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Received: 31 August 2017    Revised: 12 June 2018    Accepted: 31 July 2018

DOI: 10.1111/bioe.12519

ORIGINAL ARTICLE

Designing humans: A human rights approach

S. Matthew Liao

Center for Bioethics, New York University,

New York, USA Abstract
Advances in genomic technologies such as CRISPR‐Cas9, mitochondrial replacement
Correspondence
New York University – Center for Bioethics, techniques, and in vitro gametogenesis may soon give us more precise and efficient
719 Broadway Floor 12 New York, NY tools to have children with certain traits such as beauty, intelligence, and athleticism.
10003.
Email: matthew.liao@nyu.edu In this paper, I propose a new approach to the ethics of reproductive genetic engi‐
neering, a human rights approach. This approach relies on two claims that have cer‐
tain, independent plausibility: (a) human beings have equal moral status, and (b)
human beings have human rights to the fundamental conditions for pursuing a good
life. I first argue that the human rights approach gives us a lower bound of when re‐
productive genetic engineering would be permissible. I then compare this approach
with other approaches such as the libertarian, perfectionist, and life worth living ap‐
proaches. Against these approaches, I argue that the human rights approach offers a
novel, and more plausible, way of assessing the ethics of reproductive genetic
engineering.

KEYWORDS
CRISPR, designer babies, gene editing, gene therapy, genetic enhancement, reproductive
genetic engineering

1 | I NTRO D U C TI O N
Most people who want to have children would like them to be
healthy, smart, creative, beautiful, athletic. Advances in genomic
technologies may soon give us more precise and efficient tools to
have children with these and other traits. Indeed, a powerful new
gene‐editing technology called CRISPR‐Cas9 has made it easy,
cheap, and fast to delete certain genes and to insert new ones.1
CRISPR, which stands for clustered regularly interspaced short pal‐
indromic repeat, has two components. The first consists of an RNA
guide that can be used to find a specific piece of DNA to be modified.
The second is a set of enzymes, Cas9 (CRISPR‐associated proteins),
whose function is to cut the DNA as located by the RNA guide.
Together, CRISPR‐Cas9 enables the modification or removal of spe‐
‘search and replace’ function in a word processor. 2 In addition, scien‐
tists have also developed mitochondrial replacement techniques
(MRTs), or ‘three‐parent’ IVFs as they are sometimes called in the
popular media,3 which can enable women with mitochondrial dis‐
eases to have children who are genetically related to them but with‐
out such diseases, by transferring the nuclear genome of the
mother’s egg or zygote into an enucleated egg or zygote with healthy
mitochondria.4 Moreover, in vitro gametogenesis (IVG), which in‐
volves the artificial construction of gametes using adult body tissue
2
Specter, M. (2015, Nov 16). The gene hackers. The New Yorker. Available at: http://www.
newyorker.com/magazine/2015/11/16/the‐gene‐hackers [Accessed 28 May 2016]
3
Tingley, K. (2014, June 27). The brave new world of three‐parent IVF. The New York Times
Magazine. Available at: http://www.nytimes.com/2014/06/29/magazine/the‐brave‐new‐
world‐of‐three‐parent‐ivf.html [Accessed 28 May 2016]

cific DNA sequences, leading people to liken this system to the 4

1
Ran, F. A., Hsu, P. D., Wright, J., Agarwala, V., Scott, D. A., & Zhang, F. (2013). Genome
engineering using the CRISPR‐Cas9 system. Nature Protocols, 8, 2281–2308; Doudna, J.
A., & Charpentier, E. (2014). The new frontier of genome engineering with CRISPR‐Cas9.
Science, 346(6213), 1258096.
Tachibana, M., Sparman, M., Sritanaudomchai, H., Ma, H., Clepper, L., Woodward, J., …
Mitalipov, S. (2009). Mitochondrial gene replacement in primate offspring and embryonic
stem cells. Nature, 461, 367–372; Craven, L., Tuppen, H. A., Greggains, G. D., Harbottle, S.
J., Murphy, J. L., Cree, L. M., … Turnbull, D. M. (2010). Pronuclear transfer in human em‐
bryos to prevent transmission of mitochondrial DNA disease. Nature, 465: 82–85. For a
discussion of some of the philosophical issues surrounding mitochondrial replacement
techniques, see, for example, Liao, S. M. (2017). Do mitochondrial replacement techniques
affect qualitative or numerical identity? Bioethics, 31, 20–26.

