Ethical issues in health: are designer babies on the way?
Ethical issues in health: are designer babies on the way? |
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Key words: Genetics, health, Christianity, ethics, healing.
Introduction
There is no question; genetics is often in the news. Barely does a day go by without something being mentioned in the media. These currently include: Food and animal - Genetically modified (GM) foods and crops and Dolly the sheep – genetic manipulation of animals. With regards to human health, bovine spongiform encephalopathy, (BSE fallout); HGP as background to many discoveries reported in the media. Others are environmental issues, developing countries and the role of multi-national companies.
The prospects are indeed awesome. There are terrible diseases owing to single gene malfunction which may one day be treatable. These include: cystic fibrosis, HS, DMD. Also many diseases or conditions which are products of both genetics and environment may be treatable by individually tailored drugs - cancers or heart diseases. It must be noted that, PGD, selection of embryos to avoid passing on “bad genes”, is already taking place. Also research on gene therapy in the womb is going on now. While the results have been somewhat disappointing (no clinically effective gene therapy yet), most scientists agree that this is a matter of time, not of intrinsic problems with the science itself. The possibilities do not stop there. Soon we may have more insight into the role of genes in human behaviour and other attributes like intelligence, sexuality, disposition to aggression or nurturing; and the “suicide” gene. All may have a genetic component; even if there is a complex relation to environmental factors. Despite these remarkable possibilities, it is striking that public attention is at least as fixated on potential dangers. Ever since Dolly the sheep, there have been fears about human cloning (even if Dolly’s premature ageing slows that down). Similarly, designer babies a regular feature in newspapers leading to columnists, pressure group activists and other worriers to muse about a decline towards genetic perdition. What should one think about this ethically and theologically? Separate the questions: theologically as what Christians might find attractive; ethically as what anyone might think or find persuasive, without any specific Christian content.
The value of medicine
Too often those who are critical of genetic developments can seem to be opposed to everything that is going on. Theologically, the church has always had a strong commitment to medicine and the work of healing. From the earliest days, the church always held that God is a God who heals. This has been expressed through miracles of healing/laying on of hands, or through modern Western medicine. The church has always proclaimed that the work of healing is part of the restoration of creation. This goes back to Jesus who said: “the Spirit of the Lord is upon me to bring sight to the blind, preaching the word and healing the sick.” It is right that the church should be committed to healing and medicine. Ethically, we should remember that most developments in genetics are about healing – more sophisticated tools for tackling disease. In the therapeutic tradition of medicine, cancer has been attacked by chemotherapy/radiotherapy and surgery. As a new development, this may be done through genetically modified viruses.
What does this commitment to healing/therapy mean for genetics?
The opportunities include:
– gene therapies, where defective genes are replaced and healthy ones inserted, e.g. cystic fibrosis nasal spray; genetically modified viruses to target cancer cells
– using genetic profiles of people to know which drugs are likely to be effective
– with certain provisos, genetic screening of populations are helpful in understanding the spread of diseases and highlighting risk
– with greater provisos, genetic testing of individuals can be helpful in assisting individuals know whether they are carriers of a gene or likely to develop a particular disease
In other words, aspects of human genetics related to the therapeutic task of healing should be welcomed.
The value of human embodiment
We are all embodied. We are not just souls or free-floating consciousnesses that happen to find
ourselves in bodies. We have bodies, and these are and should be valuable to us. Theologically, this is in the Christian understanding of the goodness of creation. One of the earliest heresies is Gnosticism, which is the denial that Jesus had come in the flesh. The material didn’t count, only the spiritual. The body is evil - cf Glenn Hoddle: “my body is just a raincoat.” By contrast, early Christians always said redemption of creation: creation good but fallen, but not to be escaped from; resurrection of the body, not immortality of the soul; Jesus came in the flesh.
Ethically, a constant theme of much recent philosophy is that we can’t escape our physicality, our human limits. Franklin said “In this world nothing can be said to be certain, except death and taxes.” We are beings that will die, and beings that are liable to suffer. This is something which should be embraced, not rejected.
What does this have to do with genetics?
Designer babies, selected for athletic prowess or musical ability or intelligence or beauty, are arguably ways of trying to escape our humanity. We need to consider whether the human body is something we should try to improve on, or something we should broadly accept as it is. Other considerations are about the desire for human perfection that forms some of the hopes invested in genetic research and the quest for the perfect baby or the desire to discover the biological basis of ageing. What do such hopes tell us about our attitudes to mortality and human finitude? Is this endeavour about facing up to our human limitations or trying to escape them? For Christians, it could be that the ancient quarrel over Gnosticism has some surprisingly modern implications.
The values of justice and equal humanity
A third theological consideration in relation to genetics is the church's commitment to justice and equal humanity. In the creed, "begotten not made": Fathers were saying that Christ was radically equal to God the Father; something that is made cannot ever be fully equal to its maker -but Christ is fully divine. Similarly for human beings something made cannot be radically equal to its maker e.g. a cake, a motor car, a poem or a computer programme. This is true ethically as well. We all believe in justice: “that all human beings are equal, and should be treated equally, as full human beings in their own right.” It is almost unintelligible for someone in contemporary society to deny that they are committed to justice and to the equality of all human beings.
What are the possible implications?
– When do children become manufactured products rather than fully equal human beings in their own right?
– A recurrent Christian concern about ARTs (In-Vitro Fertilisation, etc.): a difference between using technology to assist procreation and using technology to replace procreation.
– Would cloning children be a form of treating them instrumentally, turning them into commodities?
– What would happen if we weren't happy with a child produced like this? Would we take them back to the manufacturers? Ask for a refund or a discount?"
– In the end are we really regarding such children as of equal humanity?
The same kind of commitment to justice underlies other long term concerns. Princeton University molecular biologist Lee Silver postulated a scenario, not entirely implausible, in which the genetic modification of children becomes relatively common at least for those who can afford it. Such children are liable to marry amongst themselves, perpetuating the elite and creating a secondary class of genetically unenhanced human beings resulting in a new class divide of (genetically rich) GenRich and Naturals! He even speculates that over time those marrying across the divide may over generations become less fertile. This is because genrich and naturals are actually two species. Whatever one thinks of the speculative bits, clearly this kind of social division, with deeply entrenched differences, is profoundly opposed to our current ideals.
Finally there are three considerations: which will prevail? A society which honours those values? Or a society which neglects them? This is for each of us to decide.
DMD = Duchene’s Muscular Dystrophy.
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