THERE'S A GROWING DEBATE ABOUT WHAT LIMITS, if any, should be put on genetic engineering. We are on a path in which in the not-too-distant future scientists and technicians will be able to select genes and may be able to shape characteristics of your children. Some people already argue that using that to select the sex of your child is fine, or perhaps for medical reasons. But what about other features? What if we could choose their hair color and type, their eye colors, their sexual orientation, their level of intelligence, their musical or writing ability or sports, dance, or artistic aptitude?
There is a long tradition that defends eugenics in the name of "lifting up." Now we know that the eugenics movement has a very dark history, though it was a very respectable movement in the early part of the twentieth century. Eugenics was discredited by the Nazis, by genocide, the Nuremburg Laws, by the forced sterilization laws that were enacted by the majority of American states in the 1920s and 1930s. Yet, in its earlier days, eugenics was endorsed and embraced by social reformers, by American progressives: Theodore Roosevelt was a great supporter of eugenics, Margaret Sanger, who began Planned Parenthood, was a defender of eugenics. Oliver Wendell Holmes, in a famous Supreme Court case Buck v. Bell, upheld a forced sterilization law, with the notorious line that "three generations of imbeciles is enough." Oliver Wendell Holmes! So eugenics has a very respectable lineage if you look at the people who supported it, and yet it led to forced sterilization. It ultimately leads to genocide, even though it was first done in the name of those who have been burdened or disadvantaged.
What's the moral of the story of the dark history of eugenics? Some say it's that eugenics, in its earlier version, was coercive. State laws mandated sterilization in the so-called "feeble-minded," or in the criminal classes, and, of course, in Hitler's genocide. There are many today who say the only thing wrong with eugenics was its coerciveness, and if we could imagine a eugenic program that was not mandated by the State, that was not coercive, but was chosen by the individual parents trying to help and lift up their children, then there's nothing wrong with eugenics.
But I think that's a mistake. I think that coercion was not the only thing wrong with eugenics. What we have today with designer children is privatized eugenics, free market eugenics, individualistic eugenics. Without the broad social ambitions for everyone, it's really now an instrument for privileged parents to give their kids a competitive edge. Privatized eugenics reflect a deflation of the ideal of eugenics, perverse as that ideal was in its enactment, because it's no longer trying to uplift humanity, or entire societies, but just trying to get a competitive edge. I think what's wrong with eugenics, beyond coercion, is the fact of its ambition to try to control or exercise dominion over the genetic traits of the next generation. That's morally troubling, whether done on a society-wide basis or done by individual parents trying to give their kids a competitive edge.
Of course, there are objections about whether doing this can be made safe and predictable. And there is another question about making it available in a fair way, so that it would not only be an option for rich people. But what would be your objection if the designer child were an equal option for all, publicly subsidized as part of a universal health care system, and it could be done in a way that was safe and predictable?
Is there a moral objection to this genetic engineering, beyond safety, beyond fairness? After all, we tend to praise parents who give their children every advantage they can: offer them music lessons to learn an instrument, play catch with them to learn how to be coordinated in sports, help them do their homework so that they can more fully learn what they need to learn. So what's the objection to parents wanting to give their children the advantage of genes that make it easier for them to succeed in creating a pleasant life for themselves?
It seems to me that there is a reason for a set of moral considerations that go beyond safety and fairness. What makes us most uneasy about the use of genetic engineering to enhance or to create something, has to do with the fact that the drive to create children of a certain character reflects an aspiration to freedom, mastery, and control, and to exercise our human will and our ability to remake human nature to serve our purposes and satisfy our desires. It seems to me there is something flawed but deeply attractive about that.
This uneasiness, I believe, connects to a recognition that there is a way in which who we are is a gift from the universe. And this is to say that not everything we are is a product of our own doing, and not everything in the world is open to any use we might desire or devise.
An appreciation of the giftedness of life might induce in us a certain humility. What I'm trying to articulate here is, in part, a religious sensibility, but its resonance reaches beyond religion.
