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| |
The
Case Against Perfection
MICHAEL J. SANDEL
What's wrong with designer children, bionic athletes, and
genetic engineering?
|
 |
David
by Michelangelo Buonarroti
|
Breakthroughs in genetics present us with a promise and a predicament.
The promise is that we may soon be able to treat and prevent a host of
debilitating diseases. The predicament is that our newfound genetic
knowledge may also enable us to manipulate our own nature — to enhance
our muscles, memories, and moods; to choose the sex, height, and other
genetic traits of our children; to make ourselves "better than well."
When science moves faster than moral understanding, as it does today,
men and women struggle to articulate their unease. In liberal societies
they reach first for the language of autonomy, fairness, and individual
rights. But this part of our moral vocabulary is ill equipped to address
the hardest questions posed by genetic engineering. The genomic
revolution has induced a kind of moral vertigo.
Consider cloning. The birth of Dolly the cloned sheep, in 1997, brought
a torrent of concern about the prospect of cloned human beings. There
are good medical reasons to worry. Most scientists agree that cloning is
unsafe, likely to produce offspring with serious abnormalities. (Dolly
recently died a premature death.) But suppose technology improved to the
point where clones were at no greater risk than naturally conceived
offspring. Would human cloning still be objectionable? Should our
hesitation be moral as well as medical? What, exactly, is wrong with
creating a child who is a genetic twin of one parent, or of an older
sibling who has tragically died — or, for that matter, of an admired
scientist, sports star, or celebrity?
Some say cloning is wrong because it violates the right to autonomy: by
choosing a child's genetic makeup in advance, parents deny the child's
right to an open future. A similar objection can be raised against any
form of bioengineering that allows parents to select or reject genetic
characteristics. According to this argument, genetic enhancements for
musical talent, say, or athletic prowess, would point children toward
particular choices, and so designer children would never be fully free.
At first glance the autonomy argument seems to capture what is troubling
about human cloning and other forms of genetic engineering. It is not
persuasive, for two reasons. First, it wrongly implies that absent a
designing parent, children are free to choose their characteristics for
themselves. But none of us chooses his genetic inheritance. The
alternative to a cloned or genetically enhanced child is not one whose
future is unbound by particular talents but one at the mercy of the
genetic lottery.
Second, even if a concern for autonomy explains some of our worries
about made-to-order children, it cannot explain our moral hesitation
about people who seek genetic remedies or enhancements for themselves.
Gene therapy on somatic (that is, nonreproductive) cells, such as muscle
cells and brain cells, repairs or replaces defective genes. The moral
quandary arises when people use such therapy not to cure a disease but
to reach beyond health, to enhance their physical or cognitive
capacities, to lift themselves above the norm.
Like cosmetic surgery, genetic enhancement employs medical means for
nonmedical ends — ends unrelated to curing or preventing disease or
repairing injury. But unlike cosmetic surgery, genetic enhancement is
more than skin-deep. If we are ambivalent about surgery or Botox
injections for sagging chins and furrowed brows, we are all the more
troubled by genetic engineering for stronger bodies, sharper memories,
greater intelligence, and happier moods. The question is whether we are
right to be troubled, and if so, on what grounds.
In order to grapple with the ethics of enhancement, we need to
confront questions largely lost from view — questions about the moral
status of nature, and about the proper stance of human beings toward the
given world. Since these questions verge on theology, modern
philosophers and political theorists tend to shrink from them. But our
new powers of biotechnology make them unavoidable. To see why this is
so, consider four examples already on the horizon: muscle enhancement,
memory enhancement, growth-hormone treatment, and reproductive
technologies that enable parents to choose the sex and some genetic
traits of their children. In each case what began as an attempt to treat
a disease or prevent a genetic disorder now beckons as an instrument of
improvement and consumer choice.
Muscles. Everyone would welcome a gene therapy to alleviate muscular
dystrophy and to reverse the debilitating muscle loss that comes with
old age. But what if the same therapy were used to improve athletic
performance? Researchers have developed a synthetic gene that, when
injected into the muscle cells of mice, prevents and even reverses
natural muscle deterioration. The gene not only repairs wasted or
injured muscles but also strengthens healthy ones. This success bodes
well for human applications. H. Lee Sweeney, of the University of
Pennsylvania, who leads the research, hopes his discovery will cure the
immobility that afflicts the elderly. But Sweeney's bulked-up mice have
already attracted the attention of athletes seeking a competitive edge.
