The Imperative That Needs a Business Plan

The principle operating here, stated plainly, is: where a hereditary disease can be prevented by altering the germline of an embryo, one ought to alter it, even before the alteration is known to be safe. Let us ask whether this principle, universalised, produces coherence or contradiction.

I begin with the word, because Cathy Tie has borrowed it from me. The founder of Origin Genomics calls embryo editing a “moral imperative.” An imperative is a command of reason, and there are two kinds. The hypothetical kind says: if you want this end, take these means. The categorical kind commands without condition, because it rests on what every rational being must will. My first finding is that Tie’s imperative is hypothetical dressed as categorical. Its full form is: if you wish to spare a family its hereditary disease, and if this technique works, and if its errors do not travel down the generations, then edit. Every clause that is still uncertain is a condition, and an imperative with conditions does not command. It advises. There is also a small comedy in a company announcing that duty itself demands the product it sells. The law of morality does not usually need a founder, a funding round, and a brand name.

The strongest opposing view deserves its full weight, and I will not weaken it. Its defenders say that nature already imposes genes on every child without consent. The mother who carries a lethal mutation does not ask her unborn daughter’s permission to pass it on. Refusing to edit is therefore not neutral; it is also a choice made for a person who cannot choose. If we allow chance to condemn a child, the argument runs, it is perverse to forbid reason from rescuing her. This is a serious argument, and much of it is correct.

Where it fails is in treating nature and an agent as if they occupied the same place in morality. Nature has no maxims. A mutation that arrives by inheritance is a misfortune, and no one is its author. An edit is an act, and its author is answerable for the principle behind it. When Origin Genomics alters an embryo, some person has willed that a future human being shall carry this change and whatever unknown errors come with it. The child enters the world already bearing a signature. The defender’s symmetry between “letting nature decide” and “deciding” collapses, because only one of them can be held to account. That asymmetry does not forbid the act. It means the act must meet a standard that chance never has to meet.

Now universalise. Suppose every clinic, everywhere, adopted the maxim of editing heritable disease before the technique was proven. The germline of the species would become the laboratory, and each child would be the result of the last trial as well as the subject of the next. Such a world is conceivable. What reason cannot coherently will is the purpose the maxim claims for itself: the maxim exists to protect children from inherited harm, but universalised it produces a generation of inherited uncertainty. It defeats itself. The contradiction is not in the goal. It is in pursuing the goal ahead of the knowledge that would make it safe.

The formula of humanity sharpens this. Picture a young woman at eighteen, reading her medical file and learning that her genome was revised before she had a heartbeat. She asks the question that belongs to every rational being: on whose terms was I made? If the honest answer is that she was made under a promising but unproven protocol, then she was used partly as evidence. She was a data point in someone else’s demonstration that the method works. Her cure may be real, but her standing as an end in herself was put at risk for the sake of an argument. Parents may consent for a child to be treated. No one can consent for a person to serve as a trial whose risks pass on to her own descendants.

So I state the duty with its foundations visible. Beneficence toward families facing hereditary disease is a genuine duty, but it is an imperfect one: it binds us to the end without dictating every means. The duty not to use a person merely as an instrument is perfect, and it admits no exception for good intentions. It follows that the research must come first, conducted in ways that do not create persons as its subjects. Editing may one day pass the test I have applied, once its conditions have become certainties. When that happens, no one will need to call it an imperative, because it will simply be medicine.

Until then, the girl with the file deserves a better answer than a slogan.