Making the world a better place: Genes and ethics

Science and Engineering Ethics (1995) 1, 101-110

Making the World a Better Place: Genes and Ethics

Roger Crisp st. Anne's College, Oxford

Keywords: genes, genetics, ethics, genetic engineering, transgenic plants and animals, human genetics

1. MORAL CHAOS?

Imagine the AIDS virus mutates and begins to attack m an y more people much more quickly. Scientists are b lamed for the catastrophe and there is a wor ld wide reaction against science. Laboratories are torn down, books are burned , scientists are murdered . An anti-scientific political movemen t - perhaps sprung f rom one of our political parties in Britain? - sweeps the globe. Very little of science remains.

After some centuries, enl ightened people a t tempt to revive science f rom the fragments that remain: the odd charred page of an article, a broken measur ing instrument. Gradual ly pseudo-scientific practices develop a round these fragments. N o b o d y realizes that what is being done is not really natural science at all.

This imagined scenario is not mine. But I have not bo r rowed it f rom science fiction. It comes f rom the first few pages of one of the most influential moral phi losophy books since the Second World War: Alasdair MacIntyre 's After Virtue, published in 1981.

MacIntyre 's suggestion is that our moral practices today are analogous in impor tant ways to the scientific practices of the post-renaissance per iod in his story. What we are left with are fragments of various moral traditions, shorn of the context in which they once made sense. Interminable moral debates arise be tween those who found their moral talk on fragments of different traditions. Indeed, there is no real debate, but merely entrenched groups, shouting incomprehensibly at one another over unbridgeable voids.

MacIntyre 's scepticism about mode rn moral i ty is just one version of a kind of doubt about the claims of moral i ty felt by many people. If he is right, I might as well stop now. But before I do, let me introduce the three main contemporary philosophical traditions or moral theories - that is, theories about how we should act or live.

This paper was presented as part of the 1993 Waynflete Lecture Series on Genes: Science, Law and Ethics, Magdalen College, Oxford University. Address for correspondence: Dr. R Crisp, St Alme's College, Oxford OX2 6HS, UK 1353-3452/95 © 1995 Opragen Publications

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(i) The first type of theory is known as utilitarianism. Utilitarianism is often understood as advocating 'the greatest good for the greatest number'. There are as many versions of utilitarianism as there are utilitarians. But pretty well any version of utilitarianism contains the following: 1. The claim that the only value there is is the well-being of individuals (usually

referred to as utility). 2. Some account of what this well-being consists in. The classical utilitarians,

such as Jeremy Bentham, said it was pleasure. 3. The principle that we should live or act in such a way that as much overall

well-being as possible is produced. This may, of course, require us to sacrifice our own well-being for the sake of others.

(ii) So that is utilitarianism, the view that we should produce as much well-being as possible. The second broad group of theories is best described as Kantian, since most of these theories take something from the moral writings of the German philosopher of the eighteenth century, Immanuel Kant.

Let me mention two notions central to the Kantian tradition: First, rationalism. We are rational beings and our morality must emerge from

our rationality. Kant stated the rational moral law in terms of his 'Categorical Imperative'. When you are thinking of doing something, you have to ask yourself the question, 'What if everyone did that?' and see whether you can will that it become a law of nature that everyone does just that. If you find that you can't, then you shouldn't do what you're thinking of doing.

The second Kantian notion is rights. Kant states the Categorical Imperative in various ways. One formulation tells us to treat persons never simply as means, but always at the same time as ends. One implication of this is that you cannot override someone's important interests in order to maximize well-being overall. That would be to violate that person's rights.

(iii) The final strand of theory is commonly referred to these days as virtue ethics. This has ancient roots, particularly in Plato and Aristotle, and it has undergone a recent revival over the last thirty or so years. Let me again draw out two central themes.

The first is the centrality of the virtuous person. Virtue theorists tend to object to the austerely principled approach of utilitarianism and Kantianism. Moral life is too complex to be usefully capturable in a set of easily statable principles. Rather it has at its core the life of the virtuous person, sensitive to the salient features of the various situations in which she finds herself.

It might be said, then, that moral philosophy cannot be of much use. If you are virtuous, you will know what to do; and if you're not, then mere philosophy won't make you good. If you must read, read novels. But the virtue theorist might suggest that an understanding of the virtues themselves is likely to help us in trying to understand how we should live. This, then, is the second theme: the virtues themselves.

