We are a clever bunch, us humans.
We’ve moved from pyrotechnology, the ancient art of manipulating hydrocarbons and metal, to manipulating life itself – biotechnology. Just as everything in our material world that we consider important today was developed by pyrotechnology, almost anything of profound value in the age to come may very well be grounded on biotechnology.
In 1998, Jeremy Rifkin published The Biotech Century, predicting that agriculture would be transformed, farming moved indoors, meat cultured in labs and sold in supermarkets, and gene editing reshaping the world.
Now, 26 years later, we are seeing many of his predictions come true. What used to be Twilight Zone fiction or futurism, is no longer.
The New Biotech
In case you haven’t heard, here in Singapore, we’ve got a demographic crisis on our hands.
Source: Department of Statistics
Our Government has already leveraged new reproductive technologies to counteract our rapidly aging demographics and dismal fertility rate. IVF treatment at public hospitals is heavily subsidised for residents, and elective egg-freezing has been pushed through parliament with minimal contest – consequences be damned.
Singapore has also developed a reputation for being pragmatic and utilitarian in its decision-making on ethical issues. Consider the fact that few in culture bat an eyelid at the ethical quandaries around abortion.
So now, what stands between us and the three dystopian cutting-edge reproductive technologies which could possibly address the existential population replacement problems our country is facing?
In Vitro Gametogenesis (IVG)
IVG refers to the generation of lab-grown sperm and eggs from other cell types within the body such as skin cells. Utilizing advancements in molecular biology, even skin cells can now be reprogrammed into an embryonic stem cell-like state, that can become eggs or sperm through chemical and growth factor induction in a lab dish.
Research groups in Japan and China have already demonstrated the birth of live healthy mice and rats from IVG-generated sperm and eggs. These animals could then in turn reproduce normally and give rise to the next generation of healthy offspring.
Given the success of translating breakthroughs in rodents to humans, it is plausible that these results will soon be replicated in humans.
Artificial Womb Technology
Artificial Womb Technology (AWT) refers to bioengineered systems for the gestation of human offspring outside the human body. This is known as Ectogenesis or Ectogestation. Studies with sheep have shown artificial wombs can sustain the life and development of preterm fetuses.
Clinical trials for AWT in extremely premature human babies are expected soon. However, complete ectogenesis for the full gestation period still faces formidable challenges and is unlikely in the near future.
Synthetic Human Embryos
Synthetic Human Embryos refer to embryo-like structures generated entirely from stem cells, thereby bypassing the natural process of fertilization without the need for either sperm or eggs.
In 2022 and 2023, an Israeli team at the Weizmann Institute of Science created synthetic embryos from mouse and human stem cells in separate experiments. These synthetic embryos were reported to display brains, beating hearts, as well as foundational structures of all other organs within the body, in addition to rudimentary placenta, yolk sac, and other external tissues that could potentially ensure their continued growth and development upon transfer into a womb.
To date, no animal or human-derived synthetic embryos have yet generated a live offspring, but given the rapid pace of scientific advancements in recent years, this hurdle may likely be overcome in the near future.
Amplifying the Challenge
Adding to the ethical complexities of IVG, AWT, and synthetic embryos are AI-based embryo screening and human genome editing. These technologies not only promise to prevent genetic diseases but also open the door to enhancing traits like intelligence and appearance. The screening, selection, or genetic engineering of non-disease traits like higher IQ, height and even fair complexion have already been partially discussed in public consultations by Singapore’s Bioethics Advisory Committee (BAC).
But as the biotech landscape evolves, it becomes increasingly clear that the BAC’s work is never complete and this is why a future public consultation on newly emerging reproductive technologies is necessary to address the following pertinent controversial issues.
99 Problems
1. Treatment of age-related female infertility
Advanced technologies enabling later child creation apart from a woman’s body clock overrides concerns about fertility preservation procedures such as egg freezing and ovarian tissue freezing and give rise to new ethical issues worsening the pressure on women to give birth at an advanced age or pressure on women to follow “male” career structures. There is also the risk that these technologies could indirectly influence norms, stigmatising natural conception or traditional reproductive timelines as inferior or irresponsible.
2. Posthumous reproduction for bereaved spouses and parents
Tissues and cells could be harvested from a corpse, upon the untimely death of a loved one, and be used to produce synthetic embryos, or artificial eggs and sperm via IVG, with gestation in an artificial womb. Needless to say, this would be highly controversial, especially if there is no informed consent from the deceased.
There are also ethical concerns about the rights, welfare, and psychological impact on posthumous children. It also creates complications regarding legal parental rights. For example, who has the authority over the use of these gametes and the custody of children born after death? These challenges are especially significant when thinking about inheritance rights, highlighting the need to reevaluate our existing legal systems.
3. Abuse of such technologies by de facto same-sex couples
Using these emergent technologies to beget offspring that are genetically related to both partners in relationships runs the risk of jumping the ethical gun. Just because one can do something, does not mean that one should do something.