Although the therapy is not yet approved for human use, the prospect of
genetically enhanced weight lifters, home-run sluggers, linebackers, and
sprinters is easy to imagine. The widespread use of steroids and other
performance-improving drugs in professional sports suggests that many
athletes will be eager to avail themselves of genetic enhancement.
Suppose for the sake of argument that muscle-enhancing gene therapy,
unlike steroids, turned out to be safe — or at least no riskier than a
rigorous weight-training regimen. Would there be a reason to ban its use
in sports? There is something unsettling about the image of genetically
altered athletes lifting SUVs or hitting 650-foot home runs or running a
three-minute mile. But what, exactly, is troubling about it? Is it
simply that we find such superhuman spectacles too bizarre to
contemplate? Or does our unease point to something of ethical
significance?
It might be argued that a genetically enhanced athlete, like a
drug-enhanced athlete, would have an unfair advantage over his
unenhanced competitors. But the fairness argument against enhancement
has a fatal flaw: it has always been the case that some athletes are
better endowed genetically than others, and yet we do not consider this
to undermine the fairness of competitive sports. From the standpoint of
fairness, enhanced genetic differences would be no worse than natural
ones, assuming they were safe and made available to all. If genetic
enhancement in sports is morally objectionable, it must be for reasons
other than fairness.
Memory. Genetic enhancement is possible for brains as well as brawn. In
the mid-1990s scientists managed to manipulate a memory-linked gene in
fruit flies, creating flies with photographic memories. More recently
researchers have produced smart mice by inserting extra copies of a
memory-related gene into mouse embryos. The altered mice learn more
quickly and remember things longer than normal mice. The extra copies
were programmed to remain active even in old age, and the improvement
was passed on to offspring.
Human memory is more complicated, but biotech companies, including
Memory Pharmaceuticals, are in hot pursuit of memory-enhancing drugs, or
"cognition enhancers," for human beings. The obvious market for such
drugs consists of those who suffer from Alzheimer's and other serious
memory disorders. The companies also have their sights on a bigger
market: the 81 million Americans over fifty, who are beginning to
encounter the memory loss that comes naturally with age. A drug that
reversed age-related memory loss would be a bonanza for the
pharmaceutical industry: a Viagra for the brain. Such use would straddle
the line between remedy and enhancement. Unlike a treatment for
Alzheimer's, it would cure no disease; but insofar as it restored
capacities a person once possessed, it would have a remedial aspect. It
could also have purely nonmedical uses: for example, by a lawyer
cramming to memorize facts for an upcoming trial, or by a business
executive eager to learn Mandarin on the eve of his departure for
Shanghai.
Some who worry about the ethics of cognitive enhancement point to the
danger of creating two classes of human beings: those with access to
enhancement technologies, and those who must make do with their natural
capacities. And if the enhancements could be passed down the
generations, the two classes might eventually become subspecies — the
enhanced and the merely natural. But worry about access ignores the
moral status of enhancement itself. Is the scenario troubling because
the unenhanced poor would be denied the benefits of bioengineering, or
because the enhanced affluent would somehow be dehumanized? As with
muscles, so with memory: the fundamental question is not how to ensure
equal access to enhancement but whether we should aspire to it in the
first place.
Height. Pediatricians already struggle with the ethics of enhancement
when confronted by parents who want to make their children taller. Since
the 1980s human growth hormone has been approved for children with a
hormone deficiency that makes them much shorter than average. But the
treatment also increases the height of healthy children. Some parents of
healthy children who are unhappy with their stature (typically boys) ask
why it should make a difference whether a child is short because of a
hormone deficiency or because his parents happen to be short. Whatever
the cause, the social consequences are the same.
In the face of this argument some doctors began prescribing hormone
treatments for children whose short stature was unrelated to any medical
problem. By 1996 such "off-label" use accounted for 40 percent of
human-growth-hormone prescriptions. Although it is legal to prescribe
drugs for purposes not approved by the Food and Drug Administration,
pharmaceutical companies cannot promote such use. Seeking to expand its
market, Eli Lilly & Co. recently persuaded the FDA to approve its human
growth hormone for healthy children whose projected adult height is in
the bottom one percentile — under five feet three inches for boys and
four feet eleven inches for girls. This concession raises a large
question about the ethics of enhancement: If hormone treatments need not
be limited to those with hormone deficiencies, why should they be
available only to very short children? Why shouldn't all
shorter-than-average children be able to seek treatment? And what about
a child of average height who wants to be taller so that he can make the
basketball team?
