Verschenen in: Ethical Perspectives 14:2 (2007), p. 207-211. Michael Sandel and the ethics of genetic engineering * 1. Ethics in the age of genetic engineering Herman De Dijn K.U.Leuven Biomedical science and the ongoing genetic revolution confront us with completely new ethical questions, for example the questions related to IVF and stem cell research, discussed at the end of Sandel s new book, The Case Against Perfection, but also the larger and more formidable questions discussed in the bulk of the book related to the new eugenics which seems to be awaiting us. Sandel s new essay deserves the full attention not only of academics, but also of policy makers and the general public. Sandel situates the discussion at the right level; the level where ethical questions are no longer divorced from the most fundamental questions: What is it to be human; what is or should be our relation to life, to nature? It is not possible to discuss the new ethical problems without situating genetic engineering in a broader context, the context of contemporary society as dominated by consumerism and the politics of recognition. The fundamental human desire for recognition is no longer operating in fixed traditional channels, it seeks implementation via the diversity of symbolic goods offered in the market. This situation seems to bring it about that new products and techniques for the treatment of diseases and now also for genetic disorders, invariably become instruments for improvement and consumer choice. Sandel specifically discusses the problem of enhancement in sports and in procreation. This continuous transgression from the context of healing into the context of enhancement leads to a new form of eugenics: no longer forced upon people from above, but decided individually from below, on the basis of the freedom of the consumer seeking to distinguish himself or herself under the pressure of media and market. According to Sandel, this drive towards enhancement betrays a fundamental attitude present in contemporary culture: a Promethean aspiration towards perfection. It is clear from the title of the book, that Sandel thinks this is a bad idea. From the ethical point of view, his position is sharply expressed in the following words: [T]he moral stakes in the enhancement debate are not fully captured by the familiar categories of autonomy and rights, on the one hand, and the calculation of costs and benefits, on the other. (p. 96) In other words, traditional analytical moral philosophy is incapable of seriously engaging with the new problems. 1
It is indeed customary for (especially analytic) philosophers to try to decide ethical questions on the basis of principles like autonomy (usually in combination with the noharm principle and considerations concerning justice) or in consequentialist terms. Sandel shows that on the basis of such principles and reasonings the deep ethical worries with respect to enhancement and eugenics cannot be taken care of. What is at stake are not primarily dangers for the individual, society or the human species, but more fundamental issues. In his discussion of bionic athletes, Sandel shows how certain forms of enhancement are incompatible with the very telos and the relevant virtues of sports as a meaningful human activity. In his discussion of designer children, he shows how designing parents betray something which is essential to parenthood, what he calls openness to the unbidden. He demonstrates that the problem here is not so much the possible restriction of children s autonomy, but a form of excessive, self-defeating activism. In general (t)he problem with eugenics and genetic engineering is that they represent the one-sided triumph of wilfulness over giftedness, of dominion over reverence, of molding over beholding. (p. 85) Behind people s worries with the new developments are deep questions about what it is to be human, about our relation with nature, about the very nature of ethics or morals. According to Sandel, very little has been done philosophically concerning these deeper issues. Hannah Arendt s concept of natality (which Sandel found referred to in Habermas) is invoked to express something Sandel takes to be essential in human beings: a sense of indebtedness to reality which is incompatible with the Promethean activism incapable of accepting the given. According to Sandel, the sense of indebtedness usually has a religious origin, but this need not be so. It can perfectly go together with a kind of reverence towards nature of which we are a part. Other deep problems which are touched upon concern the intrinsic link between human freedom and contingency. That as individuals and in our life we are subject to all kind of lotteries, including the genetic lottery, is not just a limitation; it is probably also the possibility condition for the most fundamental desire, the desire for happiness. Fulfilment of this desire is indeed not possible on the basis (only) of control of things and people around us. What is needed is that that which we most want, can, when we receive it, be experienced as a gift, as grace. One could add that the values in terms of which we desire fulfilment, are ultimately not things which we create ex nihilo, or which in all respects be the product of our decision. Freedom requires that the values we pursue are transcendent to our will (but of course not forced upon our will). According to Sandel, the genetic revolution has an eroding influence on three key features in our moral landscape: humility (and, one could add, gratitude with respect to the gifts for which we are indebted), responsibility (which is no so much eroded, but exponentially increased and thereby jeopardized), and even solidarity. These three features even hang together: A 2