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© 2018 John Wiley & Sons Ltd Bioethics. 2019;33:98–104.
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such as skin cells, has been shown to be possible in mice.5 Although
IVG is still in an experimental phase, it promises to obviate the need
for gamete donation, leading to an unlimited supply of embryos. All
these novel genomic techniques suggest that the possibility of creat‐
ing humans with very specific traits may not be far off.
The prospect of being able to shape and determine the charac‐
teristics of human offspring raises the question of whether it is mor‐
ally permissible to do so. The ethics of human reproductive genetic
engineering, as this area of research is sometimes called, has been
debated extensively, both in public and by academics, and there is a
wide spectrum of views, ranging from those who believe that it is not
morally permissible to engage in such activities, to those who think
that it is morally required to do so.6 In this paper, I shall not attempt
to discuss all the views that have been canvassed in the literature.
Instead, my aim is to explore a new approach to reproductive genetic
engineering, what might be called a human rights approach. This ap‐
proach relies on two claims that have certain, independent plausibil‐
7
ity and that I have defended in greater detail elsewhere:
1. All human beings have equal moral status; in particular, they
are all rightholders.
2. Human beings have human rights to the fundamental conditions
for pursuing a good life.
In Section 2, I offer some explication of, and motivation for, these
two claims. From these two claims, I then develop, in Section 3, the
human rights approach, which I argue offers a number of helpful cri‐
teria for when human reproductive genetic engineering would be im‐
permissible. In Section 4, I defend the human rights approach further
by comparing it with some other notable approaches to reproductive
genetic engineering.
2 | H U M A N M O R A L S TAT U S A N D H U M A N
R I G HT S
There is an intuitive thought that all human beings have equal
moral status, in particular, that they are all rightholders. Indeed,
the Universal Declaration of Human Rights explicitly states that
‘all human beings are born free and equal in dignity and rights’. 8
Likewise, some philosophers have argued that the term ‘human
5
Nayernia, K., Nolte, J., Michelmann, H. W., Lee, J. H., Rathsack, K., Drusenheimer, N., …
Engel, W. (2006). In vitro‐differentiated embryonic stem cells give rise to male gametes
that can generate offspring mice. Developmental Cell, 11, 125–132.
6 Moore (Ed.), Philosophy as a humanistic discipline (pp. 135–154). Princeton, NJ: Princeton
For an overview of various positions, see Liao, S. M. (2008). Selecting children: The ethics
of reproductive genetic engineering. Philosophy Compass, 3, 1–19.
7 Feinberg, J., & Levenbook, B B. (1993). Abortion. In T. Regan (Ed.), Matters of life and
Liao, S. M. (2010). The basis of human moral status. Journal of Moral Philosophy, 7, 159–
179.; Liao, S. M. (2015). Human rights as fundamental conditions for a good life. In R.
Cruft, S. M. Liao, & M. Renzo (Eds.), Philosophical foundations of human rights (pp. 79–100).
Oxford, UK: Oxford University Press.
8 12
The United Nations. (1948). Universal Declaration of Human Rights.
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      99
being’ plays an important moral role by itself,9 which could also
serve to explain why all human beings are rightholders. At the
same time, other philosophers believe that when we assess who
can be a rightholder we should meet the species neutrality require‐
ment.10 The species neutrality requirement says that an adequate
account of rightholding should provide some criterion for right‐
holding that in principle does not exclude any species and where
the criterion can be assessed through some objective, empirical
method. It might be thought that if the species neutrality require‐
ment were valid, it would not be possible to show all human beings
are rightholders. The reason is that a number of the attributes that
philosophers have considered and proposed, such as actual sen‐
tience and actual agency, do not apply to all human beings.11
Elsewhere I have argued that this need not be the case.12 In partic‐
ular, I have proposed that a sufficient condition for being a right‐
holder is having the genetic (or, more generally, the physical) basis
for moral agency, and that all human beings have the genetic basis
for moral agency.
By ‘genetic basis for moral agency’, I mean the set of physical
codes that generate moral agency. In human beings, this set of
codes is located in their genome. We know this because a lot of
complexity is needed as the developmental basis for a complex
adaptive phenotype like moral agency, and the genome contains
a significant proportion of this complexity. At present, we do not
know exactly which set of genes is necessary and sufficient for
the genetic basis for moral agency. But we can talk about a ge‐
netic basis for moral agency as long as there are genes that defi‐
nitely play no role in forming the genetic basis for moral agency.
