Mentee Essay Competition
Sign up to our 1:1 mentoring scheme where you will be assigned a medical student or junior doctor who can assist you with your application for free.
Click here to learn more.
2023 Essay Winners
Designer Babies and Genetic Engineering: The Ethical Considerations
Advancements in the field of genetic engineering have opened up extraordinary possibilities, including the potential to create ‘designer babies’. Designer babies have their genetic makeup intentionally modified to possess specific traits. This concept exhibits the opportunity for medical breakthroughs and the prevention of genetic disorders. Regardless, the complex ethical considerations must be addressed, analysing the tension between our desire to improve the well-being of future generations and the ethical implications of these modifications. It raises fundamental questions about the limits of human intervention in the natural order of life. This essay aims to explore the ethical considerations surrounding designer babies and genetic engineering, exploring the implications for individual autonomy, social justice, the potential unintended consequences, and the essence of what it means to be human.
The concept of parents or society influencing a child’s genetic makeup raises numerous concerns, where it introduces the possibility of overruling an individual’s natural genetic attributes and imposing their desired traits upon them. Utilising genetic engineering as a tool to modify human traits challenges the fundamental principle of individual autonomy – an integral pillar of medical ethics. An individual should have the right to self-determination. To which extent do we consider this practice going too far? Do we have the right to modify the genetic heritage of future generations without their consent? Individuals have a fundamental right to their genetic information and the ability to make decisions about their bodies. It poses ethical dilemmas regarding the balance between parental choice and the child's rights.
The availability of these technologies to create designer babies may hinder the progress that we have made as a society to eradicate social inequalities. Instead, we may exacerbate them. If these technologies become accessible only to the wealthy or privileged communities, it could instigate a divide between genetically-enhanced individuals and those without modifications. In addition to the existing social inequalities, further societal divisions may arise, based on genetic characteristics. This could lead to a society where those who are genetically modified have distinct advantages in areas, such as education, employment, and social standing. Genetic enhancements should be made accessible to all individuals, ensuring social justice and distributing these technologies in a fair and just manner so that there are equal opportunities for all individuals. We do not want a system that prioritises genetic privilege over capabilities and efforts. We want genetic engineering to act as a tool for promoting human well-being and reducing suffering.
Genetic engineering is a novel concept that we have not fully comprehended. We cannot guarantee that the technology lacks the risk of unintended consequences, where it may have long-term effects on individuals and future generations. This is because pursuing designer babies involves altering their genetic code – a complex and intricate system, introducing a considerable level of uncertainty and risk since it is challenging to predict the precise outcomes of genetic modifications. Therefore, it does raise ethical concerns about the potential for unintended harm. Scientists and society should be responsible for thoroughly evaluating the risks and benefits of genetic engineering, before implementing these modifications. It requires rigorous scientific research, transparent evaluation processes, and robust regulations to ensure that genetic engineering interventions are safe and effective. Ethical considerations demand a cautious approach to prevent harm and prioritise the well-being of individuals and society.
The idea of designer babies is a slippery slope in terms of eugenics. Despite the potential for genetic engineering in the use of preventing severe genetic disorders, there is a risk that individuals may use it for non-essential enhancements or cosmetic modifications. This could lead to a society that places unnecessary importance on specific traits, encouraging discrimination based on natural genetic attributes. Individuals who do not possess these enhanced traits may face marginalisation or prejudice. Unfortunately, it would promote a narrow ideal of what is considered ‘desirable’ or ‘normal’, setting unrealistic standards that cannot be attained without alterations. If genetic engineering becomes a widely-accepted practice, it could create a market-driven demand for ‘designer traits’, establishing a two-tiered society for those with financial means to afford to enhance their children’s genetic makeup and others without access to these technologies. However, it is challenging to maintain boundaries and prevent the misuse or abuse of these technologies. There should be careful consideration of the purposes for which genetic engineering is allowed, and strict guidelines to prevent its misuse.
