Creating Future People

A Review of Jonathan Anomaly's Creating Future People: The Science and Ethics of Genetic Enhancement - second edition

We are in the earliest stages of a revolution in human reproduction. While many of the earlier adherents to the belief in heredity advocated for coercive and unethical policies, recent scientific advances have enabled voluntary means of genetically enhancing future people. Science fiction is quickly becoming a reality, and the bioethics debates—once relegated to philosophy journals—will soon become major political issues. Parents will have to grapple with difficult and impactful choices about what kind of life they want their future child to live. This reprotech revolution is quickly approaching, and Jonathan Anomaly is leading the way. The second edition of Creating Future People is the best guide available for thinking seriously about the impact of genetic enhancement.

The most important recent advance in this area has been preimplantation genetic testing for polygenic disorders (PGT-P), a method couples can use to choose among multiple embryos during in vitro fertilization (IVF). Thanks to the falling cost of genetic sequencing technology, large genomic databases have been created that allow the association between different traits and genetic variants to be discovered. Measures of disease risk called polygenic risk score (PRS) have been created using information from these genomic databases. Since accurate estimates of embryo DNA can be determined with a trophectoderm biopsy, PRSs can be used to select embryos on the basis of heritable traits with PGT-P.

It is reasonable to believe that the associations found in studies of these datasets—Genome-Wide Association Studies (GWAS)—represent actual causal relationships. Importantly, one potential direction of causality is ruled out because the environment does not alter genes. The most critical test for causality that PRSs pass is that they maintain much of their predictive power for some traits when comparing siblings. This reduces the likelihood of major commonly suspected environmental confounds such as socioeconomic status, parenting, and education. The sibling comparison is informative because embryos are nearly equivalent to unborn siblings in terms of their genetic similarity.

The expected return to selection with PGT-P is a function of the trait variation, the PRS’s predictive power, and the number of embryos available. Most couples undergoing IVF are experiencing fertility issues. In such cases, a woman is not likely to produce many viable eggs and thus few embryos. The benefit of selection among two or three embryos is worthwhile but not overwhelming, but selection from five to ten embryos can be substantial and will improve as genomic databases grow. The development of an exciting technology called in vitro gametogenesis (IVG)—specifically, in vitro oogenesis—would enable the creation of eggs from somatic cells like blood or skin, permitting large batches of embryos and very large expected gains.

Perhaps even more important would be the ability to precisely edit the genes of embryos, permitting exceptionally large returns on polygenic traits. Since many traits are highly polygenic and no one is within the absolute limits of genotypic traits, we could expect to create healthier, happier, and smarter people than anyone who has ever lived. These powerful technologies have many implications for society and the future of humanity. The central focus of Creating Future People is considering the implications of enhancement for intelligence (ch. 1), morality (ch. 2), beauty (ch. 3), and health (ch. 4). As well as exploring the possibility of creating entirely synthetic people (ch. 5).

Anomaly begins with intelligence—a subject often discussed as a suitable target for genetic enhancement. The ordinary understanding of intelligence is closely aligned with its psychometric definition—a person’s general ability to reason and understand information. Intelligence is not only real, measurable, and largely stable across time (Haier, 2023), but it is also possible to accurately predict it using tests that consist of cognitively demanding test items. The many educational, career, and health-related outcomes associated with intelligence (Plomin & Stumm, p. 148) make it a good target for enhancement.

Intelligence is also highly heritable—meaning a large proportion of the variation in IQ can be attributed to genetic differences. The remaining proportion of environmental influence appears to be non-malleable—a finding corroborated by the evidence from interventions designed to increase cognitive abilities. Since the above findings undermine socially desirable beliefs about society and personal agency, they have faced resistance.

An even more politically controversial—yet empirically supported—claim is that intelligence is also associated with good outcomes at the national level. Nations with higher average IQ tend to have levels of higher economic and social development. This implies that boosting IQ could be a possible means of improving the conditions at the national level. According to economist Garett Jones, this is likely on account of the positive association between intelligence and prosocial behavior. This harmonious relationship facilitates mutually beneficial interactions that create institutions that lead to prosperity. This suggests that while gains from cognitive enhancement may be unevenly distributed, they will be broadly beneficial to society.

