The application of genetic knowledge to improve the quality of human populations is known as eugenics. Enforced sterilisation, and even mass murder, has been carried out in the name of eugenics, tarnishing the science of genetics during the twentieth century. However, genetic testing and gene therapy may soon reduce the suffering caused by genetic disease. The potential for modifying human genes will soon become greater due to the completion of the Human Genome Project and advances in cloning technology. Ethical questions now have to be confronted, in the light of the lessons from history, concerning how far human genetic manipulation should proceed. Popular culture can help us focus on the issues to be addressed. The film Gattaca (1997), for example, presents a vision of the near-future in which genetic disease has been eradicated, but only for a wealthy elite who also opt for non-medically essential genetic enhancements.
Eugenics
The term "eugenics" (literally, "good genes") was coined in 1883 by Francis Galton, a cousin of Charles Darwin, to describe selective breeding based on genetic merit. Galton believed that quotas of children should be parcelled out dependent on the hereditary endowment of the parents. Biological worth was equated with social status, however, and the poor were deemed to be poor because they were biologically inferior. The early eugenicists believed that those they chose to label "feeble-minded" should be discouraged from breeding. After Galton, a succession of eminent British biologists and politicians expressed similar views. The eugenicists appropriated Darwin's theory of natural selection to support their ideas; for example, Herbert Spencer coined the phrase "survival of the fittest" in the context of social Darwinism. Eugenicists therefore sat in judgement concerning what were good and bad genes, a judgement often clouded by the prejudices of the day.
All the genes present in a population are referred to as the gene pool. There are basically two ways of improving the gene pool: (a) by positive eugenics or selective breeding to increase the frequency of genes considered desirable and (b) by negative eugenics or the elimination of harmful genes, for example, by genetic testing and counselling prospective parents who are carriers of those genes. Negative eugenics is the easier of the two forms of eugenics to implement by social policy. The sterilisation of those carrying genes for genetic defects, however, is not based on good science. So-called "feeble-mindedness" may be based on upwards of ten recessive genes, so to rid a population of these genes would entail sterilising most of that population. However, at times sterilisation has been enforced on those deemed genetically inferior with just this aim.
From the debates among the upper classes in Britain at the turn of the century, eugenic ideas spread to the USA, where they flourished. The State Sterilisation Laws were first passed in 1910, with advocates arguing that if all marriages in the US were eugenic, then unfitness, such as feeble-mindedness, criminality, insanity or alcoholism, could be bred out in three generations. (1) By 1931, 35 states had passed sterilisation laws. The definition of "feeble-minded" was often extended to include "unwed mothers, prostitutes, petty criminals and children with disciplinary problems". The Virginia Sterilisation Law, for example, was passed in 1924 and implemented up until 1972, by which time over 7,500 people had been enforceably sterilised; many without realising what had been done to them. (2) In total, tens of thousands of Americans were sterilised in this way. In 1924, Congress passed the Immigration Act, designed to complement the sterilisation laws by limiting immigration from Eastern and Southern Europe on eugenic grounds.
Eugenic ideas then passed back to Europe. They were enthusiastically taken up in Germany, where the first European Sterilisation Law was passed in 1933. The Nazi elite, who believed themselves inherently superior and genetically pure, formulated policies of compulsory birth control for those with genetic disease. The laws were extended to "degenerate families", who included Jews, gypsies, homosexuals, alcoholics and the mentally ill. By 1939 almost 400,000 German men and women had undergone eugenic sterilisation. Revelations concerning sterilisation programs in other European countries have more recently come to light, most notably in Sweden, where around 60,000 supposed "feeble-minded" were sterilised between 1935 and 1975. However, the Nazis took the eugenics program to extremes, not only using sterilisation, but also implementing a program of mass extermination. The Holocaust, in which 6 million Jews and other groups deemed "inferior" perished, was rationalised by eugenic policies.
The lessons from history obviously need to be learned as mankind embarks on a new eugenics programme. This programme will not be based on repressive social policies, the state control of reproduction or planned attempts to change a population's gene pool, however, but on individual choices that affect genes within families from one generation to the next. It will involve genetic testing, gene therapy, genetic engineering and other DNA technologies. The applications of genetic knowledge in medicine today are largely socially acceptable, are driven by free choice and the laws of the marketplace, and offer major health benefits to individuals. This market-led human gene modification is likely to lead to a new set of ethical and social problems. The science fiction thriller Gattaca (1997) extrapolates from today's genetic technology to see what sort of problems these might be.
Discrimination down to a science: Gattaca
Gattaca, directed and written by Andrew Niccol, explores the implications of genetic modification in a near-future society, where parents have a choice between having a natural baby ("a faith birth") or a genetically enhanced baby. Genetic enhancement is expensive and therefore the choice is only available to those who can afford it. A baby born without genetic enhancement is labelled as an "In-Valid" and does not have the chances in life available to the genetic elite or "Valids", because of discrimination and selection along genetic lines. The film opens with two oppositional quotes; the first from Ecclesiastes (7: 13): "Consider God's handiwork; who can straighten what he has made crooked?"; and the second from the geneticist Willard Gaylin: "Not only do I think we will tamper with Mother Nature, I think Mother wants us to". The film's theme is whether modification of the human genome, if left to market forces, will lead to an undesirable new form of eugenics. The audience is confronted with a personal ethical question: whether they would leave their offspring's genetic make-up to chance or opt to choose their child's genetic make-up for themselves.
