The Lost Genius objection to pre-natal testing for autism

In an opinion piece on the BBC website this week Professor Simon Baron-Cohen has questioned the wisdom of adopting pre-natal screening for autism, raising the possibility that it would prevent the existence of future great mathematicians. This is a variant of a common objection to pre-natal testing or to genetic enhancement.

We could call this argument ‘The Lost Genius’ objection. The way it is usually set up is to point to a past genius, perhaps with a significant impairment or illness. For example Abraham Lincoln is thought to have had Marfan syndrome. Vincent van Gogh may have had temporal lobe epilepsy. We have all gained enormously from the lives of those individuals. It would be a bad thing if they had never existed. At the time that they were born there was no possibility of pre-natal testing. However if pre-natal testing had been available (or if their parents had been able to manipulate their genes to prevent Marfans or epilepsy) those individuals may never have existed. Therefore we should consider the possibility that in performing embryo selection, pre-natal testing and termination, or genetic enhancement we may inadvertently kill or fail to bring to birth a future Lincoln or van Gogh, Mozart or Einstein.

 The first problem with this argument is that it may seem to also threaten all acts of contraception or failure to conceive. After all, if Lincoln’s parents had not conceived him exactly when they did (for example if they had had intercourse a month, or perhaps even a day later), a different combination of sperm and egg would have resulted. So any act of contraception (or any decision not to copulate) would be susceptible to the same worry that this may result in a great genius failing to come into the world.

In addition, there is the problem that prenatal testing and termination might equally prevent the existence of evil geniuses. Hitler is thought by some to have had Asperger’s syndrome, so it is possible that prenatal testing would have led to him failing to exist – which we would all think would have been a very good thing.

But the Lost Genius argument does not depend upon there being a chance association between disability and genius. Some individuals who have significant disabilities have developed extraordinary talents. Those talents may have developed because they were not able to participate in normal activities. Alternatively their disabilities may have given them unique insights into the world around them. Autism is a particularly important condition for this argument, since there is something about autism that seems to lead in a very small number of cases to the development of exceptional mental abilities. As Baron-Cohen points out, previous Nobel prize winners in mathematics may have had autism or autism spectrum disorders. However the sort of abilities exhibited by the Dustin Hoffman character in Rain man are estimated to be present in only 1 in 200 people with an autism spectrum disorder. And for every individual with autism who manifests genius there are many more who struggle with substantial impairments, and whose families undergo enormous difficulties and distress.

So the key question that would face parents contemplating an (at the present time hypothetical) pre-natal diagnosis of autism is whether the small chance of exceptional ability outweighed the much greater chance of impairment, struggle and hardship.

One of the reasons for Baron-Cohen’s article is that at the moment there is no pre-natal test for autism. It is not understood how or why autism develops. There are genes that are associated with autism, but the relationship between these genes and the development of autism is complicated. If one of these genes were found it would at most mean that an affected embryo or fetus had a somewhat elevated risk of autism. And there is some reason to think that some of those genes might also increase the risk of non-autism-associated mathematical ability.

The simple form of the Lost Genius objection fails to provide a strong argument against pre-natal testing. However our knowledge of genetics and genetic associations is still in its infancy. Some genes may be associated with both ability and disability, and so the Baron-Cohen Lost Genius objection is worth contemplating seriously. We should encourage research to try to unravel these associations. Understanding more about how genes can affect us in both positive and negative ways will help parents make the best decisions about their future children.

Links

Autism test 'could hit maths skills' BBC 7/1/2009

A prenatal test for autism would deprive the world of future geniuses Guardian science blog 7/1/09

Election 2008 and the eugenics issue Pewsitter blog

Inside the Savant Mind: Tips for Thinking from an Extraordinary Thinker Scientific American 8/1/09

Imagine a world without autism Don SH's blog April 2008

Genetics and autism: a briefing National Autism Society

OMIM – genetics of autism

Comments

[Carl Shulman]

If a genetic variation will probably result in costs for the bearer but some chance of producing large benefits for society (for a positive expected social value), then an obvious approach would be for government or private philanthropy to subsidize it.

[Adam Bland]

I would think that as genetic testing is in its infancy, if one is to decide based on the data derived from a fetal genetic test whether or not to let the fetus live or to abort the fetus, the information should be reliable and much more comprehensive than what is currently available.

Having said that, assuming that we had enough information and the proper means to interpret stated information, as to the potential for any given child one of the obvious main concerns would center around whether or not this would be a form of social engineering which would lead to a type of "master race" and if done comprehensively a form of final solution. This is a serious concern, without even dealing with religious thought. (I am an Athiest, and as such my opinions if inperpreted as religious in nature would reflect this)

In order to be ethical, I imagine, given the above that the reason to terminate a fetus (or perhaps, if we were sufficiently scientifically knowledgeable and skilled, genetically altered) would be for the benefit of the person that the fetus would become, such as if the fetus would be shown to be the beginnings of a mentally retarded, disease prone, or deformed, which would negatively affect his/her life, especially if the malady is so severe that the person would never have the opportunity to be productive in life (and thus a drain on society), I imagine that it would be acceptable to terminate or alter the fetus. This is of course assuming that abortion is in fact legal, if it is not, the conversation is largely moot unless we can do fetal genetic engineering (to the best of my knowledge we have no such capability).