Some oppose height enhancement on the grounds that it is collectively
self-defeating; as some become taller, others become shorter relative to
the norm. Except in Lake Wobegon, not every child can be above average.
As the unenhanced began to feel shorter, they, too, might seek
treatment, leading to a hormonal arms race that left everyone worse off,
especially those who couldn't afford to buy their way up from shortness.
But the arms-race objection is not decisive on its own. Like the
fairness objection to bioengineered muscles and memory, it leaves
unexamined the attitudes and dispositions that prompt the drive for
enhancement. If we were bothered only by the injustice of adding
shortness to the problems of the poor, we could remedy that unfairness
by publicly subsidizing height enhancements. As for the relative height
deprivation suffered by innocent bystanders, we could compensate them by
taxing those who buy their way to greater height. The real question is
whether we want to live in a society where parents feel compelled to
spend a fortune to make perfectly healthy kids a few inches taller.
Sex selection. Perhaps the most inevitable
nonmedical use of bioengineering is sex selection. For centuries parents
have been trying to choose the sex of their children. Today biotech
succeeds where folk remedies failed.
One technique for sex selection arose with prenatal tests using
amniocentesis and ultrasound. These medical technologies were developed
to detect genetic abnormalities such as spina bifida and Down syndrome.
But they can also reveal the sex of the fetus — allowing for the
abortion of a fetus of an undesired sex. Even among those who favor
abortion rights, few advocate abortion simply because the parents do not
want a girl. Nevertheless, in traditional societies with a powerful
cultural preference for boys, this practice has become widespread.
Sex selection need not involve abortion, however. For couples undergoing
in vitro fertilization (IVF), it is possible to choose the sex of
the child before the fertilized egg is implanted in the womb. One method
makes use of pre-implantation genetic diagnosis (PGD), a procedure
developed to screen for genetic diseases. Several eggs are fertilized in
a petri dish and grown to the eight-cell stage (about three days). At
that point the embryos are tested to determine their sex. Those of the
desired sex are implanted; the others are typically discarded. Although
few couples are likely to undergo the difficulty and expense of IVF
simply to choose the sex of their child, embryo screening is a highly
reliable means of sex selection. And as our genetic knowledge increases,
it may be possible to use PGD to cull embryos carrying undesired genes,
such as those associated with obesity, height, and skin color. The
science-fiction movie Gattaca depicts a future in which parents
routinely screen embryos for sex, height, immunity to disease, and even
IQ. There is something troubling about the Gattaca scenario, but
it is not easy to identify what exactly is wrong with screening embryos
to choose the sex of our children.
One line of objection draws on arguments familiar from the abortion
debate. Those who believe that an embryo is a person reject embryo
screening for the same reasons they reject abortion. If an eight-cell
embryo growing in a petri dish is morally equivalent to a fully
developed human being, then discarding it is no better than aborting a
fetus, and both practices are equivalent to infanticide. Whatever its
merits, however, this "pro-life" objection is not an argument against
sex selection as such.
The latest technology poses the question of sex selection unclouded by
the matter of an embryo's moral status. The Genetics & IVF Institute, a
for-profit infertility clinic in Fairfax, Virginia, now offers a
sperm-sorting technique that makes it possible to choose the sex of
one's child before it is conceived. X-bearing sperm, which produce
girls, carry more DNA than Y-bearing sperm, which produce boys; a device
called a flow cytometer can separate them. The process, called MicroSort,
has a high rate of success.
If sex selection by sperm sorting is objectionable, it must be for
reasons that go beyond the debate about the moral status of the embryo.
One such reason is that sex selection is an instrument of sex
discrimination — typically against girls, as illustrated by the chilling
sex ratios in India and China. Some speculate that societies with
substantially more men than women will be less stable, more violent, and
more prone to crime or war. These are legitimate worries — but the
sperm-sorting company has a clever way of addressing them. It offers
MicroSort only to couples who want to choose the sex of a child for
purposes of "family balancing." Those with more sons than daughters may
choose a girl, and vice versa. But customers may not use the technology
to stock up on children of the same sex, or even to choose the sex of
their firstborn child. (So far the majority of MicroSort clients have
chosen girls.) Under restrictions of this kind, do any ethical issues
remain that should give us pause?
