Mastering Our Gen(i)es: When Do We Say No?
by Gilbert Meilaender
Gilbert Meilaender teaches theology at Valparaiso University in Valparaiso, Indiana. This article appeared in the Christian Century October 3, 1990, pp. 872-875, copyright by the Christian Century Foundation and used by permission. Current articles and subscription information can be found atwww.christiancentury.org. This material was prepared for Religion Online by Ted & Winnie Brock.
Among the stories, many no doubt apocryphal, told about George Bernard Shaw is one in which the dancer Isadora Duncan suggests to Shaw that they should have a baby, saying, "Think of a child with my body and your mind." "Ah," replies Shaw, "but suppose it had my body and your mind." This is in essence, the sort of argument to which we incline most readily when we worry about recent advances in the study and manipulation of genes and about the implications of the Human Genome Initiative. It is an argument that emphasizes uncertainty, the limits of our knowledge and the mistakes to which we are prone.
It is certainly not a silly argument, but it is destined to lose. It will lose not because of our hubris, not because we refuse to acknowledge limits or that mistakes may occur, but because by itself the argument is self-defeating. Attempting to hold before us a yellow caution light, it in fact allows us to proceed with a good conscience: We are being careful. We are aware of the dangers of human presumption. We are concerned about ethical questions. But like the father portrayed by Dustin Hoffman in that wonderful scene in Kramer vs. Kramer in which, contrary to repeated warnings, the little boy takes ice cream from the refrigerator, we have not found a persuasive way to say No.
"Proceed with caution" may be the morally correct advice. But not, perhaps, on every issue. We have not, in my view, risen to the level of moral seriousness unless and until we are prepared at least to contemplate saying No. That we are prepared to say it does not mean we must, but it means we may.
The larger issue here is theological, concerning the meaning of being human. We are strangely two-sided creatures: located in a finite world of space, time and biological constraints, yet transcending those limits with a freedom that finds its ultimate limit in the God for whom we are made. Therefore, we cannot say that it is always wrong to take control of nature and turn it in directions we think good, for such self-transcendence is an expression of the freedom that is essential to being human. Neither should we assume, however, that freedom is the sole truth about our nature, that every step beyond old limits is a praiseworthy exercise of the freedom that characterizes us. Any particular step may be the one we should not take, the one that will destroy something as essential to our humanity as freedom is.
In one of his many intriguing essays, Lewis Thomas contemplates the deeply buried origins of the word "hybrid." It comes from the Latin hybrida, a name for the offspring of a wild boar and a domestic sow. But, Thomas notes, in its more ancient origins the word "carries its own disapproval inside." Its more distant ancestor is the Greek hubris -- insolence against the gods. Hence hidden somewhere in the development of our language is a connection between the unnatural joining of two beings and human usurping of the prerogatives of the gods. "This is what the word has grown into, a warning, a code word, a shorthand signal from the language itself: if man starts doing things reserved for the gods, deifying himself, the outcome will be something worse for him, symbolically, than the litters of wild boars and domestic sows were for the Romans." Thomas is no Luddite, however, as his concluding reflections make clear.
Is there something fundamentally unnatural, or intrinsically wrong.. . in the ambition that drives us all to reach a comprehensive understanding of nature, including ourselves? I cannot believe it. It would seem to be a more unnatural thing. . . for us to come on the same scene endowed as we are with curiosity. . . and then for us to do nothing about it or, worse, to try to suppress the questions. This is the greater danger for our species, to try to pretend . . . that we do not need to satisfy our curiosity [The Medusa and the Snail].
Like a good modern, Thomas is more fearful of sloth than pride -- more fearful that we may. leave unexplored some potential for good than that we may exercise our freedom in ways that are finally destructive of our humanity.
In That Hideous Strength, "a modern fairy tale for grownups," C. S. Lewis imagined a National Institute of Co-ordinated Experiments (N.I.C.E) which is undertaking an ambitious attempt to control and shape nature. Filostrato, a slightly mad clergyman who is a member of N.I.C.E., says at one point that he awaits a more rational day when artificial metal trees will replace natural ones. Then, if we tire of a tree in one place, we simply move it elsewhere. "It never dies. No leaves to fall, no twigs, no birds building nests, no muck and mess." Applied to human beings, Filostrato’s hope is equally sanitized. "What," he asks, "are the things that most offend the dignity of man?" Answer: "Birth and breeding and death." To take control of them is, we must admit, part of the Human Genome Initiative -- indeed, still more, part of the modern project whose "legitimacy" and "curiosity" have been defended by Hans Blumenberg in his provocative (if Teutonic) book The Legitimacy of the Modern Age. What Blumenberg does not pay much attention to, however, is that the rise of the modern project was interwoven with renewed interest in magic and esoteric religion, with the thirst for control and mastery of the secrets of the universe. Still today that thirst is present: to get control of our genes and thereby, perhaps, of the elusive genies whose very unpredictability and unreliability threaten efforts at mastery.
