The applications of biotechnology have provoked debate about its ethics. Richard Holloway looks at some of the issues
One way to classify people is by the tumbler test: pessimists say it is half empty, optimists half full. In most of the great debates about human nature people place themselves somewhere on the continuum between these two poles.
There is an obvious application of the tumbler test to political theory, with people like Hobbes in the pessimist camp. Because of his low estimate of human nature, he called for strong princes to control the brutal excesses of society. John Stuart Mill, on the other hand, believed that human nature was rational and capable of altruism, so he argued for liberty and democracy. Science is the dominant narrative of our day, so it is fascinating to watch this ancient debate conduct itself in a new language. Pessimists mistrust science, optimists celebrate the enormous contribution it has made to human progress, but many people are just not sure what to make of it.
Reaching a considered judgement on the complex issues that science presents is particularly difficult in Britain at the moment, because of the approach of certain newspapers. The science correspondents in the better papers play an important part in educating the public about science and its implications, but some of the other sheets present the subject as a shoot-out between ordinary decency and overweening arrogance. This may sell papers, but it hardly does justice to the importance of the subject.
There are real anxieties, of course. The biotech revolution we are now entering will make the industrial revolution look like a minor blip on the chart of human history. Change always induces anxiety, particularly among natural pessimists, of whom Britain always seems to have more than its fair share, so it’s not surprising that recent advances in genetics have provoked alarm in certain quarters.
The paradox is that Britain has so far managed to pilot a steady course through the scientific revolutions of our era. The paradigm is the Human Fertilisation and Embryology Act of 1990. Like any human construct, it is far from perfect, but it does provide us with a model approach to the negotiation of current perplexities. Depending on which side of the pitch you stood, the 1990 Act was a masterly example of either moderate pessimism or moderate optimism, which steered a middle way through the field of reproductive science, between unfettered experimentation and the outlawing of procedures that were novel and controversial at the time. After a certain amount of ritual grandstanding on both sides of the debate, this is the approach we will almost certainly adopt to the new advances in human genetics. But we ought to keep our minds open to some of the sensitive issues that will confront us.
One of the difficulties is that the subject is inescapably linked to memories of the pseudo-science of eugenics, with its fascist echoes. The word eugenics is probably beyond rehabilitation, but behind it lies a morally complex issue. Theoretically, it will soon be possible to perform gene therapy to cure or prevent inheritable genetic diseases. These therapies in themselves raise interesting ethical problems to which I’ll return, but the issue I want to look at briefly now is their likely effect upon existing people with disabilities.
It is not too difficult to see why the disabled community might come to interpret these procedures as an attack upon their own value as human beings. We might argue that to try to mend a particular defect is far from saying that those who possess it are less human than the rest of us.
Even more complex will be the ethics of the reverse possibility, whereby a disabled couple, such as a profoundly deaf one, might invoke the process in order to design the birth of a disabled child who can be fully at home in its parents’ culture. Is there any way in which a truly multicultural society could learn to live with intentionally produced disability? If, as the disabled community claims, disability is socially constructed, might it not be possible to deconstruct it in this way and thereby create genuinely plural communities? We are going to have to breathe deeply and keep our wits about us as we negotiate some of these possibilities.
When gene therapy is perfected, it will come in two possible forms, each with its own ethical difficulties. It could be performed using somatic cells, which make up most of the cells in the body, or germ cells from sperm or eggs. Somatic cell gene therapy would only affect the individual who was treated, whereas germ cell therapy would pass the altered genes on to the next generation. In 1989 the government set up a committee to consider the ethics of gene therapy. Its report in 1992 concluded that “somatic cell gene therapy will be a new kind of treatment, but it does not represent a major departure from established medical practice; nor does it pose new ethical challenges.”
Where it is likely to become controversial, however, is when it is applied to procedures for the enhancement of physical characteristics, such as height or appearance. Though it will doubtless provoke debate, it would be hard to argue that using somatic cell gene therapy for these purposes would be more ethically problematic than getting a nose job or a breast enhancement using existing procedures. Nevertheless, we can expect the tabloids to have a field day with this therapy when it comes on-stream.
Germ cell gene therapy, if it is ever made safe, will raise a much more difficult issue. Would it be unethical to apply a technique that would affect an individual prior to conception? The philosopher John Harris argues that, if the technique is proved to be safe and efficacious, it would be unethical not to apply it, because parents have an obligation to avoid harm to their unborn children.
However, the real issue here is the moral status of the human embryo. Germ cell gene therapy will be perfected and made safe only after years of experimentation on embryos. The Human Fertilisation and Embryology Act permits experiments on embryos up to 14 days, or on the appearance of the neural or primitive streak. But this is one of the most controversial aspects of the Act and one which significant elements in British society still reject.
Most of us would probably apply a doctrine of incremental potentiality to human gametes, so that the moral status of the entity increases the closer it gets to term. The Roman Catholic Church, however, accords full human status to the embryo from the beginning, so it condemns experiments on embryos as the moral equiva- lent of the torture of human beings.
This is an example of the kind of disagreement that is inevitable in a plural society. But those of us who find these developments unproblematic ought to remember that they will be painful for intact moral communities that have a fixed perspective on the status of human gametes. If we are to avoid the culture wars that so disfigure the United States we’ll have to negotiate these complexities with great care.