Utliical Issues in Gene Therapy 
the next-of-kin may provide a substitute consent. Beforehand, the 
review body or investigators may request that a three-person GCA 
function in some or all of the cases involving the protocol. Or, inves- 
tigators can request that a GCA be convened for a single case. The 
members of the GCA are drawn from panels of previously selected 
persons from within and without the institution who have had 
experience in working with mentally impaired research subjects, 
are sensitive to the decisions made in consent to research, and are 
willing to participate in orientations for their role on the GCA. The 
tasks of the GCA are to determine (1) that an appropriate next-of- 
kin is capable of giving consent, (2) that sufficient support and agree- 
ment with the subject’s family exists to proceed with the research, 
and (3) that all applicable NIH and Clinical Center policies have been 
followed. Prior to gene therapy, IRBs or researchers themselves may 
desire to augment their normal protection of human subjects by 
these or similar methods. 
ETHICAL OBJECTIONS TO HUMAN GENE THERAPY 
A consequentialist argument has been turned against human gene 
therapy — namely, that it will initiate a future set of consequences 
that will be harmful to society and its most precious values. A ver- 
sion of this ‘slippery slope' argument is posed by its leading exponent, 
Jeremy Rifkin (1983, p. 232): 
Once we decide to begin the process of human genetic engineering, there is really 
no logical place to stop. If diabetes, sickle cell anemia, and cancer are to be 
cured by altering the genetic makeup of an individual, why not proceed to other 
‘disorders': myopia, color blindness, lefthandedness? Indeed, what is to preclude 
a society from deciding that a certain skin color is a disorder? 
Rifkin’s argument does not proceed from a view that regards ethics 
as a source of self-criticism or social justice, or even as a source of 
resolution of conflict. On the contrary, he (1983, p. 54) holds that 
ethics are designed to be compatible with the way people organize the world 
around them. Moral codes keep people's future behavior in line with the way 
society goes about organizing and assimilating its environment. 
In Rifkin’s view, then, society determines ethics. Further, Rifkin 
views U.S. society as dominated by a technological elite. He also 
holds that ethics, and ethicists, to be sure, are already coopted by a 
society too influenced by eugenic reasoning. His remedy for this 
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