Ethics

Do We Have a Moral Obligation to Genetically Enhance our Children?

The following remarks were delivered at a panel on Human Gene Editing at the World Conference of Science Journalists in San Francisco on October 26, 2017. The panel was organized by the Hastings Center. These remarks have also been published by the Hastings Center on its blog, Bioethics Forum at: http://www.thehastingscenter.org/moral-obligation-genetically-enhance-children/

The Oxford philosopher Julian Savulescu, among others, has argued that prospective parents engaging in embryo selection using preimplantation genetic diagnosis not only may seek to have genetically enhanced children but are morally obligated do so. (See, for example, his essay “Procreative Beneficence: Why We Should Select the Best Children,” Bioethics, 15, no.5/6, 2001.)
I argue that Savulescu is wrong.
Savulescu defends a moral principle he calls the principle of procreative beneficence. He states that, under this principle, prospective parents choosing among embryos “should select the child, of the possible children they could have, who is expected to have the best life, or at least as good a life as the others, based on the relevant, available information.” Among the possible enhancements he identifies are intelligence, memory, self-discipline, impulse control, foresight, patience, and a sense of humor.
Savulescu has not yet extended this principle beyond preimplantation genetic diagnosis to gene editing. He acknowledges that gene editing currently carries health risks not associated with embryo selection, and that these risks outweigh any obligation to try to bring about “the best life” for a child.
But given the speed with which CRISPR technology is advancing, it seems that  we are not far away from safe, effective gene enhancements for some traits. So according to Savulescu’s principle, when sufficient levels of safety are reached, all parents with the means to afford gene editing for enhancement will have a moral obligation to do so.
I will specify my criticisms of Savulescu’s principle, but first I want to say that I fully support the reproductive use of gene editing technology for the prevention and elimination of serious genetic diseases.
If we could use gene editing to remove the gene sequences in an embryo that cause sickle cell disease or cystic fibrosis, I would say not only that we may do so, but in the case of such severe diseases, that we have a moral obligation to do so.
I think that parents and medical professionals should always try to give a child a healthy start in life. This principle underlies the very firm moral intuition that pregnant women should not take drugs or drink alcohol to excess during pregnancy. In an era of safe gene editing, I believe it would extend to the obligation to use this technology to avoid transmitting grave inherited disease conditions.
Unlike Savulescu, however, I don’t see parents’ obligation  extending to genetic interventions that go beyond preventing disease and making people “better than well.” These include cosmetic enhancements, muscle enhancements increasing athletic performance, or cognitive enhancements such as high IQ or improved learning ability.
There are three reasons I reject the principle of procreative beneficence.First, all genetic manipulations carry some risks, whether of immediate off-target gene insertions or more complex maladies, as when the pursuit of improved learning ability may bring with it a greater sensitivity to pain (an association found in some animal studies). While it is always reasonable in medicine to incur risks to treat or prevent diseases, it is by no means clear that it is wise to do so with medically unnecessary enhancements. This is especially true when children are involved. How would we feel about parents who put their daughter through risky plastic surgeries to improve her performance in beauty contests? In other words, no matter how low the risks of enhancements, they lack the clear justification of disease treatment or prevention. The fact that genetic manipulation of early embryos or gametes affects the germ line, potentially creating new heritable diseases, compounds the problem.Second, while I believe that parents have a stern obligation to try to prevent harm to their child, it is not clear to me that they have an obligation to provide that child “the best life.” Such an obligation is what moral theorists call “supererogatory.” It involves actions above and beyond the call of duty, but which, by their very nature are not morally obligatory. I suppose there are myriad ways that you or I could make our children’s lives better—for example, we could put all our money into paying for the very best private schools—but I don’t think we are morally obligated to pursue these, any more than we are obligated to intervene genetically to give our kids the best physical constitutions. As a moral philosopher, I might add that I think that Savulescu’s insistence on this obligation follows from his continuing reliance, despite denials, on a form of on utilitarianism with its maximization of happiness. So there is a deep theoretical problem at work here.

Third, I reject Savulescu’s procreative beneficence principle because I reject its assumption that we can identify nondisease-related traits that clearly make one’s life better. Among people with a normal IQ, good memory, numeracy, and literacy are useful for a successful life, but it is by no means clear that enhancing any one of these values to a supernormal level would result in a child having a better life. The interaction of gene traits with one another and with the environment is too complex to allow the kind of predictive confidence about any trait that would be needed to apply Savulescu’s principle.

