I read this book travelling round Bulgaria, a beautiful and bucolic country, at first sight a million miles away from the high tech future it describes. The Bulgars are poor as a nation, but possess some of the finest crops and livestock in Europe. ART (assisted reproductive technology) is alive and well there, where it is hoped Bulgarian farm animals will replace the disease-ridden herds of western Europe. In connection with human reproduction, Dr. Stock has coined the term GCT – no, not the DNA codon for serine – germinal choice therapy under which he includes preimplantation genetic diagnosis, germline engineering, embryo selection, reproductive cloning, germline therapy and germline enhancement. You may find the language used distressing but, timid stranger, do not be unnerved. Dr. Stock’s thesis is that sooner rather than later we shall be able to make choices about the make-up of our offspring. The ultimate, indeed almost only, choice at present is abortion and my own limited experience of prenatal diagnosis of inborn errors of metabolism is that expectant parents almost invariably choose to abort a genetically miscreated foetus. There can surely be no rational argument against eliminating such genetic aberrations? Up to a point Lord Copper! Where a gene is so prevalent in the population, as is that for cystic fibrosis (CF), elimination of the faulty gene will actually increase the human death rate in the long run (ca. 2000y), since the advantage of being a CF carrier is also eliminated¹. But since we do not know what that advantage is, and the human condition has changed dramatically in the last 100 years, it seems a risk worth taking.

But what about other choices? Embryo selection to provide for the survival of a sibling is already here. Sex, beauty, sporting prowess, intelligence, increased lifespan, even hair loss? Ridiculous? As Dr. Stock points out the avidity with which those who can afford them take up face-lifts (and more drastic body redesign), undergo hair transplants and swallow Viagra suggests that there could be plenty wanting to avoid all these things for their offspring. And we do not go gentle into that good night. If someone offered to add another 50 healthy years to the human lifespan, would we deny that to our children? Dr. Stock deals with all this with a refreshing absence of the cant and humbug with which others have surrounded the whole field. He is also authoritative, something conspicuously absent in many of those opposing the new technology. These include the usual suspects - those who know what’s best for the rest of us and those who think man is playing God. Then there is the growing band of bioethicists, at least some of whom see the value to their evolving discipline of keeping this particular pot on the boil. Dr. Stock deals generously and at length with many of the protesters. It is hard to quarrel with his thesis that if, in the future, the technology becomes safe and widely accessible, why shouldn’t people choose, something that might strike a chord in Bulgaria, where there are high levels of infant mortality and melanoma, where smoking cigarettes is a national pastime and where choice has, for at least six hundred years of the last millennium, been denied.

This is a well-written account by someone who cares. It is informatively annotated and comprehensively referenced. Its acronyms are indexed. In St. Paul’s Cathedral, the monument to its architect says simply, if you want a monument (to him) look around you. To those who would say that GCT is a step too far, look around you. The four horsemen have their work cut out on every continent coping with the human mayhem of famine, pestilence, war and death. Our environment is sullied as never before. It is curious that in such a craven world, there are some who find the idea of bettering our heritage beyond the pale. Mankind is hardly perfect and needs to think long and hard before passing up any opportunities for self-improvement.

John Marsden