Let's go back to the example of designer children. It's very hard to make sense of what's precious or special about the relationship between parents and children without drawing, at least a little, on the ethic of giftedness. To appreciate children as gifts is to accept them as they come, not as products of our design or instruments of our ambition. Parental love is not contingent, or at least it shouldn't be contingent, on attributes that the child happens to have. We choose our friends and our spouses at least partly on qualities that we find attractive, but we do not choose our children--that's an important moral fact about parenting. Even the most conscientious parent cannot be held wholly responsible for the child that they had. This is why parenting teaches us what the theologian William May calls "an openness to the unbidden."
The problem of genetic engineering lies in the hubris of the designing parents. Even if this disposition doesn't make parents tyrants to their children, still it disfigures the relation between parent and child and it deprives the parent of the humility, the human sympathies, and the openness to the unbidden.
Now, to appreciate children as gifts and blessings from God is not to be passive in the face of illness. It's true that medical treatment intervenes with nature, but it does so for the sake of health. It doesn't represent the same bid for mastery. Even strenuous medicine, to treat or cure diseases, doesn't constitute a Promethean assault. Medicine is at least governed by a certain norm, the norm of preserving and restoring, and that is what constitutes good health.
What counts as "good health" is open to argument. There is research about whether deafness or other disabilities should be cured, or if they should be part of an identity that is cherished. But even then, the disagreement comes from the assumption that the purpose of medicine is to promote health and cure disease.
Now there is a complexity with this idea of resisting the temptation to manage, direct, and protect our children. Because we do that as parents. Parents want to educate their children, give them every opportunity, help them learn an instrument, develop athletic skill.... What then is the difference, and this is not an easy question to answer, but what is the difference between providing help with health and training, and providing this help with the use of genetic enhancement? Parents spend all this money educating their children and giving them special advantages. If that's accurate, why isn't it equally as admirable for parents to use whatever genetic technology has been developed, provided it's safe, to enhance their children's chance at life, to give them a competitive edge?
The answer I would give to this question is that the defenders of genetic engineering are right to say that there is not such a bright line between the use of genetic technology to enhance children, and the kind of heavily managed, high pressure child rearing practices that are common these days. But this similarity, this parallel, does not vindicate genetic enhancement. To the contrary, it highlights a problem with the high-pressure hyper-parenting tendencies that we see in our society today. We see the frenzy of parents at soccer game sidelines or at little league. It is a frenzy, or an anxiety even, of the parents to manage, to hold, to direct their children's lives. I don't think there is such a clear line between these two practices, but this suggests that the overreaching in genetic parenting may actually shed light on the kind of overreaching frenzied parenting that we see now.
So, let me say a word about the larger moral stance if the account I have given is right. Some people would say of this drive for mastery and life control: "That's parents exercising their freedom to give their kids the best, and who are we to criticize that freedom?"
What would happen if biotechnology dissolved our sense of giftedness? There are two answers to this question. One of them is the religious answer (which suggests that using biotechnology has us assume a role in creation that seeks to make us on par with God). Biotechnology is, in a sense, "playing God."
The moral stakes can also be understood in secular terms. One way of seeing this is to consider what would be the effect on our moral landscape if the practice of designer parents became the common way of parenting? At least two key features of our moral culture would be transformed. One of them is humility and the other is solidarity.
Let me say a word about humility and why it matters as a social ethic. Parenthood is a school for humility. We care deeply about our children but cannot choose the kind we want. Humility teaches us to reign in our need for control and to live with the unexpected. One of the blessings of seeing ourselves as creatures of nature or God is that we are not always responsible for the way we are. The more we become masters of our genetics the greater burden we bear for the talents we have and the way we perform. So with the erosion of humility comes an explosion of responsibility.
Consider the use of genetic testing. In the past, giving birth to a child with Down syndrome was a matter of chance. Today, parents of children with Down syndrome are judged or blamed. Because people will say to them "why did you bring this child into the world?" So the responsibility is greater because we have a choice. Parents should be able to choose what they want to do, but they shouldn't be free to choose the burden of choice that this new technology creates.