In the film, Antonio and Marie (Elias Koteas and Jayne Brook) have two sons, the first through a faith birth and the second using genetic enhancement. Vincent Freeman (Ethan Hawke) is the In-Valid son who, as his social label suggests, is treated as if he were an invalid from the day of his birth. In the delivery room, seconds after his birth, Vincent's heel is pricked (possibly his Achilles one) and a blood sample taken. An instant computer analysis is read out to the anxious parents, based on the genes likely to make the baby less than perfect. Sexual reproduction has dealt Vincent a seemingly weak hand, compared to the Valid norm of society. He is to be myopic, left-handed, below average height, and with a high statistical probability of dying from a heart condition by the time he is 30 years of age. The genetic testing results make the parents fatalistic and they expect the worst for their son. As Vincent grows, each cut and graze is treated as potentially life-threatening, while health insurance and hospital treatment are almost impossible for In-Valids to obtain.
For their second child Antonio and Marie put their life-savings towards a genetically enhanced Valid son (they decide the sex, while chance chose Vincent's). They meet a genetic counsellor to select which of Marie's test-tube embryos to implant, and run through a list of the desirable traits they want the boy to have. Gene modification technology has become part of consumer society. The parents agree that all genes that might contribute to genetic disease should be modified, along with those that contribute to myopia, premature baldness, obesity and alcoholism. In addition, genes that affect intelligence, height and other physical characteristics are enhanced. The counsellor reassures the parents, who are a little concerned about having so many of the embryo's genes altered: "It's still you. It's simply the best of you". Anton Freeman is born a Valid and given his father's name. His genes predict a glowing future, and he is given the best education and chances in life.
Vincent grows up feeling inferior in every way to his brother. During a swimming challenge, however, he saves his brother's life. This gives him new confidence in his abilities, which have been undervalued by everyone around him. He leaves home and takes a series of menial jobs, the only ones available to In-Valids, and eventually becomes a cleaner at the Gattaca Corporation headquarters. It is here that Vincent realises the scale of prejudice directed against those with "inferior" genes. Blood samples are extracted on entry to the Gattaca building, while samples of urine and other bodily materials are frequently taken to check the identity and genetic status of company employees. The In-Valids form an underclass, while race and skin colour is no longer seen as a basis for discrimination. As Vincent says: "They've got discrimination down to a science".
Vincent's ambition is to become a space-pilot, but he realises that he must use illegal means if he is to achieve his goal. He is introduced to Jerome Morrow (Jude Law), via an identity broker, who agrees to rent Vincent his identity for a percentage of Vincent's future earnings. Jerome is a Valid, a former swimming star, with high intelligence and an excellent physique. However, Jerome became a paraplegic after being hit by a car; an accident that terminated his employment prospects. Jerome and Vincent swap identities - Vincent becomes Jerome, while Jerome calls himself Eugene. With the use of Jerome's blood and urine, Vincent gets a job at Gattaca as Jerome. He passes security checks on a daily basis, for example, by using blood-filled fingertip patches. Vincent lacks the 20/20 vision of all Valids, and wears contact lenses to improve his vision and make his eye's resemble Jerome's. He must also learn to write with his right hand. He succeeds in his deception, excels at his job, and swiftly rises up through the system.
Vincent/Jerome can initially trust no-one in the Gattaca organisation and goes to elaborate lengths to prevent hairs or loose skin being deposited around his workstation. He obsessively showers, shaves and scrubs himself daily, and places Jerome's hairs and skin samples on his comb and around his computer keyboard. He correctly suspects that samples are secretly taken, either by the company's detectives or by suspicious colleagues. Anyone can anonymously hand in a sample, for example a hair, over a counter and get back a printout of a genetic profile. The main use of this testing service seems to be for checking the genetic profile of lovers and potential partners. Vincent strikes up a friendship with Irene (Uma Thurman), a colleague who he comes to trust, and later falls in love with. During the film they both offer each other a hair - the ultimate show of trust. She finds out that he is an In-Valid but plays along with the pretence. (3)
Only weeks before Vincent/Jerome is due to fly on his first rocket, a mission to Titan (4), the mission director is found murdered. One of Vincent's eyelashes is found near the scene of the crime and, as it's from an unregistered In-Valid, he becomes the chief suspect in the murder case. Detective Hugo (Loren Dean), and his assistant (Alan Arkin), go looking for him amongst the In-Valid community. However, Hugo soon suspects that Vincent is impersonating a Valid inside Gattaca. The police carry portable blood testing equipment, which is linked to a central DNA database - giving instant identification of hair or saliva samples. (5) Vincent narrowly escapes a couple of random security checks. When he knows they have his photograph he wants to give himself up, but Jerome talks him out of it, reassuring Vincent that no one looks at faces anymore, just DNA profiles.
It is revealed that Gattaca Director Josef (Gore Vidal) committed the murder, but Hugo continues to pursue Vincent and tracks him down to his desk in the Gattaca building. Hugo is revealed as Anton - Vincent's Valid brother. They are reconciled, and the police investigation of Vincent is dropped. Meanwhile, Irene accepts him, with all his genetic faults, and says she will wait for him to return from Titan. Vincent arrives for his mission, but does not have a final bogus urine sample to give the scientist Lamar (Xander Berkeley). We learn that Lamar has been an ally all along, covering for Vincent during routine sample tests and at the gym, though he knows he is an impostor, because he has an In-Valid son of his own. Lamar offers Vincent some advice for the future: not to hold his penis with his left hand when giving urine samples, as all Valids are right-handed. Vincent boards the rocket and flies into space, while Earth-bound Jerome commits suicide. (6)
The names used in Gattaca reflect the film's genetic concerns. The name of the corporation - Gattaca - is derived from the four letters of the genetic code (GATC), specifically the arbitrary sequence of bases: Guanine, Adenine, Thymine, Thymine, Adenine, Cytosine and Adenine. After finishing the film, Niccols looked to see where this sequence might occur in the human genome. He initially found it associated with genes involved with the workings of the heart, but was then disappointed to find that it was ubiquitous throughout the genome: "Basically we're riddled with GATTACA." (7) During the opening credits the names of the cast and crew are telegraphed by the letters of the four bases, joined afterwards by the other letters of their names. This anticipates the film's point that people are first seen in terms of their genetic profile, and only secondly as a person. Fortuitously, the entire cast had at least one of the relevant letters in their names. Jerome (meaning "sacred name") Morrow (sounds like Moreau) assumes a new identity under the name "Eugene", a reference to his good genes and eugenics - a term not explicitly used in the film. Detective Hugo is named after the Human Genome Organisation (HUGO), the body that administers the Human Genome Project. Vincent Freeman's name suggests free will and men freed from slavery; while Irene rhymes with gene and is an anagram of reine, carrying connotations with bloodlines of royal privilege. Lamar's name resembles Lamarck, whose theory that characteristics acquired during a lifetime could be passed to offspring was superseded by natural selection (although characteristics acquired by genetic engineering in ones lifetime can be passed on, if the new DNA sequences are present in the sex cells). Meanwhile, the name of Gattaca Director Josef echoes that of the Nazi geneticist Dr. Josef Mengele.
