The Case Against Perfection: Ethics in the Age of Genetic Engineering is a 2007 nonfiction book by American political philosopher Michael J. Sandel. Sandel initially wrote a short essay of the same name that was published in The Atlantic Monthly in 2004. He then expanded his arguments for the book version. Although Sandel is, by his own admission, not a bioethicist, he has had a long career in political and ethical philosophy wherein he has tackled some of the most difficult questions facing the modern world. The Case Against Perfection explores the rise of genetic engineering in sports, parenting, healthcare, and stem cell research. Sandel asks difficult questions about what it means to be human and whether bioengineering robs people of something essential.

This guide uses the 2007 Harvard University Press edition of the book.

Content Warning: This text includes discussion of eugenics, ableism, racism, abortion, and the Holocaust.

Summary

Sandel opens with an anecdote about a Deaf couple who chose a Deaf sperm donor because they wanted their child to be like them and able to fully participate in Deaf culture. Many people objected to this choice, even though it is fairly common for couples to seek sperm or egg donors who are athletic, tall, and academically successful. Sandel questions whether the cases are different and whether one is more acceptable than the other. Sandel then tells the story of a woman who paid a company to successfully clone her cat, raising questions about the ethics of cloning animals and whether this practice will inevitably lead to the cloning of humans. Sandel explores why cloning makes people uncomfortable. He considers the belief that genetic engineering robs children of autonomy, but he notes that children do not choose their genetic makeup in the absence of genetic engineering. Some people might choose to genetically engineer themselves in adulthood, which does not entail any loss of autonomy. To get at the heart of the issue, Sandel wants to examine other arguments.

Sandel outlines four ways that people may use genetic engineering in the future. The first is for muscle development, which could help elderly people maintain strength and muscle tone as they age. Such enhancements could also make athletes extraordinarily strong, even beyond what steroids are capable of. Similar technologies could improve people’s memories, potentially treating dementia and Alzheimer’s or helping people cram for tests. Sandel imagines a world where people are split into the wealthy enhanced and the poor unenhanced. Altering one’s height is already possible with the help of growth hormone injections in adolescence, though this treatment is currently reserved for children in the lowest height percentiles. In the future, Sandel imagines that this and similar practices might become more widespread. The final example Sandel gives is prenatal sex selection, a process that already exists and carries complex implications. 

In the second chapter, Sandel examines the impact of bioengineering on athletics. If an athlete can compete at a high level because of genetic enhancements, people could be disinclined to admire the athlete’s natural talents or efforts. However, athletes already go to extreme lengths with training and diet to alter their bodies and abilities; genetic alterations could come to be viewed as simply one more expression of an athlete’s commitment to the game. Sandel suggests that if genetic enhancements are permitted, they could ruin the sanctity of a game by transforming it into a spectacle.

Sandel shifts to an exploration of “designer babies”; children whose genetic makeup is selected by their parents before their birth. In the absence of genetic engineering, parents have limited control over their children’s genetic makeup, and parenthood thus requires an “openness to the unbidden” (45) that Sandel views as fundamental to the parent-child relationship. Genetic alterations give parents hubristic control over their children’s lives. On the other side of the argument, some people believe that parents are morally obligated to enhance their children to provide them with every advantage. Sandel compares parents who design their babies to parents who overschedule their children’s extracurriculars. These similarities do not make genetic engineering acceptable; they make helicopter parenting unacceptable. In both cases, parents see their children as tools to be manipulated to further their own interests instead of seeing them as complete individuals with their own agency, traits, skills, and desires.

Sandel draws an equivalence between genetic engineering and eugenics. Initially developed in the late 1800s, eugenics was a movement that aimed to prevent those deemed “unfit” from reproducing, in the hopes of creating a healthier, more capable human race. The movement became very popular in the United States and Nazi Germany. Many people in the United States and other countries were forcibly sterilized because they were deemed unfit to procreate. After World War II (WWII), the American eugenics movement declined when it became clear that eugenics had been a major contributor to Adolf Hitler’s campaign of genocide in the Holocaust. Sandel questions whether eugenics could be ethical if it were non-coercive, citing an initiative in Singapore where poor women received financial compensation if they elected to undergo sterilization. Sandel argues that the financial incentives function as a form of coercion, and that such pressures—resulting from class inequality—are an inevitable part of any eugenic program. Contemporary sperm and egg donation may have eugenic overtones: People can select donors with certain appearances, academic backgrounds, and other desirable traits.

Genetic engineering is wrong in Sandel’s eyes because it prioritizes control and dominion over others and oneself instead of being open to the uniqueness that people naturally possess. If people can choose their children’s genetics, parents who have children with genetic disorders like Down syndrome could be judged for not interfering in their children’s health. Genetic alterations could also erode solidarity among people, as some would be assured of good health and longevity. People, Sandel believes, would not benefit from a world in which such control was within anyone’s grasp.

In the Epilogue, Sandel discusses the ethics of stem cell research. This field could lead to cures for many illnesses, but it requires the destruction of zygotes. Some people who object to abortion consider these zygotes to be human beings and thus argue that using and destroying them in research initiatives is wrong. Sandel points out that even those who claim to believe this, like George W. Bush, do not typically campaign to end all stem cell research and in vitro fertilization (IVF), both of which result in the creation and destruction of zygotes. Instead, they are more likely to campaign for restrictions on which zygotes can be used and when. If they really believed that these processes were equivalent to infanticide, Sandel argues, they would take a more militant approach. The fact that they do not usually do so suggests that they are aware that zygotes and babies are not the same thing. Sandel suggests that while zygotes are not humans, they are valuable and should be honored—however, he argues that honoring something does not necessarily mean according it the rights of a human being.