KENAN MALIK Made-to-order David Beckhams; an
army of Saddam Hussein clones; a world without disease. Few subjects conjure
up more fantastic scenarios or generate more heated debates than the possibilities
of biotechnologies such as cloning and genetic engineering. For some people,
biotechnology opens the door to a Star Trek-like utopia of perfect beings.
For others it threatens a dark dystopia governed by monstrous multinationals
and peopled by a genetic underclass. And, as the recent furore over a white
couple giving birth to a black twins reveals, many people are beginning to
question even long practised and highly-regarded techniques such as IVF.
BRYAN APPLEYARD We are used to medicine as being
a response to a disease whereas I think biotechnology opens up the possibility
of more fundamental changes to the human being.
KENAN MALIK The writer Bryan Appleyard, author
of Brave New Worlds, a critique of biotechnology.
BRYAN APPLEYARD I think it is obvious although
many people don't seem to see it, that human beings are incapable of enhancing
human beings. We don't know what a better human being is. Of course if somebody's
got a disease it's better that they don't have it, all those things, but in
terms of making better human beings, what it would be better for a human being
to be then I think we can't do that. It's a scientistic delusion that we could
make people better, better human beings in any but the most simple practical
senses.
PETER GOODFELLOW One of the difficulties is
that techniques which existed for many, many years can be re-labelled as biotechnology
and then we have a new discussion about the same technique.
KENAN MALIK Peter Goodfellow, head of research
and development at the pharmaceutical giant, Glaxo SmithKline.
PETER GOODFELLOW For example, mankind, for as
long as mankind has been around have been experimenting with their environment,
the crops and the animals in the environment. So was the domestication of
the dog, the cow, the chicken, the sheep biotechnology? I think the answer
to that is actually yes, it's where we were exploiting, if you like, biological
processes for our own good and I see nothing wrong in that at all.
KENAN MALIK For Peter Goodfellow today's biotechnology
is simply the latest version of a age-old technique. For Bryan Appleyard it's
something fundamentally new and different. For all his relaxed attitude, though,
Peter Goodfellow remains deeply anxious about public perceptions. He refuses,
for instance, to talk publicly about cloning for fear that his company, Glaxo
SmithKline, will be wrongly associated in the public imagination with images
of men in white coats growing humans in the lab.
Underlying such public anxieties is the fear that science could robs us of
our humanity, that it could steal our souls, as it were. Here's Francis Fukuyama,
the American analyst and academic, whose recent book Our Posthuman Future
suggests that biotechnology threatens to undermine the dignity of being human.
FRANCIS FUKUYAMA The term dignity in Western
parlance is essentially a Christian concept which has to do with the idea
that man is created in God's image. But I believe that even if you begin from
non religious premises, there is a very powerful concept that underlies our
Western concepts of human rights that says that if you strip all secondary
attributes of people away - things like skin colour, gender, social status,
inherited class, these sorts of things - that there is an essential core set
of characteristics that define a human being as human and that give that individual
political and human rights. They would have to do with things like capacity
for reason, for moral choice, a set of uniquely human emotional responses
which very much colour our view of who we can relate to, who we deal with
in society. And that is something that is universally possessed by all human
beings and that is the basis for this very deeply embedded idea that we need
to protect human dignity through our political system.
KENAN MALIK So you see it in a sense as constituting
what it is to be human and that is what you wish to preserve from the clutches
of science, if you like?
FRANCIS FUKUYAMA Yes, that’s right. We
modify non-essential characteristics through plastic surgery, through aspirin
and through a lot of other medical interventions but I think the technology
is getting powerful enough that it is beginning to later some more fundamental
characteristics.
MARY WARNOCK Well I think it's a bit of an
exaggeration that kind of
argument.
KENAN MALIK Baroness Warnock chaired the famous
Warnock committee which, in the 1980s, explored the ethical issues surrounding
IVF treatment and helped established Britain's legal framework for dealing
with reproductive technologies.
MARY WARNOCK We've been capable of messing around
with our biology forever. I mean ever since contraception was invented for
example. And the fact that women have for years now been able to have sexual
intercourse without conceiving a baby. That's messing around with our biology,
but it's something we take completely for granted, as a great boon actually.
And I don't believe that to move on from there the work that's gone into..
infertility and helping people have children who left to nature wouldn't be
able to have children, for one reason or another. I don't think that has undermined
the nature of what it is to be human, although it's undoubtedly a biological
intervention, and sometime quite a dramatically intrusive intervention.
KENAN MALIK So does Mary Warnock think that
anything is permissible as far as biotechnology is concerned?