The case of MicroSort helps us isolate the moral objections that
would persist if muscle-enhancement, memory-enhancement, and
height-enhancement technologies were safe and available to all.
It is commonly said that genetic enhancements undermine our humanity by
threatening our capacity to act freely, to succeed by our own efforts,
and to consider ourselves responsible — worthy of praise or blame — for
the things we do and for the way we are. It is one thing to hit seventy
home runs as the result of disciplined training and effort, and
something else, something less, to hit them with the help of steroids or
genetically enhanced muscles. Of course, the roles of effort and
enhancement will be a matter of degree. But as the role of enhancement
increases, our admiration for the achievement fades — or, rather, our
admiration for the achievement shifts from the player to his pharmacist.
This suggests that our moral response to enhancement is a response to
the diminished agency of the person whose achievement is enhanced.
Though there is much to be said for this argument, I do not think the
main problem with enhancement and genetic engineering is that they
undermine effort and erode human agency. The deeper danger is that they
represent a kind of hyperagency — a Promethean aspiration to remake
nature, including human nature, to serve our purposes and satisfy our
desires. The problem is not the drift to mechanism but the drive to
mastery. And what the drive to mastery misses and may even destroy is an
appreciation of the gifted character of human powers and achievements.
To acknowledge the giftedness of life is to recognize that our talents
and powers are not wholly our own doing, despite the effort we expend to
develop and to exercise them. It is also to recognize that not
everything in the world is open to whatever use we may desire or devise.
Appreciating the gifted quality of life constrains the Promethean
project and conduces to a certain humility. It is in part a religious
sensibility. But its resonance reaches beyond religion.—
It is difficult to account for what we admire about human activity and
achievement without drawing upon some version of this idea. Consider two
types of athletic achievement. We appreciate players like Pete Rose, who
are not blessed with great natural gifts but who manage, through
striving, grit, and determination, to excel in their sport. But we also
admire players like Joe DiMaggio, who display natural gifts with grace
and effortlessness. Now, suppose we learned that both players took
performance-enhancing drugs. Whose turn to drugs would we find more
deeply disillusioning? Which aspect of the athletic ideal — effort or
gift — would be more deeply offended?
Some might say effort: the problem with drugs is that they provide a
shortcut, a way to win without striving. But striving is not the point
of sports; excellence is. And excellence consists at least partly in the
display of natural talents and gifts that are no doing of the athlete
who possesses them. This is an uncomfortable fact for democratic
societies. We want to believe that success, in sports and in life, is
something we earn, not something we inherit. Natural gifts, and the
admiration they inspire, embarrass the meritocratic faith; they cast
doubt on the conviction that praise and rewards flow from effort alone.
In the face of this embarrassment we inflate the moral significance of
striving, and depreciate giftedness. This distortion can be seen, for
example, in network-television coverage of the Olympics, which focuses
less on the feats the athletes perform than on heartrending stories of
the hardships they have overcome and the struggles they have waged to
triumph over an injury or a difficult upbringing or political turmoil in
their native land.
But effort isn't everything. No one believes that a mediocre basketball
player who works and trains even harder than Michael Jordan deserves
greater acclaim or a bigger contract. The real problem with genetically
altered athletes is that they corrupt athletic competition as a human
activity that honors the cultivation and display of natural talents.
From this standpoint, enhancement can be seen as the ultimate expression
of the ethic of effort and willfulness — a kind of high-tech striving.
The ethic of willfulness and the biotechnological powers it now enlists
are arrayed against the claims of giftedness.
The ethic of giftedness, under siege in sports, persists in the
practice of parenting. But here, too, bioengineering and genetic
enhancement threaten to dislodge it. To appreciate children as gifts is
to accept them as they come, not as objects of our design or products of
our will or instruments of our ambition. Parental love is not contingent
on the talents and attributes a child happens to have. We choose our
friends and spouses at least partly on the basis of qualities we find
attractive. But we do not choose our children. Their qualities are
unpredictable, and even the most conscientious parents cannot be held
wholly responsible for the kind of children they have. That is why
parenthood, more than other human relationships, teaches what the
theologian William F. May calls an "openness to the unbidden."
