ethical odyssey

rsa journal, february 2007

'This is revolting and turns my guts. Gawd knows what these barmy scientists are up to and what they have already got lurking in test tubes in the lab'. So wrote one correspondent to the Scotsman in response to a report that three teams of British scientists are seeking to create 'hybrid' embryos for medical research. The scientists want to transfer a human cell nucleus into an animal egg from which the nucleus has been removed. The resulting embryo would then be harvested for stem cells, to aid research into possible cures for conditions such as Alzheimers' and motor neurone disease. Scientists are keen to implant the human nucleus into an animal egg because human eggs are in short supply.

The hybrid cells would, as scientists point out, be 99.9 per cent human and 0.1 per cent cow or rabbit. But the very thought of such cells created fantastic visions of half-man, half-rabbit monsters - and not just among correspondents to the Scotsman. ‘There is a lot of innate wisdom in the yuk factor’, observed Josephine Quintavalle of the lobby group Comment on Reproductive Ethics. ‘My question is: what will the scientists actually create?’ The government seems to feel the same. It is committed to banning the creation of hybrid embryos (though it has not yet got round to drawing up the legislation) and has called on funding bodies 'to make clear that they will not fund or support research involving the creation of such hybrids'. In January the Human Fertilisation and Embryology Authority (HFEA) - the body that regulates embryological research in this country - postponed until autumn any decision on whether to license the procedure.

A sense of 'yuk'. And a fear of rampant science unrestrained by ethical concerns. These have becoming over-riding responses of many people to advances in biotechnology. Politicians and policy makers on both sides of the Atlantic have, at best. pandered to such emotions and, at worst, encouraged them. The philosopher Dame Mary Warnock, who chaired the committee that in 1984 drew up early guidelines on embryological research, suggests that policy makers should take gut feelings seriously. For 'morality to exist at all', she argues, 'there must be some things that, regardless of consequences, should not be done' because crossing such barriers generates 'a sense of outrage... a feeling that to permit a practice would be indecent or part of the collapse of civilisation'. When President George Bush last year vetoed legislation that would have provided public funding for stem cell research he warned that there can be no 'crossing the line' that 'would needlessly encourage conflict between science and ethics'.

Many people recognise the medical benefits that biotechnologies may bring. But many also fear that such benefits may be purchased at too great a price. The image we have is of an unending conflict between an amoral science, hellbent on progress at any cost, and those who seek to restrain scientific advancement and place it within a moral framework. How can we defend the dignity of human beings from being eroded by techniques such as cloning? Is it possible to stop science treating human beings as mere objects? Questions such as these betray a deep anxiety not only about the very character of scientific research and also about the ways in which biotechnologies appear to throw up new ethical questions and problems that threaten to overwhelm us.

There is, in fact, little new either in the repugnance elicited by medical progress or in the ethical problems it poses. Every new biotechnological advance,from vaccines to blood transfusions to organ transplants, has been greeted with a 'yuk' response. And not just scientific advances. Social practices that we now take for granted - such as 'mixed race' marriages and the right of gay couples to adopt children - were once, and often still are, regarded with great moral distaste. Far from being repositories of innate moral wisdom, yuk responses are often expressions of deep-seated social prejudices.

The ethical dilemmas biotechnologies pose are also often longstanding. In the same week as the furore over hybrid cells, another controversy erupted, this time over the treatment of Ashley X, a severely disabled nine-year old American girl who whose uterus and breast glands had been surgically removed in order to prevent her growing bigger and reaching puberty. Her family and doctors claim that without such treatment, Ashley could not be properly cared for at home. Outraged critics accused doctors of playing God, of treating a human being as an object and of encouraging prejudice against the disabled. The response to this case reveals that it is not just the production of hybrid cells or the development of cloning techniques that create such ethical debates.