lively sense of the contingency of our gifts an awareness that none of us is wholly responsible for his or her success saves a meritocratic society from sliding into the smug assumption that success is the crown of virtue, that the rich are rich because they are more deserving than the poor. (p. 91) In so-called continental philosophy much more work on these deep issues has been done than Sandel suggests. Arendt s concept of natality clearly refer to Heidegger s notion of Geworfenheit, to name but one example. Also notions like contingency and freedom, and their interconnection have been the subject of serious investigation. Unfortunately, these investigations very often result in academic exercises unreadable even for the learned public. A real effort is necessary to translate these insights in such a way that they can become fruitful for the broad ethical discussion mentioned here. Bringing across the importance of the relevant concepts and insights may even require to touch and raise the appropriate sensibilities via the use of literature and essayistic work. (A good example in this respect, is the study of the notion of reverence in Paul Woodruff s Reverence. Renewing a Forgotten Virtue, Oxford University Press, 2001). Anyway, Sandel s work introduces us to important questions concerning the relationship between moral decisionmaking and philosophy. If, ultimately, moral decisionmaking has to do with a sensitivity to fundamental aspects of human living, such a gratitude for giftedness, reverence, basic trust, etc., then the task of philosophy cannot simply be to find decisive arguments settling matters in one way or the other. Its major task, especially in a cultural framework characterized by activism and consequentialist attitudes, will be the difficult one to spell out in a comprehensible way what is behind the largely mute worries of ordinary people especially in bio-ethical questions. This spelling out is a kind of hermeneutics, rather than an argumentation. The force of the understanding thus gained with respect to ethical decisions can only come from the basic sensibility and attitudes themselves. Insights such as these go against the grain of most bioethical reflections and interventions today. 2. Stem Cell Ethics About one fifth of Sandel s book is an epilogue entitled: Embryo Ethics: The Stem Cell Debate. It is like an attempt to apply the general insights gained before to a concrete case. In the epilogue, Sandel discusses moral arguments for and against the use of embryos for medical research concerning genetically determined diseases. He rejects the position (taken also by some Leuven bio-ethicists) that research on IVF spare embryos is allowed, but not the creation of embryos specifically for research. He thinks that [t]he moral argument for research cloning and for stem cell research on leftover embryos stand or fall together (p. 111). The argument of the proponents is that if excess 3
embryos will eventually be discarded anyway, why should we not use them (with donor consent, of course) for potentially lifesaving research? But this is of course morally acceptable only if the question of the moral status of the embryo is already decided. If the moral status of the embryo is such that it excludes use leading to destruction, then this is also the case for leftover embryos. They shouldn t have been created in the first place and the whole practice of treating infertility by IVF is to be firmly rejected. If leftover embryos can be used for research, this implies that their moral status is not such that it cannot be overridden in function of their use for potentially lifesaving medical research. But then why not allow this also for embryos created specifically for research purposes? Fetuses also could be used for much needed research, yet their moral status excludes that their life is put in balance with the value they can have in medical research. Some things you simply do not do, notwithstanding major benefits otherwise. What then is the moral status of an embryo? Those who think it is the same as that of a baby or a human person cannot but think that the use of embryos for research is murder. Many religious people, who believe that because embryos have a soul, think like this. Sandel notices that this has consequences which are hard to accept also for the believers themselves. For example that extracting stemcells is as abhorrent as harvesting organs from a baby to save other people s lives. (Or that very early abortion is as morally bad as very late abortion.) In this context he argues that even though there is no nonarbitrary moment in the course of human development when personhood (and inviolability) sets in, this doesn t necessarily imply that a blastocyst (embryo) has the same status as a baby. It could be argued further that if religious people advocate inviolability for embryos because of their having a soul, one can still wonder why the presence of a soul would make such a difference on its own. Suppose