Along with the explosion of responsibility over our own fate and that of our children, comes, paradoxically, a diminished sense of solidarity with those less fortunate than ourselves. Here's why: the more open we are to chance in the control over our own success, the more reason we have to share our fate with others. Why, after all, do the successful owe anything to the least advantaged members of society? The answers to these questions lie very heavily in the notions of giftedness. They lean on the idea that our success has nothing to do with hard work, or other things within our control, but on good fortune--the result of the genetic lottery. If we regard our genetics as gifts rather than achievements for which we can claim credit, then we have no basis to claim that we are entitled to the good things in society.
A lively sense of the contingency of our gifts can be used in a "meritocratic" society like ours to prevent us from sliding into the idea that the rich are rich because they are more deserving than the poor. If genetic engineering enabled us to override the results of the genetic lottery, if it enabled us to replace chance with choice, it's likely that the gifted character of human powers and achievements would recede, and with it, perhaps, our capacity to see ourselves as sharing a common fate. The successful would be even more likely than they are now to see themselves as self-made and self-sufficient, and those at the bottom of society would be seen not as disadvantaged, but simply as unfit. The meritocracy would become less forgiving. So that's why humility and solidarity as features of our moral culture can help us preserve a lively sense of giftedness of our nature, of our talents, and of our achievements
A related case is the use of Ritalin in classrooms. Admittedly, it is difficult to precisely draw the line between clinical Attention Deficit Hyperactivity Disorder (ADHD) and a squirmy kid in a classroom. It is a difficult line to draw and it involves judgment on the part of the parent, the teachers, the doctor, the psychologist, and the kid. I would not for a moment say that Ritalin should never be prescribed for ADHD. There are cases, clearly, of clinical ADHD where it can help a child function and overcome a real deficiency. But Ritalin is often used either to control children in the classroom who are simply squirmy and should be dealt with by closer individual attention by the teacher, and by smaller classroom size, and so on, or by college students who do not have any prescription, simply to improve their performance on a test. The line can be difficult to draw between the medical use of Ritalin and the performance enhancement use.
In order to draw this line, we must have, not just some statistical understanding of the normal, because that can shift over time, but a substantive, normative conception of what human flourishing consists of. So parents are often pressured to consent to Ritalin, and I fear that they might face even greater pressures to participate in genetic engineering.
We can't just blame parents for responding to these pressures. How could we expect them not to? We have to take a step back and ask what is the source of those heightened, intensified pressures? There has been an enormous increase in those types of pressures having to do with the economy and society and also the educational system.
So, to go back to the question with which I began, beyond safety and beyond fairness, what is the source of our unease about designer children? I think it has something to do with our big questions about human nature and the limits of the Promethean project of mastery and control. It is tempting to think that bioengineering our children and selves is an exercise in freedom, but it really isn't. Because changing our nature to fit the world rather than the other way around is actually an ethical defeat. It distracts us from reflecting critically on the world. It deadens the impulse for social and political improvement. So rather than increase our genetic powers to fit ourselves into society, we should do what we can to create political and social realms that are more hospitable to the gifts and also to the limitations of imperfect human beings.
After completing his talk, Michael Sandel met privately to discuss his ideas with Tikkun. Here is a selection from that Q & A:
TIKKUN: What if we want to enhance our children's capacity for intellect and musical talents because of the inherent goodness of these capacities--not because they will bring any reward to them, but because we have experienced them ourselves, and know that we would have deeper pleasure in our own life if we were more advanced intellectually or musically? We would have deeper pleasure in music, if we had musical talents. So out of a generosity based on our own experience, and not out of a desire for them to compete, we want to enhance their capacity, or all people's capacity to enjoy the world. Wouldn't a communitarian society or a spiritual society want to use all of the mechanisms that are available to make it possible for people to be as intellectually developed as possible so that they could more deeply appreciate the universe in which they live?
SANDEL: Did you see Gattaca?
SANDEL: It's a science fiction movie. It's the story of a society about twenty-five years in the future, where the perfection of children through genetic technology becomes routine. They have an example of someone playing a magnificently complex piano concerto and as the camera zooms in on the keyboard, you see that the person has six fingers on each hand, genetically engineered to be capable of playing this incredibly complex piano concerto, written for someone genetically designed with six fingers.
