{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T10:35:29Z","timestamp":1758191729812,"version":"3.44.0"},"reference-count":52,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Med Humanities"],"accepted":{"date-parts":[[2025,8,6]]},"abstract":"<jats:p>This essay analyses two novels that explore reproductive scenarios which may be implemented in the near future: human germline genome editing and in vitro gametogenesis (IVG), dramatised in Eve Smith\u2019s <jats:italic>Off-Target<\/jats:italic> (2022) and Kira Peikoff\u2019s <jats:italic>Baby X<\/jats:italic> (2024), respectively.<\/jats:p>\n               <jats:p>Smith\u2019s <jats:italic>Off Target<\/jats:italic> considers the plethora of medical, ethical, social and familial implications of germline editing, which is used to modify an embryo\u2019s genome and enhance it with traits deemed optimal that will be passed on to future generations, in this way effectively creating designer babies and radically interfering with the laws of evolution and genetic inheritance. The novel deals with the potential unintended consequences of genetic engineering, in particular CRISPR\/Cas9. Genetic edits, if insufficiently tested, can have off-target effects, alluded to in the name of the novel. Peikoff\u2019s <jats:italic>Baby X<\/jats:italic> takes the premise of <jats:italic>Off Target<\/jats:italic> a step further by introducing IVG, exploring the multiple ramifications of this as yet undeveloped reproductive technology which would radically change the reproductive landscape as we know it.<\/jats:p>\n               <jats:p>Meanwhile, the science that will enable germline editing and IVG is advancing rapidly, making it imperative to consider the far-reaching repercussions of these technologies, not only in medical terms but specifically with regard to ethical implications for families and society in general. These novels are powerful reminders that the debate about the future applications of genome editing and IVG needs to happen now. The issues raised by the novels will be analysed mainly through a gender studies and bioethics lens.<\/jats:p>","DOI":"10.1136\/medhum-2025-013321","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T17:20:31Z","timestamp":1758129631000},"page":"medhum-2025-013321","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["The future of reproduction in Eve Smith\u2019s <i>Off Target<\/i> and Kira Peikoff\u2019s <i>Baby X<\/i>"],"prefix":"10.1136","author":[{"given":"Aline","family":"Ferreira","sequence":"first","affiliation":[{"name":"Languages and Cultures, Universidade de Aveiro, Aveiro, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"2025091710202016000_medhum-2025-013321v1.1","doi-asserted-by":"crossref","unstructured":"Almeida M. , and Ranisch R. . 2022. \u201cBeyond Safety: Mapping the Ethical Debate on Heritable Genome Editing Interventions\u201d. 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New Haven CT: Yale University Press."},{"key":"2025091710202016000_medhum-2025-013321v1.13","unstructured":"Green R. M . 2015. \u201cBuilding Baby from the Genes Up\u201d. Genius. Available from: https:\/\/genius.com\/Ronald-m-green-building-baby-from-the-genes-up-annotated"},{"key":"2025091710202016000_medhum-2025-013321v1.14","doi-asserted-by":"crossref","unstructured":"Haining C. M. , Savulescu J. , Keogh L. , and Schaefer G. O. . 2024. \u201cPolygenic Risk Scores and Embryonic Screening: Considerations for Regulation\u201d. Journal of Medical Ethics. doi:10.1136\/jme-2024-110145","DOI":"10.1136\/jme-2024-110145"},{"key":"2025091710202016000_medhum-2025-013321v1.15","unstructured":"Hall L . 2023. Reproduction (Cambridge, England). 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Cambridge: Cambridge University Press.","DOI":"10.1017\/9781108979382"},{"issue":"1","key":"2025091710202016000_medhum-2025-013321v1.47","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11019-019-09922-6","article-title":"\u201cIs It Ever Morally Permissible to Select for Deafness in One\u2019s Child?\u201d","volume":"23","author":"Wallis","year":"2020","journal-title":"Medicine, Health Care, and Philosophy"},{"key":"2025091710202016000_medhum-2025-013321v1.48","doi-asserted-by":"crossref","unstructured":"Wilkinson S . 2005. \u201cDesigner Babies\u2019, Instrumentalisation and the Child\u2019s Right to an Open Future\u201d. In Philosophical Reflections on Medical Ethics, edited by Athanassoulis N. , 44\u201369. London: Palgrave Macmillan.","DOI":"10.1057\/9780230273931_3"},{"key":"2025091710202016000_medhum-2025-013321v1.49","doi-asserted-by":"crossref","unstructured":"Wilkinson S . 2010. Choosing Tomorrow\u2019s Children: The Ethics of Selective Reproduction. 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