For example, the genes for my toe nails or a gene whose expres‐
sion serves only to produce pigment in the eyes probably play no
role in the formation of the genetic basis for moral agency. Also,
to have the genetic basis for moral agency, the genes that make
up that moral agency must be activated and be coordinating with
each other in an appropriate way. To illustrate the point about co‐
ordination, consider the following: suppose there is a book con‐
taining many random words, which if put together in the right
way, would result in a Shakespeare play. That book would not be a
Shakespeare play just because it contains the correct words; those
words must be organized in the right way.
There are good reasons to believe that all human beings have
the genetic basis for moral agency. Indeed, we know that all
normal functioning/developing human beings have this genetic
basis because they exercise moral agency or will exercise it; that
most comatose human beings have this genetic basis because
they have exercised moral agency; and that those with learning
9
See, for example, Diamond, C. (1991). The importance of being human. Royal Institute of
Philosophy Supplement, 29, 35–62.; Williams, B. (2008). The human prejudice. In A. W.
University Press.
10
death (3rd ed.) (pp. 195–234). New York, NY: McGraw‐Hill.
11
Singer, P. (1993). Practical ethics (2nd ed.). Cambridge, UK: Cambridge University Press;
Griffin, J. (2008). On human rights. Oxford, UK: Oxford University Press.
Liao (2010), op. cit. note 7.
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100       LIAO
difficulties, such as children with Down’s syndrome, typically ex‐
hibit some moral agency, which suggests that they also have this
genetic basis. Hence, even if the species neutrality requirement
were valid, there may be ways to show that all human beings are
rightholders.
Suppose that this is correct. What human rights do human beings
have? In my work, I have argued that human beings have human
rights to the fundamental conditions for pursuing a good life, where
a good life is one spent in pursuing certain valuable, basic activi‐
13
ties. ‘Basic’ activities are activities that are important to a human
being qua human being’s life as a whole. Sunbathing, for example, is
an activity, but is not a basic activity, because a human being qua
human being’s life as a whole is not affected if a human being does
not go sunbathing. In addition, activities that are very important to
an individual human being’s life as a whole may nevertheless not be
basic activities, because these activities may not be important to
human beings qua human beings’ life as a whole. For instance, being
a professional philosopher is very important to my life as a whole.
But being a professional philosopher is not a basic activity because it
is not an activity that is important to human beings qua human beings’
life as a whole. Finally, basic activities are ones that if a human life did
not involve the pursuit of any of them, then that life could not be a
good life. An important implication of this point is that a human
being can have a good life by pursuing just some, and not all, of the
basic activities. Some of the basic activities are as follows: deep per‐
sonal relationships with, for instance, one’s partner, friends, parents,
children; knowledge of, for example, the workings of the world, of
oneself, of others; active pleasures such as creative work and play;
and passive pleasures such as appreciating beauty.
From these basic activities, we can derive the contents of the
fundamental conditions for pursuing a good life. The fundamental
conditions are various goods, capacities, and options that human
beings qua human beings need whatever else they qua individuals
might need in order to pursue the basic activities. For example, the
fundamental goods are resources that human beings qua human be‐
ings need in order to sustain themselves corporeally, such as food,
water and air. The fundamental capacities are powers and abilities
that human beings qua human beings require whatever else they
qua individuals might require in order to pursue the basic activities.
These capacities include the capacity to think, to be motivated by
facts, to know, to choose an act freely (liberty), to appreciate the
worth of something, to develop interpersonal relationships, and to
have control of the direction of one’s life (autonomy). The funda‐
mental options are those social forms and institutions that human
13
Liao (2015), op. cit. note 7. This approach assumes that human rights are those that we
have simply in virtue of being human, and therefore belongs to what might be called a
naturalistic conception of human rights. In recent years, a new and purportedly alternative
conception of human rights, the so‐called political conception of human rights, has become
increasingly popular. According to the political conception, the distinctive nature of
human rights is to be understood in light of their role or function in modern international
political practice. Elsewhere I have argued that the theoretical distance between the nat‐
uralistic conception and the political conception is not as great as it has been made out to
be (Liao, S. M., & Etinson, A. (2012). Political and naturalistic conceptions of human rights:
A false polemic? Journal of Moral Philosophy, 9, 327–352.)
beings qua human beings require if they are to be able to exercise
their essential capacities to engage in the basic activities. Some of
these include the option to have social interaction, to acquire further
knowledge, to evaluate and appreciate things, and to determine the
direction of one’s life.
