The Quality Control of Life
Manufacturing industries routinely do quality control on their products, testing them to be certain the items being produced meet certain specifications. Any flawed products, those that do not meet the required specifications, are discarded. For the manufacturer, this helps maintain the satisfaction of the customer. But what if that same mindset were applied to human beings? We’ve seem this in terms of future possibilities, e.g., the potential to use technologies such as gene editing to make “better human beings.” While this remains a future peril in our view of creating new human beings, there is sadly a current peril of quality control for human beings.
In utero screening tests are already being used as a form of quality control over human beings. As with many technologies, it is not the tests themselves that are problematic but rather why the tests are done in many cases, and what actions are taken based on the results, that is, the attitude toward the value of an individual life. Some tests are designed specifically to detect chromosomal abnormalities. In some cases the screen is for sex chromosomes; often this has been phrased as an attempt to achieve “family balancing.” Screens for trisomies (Down syndrome, as well as Edwards and Patau syndromes) are common, and newer “non-invasive prenatal screening” using some of the mother’s blood has pushed detection early into pregnancy (10 to 12 weeks.) But why use such early screens? Sadly, as quality control. Iceland has bragged that it has “eliminated” Down syndrome from the country, but the answer is not due to medical treatment, but a nearly 100 percent abortion rate for those detected in the womb with Down syndrome.
The screens (genetic, ultrasound) have begun to have a wider reach than trisomies, but seem to be used with much the same attitude—quality control. A recent paper showed that in Denmark, where universal screening is now mandated, there was a 65-fold increase in abortions of babies with congenital heart defects. As with Iceland and Down syndrome, one headline touted that they had cut the rate of birth of infants with serious cardiac defects, but this public health improvement was by eliminating many of those with the defects, not by healing arts.
A recent editorial in The Lancet asks the question, “Are we ready for universal genomic sequencing for newborns?” There may be solid reasons to proceed, for early detection and treatment. But there are also reasons to say no, especially if the screening is used as another form of quality control. We’ve mentioned the movie GATTACA before, in which the main character struggles to overcome the stigma of not being genetically designed and enhanced. Early in the movie is a poignant scene of his birth, where the newborn’s genome is immediately taken from a heel stick and the parents are given his “readout” and told of his high potential for cardiac problems and other health issues. This information leads them to give him a different name than the one they originally intended, because he was not worthy to be the father’s namesake.
When children are not considered a gift to be cherished and nurtured, they can be viewed as a commodity, and any flaws or variance from the desired minimum specifications is an inconvenience at best, and intolerable at worst. And our viewpoint of the value of any individual human life colors our view of all other human lives.