The Australian Family, March 2003, p. 39
The Future of Biotechnology
Adam Wolfson is executive editor of The Public Interest. A slightly longer version of this article appeared in the Winter 2002 edition of that journal.
Biotechnology holds out tremendous promise for curing disease but also tempts us with the conquest of human nature in the form of a new eugenics. The question is, what general ideas and opinions in our culture might prevent us from drawing a line between the promise and the peril of biotechnology?
Before tackling this question, a few things should be said about immediate and near-at-hand developments in biotechnology. In surveying these developments, I will depend on Nicholas Wade's recent book, Life Script: How the Human Genome Discoveries Will Transform Medicine and Enhance Your Health. Wade is a highly reliable guide. A former writer for Nature and Science magazines, two preeminent science journals, he is currently a science reporter for the New York Times, where he writes on cutting-edge developments in biotechnology.
In Wade's view, the new genomic technologies will "develop in three overlapping waves of innovation which can be called conventional, germline, and life-extending." The conventional therapies will include powerful diagnostic tools known as "gene chips" that will be able to scan a person's genome and detect its vulnerability to various diseases. Meanwhile, by making use of the recently decoded human genome, scientists will soon develop powerful, protein-based wonder drugs. These new diagnostic tests and drugs will mark the dawn of what Wade calls "individualized medicine." Patients will be treated based on their particular genetic makeup, with drugs matched to individual genotypes. Also on the immediate horizon is what Wade calls "regenerative medicine." Instead of merely helping people to live longer with disease, medical science will harness the power of stem cells to grow into any number of replacement parts and organs. When a patient gets liver disease, for example, he will be supplied with a newly grown liver. Such advances in science will, Wade concludes, lead to the fulfillment of conventional medicine's "ultimate goal": good health to the end of one's days, which will add up to, on average, 120 years.
The second wave, Wade speculates, will involve germ-line manipulation of the human genome. In germ-line therapy, new genes are inserted directly into the fertilized egg; the resulting genetic changes are permanent, passed on from one generation to the next. Initially, germ-line therapy might be used to repair clear-cut genetic defects, and few people would object to that use of the technology. But, at least in theory, the technique could also be used for enhancement purposes, such as increasing height and boosting IQ or tinkering with the emotional and behavioral makeup of humans. Already, scientists have reportedly increased intelligence in mice by means of genetic manipulation.
Wade's third wave of medical innovations involves a radical increase in the "natural" life span of the human species. Already, scientists have extended the life span of fruit flies, roundworms, and mice. In the case of the roundworm, life span was quadrupled. As Wade points out, if the same were accomplished in humans, people who now live to the ripe old age of 80 years could reach 320 years.
If modern medicine's march ended with Wade's first wave, the social effects would arguably be minimal. The extension of the life span to 120 years would only complete a trend underway since the beginning of the last century, when average life expectancy was in the mid forties. It is not clear that a jump from 80 to 120 would be any more dramatic than was the jump from 40 to 80. One might ask whether Social Security would remain solvent with people living so long, but that is already a concern. One could raise other, more difficult questions about a nation in which the average age has greatly increased. Would the social ties of affinity and affection between generations remain strong if the "young" must wait until their mid seventies to hold high office or to reach the top of the corporate ladder? Would a nation of senior, senior citizens be willing to risk blood and treasure to defend itself? Would it still launch missions to the moon or send men aloft into space? Would a nation of 90-year-olds still have the capacity to consider questions anew? Or are spiritedness and a sense of wonder qualities mainly of the young? These are serious but speculative matters, which are unlikely to lead people to object to medicine's advance. Only antiscience zealots and a few exceptional stoics would say no to a long and healthy life for themselves and their children. (Of course, objections of a different sort have been raised about the morality of the means employed in the course of this "first wave," means that may involve experimenting on human embryos.)
In contrast, the second and third waves will indeed raise profound and unprecedented questions. Edward O. Wilson, the highly regarded Harvard sociobiologist, has predicted that within the next several decades, an era of "volitional evolution" will commence, in which it will be possible not only to increase intelligence and other such qualities but also to transform the basic emotional drives of Homo sapiens. One does not have to be religious to question whether man has the wisdom to gamble with human nature in this manner. Wilson himself asks why our species would "give up the defining core of its existence, built by millions of years of biological trial and error." Not only do we lack the knowledge to tinker with human nature, but there is something immoral and tyrannical about one generation of human beings experimenting upon and changing the essence of humanity for all succeeding generations.