MARY WARNOCK I think that there are ethical
limits, which are to do with
the way in which at present a child is, has genes equally from both parents,
but in a random way. And therefore the, the child is in a sense unpredictable,
each child is unpredictable. I think there should be an ethical barrier to
trying to take away the randomness in the genetic make-up of every child.
KENAN MALIK Even staunch supporters of biotechnology
acknowledge that such techniques require ethical restraint. What then are
the worrisome ethical issues, and how should we deal with them?
Three techniques cause particular concern. The first is reproductive cloning,
the artificial creation of new humans genetically identical to the parent.
Then there's therapeutic cloning, the use of special stem cells to grow human
tissues, such as brain, heart or kidney. This could potentially help treat
a myriad of disorders from Alzheimer's to heart disease. But it's controversial
because it requires the creation, manipulation and destruction of embryos.
And finally, there's genetic engineering and gene therapy. What particularly
concerns critics is germ-line therapy, the modification of genes in the sperm
or egg, or in a fertilised egg. Any such modification would affect not simply
one individual, but also all of his or her descendants.
In Britain therapeutic cloning is legal, though strictly regulated. Reproductive
cloning and germ-line therapy are illegal. In most of Western Europe all three
techniques are banned. In the USA, a presidential committee is currently debating
whether to allow federal funds to be used to support therapeutic cloning.
At the moment no federal funding can be used for any kind of embryo research,
though there is little restriction on privately funded biotechnologies.
So, there's no universal approach to the legal and ethical dilemmas thrown
up by biotechnology. What's more, most of the debate is about techniques that
don't yet exist and which, if they did, would most likely be illegal, at least
in Europe and America. Yet, it is the very uncertainties about biotechnologies
that raise hairs on the back of the neck
TOM SHAKESPEARE I think that there are all
sorts of abuses that happened in the past with very straightforward technologies.
We are in a space where vast claims are being made for biotechnology and therefore
I think we have to approach it with corresponding caution.
KENAN MALIK Tom Shakespeare, director of PEALS,
the Policy, Ethics and Life Sciences Institute at Newcastle University, and
a disability rights campaigner. What he most fears are techniques such as
germ-line therapy which seem to impose on future generations our conceptions
of what is biologically good.
TOM SHAKESPEARE I think that we don't know what
will happen to society in the future. We don't know what the consequences
of our collective actions may be, and we don't know how the person who, for
whom we are choosing will feel about what we've chosen for them so I think
we need to have care and caution in intervening in the future. If we enable
parents to manipulate their children to a greater extent in the womb or prior
to conception, then we are stoking up problems for ourselves. We're stoking
up the potential of immense resentment against parents by children who blame
them for intervening and undermining their choices, their autonomy.
KENAN MALIK But I can't see the fundamental
difference between making choices for a child when that child is an embryo
or a foetus, and making choices for that child when that child is a sentient
being in the outside world. And we make all sorts of choices for that child
in terms of education, in terms of where they live, in terms of all sorts
of aspects about their future.
TOM SHAKESPEARE Well I'll say two things in
response to that. One, I think
we should respect the rights of children far, far more. We're not in a world
where the pater familias says you will do this, and you have no choice,
so you know yes we should listen to children more. But I think that the sort
of schools that we send to children to, or the clothes that we buy for them,
or the holidays and other opportunities that we provide for them, are one
thing. But designing their physical or emotional or mental characteristics
as we may be able to do in the future is vastly more damaging because you
know your school, at the end of the day, doesn't actually make a hell of a
lot of difference but your genome could do and you cannot reverse it.
JOHN GILLOTT Not changing the genome of the
future also affects the future. Anything we do affects the future so I think
in that sense it's just obviously a false argument.
KENAN MALIK John Gillott of the Genetic Interest
Group - a pressure group campaigning for families with genetic disorders.
Changing the genetics of future generations may be unwise. But equally, he
suggests, refusing to eliminate, say, the gene that causes cystic fibrosis
may condemn future generations to continue suffering from those disorders
unnecessarily.
JOHN GILLOTT I think what's really been said
behind the argument is that we should privilege leaving things as they are
and there's something ethically superior about not intervening compared to
intervening. I think the only sensible way to approach that debate…
is really to do our best now to expand our knowledge now to do what we think
is right now and then in the future we will build upon that. We may make mistakes
but then we may make bigger mistakes by doing nothing. You've really got to
do what you think is best now, open up the possibilities for the future and
then let the future decide what it wants to do with the changes that you have
made.
