Rawls’ principle of fair equality of opportunity has been regularly discussed and criticized for being inadequate regarding natural inequalities. In so far as this egalitarian goal is sound, the purpose of the paper is to see how the prospect of radical genetic intervention might affect this particular inadequacy. I propose that, in a post-genetic setting, an appropriate response would be to extend the same rules regulating societal inequalities to a regulation of comparable genetic inequalities. I defend this stance against recent (...) arguments from the authors of From Chance to Choice and from Colin Farrelly’s alternative of the genetic difference principle. (shrink)

Should we use human germline genome modification (HGGM) only when serious diseases are involved? This belief is the underlying factor in the article written by Kleiderman, Ravitsky and Knoppers to which I now respond. In my opinion, the answer to this question should be negative. In this paper, I attempt to show that there are no good reasons to think that this technology should be limited to serious diseases once it is sufficiently proven to be safe and efficient. In fact, (...) opting otherwise would negatively harm human beings’ right to the highest standard of health that unmodified embryos could promote. Therefore, the issue should not be so much to define adequately what a serious disease is, but rather to elucidate whether this concept should play any role beyond the context of preimplantation genetic testing (PGT). This paper argues that we should not accept the similarity between technologies such as PGT and HGGM because they face different challenges and offer totally different possibilities. Therefore, we are in urgent need to build a completely new ethical architecture that covers the application of germline editing in human embryos. As a part of that process, a much deeper debate on the necessity of distinguishing different disease types is required. (shrink)

Genomics provides information on genetic susceptibility to diseases and new possibilities for interventions which can fundamentally alter the design of fair health policies. The aim of this paper is to explore implications of genomics from the perspective of equal opportunity ethics. The ideal of equal opportunity requires that individuals are held responsible for some, but not all, factors that affect their health. Informational problems, however, often make it difficult to implement the ideal of equal opportunity in the context of healthcare. (...) In this paper, examples are considered of how new genetic information may affect the way individual responsibility for choice is assigned. It is also argued that genomics may result in relocation of the responsibility cut by providing both new information and new technology. Finally, how genomics may affect healthcare policies and the market for health insurance is discussed. (shrink)

The main objection to genetic enhancement is that it will create a “genetic apartheid,” deepening existing inequalities. This paper offers considerations that can weaken the inequality argument against genetic enhancement. First, I question the dichotomy of treatment versus enhancement since the differences between the two are unclear. Second, I argue that human enhancement is part of human nature and that there is no sound reason to accept it in other domains while rejecting it in genetics. The paper also demonstrates that (...) inequality is present in every dimension of society, that “God-given” genetics is profoundly unequal, and that genetic enhancement can operate as a mechanism by which a new genetic equality can be achieved. However, the paper underlines that genetic equality is not, per se, a value to which we ought to aspire if it leads us to a uniform community of downsized human beings. Genetic equality is only valuable if it enhances humankind in general. (shrink)

Opponents of genetic enhancement technologies often argue that the pursuit of these technologies will lead to self-defeating collective outcomes, massive social inequalities, or other forms of collective harm. They assume that these harms will outweigh individual benefits. Defenders of genetic enhancement technologies counter that individual benefits will outweigh collective harms and there will be no conflict between individual and collective interests. The present contribution tries to advance the debate by providing a more detailed discussion of the conditions under which individual (...) and collective interests may conflict.It presents a simple model that clarifies the conditions in which the use of genetic enhancement technologies may lead to self-defeating collective outcomes and social inequalities. It argues that given current inequalities, these conditions might indeed obtain as new genetic knowledge leads to a transition in population health. If they do, then genetic enhancement will steepen the social gradient in health. Thus, regulating access to enhancement technologies should be a matter of social justice. (shrink)