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 JournaloLawandheBiosciences,1–35doi:10.1093/jlb/lsw039OriginalAricle
Posnaalhumangeneicenhancemenandhe
 parens pariae
docrine
Sivanamir
GeneicPolicyandBioehicsUni,TeGernerInsiueorEpidemiologyandHealhPolicyResearch,Rama-Gan,IsraelCorrespondingauhor.E-mail:sivan.amir@mail.huji.ac.il
 ABSTRACT
Tispaperexploresheroleohesae,acingas
 parenspariae
 ,wihrespecoheuure-lookingechnologyoposnaalhumangeneicenhancemen(PoGE),appliedominorsbyheirparensorhesae.Considering
 posna-al
raherhan
 prenaal
geneicenhancemen(PGE)allowsusoexplorehepuaiveobligaionsohesaewihrespeco
acual
persons,inconrasouure persons he subjecs o speculaive invesigaion in he radiionally sudied case o PGE. Par I eaures PoGE, mosly by analogy o PGE andoher (non-geneic) posnaal enhancemens. Par II examines he naureand scope o he
 parens pariae
 docrine, disinguishing beween is
 proec-ive
 and
 subsiuive
 aces. I conclude, drawing on conemporary legal con-srucions,ha:
a)
hesae’sinererenceinparenalgeneicenhancemen(GE) discreion, under is proecive role, should generally be minimal, re-served o exreme cases where grave harm o he child has been caused oris reasonably oreseeable; and
 b)
 since we canno readily 󿬁nd parens obli-gaed o geneically enhance heir offspring, he sae as
 parens pariae
 , un-derissubsiuiverole,willberespecivelyexempromsuchduyowardssae-dependen-children,saveorcerainGEsconsidereda
sinequanon
ne-cessiy,equallyobligaingparensandsaeoprovidechildrenwih.
KEYWORDS:
 geneic enhancemen, neuraliy, parens pariae, posnaal,prenaal,sae
INTRODUCTION 
Tis paper is abou he uure echnology o posnaal human geneic enhance-men (PoGE), namely 
 in vivo
 somaic cell geneic modi󿬁caion o 
 already exising 
C
 Te Auhor 2016. Published by Oxord Universiy Press on behal o Duke Universiy School o Law,Harvard Law School, Oxord Universiy Press, and Sanord Law School. Tis is an Open Access ari-cle disribued under he erms o he Creaive Commons Atribuion-NonCommercial-NoDerivs licence(htp://creaivecommons.org/licenses/by-nc-nd/4.0/),whichpermisnon-commercialreproducionanddisri- buion o he work, in any medium, provided he original work is no alered or ransormed in any way, and haheworkisproperlycied.Forcommercialre-use,pleaseconac journals.permissions@oup.com
 
Journal of Law and the Biosciences Advance Access published August 23, 2016
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2
 
 Posnaal human geneic enhancemen and he
 parenspariae
docrine
individuals, and he prospecive challenges ha he applicaion o he echnology ominorswillpresenosaeinervenionviahe
 parens pariae
docrine.From our presen perspecive, human geneic enhancemen (HGE) hrough genemodi󿬁caion is a puaive uurisic prospec. I is a highly conenious, value-vexed,provocaive echnology ha has been occupying he minds o scholars across variousdisciplines or he pas several decades. As opposed o he elaboraed heoreical dis-cussion relaing predominanly o
 prenaal
 geneic enhancemen (PGE), is
 posnaal
counerparhasbeenlargelyoverlookedhusarinheheaedacademicdiscoursesur-roundinghumanenhancemen.Presumably,suchneglecmighberaionalizedbyhehighly speculaive naure o PoGE, and atribued
 iner alia
 o he skepic one arisingrom he curren scieni󿬁c sae-o-affairs regarding he uure abiliy o perorm effec-ive posnaal geneic modi󿬁caions. Noneheless, hese purpored reasons need nodiscourage us rom recognizing ha such echnology may emerge in he uure andhereoremerissomehoughpresenly. Aclosereadingohelierauresuggesshaiwouldbeincorrecoclaimhahescholarly discourse has hus ar ignored PoGE alogeher.
1
However, while posnaalenhancemenechnologiessuchasneuroenhancemen(discussedbelow)arebeingde-liberaed,someoheparicularconsideraionsrelaingoPoGEseemobeloswihinhegeneralenhancemendebae,andoherconsideraions,suchasheroleohesae(beyond regulaion
2
) wih regard o such enhancemen—are generally disregarded.So,alhoughPoGEhasisuniqueeauresmeriingatenion(describedbelow),ihasno ye been discussed disincively rom, or independenly o, prenaal enhancemen, whichypically(alhoughnoexclusively 
3
)appliesogeneicinervenions. Where he posnaal phase o HGE is given independen sanding, various issuesmaycropuphaeiherderiveinparicularromsuchaseting,egquesionsregardingauonomy, righs, and ideniy o posnaally geneically enhanced individuals, or—alhough also applying o prenaal enhancemen—are valued differenly posnaally.Saeinervenionisexaclyonesuchexample.In his paper, I ocus my atenion on he role o he sae wih respec o PoGE. Inparicular, I examine he applicaion o he
 parens pariae
 docrine o PoGE o minors,disinguishing beween wo differen aces o he sae’s role as
 parens pariae
: ‘pro-ecive’ and ‘subsiuive’ (ie
 in lieu
 o paren/s). Wih regard o he proecive ace, IatempoideniyPoGE-speci󿬁c(harm-relaed)circumsanceshamighinvokehedocrine,inorderodeerminebohhegroundandhehresholdorsaeinervenioninsuchcases.Wihregardohesubsiuiveace,Iconsiderwheherhesaeisduy- bound, wihin is surrogae role, o geneically enhance wha I erm ‘sae-dependen
1
Seeorinsance,GlennCohenwhodiscussessomeimplicaionsoposnaal(biologicalandnon-biological)enhancemens,inI.GlennCohen,
Wha(ianyhing)isWrongwihHumanEnhancemen?Wha(ianyhing)isRighwihI?
49
ULSA 
L.
EV 
.645,648–679n.86(2014).SeealsoJohnRoberson,whooucheslighlyonhesubjecinJohnA.Roberson,
 Procreaive Libery in he Era o Genomics
29
M
.J.L.&M
ED
.439(2003).
2
Foracomprehensiveanalysisohesae’sregulaoryopionswihrespecoenhancemen,seeCohen,
supra
noe1,a652–55.
3
SeeNickBosrom&AndersSandberg,
CogniiveEnhancemen:Mehods,Ehics,RegulaoryChallenges
 ,15S
CI
.E
NG
. E
HICS
 311, 320 (2009), htp://www.nickbosrom.com/cogniive.pd  [reerring o prenaal enhance-men hrough supplemenaion o long-chained aty acids o he maernal die during lae pregnancy (andoranaddiionalperiod,posparum)].
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 Posnaal human geneic enhancemen and he
 parenspariae
docrine
 
