Noor Siddiqui was 3 years old when the movie “Gattaca” (1997) was released. I’m not sure if she’s seen it, but given that the 1990s are back in fashion, I hope her social media algorithms suggest it to her.
“Gattaca” is a science fiction drama set in a future society where genetic engineering determines a person’s social status and opportunities. In the film, a child conceived naturally is designated as an “in-valid,” genetically inferior to children conceived, screened, and chosen for implantation in a laboratory.
The film raised important questions, like whether or not genetic determinism is more powerful than free will. To many, it doubled as a cautionary tale about the application of in vitro fertilization (IVF) beyond infertility, which at that time had been in use for nearly two decades.
This summer, The New York Times opinion journalist Ross Douthat interviewed Siddiqui, founder and CEO of Orchid Health, a Silicon Valley fertility startup focused on polygenic screening of embryos. When he asked if she was worried that her company could usher in the type of caste system that “Gattaca” foreshadowed, she responded:
“I think society fundamentally rejects that idea because it is fundamentally so disgusting. We’re moving towards a world where IVF … is hopefully going to be covered for everyone. For the last 40 years rich people get to have babies and poor people who can’t afford IVF don’t get to.”
People of varying economic means can still have children. Siddiqui failed to note that people seeking IVF today are couples struggling to conceive a child through sexual intercourse, who are sterile by the nature of their sexual relationship, or who are pursuing single parenthood.
For Siddiqui, the moral problem at hand is not the possibility of a world in which a majority of people conceived and born through IVF have optimal genes and a low probability of genetic disease, while a minority conceived through sexual intercourse have comparatively greater odds of disability and propensity for gene-linked illnesses.
Her moral qualm is that all parents have a “fundamental right” to reproduce this way. The injustice lies in the financial barrier to entry.
Should this process become the standard way to have babies, Siddiqui stands to reap significant rewards with her current rate of $2,500 per embryo. The poor, the Amish, and Catholics striving to follow the Church’s teaching on sex and procreation would be the financial holdouts.
Curiously, when pressed by Douthat, she waffled as to whether she believed it is a moral imperative to reproduce this way. Siddiqui insists that no one should be pressured into it, and that no woman should be judged for her childbearing choices.
“I think that if you have enormous genetic privilege … for you to roll the dice and to get an outcome that isn’t going to lead to diseases is in the cards for you, then of course, go ahead and roll the dice,” she said.
But at another point, she proposed: “I think that it [the application of her company’s services] is a positive moral choice, it is the responsible decision as a parent, to detect that risk at the earliest possible stage and to transfer the embryo that has the best probability of a healthy life.”
Following this logic, it’s hard to see how a couple who chooses the old-fashioned way of having children would not be judged as irresponsible. The social pressures to conceive materially healthy children would be enormous, and as Douthat pointed out, the medical establishment will likely move in that direction, leaving the few children born with special medical, neurological, or psychological needs without adequate services.
Siddiqui’s characterization of what constitutes responsible parenthood is born from her own experience. Her mother suffers from a gene-linked degenerative disease known as retinitis pigmentosa, in which she gradually went blind in her 30s.
Wanting to spare their offspring her mother’s fate, Siddiqui, 31, and her husband, have chosen to conceive through IVF and have applied her technology to their 16 embryos. They intend to implant two males and two females at a future date.
She has not said what will happen to any remaining embryos, though she voiced support for a procedure referred to as “compassionate transfer,” in which remaining embryos are implanted in a woman but not expected to survive. In this scenario, the woman is not given the hormonal or medical interventions aimed at supporting implantation and pregnancy.
And while Siddiqui would not articulate if an embryo has any moral status (such as deserving of a right to life), she does believe embryos are “precious” and awe-inspiring in their ability to become the multitude of cells which comprise the human body.
It’s hard to say if she would make any moral distinction between a human embryo and the embryo of say, a labradoodle, which is also capable of proliferating and differentiating into the form of a canine.
