In one of the classic early discussions about the possible uses of advancing genetic knowledge to control and reshape human life, Paul Ramsey, more than thirty years ago, wrote the following:
I . . . raise the question whether a scientist has not an entirely frivolous conscience who, faced with the awesome technical possibility that soon human life may be created in the laboratory and then be either terminated or preserved in existence as an experiment, or, who gets up at scientific meetings and gathers to himself newspaper headlines by urging his colleagues to prepare for that scientific accomplishment by giving attention to the ethical questions it raises”if he is not at the same time, and in advance, prepared to stop the whole procedure should the ethical finding concerning this fact“situation turn out to be, for any serious conscience, murder. It would perhaps be better not to raise the ethical issues than not to raise them in earnest.
My aim in this brief essay is to invite thought about present uses of genetic screening and the attitude we ought now to have toward the project of shaping our children, lest a focus on future possibilities should tempt us here and now to an entirely frivolous conscience.
No one doubts that genetic advance will, in good time, enable us to find therapies for at least some of the devastating diseases whose causes are, in whole or part, genetic. Research is taking place on many different fronts. Xeno“transplantation”that is, transplantation of animal organs, probably pig organs, into human beings”is the focus of much work right now. Genetic therapy”in which a functioning copy of a gene is added, or, even more desirable were it possible, a defective gene is removed and replaced with a functioning version”is the holy grail of research. Although progress on the therapeutic front has been slower than many had predicted, it remains the focus of much research and many hopes. Perhaps more dramatically still, what is called germ“line therapy”an alteration not of the somatic cells of the body but of the germ cells, the sex cells by which traits are passed on to future generations”is increasingly defended and may become possible. Just as mind“boggling is the work being done to culture embryonic stem cells in order to grow organs or tissues for transplant. Because such stem cells are essentially immortal”they simply regenerate themselves”this research may even hold out the hope of retarding the aging process, which some people, at least, think desirable.
In short, from countless different angles the pace of research invites us to reflect upon the project of controlling and reshaping human beings or, more broadly still, human nature”all in the name of relieving suffering. Our language regularly invites us to view this project in favorable terms. Consider, for example, the verbal formulations I might have used here. I might have said that researchers are progressing or advancing in the treatment of genetic disease and applications of molecular biology in medicine. It would have been surprising and counterintuitive had I written that the sorts of possibilities mentioned above indicate that researchers are regressing or retreating. We can scarcely imagine that increased ability to relieve suffering or eliminate defect and disease could be anything other than progress and advance.
At the same time, everyone also acknowledges that new techniques could be misused, even though few agree on exactly what would constitute such misuse. So, for example, we have distinguished between somatic cell and germ cell therapy, approving the former and disapproving the latter. But anyone reading the literature will surely note how that line has begun to break down of late, as an increasing number of bioethicists seem willing to defend germ“line interventions. Or, we have drawn a line between therapy and enhancement”embracing the former while disapproving the latter. But, again, anyone reading the literature will note how this line too has begun to blur. In response to that blurring we may try to distinguish between health“related and non“health“related enhancements”between, for example, enhancing the bodys ability to fight certain cancers and enhancing memory or, even, kindness”but it would surely be naive of us to suppose that the pressure to blur this line will not also be enormous.
To the degree that we as a people have lost the capacity to draw lines, to decide what should and should not be done, we are forced to take refuge in virtue ethics. That is, if we cannot definitively say which acts should or should not be done, perhaps we can trust people of good character to use these new techniques without abusing them. Yet, of course, we are the people who will be using the advances in genetics and whose wisdom and virtue must be trusted. What kind of people are we? To answer that question we need to think not about what may be possible in the future but, rather, about what is done in the present. We need to focus not on future subjunctives but on present indicatives.
And our present condition is this: we have entered a new era of eugenics. That science which attempts to improve the inherited characteristics of the species and which had gone so suddenly out of fashion after World War II and the Nazi doctors now climbs steadily back toward respectability. Eugenics becomes re spectable again insofar as it promises to relieve suffering, as it claims for itself the virtue of compassion. The new eugenics has, however, a distinctly postmodern ring. In the heyday of eugenics early in the twentieth century, its proponents had in mind government“sponsored programs that might even involve centralized coercion. Thus, for example, as Bryan Appleyard, a columnist for the Sunday Times of London, has noted, A Geneticists Manifesto, signed in 1939 by twenty“two very eminent American and British scientists, called for the replacement of the superstitious attitude towards sex and reproduction now prevalent with a scientific and social attitude that would make it an honor and a privilege, if not a duty, for a mother, married or unmarried, or for a couple, to have the best children possible, both in respect of their upbringing and their genetic endowment.
By contrast, the new eugenics comes embedded in the language of privacy and choice. Its two cardinal virtues”almost the only virtues our culture now knows”are compassion and consent. Compassion moves us to relieve suffering whenever possible; consent requires that our compassion be privatized. A world in which prenatal screening followed by abortion of children diagnosed with defects has become a routine part of medical care for pregnant women”that is to say, our world”is one into which eugenics enters not through government programs but precisely as government removes itself from what is seen as entirely a private choice.