There are other, darker possibilities, human cloning among them. Despite the fact that animal clones suffer from high rates of deformity, and despite the many ethical objections to human cloning, several fertility experts in America and abroad have announced their intention to clone a human being. There is as of this writing no legal barrier standing in their way. The creation of human chimeras is another horrifying possibility. Several years ago, a biotechnology company claimed to have created an embryonic cell that was part cow, part human, the result of a fusion of a human cell nucleus and a cow egg. The embryo was allowed to grow and divide five times, though there was apparently no intention to transfer it to a uterus. This experiment was not the work of some ghoulish Dr. Kevorkian but of well-respected scientists at the established biotechnology company Advanced Cell Technology in Massachusetts. As the New York Times reported at the time, "A perplexing feature of the hybrid embryo would be that it would start mostly bovine, then become mostly yet not entirely human." Perplexing indeed, and yet perfectly legal under current law.
Given the indeterminacy of events, it seems pointless to second guess Wade and other experts in the field. Whether it will indeed become possible to enhance IQs or to quadruple the human life span is anyone's guess, though it is worth noting that these are the predictions of the scientists themselves, not the writers of science fiction. The mind boggles at what life in America would be like once the country is engulfed by Wade's second and third waves, by a freewheeling eugenics of cloning and enhancement. Yet what is within reach of analysis is the question of how our culture will respond to such breakthroughs - that is, whether it will view the new discoveries with skepticism, if not repugnance, or whether it will embrace every new possibility. For here, the area of Tocqueville's great circle, if you will, we need merely examine what is being said now about biotechnology to reach some conclusions about what will be said in the future. Of course, there is no way of knowing which arguments will prevail, for one never knows from what corner an Abraham Lincoln will emerge, transcending and transforming the political debate. But we can make some reasonable surmises nonetheless.
Today's culture wars over biotechnology concern two issues, whether to pass legislation that would criminalize reproductive as well as therapeutic cloning and whether stem cell research on embryos should receive the financial backing of the federal government. In the case of cloning, the House of Representatives has passed by a vote of 265 to 162 the Weldon bill, which would criminalize cloning of human embryos for any purpose, reproductive or therapeutic. What kind of anti-cloning law will eventually, if ever, be passed, now depends upon the Senate, where the Democrats hold a slim majority. As for federal support for research on stem cells, Bush settled on a compromise that allows the federal government to fund existing stem cell lines but not the creation of any additional ones.
The cloning and stem cell debates produced an unusual political alliance between religious conservatives and the environmental Left, both of whom favored either government regulation of, or outright bans on, the new techniques. They are opposed by liberal Democrats and the biotechnology industry. This political debate is very important and bears close watching in the years ahead. But deeper cultural trends are also at work, to which one might apply Tocqueville's label of "mores" - that is, "the habits of the heart," "the different notions possessed by men, the various opinions current among them, and the sum of ideas that shape mental habits." Of these habits, notions, opinions, and ideas, three stand out: nonjudgmentalism, scientism, and egalitarianism. Each of these, which I will discuss in turn, tends to favor the unchecked advance of the biotechnology revolution.
Whether it gains sustenance from relativism, postmodernism, or libertarianism, nonjudgmentalism has become one of the distinguishing marks of our culture. In most matters, Americans think it is wrong to judge others or to attempt to constrain their choices. The public's nonjudgmentalism was on display most recently during the Clinton scandals. According to opinion polls, the majority of Americans thought that Clinton was wrong to have had a sexual affair with a young intern and then lie about it, but they also believed that it was his private concern and none of their business. What happens when such nonjudgmentalism meets biotechnology? Will cloning and genetic enhancement be viewed as the private affairs of individuals?
There is little polling data available on what people think about future biotechnology developments, with the possible exception of cloning. On the question of human or reproductive cloning, Americans, at least for now, tend to be quite judgmental. Generally, upwards of 90 percent of the public opposes the cloning of human beings, though this opposition slackens somewhat among the young. A 1997 poll sponsored by Time and CNN found that 64 percent of 18-to-29-year-olds favored therapeutic cloning - that is, cloning for replacement tissues and parts - compared to only 32 percent of those over 65 years.
Yet it is not enough to look at polling data.