With the advances in knowledge that are almost certain to be gained from the Human Genome Initiative -- or, if its critics should win the day and it lose support, from more piecemeal genetic - research -- we will know more and- more about genetic factors causally related to health and disease and to other important aspects of life, such as intelligence and emotional states. We will gain increased mastery over birth, breeding and death. How will such knowledge be used? Is there any way of discerning in advance which exercise of freedom will prove destructive of our humanity and not truly liberating?
Before worrying about future subjunctives, we ought to pay a little heed to present indicatives. Every day new advances in our ability to diagnose -- though not necessarily to treat -- genetic disorders are being used. They are used in making decisions about abortion after prenatal diagnosis. (And soon they will be used in preimplantation genetic screening to determine whether to implant or discard the embryo.) This is not, of course, treatment of a disorder; it is simply elimination of the one suffering the disorder. But it is a use -- the most likely use, at present -- of advancing understanding of the human genome. Here is an instance in which an exercise of apparent freedom has not, in fact, proved liberating. Barbara Katz Rothman has argued persuasively that prenatal diagnosis has offered women chiefly "the illusion of choice," seemingly new possibilities which have created "new limitations on choice." The technology of prenatal diagnosis has redefined the meaning of motherhood: it is making it difficult to commit oneself to an unborn child whose diagnosis is not yet assured; it is making it increasingly difficult .to exercise one’s freedom not to abort if the diagnosis is a bad one; it is encouraging women to think of their child as a product for whose quality they must accept responsibility; and it is making it more difficult to deal with disorders and afflictions that are not within our control and must simply be accepted. Rothman’s is a powerful argument: more freedom has turned out to be less.
Reinhold Niebuhr could not have asked for a better illustration of his common refrain: that our natural vitalities may often prove destructive rather than creative of human possibilities. A desire to transcend some of the uncertainties inherent in our finite condition has created not new freedom but chains that bind in powerful and disturbing Ways. Only with great difficulty will we keep such chains from being institutionalized. Recent reports tell of a Health Maintenance Organization that wanted to cover the cost of a prenatal test for cystic fibrosis only on the condition that the woman agree to have an abortion if the fetus was afflicted with the disease. When challenged, the HMO backed down -- for now. But it is worth repeating that the most likely immediate use of new knowledge of the genome is for prenatal diagnosis and abortion of the "defective." We ought to reject that ground for abortion. That approach both expresses and encourages an attitude that opposes not disease and disorder but the diseased and afflicted human being. Such an attitude is ultimately in conflict with itself; for the urge to cure disease presupposes openness to the human dignity of sufferers and concern for them.
There are other future -- and increasingly present -- possibilities. It is common to distinguish between genetic interventions aimed at somatic cells (all bodily cells that are not involved in reproduction) and germ cells (that will become sperm or ova). To alter a person’s somatic cells is to make a change that will die when he or she dies. This is a possibility already with us and one whose scope will be considerably enlarged in the near future. To alter a person’s germ cells is to make a change that may be passed on through generations of descendants. This is a possibility whose day may come, but it is less likely in the immediate future.
With this distinction in mind some have drawn a line between intervention aimed at somatic cell therapy and intervention aimed at germ cell therapy. I suspect that on first reflection such a line -- which permits the first and prohibits the second -- both does and does not make sense to us. On the one hand, there is something awesome about an intervention that no longer deals only with the soma, the bodily form, but goes right to the very core of human identity in order to shape the future not simply of one person but of his or her descendants. We may well draw back from such an undertaking, which can seem almost godlike in its pretension to mastery.
But on the other hand, when we reflect further, we may also wonder why such a line should be drawn. Where is the clear line in a progression from (1) using animal insulin to treat diabetes, to (2) using gene remodeling techniques to grow insulin in a host bacterium that will reproduce rapidly and from which a plentiful supply of insulin can be harvested, to (3) genetic surgery to replace the defective gene in a person diagnosed as diabetic, to (4) genetic surgery immediately after fertilization in order to replace the defective gene and alter the germ cells which would otherwise have transmitted the disease to one’s offspring? We may note, as Hans Jonas put it, that even the last of three stages would not quite be characterized as the godlike act of new creation; it could still accurately be called repair or therapy. Indeed, its advantages might seem considerable: it treats the root of the problem and not only its symptoms, thereby avoiding the risk of passing the disorder on to future generations.
Nevertheless, our first intuition -- which sensed that a line ought to be drawn prohibiting alterations of term cells -- is, I think, a sound one. And the reason is precisely what seemed to be the trump card in the case for such intervention: the control exercised over future generations. To give that card its due we must add: control designed to prevent future suffering and eliminate the need for future interventions at the somatic level. Such intervention would aim at correcting not simply the illness afflicting a particular person but at shaping the nature of others still to come. Not only a human being but humankind is then the object of our intervention. Even when such intervention aims to be beneficent, we should say No to it. More than 40 years ago C. S. Lewis noted that "what we call Man’s power over Nature turns out to be a power exercised by some men over other men with Nature as its instrument." The end of this process, which we picture as the creative exercise of our rational freedom, proves to be bondage.
