The current discussions and debates about whether we should engage or support research that might alter the germ line rarely address the systematically eugenic potential that is a possible outcome. Germline is the term used to describe genetic changes that would influence inheritance across the generations, and is distinguished from genetic interventions that alter only the particular person undergoing gene therapy. Because bioethicists do not tend to formulate ethical concerns along dimensions of group stratification or access to political power on the part of groups of individuals, the discussion about the ethics of germ line intervention for group differentiation and social stratification is rare. An increased understanding of human genetics will enable the sorting of groups at higher and lower risk for certain diseases even more systematically than what was noted above.
If technology permitted entry into the germ line to eliminate either cystic fibrosis or sickle-cell anemia in an individual, that individual (or parent or guardian acting in behalf of that individual) might well make the individual choice. But a different order of ethical concern surfaces if one thinks about this more at the social and political level and less at the individual level. Zuni Indians are more likely to have cystic fibrosis than are persons of European ancestry, albeit a different mutation for cystic fibrosis than Caucasians. Yet the genetic test for cystic fibrosis is aimed at the Delta F508, the mutation most likely to be found in those of North-European ancestry. Quite simply, this is because genetic disease research is most likely to be aimed at those diseases that have the most politically powerful constituencies and/or for which there is a strong profit motive in the biotechnology industry. With more research dollars going into the Delta F508, than into the mutation which appears more frequently among the Zuni, individual Caucasians may come to believe that they are making an individual decision about altering the familial germ line. Stepping back to another level of analysis, social, political, and economic engines are driving molecular biology down certain research corridors of a particular group's genetic disorder and not others, and these have little to do with individual choice at the user end.
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