45 pages 1 hour read

The Case Against Perfection: Ethics in the Age of Genetic Engineering

Nonfiction | Book | Adult | Published in 2007

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Chapters 1-2Chapter Summaries & Analyses

Chapter 1: “The Ethics of Enhancement” - Chapter 2: “Bionic Athletes”

Chapter 1, Introduction and Section 1 Summary: “Articulating Our Unease”

Sandel opens with the story of Sharon Duchesneau and Candy McCullough, a Deaf lesbian couple who deliberately sought out a Deaf sperm donor when they conceived their child in 2002. Their decision caused an uproar among hearing people who, unlike Duchesneau and McCullough, viewed Deafness as a disability rather than a cultural identity. Sandel notes that, around the same time, another couple put out a call for an egg donor who was “five feet, ten inches tall, athletic, without major family medical problems, and [with] a combined SAT score of 1400 or above” (2). Sandel finds it ironic that this ad caused no controversy, while Duchesneau and McCullough faced intense backlash. Sandel asks why one is different from the other. Sandel then tells another story, about a woman who, in 2003, paid $50,000 to have her cat cloned. The process worked, raising inevitable questions about the possibility of cloning human beings.

As genetic technology advances in the coming years, Sandel notes, it may become possible for parents to choose their children’s genetic makeup before they are born. Cloning has been possible since 1997, although Dolly, the first cloned sheep, lived a short life. If cloning and genetic alterations were completely safe, would they be ethical? Sandel first addresses the argument of autonomy: the argument that choosing a child’s genome means that the child cannot live a fully free life. Sandel dismisses this argument, pointing out that non-engineered children do not choose their own genomes. Genetic engineering could also be something adults choose for themselves, which would not be an issue of autonomy. To really understand what might be wrong with genetic engineering, it will be necessary to go beyond questions of autonomy.

Chapter 1, Section 2 Summary: “Genetic Engineering”

Sandel imagines four ways that people might use genetic engineering in the future. The first is to create stronger muscles, which could help people maintain muscle tone as they age. The same technology could allow athletes to become extraordinarily strong. Assuming such therapies were safe, should enhanced athletes be banned from playing sports? Perhaps they would have an unfair advantage over their teammates. However, athletics is already inherently unfair, as some athletes are genetically stronger or faster than others. Sandel moves on to memory enhancement. Genetic therapies could be used to treat Alzheimer’s and dementia, but could also be used to enable people to learn and remember more effectively than their peers. Conversely, treatments could also soften or suppress traumatic memories. In all these cases, genetic engineering is likely to confer significant competitive advantages on those who undergo it—raising questions of social justice and equality given that, for the foreseeable future, these technologies are likely to remain prohibitively expensive for most of humanity. Sandel envisions a world where people are split into two classes: “the enhanced and the merely natural” (15). He questions whether such enhancements could be dehumanizing.

The third enhancement is height. It is already possible to make children taller with growth hormone injections. Currently, only children in the shortest height percentiles are eligible for this treatment; Sandel questions whether such a restriction is more ethical than allowing any child to become taller if they should wish. He also suggests that such enhancements might make shortness a marker of poverty. The last issue Sandel addresses is sex selection. In addition to aborting fetuses of the undesired sex, it is also possible to select embryos of a particular sex through a process called preimplantation genetic diagnosis. Those who oppose sex selection, because they oppose all abortions, do not make a particular argument about what is wrong with sex selection itself. Sex discrimination is another argument: Some places select against girls on a broad scale. Even if sex discrimination were not an issue, Sandel believes something would be wrong with sex selection.

Chapter 2, Introduction and Section 1 Summary: “The Athletic Ideal: Effort versus Gift”

Sandel turns his focus to bioengineering in athletics, noting that athletes whose skill comes partly from genetic engineering might have diminished agency: Perhaps the creator of the enhancements deserves part of the credit for their abilities.

While Sandel appreciates this argument, he actually believes the opposite: bioengineering gives people too much agency, allowing them to control themselves and the world they live in to an inappropriate degree. Athletes are impressive partly because of their natural gifts, and engineering would make those gifts less natural. They are also impressive because of the effort they put into becoming excellent; engineering could be a shortcut to success. However, he notes that bioengineering could instead be framed as the ultimate effort: a willingness to go to any lengths to change one’s body to better suit one’s sport.

