Genetics and Ethics is a collection of papers presented at a major conference in St. Louis and subsequently revised for publication. Brent Waters' essay in this collection warns that "much of the moral inquiry accompanying the development of genetic technologies has fixated on questions of safety, efficacy, and access, so we may fail to take into account a matrix of subtle cultural factors and expectations in which these technologies will be introduced" (138). Most of Genetics and Ethics bears witness to the truth of Waters' statement.

Generally, the authors tend to inform the reader historically, politically, sociologically, and scientifically in a very useful way. Further, they are proficient at pointing out the important ethical questions that have arisen with the various advances in genetics. However, for the most part, they do not attempt to answer these questions. And what answers are provided tend to move along the lines merely of safety, efficacy, and access, as Waters notes. Of course, lack of definitive answers is to be expected when both genetics and genetic ethics are still in their infancy, but I would still expect a better attempt to grapple with the issues than I found this book to contain.

This is not to say that the book is without value - far from it. Both beginners and experts in medical and genetic ethics will each find several of the chapters quite helpful. The interdisciplinary character of many of the essays keeps the ethical considerations concrete and provides an abundance of historical, political, and sociological background and context for the particular topics that the assorted authors take up. However, typical of such collections, not every paper is equally accessible to everyone, and some will interest only a subset even of experts in the field.

In particular, I think that most readers will find the essays by Magill and Brehany, Waters, Chadwick, and Ford most interesting, beneficial and accessible. Magill and Brehany survey the history of genetic science, policy and ethics, providing a very useful introduction to the issues and the diverse proposed distinctions and solutions.

Waters argues that the way genetic engineering (and associated technologies) are moving tends to (and often does) treat children more like products to be manufactured (and discarded if they do not meet expectations) than gifts to be received. Connected to this attitude is an approach to the future which seeks to find fulfillment in perfect children, and thus "engineers one's grace," rather than receives it.

Chadwick's article, as with most of the essays in the book, raises more questions than it proposes answers, but it is informative about an issue (prenatal genetic testing) that is more relevant for most people than genetic engineering.

Ford's essay, like Waters', is refreshing in that it not only raises questions but also provides a moral evaluation of the various facets of prenatal screening. He deals frankly with abortion as the only "therapy" currently available for serious chromosomal disorders, addressing questions of the mother's right to know, the risk to the child, and the cooperation involved in providing testing when abortion is such a common response in such cases as Down syndrome. This article provides a brief, but thorough and intelligent, ethical evaluation of the most important aspects of genetic screening and diagnosis.

Because human dignity is such an important consideration in cloning and related matters, I found Jan Heller's article to be the least helpful. He argues, as he has in previous works, that "whatever future dignity a cloned child might possess, appeals to dignity prior to its conception cannot be used as a basis for arguing that such a child should not have been born or, at least, born in this way" (123). His idea is that the dignity of a child who does not yet exist cannot even be a consideration in debates about the ethics of cloning, because neither the child nor its dignity even exists until after the cloning has taken place.

Contrary to Heller, one could make the simple observation that as soon as a cloned child comes into existence its dignity has been violated by having been brought into existence through cloning (i.e., like a manufactured product). In other words, what is really meant by referring to the dignity of future cloned persons is only that as soon as such persons exist their dignity is violated. Thus, human dignity continues to be a very important consideration in genetic ethics, especially with cloning.

One of the most beneficial aspects of the book as a whole is its extensive, 55-page bibliography. This, along with a thorough index and the editor's valuable summaries of all the papers in his preface, makes the book an important resource for studying genetic ethics.