Brave New World

“I not only think that we will tamper with Mother Nature, I think Mother wants us to.” — Willard Gaylin, Columbia College of Physicians and Surgeons

Most parents want what is best for their children. But sometimes knowing what is best for them isn’t easy.

In Andrew Niccol’s 1998 film Gattaca, Vincent is born with a heart defect that, it is predicted, will substantially shorten his life. Unfortunately this isn’t an extraordinary occurrence in the real world. According to the CDC heart defects are a factor in about 5,800 deaths per year in the United States, so it’s not an exaggeration to say that children like Vincent are born everyday.

But in Gattaca technology gives tragedy an odd twist and in so doing sets the stage for a fascinating film. You see, in Niccol’s fictional world biotechnology offered Vincent’s parents the power to correct his biological flaws before he was conceived. Instead they made him the old fashioned way, passing up both the chance to fix his heart and to enhance socially desirable traits such as height, intelligence, and appearance in him as well. As a result Vincent not only faces a shorter life, he is doomed to a new social underclass. As a genetic have-not– a “de-gene-erate” or “invalid” – he is expected to spend his life cleaning windows and emptying garbage bins.

Put yourself in his parents’ shoes. Could you avoid feeling that his problems are the product of your failings? If only you had acted differently, more responsibly, your child’s life would have been better. In Gattaca Vincent’s parents learn this lesson well. They take care to give Vincent’s little brother all the advantages technology can provide.

Niccol once remarked that he likes to set his films "about five minutes in the future." According to Gregory Stock, your five minutes are almost up.

Stock is the director of the Program on Medicine, Technology, and Society at the UCLA School of Medicine. He is also the author of Redesigning Humans: Our Inevitable Genetic Future. Redesigning Humans is about the science behind Andrew Niccol’s fiction. In it Stock promotes the benefits of "germinal choice technology" (GCT). If he is right, in the near future GCT will confront us with a Gattaca-like array of choices and dilemmas.

In one of the early scenes in Gattaca Vincent’s mother and father meet with a counselor to discuss their options for Anton, his brother-to-be. After choosing Anton’s sex, eye and hair color, and correcting genetic flaws that might lead to premature baldness, myopia, alcoholism and addictive susceptibility, and propensity for violence and obesity, they become uneasy. Mom says, "We didn’t want–diseases, yes…" And Dad continues, "We were wondering if we should leave some things to chance." The geneticist’s reply reminds them that chance–unlike choice– is unreliable: "You could conceive naturally a thousand times and never get such a result."

Stock’s version of GCT would function a bit differently than this. Step one would involve genetic screening of human embryos. Those with detectable major genetic defects would simply never be implanted in their mothers. Step two comes closer to Gattaca. In germline manipulation the genes of human sperm and eggs cells would be cleaned up before conception. The potential advantages of such technology are obvious: for example, no more insulin injections for diabetics, if we can cure their problem before birth, right? Of course this would mean taking conception out of the bedroom and into the lab via in vitro fertilization. But what parents would dare take the risk of conceiving on their own when their own children might lose their bet?

James Watson, co-winner of the Nobel Prize for his work on DNA , captures the bottom line here quite well: "No one really has the guts to say it, but if we could make better human beings [emphasis added] by knowing how to add genes, why shouldn’t we?"

It’s a question Christians should begin thinking about now, before geneticists presents us with us options we haven’t considered and feel we can’t turn down. Where do we begin?

When Lewis Carroll’s Alice asked the Cheshire Cat, "Would you tell me, please, which way I ought to go from here?" he answered, "That depends a good deal on where you want to get to." "I don’t much care where–" said Alice. "Then it doesn’t matter which way you go," said the Cat.

Carroll’s warning is noteworthy. Before we jump into the gene pool, we should consider what we are trying to achieve through our medical efforts and why. It’s especially important now, because according to Leon Kass our view of medicine is undergoing a paradigm shift.

Kass is the Addie Clark Harding Professor in the Committee on Social Thought and the College at the University of Chicago and Hertog Fellow in Social Thought at the American Enterprise Institute. He was chairman of the President’s Council on Bioethics from 2001 to 2005.  The council’s 2003 report, Beyond Therapy, (available here) is worth reading.

Traditionally the goal of medicine from a Christian perspective has been redemptive. Disease isn’t simply a biological problem; it is a moral one, the result of sin. So for the same reason we preach the gospel, we also fight the AIDS epidemic, recognizing in it yet another facet of the curse sin has brought on the world. In secular circles this is described as “therapeutic”—i.e., ‘relating to the treatment of disease’—rather than “redemptive”, but the concept is similar. However you say it, under the old paradigm the goal of medicine was to fix what is broken.

Three factors are changing this goal: technology, social pressures, and the loss of a Christian theological framework. Technology long ago gave made us capable of more than merely repairing what is broken. We’ve had the power to dispose of the deformed— e.g., the amnio-centesis test enables us to detect Downs Syndrome in an unborn child and to dispose of him via abortion before birth —and the unwanted—e.g., in India the same test is used to detect and dispose of fetuses whose only fault is that they are girls—since the 1970s. And we’ve used it.

