Thursday, March 11, 2004
Okay, shifting gears again.
The cover story of the current (April) issue of The Atlantic (the issue is not, apparently, on the web yet), is about the ethical questions posed by genetic engineering on humans. The article starts out very strong, but kind of peters out towards the end. The tone is classic Atlantic Monthly: worried in a vague, general way about change and its awesome implications. There's nothing wrong with that tone, of course, except this: it is enervating. I opened the piece interested to see if it would help clarify the sorts of questions that I take very seriously and find a hard time answering. I left feeling that the author had the same troubles I had.
The weakest argument in the piece against engineering "better" humans is that the ability and willingness to practice such engineering will erode our sense of life as a gift (of God or of some kind of personified nature) and this will erode social solidarity. And lurking behind this argument is the Rawlsian veil of ignorance. (Digression: Rawls argues for a certain kind of redistributionist liberalism on the following grounds. He assumes, following Kant, that ethical rules must be universal or they are not truly ethical. Next, he argues that to test whether the rules for distributing goods in society are ethical, we should examine them from behind a veil of ignorance about our own interests. We should think about distribution as if we did not know whether we were the richest or the poorest, the most accomplished or the least, the strongest or the weakest, because if we do not know these facts about ourselves then we can truly construct social rules from a universal perspective, and hence these rules will be ethical. He then concludes that, from behind the veil of ignorance, we would be risk-averse, and hence would seek to establish rules that would raise the poorest, weakest and least-well-endowed of society to at least a minimum level of comfortable happiness, because we might, in fact, be one of these people, and we don't want to suffer. End of digression.) We know that our success is partly due to luck, including the genetic lottery, and this knowledge can make us feel solidarity with those who have had ill luck, and willing to share with them. If the genetic lottery is abolished, we will not feel this solidarity because we will feel our own success to be more the product of our own efforts - including our efforts at genetic management - and hence social solidarity will erode. We will be less willing to stand behind the veil of ignorance in constructing our mental picture of a just distribution of goods.
One big problem with this argument is that it presumes its conclusion. Is social solidarity good? Are ethical rules necessarily universal? Or are these principles derivative of the assumption of moral equality of all human beings? I mean, a Randian reader of the article might conclude that genetic engineering of humans is a wonderful thing precisely because it would strengthen what a Randian would consider ethical principles: intrammelled individualism, the striving for perfection, and personal responsibility for one's fate. Another problem is that it's overly consequentialist. The author skirts past any prima facie ethical questions and proceeds right to what kind of a society we'd wind up with if such and such social trend combined with new powers. That makes the argument a lot weaker than it might have been.
The stronger argument in the piece, it seemed to me, is that genetic engineering necessarily deforms the relationship between parents and children, turning the latter into products and property. But the author doesn't explore the question adequately and the difficulties in identifying when good parenting becomes engineering. It's this question that I'm going to explore in more detail below.
Genetic engineering raises unique issues only in that alterations in the genome get passed down from generation to generation. But to the extent that genetic engineering is really, really robust, even this is not a substantial difference since, presumably, changes made in one generation can be reversed in the next. So I think it might be clarifying to take genetics off the table, and talk in terms of medical interventions generally to shape the biological nature of children.
Suppose it were determined that a certain virus was the cause of 90% of congenital deafness. And suppose that a simple cure is discovered. If a woman takes a certain pill regularly through her pregnancy, she will reduce the odds of bearing a deaf child by 90%. There are no meaningful side effects; the pill simply kills the virus that causes congenital deafness, and is otherwise harmless. Is it morally permissible to take this pill? Is it morally obligatory?
I think the overwhelming majority of people would say that it is morally permissible to take this pill. I suspect that most would say it's morally obligatory. How could you condemn a child to deafness when it could have been prevented?
