The Case Against Perfection: Ethics in the Age of Genetic Engineering (2007), by Michael J. Sandel

The Case against Perfection: Ethics in the Age of Genetic Engineering, hereafter referred to as The Case against Perfection, written by Michael J. Sandel, builds on a short essay featured in The Atlantic Monthly magazine in 2004. Three years later, Sandel transformed his article into a book, keeping the same title but expanding upon his personal critique of genetic engineering. The purpose of Sandel’s book is to articulate the sources of what he considers to be widespread public unease related to genetic engineering that changes the course of natural development.

Sandel is a bioethics professor at Harvard University and has written numerous books, including Liberalism and the Limits of Justice (1982), and served on the President’s Council on Bioethics from 2002 to 2005. Sandel believes that the moral questions regarding genetic engineering require spiritual discussions that have been lost in the modern world. According to Sandel, as these ethical questions revolve around theology, modern philosophers and political theorists have tended to neglect them. Sandel claims that those questions are unavoidable when addressing genetic engineering, and he attempts to address them in The Case against Perfection. There are five chapters in The Case against Perfection, in which Sandel concludes that humans need to appreciate natural abilities, achievement, and talent as gifts.

Chapter one, titled “The Ethics of Enhancement,” is an introduction to Sandel’s book. In chapter two, titled “Bionic Athletes,” Sandel discusses how athletes become less human by obtaining artificial talents by using drug enhancements and genetic engineering. In chapter three, titled “Designer Children, Designing Parents,” Sandel examines the potential for parents to become designers of their children by selecting for certain traits. In chapter four, “The Old Eugenics and the New,” Sandel compares bioengineering to free-market eugenics. In the final chapter, “Mastery and Gift,” Sandel rearticulates the argument he makes throughout the book—that humans compromise their dignity by constantly trying to achieve perfection.

Throughout The Case against Perfection, Sandel presents thought experiments in an attempt to have the reader re-evaluate his or her “unease” with genetic enhancements. Sandel warns his readers that the misuse of genetic technology could result in a world in which embryos are routinely screened for the most desirable traits: height, sex, intelligence, and immunity to disease.

Sandel considers the most popular and alluring form of non-medical genetic engineering to be selecting the sex of offspring. Sandel discusses how amniocentesis and ultrasound technologies, which were originally intended as prenatal diagnostic tools, can also reveal traits that lead to the abortion of fetuses on the basis of sex. Individuals uncomfortable with abortion, Sandel claims, also have the option of determining the sex of their children through pre-implantation genetic diagnosis followed by in vitro fertilization. Sandel also states that for individuals who object to discarding the unused embryos that result from in vitro fertilization, sperm sorting can also be used as a method of sex selection. Sperm sorting is a technique that separates the X chromosome-bearing sperm from the Y chromosome-bearing sperm. Regardless of the method, Sandel states that sex selection is objectionable for reasons that surpass the commonly argued reasons of sexual discrimination or the moral status of embryos. Sandel argues that the practice of parents choosing traits like the sex of their children threatens human dignity.

Sandel argues in chapter two that athletes taking performance-enhancing drugs are a further affront to human dignity. Sandel states that the appreciation for a baseball player hitting consecutive home-runs might shift from the athlete to the pharmacist if the baseball player was taking drugs to enhance his athletic performance. Sandel is not as concerned with an athlete’s hard work being supplemented by drugs as he is with the desire to modify innate natural ability. Sandel believes that the desire to achieve perfection will destroy the appreciation for those who are naturally gifted. Sandel states that this opinion is due in part to religious sensibilities, but rebuts potential objections by stating that its significance goes beyond religion.

In chapter three, Sandel expands upon the idea of natural ability by describing what he considers to be the ethics regarding giftedness. Sandel claims that children need to be appreciated as gifts or blessings, and accepted as they are rather than viewed as objects of potential human design. Sandel believes that when parents do not recognize life as a gift, they are faced with the problem of striving to master the mystery of birth. Sandel argues that this can destroy the relationship between parent and child, and does not demonstrate humility.

In the same chapter, Sandel also discusses how parents should act when faced with illness and disease. Sandel believes that parents should not be passive because healing illness allows natural capacities to flourish. Sandel states that medicine should be practiced solely with the intent of promoting health and curing disease. When medicine is used for genetic enhancement instead of healing, this is where Sandel views problems arising. Sandel encourages parents to help their children discover natural talents and gifts instead of seeking to genetically-enhancement, as the latter is overreaching about what it means to be human. According to Sandel, overreaching is unethical because as parents try to achieve perfection, it denies the norm of unconditional love.

Chapter four presents Sandel’s comparison of eugenics to genetic engineering. Sandel discusses what he considers to be three types of eugenics: the old, the free-market, and the liberal. Sandel focuses primarily on free-market eugentics and states that although some defenders of free-market eugenics claim that there is no coercion to this style of genetic enhancement, Sandel still believes that there are underlying problems with determining the genetic makeup of offspring, even if it is not compulsory. To illustrate his point, Sandel presents a scenario involving a mother that wants to avoid giving birth to a gay child, assuming a hypothetical gene could determine whether a child was going to be homosexual or not. Based on this scenario, Sandel states that it is morally troubling to contemplate abortion in order to avoid having a gay child, and that therefore it is amoral to practice free-market eugenics even where no coercion is involved.

In his final chapter, Sandel reiterates his main arguments by bringing together his thoughts on giftedness and tying it to religion. Sandel believes that people misunderstand their place in creation, often confusing it with the role of God. Sandel states that mankind needs to remain humble, which in his view means that parents should not pick and choose the genetic traits of their offspring. Sandel reiterates that parents need to be open to loving their children even when faced with the unexpected, and that genetic self-improvement may ruin humility by creating talents and abilities that are not natural.