Human nature and identity are fundamental aspects of what it means to be human. The notion of genetic engineering and designer babies challenges our understanding of these concepts, raising ethical considerations. Although genetics shape our physical traits and certain aspects of our cognitive abilities, human nature encompasses much more than our genetic makeup. Human identity is a complex interaction of genetics, environment, culture, and personal experiences. It encompasses our emotions, creativity, moral reasoning, and social relationships. Genetic engineering raises concerns about reducing human identity to mere genetic determinism. This approach overlooks the richness and diversity of human experiences. Our identity is not limited to a predetermined set of genetic traits but due to the relationship between our genetics and the dynamic interactions we have with the world around us. Genetic engineering should be approached with caution, ensuring that it respects and preserves the essence of human nature and identity.
The ethical considerations surrounding designer babies and genetic engineering are complex and multifaceted. While genetic technologies offer the potential to eradicate genetic disorders and improve the quality of life for individuals, we cannot overlook the ethical implications. When we navigate the ethical landscape of genetic engineering, we have to respect individual autonomy, ensure social justice, consider unintended consequences, guard against a slippery slope, and maintain a deep appreciation for human nature and identity. We must engage in comprehensive and inclusive ethical discussions to shape responsible guidelines that uphold human values and promote the well-being of all individuals. Once the ethical considerations have been addressed, we can harness the potential of genetic engineering while safeguarding against the risks and ensuring that its applications align with our principles and aspirations for a just and fair society.
Word Count: 1001 words
Interesting Engineering, 2019. Designer Babies: Gene-Editing and the Controversial Use of CRISPR. (online) Available at: https://interestingengineering.com/science/designer-babies-gene-editing-and-the-controversial-use-of-crispr. (Accessed 19th June 2023)
Scientific American, 2021. A New Era of Designer Babies May Be Based on Overhyped Science. (online) Available at: https://www.scientificamerican.com/article/a-new-era-of-designer-babies-may-be-based-on-overhyped-science/. (Accessed 19th June 2023)
The Guardian, 2017. Designer babies: an ethical horror waiting to happen? (online) Available at: Designer babies: an ethical horror waiting to happen? | Reproduction | The Guardian. (Accessed 19th June 2023)
The Embryo Project Encyclopaedia, 2011. Ethics of Designer Babies. (online) Available at: https://embryo.asu.edu/pages/ethics-designer-babies. (Accessed 19th June 2023)
MIT Technology Review, 2015. Engineering the Perfect Baby. (online) Available at: https://www.technologyreview.com/2015/03/05/249167/engineering-the-perfect-baby/. (Accessed 19th June 2023)
Why Sleep? The Physical and Mental Health Ramifications of Sleep Deprivation
Sleep is one of the most underrated bodily functions that occurs in terms of its benefits to the body. In this essay, I will discuss the various ways that sleep affects us individually and as a national (or global) community.
Sleep is both important physiologically and psychologically in various ways. Physiologically, sleep acts as a recovery period for the body and mind, where the body can repair itself from the activities of the day. After sleeping for the proper amount of time and having good sleep quality, we are better at making decisions as we are more alert. Lack of sleep can be detrimental to both the individual that lacks sleep and the community the individual interacts in. Sleep deficiency can lead to industrial accidents and various diseases, as the body needs sleep to ward off disease. Man-made disasters, for instance, the Chernobyl nuclear plant accident was caused in part by the sleepiness of an operator who had poor sleep. A shorter duration of sleep has also been linked to the development of coronary artery calcification in the concerned individuals, and the presence of which is usually a predictor of coronary heart disease. Lack of sleep is known to negatively affect the immune system of individuals over a sustained period of deficient sleep. Mentally, sleep deprivation can lead to depression and anxiety, which can worsen over a continued lack of sleep. (MedlinePlus, 2017). Despite these glaring effects, it is estimated that around 1 in 3 adults in the United States of America report that they do not get enough sleep or rest evert day. And this results in almost 40% of adults commenting that they have fallen asleep during the day mistakenly at least once a month. (National Heart, Lung, and Blood Institute, 2022).