May's resonant phrase helps us see that the deepest moral objection to
enhancement lies less in the perfection it seeks than in the human
disposition it expresses and promotes. The problem is not that parents
usurp the autonomy of a child they design. The problem lies in the
hubris of the designing parents, in their drive to master the mystery of
birth. Even if this disposition did not make parents tyrants to their
children, it would disfigure the relation between parent and child, and
deprive the parent of the humility and enlarged human sympathies that an
openness to the unbidden can cultivate.
To appreciate children as gifts or blessings is not, of course, to be
passive in the face of illness or disease. Medical intervention to cure
or prevent illness or restore the injured to health does not desecrate
nature but honors it. Healing sickness or injury does not override a
child's natural capacities but permits them to flourish.
Nor does the sense of life as a gift mean that parents must shrink from
shaping and directing the development of their child. Just as athletes
and artists have an obligation to cultivate their talents, so parents
have an obligation to cultivate their children, to help them discover
and develop their talents and gifts. As May points out, parents give
their children two kinds of love: accepting love and transforming love.
Accepting love affirms the being of the child, whereas transforming love
seeks the well-being of the child. Each aspect corrects the excesses of
the other, he writes: "Attachment becomes too quietistic if it slackens
into mere acceptance of the child as he is." Parents have a duty to
promote their children's excellence.
These days, however, overly ambitious parents are prone to get carried
away with transforming love — promoting and demanding all manner of
accomplishments from their children, seeking perfection. "Parents find
it difficult to maintain an equilibrium between the two sides of love,"
May observes. "Accepting love, without transforming love, slides into
indulgence and finally neglect. Transforming love, without accepting
love, badgers and finally rejects." May finds in these competing
impulses a parallel with modern science: it, too, engages us in
beholding the given world, studying and savoring it, and also in molding
the world, transforming and perfecting it.
The mandate to mold our children, to cultivate and improve them,
complicates the case against enhancement. We usually admire parents who
seek the best for their children, who spare no effort to help them
achieve happiness and success. Some parents confer advantages on their
children by enrolling them in expensive schools, hiring private tutors,
sending them to tennis camp, providing them with piano lessons, ballet
lessons, swimming lessons, SAT-prep courses, and so on. If it is
permissible and even admirable for parents to help their children in
these ways, why isn't it equally admirable for parents to use whatever
genetic technologies may emerge (provided they are safe) to enhance
their children's intelligence, musical ability, or athletic prowess?
The defenders of enhancement are right to this extent: improving
children through genetic engineering is similar in spirit to the heavily
managed, high-pressure child-rearing that is now common. But this
similarity does not vindicate genetic enhancement. On the contrary, it
highlights a problem with the trend toward hyperparenting. One
conspicuous example of this trend is sports-crazed parents bent on
making champions of their children. Another is the frenzied drive of
overbearing parents to mold and manage their children's academic
careers.
As the pressure for performance increases, so does the need to help
distractible children concentrate on the task at hand. This may be why
diagnoses of attention deficit and hyperactivity disorder have increased
so sharply. Lawrence Diller, a pediatrician and the author of
Running on Ritalin, estimates that five to six percent of
American children under eighteen (a total of four to five million kids)
are currently prescribed Ritalin, Adderall, and other stimulants, the
treatment of choice for ADHD. (Stimulants counteract hyperactivity by
making it easier to focus and sustain attention.) The number of Ritalin
prescriptions for children and adolescents has tripled over the past
decade, but not all users suffer from attention disorders or
hyperactivity. High school and college students have learned that
prescription stimulants improve concentration for those with normal
attention spans, and some buy or borrow their classmates' drugs to
enhance their performance on the SAT or other exams. Since stimulants
work for both medical and nonmedical purposes, they raise the same moral
questions posed by other technologies of enhancement.
However those questions are resolved, the debate reveals the cultural
distance we have traveled since the debate over marijuana, LSD, and
other drugs a generation ago. Unlike the drugs of the 1960s and 1970s,
Ritalin and Adderall are not for checking out but for buckling down, not
for beholding the world and taking it in but for molding the world and
fitting in. We used to speak of nonmedical drug use as "recreational."
That term no longer applies. The steroids and stimulants that figure in
the enhancement debate are not a source of recreation but a bid for
compliance — a way of answering a competitive society's demand to
improve our performance and perfect our nature. This demand for
performance and perfection animates the impulse to rail against the
given. It is the deepest source of the moral trouble with enhancement.