The genetic theme is also apparent in the mise-en-scène, in particular in the spiral staircase in the centre of Jerome's apartment, which rises like a double helix out of the floor. The wheelchair-bound Valid circles around it, and on one occasion struggles up it using his hands, while Vincent is referred to as "a borrowed ladder" for taking his new identity from Jerome's genome. The film uses colour expressionistically, for example to recall the sickly skies of Vincent's childhood, and to echo the clinical lives of the Valids. The Director of Photography Slawomir Idziak achieves cool, flat images using blue, yellow and green filters. The architecture is clean and precise, with elements of Frank Lloyd Wright and minimalism, while Michael Nyman's post-minimalist score complements the images. The Gattaca centre, designed by Jan Roelfs, exhibits an antiseptic interior that epitomises the society created by the Valids. Each workstation in the office is identical; with none of the family photos, Gary Larson or Dilbert cartoons, or assorted clutter with which workers today individualise their desks. The only untidiness in Jerome's apartment is the table strewn with medical equipment, for supplying the blood and urine samples that Vincent needs to get through each day undetected.
The Valids look fit and healthy, with perfectly toned bodies. Ethan Hawke, previously best known for roles in "slacker" movies, had to work-out prior to filming in order to develop the physique necessary to play an In-Valid who impersonates a Valid. A typical day at the office involves a session working out in the company's gym, but Vincent has to use a fake electrode to playback Jerome's heartbeat, to fool the monitoring equipment. The obsession with the "body beautiful" is in-tune with the film's location in Los Angeles. California is also home to the first sperm banks offering genetically superior sperm, as discussed later in this chapter. It is therefore likely that Los Angeles will be the place where non-medically essential genetic enhancement starts.
The demand for this technology is certainly present in the USA. In a teaser poster campaign to promote the film, parents were offered a free-phone number to contact if they wanted further information about how to engineer their offspring. It was not obvious that these were film posters, as the film information was only given at the bottom in very small typeface. Thousands rang the toll-free number (1-888-BEST-DNA), thinking it was for real, wanting to find out how they could choose the sex, height, eye and skin colour or intelligence of their future child. The phone line was disconnected and the adverts changed following protests from the American Society for Reproductive Medicine. (8)
Niccols assembled a multi-racial cast to play extras, to emphasise the new division of society based on genetic discrimination. This served to point out the arbitrary nature of discrimination, but it is an aspect of the film that does not ring true. In reality, genetic discrimination is likely to overlay and reinforce existing prejudices, including racial and class prejudices. Gattaca's prediction of a society divided between the genetic haves and the have-nots, however, does rest firmly on trends evident in today's medicine, which is increasingly polarised into public and private healthcare treatment. It is essentially an economic division, with the wealthy turning to private medicine and the less wealthy relying on underfunded state healthcare systems. Genetic enhancement is only likely to be available to those with the wealth to afford it. The biggest divisions between the technological haves and have-nots, however, will not be within developed countries, but between those living in the developed and developing worlds.
The patenting of human genes could mean that genetic manipulation technology becomes concentrating in the hands of a small number of multinational corporations. Patents on biotechnology deny health workers in developing countries access to information, while the commercial exploitation of the technology, based on market forces, ensures that only the wealthy are likely to benefit. The power of multinational corporations is reflected in Gattaca, where genetic technology is furthering corporate economic interests, rather than national political interests. The main beneficiary of genetic enhancement is the corporation, which has an endless supply of top-quality Valid workers to choose from. A job interview involves a genetic test, and nothing more. "My real résumé was in my cells", says Vincent after getting the job at the Gattaca corporation, with one of Jerome's samples.
Niccols has said that he wanted to make an open-minded film that was not totally against the application of genetic knowledge to modify human genes. The population in Gattaca has shed the burden of crippling genetic disease - a worthy aim - but seems to have gone too far in their search for bodily perfection.
"I would hate for anyone to look at my film and think it is advocating that you never tamper with genes",
Niccols has said,
"because there have been and will be many positive things to come out of this
kind of science in terms of curing diseases.
But the problem is that blurred line between health and enhancement. How far do we go?
Is short-sightedness a disease? Premature balding? Crooked teeth? Where do we draw the line?" (9)
Left-handedness, for example, has been correlated with a slightly reduced life expectancy, but is artificially selected against southpaws justified? Society may find it difficult to forbid parents to improve their child's chances of good health and a long life, if these options are available. It is unclear to what extent, if any, western societies could dictate a family's reproductive choices. Society does, however, have a stake in the outcome of these individual decisions and a social consensus needs to be sought, and guidelines drawn up, before technology gets too far ahead of social policy. The ambiguity of the film confused some reviewers who were looking for a clear take-home message. However, the film should be applauded for avoided simplistic conclusions. The film succeeds in raising the relevant issues for an audience and allows them to think them through for themselves.
