Editor’s note, October 4, 8 am ET: We’re bringing you some of our best-loved Your Mileage May Vary columns while Sigal Samuel is on parental leave. The one below was originally published last year.

This unconventional advice column offers you a unique framework for thinking through moral dilemmas. It’s based on value pluralism: the idea that each of us has multiple values that are equally valid but that often conflict with each other. Submit your own question here.

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My partner and I did IVF recently and luckily we ended up with several embryos. One of those will be implanted in me so I hopefully get pregnant. But which one?

My fertility clinic is encouraging me to do PGT-A testing, which would screen for things like Down syndrome and would also let me see the sex of each embryo so I could potentially choose whichever I want. (And to be honest, I really want a girl!) I’m also hearing about these new companies that can test embryos for all kinds of things — like how smart the kid might be, how tall they’ll get, and whether they’ll have a lower chance of getting breast cancer, diabetes, mental illness, stuff like that.

I don’t know how to feel about any of this. On the one hand, it feels weirdly eugenics-y to do so much tinkering with embryos, and I can’t help feeling a little pressured into overmedicalizing everything with these expensive tests. But then again, if I could do something to make my baby healthier and happier, don’t I kind of have to do everything in my power? What does a parent owe their child?

Dear Expecting,

This is such an exciting — and also confusing — time. You’re about to have your first kid, and that comes with all sorts of fears and insecurities and hopes and dreams. You want to do the right thing — no, the best thing! — for your child. It’s a beautiful impulse. Unfortunately, it makes it easy for companies to prey on you.

So let me walk you through what these companies can and can’t really provide. After we talk about the science, we can talk about the ethics. 

The simpler test you mentioned, PGT-A, has been around since the 1990s. It can indeed screen for conditions like Down syndrome and let you see the sex of each embryo. Mind you, that doesn’t predict what gender your child will ultimately end up identifying with — more on that soon.

The newer testing you mentioned is called polygenic testing. The conditions it screens for are complex ones, influenced by thousands of genes. We’re talking about everything from breast cancer to depression. Some companies even offer screenings not for disease prevention, but for genetic enhancement — so you can select for a taller kid or a kid with higher IQ.

Polygenic testing companies claim to predict each embryo’s risk for each condition, and the potential reduction of risk you’ll get if you choose one embryo over another. As the statistical geneticist Sasha Gusev explains, it’s very, very easy to be misled by this claim. If the company claims to lower absolute risk of Type 2 diabetes by 12 percent, you might think this means, “The chance of my kid ever developing diabetes just went down by 12 percent — great!” But really what it means is that, all else equal, a kid who would’ve developed diabetes is likely now at the high end of pre-diabetes instead, or just develops diabetes a few years later. The same holds true for other conditions, like breast cancer. Sure, if your kid is going to develop diabetes or breast cancer, you’d rather they develop it later — but it’s not the bill of perfect health customers might imagine.  

“Typical risk reduction estimates tend to exploit statistical assumptions to overstate their benefits and lead to confusion,” Gusev writes.

It’s also important to note that there’s a difference between a physical disease like cancer, which is straightforwardly and universally negative, and a complex mental health condition like depression. For one thing, polygenic scores don’t perform as well in psychiatry, as the psychologist Eric Turkheimer notes. Plus, most mental health conditions come in mild to moderate to severe forms, and it’s not clear that we should want to get rid of mild or moderate manifestations. 

“Sure, it would be nice if no one ever got depressed, but what would that actually mean?” Turkheimer writes. “People are going to be sad, and the most modern models of psychiatric disorders view most of them as extremes on continuous dimensions of normal behavior. I don’t think we want some kind of genetic version of Soma.”

To give a personal example: I have generalized anxiety with some obsessive tendencies. Is that a major pain in the butt sometimes? You bet. But if I could wave a magic wand and get rid of it, would I? No. In my experience, this trait is linked to another trait I deeply value: my creativity. The same thing that propels me down rabbit holes of worry also propels me down rabbit holes of getting super curious about some topic, researching it into the wee hours of the morning, and then writing a novel or children’s book about it.

That brings me to one other scientific issue: pleiotropy. It’s a fancy term for a simple truth, which is that genes can have an effect on more than one trait. When it comes to behavioral polygenic testing, we actually know very little about which genes cause what — a gene that’s correlated with depression or anxiety may also be correlated with a bunch of other things. So, if everyone were to start selecting embryos to try to protect their kids from depression or anxiety, what would happen? We don’t know! 

Pleiotropy is a scientific issue, but it’s also a moral issue, because in trying to protect your kid from a negative outcome, you could also be accidentally barring them from a positive one.

And that’s just the tip of the moral iceberg.