Let me illustrate this complexity with a story. In college, I had two roommates. (For privacy’s sake I’m changing their names.) John  graduated cum laude, went on to a fine Ivy League law school, and reached the apogee of his career when he was elected mayor of his small hometown. I was the best student of the three, graduating summa cum laude and having a solid and satisfying career as an academic ethicist. Harry, was by far the poorest student among us: he barely applied himself, earned straight C’s, and couldn’t get into a top law school. As a result, Harry moved into an arcane field of law at a lesser New York firm, and eventually rose to the top of the new field of merger and acquisition law. Today, Harry  is an extremely wealthy financial industry attorney, and has served as trustee of Brown University, our alma mater.

I am not telling this story to argue that money is the measure of the man. Nor am I saying that any of the traits that led my roommates and me into our lives are genetically based. I offer this anecdote only to indicate how difficult—if not impossible—it is to predict that any character trait, genetic or otherwise, will lead to worldly success much less to happiness. This means that, above and beyond striving to help their offspring have normal health, parents are under no obligation to use genetic technologies to provide those children with nondisease-related genetic enhancements.

If parents are under no obligation to use gene editing for enhancement purposes, may they ethically do so? Should parents be allowed to pursue such genetic enhancements, at least when they’re shown to be sufficiently safe?

This is a complex question that I have written a book about (Babies by Design, 2007). There are many reasons people fear the use of genetics for nondisease-related enhancements. One  fear is that money and genes will work together to produce a “genobility,” a society marked by genetically increased social inequalities. This could happen on a national or international basis. Another is the fear that, in the quest to have athletically gifted children, parents will spark an “arms race,” seeking positional advantage for their children, that concludes by advantaging no one and maybe even harming them. An analogy here is to sports doping which, if widely pursued, benefits no one and risks damaging the individual athletes.

I have no easy answer to the question of whether these ethical concerns or others are so significant that we should try to prohibit parents from these choices.

But I do know that parents seeking such enhancements will likely be disappointed. As I said, parents are under no obligation to pursue genetic enhancements. Furthermore, it’s probably foolish to try to secure the best life possible for one’s child by genetic means. We cannot identify what makes for a best life in this connection. The healthy natural human genome has enough variety in it to let any child successfully navigate the world and fulfill his or her own vision of happiness.

 

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Ethics

Response to Karen Lebacqz and Stephen Palmquist

On May 30, 2015, Dartmouth’s Religion Department hosted a conference celebrating my retirement and that of my colleague Nancy Frankenberry. For that conference, Karen Lebacqz and Stephen R. Palmquist delivered papers examining my writings in the areas of bioethics and philosophy of religion.  Karen Lebacqz’s paper, entitled “On Hope and Hard Choices: Ronald M. Green and Bioethics” now appears in the December issue of The Journal of Religious Ethics [Vol. 44, no. 4, (2016), pp. 722-737], where it is followed by the published version of Stephen R. Palmquist’s paper, entitled, “The Paradox of Inwardness in Kant and Kierkegaard: Ronald Green’s Legacy in Philosophy of Religion” [The Journal of Religious Ethics [Vol. 44, no. 4, (2016), pp. 738-751].

My own “Response to Karen Lebacqz and Stephen Palmquist,” delivered at the conference, follows their papers in the journal [The Journal of Religious Ethics [Vol. 44, no. 4, (2016), pp. 752-759]. As an author, I am permitted to share this essay with interested readers. It can be read here: response-to-kl-sp

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Ethics

My article: Bibi Netanyahu and the Grand Mufti of Jerusalem

SPEAKING BEFORE THE 37TH ZIONIST CONGRESS on October 20th, Bibi Netanyahu, prime minister of Israel, said Muhammad Amin al-Husayni, the grand mufti of Jerusalem during WWII, had played a key role in urging Hitler to exterminate the Jews. Netanyahu’s speech has sparked a wave of CONTROVERSY.

By coincidence, Netanyahu’s speech was given at the same time as The Journal of Religious Ethics published an ARTICLE BY MICHAEL SELLS of the University of Chicago rebutting many claims regarding the Grand Mufti’s role in the Holocaust. Following Sells’ article is a RESPONSE by me which develops the ethical implications of this discussion.

Clicking on the  words in all-caps will take you to these documents.