One of the film's weaknesses is that it underplays its oppositions. Vincent stands in opposition to the Valids, but he is too much like a Valid for the film to mount a vigorous defence for all the genetically-challenged members of society. None of the In-Valids portrayed has any obvious signs of genetic disease or disability. (10) It is implied that with some intensive book-learning, and a bit of hard physical exercise, Vincent can attain the level of a Valid. However, most of those discriminated against will not have this option. Meanwhile, Uma Thurman's character is presented as society's ideal type of woman, but no alternative type of woman is represented. In essence, dystopias and utopias usually co-exist, for their respective merits to be judged, but the counter-world to the Gattaca corporation is only hinted at.
The unrealistic portrayal of simple genetic constructs being responsible for complex characteristics will be discussed in the following chapter. Even if genes could be modified to alter complex behaviours, however, it might prove counter-productive or even dangerous. Complex characteristics are likely to be determined by many interacting genes spread throughout the genome. The problem with modifying genes in these cases is, therefore, that if a gene affects a number of different traits, its modification may improve one trait, but detrimentally affect another. An example of this from medical genetics is sickle cell anaemia. The single gene responsible for this disease is selected for in the tropics because it is associated with resistance to malaria. Deleting the gene for sickle cell anaemia therefore may leave a "genetically enhanced" individual more liable to malarial illness. With multiple genes acting to influence complex characteristics, the effects will be much less predictable. Another point worth making is that parents choose their offspring's traits at the embryo stage, but when the offspring become adult these traits may be of less value. Non-medically essential genetic modification is in a sense fashionable, and fashions change.
Nevertheless, the finding of genes that correlate with human characteristics, the commercialisation of genetic technology, and parents' desire for their offspring to have the best start in life, will ensure that market forces drive a new programme of human genetic improvement. This has been described as the "new eugenics". It will not involve enforced sterilisation or other socially repressive legislation, but will be driven by consumer demand, individual choice and economic factors. Many of the ethical issues raised in Gattaca concerning the "new eugenics" are already confronting us. These include choices relating to genetic testing, gene therapy, infertility treatment and artificial insemination.
Genetic testing and gene therapy
Today about one hundred genetic tests are available to predict different genetic diseases, caused by the incorrect functioning of single genes. There are about 5,000 known single gene defects, and further screening tests will be developed as and when the location of more of these genes become known. Single gene defects are of three types: recessive, dominant or sex-linked. If both parents carry a recessive gene for a particular disease, then there is a relatively high (25 per cent) chance of any baby of theirs having that disease. Recessive gene disorders include cystic fibrosis (CF) and thalassaemia. If a dominant gene defect is inheriting it will cause genetic disease in that individual. Therefore, dominant gene disorders usually only become prevalent in elderly people, else they would be infrequently inherited. The most common example is Huntingdon's chorea. Sex-linked gene defects are carried on the X chromosome, of which females have two and males have one (along with a Y). Any recessive gene defect on the X chromosome, therefore, will be expressed in men, as there is no other gene allele present. There are about 300 known X-linked disorders, including Duchenne Muscular Dystrophy (DMD), an incurable muscle wasting disease that affects young males, and haemophilia. (11)
People carrying genes for certain genetic diseases can be identified by genetic testing, allowing them to make informed decisions about reproduction. Genetic testing without adequate counselling, however, can be problematic. Mandatory screening for DMD, for example, proved controversial when introduced in parts of the US in the early 1990s. Parents were upset that tests were done without their consent, while concern was expressed that the knowledge of a positive test might affect a parent's relationship with their child. Patients who have received positive (or even negative) genetic test results relating to them or their families have reported feelings of fatalism, which can lead to psychiatric problems. (12) Fatalism is evident in a Gattaca world, where the parents have a different attitude to their Valid and In-Valid sons. Counselling is today seen as an essential part of the genetic testing process, but it remains an area fraught with ethical dilemmas. In the USA, the National Institutes of Health (NIH) in 1997 stated that all couples planning children should be offered a genetic test for CF, the first time that a genetic test for a disease had been recommended for the general population, although testing is not mandatory. (13)
In addition to deciding whether to become pregnant, choice exists concerning whether to terminate or carry on with a pregnancy in the light of genetic test and ultrasound scan results. In the USA, terminations have occurred when genetic tests have revealed irregularities, even though it was not known whether changes in that part of the chromosome would lead to any problems. A range of genetic conditions, including achondroplasia and Down's syndrome, may lead parents to seek an abortion. Many might question the ethics of terminating a life because of certain gene mutations. In addition, society would be deprived of those many individuals who have died young through genetic disease but who have made important contributions to society and culture.
Genetic testing at an early age could however be beneficial for health, by allowing preventative measures to be implemented. Appropriate diet and exercise, for example, might offset a known genetic propensity to heart disease. These environmental modifications to genetic destiny are undervalued in a Gattaca world. This is also becoming the case in today's world, where insurance companies, employers and other interested parties are increasingly seeking the results of genetic tests. A positive result for an undesirable gene may soon affect an individual's ability to get insurance, a mortgage or a job. Professional bodies are developing guidelines on genetic testing, to try and strike a balance between their desire to know as much as possible about an individual's genetic make-up and that individual's right to have certain information withheld. (14) In a recent case in the USA, an insurance company offered to pay for the termination of an embryo with a CF gene, but refused to pay any subsequent healthcare if the baby was born. In Gattaca the authorities refuse to grant Vincent health insurance, on the basis of genetic tests, while his genes prevent him obtaining any work other than menial labour. We are told that the laws that exist to prevent genetic discrimination are completely ignored in a Gattaca world. (15) However, a Gattaca world is not inevitable, providing legislation is passed and enforced, which protects the individual from organisations who would discriminate against them solely on the basis of their genetic code.