Some see a clear line between genetic enhancement and other ways that
people seek improvement in their children and themselves. Genetic
manipulation seems somehow worse — more intrusive, more sinister — than
other ways of enhancing performance and seeking success. But morally
speaking, the difference is less significant than it seems.
Bioengineering gives us reason to question the low-tech, high-pressure
child-rearing practices we commonly accept. The hyperparenting familiar
in our time represents an anxious excess of mastery and dominion that
misses the sense of life as a gift. This draws it disturbingly close to
eugenics.
The shadow of eugenics hangs over today's debates about genetic
engineering and enhancement. Critics of genetic engineering argue that
human cloning, enhancement, and the quest for designer children are
nothing more than "privatized" or "free-market" eugenics. Defenders of
enhancement reply that genetic choices freely made are not really
eugenic — at least not in the pejorative sense. To remove the coercion,
they argue, is to remove the very thing that makes eugenic policies
repugnant.
Sorting out the lesson of eugenics is another way of wrestling with the
ethics of enhancement. The Nazis gave eugenics a bad name. But what,
precisely, was wrong with it? Was the old eugenics objectionable only
insofar as it was coercive? Or is there something inherently wrong with
the resolve to deliberately design our progeny's traits?
James Watson, the biologist who, with Francis Crick, discovered the
structure of DNA, sees nothing wrong with genetic engineering and
enhancement, provided they are freely chosen rather than state-imposed.
And yet Watson's language contains more than a whiff of the old eugenic
sensibility. "If you really are stupid, I would call that a disease," he
recently told The Times of London. "The lower 10 percent who
really have difficulty, even in elementary school, what's the cause of
it? A lot of people would like to say, 'Well, poverty, things like
that.' It probably isn't. So I'd like to get rid of that, to help the
lower 10 percent." A few years ago Watson stirred controversy by saying
that if a gene for homosexuality were discovered, a woman should be free
to abort a fetus that carried it. When his remark provoked an uproar, he
replied that he was not singling out gays but asserting a principle:
women should be free to abort fetuses for any reason of genetic
preference — for example, if the child would be dyslexic, or lacking
musical talent, or too short to play basketball.
Watson's scenarios are clearly objectionable to those for whom all
abortion is an unspeakable crime. But for those who do not subscribe to
the pro-life position, these scenarios raise a hard question: If it is
morally troubling to contemplate abortion to avoid a gay child or a
dyslexic one, doesn't this suggest that something is wrong with acting
on any eugenic preference, even when no state coercion is involved?
Consider the market in eggs and sperm. The advent of artificial
insemination allows prospective parents to shop for gametes with the
genetic traits they desire in their offspring. It is a less predictable
way to design children than cloning or pre-implantation genetic
screening, but it offers a good example of a procreative practice in
which the old eugenics meets the new consumerism. A few years ago some
Ivy League newspapers ran an ad seeking an egg from a woman who was at
least five feet ten inches tall and athletic, had no major family
medical problems, and had a combined SAT score of 1400 or above. The ad
offered $50,000 for an egg from a donor with these traits. More recently
a Web site was launched claiming to auction eggs from fashion models
whose photos appeared on the site, at starting bids of $15,000 to
$150,000.
On what grounds, if any, is the egg market morally objectionable? Since
no one is forced to buy or sell, it cannot be wrong for reasons of
coercion. Some might worry that hefty prices would exploit poor women by
presenting them with an offer they couldn't refuse. But the designer
eggs that fetch the highest prices are likely to be sought from the
privileged, not the poor. If the market for premium eggs gives us moral
qualms, this, too, shows that concerns about eugenics are not put to
rest by freedom of choice.
A tale of two sperm banks helps explain why. The Repository for Germinal
Choice, one of America's first sperm banks, was not a commercial
enterprise. It was opened in 1980 by Robert Graham, a philanthropist
dedicated to improving the world's "germ plasm" and counteracting the
rise of "retrograde humans." His plan was to collect the sperm of Nobel
Prize-winning scientists and make it available to women of high
intelligence, in hopes of breeding supersmart babies. But Graham had
trouble persuading Nobel laureates to donate their sperm for his bizarre
scheme, and so settled for sperm from young scientists of high promise.
His sperm bank closed in 1999.
