Читать книгу Bioethics - Группа авторов - Страница 124

Before discussing the therapy–enhancement distinction, it is important that we understand another distinction that should inform our discussion, viz. the distinction between somatic and germline interventions.^23,24 Somatic interventions attempt to modify somatic cells, while germline interventions attempt to modify germ cells. The gene therapy clinical trials that have been performed thus far have been on somatic cells. If we combine these two distinctions, we obtain four types of genetic interventions:

1 Somatic genetic therapy (SGT)

2 Germline genetic therapy (GLGT)

3 Somatic genetic enhancement (SGE)

4 Germline genetic enhancement (GLGE)

While I accept the distinction between somatic and germline interventions, it is important to note that even interventions designed to affect somatic cells can also affect germ cells: current SGT trials carry a slight risk of altering germ cells.²⁵ Even so, one might argue that this is a morally significant distinction because somatic interventions usually affect only the patient, while germline interventions are likely to affect future generations.²⁶ In any case, the therapy–enhancement distinction encompasses somatic as well as germline interventions, and my discussion of this distinction will include both somatic as well as germline interventions.