Sleeping helps to maintain many vital bodily functions, so it heavily impacts health. Consistent, adequate sleep is also a reliable predictor of living a longer and more productive life (healthysleep.med.harvard.edu, 2008). One way sleep does this is by playing an important role in affecting how we perform when we are awake. The amount of sleep alone is not important, but also the quality of the sleep. Decrease in overall sleep time can increase the chances of one forgetting things more easily and being less effective in memory storage, learning, judgement and mood (American Thoracic Society, 2018). Sleep quality can even go so far as to affect the balance and posture of individuals when sleep quality begins to and continues to decrease (Montesinos et al., 2018). This has a knock-on effect on the daily activities the individual undertakes throughout the day.
Sleep cycles consist of five different stages: the wake state, the N1 stage, N2 stage, N3 stage and REM stage (Patel and Araujo, 2018). The body uses the different stages of sleep for different processes, for example the N2 stage, which is the stage of deeper sleep, is used to consolidate information into the memory by the process of sleep spindles. The N3 stage is used by the body to repair tissues and strengthen the immune system. During Non-REM sleep, breathing and heart rates slow. These stages of sleep can be monitored and evaluated using different machines, including an electroencephalogram (EEG). Research shows that the pattern of these sleep stages can be altered by other external factors, for example, biological and clinical factors (Yetton et al., 2018). Different parts of the brain are involved in the whole process of sleep because of the uniqueness of its ability to regulate core processes of the body during its occurrence. Some parts of the brain involved in sleep are the pineal gland, which is responsible for releasing the hormone melatonin, which aids sleep, and the brain stem, which sends out signals to the muscles of the body to relax to prevent people from acting out their dreams whilst they are sleeping. Figure 1 clearly shows the different stages of sleep we are in as the night progresses.
Sleep problems are very common in developed countries, and they exist in different ways. Between 50 and 70 million people in the United States of America are suffering from chronic sleep and wakefulness disorders. These are deficits mainly in either the quality of sleep or the quantity of sleep. Sleep disruption is a term that describes conditions that affect the continuity of sleep. These sleep disruptions are mainly caused by lifestyle choices and other factors for example, other medical conditions. The short-term effects of sleep disruptions are different in both adolescents and adults, these categories can further be divided into healthy and unhealthy or with existing medical conditions. (Medic, Wille and Hemels, 2017). However, there are some implications that occur generally across the whole population. Some of these implications are increased chances of certain diseases like diabetes mellitus and cardiovascular diseases (Chattu et al., 2018).
Interestingly, amidst the long list of consequences, sleep disruption also has some benefits which include energy conservation and modulation of memory (Feriante and Singh, 2020). But it is evident that the disadvantages of sleep disruption far outweigh the advantages of it. Examples of common sleep disorders include sleep apnea, which is a breathing disorder that is prevalent when the individual is sleeping. Sleep apnea causes pauses in breathing for short periods of time whilst sleeping. Sleep apnea is further divided into central and obstructive sleep apnea. The more problematic type of sleep apnea tends to be obstructive because it is associated with a larger range of health problems including pulmonary hypertension and thinking problems (Suni and Singh, 2020). Another common sleep disorder is narcolepsy, which is a disorder of sleep regulation that is caused neurologically. People with narcolepsy often experience uncontrollable and sudden episodes of falling asleep, even during the daytime (Cleveland Clinic, 2020).
In conclusion, sleep is essential for the daily, efficient functioning of the body. Reliant on this underrated process are many processes, and this highlights that high quality sleep for the right duration of time is essential, and not to be considered as a luxury, as sleep is commonly viewed.
American Thoracic Society (2018). American Thoracic Society. [online] Available at: https://www.thoracic.org/patients/patient-resources/resources/sleep-and-performance.pdf [Accessed 19 Jun. 2023].