If opinion polls were the decisive measure of public sentiment, why has Congress thus far failed to ban reproductive cloning? Given the lack of legal action, one might question the depth of Americans' opposition. As many pundits have noted, when the first baby clone is born, with its cute face splashed on the cover of every magazine, opposition is likely to melt away. In other words, which laws get passed and which laws do not is at least as important a measure of public sentiment as opinion polls.
The popular culture can also tell us something about public opinion on these issues. Consider a recent Hollywood film about cloning, starring Arnold Schwarzenegger. The movie, entitled Sixth Day, takes place in the near future: Human cloning has been made illegal after some disastrous experiments, but corporate America wants the ban overturned, a ban that is strongly supported by a motley crew of religious zealots. Arnold plays a typical American who, though not religious, has qualms about cloning. When his daughter's pet dog dies, he will not pay for a clone-replacement because he finds the idea simply too weird. His anticloning prejudice seems confirmed when an evil corporate CEO mistakenly clones him, unleashing all sorts of mayhem. But this is no update of the Frankenstein story, warning of the hubris of science, for Arnold comes to appreciate that his clone is a person too, with human feelings and a soul. And even though his clone has sex with his wife, Arnold befriends him anyway. It's only a matter of loving himself, and what could be more natural and pleasing to democratic taste than self-love? By movie's end, Arnold, now enlightened, clones his daughter's dead pooch, and everyone, he and his clone, live happily ever after.
More sophisticated versions of nonjudgmentalism spring from the ideologies of postmodernism and libertarianism. Just as biotechnology has led religious conservatives to work with environmental Greens, so too it has led conservative libertarians to join hands with the postmodern Left.
It is, of course, no secret that over the last several decades, postmodern ideas have become increasingly prevalent, most notably in academic circles. From a postmodern perspective, developments in biotechnology might seem both to confirm that "human nature" is entirely plastic and to open the door to new, experimental modes of being. Harvard law professor Laurence Tribe's writings on these issues illustrate postmodernism's influence on the biotechnology debate. In the early 1970s, when America's first great cloning debate occurred (somewhat prematurely, as it turned out), Tribe opposed the cloning of humans on the traditional liberal grounds that it amounted to using humans as means and not ends. Yet 25 years later, after the arrival of Dolly the cloned sheep, Tribe reversed his position. Under the influence of postmodernism, he argued that it cannot be known whether cloning is degrading of human nature, which he now, in good postmodern fashion, puts in quotation marks. Furthermore, he attacked those who opposed cloning as "essentialists" and claimed that a ban on human cloning risks, in his words, "cutting [society] off from vital experimentation and risks sterilizing a significant part of its capacity to grow."
Those influenced by postmodernism do not view cloning as something to be merely tolerated or as the price society must pay for the medical benefits that this technique might yield. Instead, they see cloning as a positive good, a way of breaking down old habits of thought and overturning what they view as harmful prejudices. To them, cloning is the ultimate "transgression."
A more buttoned-down version of nonjudgmentalism can be found on the Right among those who call themselves libertarians. They argue with respect to biotechnology, as they do with most other social questions - whether it is gambling, pornography, drugs, or divorce - that it is none of the government's business what consenting adults do with their time, money, and bodies. A ban on cloning is the "road to serfdom" all over again. In their view, we should trust individuals to know what is best for themselves. Conveniently, libertarians overlook the fact that eugenics involves third parties who have not consented to the proposed genetic engineering, whether it is the clone-to-be, the "designer baby," or the new race of "posthumans."
How far nonjudgmentalism might eventually reach can be glimpsed from the New York Times article that I mentioned earlier. The reporter acknowledged that the American public would be greatly troubled by the possibility of mixing man with animal, but he added the key qualifier, "at least at first." For as it happens, many scientists and bioethicists already believe that this is a rather outdated distinction. Said one expert: "'Biologically a lot of this research is showing us similarities and the upshot in a hundred years may be that the lines between humans and nonhumans will be viewed as a little bit grayer.'" A slogan for the next century might be: "Down with speciesism!"
Nonjudgmentalism finds an ally in what I will call "scientism," which may ultimately pose a more fundamental, and perhaps less familiar, challenge. Today, many believe that scientists should be the judge of their own cause, free of the meddlesome control of moralists, philosophers, theologians, and politicians. Examples of this mindset are not hard to find. In an article on Bush's stem cell deliberations, New York Times columnist Frank Rich complained that "political science [is taking] precedence over biological science." Similarly, after Bush's stem cell decision, Representative Richard Gephardt objected that "Americans know this is not the decision that the science community needs to go full force."