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Ethics

Obama as Theologian of Grace: Comment on Obama’s Eulogy for Reverend Clamenta Pinckney

FOLLOWING IS AN OP ED THAT I SUBMITTED TO THE NYT, WASHINGTON POST, AND LA TIMES, NONE HAD ROOM FOR IT, BUT THANKS TO THE FREEDOM OF THE INTERNET, I AM PUBLISHING IT MYSELF:

Obama as a Theologian of Grace

President Obama’s eulogy to Reverend Clementa Pinckney may rank as one of the great addresses of American history, alongside Lincoln’s Second Inaugural, his Gettysburg Address, and Martin Luther King’s “I Have a Dream” speech

As an oratorical work, the speech is sublime. With those other great American addresses it will probably enter into the liturgy of what sociologist Robert Bellah has called “America’s civil religion.” But it is profound, as well, in its ethical, theological, and political insight, drawing on some of the deepest themes of biblical religion.

The first section of the speech is eulogy, remembering and honoring the Reverend Pinckney and those who died with him. Here Mr. Obama paints a vivid portrait of the fallen pastor and state senator, ranging from mention of his graciousness to his “deceptive sense of humor.” This section concludes with praise that says more in its simplicity and universality than any list of accomplishments: “What a good man.” The ethical point is clear. Persons and nations are measured not by their possessions or accomplishments but by their moral righteousness.

In the second section of the speech, we are in an African American church. Although the large turnout caused the event to be placed in a municipal arena, the President is speaking to and from an AME congregation. He reminds us of the importance of the black churches from the times of slavery to the Civil Rights movement, when they served as “as hush harbors, where slaves could worship in safety, praise houses, where their free descendants could gather and shout ‘Hallelujah,’ rest stops for the weary along the Underground Railroad, bunkers for the foot soldiers of the civil-rights movement.” They continue today, he adds, “As places where children are loved and fed and kept out of harms way and told that they are beautiful and smart and taught that they matter.” It is, he says, “our beating heart, the place where our dignity as a people is inviolate.

Then, amazingly, the President turns theologian and pastor, delivering the body of his text as a meditation or sermon on the meaning of grace. “This whole week,” he says, “I’ve been reflecting on this idea of grace.”

This turn is initially surprising, even inappropriate. How can a terrible tragedy like the cold-blooded murder of nine people be seen as an act of grace? Why is grace even mentioned here? True, the families of the victims have expressed their forgiveness of the killer. That forgiveness is an act of grace, as the President observes. But for most of us, the killing evokes anger—anger at the murderer, and anger at a God who can allow such things. Why, then, the theme of grace?

Explaining that “God works in mysterious ways,” using even a killer to his ends, the President then returns to the hymn, “Amazing grace,” reciting its opening words:

Amazing Grace, how sweet the sound,

That saved a wretch like me.

I once was lost, but now I’m found,

Was blind, but now I see.

Here’s the crucial turn. God’s grace, Obama tells us, is not found only, as we think, in blessings, or even in the lifting of merited punishments. Grace, he says, is “the free and benevolent favor of God.” But that favor can also be bestowed through the infliction of tragedy and suffering. Drawing implicitly on the work of the Protestant theologian Reinhold Niebuhr and others, the President observes that grace arrives when our self-esteem and self-will are broken, when we are forced by suffering to see what we were unable or unwilling to see.

In the deep scrutiny of American society that follows, the President itemizes our many points of blindness and selfishness. Our blindness to the offensive meaning of the Confederate Flag, our blindness to the pervasive poverty and inequality that mar the lives of so many children, our blindness to the gun violence that takes 30 American lives each day, our blindness to the systematic unfairness of the criminal-justice system that dooms so many black youngsters to wasted lives. And our blindness even to the lingering but subtle racial bias that infects the best intentioned of us, and that leads an employer  “to call Johnny back for a job interview but not Jamal.”

Here, the President’s eulogy echoes the conclusion of Lincoln’s Second Inaugural, where the devastating bloodshed of the Civil War itself is described as a “true and righteous” judgment of God, and as invitation and opportunity  “to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.” Tragedy and bloodshed as divine grace. Drawing from the deepest resources of Christian faith, with the crucifixion at its center, both Lincoln and Obama present suffering as God’s blessing. Divine Grace is not only the enjoyment of goods, but also the breaking of our self-will and the opening of our eyes. Amazing grace.

And, then, the President sings the hymn—performs the hymn—moving his body as a worshipper. We are again in the black church, and the President is pastor and leader. He has told us what the black church means, and now he shows it.

The address resumes the character of a eulogy with the President stating the names of the victims. Returning appropriately to the expected meaning of grace as blessing and favor, the President says of each of the fallen, “May grace lead them home,” adding, “May God continue to shed His Grace on the United States of America.”

The address thus ends with words from another civil religion hymn, “America the Beautiful.” This suggests that the nation will only experience the grace of the song’s many promised blessings of abundance and plenitude if, through the grace of this tragedy, we open our eyes and overcome our “original sin” of racial injustice.

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