Biotechnologies raise not new ethical dilemmas, but old ethical ones in a new context. In part that new context has been created by the pace of scientific advance in fields such as embryology and genetics. But it has also been created by growing social uncertainties. We live in an age of tremendous confusion and dislocation - moral, political and social - and these have helped shape the public’s attitude both to science and to ethics.

There are few things that have more changed our world than has science. From Galileo to Darwin, from Newton to Einstein, scientists and their discoveries have helped transform material conditions and opened up new social and moral vistas. Yet it is the very notion of human-directed change that many people today find so troubling.

This is an age of cynicism and scepticism, particularly about human capacities. There is a widespread sense that every impression that humans make upon the world is for the worse. The attempt to master nature seems to have led to global warming and species depletion. The attempt to master society has given us Auschwitz and ethnic cleansing. 'In a real sense', the late ecologist Murray Bookchin noted, 'we seem to be afraid of ourselves - of our uniquely human attributes. We seem to be suffering from a decline in human self-confidence and in our ability to create ethically meaningful lives that enrich humanity and the non-human world.'

While human activity is held in low esteem, nature is becoming deified. In almost every aspect of life - from health treatments to food production - the 'natural' is regarded as morally superior to the artificial, or human. 'The "natural"', as the American mathematician Norman Levitt has put it, 'is the virtuous opposite of the degraded manifestations of humanity’s fallen state'. Nature 'is the code word for the way things are meant to be rather than the way they are.'

The disillusion with human activity, on the one hand, and the deification of nature, on the other, has transformed not just our view of science but also our understanding of ethics. Historically, the scientific revolution developed as part of a broader transformation of the way people understood the relationship between humanity and nature. Reason and experiment came to replace revelation as the sources of knowledge, and there emerged a growing conviction that humankind could achieve freedom, both from the constraints of nature and the tyranny of Man, through the agency of its own efforts. The result was the development of humanism and the creation of a more human-centred morality. Notions of right and wrong became increasingly regarded as human, rather than divine, creations and ethical concerns as growing out of human needs. Knowledge itself was seen as an ethical good and the exploitation of knowledge to advance social, scientific and medical progress a moral imperative.

Today's debased view of humanity is, however, giving rise to a very different notion of ethics. On the one hand ethics seem to have taken over our lives. From shopping to health treatments we are constantly urged to be 'ethical'. At the same time, though, ethics seem to have been drained of much of their traditional meaning. Questions of right and wrong are judged less in relation to human needs than as a means of deciding how best to reduce the impact of humanity on the planet. To be 'ethical' has come to mean producing fewer humans, consuming fewer goods, tampering less with nature - in other words it has become synonymous with restraint and caution.

All this has distorted the debate about the ethics of biological technology. Scientific advances that threaten to transform our relationship with nature are often seen as unnatural, and hence unethical. 'Have we the right', the molecular biologist Ervin Chargaff asks, 'to counteract, irreversibly, the evolutionary wisdom of millions of years?' According to a European Parliament committee report on genetic engineering 'each generation must be allowed to struggle with human nature as it is given to them, and not with the irreversible biological results of their forebears' actions'.

The idea that nature embodies certain verities, and these verities define the boundaries that we transgress at our peril, is at the heart of contemporary fear of the new biology. It is a view that turns ethical arguments on their head. Take for instance the debate about human cloning. Ever since the birth in July 1996 of Dolly the sheep at Scotland's Roslin Institute, there has been universal condemnation of the idea that humans too may be similarly duplicated. Unesco has declared cloning to be 'contrary to human dignity'. President Bush has insisted that 'we recoil at the idea of growing human beings for spare parts, or creating life for our convenience'. Cloning, the European parliament declared, 'is a serious violation of fundamental human rights and is contrary to the principle of equality of human beings as it permits a eugenic and racist selection of the human race'.

Yet if we move away from what bioethicist John Harris has called 'olfactory moral philosophy', there are no reasons to regard as unethical the cloning of humans. There is, on the other hand, something deeply immoral about a campaign that seeks to block the advancement, not just of reproductive technology, but also of other medical techniques based on cloning methods which could potentially save hundreds of thousands of lives, and lessen the suffering of many more.