Genetic enhancement by gene therapy is already starting to be used to treat fatal genetic diseases. Hundreds of medical trials have been approved, mainly in the USA. Gene therapy involves supplying a correctly functioning gene, to take over the function of a defective gene. The first attempt at gene therapy was an unauthorised one in Israel in 1980. A US doctor, Martin Cline, unsuccessfully experimented on two patients dying with thalassaemia. The first fully sanctioned attempt was in the USA in 1989 by French Anderson and his colleagues at the National Institutes of Health (NIH), who treated a girl with adenosine deaminase (ADA) deficiency - a rare and severe immune disease - by administering a functional ADA gene. The technique involved inserting genes coding for ADA into blood cells taken from the girl and then returning them to her body. In the early 1990s, Anderson used related techniques to treat children with an hereditary disorder called severe combined immune deficiency (SCID), caused by the lack of an enzyme in the immune system. (16)
At its simplest, gene therapy involves the repeated administration of genes. Nasal sprays deliver CF genes non-invasively into the body, for example, although treatment must be administered every two weeks. However, even then it is a complicated procedure, involving many stages. First the gene of interest must be identified, located and copied many times using PCR. Then the gene is incorporated into a cloning vector, using recently developed cell cloning techniques, which will transport it to its site of action. Structures called liposomes, like microscopic bags of fat, are usually used for this purpose, because they readily fuse with cell membranes and can carry genes into cells. Once inside the target cell, the gene must integrate into the cell's DNA. This is usually at random and can either place the gene too far from the regulator and promoter genes needed to activate it, or it might come to lie within an existing gene and disrupt that gene's function. The integrated gene must then express protein to relieve the symptoms of the genetic disease. It is still unclear whether any of today's gene therapy techniques actually work. In late 1999, the first death attributed to gene therapy treatment initiated a more sober appraisal of the ongoing clinical trials.
Gene therapy is currently targeted at single gene defects. These defective genes usually malfunction because they do not produce the protein they are programmed to make. Aiming at multiple gene targets, as happens in a Gattaca world, where complex behavioural and physical characteristics are modified, is way beyond today's technology. However, research is underway to develop techniques that may enable more complex diseases, such as AIDS and various cancers to be treated. A key development in this area will be artificial chromosomes, in which a set of genes could be delivered together into a cell. (17)
The gene therapy considered so far has aimed at replacing the function of genes in somatic cells, that is cells in adults that are already specialised in their function, rather than the reproductive cells or embryo cells. Somatic cell changes are not inheritable. In the future, however, techniques may be developed to modify or replace genes in an inheritable manner (germ line therapy). This would ensure that genetic disease is treated before it appears in the offspring of whose initially treated. It could be done with the long-term goal of eradicating certain genetic diseases. With germ line therapy, genes would be modified in every cell of the body, not just in localised places as occurs with somatic cell gene therapy. Therefore, once the parents have deleted genes associated with genetic disease and "enhanced" genes for eye colour, height and so on, all these modified genes will in turn be passed on to future generations. The gene modifications in Gattaca appear to be germ line changes. Gene therapy also enables transgenes, genes from other species, to be integrated into the human genome. Again, these could become a permanent part of the human gene pool. This option appears not have been pursued, however, in a Gattaca world.
Genetic modification in the future may lead to a number of novel legal problems. Children may sue the medical profession, via their parents, using the concept of "wrongful birth", for being born with a known genetic disease, which their parents were not informed about. In addition to this inter-generational justice, in a Gattaca world one could envisage geneticists being sued if things do not go according to the genetic blueprint. This may indeed be a factor that limits the application of non-medically essential gene modification.
When gene therapy technology comes of age, the question of what are legitimate uses for the technology will need to be confronted. As shown in Gattaca, drawing a line between ethical and unethical uses of gene modification technology may not be easy. While gene therapy lies in the future, however, the "new eugenics" is already with us, in the form of genetic testing and artificial insemination with genetically-screened sperm.
In vitro fertilisation and genius sperm
The first use of Donor Insemination (DI), or artificial insemination by donor, to treat infertility, based on techniques used to breed livestock by sperm injection, occurred in Britain as long ago as 1939. Sperm donors remained anonymous, while the whole procedure was surrounded by a high degree of secrecy. A scientific report in 1945 by the infertility pioneers Mary Barton and Margaret Jackson created a great deal of controversy. The phrase "test tube baby", with its Brave New World connotations involving the state's control of reproduction, started to be widely used in the media from this time. (18) By the late 1950s it was estimated that several thousand children had been born as a result of DI, but various social prejudices ensured that it would be many years before the technique became a widely accepted treatment for infertility. (19)
The technique of in vitro fertilisation (IVF) - literally, fertilisation (of an egg) in glass - came of age with the birth of Louise Brown in July 1978. Robert Edwards and Patrick Steptoe achieved this success after many years of endeavour, and in the face of widespread scepticism. The phrase "test-tube baby" took on a new meaning after Louise's birth, as she was the first baby conceived outside of her mother's womb. An initially low success rate of IVF was improved by treating women with hormones that caused them to super-ovulate, yielding several rather than one egg per cycle. During IVF several eggs (ova) are fertilised with sperm in a petri-dish, to produce embryos that are genetically unique, although only one or two will be implanted into the womb. This spare embryo production raised the volume of opposition to IVF during the 1980s and created new ethical dilemmas. A further advance followed the discovery that human embryos could be safely frozen (as can eggs and sperm), allowing them to be implanted over a period of time and reducing wastage. (20) IVF is now a routine procedure, and has been used by around half a million couples to conceive children. Ethical views on IVF have changed and it is now widely considered to be socially acceptable. It is an expensive treatment, however, that is only available to those who can afford it. (21)
