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Comment by mc32 | Hacker News Reader

>Is it ethical to make a little person taller?

No [there is no ethical problem], why would something which has no negative effect on anyone else present an ethical challenge? It doesn’t say make everyone into a 6’7” basketball athlete, it says make small people taller which translates into a more normal height range.

If everyone potentially affected by dwarfism in the future were diverted into normal growth via treatment, in a few generations there would be no one left who is affected by it physically.

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Maybe its similar to what happens sometimes with young deaf children whose parents are deaf? The parents sometimes refuse to get cochlear implants for the child that would give the child normal or near normal hearing, on the grounds that they want the child to grow up fully in "deaf culture".

Many who have been deaf all their lives, as opposed to those who lost their hearing as adults, view deafness as just a difference, not as a disability to be cured or fixed, apparently similar to the way most see race and ethnicity. Telling them they need to "fix" their child's hearing apparently to them is like, say, telling a Jewish family they need to raise their kids Christian.

Achondroplasia has a hereditary component, so there will be families where both parents have it and their child has it, and they have many relatives with it. I would not be surprised if some of them feel that there is an achondroplasia culture, and it is wrong to "fix" a child to make them fit non-achondroplasia culture.

There are tons of nasty side effects that go with dwarfism; it's not as though it's _just_ being short. It can cause bowleggedness, hunchback, limited mobility of elbows, and all sorts of other issues [0] (yes, those refer to the specific kind of dwarfism this medicine treats). A parent can't subject his kid to those just so he can feel like his kid fits a "culture". It's wrong for the same reason mutilating girls' genitals to fit a "culture" is wrong. It is unethical to cause a child a lifetime of problems for personal gratification or because of a parent's insecurities. At least cochlear implants can be given at a later age; this is a developmental thing which a child cannot choose for himself at a later age.

[0] https://www.mayoclinic.org/diseases-conditions/dwarfism/symp...

When referencing baby genital mutilation, it might be worth dropping the "female". It's just as horrible to slice up a male baby's genitalia, and it's done much more often.

I wonder how much more prevalent phimosis would be if infant circumcision weren’t a thing, though. Speaking from experience here, lol, adult circumcision was not fun.

Not very. Few countries practice widespread circumcision.

All genital mutilation is wrong.

Seems like you could make the same argument for foot binding.

I think you’re reasoning is sound, I’m also dismayed to think of people who would deprive their child of SOUND.

That should be a jail-able offense, assuming they are making a decision that can’t be undone.

The ethical issue lies in classifying different kinds of people as undesirable and then fixing them with drugs.

Sometimes "fixing" a specific condition sounds obviously ethical to some and to others it is offensive.

> If everyone affected by dwarfism in the future were diverted into normal growth via treatment, in a few generations there would be no one left who is affected by it physically.

Why would it? Unless the changes are made at the genetic level nothing change. Well, some things will change.

I believe the opposite is true. It would promote more of the genes in society, because dwarfism is sexually selected against. Thus more children would be born with dwarfism.

There are many afflictions which are hereditary. We typically don’t go about saying how finding treatments that allow these people to live at all or live improved lives inflicts the possibility of further establishing the affliction in a population into the future. I mean this comes off as kind of close to a eugenic attitude, although not quite there.

I’d be okay with some sort of disclosure for future partners as we’d be for many things of this nature.

I think enforcing any sort of eugenic policies would also be unethical including the forced disclosure of the medical procedures we are discussing.

It's hard for me to believe something is wrong and shouldn't be done while simultaneously believing it should not be prevented with policy.

We need to evolve the ability to uncover deception with our minds and prevent betrayal innately. Those who can do that possess gifts that will reward the successful species in the very long term.

As it is, we are unable to detect and prevent it as a society and we need that skill. I admire it in those I know who have it. I wish I was better at it.

You do get people complaining, with no apparent irony, about how modern medicine weakens the human race by allowing unfit people to reproduce, often with an extremely broad definition of "unfit". Idiocracy will be invariably be mentioned.

And then they get offended when you say that's eugenics.

So few people seem to understand this. People tend to think I'm insane when I suggest that abortion of down-syndrome foetuses will eventually lead to more down-syndrome foetuses.

That is different because down syndrome is not hereditary. It's caused when chromosomes don't properly separate due their tangling caused by aging of egg cells.

Plus, if it were a hereditary genetic condition, abortion would eliminate those genes from the population reducing the occurrence over time.

Would you agree that there are probably some genes, especially on the mothers side which would increase the likelihood of the foetus having down-syndrome?

Or some genes on the mothers side which will increase likelihood of engaging in behaviour that increase the chances of the foetus having down-syndrome? (Smoking etc...)

Because if so, then a huge evolutionary pressure has been lifted from having a down-syndrome child. In the past having such a child would incur immense cost. There are of course difficulties birthing and sustaining an evolutionary dead-end which would reduce the birth-rate of down-syndrome having couples right?

Therefore, genes which increase the likelihood of having down-syndrome will proliferate much more in world which aborts down-syndrome foetuses right?

If dwarfism becomes something that's routinely treated in childhood, like a cleft palate, then there will still be people who have it, but no one with access to basic health care will be affected by it.

It's being tested on children who can't really consent- for obvious, practical reasons. The people who are really deciding this are the children's parents.

As long as it’s an approved procedure with minimal side effects where the benefits far outweigh the downsides, I don’t see that as a problem any more than parents who get other non life saving treatments for their kids which will be beneficial in the future.

I think you're probably right, and that it doesn't make much sense to not give your child a drug that would fix their bone growth even if it isn't literally life-saving.

As long as the side effects are well studied and strictly less bad than the alternative. If the side effects were awful then it would be much trickier, but it seems like that's not the case.

Skin color effects your future.

Should parents change their child's skin colour.

If you think that has ethical issues, then so does height.

Cosmetics can change your life path

Crooked teeth we accept as ethical to change in children.

Breast size we don't.

I think ethics is involved, even if it's wrong.

As I recall, being significantly out of range in terms of height also has fairly broad health implications due to maldevelopment of internal structure.

So, it's not just height that gets fixed.

Height is a predictor of evolutionary viability in humans. Altering the physical manifestation of any genotype, does affect both one's mate and potential offspring. Therefore it is deception and thus, imo, unethical.

I believe this is true of all medical procedures that counteract genetically maladaptive traits.

Fine, require disclosure of some sort in the event of possible procreation.

That's only a partial solution, rational thought has little to do with sexual selection. I don't think we can come up with anything better though.

My partner and I got dna tests before beginning on the path of procreation. We were making a decision that affected a human being that would have no input on its coming into existence. We owe it to a child we would come to respect and love to be very conscious in every aspect of its life including its genetic viability.

Less than rational thought in such a matter, I believe is very selfish and unkind to a life that I may create.

I understand this isn't the normal way of thinking on the issue, but I wish it was more common.

The premise that backs this approach seems to be that there is a black and white “genetic standard” but the reality is surely very subtle shades of grey. What are the parameters for deciding between genetically viable and genetically unviable?

It's not a genetic standard, it's a phenotypic advantage. Taller humans are preferred by other humans and have a physical advantage over the competition so they are more likely to survive as the fittest.

Correct. This is why, for example, we all agree that it is unethical to get laser eye surgery, because that would be deceiving potential mates about the genetic viability of poor vision.

As mc32 argues in a sibling comment of yours, hiding that laser surgery could be considered unethical. Situation changes when you disclose it.

Best to refrain from flippant sarcasm when dealing with such sensitive matters, especially online.

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