Genetic Testing: Between Medical Promises and Ethical Concerns

Types of Genetic Tests Available: PGT-A and Polygenic Testing

Preimplantation Genetic Testing (PGT-A) has been used since the 1990s to detect chromosomal conditions such as Down syndrome and determine fetal sex. Polygenic testing is a newer and more complex technology, analyzing thousands of genes associated with complex conditions such as breast cancer, diabetes, mental illnesses, and even traits like height and intelligence. The history of technology development and its impact on society are clearly evident in these advancements.

Risks of Misleading Promises and Psychological Impacts of Genetic Testing

Companies marketing these tests sometimes try to exaggerate their benefits, such as claiming to reduce the risk of type 2 diabetes by 12%, which may actually mean delaying the onset of the disease for a few years rather than complete prevention. Furthermore, polygenic tests are not good enough at predicting psychological conditions like depression, raising questions about whether mild or moderate manifestations of these conditions should be sought to be eliminated, especially since some traits like anxiety can be linked to creativity.

One of the main scientific problems lies in the phenomenon of "Pleiotropy," where a single gene can affect more than one trait (phenotype) simultaneously. Attempting to select an embryo to reduce the risk of a specific condition may inadvertently remove other positive traits or affect different vital functions.

Moreover, treating children as consumable goods that can be chosen can lead to severe psychological harm. If parents choose an embryo based on the expectation of high intelligence, and then the child turns out to have low intelligence, the child may feel that they have not lived up to their parents' expectations. The same applies to choosing the sex of the fetus; the child may feel disappointed if they do not conform to the gender expectations set by their parents.

Ethical and Social Considerations of Genetic Testing

These technologies raise serious concerns about exacerbating social inequalities. Polygenic testing is very expensive, which could lead to the emergence of a new social class where the wealthy have the opportunity to have "genetically enhanced" children, widening the gap between the rich and the poor.

Even if these tests become accessible to everyone in the future, implicit social pressure may arise to undergo these biological modifications. Refusing embryo selection could mean placing the child at a professional disadvantage or facing moral condemnation for having "unenhanced" children when enhancement is possible. Societies may then not provide health insurance or facilities for children with disabilities, arguing that it was a "parental choice."

Some philosophers, such as Julian Savulescu, argue that parents have an "ethical obligation to have children with the best chance of a better life." Despite the appeal of this concept, it can lead to neglecting other important values such as diversity. Indeed, the impact of artificial intelligence across various fields, including ethics and society, has become a focus of widespread discussions.

"Satisficing" in Genetic Testing

The article suggests a logical alternative to this approach, the concept of "Satisficing," which means choosing the "good enough" option. In cases of serious diseases that cause severe debilitation or early death, such as Tay-Sachs disease or a BRCA mutation that increases the risk of cancer, genetic testing for prevention is a great gift and can be a crucial choice.

As for conditions that may cause suffering but are also compatible with a happy and fulfilling life, such as autism or some mental health conditions, changing the social environment and providing appropriate support can be as important as biological interventions, and without the societal risks associated with polygenic testing.

Ultimately, defining "a good enough life" varies from parent to parent, and largely depends on the emotional, social, and financial resources available to deal with any health or developmental condition. Parents should resist any pressure or embarrassment that may come from profit-driven entities, and make decisions that suit their families and circumstances, recognizing that genetic testing should provide more options and support autonomy, not limit it or impose a single path.