Another issue is the potential psychological harm that can result from commodifying our kids — treating them like consumer objects with selectable parts. Let’s say you use polygenic testing to try to select for high IQ. Even if the company’s predictor is right 80 percent of the time, that means it’s wrong 20 percent of the time. What happens if it’s wrong about your kid, and they end up with a low IQ instead of a high one? How will your kid feel? Unless you hide the truth from them, they’ll know that they are not what you wanted, that they failed to live up to the vision you went out of your way to chase.

The same goes for sex selection via good old PGT-A. I know you really want a girl. But what would happen if you select for a girl, and then your child grows up and turns out to be trans? They may feel an extra sense that they’re letting you down by not conforming to the gender expectations you had for them.

Then there are the ethical questions around unequal access. Polygenic testing isn’t cheap. (One company, Orchid, charges $2,500 per screened embryo. Test 10 embryos and that’ll cost you $25,000.) So, at least in the short term, that raises the specter of entrenching a caste system, where the gap between rich and poor expands dramatically as the rich get smarter and stronger.

Technologies tend to get cheaper over time, so maybe everyone will ultimately be able to afford polygenic testing. But that raises another problem: implicit coercion. If more and more of us make ourselves smarter and stronger, we may create a society in which everyone feels pressure to alter their child’s biology — even if they don’t want to. To refuse embryo selection would mean to put a child at a huge professional disadvantage, or to face moral condemnation for making “suboptimal” kids when optimization is possible. Society may no longer offer health insurance benefits or accommodations for kids with disabilities (or even non-enhanced IQ), reasoning that “it was the parents’ choice.” 

Some philosophers, like Julian Savalescu, already argue that parents have a “moral obligation to create children with the best chance of the best life.” Polygenic testing companies love that argument; Orchid founder Noor Siddiqui tells parents that “the responsible decision” is to “protect their children” from disease, using language like, “What if you could have stopped it…but chose not to?” And we generally live in a culture that’s obsessed with optimization. 

So it’s no wonder that you find yourself asking, “If I could do something to make my baby healthier and happier, don’t I kind of have to do everything in my power?” 

It’s a view that will be very appealing to utilitarians, who believe the right action is the action that maximizes well-being or happiness. But maximizing principles can be dangerous. If we’re laser-focused on maximizing one value, however noble it may be, that can lead us to overlook a host of other important values. Think about diversity, for example; polygenic testing could lead to a less diverse world. 

And it’s not even clear how to maximize well-being given that each embryo will have some downsides: How would you choose between one embryo with a slightly elevated risk for schizophrenia, another with a moderately elevated risk for cancer, and a third with a high risk for Alzheimer’s? You’d have to decide how to rank the importance of each condition, which would require a dizzying bit of moral math: How much weight do you put on the longevity associated with each condition, how much on patient-reported quality of life for each condition, and how much on your own ability to cope with each — and society’s ability (which will change over the years)? Plus, even if the screening does end up optimizing life for your individual child, it could have negative effects on the population level, for the reasons we covered above.

As the Nobel laureate Herbert Simon pointed out, many problems contain way more variables and way too much uncertainty for maximizing along a single axis to be feasible or even desirable. So it often makes sense to just go with an option that’s “good enough.” He coined the term “satisficing” — a portmanteau of “satisfying” and “sufficing” — to describe opting for this good enough choice.

What would satisficing look like in the context of embryos? If there’s a very serious condition that runs in your family — like Tay-Sachs or the BRCA mutation that markedly increases cancer risk — then I do think there’s a strong case for screening for that. These conditions are debilitating and can lead to early death. Nobody wants them. Genetic testing that lets us prevent them is an awesome gift. 

Then there are conditions that can include suffering, like autism, but can also be very compatible with a happy life. Mental health conditions in particular are heavily socially constructed — a lot of the associated suffering comes about because society constructs a certain biological reality as a problem and doesn’t support the people who have it. In these cases, if you want to give your child a “good enough” or even “optimized” life, remember that you don’t have to achieve that by biological means; working to change the social environment can be just as important, and it doesn’t carry the societal risks associated with polygenic testing. 

Ultimately, when considering what counts as a “good enough” life, each parent will draw the line in a slightly different place. And there’s a part of that that can’t be boiled down to objective facts about disease, because this is also about how well-resourced the parent feels — emotionally, socially, and financially — to deal with a certain condition. What feels manageable to one parent may feel crushingly hard to another. 

So, I can’t tell you exactly which screenings to do and which to forgo. What I do want to tell you is to resist being bullied or shamed by others, especially those with a profit incentive to push you in a certain direction.

As the epidemiologist Abby Lippman has noted, genetic testing is supposed to offer parents more choice, but it too often has the opposite effect. When someone like Orchid’s Siddiqui says about a disease, “What if you could have stopped it…but chose not to?” — well, that language preys on parents’ worst fears and insecurities. It holds parents hostage while pretending to be giving them more autonomy. 

