The questions are arranged in three sections: Organ Transplantation/Donation, Genetics Testing/IVF, and “Designer Babies.” They are designed to raise key ethical issues, provide important information on the science, and help you get in touch with your own moral compass. With a nod to the realities of many women’s lives, we have written them in such a way that you can participate in the discussion even if you haven’t read the books.
We suggest you read through the questions and select 5-10 for discussion purposes. The last question is the ACTION CONNECTION QUESTION which ties all the issues raised into a relevant policy consideration. After your discussion, we encourage all readers to check out the Policy Questions section of the website for more detailed information on the science, ethical frameworks to consider these issues, and policy options.
Bioethics Book Club Discussion Questions
Bioethical Issue: Organ Transplantation/Donation
• According to the BBC, "The UK company PPL Therapeutics has created various strains of genetically modified pig, most recently a knockout pig missing the gene thought to be responsible for a major part of the rejection response. If scientists can get it right, then new designer pigs could be cloned to produce a limitless supply of organs.”
Is it ethical to create an animal for transplant purposes?
What do you think about the pigoons (p. 22)—transgenic knockout pigs that are used as human organ farms? Is this an ethical practice? Why or why not?
• Baboons have been used for bone-marrow transplants, liver transplants, and heart transplants. Pigs have been used for islet cell transplant and heart valve transplant.
Is xenotransplantation ethical?
Bioethical Issue: Genetic Testing/IVF
• On p. 23, the pigoons are compared favorably with “keeping a for-harvest child or two stashed away in some illegal baby orchard.”
Is it ethical to have a child for the express purpose of saving the life of an older sibling?
• There have been several cases in which the parents of a seriously ill child have had another child, in hopes that the younger sibling could serve as a donor.
Is it ethical to use preimplantation genetic testing and IVF to identify which embryos to implant, with the goal of a close genetic match to a sick family member?
Would it be ethical to genetically engineer a sibling to be a close genetic match?
Would it be ethical to clone oneself as an organ farm—for future use?
Bioethical issue: “Designer Babies”
• In the world Jimmy and Crake live in, people can genetically engineer themselves and their children to possess desirable characteristics. In the pleeblands, Jimmy is amazed to see the products he markets being sold: “Gender, sexual orientation, height, color of skin and eyes—it’s all on order, it can all be done or undone. You have no idea how much money changes hands on this one street alone,” says Crake. (p. 289)
Do you think that people would really use these technologies if they were available?
What might be ethical arguments for and against this?
What social implications might arise from the commercialization of such technologies?
• Jimmy is amazed by his visit to the pleeblands: “The pleebland inhabitants didn’t look like the mental deficients the Compounders were fond of depicting, or most of them didn’t.…Asymmetries, deformities: the faces here were a far cry from the regularity of the Compounds. There were even bad teeth. He was gawking.” (p. 288)
Would you want to live in a world where everyone looks alike?
What might this mean for our concepts of beauty and individuality?
• “Designer babies” are mentioned on p. 25 and again on p. 304: “They’d be able to create totally chosen babies that would incorporate, any feature, physical or mental or spiritual, that the buyer might wish to select. The present methods on offer were very hit-or-miss, said Crake: certain hereditary diseases could be screened out, true, but apart from that there was a lot of spoilage, a lot of waste. The customers never knew whether they’d get exactly what they’d paid for; in addition to which, there were too many unintended consequences.”
Arthur Caplan, Glenn McGee, and David Magnus of the University of Pennsylvania Center for Bioethics said in a 1999 British Medical Journal article, “It is not clear that it is any less ethical to allow parents to pick the eye color of their child or to try to create a fetus with a propensity for mathematics than it is to permit them to teach their children the values of a particular religion or require them to play the piano.” Do you agree or disagree?
If we could genetically engineer our children to have the traits we desire, would it be morally acceptable to do so?
What ethical questions arise when we’re talking about changing another person’s genetic makeup, rather than our own?
Is it morally different to do this with our own children than with someone else’s?
Is it morally different to select “for” a certain trait (e.g., intelligence, height, or beauty) than to select “against” another one (e.g., illness, disability)?
Do you think genetic engineering would have a deleterious effect on the lives, or the valuing of the lives, of people with disabilities?
Do you think genetic engineering could ever create a positive moral duty for parents to make the best child they can, using available technology?
Given that these procedures are likely to be costly, and not be covered by insurance, what might be the social justice implications of access to genetic technologies?
• Crake’s stated intention was to improve on humanity, and he views the Crakers as “the art of the possible.” (p. 305)
What are some of the things he does, or tries to do, with the design of the Crakers?
What are the things he tries to eliminate, but can’t?
Are there characteristics that are central to all humanity?
Is there such a thing as “human nature”? How do you think Atwood would answer this question?
Although genetic engineering remains on the distant horizon, technological advances are bringing it from the imaginable to the possible. Policy makers are evaluating the potential options: ban it, regulate it, or encourage it. Based on today’s discussion, what factors would you want policy makers to keep in mind as they decide the future of genetic engineering policy?