Our society’s heroes embody our values. We idolize the attractive, the athletic, and the intelligent and reward them with riches and positions of power and responsibility. So each year parents spend billions of dollars on cosmetic surgery, coaches, and tutors for their children in hopes of enhancing these qualities in them. In market terms this constitutes a demand looking for what biotechnology promises to supply. In medicine this creates the demand for a new paradigm. We want it to do more than merely repair what’s broken. We want it to make us better.

The line between therapy and enhancement has also been blurred by the loss of a Christian theological framework. The therapy/enhancement distinction, long the centerpiece of the old paradigm, has fallen into disfavor simply because we aren’t satisfied with it anymore. In chapter one of Beyond Therapy, entitled “Biotechnology and the Pursuit of Happiness,” we find

“The distinction rests on the assumption that there is a natural human “whole” whose healthy functioning is the goal of therapeutic medicine… Yet this observation points to the deepest reason why the distinction between healing and enhancing is, finally, of insufficient ethical, and even less practical, value. For the human being whose wholeness or healing is sought or accomplished by biomedical therapy is finite and frail, medicine or no medicine.

The healthy body declines and its parts wear out. The sound mind slows down and has trouble remembering things. The soul has aspirations beyond what even a healthy body can realize, and it becomes weary from frustration. Even at its fittest, the fatigable and limited human body rarely carries out flawlessly even the ordinary desires of the soul. For this reason (among others) the desires of many human beings—for more, for better, for the unlimited, or even for the merely different—will not be satisfied with the average, nor will they take their bearings from the distinction between normal and abnormal, or even between the healthy and the better-than-healthy.”

There’s more that needs replying to in this statement than I could possibly do so here, but for the moment I’ll say only this. The final argument in the minds of many against the old medical paradigm is that it is both artificial and unsatisfying. Artificial in that we have no idea of what “wholeness” looks like. Unsatisfying, because even physical near-perfection isn’t enough. It’s here, I think, that we feel the loss of a biblical framework most keenly.

In Genesis 1 we’re told the story of how God created Adam and Eve in the beginning in his image. Pronouncing them good meant more than that they were morally acceptable; he meant that they were exactly as human beings should be.

In Genesis 3 sin enters the picture and with it disease, death, and the need for modern medicine. In the debate on bioethics God rarely appears, and when he does it’s often only to take the blame for the mess. (Niccol begins Gattaca with a quote from Ecclesiastes 7:3: “Consider Gods’ handiwork: who can straighten what he hath made crooked?”) But the Bible teaches that our problems and those of our world are not the result of less-than-intelligent design on God’s part. They are the consequences of an historical act: the Fall.

The work of Christ is to redeem and restore that which is lost and broken by sin. For us this means becoming like Christ and in so doing more like Adam and Eve were before the Fall. Wholeness—theologically and biologically—is personified in Jesus.

In light of this Christians have long understood that part of the purpose of science is to provide a kind of medical/theological therapy for the results of the Fall, as in Francis Bacon’s oft-quoted line: “Man by the Fall fell at the same time from his innocence and from his dominion over creation. Both of these losses, however, can even in this life be in some parts repaired: the former by religion and faith, the latter by the arts and sciences.” In a fallen world substituting ignorance and fatalism for science is practically and biblically unthinkable. The old complaint about scientists “playing God” when they exercise their power simply has no theological warrant, for it is God  himself who calls us to wield it.

However, Christians have long realized that there are things science should not and cannot do. The case against biotechnology like Stock’s GCT is firmly rooted in this understanding. We should not engage in science that destroys rather than redeems human beings. I was born in Montgomery, Alabama in 1954, in the 22nd year of the Tuskegee Experiment in which a group of poor black men were deliberately allowed to die of syphilis, in the hope of advancing scientific knowledge on the progress of the disease. Stock’s suggestion that we improve people by disposing of genetically inferior fetuses is poor science for the same reason the Tuskegee Experiment was poor science: it heals nothing, rights no wrongs, and destroys the very people it should serve.

At the same time we must realize that biotechnology cannot make good on the promises some make in its name. James Watson’s question—“…if we could make better humans… why shouldn’t we?”— implies something that the Scriptures contradict: that modern science can improve on the creator’s original design and in so doing make us happier, perhaps even “satisfy the desires of the soul.” This isn’t merely wrong, it’s impossible.

So which way ought we to go from here?  Back to the old therapeutic model and away from biotechnology’s vain offers to redefine science and to redefine us.

If Niccol and Stock’s predictions are at all accurate, staying on this path will be difficult. The consequences of persistence could range from the merely awkward—e.g., refraining from choosing the sex of our children (a capability we already have)—to the quite costly: making the same choices Vincent’s parents made for him in Gattaca. While our standing before God isn’t dependent upon our appearance, our athletic abilities, or our intelligence, our standing in society might be. Foreswearing the control biotechnology may one day offer us over these things may also one day be socially and economically expensive to us and our children. In Gattaca Vincent’s parents said no in the name of romance, and he paid the price.

Are we ready to say no in the name of Christ?

Greg