SANDEL: Yes, yes, because it couldn't be played with someone with only five fingers on one hand. Now, what about that. Does that bother you? Is there some hesitation ...?
TIKKUN: Well, I think it's a different argument. The argument's about whether there's hubris involved in changing the way nature has set us or God has created us, and there I agree with that argument entirely.
SANDEL: But that would give you pause ...
TIKKUN: Yes ... because of the hubris argument. But, the way that you dealt with it in the conversation was to say, "Well, the changes that we are going to allow are changes that are medically oriented towards healing or repairing (you didn't use these words, its implicit in medical practice) towards a "normal" vision of what human life is. Now, I think that question, of what a "normal human life" is, is historically determined, and isn't in the Bible or in human intuition in some obvious way. "Normal human life" continues to transform, so today medical science thinks its perfectly O.K. to preserve people past the age of 100, even if that means that all kinds of invasive techniques are used, because people can; and if it can be done, then they give people that choice. So, I'm not sure that medicine has a value-free, or a rational foundation for its judgments on what is restorative versus what is transformative.
Let me give you one other example. There are many people, who today take anti-depressants. The argument for antidepressants is that in your "normal" state, and that may have been how you were since early childhood, until the time in which your psychiatrist gave you these pills, you obviously had some physical defect that made it impossible to make you happy, and when you take this, you are much happier. I am saying that that is normal medical practice today, but it assumes an altered state of their consciousness, because it is assuming that the "normal" way to be is "happy" as opposed to unhappy.
SANDEL: Yeah, happiness of that kind, happiness in the sense of not suffering from depression is, I think, a perfectly legitimate aim of psychiatry and psychotherapeutic drugs.
TIKKUN: But what I'm saying is that I think you need a more substantive vision of what is "normality," for your use of this distinction in medicine, reparative versus "performative" or enhancing.
SANDEL: I wouldn't disagree. I think that in order to draw the line between medical uses and enhancement uses, we have to have not just some statistical understanding of the normal, because that can shift over time, but a substantive conception of human flourishing, and I don't think we can define both without having a substantive, normative conception of what human flourishing consists of.
In other writings I've tried to give some account of those elements of human flourishing that have to do with participation in civic life and sharing in self government and political participation, but that's only one aspect of human flourishing, not the whole of human flourishing, and in discussing what counts as health as against enhancement, which is the subject of this book, I agree with you that providing a full account of what counts as human flourishing is unavoidable.
TIKKUN: I don't know if you really have answered the question of: What if there was a way of improving people's intelligence? I mean, you said six fingers and so forth ... what if I said same body, but the enhancement is more like giving a pregnant women a pill, that has the consequence that the child develops a higher level of intelligence and a higher capacity to respond to beauty.
SANDEL: Here's why I'm reluctant to embrace that. I'm skeptical, first of all, of genetic enhancement even of IQ, which is a very narrow and inadequate measure of intelligence and the human capacity.
TIKKUN: Yes, I think it's totally misguided.
SANDEL: But even that, narrow as it is, is very unlikely any time in the foreseeable future. So, to imagine that a richer notion of intelligence and human capacities, including aesthetic capacities, which are even more complex than IQ, narrow as it is, to imagine that there would be a genetic "fix" or a genetic manipulation for therapy....
TIKKUN: That's dealing with the practical question, not the principled issue. Be clear in your arguments there, you're always distinguishing between them.
SANDEL: All right, fair enough. But here, my skepticism that there could even in principle be a kind of genetic manipulation that would enhance the capacity for a broader range of human excellences, aesthetic, moral--some people say, well suppose we could have some gene therapy that would enhance people's moral capacity--I think that in principle I am skeptical that there could be one, and if there could, then I'd be worried because everything that we understand about what it means to be a human being, what the human virtues consist in, what it means to be capable of aesthetic appreciation of wonder and awe, are so much bound up with elements of human character (deliberation and the capacity for self-reflection) that to imagine that those capacities could be deepened in a pill, would cause unimaginable damage to everything we understand about human moral character.
