The Real Meaning of Genetics
Eric Cohen, The New Atlantis
With a subject as large and as profound as modern genetics, we face a major question from the start about how to approach it. We could take a scientific approach, examining the use of information technology in genomic research, or the latest advances in identifying certain genetic mutations, or the transfer of genetic knowledge into useful medical technologies. We could take a social scientific approach, seeking to understand the economic incentives that drive the genetic research agenda, or surveying public attitudes toward genetic testing, or documenting the use of reproductive genetic technology according to socioeconomic class. We could take a public safety approach, reviewing different genetic tests and therapies for safety and efficacy, and ensuring that sound regulatory procedures are in place to protect and inform vulnerable patients undergoing gene therapy trials. As we think about the genetic future, all of these approaches are valuable, but none of them is sufficient.
The reason we care so much about the new genetics is that we sense that this area of science will touch on the deepest matters of human life—such as how we have children, how we experience freedom, and how we face sickness and death. Like no other area of modern science and technology, genetics inspires both dreams and nightmares about the human future with equal passion: the dream of perfect babies, the nightmare of genetic tyranny. But as usual, the dream and the nightmare are not the best guides to understanding the real meaning of genetics. We need a more sober approach—one that confronts the real ethical dilemmas we face, without constructing such a monstrous image of the future that our gravest warnings are ignored like the bioethics boy who cried wolf.
Possibility and Prediction
In thinking about the new genetics, we seem to commit two errors at once: worrying too much too early and worrying too little too late. For decades, scientists and science-fiction writers—and it is sometimes hard to tell the difference—have predicted the coming of genetic engineering: some with fear and loathing, some with anticipatory glee. But when the gradual pace of technological change does not seem as wonderful as the dream or as terrible as the nightmare, we get used to our new powers all too readily. Profound change quickly seems prosaic, because we measure it against the world we imagined instead of the world we truly have. Our technological advances—including those that require overriding existing moral boundaries—quickly seem insufficient, because the human desire for perfect control and perfect happiness is insatiable.
Of course, sometimes we face the opposite problem: Scientists assure us that today’s breakthrough will not lead to tomorrow’s nightmare. They tell us that what we want (like cures for disease) is just over the horizon, but that what we fear (like human cloning) is technologically impossible. The case of human cloning is indeed instructive, revealing the dangers of both over-prediction and under-prediction. So permit me a brief historical digression, but a digression with a point.
In the 1970s, as the first human embryos were being produced outside the human body, many critics treated in vitro fertilization and human cloning as equally pregnant developments, with genetic engineering lurking not far behind. James Watson testified before the United States Congress in 1971, declaring that we must pass laws about cloning now before it is too late. In one sense, perhaps, the oracles were right: Even if human cloning did not come as fast as they expected, it is coming and probably coming soon. But because we worried so much more about human cloning even then, test-tube babies came to seem prosaic very quickly, in part because they were not clones and in part because the babies themselves were such a blessing. We barely paused to consider the strangeness of originating human life in the laboratory; of beholding, with human eyes, our own human origins; of suspending nascent human life in the freezer; of further separating procreation from sex. Of course, IVF has been a great gift for many infertile couples. It has answered the biblical Hannah’s cry, and fulfilled time and again the longing most individuals and couples possess to have a child of their own, flesh of their own flesh. But it has also created strange new prospects, including the novel possibility of giving birth to another couple’s child—flesh not of my flesh, you might say—and the possibility of picking-and-choosing human embryos for life or death based on their genetic characteristics. It has also left us the tragic question of deciding what we owe the thousands of embryos now left-over in freezers—a dilemma with no satisfying moral answer.
But this is only the first part of the cloning story. Fast-forward now to the 1980s. By then, IVF had become normal, while many leading scientists assured the world that mammals could never be cloned. Ian Wilmut and his team in Scotland proved them all wrong with the birth of Dolly in 1996, and something similar seems to be happening now with primate and human cloning. In 2002, Gerald Schatten, a cloning researcher at the University of Pittsburgh, said “primate cloning, including human cloning, will not be in our lifetimes.” By 2003, he was saying that “given enough time and materials, we may discover how to make it work.” And by 2005, Schatten and his South Korean colleagues had reliably cloned human embryos to the blastocyst stage, the very biological moment when they might be implanted to initiate a pregnancy. In all likelihood, the age of human reproductive cloning is not far off, even if the age of full-blown genetic engineering may never come.
Looking at where the science of genetics is heading, we must beware the twin vices of over-prediction and under-prediction. Over-prediction risks blinding us to the significance of present realities, by inebriating us with distant dreams and distant nightmares. Under-prediction risks blinding us to where today’s technological breakthroughs may lead, both for better and for worse. Prediction requires the right kind of caution—caution about letting our imaginations run wild, and caution about letting science proceed without limits, because we falsely assume that it is always innocent and always will be. To think clearly, therefore, we must put aside the grand dreams and great nightmares of the genetic future to consider the moral meaning of the genetic present—the meaning of what we can do now and why we do it. And we need to explore what these new genetic possibilities might mean for how we live, what we value, and how we treat one another.
Humanly speaking, the new genetics seems to have five dimensions or meanings: (1) genetics as a route to self-understanding, a way of knowing ourselves; (2) genetics as a route to new medical therapies, a way of curing ourselves; (3) genetics as a potential tool for human re-engineering, a prospect I find far-fetched; (4) genetics as a means of knowing something about our biological destiny, about our health and sickness in the future; and (5) genetics as a tool for screening the traits of the next generation, for choosing some lives and rejecting others. I want to explore each of these five dimensions in turn—beginning with the hunger for self-understanding.