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So according to MacIntyre's picture, modern ethics is a matter of philosophers from these various schools failing to understand one another. But I doubt myself that this is the case. A utilitarian can see what a Kantian is getting at; it is just that the Kantian must be wrong because utilitarianism is right. The view that only one of these theories could be right is what explains the deep disagreement among contemporary philosophers of morality, not MacIntyre's apocalyptic vision.

In a sense, of course, not all of the theories could be right, since they offer different prescriptions for action. But this fact is trivial. A moral theory is an attempt to ground reasons for living and acting in values. Utilitarianism offers us the value of well-being - both non-human and human. Kantian theories rest on the value of fairness ('What if everyone did that?' can in most circumstances be rephrased as 'What entitles you to do that and not others?'). They also rest on other values, such as that of autonomy and respect for autonomy, which provides the basis for rights. Virtue ethics is supported by the values of justice, generosity, kindness and wisdom. How can it be right, the virtue theorist will ask, not to live so that one's life instantiates these goods?

But there is no reason why the world could not contain all of these values - and indeed more, for the list of theories I gave you was in fact rather parochial. Consider for example the theories of morality popular on the continent which rest on the value of authenticity, or Eastern traditions which emphasize bodily transcendence.

I suggest, then, that moral philosophers lower their sights and, if they locate themselves within a tradition, begin to see themselves as aiming to characterize a small part of the evaluative world rather than the whole of it. Nor does my advocacy of open-mindedness here apply only to philosophers. The world is full of conflicts between those who, having located one sphere of value, refuse to accept that there could be others. Biotechnology is no different. The debates here are already polarized, and the positions on genetics are already well staked out. This is a great pity. Polarization is likely to make rational discussion impossible, and it may lead to mistaken decisions. It is not only moral philosophers but all of us who must learn to look for the values underlying ethical positions different from our own. If we fail to do this in biotechnology, we shall end up shouting incomprehensibly across yet another void.

2. C H A N G I N G THE WORLD

In the second part of this paper, I shall begin to consider some of the central questions which have arisen in genetics over the last few years by thinking about what values are at stake. What I want to do first is to distinguish, admittedly rather roughly, us - human beings, that is - from the world, and to talk about genetic changes to the world.

I suggested above that moral philosophy is concerned with the identification of what reasons we have to act or not to act in certain ways. Most of the dilemmas in genetics are of this kind. There appear to be certain reasons for and against


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certain practices, and the question we have to ask is: how do we resolve the conflict?

The reasons for developing transgenic plants and non-human animals are fairly straightforward. Genetic advances in this area may produce great benefits in the areas of agriculture, food, health care, energy and the environment, and scientific research. Consider for example the tomato which doesn't go squishy on the supermarket shelf. A couple of well-known animal cases are the Factor IX sheep, which secrete human pharmaceuticals in their milk. and genetically engineered BST (bovine somatropin) which increases milk production.

(i) What objections could be made to these apparently benign changes to the world? There are, of course, many and I shall not be able to discuss all of them. I shall concentrate on four broad areas of objection, the first being what I call ethical

conservatism. Michael Fox, for instance, a well-known American environmentalist, argues that any kind of transgenic manipulation is wrong 'because it violates the genetic integrity or telos of organisms or species'.

Scientists may well have doubts about the coherence of this kind of conservatism. They will tell us that it is a mistake to see species boundaries as clear distinctions between natural kinds. If the view is merely that the status quo is good in itself, then the worst violator of genetic integrity over time has surely been evolution itself.

The use of the word 'telos" by ethical conservatives suggests that the roots of their view lie in Aristotelian biology and ethics, according to which the kosmos is constructed in such a way that there is a good life to be lived by each member of a natural kind which can be understood in terms of the life that typifies or characterizes that kind. But this kind of view confuses two senses of 'good for'. In one sense, drastically changing the nature of the species would be bad for that species. Indeed, it might make it disappear. But it is a further question whether this is a bad thing, something to provide us with a reason for not doing it. Consider HIV. If a scientist were to discover something that was very bad for that virus, the fact that this something would 'violate the telos' of that virus seems to provide no reason for not going ahead. In other words, the question we must ask here is not, 'What would be good and bad for a particular species?', but 'What would be good or bad things to do?'. And that question can be asked on the assumption that change in itself is neither good nor bad.

(ii) The second alleged problem with changing the world is that genetic diversity will be decreased, which may have disastrous consequences for many life forms on earth. This loss in diversity may result, for example, from cloning one individual from another, or from the concentration on certain genes which are useful to humankind at the expense of others.