When several embryos are available during IVF, pre-implantation genetic diagnosis (PGD) can be used to select the embryo with the most favourable genes for implantation. This choice is shown in Gattaca, when the parents meet the geneticist/counsellor, and one embryo is selected from four seen on a monitor screen. Embryos free of genes known to cause genetic disease are selected, but in a Gattaca world this procedure is extended to encompass a range of non-medically essential genetic changes. PGD involves taking one cell from an embryo and then using the technique of PCR to make millions of copies of a DNA sequence within three hours, so that genes can easily be analysed. PGD was first used in reality to enable parents to choose the sex of their child. It is possible to separate sperm having X and Y chromosomes, which look different when stained with fluorescent dye, before fertilisation of the egg in IVF treatment. Sperm containing X chromosomes result in female embryos and those containing Y chromosomes result in male embryos. An embryo of known sex can therefore be implanted using PGD. It is estimated that over 2,000 babies of preferred gender had been born up to 1998. Most of these were to avoid sex-linked genetic disorders in the offspring. For example, mothers at risk of having boys with DMD can elect to have only female embryos implanted, who may carry but are not at risk from the disease. However, the service is increasingly being offered for "purposes of family balancing". (22)
Embryo-freezing or cryogenic technology can now enable parents to plan when to have children. The first so-called "life-style" baby hit the headlines in July 1998 when a London couple had an embryo frozen, so they could have a child through IVF at a more convenient stage later in their lives. Like many modern couples, they were both pursuing careers and were planning to start a family when they were in their late thirties. By freezing one of their embryos, they reduced the risk of conceiving a child having a number of genetic disorders associated with late pregnancy. (23) Woman as old as 55 can have IVF in Britain, and older woman have conceived through IVF in the USA, extending the effective reproductive age. (24) Tissue from the ovary can also be frozen and re-implanted, enabling women undergoing treatments that would render them infertile, such as chemotherapy, to regain fertility later in life. It has been suggested that this technique could also be used to postpone the menopause, further increasing the reproductive age of women.
In the early days of cinema, artificial insemination was looked upon as an unnatural birthing practice. For example, in Alraune (1918) it unsurprisingly leads to the birth of a soulless murderess. DI has now become a relatively common, and even fashionable, means of conception for certain groups in society. (25) The idea of IVF was also widely considered repugnant, until the birth of the first IVF baby started to change public opinion. Critics still label the latest assisted reproductive technology with the phrase "unnatural practice". In a recent controversial case in England, Diane Blood was denied permission to use her dead husband's sperm to conceive using an IVF technique called Intra-Cytoplasmic Sperm Injection (ICSI), used when sperm counts are low, because her husband did not leave her written permission. She eventually conceived after treatment at a clinic in Belgium. (26) Techniques relating to cloning, however, have probably attracted the most opposition from those concerned about developments in assisted conception, as noted previously.
Those seeking to conceive today via DI need not resort to extreme secrecy and mystery donors. They can purchase sperm from sperm banks, with the knowledge that it contains genes linked to high intelligence and various favourable physical characteristics. Parents have always had a big say in the genetic make-up of their offspring, of course, by choosing a suitable partner to contribute half the child's genes. In Gattaca, couples who peruse print-outs of each other's genetic codes are just taking this a stage further. Sperm banks in California supply the equivalent of genetic print-outs of their donors' sperm, with abundant information on intellectual prowess, family history and medical background.
One Californian sperm bank, The Repository for Germinal Choice, started out by offering sperm donated by Nobel Prize Winners in 1982. (27) The bank initially scanned professional journals to find the names of potential donors to recruit. They now offer sperm from thousands of men with high IQs, particularly scientists and other academics. Sperm donors are guaranteed anonymity, if they request it, but need to supply a considerable amount of information relating to their genetic background. This includes any results of screenings for genetic disease, e.g. CF and Tay-Sachs, other disease, e.g. AIDS and hepatitis, ethnic origin, physical characteristics, family and medical history, professional accomplishments and various narratives, including why they wanted to become sperm donors. The reasons range from the senior professor who thinks his sperm is god's gift to women, to the pathologically shy chemist who sees the donor route as the only way he is likely to sire offspring. All the information is reproduced in catalogues from which clients choose the sperm with the right genes for them. The catalogues of this and other sperm banks, including Heredity Choice and the California Cryobank, are also available over the Internet. (28) All the sperm banks require a certain level of college education of their donors. Hundreds of babies have been born from banked sperm, with some donors responsible for thirty or more offspring. The clinics protect the anonymity of their donors, who are not officially classified as fathers for obvious legal reasons. Awkward situations are already arising, however, as these children grow up and go searching for their genetic fathers.
In the Ivan Reitman comedy Twins (1988), sperm derived from the genes of six fathers, "distinguished men chosen for their genetic excellence", is used, "to produce a physically, spiritually and mentally advanced human being". The film opens with a flash-back sequence in a genetics laboratory. A voice-over by Doctor Traven (Nehemiah Persoff) relates the story of how Julius Benedict (Arnold Schwarzenegger) was produced as part of a secret scientific experiment, conducted by the American Government. However, instead of just the designer baby being born, we see newborn twins. We cut to the film's present, when on Julius' 35th birthday, Traven informs him for the first time that he has a twin.
