Imprimis

Releasing the Genetic Genie: How Risky?

Alexander Capron
Professor of Law, Ethics, and Public Policy, Georgetown University


Alexander CapronAlexander Morgan Capron recently completed three years' service as executive director of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, which rendered its final report early in 1983. He is currently Professor of Law, Ethics, and Public Policy at Georgetown University.



Editor's Preview: What actually goes on at a seminar of the Center for Constructive Alternatives?

Leading thinkers from around the world gather with Hillsdale College students and faculty for a week of exploring ideas and values in collision. Issues in public policy and ethics are clarified. Genuine liberal arts education—rare on today's vocational-minded, relativist campuses—occurs.

Both conservative and liberal viewpoints are presented in the CCA, without labels so students can weigh them on their merits. Imprimis this month invites its readers to join in that experience of responsible choice between clashing ideas.

Professors Alexander Capron and Liebe Cavalieri were among ten speakers at a CCA seminar on the genetic revolution in March 1983. One's theme was promise; the other's, concern. Which, in your opinion, makes the more liberal argument and which the more conservative? How do their premises differ? Which side do you take?


Enormous Potential for Good

Science raises many important issues for society—yet none are more important than those being created by genetic engineering.

Until a few years ago, when a person used that term, he was speaking metaphorically—as a mother would if she said she hoped to “engineer” a marriage between her daughter and a handsome young doctor. Today fact has replaced metaphor. The changes that can be constructed in genes are direct and precise.

In 1965 the term “genetic engineering” was coined for what has come to be a wide range of techniques by which scientists can add genetically determined characteristics to cells that would not otherwise have possessed them.

In the early 1970s, scientists learned how to isolate specific sequences in the deoxyribonucleic acid (or DNA) from one species and attach this genetic material—”recombinant DNA”—to a different species. The layperson’s term “gene splicing” describes the technology well, for like a seaman putting two pieces of rope together, a scientist using the recombinant DNA method can chemically “snip” a DNA chain at a predetermined place and attach another piece of DNA at that site.

My conclusion is that the technique is one with enormous potential for good—but we must look before we leap. There is need for public participation in an explicit process of scrutinizing the ethical and social implications of gene splicing.

Why is gene splicing done? The scientist at the bench will give you the old Hillary-on-Everest answer—it is done because it is there, because the process of gaining the knowledge is so fascinating. And indeed it is—it is elegant and it promises to provide answers to many fundamental issues in biology—from the molecular to the cellular to the evolutionary level.

Today it is also apparent that gene splicing has many more practical applications—in industry, in agriculture and in medicine. I want to concentrate on the latter—to provide a focus for our discussion because I think it is the application that raises the most interesting questions.

Medical Applications

The President’s Commission has recently completed a study of the medical applications of genetic engineering. We examined three ways in which gene splicing may enter into the treatment of human beings. Moving from the most near-at-hand and familiar to the most far-off and controversial, they are: the production of useful drugs and biologics, the diagnosis of genetic diseases and the cure of such diseases.

You have probably already heard about the first of these subjects, particularly the use of recombinant DNA techniques to create bacteria capable of producing desirable medical products—like interferon or human growth hormone.

The second area in which gene splicing can be applied in medical care—namely in genetic screening and diagnosis—has also recently begun bearing fruit. This technique holds great promise for genetic disorders or carrier status that until now have not been readily diagnosable because present testing methods look for gene products rather than for the genes themselves.

Potentially, the technique would not only be useful in prenatal and carrier screening for recognized “genetic defects” but also in detecting the presence or absence of genes associated with other conditions or characteristics.

The most novel and important area is in using gene splicing to cure genetic disorders. If this proves possible, it would differ from other treatments because it would not involve the manipulation of the patient or the application (often continually) of a drug but the actual alteration of the cause of the condition itself.

Although treatments of this sort are almost certainly further in the future than other therapeutic uses of gene splicing, they raise much more troubling issues. There are the special ethical problems of creating human beings with the intention of altering them—entirely without their consent. And there are the social and biological concerns over deleterious changes that rather than being limited to one person or one generation would become part of the human genetic inheritance.

The Frankenstein Factor

In reviewing statements about gene splicing in the popular press, I have been struck by the frequent invocation of what Willard Gaylin some years ago called the “Frankenstein factor.” The analogy is illuminating for several reasons. First, Dr. Frankenstein was a creator of new life and the gene splicers have raised questions about mankind’s role as creator. Second, Dr. Frankenstein’s creation was a frightening monster and gene splicing has raised fears about strange new life forms.

The Frankenstein story also reminds us of the tale of the Sorcerer’s Apprentice—in both, a development intended to be beneficial proved to be dangerous when it got out of control.

Fourth, the Frankenstein analogy bespeaks people’s concern that something is being done to them and their world by individuals concerned with their own goals but not necessarily with human betterment. As C. S. Lewis once observed, “Man’s power over nature is really the power of some men over others with nature as their instrument.”

But most particularly, it seems to me that the Frankenstein story was on the lips of many people—both scientists and lay people—because it dealt with the creation of a new being with a human form.

