Now that scientists can use natural enzymes to target and snip genes with unprecedented accuracy, “it seems likely that gene therapies––eliminating mutant genes that cause some severe, mostly very rare diseases––might finally bear fruit, if they can be shown to be safe for human use,” The Guardian reported earlier this year in an article on designer babies. “Clinical trials are now under way.”

Reporter Phillip Ball quoted one expert as follows:

Because of unknown health risks and widespread public distrust of gene editing, bioethicist Ronald Green of Dartmouth College in New Hampshire says he does not foresee widespread use of Crispr-Cas9 in the next two decades, even for the prevention of genetic disease, let alone for designer babies. However, Green does see gene editing appearing on the menu eventually, and perhaps not just for medical therapies. “It is unavoidably in our future,” he said, “and I believe it will become one of the central foci of our social debates later in this century and in the century beyond.”

In those future debates, gene editing to prevent disease is likely to be the least controversial use. Some folks will grant that trying to reduce disease is a reasonable course even as they argue against gene editing for cognitive or aesthetic enhancement. Others will remain wary of editing the genes of their child. If early gene editing efforts cause harm past some threshold, the backlash may render my prediction incorrect. Barring that, it seems likely that gene editors will gain the ability to safely prevent some awful diseases, and that the holdouts who fear or morally object to their methods will dwindle more and more with every passing year.

Once they’re no more numerous or influential than, say, today’s Christian Scientists, the relevant politics will be quite changed. Holdouts who fear that gene editing is putting humanity on a slippery slope to disaster or who have religious objections to the technique or who just prefer “the old-fashioned way” in their gut will conceive a child. If he or she is healthy all will be fine. But some holdouts will give birth to a child with a painful or fatal condition that could have been prevented.

People will get angry at those parents and seek to punish them.

Or at least that is the course I foresee (even though there is arguably an ethical distinction between refraining from editing the genes of a future human and denying essential medical treatment to an already living human, who is understood to have individual rights independent from or not entirely subject to the beliefs of their guardians).

Regardless of whether you agree with my prediction, I’d like to know what you think about the ethics of this matter. A subset of readers will oppose punishing Christian Scientists today for, say, declining to allow the removal of a burst appendix. Such readers presumably oppose punishing the gene editing holdouts of the future, too.