GENETIC THERAPY

Genetic therapy is commonly defined as the experimental application of genetic engineering to the transplantation of genes into human cells in order to cure or prevent a disease caused by a genetic defect (e.g. replacing a mutated gene that causes disease with a healthy gene, inactivating an improperly functioning mutated gene, or introducing a new disease-fighting gene into the body). I argue that genetic therapy should be a matter of voluntary individual choice rather than “societal choice”. This view has broad implications for the regulation of and funding for genetic therapy.

Genetic therapy should be a matter of individual choice rather than “societal choice” for the following three reasons: genetic engineering causally affects the relevant individual directly via positive and/or negative benefits, but causally affects the relevant society only indirectly via the reactions of other individuals to the treated individual; in large industrialized civilizations — such as the United States — “societal choice” is a euphemism for State power, which is exceedingly dangerous based on historical precedent (Nazi Germany is the obvious example) and the reality that all States wield their ultimate decision-making authorities via aggression, which is the initiation or the threat of violence against a person or a person’s justly acquired property; and implementation of a comprehensive “societal choice” policy, even in the most benign scenario, necessarily requires a physician to participate in decisions regarding the allocation of scarce medical resources, which violates his or her fundamental ethical obligation to “do all that he or she can for the benefit of the individual patient” (see Opinion 2.03 – Allocation of Limited Medical Resources in the AMA Code of Medical Ethics).

The assertion that genetic therapy is a matter of individual choice rather than “societal choice” has broad implications for the regulation of and funding for genetic engineering. The individual choice scenario functions via regulation by inherent market economy self-management mechanisms — examples include but are not limited to decreased market share then business failure due to loss of reputation/shoddy products/poor service and private organizations that settle disputes/independently test products/disseminate information for consumers and producers — and funding by voluntary market economy exchanges of justly acquired property between individuals and/or private organizations (termed the “economic means” of satisfying human desires by sociologist and political economist Franz Oppenheimer).  On the other hand, the “societal choice” scenario in a large industrialized civilization functions via regulation by State legislation and funding by forcible State expropriation of the justly acquired property of individuals and private organizations (termed the “political means” of satisfying human desires by Oppenheimer). Genetic engineering, unfortunately from my point of view, is emerging in a quasi-fascist American healthcare system, which has much more in common with the “societal choice “ model than the individual choice model.

In conclusion, for multiple bioethical reasons genetic engineering should be a therapy voluntarily chosen by individuals acting in a self-regulating market economy that is funded by exchanges of justly acquired property between individuals and/or private organizations.