Is this eugenics? Yes, but to some in Silicon Valley, there is a distinction between “enabling parents to make genomic choices” and the Nazi program of “eliminating undesirable” humans. Somehow if the parents have a say in it, it shifts from morally repugnant to morally acceptable, even laudable.
Apart from Douthat, there haven’t been many loud voices so far raising questions about Orchid’s aims, Siddiqui’s moral zigzags, or similar technologies coming from Silicon Valley, such as those which screen embryos for higher I.Q. as recently reported in The Wall Street Journal.
This is not surprising, given the libertarian views of sex that dominate our culture, best characterized as the philosophy of “You do you.” And in a world shaped by artificial contraception and sterilization by choice, there is no inherent link between sexual intercourse and childbearing in the public’s mind. To quote Siddiqui, “Sex is for fun — Orchid and embryo screening is for babies.”
You don’t have to be a person of religious faith to see the obvious problems this mentality implies for the future of humanity. But when it comes to seriously weighing the ethical and moral implications of things like in vitro fertilization and genetic screening and therapy, the Catholic Church has for years stood alone as a moral voice.
The world has figures like St. Pope Paul VI to thank for this. Almost 70 years ago, when faced with pressure to change the Church’s teaching on birth control, he introduced the concept of “responsible parenthood” as an “exercise of love and freedom where spouses recognize their duty to God, themselves, their families, and society,” that allows couples “to either generously welcome new life or prudently postpone a birth” for “serious reasons and with respect for moral law.”
No couple is obligated to procreate if there are grave circumstances facing any member of a given family. In fact, a couple’s fears about passing on a high-risk genetically linked disease can be a valid part of their discernment not to have biological children.
Siddiqui says her technology gives parents the power to prevent the suffering of their child. But the technology doesn’t prevent illness in any one child — it prevents the embryos with the probability of disease from continuing to live.
Creating new life only to kill it (at its embryonic stage or later through abortion) is morally impermissible. In what scenario should a society bring children into existence only to sacrifice them so that one of them might survive?
As for IVF, the 1987 Vatican document Donum Vitae (Respect for Human Life) outlines how couples struggling with infertility can and should seek treatments for its underlying causes. Those scientific and medical efforts have been championed by laymen and laywomen in the form of Naprotechnology, which is being sought in increasing numbers by Catholics and nonbelievers alike for its effectiveness, which is greater than IVF and does not pose the health risks for women that hyper-stimulation of ovulation and egg retrieval do.
The Church also encourages couples to use assisted reproductive technologies which preserve the unity of the procreative and reproductive dimension of sex but do not replace them.
Another document from the Holy See from 2008, Dignitas Personae (The Dignity of a Person), explained how Catholics can use genetic screening and even genetic therapy in good conscience, so long as it’s not done to eliminate the infirm or manipulate gametes that could result in unpredictable consequences for individuals or society.
I don’t know if Siddiqui and others in Silicon Valley would listen to men in Roman collars on these issues. Many bishops sat on the sidelines as artificial contraception became mainstream, while the warnings of others went largely unheeded. More recently, they have largely stayed quiet as Americans have accepted in vitro fertilization as a positive means for any willing individual or couple to have a child.
But Catholics — priests, bishops, and popes among them — have been bold when it comes to proclaiming the need to protect children, whether in migrant camps or in the womb, the children being conceived and screened in laboratories possess the same dignity. Who will speak up for them?
Siddiqui’s Orchid is poised to usher in a reproductive revolution which changes the nature and meaning of what it means to bring children into the world and whether or not those children are truly free, or shackled by the expectation that they live up to their parents’ desires for them, no matter how sincere. Believing you are here by chance might be far less burdensome to a child’s psyche than knowing he was chosen at the expense of others.
In the end, it will be Siddiqui’s own children who will teach her that she could never prevent their suffering, or their mortality. Her job as their mother will be to guide them through life, which can break your heart, but is always worth living.