Having the fundamental conditions for pursuing a good life of
course cannot guarantee that an individual has a good life; no condi‐
tion can guarantee this. Rather, these goods, capacities, and options
enable human beings to pursue the basic activities. Also, many of the
fundamental conditions are all‐purpose conditions, in that they are
needed whatever basic activity one aims to pursue. For example, all
human beings need food, water, the capacity to think, and the capac‐
ity to determine the direction of their lives, whatever basic activity
they aim to pursue. Also, it is possible that some fundamental condi‐
tions are needed just for pursuing particular basic activities. For in‐
stance, the capacity to develop deep personal relationships may be
needed only if one aims to pursue deep personal relationships. If so,
we can leave it open whether a particular individual will make use of
all the fundamental conditions when pursuing a particular kind of
good life. Still, as I shall shortly argue, an individual should have all
the fundamental conditions, because having all the fundamental
conditions would enable an individual to pursue any basic activity in
a good life. This could become important if, for example, an individ‐
ual changes his/her mind about pursuing a particular kind of good
life.14
In my view, these fundamental conditions for pursuing a good
life ground human rights because having these conditions is of fun‐
damental importance to human beings, and because rights can offer
powerful protection to those who possess them. The former is true,
because if anything is of fundamental importance to human beings,
then pursuing a characteristically good human life is. It seems clear
that if we attach a certain importance to an end, we must attach
14
In other words, while I am a disjunctivist about basic activities, i.e., I do not think that a
person has to pursue all the basic activities in order to have a good life, I am a conjunctivist
about fundamental conditions, i.e., I think that a person has a right to all the fundamental
conditions. Also, my notion of fundamental conditions might prompt some to think of Martha
Nussbaum’s central capabilities approach; Nussbaum, M. C. (2011). Creating capabilities: The
human development approach. Cambridge: Belknap Press; In Liao (2015), op. cit. note 7, I ex‐
plain in greater detail how the two views differ. All too briefly, the hallmark of Nussbaum’s
approach is her emphasis on our opportunities to choose to do certain things, i.e., capabili‐
ties, rather than on what we actually choose to do, i.e., functionings. However, many human
rights cannot be adequately explained in terms of capabilities. For example, in the Universal
Declaration of Human Rights (The United Nations, op. cit. note 8), there are a number of
human rights that protect our moral status as persons, i.e., status rights, such as the right to
recognition everywhere as a person before the law (Article 6); the right to equal protection
before the law (Article 7); the right against arbitrary arrest, detention or exile (Article 9); the
right to a fair and public hearing (Article 10); the right to be presumed innocent until proven
guilty (Article 11). Nussbaum’s approach seems to imply that one can sometimes choose not
to exercise these rights, since capabilities are concerned with our real opportunities to
choose. But it does not seem that one can sometimes choose whether or not to exercise
these rights. For instance, it does not seem that one can sometimes choose not to be recog‐
nized everywhere as a person before the law; choose not to have equal protection before the
law; choose to be arrested arbitrarily; choose to have an unfair hearing; and choose to be
presumed guilty. Hence, capabilities do not seem particularly well suited to explain these
rights. In contrast, my approach can explain status rights. When we pursue the basic activi‐
ties, conflicts with others are bound to arise. If and when such conflicts arise, we need guar‐
antees that we would be treated fairly and equally. Fair trial, presumption of innocence, equal
protection before the law, not being arrested arbitrarily, and so on, serve to ensure that we
would be treated fairly and equally. As such, they are things that human beings qua human
beings need whatever they qua individuals might need in order to pursue the basic activities.
As such, the approach I advocate can explain why there are these human rights.
LIAO
this importance to the (essential) means to this end. For example, if
we care about making a cake, then we must care about the (essen‐
tial) ingredients that would enter into making this cake such as flour,
butter, sugar, eggs, and raising agents. Losing any of these essential
ingredients is tantamount to losing the cake itself. Given this, since
pursuing a good life is of fundamental importance to human beings,
having the fundamental conditions for pursuing a good life must also
be of fundamental importance to human beings.