the soul is taken to be a reality of a certain exquisite, spiritual kind. Why should spiritual reality have such importance? The strange or complicated nature of something is not enough; it obtains its moral status only within a certain viewpoint, the viewpoint of respect which is not based on scientific or quasi-scientific insights in kinds of nature or complexity. Only within the viewpoint of respect can certain (categories of) entities be seen as really inviolable, however insignificant ( only a blastocyst or a fetus) they may seem. If this is compatible with Sandel s viewpoint, as I suppose it is (see p. 125), then of course it cannot be the real presence of a soul, nor the embryo s physical potentiality of development into a full human being, which are deciding factors determining the moral status of the embryo. But then it also doesn t follow from the fact that it is only a blastocyst (whether especially created, or leftover), that its use is less problematic than say the use of a fetus. 4
The real context of debate is not physics or metaphysics, but the moral practice of respecting human beings even before they are born and after they have died. It is within this context that the question of the respect appropriate to the embryo must be decided. Sandel rightly draws our attention to certain practices which are closely related to or expressive of moral respect: name giving, and rituals like burial. Denying a person his or her name (as in Nazi concentration camps), or denying burial, are serious moral wrongdoings. Fetuses are not given a name and are not properly buried. The degrees of absence or presence of these practices may be indications of the relative respect paid or to be paid. Even though aborted fetuses are not properly buried, it is wrong to dispose of them as simply waste. Sometimes parents ask for fetuses to be buried. That people find the creation of embryos specifically for research too instrumentalist an attitude, notwithstanding possible advantages in the fight against terrible diseases, does not seem to me completely incomprehensible. After all, in Sandel s own terminology, although an embryo is only a blastocyst, it is not just material, or reserve parts, it is and should be seen in the words of Sandel himself as the mystery of the first stirrings of human life. (p. 127) Mystery is not to be taken here in the sense of too complex (yet) for our understanding, or beyond the scope of scientific understanding, but in the sense in which that which we (already) perfectly comprehend, can (still) be seen as an object of awe and great significance, and as untouchable. Of course embryos are a very small clustering of cells, hardly noticeable except under a microscope. Yet, if a woman knows she is pregnant, even at a very early stage she already thinks of the embryo as her child to be, as a mystery. If she loses her child, there will be a process of mourning. Supposing we do come to accept the use of embryos for research, should there not be some sort of ritual way to appease the little ghosts, as the Japanese have it in the Hasedera-temple at Kamakura for the huge number of aborted children? Sandel discusses the question whether embryo research is not the beginning of a slippery slope towards embryo farms, commodification of zygotes, etc. Is this, so he asks himself, another episode in the erosion of our human sensibility? (p. 128) He finds this much too alarmist and pleads for a reasonable attitude: allowing also leftover or created embryos to be used for research in the service of health (and not enhancement), but in combination with regulations concerning fertility clinics, restrictions on reproductive cloning, on the commodification of human tissues, etc. He is undoubtedly right in his plea for reasonableness. Yet, as in the case of abortion, it may be extremely important that there are voices in society warning against the dangers that human dignity, even before birth and after death, is effectively eroded by the blindness having to do with the activist pursuit of comfort, of gain, of fame (through research). It would be a mistake to accuse these voices automatically of unreasonableness and fanaticism. On the contrary, they 5
should be carefully listened to, so as to be sure that we have not become half blind for the ethical truth, for the mystery of human life, even before birth. As Sandel says, the genomic revolution confronts us with questions largely lost from view in the modern world questions about the moral status of nature, and about the proper stance of human beings towards the given world. Since these questions verge on theology, modern philosophers and political scientists tend to shrink from them. But our new powers of biotechnology make them unavoidable. (p. 9-10) Ethics is supposed to lag far behind in development if compared to science and technology. This book shows that what is needed to close the gap, is not a more professional and technical bioethics, but a renewed attention to the real depth behind our ethical problems. Sandel s book, which is a real pleasure to read both because of its style and because of its content, is the sort of philosophy we badly need today. * Michael J. Sandel, The Case Against Perfection. Ethics in the Age of Genetic Engineering, Cambridge (Mass.) & London, The Belknap Press of Harvard University Press, 2007, 162 p. [ISBN 978-0-674-01927-0] 6