And even if the utilization of such new reproductive technologies is banned for de facto same-sex couples in Singapore, these can still be done overseas. The resulting offspring will thus pose a quagmire for the Singapore Government, which will then have to resolve legal issues pertaining to residency, citizenship, and parenthood rights.
4. Mass production of donor sperm and eggs
IVG technology can facilitate the mass production of donor sperm and eggs for infertile patients, which are currently in short supply worldwide. Customised IVG for individual patients would likely lead to excess production of eggs and sperm which may be donated to other infertile patients who cannot afford the high costs of the procedure. Great.
But this also entails other increased risks around genetic homogeneity, as using a small pool of desirable donors could lead to a reduction in genetic diversity. Such homogeneity makes populations vulnerable to disease outbreaks and environmental shifts.
A population also runs the risk of unintended incestuous sexual relationships and marriages between numerous donor-conceived offspring of a single individual, which may be further exacerbated by the high population density and small size of Singapore.
5. Eugenics concerns
A common related concern would be the mass production of donor eggs and sperm from desirable and accomplished individuals such as famous actors and actresses, fashion models, sports stars, brilliant physicists, and acclaimed musicians, to supply boutique eugenics agencies, commodifying children and undoing decades of work to undo the latent class structures in societies.
IVG technology and the creation of synthetic embryos from stem cells will also overcome the current bottleneck in AI-based embryo polygenic screening and human germline genome editing by making abundant the number of embryos available for screening, selection, or gene modification. The key ethical issue here lies in the application of such technologies for human enhancement, that is the screening, selection, or genetic engineering of non-disease socially desirable traits such as high IQ, athletic prowess, and physical characteristics related to beauty standards, but it also goes beyond skin depth.
This process raises significant ethical concerns, not only about the moral ramifications of striving for an idealized version of humanity but also about the societal pressure it could create for all parents to use such technologies. Selection might not only focus on physical abilities but could extend to psychological traits and behavioral predispositions, like emotional resilience or temperament, shaping future generations by filtering out “undesirable” characteristics. This trend could ultimately alter what society considers acceptable or worthy human traits, amplifying inequality and discrimination based on one’s genetic composition.
6. Avoidance of pregnancy
The abuse of artificial womb technology will enable otherwise healthy and fertile women to avoid the physical burdens and pains of pregnancy and childbirth. Some may celebrate this as achievement of a new form of gender equality and feminist liberation, as well as to obviate the need to take maternity leave so that women can focus on their work and career advancement.
However it also poses questions about the role of parental involvement in early bonding stages. Removing gestation from the parenting equation might impact the parent-child relationship long-term, potentially diminishing the value of the intimate process of pregnancy and the bonding that occurs during it.
7. Assuaging guilt and avoiding parental responsibility
Artificial Womb Technology will be able to lessen the moral guilt of abortion by sustaining the life and development of foetuses after discontinued pregnancies, and then giving the child up for adoption or orphanage upbringing. However, as if orphans didn’t have it hard enough, the psychological complexities and social stigmas for children not only orphaned but also artificially gestated are profound.
8. Rights of synthetic humans
If synthetic embryos prove capable of generating live offspring, questions will inevitably arise regarding their personhood, moral status, and their ethical use in various biomedical applications, such as tissue and organ transplantation or pharmaceutical testing. Ethical guidelines concerning the treatment of synthetic embryos may need significant updates, particularly if they develop biological features or even consciousness. At what point, if any, do synthetic embryos attain rights, and how do we ensure their ethical treatment while still advancing legitimate scientific research?
9. A new class of human exploitation
Technologies like IVG and synthetic embryo development also raise the risk of commodification and exploitation of biological materials. The demand for cells, eggs, and other tissues could lead to economically disadvantaged individuals being coerced into supplying them. This commodification of human tissue blurs the line between altruistic contribution and economic pressure.
10. The commodification of the human genome
At the same time, the growing corporate interest in these technologies presents the risk of biological patent wars. Patenting genetic processes might result in monopolies over human reproduction, restricting access and making these powerful technologies available only to those who can afford them, thus creating new inequalities. Balancing reproductive rights with these evolving risks, while ensuring that such technologies do not become instruments of coercive societal control, remains a central ethical challenge.
11. The dangerous misuse of science
Unauthorized genetic experimentation and the misuse of synthetic embryo technologies present significant risks to society. The ability to modify embryos in labs could lead to black-market experimentation by rogue actors attempting unethical modifications for profit, potentially causing unforeseen health complications or unintentional genetic diseases. Furthermore, these powerful technologies could be misused for bioterrorism, with genetic modifications being deliberately designed to introduce harmful traits or diseases. Ensuring tight regulation is crucial to safeguarding against such misuse, while maintaining a balance that does not stifle legitimate innovation.
As these technologies inch us closer to what was once thought of as science fiction, we must confront the ethical dilemmas they bring. If we fail to question how far we are willing to go, we might find ourselves lost in a twilight zone of our own making – where possibilities are endless but humanity’s moral compass is blurred.
Special thanks to Dr Alexis Heng for bringing this to our attention. He first wrote about this here.