Genetic Self-Understanding
The first reason for engaging in modern genetics is simply man’s desire to know himself, a desire that nearly all of us share, if not in equal degrees. Alone among the animals, human beings possess the capacity and the drive to look upon ourselves as objects of inquiry. We study ourselves because we are not content simply being ourselves. We are not satisfied living immediately in nature like the other animals do. Food and sex alone do not satiate us. We do not accept the given world as it is; we also seek to uncover its meaning and structure. Modern biology, of course, is only one avenue of self-understanding, one way of asking questions. But it is an especially powerful and prominent way of seeking self-knowledge in the modern age. Instead of asking who we are by exploring how humans live, the biologist asks who we are by examining the mechanics of human life. Genetics fits perfectly within this vision: it seems to offer us a code for life; it promises to shed empirical light on our place in nature; it claims to tell us something reliable about our human design, our pre-human origins, and our post-human fate.
But it is also true that the more we learn about genetics, the more we seem to confront the limits as well as the significance of genetic explanation. As the cell biologist Lenny Moss put it (in a passage quoted in these pages by Steve Talbott):
Once upon a time it was believed that something called “genes” were integral units, that each specified a piece of phenotype, that the phenotype as a whole was the result of the sum of these units, and that evolutionary change was the result of new changes created by random mutation and differential survival. Once upon a time it was believed that the chromosomal location of genes was irrelevant, that DNA was the citadel of stability, that DNA which didn’t code for proteins was biological “junk,” and that coding DNA included, as it were, its own instructions for use. Once upon a time it would have stood to reason that the complexity of an organism would be proportional to the number of its unique genetic units.
But in fact, the triumph of modern genetics has also meant the humbling of modern genetics. Big hypotheses now seem to require revision and greater measure. And in many ways, we are probably relieved that genetics does not tell us everything we need to know about ourselves. For human beings, this means that we are still more free than any genetic account of being human would leave us. And for young scientists, this means that life’s mystery is still as great as ever; today’s earnest graduate student can surpass even Watson and Crick in making the crucial breakthrough that might reveal our humanity once and for all—that might give us “the secret of life,” as Crick declared when he burst into the British pub in 1953.
Even as we are relieved at discovering the limits of genetic determinism, however, our hunger for genetic explanation remains strong. Disease is also a threat to our freedom, after all, and we still hope that genetics might help us conquer that mortal threat. We still hope that genetics is the secret of disease, if not the secret of life.
Genetic Therapy
And this leads me to the second dimension of the new genetics: the search for medical cures. Modern science, unlike ancient science, does not rest on the foundation of curiosity alone. It seeks to conquer nature, not simply to understand nature’s meaning. And while man may be the only truly curious animal, his curiosity is not his only guiding passion. He also seeks health and he certainly fears death. Like other animals, human beings seek comfort and survival. But unlike other animals, we possess the capacity to pursue comfort and survival through the systematic application of reason. Modern science, especially modern biology, promises the “relief of man’s estate,” in Francis Bacon’s famous phrase, in return for the right to explore nature without limits. Descartes skillfully negotiated this bargain centuries ago, and I quote here a passage much cited by those interested in the origins of modern science:
So soon as I had acquired some general notions concerning Physics … they caused me to see that it is possible to attain knowledge which is very useful for life, and that, instead of that speculative philosophy which is found in the Schools, we may find a practical philosophy by means of which, knowing the force and the action of fire, water, air, the stars, heaven, and all the other bodies that environ us, as distinctly as we know the different crafts of our artisans, we can in the same way employ them in all those uses to which they are adapted, and thus render ourselves as the masters and possessors of nature.
Not surprisingly, the “nature” we most seek to “master” is our own. We seek to conquer human disease, and perhaps even to make death itself a series of conquerable diseases. It is apparently part of our genetic code to revolt against our genetic fate.
Of course, the “speculative philosophy” of the Schools that Descartes sought to leave behind was religious metaphysics—which is to say, the search for man’s place in the cosmological whole and before God. The new science and the old religion thus seem to present us with two different ways of revolting against our biological fate: The religious believer seeks such revolt beyond nature in God, by looking beyond our genetic deficiencies to the hope of eternal salvation. The scientist seeks such revolt through nature in science, by understanding nature’s mishaps (or mutations) so that we might correct them. The unknowable God, if you believe He really exists, promises better long-term results; He “cures” us forever, but only after death. The empirical scientist, if you give him enough public funding, provides better short-term results; he cures us now, but only for a while. This does not mean that science and religion are enemies: religious people are often great scientists, and great scientists are often deeply religious. But it does suggest that the cure-seeking scientist lives on the narrow ridge between holiness and rebellion: He imitates the old God by healing the sick; or he supplants the old God by believing that he can eradicate all sickness, by working within nature rather than looking beyond it.
Genetics, in this sense, is simply a new frontier in the long ascent of modern medicine. It aims to repair broken genes or correct disease-causing mutations by direct intervention. And it aims to use our growing understanding of the human genome to diagnose and treat human disease with greater precision.
But it turns out that most diseases are more complicated than genetics alone, and that markers for identifying and predicting a given disease do not always or easily translate into usable knowledge about the disease’s causation. The capacity to fix genes with perfect precision and without side effects is also proving remarkably difficult. Already, there have been some high-profile examples of gene-therapy trials going terribly wrong, and the field now proceeds with perhaps a more befitting caution. Over time, of course, there is little doubt that our genetic knowledge will improve modern medicine and thus prove a great blessing to us all. But there also seems little doubt that the new genetics will probably not be the therapeutic panacea that many once hoped, and which many scientists and policymakers offered as a central justification for the human genome project. Biological knowledge and biological control are simply not the same, even when it comes to curing disease, and most certainly when it comes to so-called genetic engineering.