Chattu, V., Manzar, Md., Kumary, S., Burman, D., Spence, D. and Pandi-Perumal, S. (2018). The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare, 7(1), p.1. doi:https://doi.org/10.3390/healthcare7010001.
Cleveland Clinic (2020). Common Sleep Disorders: Symptoms, Causes & Treatment. [online] Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/articles/11429-common-sleep-disorders. [Accessed 19 Jun. 2023].
Feriante, J. and Singh, S. (2020). REM Rebound Effect. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560713/ [Accessed 19 Jun. 2023].
healthysleep.med.harvard.edu. (2008). Sleep and Health | Need Sleep. [online] Available at: https://healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/health [Accessed 19 Jun. 2023].
Medic, G., Wille, M. and Hemels, M. (2017). Short- and long-term Health Consequences of Sleep Disruption. Nature and Science of Sleep, [online] 9(9), pp.151–161. doi:https://doi.org/10.2147/nss.s134864.
MedlinePlus (2017). Sleep and your health: MedlinePlus Medical Encyclopedia. [online] Medlineplus.gov. Available at: https://medlineplus.gov/ency/patientinstructions/000871.htm [Accessed 19 Jun. 2023].
Montesinos, L., Castaldo, R., Cappuccio, F.P. and Pecchia, L. (2018). Day-to-day variations in sleep quality affect standing balance in healthy adults. Scientific Reports, 8(1). doi:https://doi.org/10.1038/s41598-018-36053-4.
National Heart, Lung, and Blood Institute (2022). Sleep Deprivation and Deficiency - What Are Sleep Deprivation and Deficiency? | NHLBI, NIH. [online] www.nhlbi.nih.gov. Available at: https://www.nhlbi.nih.gov/health/sleep-deprivation [Accessed 19 Jun. 2023].
Patel, A.K. and Araujo, J.F. (2018). Physiology, Sleep Stages. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK526132/ [Accessed 19 Jun. 2023].
Sleep Foundation (2023). Available at: https://www.sleepfoundation.org/wp-content/uploads/2023/03/SF-23-069_SleepCycle_Chart_Mobile-768x988.png [Accessed 19 Jun. 2023].
Suni, E. and Singh, A. (2020). Sleep Apnea: Symptoms and Causes. [online] Sleep Foundation. Available at: https://www.sleepfoundation.org/sleep-apnea. [Accessed 19 Jun. 2023].
Yetton, B.D., McDevitt, E.A., Cellini, N., Shelton, C. and Mednick, S.C. (2018). Quantifying sleep architecture dynamics and individual differences using big data and Bayesian networks. PLOS ONE, 13(4), p.e0194604. doi:https://doi.org/10.1371/journal.pone.0194604.
2022 Essay Winners
Would Decriminalisation of Possession and Personal Use of Drugs Benefit the NHS?
In the UK, it is currently illegal to take, carry, make, or supply drugs, with the penalty ranging between a fine and a prison sentence. However, this approach is not effective, since drug misuse and addiction are widespread problems in our society, and they put immense strain on the NHS every year. Perhaps rehabilitation would be more effective than punishing drug users like criminals- the Executive Director of the Canadian Public Health Association once said, ‘If you want to deal with drugs, you need to deal with the reasons why people use drugs’ (CMAJ, 2014). The decriminalisation of drugs involves ceasing to treat drug possession and personal use as illegal, and I believe that, with increased funding on rehabilitation and mental health facilities, this would greatly benefit the NHS.
