|Making sense of new genetic and reproductive technologies forces us to reconsider how we understand ourselves and how we relate to each other, our bodies and the creatures around us. What does it mean to be human when researchers can cross species? What does it mean to be a parent when so many people can contribute to the birth of a child? What does it mean to have rights when such personal information—DNA—can be so easily sampled?
As legal scholar Lori Andrews says in an interview for BLOODLINES, "We do a kind of bioethics fire drill every time a new technology comes along and we run around and wring our hands and have commissions on it. But if we started from values and said, 'Hey—these are important to us. It's important to have physical integrity. It's important to control privacy. It's important to assure that if there's a beneficial technology that poor people aren't just left out entirely.' If we started from values, then it would be much easier to make a judgment about technologies."
Freedom, equality, justice and dignity are some of the values that concern ethicists. New biotechnologies are deeply entwined with these fundamental values because they touch every aspect of our private and public lives, from how we are born to what we pass on to the next generation. Every time we go to the doctor or to work, sit in a class or courtroom or join in religious activities, we participate in assumptions about privacy, autonomy, responsibility, equality and justice, and to the extent biotechnology challenges these notions, it also challenges the institutions that embrace them.
How we choose to measure the meaning and value of human life has very practical political consequences. Deciding what is normal, for example, is far more than an intellectual exercise. When a new biotechnology like genetic testing asks us to define what is normal or healthy for human beings, it poses basic questions like who to include in a reformed health care system, who to protect from discrimination and who to hold responsible for their behavior. In the absence of public debate and consensus on these issues, the application of these technologies may create dilemmas for which society is not yet prepared.
At various junctures in the 30-year history of biotechnology, advisory boards and committees have been created to grapple with emerging ethical issues and recommend policies. (The Recombinant DNA Advisory Committee in 1974, the Ethical, Legal and Social Implications Program at the Human Genome Project in 1990 and the National Bioethics Advisory Commission in 1999.) Congress, the President and state leaders frequently establish these groups on the heels of surprising advances like the discovery of recombinant DNA, or perceived misuses of technology such as the birth of the first baby by assisted reproductive technologies and unproven claims about the first cloned baby.
Following are some of the many questions and themes raised by new biotechnologies.
The Body and Life
- Is life sacred, irreparably harmed by genetic and reproductive interventions?
- Where should we draw the line on human modification? Should we allow screening out of embryos with disabilities? "Enhancing" humans? Changing future generations?
- Are we obliged to use the tools we have to improve living things, even if that means destroying some life in the process?
- Do our manipulations simply advance evolution, or do they constitute hubris—or poor judgment—in the face of it?
- How and to what extent should the elements of life (genes, tissues, embryos) be recombined, discarded or relegated to the market?
- What is at stake in such decisions and who will make them?
The Self and Others
- Do genetic and reproductive technologies introduce new—or newly potent—harms? How do those harms weigh against the benefits?
- How should human beings be treated? Are they part of a genetic community, a source of valuable resources and services or active agents in genetic evolution?
- Do the risks and consequences of new biotechnologies push individual decision making about having a child, knowing a risk or trying a treatment into the sphere of public health and policy?
- Do new reproductive and genetic technologies allow or even force us to choose what kinds of people there should be?
- How do established individual rights (autonomy, informed consent, physical integrity) hold up to technologies that encompass whole families, communities or future generations?
- Do we need to explore new ethical or social models of balancing the individual with the community?
Access and Fairness
- Who benefits from and who bears the costs—economic, social, psychological—of new biotechnology?
- Who will have access to and who will pay for new biotechnologies? Who will decide these questions?
- What do the possibilities of genetic and reproductive technologies suggest about distributive justice, that is, whether or not we consider people "born equal," whether or not we continue to protect certain classes and what kind of social resource we consider human genes and tissues to be?
People's answers to these questions differ widely, especially in America where cultural and religious diversity is embedded in our social and political fabric. The potential for creating, using and profiting from living organisms brings us ethical dilemmas of many kinds. It also provokes passionate, visceral and possibly irreconcilable reactions from people across the socio-politico-economic spectrum, making for difficult governance as well as strange alliances. (For example, some conservative republicans and some traditional liberals agree that both reproductive and therapeutic cloning should be banned.)
Biotechnologies allow us to manipulate life in ways we could not imagine just a few years ago. They force us to reconsider what it is to be human and reexamine how we order society and relate to others. How we answer these questions, as individuals and as a society, suggests a lot about who we are.