Julius has been bought up in affluence on a tropical island and, although "pure in body and spirit", is completely inexperienced in the ways of the world. Meanwhile, his twin Vincent (Danny De Vito) has been bought up in an orphanage and is street-wise. Julius finds Vincent, but is amazed at their physical differences. Julius is tall and well-built, while Vincent is short and not so well-built. Identical twins need not necessarily look the same. For example, a gene mutation affecting a physical characteristic could occur in one twin only. In his book Twins, Lawrence Wright describes how in rare cases identical twins can be produced from a placenta that is only partially attached to the womb, with the result that one twin may develop into a miniature version of the other. (29) The physical differences portrayed in the movie are highly improbable of course, but the behavioural similarities represented are true to life. The film shows Julius and Vincent to have the shared tastes, habits and behavioural mannerisms common to identical twins. The film in this respect reflects the uncanny similarities found in studies of identical twins reared apart. (30) In particular, the film-makers might have been influenced by the case of Jack Yufe and Oskar Stöhr, identical twins separated a few months after birth. Jack was bought up as a Jew and spent an idyllic childhood on the tropical island of Trinidad, while Oskar was bought up as a Nazi in Germany during the Second World War (WWII) and was severely disciplined during his childhood. (31) When they met as adults they had remarkably similar personality profiles, but their social conditioning prevented them ever becoming friendly toward one another.
In Twins, criminal behaviour is shown to be an aberration of Vincent's true (genetic) nature, bought about by a more difficult environment during his upbringing than Julius experienced. Their physical differences serve to emphasise their individuality, however, undermining representations of behavioural similarity. Ultimately, it is difficult to regard them as twins with identical genetics. During the second half of the film, the twins set out on a journey and visit Doctor Traven, looking for answers from their "maker". He explains how, after the egg was fertilised with the "sperm milk-shake", the embryo split into two unequal parts. All the "purity and strength" went into Julius' half, and all the "genetic garbage" into Vincent's half. Julius embraces his disconsolate identical twin, saying: "You are the missing part of my life and I am the missing part of your life", that is with human nature you have to take the rough with the smooth. They then search for their genetic mother, who Traven informs them is still alive, and become re-united with her. They subsequently marry sisters and (naturally) produce two sets of twins.
The film, despite being pure DNA hokum, has an interesting eugenics subtext. Many people throughout this century have been labelled as "genetic garbage", just like Vincent, by scientists and people in power holding eugenic views. The German-accented and eugenic slogan spouting Doctor Traven can therefore be read as a reincarnation of Dr. Josef Mengele. Like many former Nazi scientists, we learn that Traven arrived in the Americas after WWII and continued his research behind the closed doors of a government research establishment. Julius is the Aryan superman (played by an Austrian bodybuilder with right-wing Republican views), a product of an eugenics program. The rejected genes belong to Vincent, a diminutive Jew as played by Danny De Vito. Interestingly, De Vito was one of the producers of Gattaca, a film that also puts the case for those who are prejudiced against because of their genes. Vincent is the name of the "underdog" brother in both Gattaca and Twins, and recalls the free-spirit, talent, and genetic defects of Vincent Van Gogh. Both Vincents are shown to be the equals of their brothers in these films, despite what the eugenicists say.
Ivan Reitman's companion piece to Twins, the IVF comedy Junior (1994), also starred Arnold Schwarzenegger, as the fertility scientist Dr. Alexander Hesse, and Danny De Vito, as his assistant Dr. Larry Abrogast. Hesse has developed a fertility drug called Expectane, which reduces miscarriages in chimpanzees, and wants to start clinical trials on humans. However, department head Noah Banes (Frank Langella) stops his funding, after the Food and Drug Administration (FDA) refuse to approve the drug. His laboratory is taken over by Dr. Diana Reddin (Emma Thompson), another fertility scientist, who arrives with a freezer full of eggs, including her own in a vial labelled "Junior". Abrogast steals her eggs, fertilises them with Hesse's sperm, and injects them into Hesse's abdomen, after his course of Expectane treatment. An egg implants in Hesse's peritoneal cavity and he becomes pregnant. This may not be as far-fetched as it might at first sound, as eggs sometimes implant and develop in the peritoneal cavity of women. (32) The men decide that they will terminate the pregnancy after the first trimester. However, Hesse changes emotionally, as well as physically, and decides he cannot terminate his pregnancy. He falls in love with Reddin, who learns that she is the "father". They decide to rear the baby together.
We learn that the Expectane experiment is against university and FDA guidelines, yet, however unethical it might be, we are on the side of the scientists, although not necessarily on the side of the Lyndon Pharmaceutical company who wish to commercially exploit the drug. The film therefore reflects growing acceptance of IVF, and biotechnology in the service of reproductive medicine. As in Multiplicity, the scientist is not mad and no moral judgement against reproductive technology is made. Junior abrogates any responsibility it might feel for egg theft, human experimentation against ethical guidelines and so on. The lack of moral retribution is a feature of comedy generally compared to other genres, particularly horror films with mad scientists. However, Junior is a reactionary film, in which IVF technology merely serves the main moral agenda. Schwarzenegger becomes "feminised" and turns into something like a Stepford Wife, but without any irony or feminist message, while Emma Thompson's fiercely independent researcher similarly becomes a dutiful housewife after the baby's birth. When Hesse decides to keep the baby, it is clearly to be read as a stance against abortion. One critic described Junior as, "A pro-life ode to the nuclear family", which reflected the conservative Republican sweep of both Congress and the Senate that had occurred just before the film's release. (33)
In the future dystopia depicted in The Handmaid's Tale (1990), based on the novel by Margaret Atwood, religious fundamentalism has ensured that contraception, abortion and infertility treatments have all been abolished. The population is taught that genetic engineering and "test-tube babies" are among the past sins of society. The film, in common with The Stepford Wives (1974), shows what might happen to Women's Liberation and a woman's right to make reproductive choices if Pat Robertson and the Moral Majority held power in the USA. (34) A crisis occurs in the calvinist-come-fascist society of The Handmaid's Tale, however, when female fertility rates drop, due to environmental factors. (35) To reproduce at all, the ruling elite must utilise surrogate mothers - fertile slaves from the lower classes - who are mandated to carry their babies. The husbands impregnate the surrogates in the traditional way and in the presence of their wives. The surrogate handmaidens are in effect test-tubes, but test-tubes that are acceptable to a society that shuns what it consider as "unnatural reproduction". While The Handmaid's Tale is a parable warning of the consequences of the religious right turning back the clock on women's rights and assisted reproduction, Gattaca warns that ethical limits need to be placed on the uses of reproductive technology - it should not just race ahead to a timetable dictated by unregulated market forces.
