Berger E M, Gert B M
Department of Biology, Dartmouth College, Hanover, New Hampshire 03755.
J Med Philos. 1991 Dec;16(6):667-83. doi: 10.1093/jmp/16.6.667.
Recombinant DNA technology will soon allow physicians an opportunity to carry out both somatic cell- and germ-line gene therapy. While somatic cell gene therapy raises no new ethical problems, gene therapy of gametes, fertilized eggs or early embryos does raise several novel concerns. The first issue discussed here relates to making a distinction between negative and positive eugenics; the second issue deals with the evolutionary consequences of lost genetic diversity. In distinguishing between positive and negative eugenics, the concept of malady is applied as a definitional criterion for identifying genetic disorders that could qualify for germ-line therapy. Because gene replacement techniques are currently unavailable for humans, and because even if they were possible the number of people involved would be quite small, the loss of diversity concern seems moot. Finally, we discuss the issue of iatrogenic disorders associated with gene therapy and discuss several 'real world considerations.'
重组DNA技术很快将使医生有机会进行体细胞基因治疗和生殖系基因治疗。虽然体细胞基因治疗没有引发新的伦理问题，但对配子、受精卵或早期胚胎进行基因治疗确实引发了一些新的担忧。这里讨论的第一个问题涉及区分消极优生学和积极优生学；第二个问题涉及遗传多样性丧失的进化后果。在区分积极优生学和消极优生学时，疾病的概念被用作确定可能符合生殖系治疗条件的遗传疾病的定义标准。由于目前人类无法使用基因替代技术，而且即使有可能，涉及的人数也会相当少，因此对多样性丧失的担忧似乎没有实际意义。最后，我们讨论与基因治疗相关的医源性疾病问题，并讨论一些“现实世界的考虑因素”。