Decriminalisation consistently results in lower addiction and substance abuse rates. For example, in 2001, Portugal decriminalised the possession of all drugs for personal use. In 1974, the strict Estado Novo regime ended, and this led to a 27 year-long war on drugs in Portugal. Drug use soared: by 2000, 1% of the population was addicted to heroin, and Portugal had the highest HIV infection rate in the EU. This is when Portugal decriminalised the possession of drugs, and since then levels of drug use have been below the European average (Sellers, 2022). The number of deaths caused by drug overdose fell to just 16 in 2012 (Drug Policy Alliance, 2015): this is a stark contrast to England and Wales, where the total number of deaths related to drug misuse was 1,605 in 2011 (NHS Statistics on Drug Misuse, 2012). This data clearly illustrates how effective decriminalisation was in Portugal, after it led to an enormous decrease in levels of drug use, and the number of deaths due to overdose has plummeted too. Drug users are now treated like unwell patients who need rehabilitation, and addiction is seen as a mental illness. Therefore, I believe that this approach would benefit the NHS since it has proven to be extremely successful in Portugal. It would reduce the strain on the NHS, as drug use rates would likely fall here in the UK too, leading to reduced addiction rates and fewer deaths due to drug overdose. If fewer people are addicted to drugs, the annual cost of drug addiction for the NHS would fall, saving valuable NHS money and resources.
Furthermore, decriminalisation would result in rehabilitation for drug misuse becoming more accessible, thus making it easier for people to get help earlier. People who suffer from drug issues would be less likely to overdose, and fewer people would suffer from long-term health conditions as a result of their drug use. Drug users suffer from a wide variety of health conditions, including mental health issues (depression, anxiety, psychosis, etc.), heart disease, blood-borne viruses, and lung disease (Public Health England, 2022). One example of this is HIV- sharing syringes is the second riskiest behaviour for contracting HIV (Centers for Disease Control and Prevention, 2019). Decriminalisation would result in fewer people sharing syringes, thus reducing the rates of HIV in the UK. The NHS would then be put under less strain, as fewer drug users would be suffering from this chronic condition and fewer NHS resources and funds would need to be allocated to treating and monitoring HIV. Another example is mental health conditions. Drugs can have a drastic effect on your mental health; many affect your mood and can lead users to develop conditions such as anxiety, depression, psychosis, and this can result in suicide. A reduction in drug rates due to decriminalisation would significantly reduce the number of people living with these conditions.
NHS mental health services are already incredibly stretched, and, over time, decriminalisation would reduce the number of people needing to access these services. Annually, drug misuse costs the NHS around £488 million in England (Morse, 2017). I believe that decriminalisation would benefit the NHS because it would reduce the amount of money that the NHS would need to spend on drug misuse, addiction, and treating long-term health conditions as a result of drug use. This money would be better spent on improving rehabilitation facilities and increasing their capacities, and on expanding mental health facilities too. Therefore, this would make rehabilitation more accessible, so drug users would be able to access rehab and mental health support easier. Overall, the cost of drug misuse, addiction, and overdose for the NHS would decrease, and this money would be best spent on improving rehabilitation and mental health care. These services would be under less strain and drug users would be able to access the support they need to recover and reintegrate back into society.
Decriminalising drugs would also reduce the number of people in prison for drug offences. For example, in Portugal, over half of the prison population was there for drug-related reasons (Sellers, 2022). Since drugs have been decriminalised for personal use, this has fallen from 40% to just 15% (Transform Drug Policy Foundation, 2021). It is clear from this evidence that decriminalising drugs for personal use would reduce the number of people in British prisons. Prisons have extremely detrimental effects on both a person’s physical and mental health. The isolation from family, shame, emotional stress, and lack of control in prisons often lead to mental health problems such as anxiety and depression. Many people turn to drugs to deal with these issues, and this, alongside the rampancy of illicit drugs in prisons, often makes people’s substance abuse problems worse rather than better whilst they are in prison. Keeping as many people out of prison as possible would reduce the number of people suffering from severe mental health problems, thus reducing the strain on the NHS. This would, in turn, reduce the number of people turning to drugs as a way of coping with these issues. Prisons are also very damaging to a person’s physical health- people in prisons are disproportionately likely to suffer from chronic conditions, such as diabetes. Health care in prisons is often low-quality and difficult to access, and other problems such as overcrowding and poor hygiene make it challenging for people to live healthy lives whilst in prison. Chronic conditions require years of monitoring and reducing numbers in prisons would lower the number of people living with these conditions. I believe that decriminalising drugs would benefit the NHS because it would lower the number of people in prisons. Therefore, fewer people would develop physical and mental health conditions in prison, thus cutting costs and reducing the strain on the NHS. These costs could potentially fund rehabilitation services, which are cheaper and often more effective than prisons. This could further reduce the number of people with substance abuse issues, as they could be rehabilitated and reintegrated back into society instead of being locked away.