The Valids in Gattaca may eventually become more alike. This genetic homogeneity will arise as each generation adds enhancements in an accumulative manner, toward society's ideal of the perfect baby. The Valids may eventually approach the basic constraints imposed by the design of the human body, and further enhancements to desirable traits will become increasingly less significant. For example, humans can only swim so fast, due to basic body design constraints. (36) Therefore, it is likely that with widespread genetic enhancement, well beyond that necessary to treat disease, genetic diversity will slowly decrease. In the extreme case, specific types of Valids may effectively become clones, as cloning is also a stabilisation of one form. The geneticist Lee Silver suggested in his book Remaking Eden that a few centuries of genetic engineering might lead to the creation of a new species, no longer willing or even able to mate with its poor gene relation. (37) However, an alternative scenario might be that a backlash occurs, with the elite again trusting in evolutionary processes. Genetic diversity is considered to be essential for a species' evolution and long-term survival, while the conservation of biodiversity has risen up the political agenda. (38) The In-Valids represent a genetically diverse human gene pool. One might even predict Valid women eventually having illicit affairs with In-Valids to get pregnant, possibly with subsequent minor enhancement. Blood test data has consistently revealed that around 10 per cent of babies have genetic fathers different from their male parent, due to marital infidelity. Whether the lack of genetic privacy in a Gattaca world reduces marital infidelity is not revealed in the film. (39)
The pressure on "genetically enhanced" children to succeed may be intense, particularly if parents do not understand the inherent limitations in genetic enhancement. Children conceived from high-IQ sperm have already reported it, and genetically modified children will certainly find it so. In Gattaca, children have been designed by their parents to excel in at least one particular activity. For example, a twelve-fingered pianist, who has music especially written for him, is held up as the paragon of musical greatness. His particular genetic enhancement could be obtained in reality by simulating a homeotic mutation in the hox genes controlling hand structure. The Valids are expected to succeed because of their genetic advantage, but others may also have similar genetic enhancements. Jerome's enhanced genes have given him the potential to be a great swimming champion, but he only comes second in the major (Olympic) event in his life. He shows his silver medal to Vincent as if it's a badge of failure. Jerome ultimately cannot take the pressure put upon him by his parents and society. He suffers from the burden of perfection. It is suggested that he deliberately walks out in front of a car - the accident which resulted in him becoming a paraplegic. Another consideration is the child's obligation to use the gifts they have been given. (40) Their fate appears to be pre-determined by their genes. However, this is to ignore free will. Ultimately a genetic enhancement is not enough, as it is the entire personality (rounded by life experiences) that affects an individual's ability to use his or her given talents.
The responsibility of the parents with respect to their genetically modified offspring formed the basis of an interesting episode of Star Trek: Deep Space Nine. In Doctor Bashir, I Presume (1997) genetic enhancement ("DNA re-sequencing"), which had previously been as acceptable to society as in Gattaca, has been made illegal in all cases except for repairing serious birth defects. (41) The ban was imposed because of the experience gained from genetic enhancements done at the Darwin Genetic Research Station on Earth, whereby individuals had arisen with high intelligence, great ambition and a strong thirst for power. One of these individuals, Khan, was a particular megalomaniac (see, for example, Star Trek II: The Wrath of Khan, 1982). A minority among the genetically enhanced had triggered the "Eugenics Wars", which led to the outlawing of genetic enhancement. (42) Genetic enhancement, however, remained available via the black-market on certain planets. Julian Bashir (Alexander Siddig), the doctor on the space station Deep Space Nine is being considered for an important new job, which involves careful screening of his past. Bashir learns that his parents had him genetically enhanced at age six, during his early school years, when they saw that he was below average mentally and physically frail. After the enhancements in his IQ, hand-to-eye co-ordination and other traits, he never looked back - swiftly rising through the medical ranks in Starfleet. However, Julian on confronting his parents, for the first time in many years, does not thank them for his gifts: "You used to be my father, but now you are my architect - the man who designed a better son". His parents plead that they did what any parents would do - try to give their son the best chance in life. The Admiral arbitrates and decides on Julian's fate. The father takes full responsibility, pleading guilty to illegal genetic engineering, and is sentenced to two years in jail. Julian is absolved of blame and is free to carry on his good work. The incidence, needless to say, reconciles Julian with his parents. (43)
The family conflicts that can potentially occur from genetic testing, gene therapy, new assisted reproductive technologies and (in the future) genetic enhancement are likely to provide a rich stream of drama for film-makers to exploit. The totalitarian state of Brave New World, with its state controlled reproduction, is unlikely now to ever occur. However, the "new eugenics", led by market forces and individual's free choice, is just around the corner. Gattaca was therefore a timely film. Intelligent and thought-provoking, it acted as a focus for a debate on important ethical issues. It should be hoped that more film-makers use cinema in this way to explore the possible social implications of the new genetics.
Notes
Chapter 7: All in the Genes?
References:Complete bibliography of book, including all names on multi-author publications and details of edited books.
Chapter 1: It came from the laboratory.
Chapter 2: Dinosaur Resurrection.
Chapter 3: Confronting the Clone.
Chapter 4: Cloning the Alien.
Chapter 5: Danger: Genetically Modified Organisms.
Chapter 6: Designer Babies.
Chapter 7: All in the Genes?
Chapter 8: Real-life Science.