You are nobody’s hostage. You are a moral agent free to look at the many different relevant factors, weigh them all in the balance, and then make the choice that works well enough for your family.   

Bonus: What I’m reading

• Silicon Valley is obsessed with IQ, so it’s no surprise that tech execs there are using polygenic testing in hopes of creating supersmart babies. This article shows the kind of mental pretzels customers get into when trying to figure out whether to select the embryo with the highest predicted IQ or that with the lowest risk of disorders. One couple asks: “How much additional risk of ADHD cancels out against 10 extra IQ points?”

• Rereading “The Last Children of Down Syndrome,” Sarah Zhang’s 2020 Atlantic feature on prenatal testing, it struck me that when people think “prenatal testing,” Down syndrome is often the first condition that comes to mind, even though it’s not the most severe or straightforwardly negative (it’s compatible with a happy life). It’s just that Down syndrome was easy to test for, so we started testing for it early. I wonder if that built up the condition as a bogeyman in the expectant parent’s imagination — if the fact that we could screen for it shaped the public’s perception of Down syndrome as something that should be screened for and potentially screened out.

• One trait that many people assume we should select for is a great memory. But I highly recommend the short story “Funes the Memorious” by Jorge Luis Borges. It’s a reminder that having too good a memory is not always a benefit.  

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Editor’s note, September 20, 8 am ET: We’re bringing you some of our best-loved Your Mileage May Vary columns while Sigal Samuel is on parental leave. The one below was originally published last September.

This unconventional advice column offers you a unique framework for thinking through moral dilemmas. It’s based on value pluralism: the idea that each of us has multiple values that are equally valid but that often conflict with each other. Submit your own question here.

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The Jewish High Holidays are coming up, and that includes Yom Kippur. It’s a holiday that encourages people to reflect on their behavior and make amends. That’s all well and good, but I’m someone who struggles with scrupulosity — constantly worrying about my morality and if I’m doing The Most Possible Good™.

In practice this is far more paralyzing than motivating. Fixating on the ethical implications of all possible decisions makes it harder to take any action, and I’ve lost hours scouring my memories of my past behavior for immorality like a football player watching footage of their games to analyze what they could do differently. Guilt simply isn’t serving me, but I worry that saying to hell with all that means I’ll stop striving to be a better person and become morally complacent.

I’ve observed Yom Kippur for decades, and don’t want to simply avoid the day. But the holiday is a moral scrupulosity trigger. How do you think I should approach this? I want to stop feeling guilty for letting guilt get in my own way.

Dear Scrupulous, 

Have you ever heard the story about what happened when God decided to give the Bible to flesh-and-blood human beings? According to the ancient rabbis, the angels hated the idea. They argued that humans were deeply flawed mortals who didn’t deserve such a holy scripture; only angels could be worthy of it, so it should stay up in heaven. 

It fell to Moses to rebut the angels’ argument. He asked them: What do you angels need the Bible for? The Bible says not to murder, not to commit adultery, not to steal — do you have jealousy or other emotions that could lead you to do those things? The Bible says to honor your father and mother — but you don’t have parents, so how could you ever do that? And the Bible says to sanctify the Sabbath — but you never do any work, so how could you even honor the Sabbath by resting? 

The angels saw that Moses was right. Angels are really great at one thing: being perfect. But perfect creatures are static. They don’t experience painful challenges, they don’t grow, and they don’t make choices that add beauty to the world. We humans do those things. God gives the Bible to humans not to make them into angels — but to make them better at being the unique thing they are: human animals, with feelings, flaws, and all, that can learn to use their capabilities in more beautiful ways.

I think there’s a lot of wisdom in this story. And I want you to notice how far it is from demanding that humans do “The Most Possible Good™.” That language suggests a maximizing ethical theory like utilitarianism, which says that we have to do the action that produces the greatest good for the greatest number. In other words, we have to optimize. 

Moral optimization may be possible for angels, but not for humans. We each hold multiple values, and sometimes those values are in tension with each other, forcing us to strike a balance as best we can. We’re not omniscient beings who can know with certainty how best to strike the balance. 

What’s more, sometimes different kinds of moral good straight-up conflict with each other. Think of a woman who faces a trade-off: She wants to become a nun but also wants to become a mother. She can’t balance between those options — she has to choose. And what’s the better choice? We can’t say because the options are incommensurable. There’s no single yardstick by which to measure them so we can’t compare them to find out which is greater.

Given that this complexity is baked into the human condition, it’s impossible to be a perfect optimizing machine. And the more you try to force yourself to be that, the harder it’ll be for you to actually help others, because you’ll just be so burned out. As you’ve already discovered, the optimizing mindset is exhausting — you end up expending a lot of precious mental resources that you could be spending on something else. It can even lead to paralysis. And a lot of the time, there’s no knowably best decision.