Chapter 2, Section 2 Summary: “Performance Enhancement: High Tech and Low Tech”

Athletes change their bodies and gain advantages in many ways. Running shoes make running easier, but they do not undermine the skill involved in running. Tiger Woods had laser eye surgery, which improved his golf game, but doing so did not give him an unfair advantage. Some athletes try to gain advantages that go beyond these normative, comparatively accessible examples. For instance, they might take part in extremely rigorous training regimes or follow extreme diets. Sandel does not believe that these intense training alterations are meaningfully different from bioengineering. He argues that any intervention is objectionable if it compromises the integrity of a sport or game by failing to honor athletes’ natural abilities and by pushing them toward efforts that harm them and that undermine their sports.

Chapter 2, Section 3 Summary: “The Essence of the Game”

Sandel distinguishes between sport and spectacle. Sport must honor athletes’ abilities and must have rules and regulations that celebrate the skills each game is meant to test. Wrestling is a sport, but the version of wrestling practiced in the World Wrestling Federation (WWF), where people hit each other with folding chairs, is a spectacle. Similar discussions exist in the music world, where some people believe it is unacceptable for pianists to take beta blockers that calm their nerves before a performance, while others argue that the definition of a great pianist need not include an ability to handle stage fright. Likewise, some people believe that microphones and audio technologies have transformed opera and Broadway musicals from art forms into spectacles. Sandel quotes Anthony Tommasini, who notes that lyrics in Broadway shows have become “less subtle and intricate” (40) than they used to be. 

Some people, like former Supreme Court Justice Antonin Scalia, have argued that sports do not have a point; their rules are arbitrary, so there is no need to parse which skills or abilities are central to a sport and which are incidental. Scalia made this argument when he objected to a golfer with a disability being permitted to ride a golf cart between holes; Sandel points out, however, that the ability to walk is not what golf is about. In his view, it is possible to draw a clear distinction between an integral skill, like the ability to drive the ball down the fairway, and an incidental one, like the ability to walk to where the ball lands. Bioengineering and invasive athletic enhancements are inappropriate because they promote a fundamental disregard for sports as an honest athletic competition and a celebration of excellence.

Chapters 1-2 Analysis

Sandel originally wrote this text in the early 2000s, when debates about genetic engineering were a big part of public discourse. In the world of athletics, “genetic doping” is still a topic of extensive discussion. The Genetic Literacy Project notes that “[t]o date, there has not been an identified case of gene doping in athletics” (Moxon, Sam. “CRISPR Gene Doping: The Next ‘Big Issue’ in World Athletics.” Genetic Literacy Project, 2023), but that could change soon. A genome-editing technology called Clustered Regularly Interspaced Short Palindromic Repeats, or CRISPR, had already been developed when Sandel published The Case Against Perfection. It has been refined in the years since and is now used in some real medical contexts. If athletes were to use genetic doping, they could use CRISPR as a means of gene editing.

In Chapters 1 and 2, Sandel uses several anecdotes to illustrate the ethical questions underlying the emerging field of genetic engineering. The story of Sharon Duscheneau and Candy McCullough—the Deaf couple who sought a Deaf sperm donor for their future child—functions to expose some of the hypocrisies and logical inconsistencies underlying many people’s objections to genetic engineering. This anecdote exemplifies Sandel’s rhetorical approach throughout the book. Though he ultimately takes a firm stance against most forms of genetic engineering, he resists simple answers and seeks to address the questions of genetic engineering in all their complexity.

The question of the two families who wanted to choose aspects of their future child’s genetics is connected to the theme of Health and Eugenics. Throughout the book, Sandel argues that bioengineering functions as a modern form of eugenics, exacerbating the prejudices already built into the social structure. The backlash faced by Sharon Duchesneau and Candy McCullough over their choice to seek a Deaf sperm donor exemplifies this problem. Sandel notes the paradox underlying this backlash: Few people objected to the family who wanted an egg donor with a high SAT score, but they objected to the family who chose to have a Deaf child. The first choice is fundamentally normative: The SAT score parents were making choices that aligned with their culture’s views on health and disability. The Deaf parents were making a non-normative choice that challenged people’s views on health, disability, and Deafness. This is ultimately a question of eugenics: one of these children fits the widely held but largely unspoken eugenic ideal of contemporary American society. The other is, despite progress in Deaf advocacy and discussions about ableism, widely considered less desirable or less valuable.

Part of what bothers Sandel about genetic enhancements is that they push people toward Mastery and Control and away from a concept he later describes as Openness to the Unbidden. Choosing to have a Deaf baby or a baby from an athletic, academically inclined donor are both attempts to control who a baby will be. Sandel notes that people responded to these cases differently, but he argues that both choices are morally unacceptable for the same reason: because they attempt to control what is best left up to nature and chance. An ongoing quest for mastery and control in genetics could pressure people to edit their genetics to become the best that they can be, instead of allowing them to appreciate their natural talents without judgment or shame. This concept applies to parenting and to athletics, as these two chapters make clear.

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