While these benefits are a cause for enthusiasm, insightful thinkers have raised objections. Persson and Savulescu (2008) argue that cognitive enhancement could pose a risk to humanity without moral enhancement. An intelligent person bent on doing evil may have a higher capacity than his or her less intelligent counterpart. To this point, Anomaly raises three rebuttals: (1) genetically enhanced—and thus better-functioning—societies are better equipped to identify and catch criminals, (2) prohibiting the technology will create disparities because wealthy parents can better evade bans, and (3) selection for conscientiousness would likely serve as a form of moral enhancement.

Despite forwarding these responses, Anomaly believes there is no wholly satisfying reply to Persson and Savulescu’s concerns. Whether or not cognitive enhancement is a net positive is a complicated question. However, a compelling heuristic to evaluate this question is Nick Bostrom and Toby Ord’s “reversal test,” which challenges us to question status quo ethical positions. The idea is to ask someone opposed to changing a certain parameter to consider whether it is good to change in the opposite direction. If there is no clear reason, then it may be some indication of status quo bias. In our case, this consists of asking if it would be good to make humanity less intelligent to reduce existential risk. That seems quite unlikely, especially considering the threat of non-anthropic existential risks.

A further reply could be to evoke “Chesterton’s fence”—an analogy wherein G. K. Chesterton suggests it would be unwise to tear down a fence you discover while walking if you are unsure what function it serves. I would note that human behavior can be understood in the context of evolution—the “purpose” of our mental faculties is to further the prevalence of their associated genes, which is often in contention with promoting human flourishing. Ultimately, Anomaly believes there is a balance to be had, saying we can avoid extreme action “while recognizing that sometimes we can be reasonably sure that Chesterton’s fence is indeed a pointless roadblock rather than a socially significant signpost.”

Selection for other cognitive traits like personality poses an even more difficult problem than selection for intelligence. There are advantages and disadvantages to different personalities, and the interconnected nature of society makes this a collective action problem. For example, extraversion in a world of only introverts may make life difficult if it is hard to find people who want to socialize with you. A cognitively diverse society may be for the best since a well-functioning society consists of a balance of people with perspectives and traits. For example, conservatives and progressives may bring unique political views that balance each other out in a beneficial way.

Another relevant aspect of the collective action problem of cognitive enhancement is that some goods are positional, such as admission to elite schools. In the far future, those who do not use genetic enhancement may find that their children are suffering a loss of opportunity. Our increasingly technological society is less dependent on low-skilled labor and compensates much more for highly cognitively demanding tasks. Furthermore, many people quietly consider the relative worth of people, even if they believe that moral status should be extended to everyone. Thus, a massively enhanced society may produce large inequalities if certain traits—like intelligence and conscientiousness—are highly rewarded in terms of wealth and social status.

Anomaly investigates two possible solutions: subsidy and force. We could subsidize socially beneficial technologies for those who cannot afford them. This means that a broader proportion of society is able to have access and benefit—perhaps leading to a more equitable society. Alternatively, we could use coercion to prevent couples from using this technology. However, this may exacerbate inequality as the highly privileged elites may have ways of evading bans—further entrenching unequal outcomes. A less coercive idea is to support the proliferation of communities or states with different rules, allowing people with different beliefs about reproductive autonomy to form their own communities.

While social stratification due to genetic enhancement technology is far off, Anomaly gives some interesting points to consider. The latter proposal about separate communities was reminiscent of the visions of utopia proposed by Robert Nozick in his book Anarchy, State, and Utopia. Perhaps the world would be better if people could sort themselves into their own communities with unique ideas about the proper role of genetic enhancement.