Critics of cloning present three main ethical objections. The first is that in creating exact copies of people we undermine human dignity and personal identity. Any human child conceived through cloning will certainly be the genetic twin of the person who is the cell donor. But to have the same genome is not to be the same person. Genes play an important part in shaping who we are. But in no way do they determine who we are, or how we behave. After all natural clones - identical twins - far from being duplicates of each other, often differ in everything from their fingerprints to their political convictions.

The second objection is that cloning turns human beings into means, not ends. Cloned children, critics argue, will simply be the means for their parents' self-aggrandisement. This may well be true, but it is also true for many children born in conventional ways. In any case, as John Harris points out, in many areas of life - in employment, family relations, sexual relations - we use people at least partially as means. If in everyday life we take a pragmatic approach to the Kantian maxim that 'the individual should never be thought of merely as a means, but always also as an end’, why not in relation to medical advances too?

Thirdly, critics claim that cloning is unnatural. 'From time immemorial', the American writer Jeremy Rifkin argues, 'we have thought of the birth of our progeny as a gift bestowed by God or a beneficent nature'. According to Rifkin, 'the coming together of sperm and egg represents a moment of surrender to forces outside of our control'.

Cloning is certainly unnatural. But then so is virtually every human activity. The whole point of any medical intervention, from taking an aspirin to heart surgery, is to ensure that humans are not at the mercy of 'forces outside our control'. The real argument here is an argument against conscious design - 'Better by Accident than by Design' as Josephine Quintavalle has put it in the title of an essay. It is an attitude that fits in well with contemporary anxieties about human intervention. But the very existence of an ethical world depends on the human capacity for conscious design. What allows humans to live in a moral world is our ability to distinguish between right and wrong, and to act upon that distinction to transform both ourselves and our world for the better.

An undesigned world would be an unethical world. That is why we need to turn the argument about science and ethics on its head. There are no moral reasons for not pursuing cloning technology or for preventing the production of hybrid cells. But there is something morally repugnant about the campaigns against such technologies. By restraining research, opponents are helping to prevent the development of new medical treatments that draw upon these techniques, and hence allowing many people to suffer unnecessarily.

Much the same is true in the debate about so-called 'designer babies'. There is nothing morally problematic, John Harris suggests, in allowing a child with 'a particular skin colour, hair colour, eye colour or a range of useful abilities... to be born or created'. Such a child would not be born in a harmed condition, nor would it be harmful to others. However it would be morally problematic to choose to create a child with severe disabilities. Given that scientists are now developing techniques - such as preimplantation genetic diagnosis or PGD - that enable parents to screen embryos for genetic defects such as cystic fibrosis or sickle cell anaemia, the demand that we leave it to accident rather than design is not to abjure choice. It is to take a conscious decision to risk the possibility of bringing into the world a child with severe disabilities knowing that we might have been able to prevent his or her pain and trauma. Here, as in the debate about cloning, ethical fears about scientific advances are ensuring unnecessary suffering.

None of this is to say that new technologies do not raise important questions both about how to regulate society and about what it is to be human. The prospect of widespread genetic leads to questions about how to organise health insurance in the future. It also raises issues about individual rights and privacy. New neurological techniques raise similar issues, and may in time lead to debates about the meaning of selfhood, agency and responsibility.

Issues such as these cannot, however, be rationally debated if we begin with the presumption of an inevitable clash between science and ethics and of the need for ethical restraints on scientific advances. The real struggle is not between science, on the one side, and morality on the other. It is between different visions of what it is to be ethical. It is time we stopped indulging the myth that the moral high ground is necessarily occupied by those wish to place a restraining hand on scientific research and started making the case instead for a human-centred morality that seeks rationally to use scientific advances to alleviate suffering and improve our lives.