KENAN MALIK For Francis Fukuyama there is a
broader concern with germ-line therapy – we should not do to human nature
what we seem to have done to the Amazon rain forest.
FRANCIS FUKUYAMA You can make an analogy with
ecosystems. We don't do a lot of engineering projects that we used to, big
hydro-electric projects for example, as we simply did not anticipate the very
complicated chain of consequences that would flow from damming up big rivers.
And so that is something that we choose not to do in the developed world today.
And I think something very similar is likely to happen should we proceed too
incautiously in this area as well.
KENAN MALIK So do you suggest there's a particular
relationship between humanity and nature and that one should not upset that
relationship to too great a degree?
FRANCIS FUKUYAMA Yes, I think that's the basic
argument.
JOHN GILLOTT Nature has not created perfect
organisms, there isn't such a thing in nature. The long evolutionary history
of animal species and the human species is one of making do.
KENAN MALIK John Gillott of the Genetic Interest
Group.
JOHN GILLOTT We know that, operating blindly,
nature has given us recessive human genetic diseases whereby the possession
of two of the wrong genes leads to many serious and crippling diseases. On
the other side, though, because nature has had a long time there is obviously
a great deal of mutual interdependence within the genes and the genomes and
there are some very sophisticated regulatory mechanisms and it would be foolish
to go blundering in there. The ultimate goal will be intelligent design. Something
like germ line genetic engineering should be an ultimate goal.
KENAN MALIK Nature in other words is a bad designer
because it is a blind designer. We only need medicine, and hence biotechnology,
because evolution has left us with jerry-built bodies that constantly break
down with headaches and backaches, cancers and coronaries, schizophrenia and
depression. So why shouldn't we interfere with nature's creation and try and
improve our genome?
This debate about germ-line therapy is important, but it's also a bit abstract.
Germ-line therapy is both technically difficult and illegal. What gives most
anxieties to critics of biotechnology are simpler - and legal - techniques
that can do the same job. One such technique is pre-implantation genetic diagnosis,
or PGD. Used during IVF procedures, PGD is a technique that allows doctors
to test an embryo for genetic disorders prior to its transfer to the uterus.
It makes it possible for couples or individuals with serious inherited disorders
to decrease the risk of having a child who is affected by the same problem
- such as cystic fibrosis or Tay Sachs disease. But it's controversial because
it can be used to test the embryo for many other things - such as its sex
and maybe eventually in the future, some people fear, its sexuality.
BRYAN APPLEYARD It encourages for example the
belief that we might medicalise a lot of things that we don't currently medicalise.
The medicalisation is a very important point because it brings in areas of
human life which people feel discontented about but have never previously
been thought as medical problems. I mean it extends the definition of disease,
it extends the definition of disability because we can, we now feel we can
change these things at the genetic level. The obvious problem with that is
that these things are not diseases. It is not a disease to be short, it is
not a disease to be homosexual. We know that. That is the way we construct
our attitudes to diseases. But if we start thinking that those things that
can be put right, corrected, then that extends the idea of what medicine is
for.
KENAN MALIK Bryan Appleyard. The tendency to
view human differences in terms of medical disorders is certainly troubling,
and the possibility of consumer choice in genetic intervention raises important
questions. Should the individual have autonomy to choose their child's sex,
sexuality or eye-colour, or should society define the limits to such choice?
Even simpler methods than PGD, though, allow people to impose choices upon
future generations. Recently, a lesbian couple in the US, both of whom are
deaf, created a deaf child by insisting on sperm from a deaf donor. Many people
were appalled. But this is arguably more a debate about questions of identity
and disability, of individual autonomy, and about how we look upon children,
than it is about the ethics of biotechnology as such.
Tom Shakespeare has other worries about the impact of genetic interventions
on perceptions of disability.
TOM SHAKESPEARE Research recently showed that
the availability of screening for Downs Syndrome has changed the ways in which
many people regard children with Downs Syndrome so if you see a family with
a Downs Syndrome child, in the street, you now think well why didn't they
avoid that? Why were they irresponsible? What went wrong? It's their fault
and maybe you even think well the welfare state or the insurance company shouldn't
have to pay. So although in theory this research may not have negative implications
to disabled people, in practice the social consequences may be less tolerance.
JOHN GILLOTT I think empirically the argument
fails, I think that we are in a society now which is more sympathetic and
supportive of disability and even actually of the values of the disability
rights activists whilst at the same time there is clearly an interest in genetics.
KENAN MALIK John Gillott, with a very different
argument about perceptions of disability.
