The ethics of human genomic enhancement: a framework for public health policy

Thesis

The pursuit of human genomic enhancement raises bioethical questions surrounding not only individual rights and the consequences of enhancement for enhanced individuals, but surrounding the interests of other groups and whole societies that might be affected by human enhancement. A thorough examination of these ‘collective-level’ morally relevant considerations is needed for bioethics that aims to inform policymaking. The question of whether a given type of human genomic enhancement should be implemented by policymakers in a given country can only be answered by undertaking more collective-oriented ethical analysis. The novel collective-oriented framework for ethical analysis that I present here treats heritable human genomic enhancements as potential public health measures. Considering enhancements as public health measures has a distinct advantage in comparison to past approaches, primarily because public health ethics is an area where a collective-oriented approach has been particularly well developed—thus, taking concepts from that area and applying them to enhancement considered as a public health measure contributes to thorough ethical analysis. I call my resulting framework for performing ethical analysis the ‘Collectivist Public Health framework’. The framework first assesses the consequences of enhancement for groups and society based on their identifiable interests, determining whether it benefits the collective, and whether the magnitude of any harms imposed on individuals or groups are acceptable. It then assesses whether the distribution of these harms and benefits across the country’s population is acceptable. Finally, it compares alternative policies for implementing a given enhancement. The framework can be effectively defended against claims that it may lead to eugenics, that it will incur a loss of human dignity, and that it poses problems surrounding public health resource allocation. Applying the framework to case studies, I find some human genomic enhancements to be ethically desirable public health measures.

Authors: Johnson, TF

• Type of award: DPhil
• Level of award: Doctoral
• Awarding institution: University of Oxford
• Language: English
• Keywords: genome editing; human enhancement; public health ethics; practical ethics
• Subjects: Applied ethics; Ethics