Some people may argue that decriminalisation would increase addiction rates, and the NHS hasn’t got the mental health or rehabilitation facilities to cope with this. An increasing number of people are in contact with drug services in England, and decriminalisation would only cause this number to increase. Very dangerous drugs would become much cheaper and more accessible, which would encourage experimentation and it could lead to an increase in cases of overdose. Also, it could lead to an increase in syringe sharing, which is the second riskiest behaviour for contracting HIV. Drug misuse currently costs the NHS £488 million every year (Morse, 2017), and decriminalisation would only further increase this cost. Overall, some may argue that decriminalisation would not benefit the NHS because it would increase the accessibility of dangerous drugs, hence leading to more cases of overdose. The NHS is already stretched to its limit, and more overdoses would put further strain on frontline NHS workers in busy Emergency Departments. There is not adequate mental health support available to treat the psychological consequences that will follow on from an increase in drug misuse, and HIV cases would rise due to increased syringe sharing. The NHS would not be able to cope with this further pressure with the current level of funding, so decriminalisation would not be beneficial.
In conclusion, I believe that decriminalising the personal use and possession of drugs would benefit the NHS because addiction and substance abuse rates would drop, more people affected by drug misuse would be able to access help, and the number of people suffering from mental and physical health problems due to conditions in prisons would decrease. This would ease a lot of strain from an already-stretched NHS. For decriminalisation to work, I believe that the government would need to increase funding of rehabilitation and treatment facilities, but overall, this would be the best way of tackling addiction and substance abuse in the UK, since individuals are more likely to find recovery in rehabilitation than in jail.
CMAJ (2014) Decriminalize drugs and use public health [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4081223/
Sellers, W. (2022) The decriminalisation of illegal drugs: a legal minefield [Online]. Available at: The decriminalisation of illegal drugs: a legal minefield – Will Sellers (royalhospitalschool.org)
Drug Policy Alliance (2015) Drug Decriminalization in Portugal: A Health-Centered Approach [Online]. Available at: https://drugpolicy.org/sites/default/files/DPA_Fact_Sheet_Portugal_Decriminalization_Feb2015.pdf
NHS Statistics on Drug Misuse (2012) Statistics on Drug Misuse- England, 2012 [Online]. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-drug-misuse/2012
Public Health England (2022) Misuse of illicit drugs and medicines: applying All Our Health [Online]. Available at: https://www.gov.uk/government/publications/misuse-of-illicit-drugs-and-medicines-applying-all-our-health/misuse-of-illicit-drugs-and-medicines-applying-all-our-health
Centers for Disease Control and Prevention (2019) Injection Drug Use and HIV Risk [Online]. Available at: https://www.cdc.gov/hiv/pdf/risk/cdc-hiv-idu-fact-sheet.pdf
Morse, G. (2017) Addiction and Substance misuse pathways [Online]. Available at: http://tvscn.nhs.uk/wp-content/uploads/2017/12/Gordon-Morse-Addiction-and-Substance-misuse-pathways-1.pdf
Transform Drug Policy Foundation (2021) Drug Decriminalization in Portugal: Setting the Record Straight [Online]. Available at: https://transformdrugs.org/blog/drug-decriminalisation-in-portugal-setting-the-record-straight