JOHN GILLOTT Essentially it seems to me what
some disability rights activists are arguing when they make the argument that
changing genes leads to a devaluing of people with those genes is in a sense
to identify the person with the genetics which I want to resist, you know.
From a broad humanist point of view you want to treat people equal as human
beings and consider biology as separate from that. But in a sense the disability
rights critique is almost pushing the two together and it's claiming a link
between identity and genetics and I think it's far preferable to try and step
back from that, try and consider people as equal but consider some people
as having genetic disorders and some people broadly speaking as being healthy.
KENAN MALIK The questions about biotechnology
raised by Tom Shakespeare, Bryan Appleyard and Francis Fukuyama are important,
not least because they demonstrate how opposition to biotechnology draws together
many diverse political and personal strands - a religious distaste for undermining
the sanctity of God's creation; a secular defence of the dignity of Man; a
radical critique of the social consequences of biotechnology. But how much
of this is really new?
THE TIMES It is not fanciful to say that
at this stage... the end of human beings as a wild breeding race could be
in sight.
KENAN MALIK That's a response not to cloning
or to genetic engineering but to in vitro fertilisation. It comes from an
essay in the Times in 1969, in the days when many people viewed IVF
with the same abhorrence which now greets the prospect of cloned humans or
designer babies.
THE TIMES The cheapest and surest way
for any small impoverished country to improve its wealth and influence would
be to concentrate on breeding a race of intellectual giants... and as soon
as one nation adopted a policy of effective selective breeding... others might
feel compelled to follow suit. The threat that this might pose to accepted
human values would be extremely grave.
KENAN MALIK Even heart transplants were once
seen as ethical dubious, as Peter Goodfellow points out.
PETER GOODFELLOW When people first did transplantations
it was believed that there were all sorts of questions about identity which
were being raised and I think for the most part those questions have gone
away as people have become comfortable with the idea.
KENAN MALIK Today we have lost most of our anxieties
about transplants and even about IVF, the black and white mix-up notwithstanding.
Perhaps in 10 or 20 years' time we will have lost our anxieties about cloning
and genetic engineering, too. And, if 30 years ago we had been as squeamish
as we are now urged to be about today's biotechnologies, we might still be
living in a world without transplants and fertility treatments.
The history of medical advances suggests, then, that pragmatism might be the
best approach: take ethical considerations seriously, but don't allow them
to obstruct the development of might be very useful technologies. Such pragmatism
does not necessarily mean a free-for-all. John Gillott, for instance, can't
see an ethical objection to germ-line therapy, but he does have safety worries.
JOHN GILLOTT I think there is a sensible argument
for saying that we should
be cautious about germ line engineering because of the permanency of the changes.
There's a very sensible argument at present for not doing it which is simply
that the current state of knowledge does not allow us to have a proper understanding
of the effect of all the changes that we might make.
KENAN MALIK What pragmatism does allow us to
do is to separate the ethical and the safety questions, to have a broad ethical
debate about the meaning of human dignity and the social role of science and
medicine, while at the same time taking practical decisions on biotechnology
according to criteria of safety.
The trouble with such pragmatism, though, is that it does not address the
absolute ethical objections that many people have to some biotechnologies.
BRYAN APPLEYARD It seems to me that the question
of experimentation on embryos is pretty clearcut.
KENAN MALIK Bryan Appleyard.
BRYAN APPLEYARD I mean if you say, fine, experiment
on embryos, then I can't really see why you don't experiment on foetuses and
on handicapped newborn babies. I don't see the distinction really to be honest.
I mean you can make distinctions about feeling pain and things like that but
I think that is pretty marginal and actually we don't really know when these
things feel pain or whatever.
But if you say well actually we don't want to do that because we as a society
feel strongly about the human, the sacred or sacrosanct nature of the human
self. We think it begins here. You know scientifically this may be difficult
to establish but I don't see that there is any problem with that.
KENAN MALIK In practice, though, most people
tend to moderate such absolute ethical injunctions, however deeply felt, in
response to practical needs. Most people, for instance, whatever their views
on embryo rights, accept the ethical legitimacy of in vitro fertilisation,
despite the fact that for every successful IVF pregnancy, many embryos are
created and destroyed. Similarly, there is widespread acceptance of women's
right to abortion, even if many consider it a distasteful practice. In other
words, even if you accept that embryos have a special status, in practice
you tend to adopt a pragmatic approach, unless you are willing to reject such
things as abortion, IVF, and so on. There is no evidence that this pragmatism
has led to a diminished respect for human dignity - 20 years of IVF has not
made us more willing to experiment on the handicapped. So, can't we take a
similar pragmatic approach to the use of embryos in, say, cloning procedures?