Note that word "force," for it is a favorite of those, whether liberal or conservative, who are under the sway of scientism. Earlier in the year, for example, former Speaker of the House Newt Gingrich made a fetish of force when he urged his Republican colleagues to replace their conservative principles with a simple belief in, as he put it, "technology as a force of change." A variation on this theme holds that scientific "progress" is inevitable, and so the attempt to stop it is futile. There is a certain irony in this notion of science as unstoppable force. Modern science, whose overriding goal is the conquest of the blind forces of nature, is now itself considered a blind force beyond human control.
As long as medical science remained dedicated to relief of suffering, no democratic oversight was required. For relief of suffering is, almost by definition, the democratic goal. Yet today, medical science is on the verge of finding a new polestar - one other than health - by which to organize its activities and to guide its progress. This is the crucial thesis of Nicholas Wade's book. In his words:
"Though [today's genomic] revolution is being conducted in the name of medicine, it will not necessarily stop at its implied goal, the attainment of perfect health. The power to reshape the human clay has no clear limits. How far should we go in enhancing qualities other than health, such as physique or intelligence?"
It is a question that haunts Wade. "Increasing life expectancy lies fully within the agreed goal of contemporary medicine," he states, while "increasing the life span is a different and far more ambitious goal." Once "the ultimate goal of conventional medicine," namely health, is achieved, "radical departures" like germ-line engineering are in the bidding, he writes. "The true dangers of genome engineering," he warns, "lie in the question of what changes should be permitted, if any, other than those directly related to health."
In writing that the "implied," "agreed," and "ultimate goal" of medicine is health, Wade is trading on an understanding of the modern scientific project formulated four hundred years ago by Francis Bacon. On the one hand, Bacon wished to liberate the pursuit of knowledge from the shackles of religion and the stultifying influence of ancient philosophy. He foresaw the kind of science we have today, one that produces all sorts of powerful inventions and cures. But on the other hand, in order to prevent the misuse of this liberated science, Bacon proposed that it be given one exclusive and binding directive: "the relief of man's estate." In The Great Instauration he starkly warned:
"Lastly, I would address one general admonition to all; that they consider what are the true ends of knowledge, and that they seek it ... but for the benefit and use of life; and that they perfect and govern it in charity."
As several scholars have noted, Bacon's scientist was to be, in a sense, a secular priest. He would devote himself to the conquest of nature, but only for the altruistic purpose of ministering to the sick. He would be full of curiosity about the natural world and ambition to subdue it, but he would also be full of charity for the lot of man.
In his 1966 book The Phenomenon of Life, the philosopher Hans Jonas scrutinized charity's role in directing and giving purpose to modern science, and argued that Bacon's attempt to graft charity onto science was bound to fail eventually. The problem is that the scientist, strictly in his capacity as a scientist, cannot justify such a goal, for the intellectual and moral sources of charity are independent of the scientist's discipline. As Jonas formulated the quandary:
"The need for charity or benevolence in the use of theory stems from the fact that power can be for evil as well as for good. Now, charity is not itself among the fruits of theory in the modern sense. As a qualifying condition of its use - which use theory itself does not specify, let alone assure - it must spring from a source transcendent to the knowledge that the theory supplies."
From Bacon's time to our own, medical science has by and large limited itself to the charitable aim of making imperfect men comfortable. But now, it is clear, many scientists have set their sights on the new goal of perfecting imperfect men, not to mention such oddities as cloning. And in today's secularized culture, it is increasingly difficult to insist, as Bacon once did, that scientists should be governed by a religious or ethical norm like charity. Such a norm is dismissed as the residue of a faded religious faith, a faith that must not be forced on nonbelievers, or a humanism that has been discredited. Meanwhile, others, influenced by the nonjudgmentalism of the day, think it none of their business to dictate goals and values to scientists. So what if cloning or genetic enhancement are largely unrelated to the relief of suffering; why, it is demanded, should this remain science's goal, especially today when science is capable of doing so much more? E. O. Wilson considers this "the ultimate question: To what end, or ends, if any in particular, should human genius direct itself?" Bacon's answer evidently no longer suffices.