Now having said that, I think there are two other concerns, first issue of the lost geniuses; I do not believe that the mere possibility that the person could perhaps be a genius despite deformity, retardation, etc. is a strong enough argument to forbid the termination or alteration of the fetus.

The other obvious concern which would really bother me goes to the "master race"/social engineering issue, which would be should the state mandate that all fetuses that have X, Y, and Z qualities be terminated? This would be a subject is difficult at best to address. Less disease, deformities, and genetic disorders would be a good thing, but I wonder how judiciously the Oliver Wendall Holmes sentiment "Three generations of idiots are enough" (referring to sterilization of third generation convicts, as they are more often than not a part of the proleteriat, and by definition multiply quickly and with little (in most, but certainly not all cases) benefit for society at large.) There is an issue of world population and the further I go with this line of thought the more complicated it becomes. I certainly do not believe that I have the answer to that issue, but I do think I understand in general terms the implications of that issue.

I hope that this response is focused enough and not to verbose.

Cheers,

-Adam Bland

[Dominic Wilkinson]

thanks Carl, Adam,

from further reports in the last few days it is clear that the pre-natal autism test discussed by Baron-Cohen and colleagues is actually a hormone test during pregnancy. Higher testosterone levels in the amniotic fluid are associated with autistic traits.

Carl - you are right, the benefits of not preventing autism may be to the wider community (for example by having a small number of talented autistic mathematicians), but the costs borne by the few. So one way of encouraging parents not to select against autism would be to provide monetary (or other) compensation.

Adam - you raise several points.
How reliable does genetic information need to be for parents to use it? (There are 2 questions here - what should parents do, and what should they be permitted to do?) Given that in many parts of the world parents may choose to have a termination of pregnancy (at least in the first half) for any reason at all, it does not seem plausible that parents would or could be prevented from having a termination on the basis of a test for autism even if that test is unreliable. On the other hand it is important for parents to be aware of the limitations of testing, and to understand what test results mean.
Neither termination of pregnancy, not genetic alteration can conceivably be in the interests of fetus. Termination of pregnancy could only be construed as being in the interests of the child if they were predicted to have a life so terrible from their own perspective (if they survived) as to be not worth living. However autism does not fit in to that category in most cases. Genetic alteration (to prevent autism) would be likely to change the identity of the individual in such a significant way that we might question whether the person so-created was identical with the original fetus. see for example
http://www.journals.uchicago.edu/doi/full/10.1086/589530

It is important when talking about voluntary pre-natal testing not to confuse this with coercive universal selection. We are talking about whether parents should be allowed to make choices about the future lives of their children. There are many reasons for thinking that mandatory state-based selection would be neither inevitable nor even likely if parents were allowed to perform prenatal testing for autism or other conditions like it.

cheers
Dom

[Aaron]

We have to ask if we would deliberately engineer such a child. It's seems wrong to bring a suffering person in to the world just so that everyone else can benefit from its genius. (I don't know how much autistic people suffer, but Marfan syndrome and temporal lobe epilepsy can't be too pleasant.)

Or imagine this sort of engineering was a routine thing. Every 1000th or so child born is engineered* to be a van Gogh or whatever. Someone eventually comes along and says we should cease this practice, but then someone replies that we'd be losing geniuses. Would this be an acceptable objection? I think not.

*('Engineer' here can mean either genetic manipulation or environmental manipulation.)

[Dominic Wilkinson]

interesting point Aaron,

you are applying a variation of the reversal test to ask whether our attitude to pre-natal testing for autism is a result of the status-quo bias. (www.nickbostrom.com/ethics/statusquo.pdf)

Let me alter your example a little.
So imagine that we live in a society in which there are no individuals with autism. Would we deliberately introduce an autism modification to fetuses, knowing that many of those fetuses would have reduced wellbeing (less than they would without autism), but that one in 200 would be an autistic savant?
We would think it wrong if such a modification were forced on prospective parents. (Imagine that it was applied at random to 20 in 10000 pregnancies). On the other hand if parents freely chose to have such a modification, it would not seem objectionable to permit them to do so. (There are some non-identity issues here, so let us assume that the autism modification is identity-altering)

(I think it is worth being clear that autism does not necessarily or even usually cause individuals to suffer directly. It does not lead to pain or distressing physical symptoms. Some of the suffering associated with autism might be result of the way that our society (of neurotypicals) responds to individuals who interact and interpret the world in non-standard ways. On the other hand I think that autism clearly affects the potential for wellbeing.)

cheers
Dom