Anomaly forwards an alarming thought about the use of coercion and social pressure with regard to reproduction. Once again, we are likely far from such profound social change, but it is an interesting question to ponder. Imagine it was completely free, virtually painless (perhaps using in vitro gametogenesis and artificial wombs), and extremely powerful (e.g., adding 20 years to your child’s life). Would it not be reasonable to pressure parents to extend their child’s life considerably? We exert all sorts of social pressure against harmful practices now (e.g., not vaccinating your child, hitting your child).

The increasing power of technology—not just genetic enhancement technology— is a double-edged sword. We can improve our lives tremendously, but nefarious actors may be able to produce more harm. As more time passes and the power of technology grows, we may be in an increasingly vulnerable state thanks to potentially destructive technology like engineered viruses. To avoid destruction, it may be necessary to improve our moral psychology. As Savulescu and Persson say, we may be “unfit for the future” due to our evolved psychology’s mismatch with current conditions.

Anomaly focuses first on the potential for changing our behavior through increasing or decreasing hormones: oxytocin, cortisol, and testosterone. While oxytocin has a positive association with empathy, administering it appears to only increase cooperation with people in close proximity rather than generally. Anomaly suggests it may lead to decreased consideration for anonymous people, potentially leading to increased ethnocentrism. Since a lot of the enhancement problems will involve large-scale coordination problems in which people have to consider the ethical interests of people far outside of their social networks, oxytocin may not be an appropriate target for enhancement.

Another potential route is influencing the testosterone-to-cortisol ratio. A person with high testosterone and low cortisol tends to be aggressive and unempathetic. While less aggression and callousness could be beneficial, it is worth reevaluating the importance of selecting empathy, especially considering this may also be another collective action problem. Enhancing empathy may not be an evolutionarily stable strategy. A person who exploits altruistic people can benefit from bad behavior, while the altruistic person suffers for being good.

A functional society involves frequent cooperative decisions, so trusting others can be beneficial when we have a society with many cooperative people. When society is filled with exploiters, acting in one’s own self-interest is wise. Too much “pathological altruism” could actually undermine society. Anomaly believes the best approach is to inform prospective parents about the benefits of “strong reciprocators” for institutions and the possibility of exploitation. If we do not overcome this potential pitfall of altruism, the case for moral enhancement may be undermined.

Beyond moral behavior, cosmetic enhancement also has collective action problems. Practically everyone acknowledges there are many advantages to being attractive. Some even go to great lengths to make themselves more attractive, such as by spending lots of money on clothing, gym time, or cosmetic surgery. We care about beauty—like all human behavior—because of our evolutionary history. Beauty serves as a signal of reproductive fitness, and signals of reproductive fitness are exaggerated via the process of sexual selection. This can result in strange behavior, such as the Australian bowerbird creating an elaborate bower structure decorated with blue objects.

The evolutionary function of beauty matters for understanding its relationship to genetic enhancement because it lets us recognize that the positive correlation between attractiveness and physical health is not coincidental and that beauty is not merely socially constructed. Moreover, it illustrates how cosmetic enhancement may be dangerous due to runaway selection. Aesthetic traits are positional goods in which much of the benefits of attractiveness are being more attractive than other people. The positionality gives us some justification for regulation, similar to how there is some justification for regulating or taxing luxury goods that are used for signaling purposes. Anomaly explains:

Suppose that we select for tall sons and curvy daughters, knowing these traits are considered both sexually attractive to potential partners, and likely to raise our kids’ social status. We might do this because conventionally beautiful men and women are likely to earn more income, and are more sexually attractive to mates than their less beautiful counterparts. It is conceivable that as we enhance these traits, preferences for them will also ramp up. Ronald Fischer showed that genes which code for a sexually selected trait are likely to be linked with those that tend to produce a preference for that trait in the opposite sex. In the environments in which we now live, very tall people are more likely to suffer joint injuries (due to carrying a lot of extra weight), and may suffer unhealthy heart conditions (due to an increased ratio of body size to heart size). And women with large breasts may be more likely to suffer from back injuries, as well as having to carry around extra weight that isn’t especially useful (shapely breasts have no effect on breastfeeding, but instead seem to be purely sexually selected).