3
children’ (SDC), who have no (ye) been enhanced in his ashion by heir nauralparens.Inmyanalysis,IrequenlyreeroPGE(solely)orpurposesoanalogy.Suchanal-ogy serves o delineae PoGE, and a he same ime accenuaes various eaures anddilemmas o PGE. While hese wo echnologies share some common characerisics,hey widely differ in several crucial respecs; mos signi󿬁can o all is he moral sauso he candidae or enhancemen. My analysis demonsraes, among oher hings, heimplicaionsohesedifferencesorheapplicaionohe
 parenspariae
docrineoourseting. Aheouseomypaper,Iwouldlikeomakeheollowingbasicpresupposiions.(i) HGEwillbepossibleinheorhcominguure;(ii) Te echnology will prove o be sufficienly effecive and sae and, conse-quenly,willbeprevalenlyimplemened;and(iii) PoGE echnology will be preceded by PGE echnology. Hence, wih heinroducion o he echnology o posnaal enhancemen, boh echnolo-gieswillbeavailable—usuallymakingheuseoeiheraninormedchoice beween wo opions. (Acually, here is a hird opion, which I erm he‘nauralchoice’,namely 
no 
oenhance.)Bu beore we begin, in order o rame he debae, an inroducory noe is war-raned:orpurposesoouranalysis,enhancemenshallbenarrowlyconsruedas‘aar-geedmanipulaionoceraineauresoone’sgeneicconsiuion,aimedaimprovingparicularraisandapiudesor
 purelyelecive
reasons’;hais,beingamelioraivewih-ou direcly inending o rea a geneic condiion or correc a geneic 󿬂aw. Also, hispaper will no consider sel-enhancemen o aduls, or enhancemen o menally in-capaciaed individuals, ocusing sricly on he enhancemen o children by heir par-ens/guardiansorhesae.Tepaperisdividedinowopars:ParIisdedicaedoheinroducionoPoGE.I offers some comparaive examples o oher (non-geneic) posnaal enhancemens,as well as a disincion beween PoGE and PGE relevan eaures. Par II concerns hesae’s role as
 parens pariae
 in he conex o PoGE. Is 󿬁rs secion addresses in brie (poliical and moral) sae neuraliy, as a hreshold condiion or sae inervenion inPoGEo children. Following he conclusions o his secion(rejecinga policy opureneuraliy or our seting), he second secion will analyse he sae’s obligaions o ac-ivelyinerveneosaeguardheineressochildrenunderhe
 parenspariae
docrine,in he speci󿬁c conex o PoGE, under wo differen aces o he sae’s role as
 parens pariae
:‘proecive’and‘subsiuive’,aswillbedisinguishedurherbelow.
I. POSTNATAL HUMAN GENETIC ENHANCEMENT
LeusimagineanerawherePoGEisrouinelypracicedandisconsideredalegiimaeparenal shaping ool o one’s children. Tis (presenly) science-󿬁cionesque scenariomigh very well become a realiy in he no-so-disan uure. Te inelucable prospec-ive realiy seems o be ha we are a he hreshold (which, in scieni󿬁c erms, wouldreadassomewherebeweenaewyearsandaewdecades)oPoGEbecomingavailableohepublic,wihmanyimporanaspecsyeoconsider.
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