TIKKUN: If you give that "moral pill" then you raise the theological question about choice between good and bad. God made us free to make that choice.
SANDEL: A "pill" for morality would be wrong. But a pill for talent, creativity, or imagination, things that aren't the result of the human will, but the ability to imagine a moral circumstance ... if that could be reduced to a pill it would transform our understanding of our moral lives and also our capacity for self-reflection and reinterpreting our own circumstance to transform that circumstance. That is also a capacity that goes beyond free will and it is very difficult and scary to imagine that a pill would replace our ability for self-reflection or moral imagination or for freedom. These are two aspects of the moral life that depend on deliberate and reflective human participation in the constitution of our humanity and that's why I am skeptical, even in principle, that there ever could be or should be a pill or genetic therapy that could replicate these capacities.
TIKKUN: I know people that have taken psychotropic or hallucinogenic drugs, and because of these things, they have an increased moral sensitivity. It has increased their capacity to be loving.
SANDEL: I have heard of the same thing, but I am skeptical: I would distinguish between alleviating depression and actually [gaining extraordinary qualities]. I would be worried if there were a pill that could make people loving who didn't already have it within them.
TIKKUN: Everyone has the ability to be loving, but there are so many forces in our lives, including our internalized vision of ourselves shaped through childhood and adult life experiences that block us from staying in touch with that capacity.
SANDEL: The pill would simply remove an obstacle to the expression of that capacity? In that scenario, it would be closer to medications for depression.
TIKKUN: But what if there was a manipulation of genes that could have the same consequence? What if there are certain gene structures that make it more difficult for some people to connect to one another?
SANDEL: I worry about it, and I'm open to evidence that would not be merely scientific, but the kind of evidence that is also derived from narratives, witnessing, and ways of determining the effect. But I wonder, do you think God intended us to exercise a Promethean power to transform the basis of our morality?
TIKKUN: I don't think that God intended that. I think She gave us that freedom to make that choice and imbued us with the spiritual grounds to say, "Don't make that one."
SANDEL: One of the intriguing features of the Jewish understanding of the relation of humans to the Creator is that on one hand, Judaism affords humans a role in creation--some Rabbis say that God left creation incomplete in order to leave room for humans to participate in creation. So on the one hand, its deeply empowering. And yet, at the same time, there is a tension between the creative role of humans, and the limits, which are bound up with the tremendous concern with idolatry as the ultimate sin. And I think idolatry looms largely in Judaism precisely because of the temptation to overreach, which flows from this creative role. So while human beings are partners with God, they are at the same time worried about idolatry and overreaching. There is a tension deeply embedded in Jewish understanding of humans' relation to nature, creation, and God, and this tension has to be kept at the center of these discussions about technology.
TIKKUN: What counts as overreaching? I agree with you, but there is also a need to counter the old Jewish fundamentalist argument about "don't disturb the universe, let God work it out: we shouldn't engage in fundamentally trying to socially engineer the universe, because God has a plan and it will all work out ..."
SANDEL: And that's missing the other half of the tension. You can take this all the way back to the permission to heal the sick ... there is a Midrash that tries to account for this, tries to reconcile the idea that the practice of medicine is idolatry. A doctor comes to a man, and the man says, "Who are you to violate God's will by intervening in my health?" and the Rabbi says, "I'm the doctor--tell me, what do you do for a living?" and the man says, "I'm a farmer." And the Rabbi says, "When you plant and plow and cultivate, you're forcing the earth to bring forth a crop that wouldn't ordinarily grow ... is that a violation of God's will?"
TIKKUN: Some people think we should never exercise mastery of the world, because our hubris has gone too far. We have to learn to live with the world. But then people counter: part of our evolution is learning mastery. We need to find the equanimity between mastery and mystery ... and then we heal.
SANDEL: Yes, and striking that balance is the challenge. And figuring out for any one of these practices what constitutes finding that balance requires grappling with moral questions, the nature of humans, and religious and spiritual questions.