That rights can offer powerful normative protection to those
who possess them is well known.15 By their nature, rights secure the
interests of the rightholders by requiring others, the duty bearers, to
perform certain services for the rightholders or not to interfere with
the rightholders’ pursuit of their essential interests. In addition, at
least on certain structural accounts of rights, rights typically prevent
the rightholders’ interests that ground rights from being part of a
first‐order utilitarian calculus. This means that if a rightholder has a
right to something, then typically no non‐right considerations can
16
override the rightholder’s right to that thing. Finally, as some writ‐
ers have pointed out, because the rightholders are entitled to these
services as a matter of rights, this means that the rightholders can
simply expect the services without requesting them.17
Given the strong protection that rights can offer for the right‐
holders, and given the importance of having these fundamental
conditions to human beings, it seems reasonable that human beings
have rights to these fundamental conditions. If this is correct, this
provides us with an argument for the idea that human beings have
human rights to the fundamental conditions for pursuing a good life.
3 | A H U M A N R I G HT S A PPROAC H
TO H U M A N R E PRO D U C TI V E G E N E TI C
ENGINEERING
Drawing on these two claims, I shall now develop a human rights
approach to human reproductive genetic engineering. To do this, it is
helpful first to distinguish between modification, on the one hand,
and selection/creation on the other hand. Modification involves alter‐
ing certain genes in an existing embryo or gamete in order to obtain
the desired genetic traits. Selection involves selecting certain gam‐
etes or embryos that have the desired genetic traits. In the future, it
may be possible to create entire gametes or embryos for
18
selection.
15
Rights could also have non‐instrumental importance in addition to having instrumental
importance.
16
Dworkin, R. (1977). Taking rights seriously. London, UK: Duckworth.
17
Feinberg, J. (1970). The nature and value of rights. In E. L. Bandman & B. Bandman (Eds.),
Bioethics and human rights: A reader for health professionals (pp. 19–31). Boston, MA: Little,
Brown.
18
A number of scientists have begun exploring the possibility of creating a synthetic
human genome, that is, using chemicals to manufacture all the DNA in human chromo‐
somes. Swetlitz, I. (2016, Oct 28). Synthetic human genome project releases its draft time‐
line. STAT. Available from: https://www.statnews.com/2016/10/28/synthetic‐human‐ge‐
nome‐timeline/ [Accessed 11 June 2017]
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The distinction between modification and selection/creation is
normatively important because, in the case of modification, the re‐
sulting being could later complain that she was harmed and that she
could have been different if modification had not taken place.
Modification therefore raises issues of narrative identity and per‐
sonal autonomy. In the case of selection/creation, the resulting
being could not later complain that she was harmed and that she
could have been otherwise, because she would not have existed if a
different being had been selected/created.19
Of the different kinds of fundamental conditions, the fundamen‐
tal capacities are particularly relevant for the ethics of reproductive
genetic engineering. Here is a non‐exhaustive (and not uncontro‐
versial) list of the fundamental capacities: the capacity to act, which
includes the five senses (sight, hearing, smell, touch, and taste);
movement; reproductive capacity; the capacity to think; the capacity
to be motivated and to have emotions; the capacity to interact with
others and with one’s environment; and the capacity to be moral.
Pulling these discussions together, we can derive at least four
claims for the ethics of reproductive genetic engineering.
• Claim 1: Other things being equal, it is not permissible deliberately
to create an offspring who will not have all the fundamental capac-
ities. For example, given a choice between creating an offspring
who will have the fundamental capacities and creating another off‐
spring who will not have the fundamental capacities, we should
choose the former rather than the latter. For instance, suppose that
we have a choice between creating a healthy offspring and creating
another offspring who will develop Tay–Sachs disease. The human
rights approach says that we should choose to do the former rather
than the latter. Or, to take a more controversial case, suppose that
the capacity to hear is a fundamental capacity. After all, so many
basic human activities such as listening to beautiful compositions by
Beethoven, a child’s laughter, or the chirping sounds of morning
birds depend on our being able to hear such that an argument can
be made that this capacity is an all‐purpose, fundamental capac‐
ity.20 If so, suppose that we have a choice between creating an off‐
spring who will have all the fundamental capacities and creating
another offspring who will be deaf. The human rights approach
would say that we should choose the former rather than the latter.