An agricultural example of this danger is the U.S. wheat crop. The tendency this century has been to create strains of wheat which are genetically very similar to one another and usually selected for high productivity. In 1954, a stemrust



halved the crop of macaroni wheat in the U.S.; and in 1969, a blight fungus had the same effect on corn. Luckily, a 'gene bank' had been kept, and strains resistant to the new pathogens could be selected from it. But without the bank consequences could have been very serious indeed.

This particular objection does not, like the previous one, rest on a philosophical mistake. There is an argument here, and the question we have to ask is: who is to decide on the magnitude of the risks? Now I am not against the discussion of these issues by the public or by non-expert committees. Nevertheless, on matters like these, the views of impartial and informed scientists must be taken as final. And the view of such scientists at present is - pretty much without exception - that the current level of genetic manipulation poses risks sufficient to justify at the very most requiring scientists to be accountable to the public and subject to governmental scrutiny before proceeding with any experiment. One relevant factor here is that present techniques tend to insert new genes in animals rather than remove them, so that it may be argued that diversity is actually increased. In addition, retrovirus factors can be used such that they infect only once, thus removing the possibility of a gene 'going wild'.

(iii) Here is a third strand of objections, which relates particularly to the genetic manipulation of animals. Consider, for example, the pigs produced at the Agricultural Research Center at Beltsville in Maryland. The 'Beltsville pigs' are the result of the insertion of foreign growth hormones into pig embryos to increase their growth rate. This has resulted in gross deformity: the pigs are crippled with arthritis, cross-eyed and have various skin problems. Another topical example is the 'Oncomouse', which has been engineered to begin dying from cancer a few weeks after being born. Some will argue, then, that animal welfare considerations rule out genetic engineering. The suggestion is that the widespread practice of genetic engineering of animals is bound to throw up such animals, even if they are not intended.

One important question here, it might be argued, is whether the lives of animals like the Beltsville pigs are actually worth living. If they are, despite the suffering they involve, then the practice of genetic engineering might be said to have benefited the particular animals which are born. For without the engineering they would not have been born at all. And if the animals' lives are clearly worth not living - that is, worse than nothing - they can be painlessly killed.

But this argument cannot deal with the Oncomouse. For the whole point of using an Oncomouse is that it be allowed to die from cancer. Putting it down would defeat the object. Let us say that it is bad overall to be born an Oncomouse. Those few early weeks of healthy life will not counterbalance the suffering of the death from cancer. Here, then, we have two welfare values in the balance: those of the Oncomice and those of potential cancer victims. I would be prepared to argue that the inflicting of this suffering on Oncomice cannot be ruled out from the start. But this is not to say that the causing of suffering to non-humans is not to be taken very seriously indeed: scientists must be able to show that there is no alternative


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available such as the use of tissue culture and that their research program meets the usual standards. And governments and other funding bodies, since their aim is presumably to minimize the suffering caused by cancer, might at least consider spending on preventive health education along with, or perhaps even instead of, the experiments.

(iv) The final group of objections one might call broadly political, and they consist mostly in doubts about the morality of corporate capitalism. Edward Yoxen, in his book The Gene Business ten years ago, described a scenario in which developing countries have to buy back from multinational companies plants that have been developed from their own indigenous resources. Here industrial genetic engineering is just another form of exploitation of the poor by the rich.

Another concern is the secrecy necessary for successful competition in the market place. A lack of openness can result in catastrophe. An institution can take on a life of its own such that individuals participating in it feel little personal responsibility for the consequences of their carrying out whatever is required to meet the goals of that institution.

A third worry is the emphasis placed on profit in the direction of scientific research. Increasing commercialization of science may result not in the products which will be best for humankind as a whole, but those which best serve the interests of the shareholders.

The first thing to note about these objections is that they are not specifically to industrial genetic engineering. The first is an expression of concern about the moral relationship between the developed and the developing world, the second about the irresponsibility of multinational corporations, and the third about the inefficiency of the market.

The fact that these are concerns not just about genetic engineering does not mean that we can ignore their implication here. First, multinationals must not be permitted further to increase their stranglehold on the poor by, for example, patenting species and charging extortionate prices for their products. Second, they and their researchers must be open to public scrutiny. Third, public funding of scientific research in this area should be increased, particularly in those areas which may be of great general benefit but of little financial interest to multinationals.

3. C H A N G I N G OURSELVES

Many people find genetics applied to human beings morally far more problematic than that which changes the world. The reasons for genetic engineering here are almost entirely related to human quality of life. The huge potential benefits to health care from genetic engineering are now well known.