And yet, there are advocates for the deaf who would argue that such a moral stance amounts to "genocide" of the deaf community. If such a pill were widely used, far fewer deaf people would be born - so few that, probably, deaf culture would die out. Advocates for the deaf would argue that deaf people have unique perceptions, and have produced unique contributions to civilization - including a highly sophisticated language - that would be destroyed were there no more deaf people in the world. At a minimum, these advocates would claim, you cannot say that it is morally obligatory to take the pill; at a minimum, parents should be permitted to refuse to take the pill - deaf parents in particular, who might want a deaf child, and would be in a particularly good position to raise one, and in a less-ideal position to raise a hearing child.
Indeed, such advocates might argue, if it's acceptable for the hearing to take such a pill, it should be acceptable for the deaf to take a pill containing the virus. After all, deaf advocates might claim, the deaf consider themselves to be different from the hearing, not inferior, and they should be able to reproduce their own kind. If we're not all bound to abide by the laws of chance, then if the hearing should be guaranteed hearing children, then the deaf should be guaranteed deaf children.
I think this is an absurd line of reasoning. But it's not obvious on its face where to disagree. To be deaf is, certainly, a disability. We are made to hear. And the compensating achievements of the deaf are just that: compensations. They compensate for a deficiency; they are not some objectively equal alternative mode of perception and being. Moreover, in this thought experiment deafness is caused by a virus; how can it be impermissable to kill a virus, or permissable to introduce one, which would seem to be the arguments of our hypothetical deaf advocates?
But how far does this logic extend? Suppose, for example, that it's not a virus that causes congenital deafness, but a genetic defect. Assume there's still a pill that cures it; the pill contains a virus, custom-engineered to alter the genes of an infant to correct the deafness-causing defect. Is the moral calculus the same? The deaf advocates could now claim that the treatment is unnatural. Sure, most people are meant to be hearing, but some, because of their genes, are meant to be deaf. How can the hearing claim that their state is the only natural one, and all other states a defect?
Let's take another example. Rather than deafness, homosexuality. Suppose a "gay gene" were discovered. And suppose a genetic treatment were discovered - one that, if introduced into the uterine environment, would prevent the expression of the "gay gene" and hence ensure heterosexual orientation in one's offspring. Again, assume no side effects.
Is it permissable to take the pill? Is it obligatory? Whereas the arguments of the deaf advocates might be rejected, I suspect the arguments of gay advocates would get more of a . . . hearing. (Sorry.) Gay advocates would argue - correctly - that gay people have made enormous contributions to civilization; that the history of art in particular would be spectacularly diminished were the gay sensibility to be obliterated by such prenatal intervention. They would argue that someone's choice of sexual partner is of no moral significance, and that this fact is now enshrined in law on a number of levels. Allowing prenatal intervention to prevent the expression of "gay genes" would be tantamount to genocide against gay people.
Others, of course, would argue that gayness is a considerable disability; most prominently, it makes it impossible for someone to form a natural family, with children. Surely a parent could choose to spare his or her child from such a debility? Even if it is not morally obligatory to take the pill, surely it's morally permissable? Indeed, to say it is not permissable is to say that moral objections to homosexuality are evil even if sexual orientation is chosen. That's a pretty extreme position, isn't it?
Very well, then, the advocates might argue: if straights are permitted to prevent their children from being born gay, then gays should be permitted to ensure that their children are born gay. Isn't that reasonable? Isn't a lesbian couple in a better position to raise a lesbian daughter than a straight one? Wouldn't straights even prefer it if this were the state of affairs?
Again, I think this line of reasoning is absurd. But it is not as easy to attack as I would like. There is no hard line between difference and disability - are short people disabled? are shy people? - and therefore it is not obvious when we cross the line between therapy, which most people would consider at a minimum permissable and conceivably mandatory - and engineering for a particular outcome. Most people would argue that to take a pill to prevent deafness or homosexuality in one's offspring is legitimate if not mandatory, and to take a pill to cause deafness or homosexuality in one's offspring is abhorrent. But deaf people and gay people might well consider any such intervention an example of engineering rather than therapy, and demand the equal right to engineer their own offspring in the opposite direction - precisely what most people would find abhorrent. And yet, we can't get out of the problem by simply banning all intervention. In the examples I've given in these thought-experiments, the therapies in question are safe and do not involve tampering with the human genetic code; they involve killing or introducing viruses, expressing or suppressing the expression of genes. If these kinds of therapies are impermissable because they are interventions, then how can we prevent the expression of a schizophrenia gene, my first example?