• Claim 2: Suppose that an offspring who lacks some of the fun-
damental capacities is already created. It can be permissible to
bring this offspring to term. Why is this? For one thing, on the
human rights approach, the offspring is a rightholder and there‐
fore has the same moral status as other human beings. Also, the
offspring may still have enough of other kinds of fundamental
capacities to be able to pursue some of the basic activities in
a good life. Recall that one may not need all the fundamental
conditions to pursue some of the basic activities. To illustrate,
suppose that an offspring who will be deaf is already created and
19
This is the so‐called non‐identity problem. Parfit, D. (1984). Reasons and persons. Oxford,
UK: Oxford University Press.
20
I am not wedded to this example. So if a reader feels that hearing is not a fundamental
capacity, we can substitute hearing with some other example, e.g., the capacity to think.
102       |
suppose that hearing is a fundamental capacity. On the human
rights approach, it can be permissible to select and bring this off‐
spring to term. The reason is that this offspring is a rightholder
and will have enough of other kinds of fundamental capacities
to be able to pursue some of the basic activities. Indeed, the
resulting offspring will still have the capacity to have emotions,
be able to move freely, be able to think, and so on. Hence, the
human rights approach implies that the claim that ‘it is not per‐
missible deliberately to create an offspring who will not have all
the fundamental capacities’ and the claim that ‘if an offspring
who lacks some of the fundamental capacities is already created,
it can be permissible to select and bring the offspring to term’ are
compatible.
• Claim 3: Other things being equal, it is not permissible to cause
an existing offspring to lack some of the fundamental capacities.
Again, suppose that hearing is a fundamental capacity. It would
not be permissible, for example, to use CRISPR to cause an off‐
spring to lack hearing genes. The reason is that human beings
have human rights to the fundamental conditions for pursuing a
good life. Given this, there is a duty not to cause a human being
to lack fundamental conditions. Since hearing is a fundamental
capacity, it follows that there is a duty not to cause a human being
to lack hearing genes.
• Claim 4: Suppose that an offspring has defective genes for certain
fundamental capacities. Suppose that it is possible to correct
these defects. In some cases, it would be impermissible not to
correct these defects. For example, suppose that seeing is a fun‐
damental capacity and suppose that an offspring has congenital
blindness. 21 Moreover, suppose that it is really easy to correct this
genetic defect; one just has to apply certain chemicals, which, let
us suppose, have no other side effects. It seems that it would be
impermissible not to correct this defect in such a case. The ratio‐
nale is that human beings have human rights to the fundamental
conditions for pursuing a good life. In my view, this means that
there is a positive duty on the part of everyone to see to it that
human beings have all the fundamental conditions, especially
when the duty is not too demanding. 22 In this case, it is stipulated
that it is not too demanding to see to it that the offspring has all
the fundamental capacities (one just has to apply some chemi‐
cals). Given this, it seems that there would be a duty to correct the
defects in this offspring by applying the chemicals, and that it
would be impermissible not to do so.
As one can see, these claims primarily provide a ‘lower bound’
of when reproductive genetic engineering would be permissible. Is
there an upper bound? Would it be permissible, for example, to create
an offspring who will be superintelligent or greatly enhanced in some
other way? There is not enough space here to explore this issue, but
as far as I can tell, other things being equal, the human rights approach
does not in principle object to the creation of such an offspring.
21
Again, the reader is welcome to use a different example if the reader believes that being
able to see is not a fundamental capacity.
22
Liao, S. M. (2015). The right to be loved. New York, NY: Oxford University Press, Chapter 5.
LIAO
4 | CO M PA R I N G TH E H U M A N R I G HT S
A PPROAC H W ITH OTH E R A PPROAC H E S
To support the human rights approach further, let us compare it with
some other notable approaches to reproductive genetic engineer‐
ing. I shall not attempt to be exhaustive and I shall focus on ap‐
proaches that accept that it can at least sometimes be permissible to
engage in reproductive genetic engineering. 23
For instance, consider the libertarian approach, according to
which it is morally permissible to create any kind of offspring we
like. 24 The libertarian approach seems too permissive. On this ap‐
proach, it would be permissible to create an offspring whose life will
be full of pain and suffering, e.g., a child with Tay–Sachs disease. In
contrast, on the human rights approach, it would be impermissible
deliberately to create an offspring who will not have fundamental
capacities. This means that on the human rights approach, it would
not be permissible to create a child with Tay–Sachs disease.