Perhaps we can. But perhaps, also, the most difficult set of questions relate
to how this tension between ethical concerns and pragmatic needs should be
reflected in legislation.
FRANCIS FUKUYAMA I think that regulation is
inevitable in this area. I think there are many areas of technology, for example
information technology, that are much more genuinely morally neutral, most
of their effects are relatively positive. But biotechnology is an area that
is so pervaded by human values and in which there is going to be such societal
disagreement over those values that it is I think unbelievable that you can
proceed very far down this road without fairly strict rules.
KENAN MALIK Francis Fukuyama, who's a member
of the committee advising President Bush on how to regulate biotechnology.
Mary Warnock, who chaired a similar committee in Britain in the 1980s, suggests
that regulation should provide not so much ethical guidance as reassurance.
MARY WARNOCK No legislator, presumably, and
no head of a laboratory, can afford to disregard entirely what people see
as that dangers, hazards, unacceptable nature of what they're doing. And therefore
there is this element that regulation is to reassure people who might be hostile
to what's going on. That it isn't allowed at any rate to be a free-for-all.
It is a kind of compromise. I don't like particularly saying that the point
of regulation is reassurance. But I think the other side of it is that the,
if there were no regulation of the permissible, permitted experiments using
human embryos, then I think the scientists and doctors would be perpetually
be having to look over their shoulder and see who was going to sabotage their
lab and who was going to expose some malpractices, or what were thought to
be malpractices. I think scientists themselves feel more secure when they
are sticking to the regulations.
KENAN MALIK John Gillott, of the Genetic Interest
group, pleads for still less restriction.
JOHN GILLOTT I think it's completely legitimate
for parliament, for societies to say we don't want to see this happen. That's
a kind of debate that should be had. It could then be resolved in a couple
of ways really. It could be resolved by a kind of majority, majoritarian kind
of decision, a vote, or - and this is probably what I would prefer - you could
try and resolve it in a more kind of libertarian way. You could try and make
the argument to people that OK you personally don't want this. Other people
do. If you can't show a great harm to people through this procedure, then
you should really back off and you should allow this to proceed so that we
can examine the results of this kind of innovation, this kind of inquiry and
we could see the results of it.
KENAN MALIK For Francis Fukuyama, the fact that
society is deeply divided on ethical issues demonstrates the necessity for
strict regulation. For Mary Warnock, it reveals the need for official reassurance.
For John Gillott, it suggests that such conflicts are best resolved through
public debate rather than through government legislation. But the argument
that regulation should ignore ethical objections in favour simply of safety
considerations is itself, Francis Fukuyama suggests, an ethical stance.
FRANCIS FUKUYAMA I think that if you simply
choose safety as your only criteria you're making an implicit ethical judgement
about this technology. That's not an ethically neutral choice. What you're
saying is that the ability to intervene in the genetic construction of human
beings is something that's simply up to the free market or individual choice
or some combination of the two. You shouldn't kid yourself that that's an
ethically neutral position.
KENAN MALIK It's true that the pragmatic stance
is not ethically neutral, but we can, I think, view this more positively than
Francis Fukuyama does. Part of the problem with the biotechnology debate is
that we tend see it in terms of a conflict between hard, rational scientists
hellbent on progress whatever the cost and those who wish to put morality
into the picture. Yet, what could be a more moral activity than the pursuit
of scientific and medical progress?
MARY WARNOCK It's always thought that scientists
are without any ethical considerations at all. It seems to me that the profession
that's most manifestly motivated by a moral imperative is the medical profession.
And the scientists are working hand in hand with the medical profession. The
aim to alleviate suffering is a, genuinely a moral aim and it, it's part of
human nature, fortunately. I think that it would be ethically totally unacceptable
to bring down a barrier and say, doctors may not go any further than this.
KENAN MALIK Mary Warnock. The real debate is
not about science versus ethics, but about the kind of ethics that we want.
Do we wish to be guided by an absolutist morality or a pragmatic one rooted
in concrete human needs - such as the need for a solution to Parkinson's,
Alzheimer's and Aids? Imposing arbitrary ethical injunctions will make for
neither a more moral nor a healthier society. Ethical fears about heart transplants
and IVF melted away as people saw the real benefits of these techniques. The
same is likely to be true of cloning and gene therapy. Why not regulate to
prevent maverick scientists pursuing harmful projects - but otherwise give
them a free hand and see what benefits they can produce?