Into the Future

The Times today has an article about women who are choosing preventative mastectomies out of fear of breast cancer. The article is a bit of manipulative, somewhat clumsy journalism, rife with pathos, but it did get me thinking about genetics and genetic testing, which are beginning to be more accessible in the United States. Many people seem to feel like genetic testing is an important weapon in the war against cancer, and maybe they’re right. But I found the article rather difficult to read seriously, because the contents were so far abstracted from my reality.

Ultimately, this article was about a dilemma for the rich, or at least the middle class; I, for example, could never afford genetic testing. If I somehow scraped together the funds, I wouldn’t be able to afford to take any action on it, let alone an extremely expensive surgical procedure like a mastectomy. In fact, like many American women, if I was diagnosed with breast cancer, my best hope would be to die quickly, because I could not afford even the most basic of treatment. For all of you who oppose universal healthcare: scroll down for a picture of untreated breast cancer.

The paper makes a reference to the “DNA age,” but I think it’s just another example of the growing gap between rich and poor. Wealthy people can afford extensive genetic testing, and when gene therapy and high tech solutions become available, these will be within reach as well. But the vast majority of us don’t need to agonize over whether or not to get genetic testing, because it’s not even an option.

In a way, genetic testing feels like fortunetelling, to me. A form of looking into an uncertain future; does looking into the future influence the outcome?

Genetic testing seems to have become pretty standard for expecting mothers, as well, which I think is very interesting and somewhat terrifying. Surely, such testing is only prudent, ensuring that the baby is healthy and making note of any conditions which may complicate the pregnancy, right? But what happens when the baby isn’t healthy? Are we unwittingly entering an age of eugenics? I am beginning to fear that we are, when I see “termination” recommended for abnormal prenatal tests. Are there cases when this may be a more humane and sensible solution? Most assuredly, I think, when it is clear that the infant would have lived a brief and tormented life. But should we encourage abortion for children with Trisomy 21? Trisomy 13? Many people with these conditions go on to live healthy, happy lives despite their disabilities; should we really be denying them that chance?

On the one hand, people with genetic defects may incur substantial medical bills over the course of their lives, or require serious intensive care. That’s a huge commitment to ask for, even from people who are already willing to be parents. A severely disabled kid can really change your life, I know; but isn’t that a risk you take every time you decide to have unprotected sex? Are people only interested in parenting perfect, whole children? I’ve really been struggling with this lately.

It feels odd to be arguing against abortion, since I am an ardent supporter of the right to choose, but I think that aborting because your baby could be abnormal is a bad reason, and I’m not sure I support it. I realize that this sets me up for attack from some members of the feminist community, who seem to think that there is never a gray area or a middle ground, we need to be all for one or fail. One person’s abnormality may be another person’s normality, and I feel like it sets us up for a truly eugenic society, where people abort children for more trivial reasons. Hell, they already do, when multiple embryos are implanted and then “culled” once they take. This is done, of course, to ensure that at least one embryo does take, and I understand the rationale, although I am extremely opposed to fertility treatment for a variety of reasons which I may discuss at some other point. Will blonde hair someday become a genetic defect? Will parents abort embryos which won’t develop into smart people? Infants who are predisposed to obesity? Will we find ourselves engineering the future? And, if we do, where will it lead us?