I am not invoking the Nazi analogy, which has been disputed as often as it has been invoked in bioethical argument. I am not claiming that we find ourselves on a slippery slope, at the foot of which might lie Nazi“like deeds. Instead, I simply note how easily we may deceive ourselves about what we do here and now, how subjectively well“meaning people may approve objective evil. Just that, in fact, is the most terrifying point of Robert Jay Liftons great work, The Nazi Doctors . He invites us to see within ourselves”good people whom we suppose ourselves to be”the possibility of great evil. We thus find ourselves returning, Lifton writes near the end of his discussion of the doubling that made it psychologically possible to be a Nazi doctor, to the recognition that most of what Nazi doctors did would be within the potential capability”at least under certain conditions”of most doctors and of most people. To read Liftons account is, for the most part, to read of good and ordinary people in the grip of an ideology who suppose themselves to be engaged in a compassionate and healing endeavor. Something like that, Lifton suggests, is an almost universal possibility. And something like that, I am suggesting”something very different because cloaked in the language of privacy, yet not so different because it sanitizes and medicalizes as healing the killing of defectives”is by far the most common present use of genetic advance.
This is our present situation. The day may come when we can treat and cure prenatally or postnatally many genetic diseases; however, for the moment we can diagnose prenatally far more than we can treat. In the meantime, therefore, we screen and abort. For now that is essentially the only treatment for illness diagnosed prenatally. We know more and more about the child in utero ; hence, people quite naturally seek and use such knowledge in order to select the babies they desire and abort those they do not want. This is the new eugenics”which relies not on government coercion but on private choice and desire, on the commodification of children. Thus, Appleyard writes, We could not now respectably speak of the improvement of the race or of selective breeding”the terminology of the old eugenics”but we do speak of the quality of life and assess our children in consumerist terms. Not only is the meaning of childhood distorted but the meaning of parenthood as well. Selective abortion means selective acceptance. The unconditional character of maternal and paternal love is replaced by choice, quality control, and an only conditional acceptance.
People who have chosen or have been taught to think this way are the people who will be deciding what constitutes proper use or misuse of advancing genetic technology. We run the risk of cultivating frivolous consciences, therefore, if we pay attention to the moral conundrums of future subjunctives while studiously ignoring present indicatives. For as long as we are willing to rely on the routinized practice of prenatal screening followed by selective abortion we are not people who should be trusted to design their descendants.
Suppose, however, that we could be so trusted and that the capacity to design and shape our children, to shape their nature and character, were really ours. What sort of people should we aim to create? Taking my inspiration from a short piece written by Alasdair MacIntyre more than two decades ago (Seven Traits for the Future, Hastings Center Report , February 1979), I suggest that we ponder this question briefly. An obvious way to answer the question is to think in terms that our moral tradition has taught us, in terms of the four cardinal and the three theological virtues. We should aim to design children who would be characterized by prudence, justice, courage, and temperance”and, in addition, by faith, hope, and love.
Within the Western moral tradition, so nicely articulated by Josef Pieper in The Four Cardinal Virtues , the virtue of prudence means something quite different from our use today of a word such as prudential. For us, in fact, there is a certain tension between being good and being prudent. In the longer view of the tradition, however, the virtue of prudence enables us to see things as they really are. Not just as we would like them to be, or fear that they must be, or greedily hope they may be”but as they truly are.
Two things follow. On the one hand, this implies that nature itself”apart from our own shaping activity”has order and form to be discerned by the prudent man or woman. Prudence seeks to conform to the reality of things and does not suppose that our humanity consists only in our power of mastery over nature. Hence, the first task, as MacIntyre suggested, is not to change the world but to understand and interpret it.
On the other hand, human prudence can never exhaust or comprehensively understand the meaning and order of our world. MacIntyre illustrates how the limits to our understanding are evident in the very possibility of radical conceptual innovation. Relying on Karl Popper, he asks what it would have been like had one of our ancestors predicted the invention of the wheel. In order to explain his prediction this ancestor would have had to describe axle, rim, and spokes”in short not just to predict the invention of, but, in fact, to invent the wheel. The lesson being: we simply cannot predict with any precision what the future may be like, what innovations may appear; and we will want children who can accept the limits of our knowledge, who know that not everything is within our control.
To see the world rightly is, among other things, to see the difference between mine and thine”that is, to be just. Justice is not yet love; it is life with , not life for , the neighbor. Without denying our fellow humanity, justice maintains distance between us, lest the life of one should be entirely absorbed within the aims and purposes of another. Hence, to be just is to respect the rights of others, to recognize the claim upon us of their equal dignity. The denial of that common humanity is, as Pieper writes, the formal justification for every exercise of totalitarian power. Such power, of course, can be exercised not only synchronically but also diachronically”across generations.
