her passionate advocacy and avoid repeating her mistakes.

Rebecca Tuhus-Dubrow is a journalist based in Brooklyn.