There are two important distinctions to be grasped before we move on, each of which cuts across the other. The first is that between somatic cell gene therapy and germ-line gene therapy. Somatic cell gene therapy is structurally similar to



ordinary treatments for disease. A patient will be treated genetically for a certain condition without this affecting his or her reproductive potential. Germ-line therapy, however, does affect a person's gametes. In general, people are happier with somatic cell gene therapy than with germ-line therapy.

The second distinction is between negative and positive genetic engineering. Negative engineering is, roughly, an attempt to remedy defects, while positive is an attempt to create improvements. Were biotechnology to cure my blindness, that would be negative engineering; were it to make me more intelligent or taller, on the assumption that I am already fairly intelligent and not short, that would be positive. People are generally happier with negative than with positive genetic engineering.

(i) Again, the best way into the debates here will be by examining the objections to the position that quality of life considerations justify genetic engineering of human beings. I shall again confine myself to discussing broad groups of objections.

One set of issues revolves around genetic screening and counselling. Prenatal diagnosis has been used for example to deal with hereditary conditions such as thalassaemia. Some will object to the abortions which follow the identification of a defective embryo on the ground that abortion is killing and therefore wrong. Others will draw our attention to an issue similar to one of those which arose in the Oncomouse case. Imagine that a foetus with Huntington's is identified and aborted, so that another pregnancy could be attempted. Now were the very same foetus to emerge without Huntington's after the second pregnancy, many would find that their objection to the termination of the first pregnancy had lapsed. But of course it does not. The first foetus is killed and replaced by another. It is being deprived of a valuable life - most lives which end in death by Huntington's are probably worth living - in order to make way for another whose life is likely to be more valuable.

What seems so terrible about this to many people is that the second foetus does not even exist yet, while the first does. The first is clearly harmed, whereas if the second were not brought into being it could not be said to have been harmed, since it does not exist to be harmed. Those who support abortions in cases like these are likely to appeal to the increased quality of life of the second foetus. But this is unlikely to persuade those who believe in moral principles forbidding serious harm to others.

Another worry - voiced by many disabled groups - is that such treatments, because they will diminish the number of sufferers from certain conditions, may result in fewer resources' being allocated to the sufferers who do exist and even in discrimination. This view must be taken very seriously. Public and governmental education must ensure that the rights of the disabled and other groups are not overridden.

The same issue - a conflict between presently existing beings and potential future beings - arises in genetic counselling. A doctor may be clear that a person's


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life will be blighted by the news that she has Huntington's . She may even have asked not to be told any bad news. But if she is considering having children, the doctor is faced with the di lemma of balancing present against future interests.

Another problem bound to arise in screening and counselling is that of confidentiality. A mother may ask her doctor not to inform her daughter that she is beginning to die from Huntington's . What is the doctor to do if the daughter informs him that she is thinking of starting a family?

A more widespread problem is that of discrimination in employment and insurance. Some of this may well be quite unjustifiable, as was, for example, the grounding of black air crews in the United States after the 1970s mass screening program for sickle cell anaemia. This kind of discrimination is a result of badly planned screening programs and a lack of understanding, and is therefore easily preventable.

More difficult to prevent will be screening requirements by employers and insurers. Steps must be taken now to outlaw such requirements and to permit individuals to choose whether to be screened. The reason for this is simple and Kantian: fairness. It is a paradigm case of unfairness when someone who has been unfortunate enough to have a certain harmful condition should then suffer further harm from unemployment or impossibly high insurance premiums. From the moral point of view, insurance schemes are best seen as a way of sharing as fairly as possible the burden of risk in cases where the risk is not a person's responsibility.

(ii) Now let me move on to some more general objections to genetic engineering in relation to h u m a n beings. Most of these objections apply in particular to germ- line and positive engineering.

The first general objection is linked again to ethical conservatism. A view quite popular on the continent is that there is a human genetic patrimony, which members of future generations each have a right to enjoy. This view, so far as I can unders tand it, seems to run into the same sort of problem as ethical conservatism: the valuing of the status quo as such. Surely, if future generations have rights, they are - others things being equal - to the best possible quality of life?

(iii) Another general objection comes from the Kantian stable. Remember the 'means and ends' version of the Categorical Imperative. This is taken to require one to obtain consent before treating anyone in a way that could be construed as using them. If I take a taxi ride, for example, I am not failing to treat the driver as an end in herself, since she consents to what I am doing.