Nonjudgmentalism and scientism would prepare the way for a laissez-faire eugenics. People would choose what genetic enhancements they please and can pay for, and scientists would create as they like. But there is another widely held notion in America - egalitarianism - which pulls in a different direction. It too will make resistance to the biotechnology revolution difficult, but the outcome will be instead of a laissez-faire eugenics some form of government-subsidized and regulated eugenics.
In his 1997 book Remaking Eden, Princeton molecular biologist Lee Silver speculates that in the future two genetic classes will emerge, the "GenRich," a hereditary class of genetic aristocrats, who take advantage of the new science of eugenics, and the "Naturals," who cannot afford to enhance their offspring. Whatever Silver's competency in science, his political analysis is probably off the mark. As Francis Fukuyama has pointed out, if genetic enhancement were to become possible, democratic publics would take to the streets with knives and guns before allowing Silver's scenario to come to pass. The lower and middle classes would insist that their children be provided with the same eugenic enhancements available to the children of the rich. In time, the U.S. government would subsidize eugenic programs, not to create an overclass but to preserve equality, to elevate everyone's natural endowments.
Indeed, some of today's most influential liberal thinkers have defended eugenics on these grounds. That they should do so is especially interesting, if not surprising, since liberals have for the better part of the last 50 years attacked genetic explanations of human behavior as discredited holdovers of Nazism and fascism. At the same time, however, liberals have also denied the possibility of "equality of opportunity." Individuals, they point out, each begin life from a particular socio-economic class and with different natural abilities. This realism, as it were, about the limits of equality in a free society ultimately softened liberal objections to eugenics.
In John Rawls's classic A Theory of Justice, published in 1971, long before the biotechnology revolution, a curious passage appeared. Rawls states that he will not consider the question of eugenics but then notes briefly that it is
"in the interest of each to have greater natural assets. This enables him to pursue a preferred plan of life. In the original position, then, the parties want to insure for their descendants the best genetic endowment (assuming their own to be fixed). The pursuit of reasonable policies in this regard is something that earlier generations owe to later ones, this being a question that arises between generations. Thus over time a society is to take steps at least to preserve the general level of natural abilities and to prevent the diffusion of serious defects."
Rawls concludes by stating, "I shall not pursue this thought further," but thirty years later, with the potential of genetic engineering more evident, his disciple Ronald Dworkin is not so reticent. In his 2000 book, Sovereign Virtue: The Theory and Practice of Equality, he vigorously and at length defends genetic engineering on the grounds of equality. The equality principle requires, in his view, that we do all in our power - including eugenics - to make each life a successful one. The step from government redistribution of income in the name of equality to government-sponsored eugenics in the name of equality is apparently a small one.
At the end of his book, Nicholas Wade captures the strange marriage that might come about between the democratic passion for equality and the science of eugenics. "The sequencing of the human genome makes it possible to envisage for the first time the creation of a genetically more just society, one in which the most fundamental kind of wealth - the genes that confer health and fitness - would for the first time be accessible to all."
Nonjudgmentalism, scientism, and equality - these three notions form the backdrop against which the biotechnology revolution is unfolding. Together, they make up, as Tocqueville would say, the "great circle" of our future. This does not mean that it is futile to resist biotechnology's advance. I do not wish to spread despair. Congress will in all likelihood enact a ban against human cloning, and President Bush has made clear that the federal government will not unconditionally endorse experimentation on human embryos. The president has also appointed the bioethicist Leon Kass to head a national commission with the broad mandate of guiding policy makers and the public through the moral minefield of the biotechnology revolution. These are important counter-developments to the trends I have canvassed.
Then there is the role that chance plays. The attack on the Pentagon and the World Trade Center could transform our culture in deep and lasting ways. Nonjudgmentalism may not seem quite so laudable in this other brave new world we have now unfortunately entered - a world of terror on our very own shores. And bioterrorism in the form of anthrax and smallpox reminds us, more vividly perhaps than any theoretical argument, that the life sciences can also be used for evil and death. Though hardly worth the price, we may regain our moral compass and rediscover what has always been most admirable about the American experiment: Not so much our science and technology, as wonderful and inspiring as these are, but our democratic way of life, our example to the world of a free people governing itself.
If nothing else, the events of September 11 remind us not to become overly distracted by the biotechnology revolution. It raises many profound questions but poses no immediate crisis. Criticism of biotechnology's progression must not be allowed to develop into something else, an indictment of America in its entirety. For whatever the country's excesses, and there are no doubt many, America remains the last, best hope of good-willed people everywhere.