Justice requires, at least in some times and places, courage. For there will be moments when it is injurious to ones own interests or, simply, dangerous to be just. Courage is a necessary human virtue precisely because we are creatures always vulnerable to injury”the greatest of which, of course, is death. We have tended to picture courage as a martial virtue needed by those who must face enemies and fight. But Pieper reminds us that in our world, and perhaps in any world, it is needed as much by those who only suffer”not those who attack, but those who endure. It is needed if we are, one day, to accept the appropriateness of our own death, to acknowledge that a just affirmation of the claims of others means that we must recognize that our own time and place is not the master of every time and place, that we must give place to those who come after us.
To be that courageous in the service of justice cannot be possible for one whose inner self is not fundamentally in right order and at peace. Lacking such order, we are bound to grasp for what we desire at any moment, to flinch when sacrifice of our own desires seems needed for the sake of others. We should, therefore, want our children to be not only prudent, just, and courageous, but also temperate.
High as such an ideal of character is, however, Christians will not rest content with an ideal that can and has been known apart from Christ. They will also want the threefold graces of faith, hope, and love to be formed in their children. Faith is the conviction of things not seen. Because we cannot fully see the way ahead, because, as I noted above, we must always live with uncertainty about the future, we are unable to secure our own lives. We exercise control of various sorts, we improve the human condition, but mastery eludes us. Hence, we must want our children to know the limits of their power, to seek wisdom more than power. Indeed, if our faith seeks its security finally in God, our life must be oriented toward One who most emphatically is not within our control. As philosopher Robert Meagher writes, describing St. Augustines view: It seems that one may either strive to want the right thing, or strive to have what one wants. The search for wisdom somehow involves the renunciation of power, the renunciation of possession, while the search for power somehow involves the renunciation of wisdom, since it presupposes the appropriateness of what it is striving to attain.
Because faith requires that we live without trying to secure our own future, it needs to be joined with the virtue of hope. We must hope and expect that God can complete what is incomplete in our own strivings, especially when, in order to live justly, we refrain from achieving good that can be gotten only by evil means. You might have helped me, future generations may say, had you only been willing to dirty your hands a bit. There is no reply to such a charge without an appeal to hope, without a sense of the limits of our responsibility to do the good. Above all, Kierkegaard writes, the one who in truth wills the Good must not be busy. In quiet patience he must leave it to the Good itself what reward he shall have, and what he shall accomplish. To be hopeful is to adopt the posture of one who waits, who knows his fundamental neediness and dependence; for, after all, were the good for which we wait at our own disposal, there would be no need for hope.
There remains love, the greatest of the virtues. Love signifies approval, and, Josef Pieper writes, the most extreme form of affirmation that can possibly be conceived of is creatio , making to be. Hence, our own love mirrors the creative love of God, which bestows on us the divine word of approval. Love therefore is, in Piepers words, a way of turning to another and saying, Its good that you exist; its good that you are in this world. As we hope to become people who can love our own children in this way, so we would want them, in turn, to be people who can love as they have been loved”with an affirmation that is not conditioned upon the qualities of the loved one.
We can say, by way of summary, that, were we to undertake the project of designing our descendants, we should want them to be people who do not think the natural world infinitely malleable to their projects; who reckon from the outset with limits to their own knowledge of and control over the future; who respect the equal dignity of their fellows and do not seek to coopt others as means to their own (even if good) ends; who acknowledge even their own death, the ultimate of limits; who are prepared to subordinate their needs to the good of others; who are more disposed to seek wisdom than power; who know that the good is not finally at their own disposal; and who live in a manner that says to others, Its good that you exist.
My argument has come at the question of designing our descendants in two stages. I first suggested that people who live as we do”who have accepted as useful the routinized practice of prenatal screening”are people who have no business attempting to reach out and shape future generations. But, second, I asked what kind of descendants we should seek to create if we were people fit to undertake such a task. If we are drawn to the description I have given in terms of the cardinal and the theological virtues, we should be able to see, from a quite different angle, why designing descendants is a project we ought not undertake. I said earlier that I took the inspiration for this idea from Alasdair MacIntyre, and I can do no better than repeat here the words with which he concluded his own exploration of the traits we should want our children to have.
If in designing our descendants we succeeded in designing people who possessed just those traits that I have described, . . . what we would have done is to design descendants whose virtues would be such that they would be quite unwilling in turn to design their descendants. We should in fact have brought our own project of designing descendants to an end.
It turns out then that my argument has immediate practical consequences. For if we conclude that the project of designing our descendants would, if successful, result in descendants who would reject that project, then it would clearly be better never to embark on our project at all. Otherwise we shall risk producing descendants who will be deeply ungrateful and aghast at the people”ourselves”who brought them into existence.
Gilbert Meilaender holds the Richard and Phyllis Duesenberg Chair in Christian Ethics at Valparaiso University.