So instead of trying to optimize everything, you can adopt a goal that’s humbler but more realistic: to live in line with your values as best you can. 

I know that can feel scary. Optimizing makes being human feel less risky. It provides a sense of control, and therefore a sense of safety. The unspoken premise is that if you optimize, you’ll never have to ask yourself: How could I screw up that badly? 

But there’s another way to feel safe. It’s about leaning into the fact that we are imperfect and vulnerable creatures and that even when we’re trying our hardest there will be some things that we do not do optimally.

Of course, we should still try to live in line with our values. But in those moments when we fall short, we shouldn’t berate ourselves, thinking, “I sinned!” In Hebrew, the word we typically translate as “to sin” (lachto) actually means “to miss the mark.” It’s the same word we’d use to describe someone with a bow and arrow who’s targeting the bullseye but misses it slightly. This is a useful image, because it reminds us just how normal it is to miss the mark. Just as the archer’s arrow is buffeted around by the wind, we’re buffeted around by all the physical and psychological conditions acting upon us — naturally we won’t always hit the bullseye! And when we do miss the mark, we deserve compassion.

I know what you’re thinking: What if adopting this mindset means you’ll become morally complacent and let yourself off the hook too easily? This is one of the most common objections to practicing self-compassion. But research shows it’s not well-founded. In fact, psychologists have found that more self-compassionate people are better able to acknowledge when they’ve made a mistake. They’re more likely to want to apologize and make amends to others when they mess up. And they try to do better the next time around. Why? Because, to them, mistakes don’t feel so psychologically damning. That allows them to take more — not less — responsibility for their actions.

Yom Kippur can feel terrifying when any mistake you’ve made over the past year seems damning. But according to the ancient rabbis, Yom Kippur is not meant to be a somber day — it’s one of the happiest days of the year! After all, it was on Yom Kippur that Moses descended from Mount Sinai carrying the second set of tablets inscribed with the Ten Commandments, ready to gift them to the people. 

You probably know what happened to the first set of tablets: Moses shattered them after seeing the Israelites engaged in idol worship. What’s less known is that, according to one rabbinic story, God’s response to the shattering of those tablets was to actually congratulate Moses. Why did God think breaking them was the right move? And what was different about the second set? 

While the first tablets had been fashioned by God and God alone, the second tablets were a human-divine collaboration: Moses carved the stone and God inscribed the words. And while the first tablets contained only the words of the Ten Commandments — a black-and-white, rule-based morality — the rabbis tell us that the second tablets contained within them all the stories and interpretations that Jewish sages would later develop.

In other words, God recognized that you can’t just give humans a list of moral rules and call it a day. Maybe that would work for angels, who live in a simplified, disembodied world, but our ethical life is just too messy and multifaceted to be captured by any single set of universally binding moral principles. Yet God chose people over angels anyway, inviting us into the collaboration and embracing our humanness rather than rejecting it.

So, to the rabbis, Yom Kippur was a happy day because they fully expected that God would accept and embrace messy humans. 

Please, don’t try to be more zealous than God.

When you’re taking action, by all means, aim your arrows as true as you can — try to hit the bullseye, the place that captures as much of what you value as possible. But once you’ve released the arrow from your bow, let it be. 

If it turns out that you missed the mark, that you acted suboptimally, I put it to you that that is okay. You are not an angel. You are not a perfect optimizing machine. You do not have access to a magical mathematical formula that can consider countless incommensurable variables and spit out the very best move with certainty. You are human and you do the best you can with what you’ve got. 

The wisdom of these millennia-old stories is that that’s good enough for God. Let it be good enough for you, too. 

Bonus: What I’m reading

• Writing this column reminded me of The Mindful Self-Compassion Workbook, written by the psychologists Kristin Neff and Chris Germer. It really helped me develop a self-compassion practice, which has in turn helped me get a grip on my own scrupulosity. I also strongly recommend the eight-week self-compassion course run out of Neff and Germer’s nonprofit, the Center for Mindful Self-Compassion.

• I’ve always associated the philosopher Thomas Nagel with questions about consciousness, but I recently learned that he’s also super interested in questions about religion. In a great essay called “Secular Philosophy and the Religious Temperament,” Nagel asks: What, if anything, does secular philosophy have to put in the place of religion? More specifically, can it answer the question: What is the underlying nature of the universe, and how can the human individual live in harmony with it? 

• In this Aeon essay, philosopher Elad Uzan argues that AI will not be able to solve ethics for us, despite what some people hope. Drawing on the mathematician Kurt Gödel’s famous incompleteness theorems, Uzan writes, “just as mathematics will always contain truths that lie beyond formal proof, morality will always contain complexities that defy algorithmic resolution.”