Like the new knowledge associated with Copernicus, Darwin, Freud, and Einstein, that associated with the gene splicers offers further challenge to human beings’ conception of themselves as the unique and even sacrosanct center of the universe. By identifying DNA and learning how to manipulate it, science seems to have reduced people to a set of malleable molecules that can be interchanged with those of species that people regard as inferior.

And unlike the earlier revolutionary discoveries, those in molecular biology are not merely descriptive; they give scientists vast new power for action. The use of this new power has frequently been labelled “playing God.” This description carries with it an implication that it is wrong for human beings to engage in this activity at all—that we have overreached ourselves by pretending to have God-like powers.

This objection has several possible meanings. At least one is not persuasive. For millenia, people have interfered with nature both intentionally and unintentionally as a side effect of other human activities. There is some difference in aspects of gene splicing, however, that might create hybrids that are capable of reproducing themselves—but here the concern would not be that crossing species lines is inherently wrong, merely that if the effects are deleterious their harm may be multiplied by their perpetuation into later generations—like a recombinant DNA Dutch elm disease. This is an issue that deserves to be treated with great care, but it is not one that raises a problem of principle.

There is, however, another aspect to the complaint about “playing God” in crossing species lines where a prohibition may be in order, and that is in the hybridization of human beings with other living things.

The prospect of creating an actual being with partially human characteristics offends a deeply held taboo. There is, however, no legal or regulatory prohibition of such a step. And if the barrier is to survive in the face of scientific advances, the reasoning behind it will need further attention. It may, for example, be fruitful to clarify what it is about human beings that is unique—whether it is the sum of their characteristics or the possession of particular characteristics. There is a certain irony here since a person approaching the subject from a religious or philosophical position is likely to deny that human beings are simply a reflection of the particular chemicals that make them up, and yet the objection being raised is to an alternation in those chemicals.

When one moves from absolute prohibitions on the human uses of gene splicing to questions of particular consequences, one is faced immediately with a realization of the great uncertainty in this field.

The concern for personal health has several bases. One is the notion that in replacing a particular DNA sequence that is regarded as deleterious, a physician might also unintentionally be removing other genetic material that is in fact beneficial. Moreover, even when only a particular gene is replaced there is a risk that some advantage supplied by the gene may be lost. Little is known about the range of effects a single gene can have; many affect several parts of the body in what appear to be a wide variety of ways.

The possibility that genetic changes would be inherited also raises many questions. For example, would such alternations be so widespread in society that the gene pool would lose desirable diversity, thereby exposing mankind—like some inbred strain of rice or corn—to the risk of decimation by a newly arising pathogen?

Social Questions

In addition, the ability to change one’s genes challenges the basic assumptions about people’s links to, and responsibility for, their progeny. In some ways, one’s responsibility may be increased: Will it be acceptable for people simply to take the results of the natural lottery by which characteristics are now determined, or will responsible parents be expected to “correct” bad genes and to augment others to give their children an opportunity for a higher level of physical or cognitive functioning?

On the other hand, knowing that future generations may employ an even more advanced technology to alter or to replace characteristics passed on to them may weaken people’s sense of genetic continuity. Furthermore, by blurring the line between what counts as a serious defect or disability and what is “normal functioning,” gene splicing may alter our perception of what society owes to children, particularly those burdened by handicaps.

The potential of gene therapy or surgery to improve functioning calls into question the scope and limits of a central element of a democratic political theory: the commitment of equality of opportunity. Would genetic engineering become mandatory—along, perhaps, with restrictions on natural reproduction—in order to avoid the effects of the natural lottery that has such a profound influence on our opportunities in life?

Any discussion of equality leads naturally into a discussion of justice. Who should decide which line of genetic engineering ought to be pursued and which applications of the technology to which patients ought to be undertaken? This is a question that seldom arises about medical progress. Decisionmaking in medicine is widely dispersed, resting upon the tripod of peer standards, patient consent, and very broad and general state regulation. But if genetic engineering comes to be seen as a very beneficial and powerful form of treatment, questions will certainly be raised about access to it not only in the use of techniques that have been developed but also in deciding about which areas need to be pursued.

It seems to me that this issue lies behind the concerns that have been expressed by many about the effect of commercial involvement in the basic research carried on by academic and other independent institutions and about the effects of such control on the availability of dispassionate expert advice for policymakers.

Although the Commission found that the issues raised by gene splicing in human beings can better be taken into account by biomedical scientists, government officials, and the public if they are considered individually, it would be a mistake to respond to the new technology solely by reducing all concerns to assessments of particular consequences or applications.

Even after the potential consequences have been carefully sifted and their implications for human welfare have been explored, there remains an important residual concern expressed by the warning against “playing God.” It reminds human beings that they are only human and will some day have to pay if they underestimate their own ignorance and fallibility.

At this point in the development of genetic engineering no reasons have been found for abandoning the entire enterprise—indeed, it would probably be naive to assume that it could be. To expect humanity to turn its back on what may be one of the greatest technological revolutions may itself betray a failure to recognize the limits of individual and social self-restraint.

Assuming that research will continue somewhere, it seems more prudent to encourage its development and control under the sophisticated and responsive regulatory arrangements of this country, subject to the scrutiny of a free press and within the general framework of democratic institutions.