Despite these concerns, there is a decent case that runaway selection for attractiveness is not so much of an issue. There are limits to some benefits—once you achieve a certain level of facial symmetry or hip-to-waist ratio, there is little to be gained. Unlike partners, parents likely do not have strong feelings that are elicited by attraction, so they will be more likely to prioritize other traits like health. Even if we do exist in a society that prioritizes attractiveness too much, cosmetic change through genetic enhancement may be better than surgery since it could be potentially less invasive, less expensive, and safer. Ultimately, we may inadvertently get cosmetic enhancement due to parents’ efforts to reduce genetic load, inadvertently making their child more attractive.

Anomaly raises the point that some people discriminate on the basis of physical attractiveness—a phenomenon called “lookism.” People associate positive traits with good-looking people. This seems like an unfortunate form of discrimination, but it does not mean we should prevent people from improving their appearance. Even if society is unjust, it is reasonable for parents to want to reduce the extent to which their child experiences injustice. Moreover, we can reduce unjust discrimination while improving cosmetic appearance. Like with other traits, this will potentially lead to inequality. In response to this, Anomaly says:

There will always be differences in access to goods, and sometimes this is a necessary consequence of an efficiently functioning market. In a market system, where private property and free exchange are protected, those with more wealth or risk tolerance buy new products first. This allows the product to be evaluated for safety, and to become cheap enough through mass production that those with less wealth or more risk aversion can eventually enjoy it. There is no principled difference between automobiles, clothing, or genetic enhancement procedures. The morally salient fact about enhancement technologies is that they will allow large inequalities of ability to emerge quickly, which is more troubling than inequalities in access to designer clothes or exotic food. Inequalities in intelligence or beauty could lead to more discrimination against the unenhanced, and a general level of contempt by the able toward the unable (assuming moral enhancement doesn’t mitigate this).

While we have defended beauty on the grounds that parents could make their children healthier by enhancing their appearance, some even object to enhancing children’s health. As of the time of writing, only polygenic embryo selection for health is available. The two most prominent providers of this service—Genomic Prediction and Orchid Health—do not provide information on intelligence, personality, morality, or beauty. Still, there are many skeptics who believe that providing this service is unethical. While I think this practice is perfectly defensible currently, there is a potential cause for concern when considering future collective action problems in which choices that maximize individual welfare could yield a suboptimal outcome for society.

Anomaly provides an illustration using the condition of sickle cell disease (SCD), a monogenic disorder that arises when a child is born with two abnormal hemoglobin beta gene alleles. This allele persists in people from areas where malaria is common because having one abnormal hemoglobin beta gene allele—sickle cell trait (SCT)—confers an advantage against malaria. The benefit of SCT depends on how common malaria is, as well as how common SCT is in the population. If many people have SCT, then many people will have children with sickle cell disease. This illustrates how the health of individuals can be related to the health of the population.

The complex nature of communicable diseases also illustrates the interconnected nature of genetic enhancement choices. Anomaly provides the example of the Irish Potato Famine, in which the microbe Phytophthora infestans wiped out a single variety of potato. The impact would have been less if there were more diversity. In animals, sexual reproduction may have partly evolved to introduce immune diversity in order to resist parasites. In the context of genetic enhancement, this illustrates why it may be a bad idea to genetically engineer humans to have a “perfect” immune system. If the “perfect” immune system became universal, human beings would be especially in danger of a fast-spreading parasite when it eventually evolved. Anomaly recommends caution:

In the case of enhancement against infectious disease, the risks of doing nothing are serious: infectious diseases will continue to decimate populations unless we take some precautions against them doing so. While it’s true that we should be cautious about making radical changes to our innate immune system, we should not assume that our bodies are optimized by evolution to deal with the microbes that our children will encounter. Microbes will continue to evolve, many of our infections are a function of environments we’ve created over the past few thousand years, and genes are not fine-tuned by a master engineer to suit us under the variety of environments our descendants will populate.