So: suppose we take a hard line. Disabilities are disabilities, full stop. Deafness is not equal to hearing; it's inferior. Homosexuality is not equal to heterosexuality; it's inferior. You can, though you are not obligated to (we won't take that hard a line) intervene medically to prevent these conditions, not to introduce them. The compensating achievements of deaf or gay people do not constitute a moral reason to allow a disability to continue; castrati have beautiful voices, too, but we don't produce them either anymore. Does this solve our problem?
Well, let's take another thought experiment to see. There is a good body of evidence that breastfed children have a 5 IQ-point advantage over formula-fed children. (IQ is a complicated thing, with genetic and environmental components that are not well understood, and can vary over short spans of time as well as during a single individual's life, and I don't pretend to be an expert. But the breastfeeding stats appear to be pretty widely supported.) Is it permissable for a woman to breastfeed her children? Is it mandatory? I imagine no one will argue that this is anything but a choice for a woman to make; of course she can breastfeed, and of course she can bottle feed. I think we'd all agree this one falls into the "can I drive my car while pregnant" category. The main moral implications of the breast/bottle IQ finding, it seems to me, are in the area of public information: women should know the costs and risks of bottle feeding, and it's especially important to spread that knowledge among those most likely to be ignorant of these facts, most likely to bottle-feed, and whose children are most likely to suffer if they manifest low IQs (these happen to generally be the same people).
Okay: suppose the medical wizards discover a new baby formula that increases the average IQ of children by 5 points. Should such a formula be made generally available (assuming it's safe)? Should women be told that it's better for them to bottle-feed with the new formula than to breastfeed?
A lot of people will say, "sure." But some will be uncomfortable. We're edging towards engineering brighter babies, after all. It's one thing to say, "make sure your baby takes his vitamin supplement so he grows up big and strong." It's another to say, "make sure your baby takes her vitamin supplement so her IQ will go up 5 points." Isn't it?
I think most of us have, again, a sense of what constitutes a "natural" regimen - of diet, exercise, etc. - and would have no problem with science identifying what natural regimen best suits the human organism and makes us most fit, physically and mentally. We sense a shift in moral ground when we start talking about interventions that make us more than naturally fit. But is there really any difference between eating more fish and getting smarter and taking a pill and getting smarter? And is there really any difference between taking a pill and altering the expression of our genes?
Okay, let's take a hard line again: there's nothing wrong with wanting kids with higher IQs. It's morally right to do what's best for your children, so it's morally right to do whatever - from better diet to gene therapy - to raise your kid's IQs. In fact, this kind of intervention is more moral than the kinds of intensive training regimens that many pressure-cooker kids go through these days, because neither better diet nor gene therapy will deform a kid's personality the way incessant flash-card practice will. So bring it on.
So where do we draw the line? A higher IQ is good. What about a longer attention span? Quicker reflexes? Longer legs? A more winning personality? Clearer skin? Blonder hair? More sex appeal? Less sex appeal? When do we cross the line from "I'm only doing what's best for my child" to "I'm trying to engineer the best child?" The former, I think most would agree, is good. The latter, I think most would agree, is bad. Where's the line?
It's not clear where the hard lines are in any of these cases. Where do you draw the line between difference and disability? Where do you draw the line between maximizing your potential and engineering your potential? Does normal human biology have any special moral status? Does your particular nature have any moral status? These are the questions that need to be answered to speak intelligently about these matters. The extreme answers - all intervention is wrong because it is Promethean hubris; all intervention is fine because freedom should be maximized - are not, in fact, morally serious.