In addition, consider the wine capacity case: supposeNext, con‐
sider the perfectionist approach, according to which there is a prima
facie obligation to create an offspring who will have the best chance
of having the best life. 25 In my view, the perfectionist approach is
proves too much. 26 For one thing, suppose that being male or white
or tall or heterosexual will provide the best chance of having the best
life in our society. The perfectionist approach implies that there is at
least a prima facie obligation to select an offspring with such charac‐
teristics. that you can create an offspring who will have the capac‐
ity to enjoy very fine wine or another offspring who will have the
capacity to enjoy super fine wine. Suppose that the offspring who
has the capacity to enjoy super fine wine will have the best chance
of having the best life. The perfectionist approach implies that you
would have a prima facie obligation to create an offspring who has
the capacity to enjoy super fine wine, which seems counterintui‐
tive. In contrast, the human rights approach does not have these
implications. On the human rights approach, other things being
equal, there are only moral obligations to create offsprings who
will have fundamental capacities (should one decide to create any
offspring at all). Being male or white or tall or heterosexual is not a
fundamental capacity. Nor is being able to enjoy super fine wine a
fundamental capacity. As such, on the human rights approach,
there are no obligations to create offsprings with such traits.
Lastly, consider the life worth living approach, according to which it
is morally permissible to create an offspring whose life is worth liv‐
ing. ‘A life worth living’ can be understood as a life that contains
23
For critical assessment of approaches that are more restrictive, see Liao, op. cit. note 6.
24
In Children of Choice, John Robertson defends a strong procreative liberty (Robertson, J.
A. (1994). Children of choice: Freedom and the new reproductive technologies. Princeton, NJ:
Princeton University Press.) There are questions about whether Robertson or anyone else
would endorse something as extreme as the libertarian approach. Still, it is useful to men‐
tion the libertarian approach in order to contrast it with the life worth living approach,
which we shall discuss shortly.
25
Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best
chance of the best life. Bioethics, 23, 274–290.
26
See also Liao, op. cit. note 6.
LIAO
some positive values and the amount of negative values that this life
contains, e.g., pain, is not sufficient to negate the positive values that
this life has. For instance, Jonathan Glover asks, ‘Can it be right to
bring a child into the world so long as we expect the child to have a
quality of life at least at the zero line just above that “very terrible”
level?’ His answer is that ‘how can it be that we owed it to the child
to prevent his or her life?’27 Likewise, some writers in the literature
on disability, who believe that disability is not in itself something that
makes people’s lives go worse, may also be amenable to this
28
approach.
An implication of the life worth living approach is that if an off‐
spring with a particular disability has already been created, it can be
permissible to continue to bring this offspring to term, as long as this
offspring can have a life worth living. In contrast, some advocates of
the perfectionist approach have argued that it would be wrong to
continue to bring such an offspring to term, given that the offspring
would not have the best chance of having the best life. 29
On this point, the human rights approach sides with the life
worth living approach. The reason is that on the human rights ap‐
proach, an offspring with disability would still be a rightholder and
may have enough of other kinds of fundamental capacities such that
the offspring can pursue some of the basic activities. Given this, on
the human rights approach, it would be permissible to continue to
bring this offspring to term.
Still, there are several differences between the life worth living
approach and the human rights approach. One difference pertains to
when an offspring has not yet been created. The life worth living ap‐
proach implies that it can be permissible to create an offspring who
lacks certain fundamental capacities as long as the resulting off‐
spring can have a life worth living. For instance, suppose that hear‐
ing is a fundamental capacity. The life worth living approach implies
that it can be permissible to create an offspring who will be deaf,
since those who are deaf can have lives worth living. On the human
rights approach, it would be impermissible deliberately to create an
offspring who lacks a certain fundamental capacity such as hearing.
A starker difference between the life worth living approach and
the human rights approach pertains to certain cases of modification.
In particular, on the life worth living approach, it seems permissible
to cause an embryo to lack certain fundamental capacities such as
hearing, as long as the resulting offspring can still have a life worth
living (and provided that this is done early enough so that the off‐
30
spring does not experience transition costs). As we have seen, on
the human rights approach, such an action would be impermissible,
because there is a duty not to cause a human being to lack funda‐
mental conditions such as hearing.
27
Glover, J. (2006). Choosing children: The ethical dilemmas of genetic intervention. Oxford,
UK: Oxford University Press., p. 52. However, because it is difficult to determine when a
life is not worth living, Glover eventually proposes that what parents should aim at is to
have only children with ‘a decent chance of a good life’ (Ibid: 63).