The more wise approach is to select against inherited diseases like cancer and diabetes. There is a lot of potential in this area since virtually every disease is affected by genes. Anomaly asks us to consider how we would select among many embryos if we had the power to select with 25 different predictors like schizophrenia, hypertension, intelligence, and height. A wise choice is to use an objective criteria such as quality adjusted life years (QALYs). Even if there are positive correlations between traits we like and dislike, parents could still reach a reasonable conclusion about what is the best embryo by selecting using a broad index. Moreover, this phenomenon of undesirable correlations—negative pleiotropy—is not too much of an issue because the evidence suggests that selecting against one disease inadvertently selects against others.

After covering the collective action problems of intelligence, morality, beauty, and health, Anomaly considers the far future possibility of constructing people from scratch. If an embryo could be constructed artificially—possibly with the help of AI—there would be immense possibilities in the type of person we could create. An entirely synthetic child could have no deleterious mutations. Anomaly also poses the following interesting possibility:

We might even use this kind of technology to transmit the data for assembling people on other planets, in other solar systems, with bodies that are better adapted for different conditions. In this sense, humans could colonize other planets without leaving our own.

In principle, we could also create genetic replicas of ourselves on our own planet, or on other planets – assuming that people or some other form of intelligent life has colonized other planets, and would faithfully carry out our plan to create people in another place. Synthetic replicas would not be psychological replicas: they would share our psychological dispositions (because that they share our genetic code); but they would have very different experiences, and end up as quite different people.

Assume for the moment that all of this is possible. Sending plans for how to construct a particular kind of living thing from one place to another is technologically challenging. It presupposes a much deeper understanding of genomics than we have now, and it requires the relevant ingredients, a hospitable environment, and willing executioners of our plans. But it is conceivable, and it violates no laws of physics that we know of.

Would we want to do this? I can’t answer for everybody, but I think many people would. We might see it as a kind of immortality, although we would lack any psychological connection to a genetic replica of ourselves born somewhere else. We wouldn’t suddenly wake up in a new body in a different place. Replicas would instead function like a twin born in a different time and place. We might see replicas, or edited versions of them, as a kind of survival in the sense that parents live vicariously through their (genetically related) children. We all wish our lives went different at various stages, and many people seem to take joy in thinking of their kids as versions of themselves who might learn from their parents’ mistakes. There is nothing wrong with living vicariously. It isn’t immortality, exactly, but it’s similar in some ways. And if we generate enhanced versions of ourselves we would be conferring benefits on another person that would presumably make their lives go better.

The ambitious vision of the future Anomaly discusses may be disturbing to some. They may ask whether we should really be so ambitious as to change humanity. After all, it may be that Chesterton’s Fence is the correct analogy. But Chesterton also proposed another metaphor which Anomaly calls “Chesterton’s Post”: if you leave a white post to the forces of nature, it will turn black and must be painted white again. Differential fertility and accumulation of deleterious mutations means that we are changing all the time. We cannot escape the implications of genetic change, but we can make deliberate and intelligent decisions with enhancement.

Those opposed to enhancement also need to recognize that we cannot prevent it from becoming a reality. The ability to cosmetically, cognitively, and morally enhance children is coming in the very near future. The public backlash will be fierce. Many parents will have to make an important decision: maintain their moral commitment to blank slate thinking or take the necessary steps to improve the wellbeing of their child with genetic enhancement. Ultimately, I predict the desire for healthy, happy, and smart children will be too strong, and many will come to accept the powerful role that genes play in our lives.

The future of humanity is shaped by the decisions of parents, society, and the political institutions we create. Anomaly concludes saying “[i]t is up to us to think through what kinds of institutions we should create, and what kinds of future people should exist.” Jonathan Anomaly’s Creating Future People is a unique and interesting book that lays the groundwork for the many discussions that are necessary when the thought experiments of today become the reality of tomorrow.

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The first edition of Creating Future People is freely available for download. The second edition is available for purchase through Routledge or on Amazon. Thanks for reading! For more on genetic enhancement, subscribe to Parrhesia.

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