The objection here is that we are failing to treat future generations as ends in themselves and affecting them in various ways wi thout gaining their consent. The notion of consent here is surely a red herring. Whatever we do will have been done without the consent of future generations. But are we using them as a means? Surely this depends on our reasons for genetic engineering. If I want to interfere with the nature of future generations merely to further my own career or



to satisfy my curiosity, and would in fact harm them if necessary, this might seem objectionable: it would hardly be virtuous. But many scientists who work in these areas are genuinely concerned about the quality of life of future people in a way which those people will not or would not find objectionable.

(iv) Another connected strand of objection also concerns our own characters and attitudes, virtues and vices. This is the suggestion that scientists in this area - concerned in any kind of genetic engineering - are 'playing God'.

In its simplest form, this objection was dealt wi th at least by the time of the Scottish philosopher David Hume in the eighteenth century. If it is objectionable to interfere with the course of nature, then one cannot stand aside to avoid a falling rock or take an aspirin to avoid a headache.

What lies at the heart of the 'playing God' objection is ant ipathy to scientific arrogance - the view that scientists know what is best and will do it regardless. I 'm sure that most scientists are not arrogant. I suspect that the real concern here is with the possibility of positive genetic engineering, particularly that affecting a germ-line. An English philosopher, the late John Mackie, once pointed out that if this had been possible in the nineteenth century everyone would now be intolerably pious and chaste.

Here the answer is again openness and public accountability. In particular, there may be serious problems of unfairness if we permit positive genetic engineering of the children of the rich alone. But I must confess that if it became possible to make everyone more intelligent or more musical or even kinder, I would not find it obvious that we should refrain from carefully going down the road of positive engineering. At present, of course, the first step on this road is a long way off. But it provides an interesting focus for moral discussion which may have implications for the world as it is now.

(v) The final two objections are very common and closely connected. The first is the slippery slope objection. The argument here is that apparently harmless work - such as that concerning the 'dunce gene' in flies - is the first step on a slippery slope to quite unacceptable practices in the future. So we should not take these first steps. Here is a well-known opponent of genetic engineering, Jeremy Rifkind, in his book Algeny, published over ten years ago:

"Once we decide to begin the process of human genetic engineering, there is really no logical place to stop. If diabetes, sickle cell anaemia, and cancer are to be cured by altering the genetic make-up of an individual, w h y not proceed to other 'disorders': myopia, color blindness, lefthandedness? Indeed, what is to preclude a society from deciding that a certain skin color is a disorder?"

This quotation does illustrate something interesting, viz. the vagueness of the boundary between negative and positive engineering. Is short-sightedness a 'disorder ' to be prevented negatively? Or is 20-20 vision a good to be brought about positively?


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To return to the objection, Rifkin's version of the slippery slope argument seems to be logical. Once the process is underway, he suggests, there is no non- arbitrary place to stop. But this is quite wrong. What makes diabetes a disorder is the effect it has on people's quality of life. And that would be the reason for preventing it (remember utilitarianism and the importance of welfare). No such argument would be available for skin color, and any attempt to mount one would be ludicrous.

What about the empirical argument that nevertheless such discrimination and other appalling practices will occur? Again, this seems quite implausible, and I'd like here to introduce an argument of the Danish philosopher Nils Holtug. Those who are committed to banning genetic research on the grounds of a slippery slope argument must also accept that surgical research should be banned. For surgical research will make possible awful practices which today are not possible.

(vi) This brings me to the final argument, the so-called Trojan Horse or Pandora's

Box objection. The slippery slope argument relies on implausible claims about what will happen. The Trojan Horse objection allows probabilities into the equation, and suggests that the worst case scenarios are so bad that even a small probability of their occurring is sufficient to rule out research which may make them possible. Two possibilities are usually envisaged here. One is the misuse of genetic engineering by, for example, mad dictators. The other is that of great disasters.

Now it has to be accepted that predictions about the medium or long term future are notoriously unreliable. As I have suggested already, decisions here must be made by informed and impartial scientists answerable to the public. At present, such scientists are prepared to support further research. But making rational decisions in the way I am suggesting requires a level of public debate, fuelled by increased spending on scientific education at all levels, which at present is woefully lacking (one recent survey suggested that only 38% of people in the UK had heard of biotechnology, while 91% had heard of silicon chips).

One of the ironies of genetic engineering is that the more we come to know about ourselves, the less we know about our future. Although, as I have said, prediction is itself a risky business, my guess is that the genetic engineering revolution will continue, and that - especially if there is rational and open debate about its progress - it will make the world a better place.

Acknowledgement: I am grateful to my fellow Waynflete lecturers for their instruction and advice. Dr Roger Crisp is Fellow and Tutor in Philosophy at St Anne's College, Oxford University, UK.


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Making the world a better place: Genes and ethics