The last men, far from being the heirs of power, will be of all men most subject to the dead hand of the great planners and conditioners and will themselves exercise least power upon the future. The real picture is that of one dominant age.., which resists all previous ages most successfully and dominates all subsequent ages most irresistibly, and thus is the real master of the human species. . . There neither is nor can be any simple increase of power on Man’s side. Each new power won by man is a power over man as well.
The dehumanizing deeds, if they are done, will not be done by obviously evil men and women. They will be the work of those who are moved by the thirst for knowledge, fame and power -- but also by beneficent concern for future suffering. A real devil we could resist. But a project of human mastery carried out in the name of beneficence, promising to relieve suffering -- that it is harder to turn our back on.
The principles that have emerged thus far are these: We should seek new knowledge of our genes (and we can say this without deciding whether the Human Genome Initiative is the wisest and most cost-effective way to do so) We should seek therapies for the genetic disorders that afflict many people. But we should turn against disease, not against those who are diseased. And we should focus our therapeutic efforts on particular afflicted human beings, not on humankind. These principles go at least some way toward guiding our aims in genetic research and directing our use of advances in knowledge. They rule out selective abortion of defective fetuses, and they focus our attention on therapies aimed at somatic cells rather than germ cells.
For the present, of course, even somatic cell therapies will be very few, but their number will grow. How, finally, shall we think about that possibility? The time may come when we can replace the defective gene that causes diabetes. The time may also come when -- even granting the complex interactions of nature and nurture -- we can intervene to alter a gene or genes that strongly determine some cognitive abilities. Is there any important moral difference -- any line that can be drawn -- between intervention aimed at treating what everyone acknowledges to be a disease and intervention aimed at enhancing cognitive ability?
To make such a distinction requires a carefully circumscribed definition of health, one quite different from the famous definition once given by the World Health Organization: "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." Many criticisms of such a wide-ranging definition have been offered, and surely it cries out for religious critique. Complete well-being? Offered by physicians who, though they have long since renounced the garb and ways of the shaman, are still cast in the role of soter? If a definition like this one guides our aims, there will be no end to our efforts to reshape those who fall short of complete well-being. And, significantly, we will never reach a time when we are prepared simply to accept a person as he or she is -- to oppose diseases but accept persons without qualification. There will be no logical end -- apart from the current frontiers of knowledge -- to our proposals for remaking and reshaping those for whom we are responsible.
A less Promethean definition of health, which recognizes that there is no single positive vision of well-being, would still allow us to intervene against disorders that bring pain or hinder an individual in carrying out the biological functions necessary for personal or species survival. There is, of course, much more to our desires for life and happiness than that, but our visions of fulfillment differ in countless ways. It may be difficult, and is in any case unwise, to attempt to control such choices, but we should limit the interventions we impose on others in our care -- limit them to those that clearly seek to treat disease.
In our saner moments we know that parents today are far too eager to use the methods already available -- chiefly in the realm of controlling nurture rather than nature -- to shape the lives of their children. We are unwilling to let the mystery of personhood -- equal in dignity to our own -- unfold in the lives of our children. Contemplating the question of whether we are really likely to use advances in genetics to create children whose abilities and talents are enhanced in various ways, Robert Wright has suggested that the answer is obvious if we simply look at what we already do.
Each year thousands of Manhattan parents work up a cold sweat over whether their four-year-olds will get admitted to the best private kindergartens or merely the very good ones. And, for that matter, similar worries preoccupy parents all across the country. They spend millions prepping their kids for SAT tests, honing their athletic skills, and teaching them to carry a tune. . . . Just your typical parent, sitting nervously in the bleachers at a Little League game.
Hence we need more than clarity about disease and health. We need a renewed sense of the mystery of the human person and the limits to our own efforts at shaping and transforming character. Here the argument from uncertainty has real validity. As John Henry Newman wrote: "Basil and Julian were fellow students at the schools of Athens; and one became the saint and doctor of the Church, the other her scoffing and relentless foe."
Even more, we need the virtue of love. Love -- that can say, without qualification, to another: "It’s good that you exist." Love -- that in its open-hearted acceptance of another disciplines and restrains the urge to transform and remake. Love -- that is willing to be godlike when confronted with the diverse aims and even the suffering of our children, willing, that is, sometimes to bear suffering rather than simply to try to do away with it.. Probably we cannot draw any clear and distinct line here, but we are badly in need of powers of discernment.
Oliver O’Donovan has called attention to the contemporary significance of the distinction between one who is begotten and one who is made. One whom we beget shares in our being, is equal in dignity to us. One whom we make has been distanced from us, become the product of our will, and we know how limitless that will can be. Of course, parents are responsible for the nurture of those whom they have begotten, and such nurture can and should sometimes be demanding. But when we know ourselves as begetters, not makers, we will seek to shape and nurture only those whom we first accept without qualification. Were that outlook to shape our analysis of somatic cell interventon we would have little to fear from it. Indeed, were that outlook more generally to shape our vision, we should be more accepting of recalcitrant genes and less eager to be master of the genies from whom ultimately we have nothing to fear.