28
See, for example, Barnes, E. (2016). The minority body: A theory of disability. Oxford, UK:
Oxford University Press.
29
Savulescu & Kahane, op. cit. note 25.
30
See, for example, Barnes, op. cit. note 28.
|
      103
Relatedly, suppose that an offspring has congenital deafness and
it would be very easy to correct the genes that undermine the devel‐
opment of hearing in this offspring (e.g., by applying certain chemi‐
cals). On the life worth living approach, it would be permissible not
to correct this defect, as long as the resulting offspring can still have
a life worth living (and provided that this is done early enough so that
the offspring does not experience transition costs).31 Again, as we
have seen, on the human rights approach, it would be impermissible
not to correct this defect, given that it would be easy to do so.
Here it is worth discussing how the human rights approach dif‐
fers from both the perfectionist approach and the life worth living
approach. The perfectionist approach and the life worth living ap‐
proach are both in some ways concerned with an individual’s well‐
being, in particular, how well an individual’s whole life can go. Indeed,
the perfectionist approach is interested in the offspring’s having the
best life possible, while the life worth living approach is interested
in the offspring’s attaining a minimally decent life. In contrast, the
human rights approach is concerned with an agent’s powers and
abilities, that is, the fundamental capacities, to do certain things at
particular moments in a life. Having these fundamental capacities
cannot guarantee that an individual would have a life worth living
let alone the best life possible, since someone with the full set of
fundamental capacities could end up in a car crash the next day or do
terrible things with those capacities. Hence, having these fundamen‐
tal capacities does not have direct implications for an individual’s
well‐being. What having the fundamental capacities does is enable
an individual to pursue the basic activities at particular moments in
a life.
5 | CONCLUSION
Advances in reproductive genetic engineering have the potential to
transform human lives. Not only do they promise to allow us to se‐
lect children free of diseases, they can also enable us to select chil‐
dren with desirable traits. In this paper, I outlined what I call a human
rights approach and I argued that this approach allows us to make at
least four claims about reproductive genetic engineering:
1. It is not permissible deliberately to create an offspring who
will not have all the fundamental capacities.
2. If an offspring who lacks some of the fundamental capacities is
already created, it can be permissible to bring the offspring to
term.
3. Other things being equal, it is not permissible to cause an existing
offspring to lack some of the fundamental capacities.
4. If it is possible to correct certain defects in the fundamental ca‐
pacities of an offspring, and if it is not too demanding to do so, it
can be impermissible not to do so.
31
Ibid.
104       | LIAO

I also argued that the human rights approach is more plausible C O N FL I C T O F I N T E R E S T

than the libertarian approach, the perfectionist approach, and the
The author declares no conflict of interest.
life worth living approach. A more comprehensive discussion of the
ethics of reproductive genetic engineering would need to consider
ORCID
other approaches.32 Still, I hope to have shown that the human rights
approach offers a promising new way of thinking about when and S. Matthew Liao  http://orcid.org/0000-0001-6579-8656
whether reproductive genetic engineering is permissible and that
this approach deserves further consideration in the lively debate S. Matthew Liao is Arthur Zitrin Professor of Bioethics and
about designing humans. Director of the Center for Bioethics at New York University. He
is the author of The right to be loved (Oxford University Press,
2015) and over 60 articles in philosophy and bioethics. He has
AC K N OW L E D G E M E N T S
given TED and TEDx talks in New York and Geneva, and his work
I would like to thank Frances Kamm, Sarah Gokhale, Wibke has been featured in the New York Times, The Atlantic, The
Gruetjen, two anonymous referees at Bioethics, and the audience Guardian, the BBC, Harper’s Magazine, Sydney Morning Herald,
at the Inaugural Arthur Zitrin Lecture at New York University, Scientific American, Newsweek and other media outlets.
NYU Shanghai, the Center for Research on Ethical, Legal & Social
Implications of Psychiatric, Neurologic & Behavioral Genetics at
Columbia University, the New York Bar Association, the Colloquium
How to cite this article: Liao SM. Designing humans: A human
on Ability and Enhancement at University of Richmond, and the New
rights approach. Bioethics. 2019;33:98–104. https://doi.
York Hall of Science for their helpful comments on earlier versions
org/10.1111/bioe.12519
of this article.

32
I have assessed some other approaches in Liao, op. cit. note 6.