In contrast, California Cryobank, one of the world's leading sperm
banks, is a for-profit company with no overt eugenic mission. Cappy
Rothman, M.D., a co-founder of the firm, has nothing but disdain for
Graham's eugenics, although the standards Cryobank imposes on the sperm
it recruits are exacting. Cryobank has offices in Cambridge,
Massachusetts, between Harvard and MIT, and in Palo Alto, California,
near Stanford. It advertises for donors in campus newspapers
(compensation up to $900 a month), and accepts less than five percent of
the men who apply. Cryobank's marketing materials play up the
prestigious source of its sperm. Its catalogue provides detailed
information about the physical characteristics of each donor, along with
his ethnic origin and college major. For an extra fee prospective
customers can buy the results of a test that assesses the donor's
temperament and character type. Rothman reports that Cryobank's ideal
sperm donor is six feet tall, with brown eyes, blond hair, and dimples,
and has a college degree — not because the company wants to propagate
those traits, but because those are the traits his customers want: "If
our customers wanted high school dropouts, we would give them high
school dropouts."
Not everyone objects to marketing sperm. But anyone who is troubled by
the eugenic aspect of the Nobel Prize sperm bank should be equally
troubled by Cryobank, consumer-driven though it be. What, after all, is
the moral difference between designing children according to an explicit
eugenic purpose and designing children according to the dictates of the
market? Whether the aim is to improve humanity's "germ plasm" or to
cater to consumer preferences, both practices are eugenic insofar as
both make children into products of deliberate design.
A number of political philosophers call for a new "liberal eugenics."
They argue that a moral distinction can be drawn between the old eugenic
policies and genetic enhancements that do not restrict the autonomy of
the child. "While old-fashioned authoritarian eugenicists sought to
produce citizens out of a single centrally designed mould," writes
Nicholas Agar, "the distinguishing mark of the new liberal eugenics is
state neutrality." Government may not tell parents what sort of children
to design, and parents may engineer in their children only those traits
that improve their capacities without biasing their choice of life
plans. A recent text on genetics and justice, written by the
bioethicists Allen Buchanan, Dan W. Brock, Norman Daniels, and Daniel
Wikler, offers a similar view. The "bad reputation of eugenics," they
write, is due to practices that "might be avoidable in a future eugenic
program." The problem with the old eugenics was that its burdens fell
disproportionately on the weak and the poor, who were unjustly
sterilized and segregated. But provided that the benefits and burdens of
genetic improvement are fairly distributed, these bioethicists argue,
eugenic measures are unobjectionable and may even be morally required.
The libertarian philosopher Robert Nozick proposed a "genetic
supermarket" that would enable parents to order children by design
without imposing a single design on the society as a whole: "This
supermarket system has the great virtue that it involves no centralized
decision fixing the future human type(s)."
Even the leading philosopher of American liberalism, John Rawls, in his
classic A Theory of Justice (1971), offered a brief endorsement
of noncoercive eugenics. Even in a society that agrees to share the
benefits and burdens of the genetic lottery, it is "in the interest of
each to have greater natural assets," Rawls wrote. "This enables him to
pursue a preferred plan of life." The parties to the social contract
"want to insure for their descendants the best genetic endowment
(assuming their own to be fixed)." Eugenic policies are therefore not
only permissible but required as a matter of justice. "Thus over time a
society is to take steps at least to preserve the general level of
natural abilities and to prevent the diffusion of serious defects."
But removing the coercion does not vindicate eugenics. The
problem with eugenics and genetic engineering is that they represent the
one-sided triumph of willfulness over giftedness, of dominion over
reverence, of molding over beholding. Why, we may wonder, should we
worry about this triumph? Why not shake off our unease about genetic
enhancement as so much superstition? What would be lost if biotechnology
dissolved our sense of giftedness?
From a religious standpoint the answer is clear: To believe that our
talents and powers are wholly our own doing is to misunderstand our
place in creation, to confuse our role with God's. Religion is not the
only source of reasons to care about giftedness, however. The moral
stakes can also be described in secular terms. If bioengineering made
the myth of the "self-made man" come true, it would be difficult to view
our talents as gifts for which we are indebted, rather than as
achievements for which we are responsible. This would transform three
key features of our moral landscape: humility, responsibility, and
solidarity.
In a social world that prizes mastery and control, parenthood is a
school for humility. That we care deeply about our children and yet
cannot choose the kind we want teaches parents to be open to the
unbidden. Such openness is a disposition worth affirming, not only
within families but in the wider world as well. It invites us to abide
the unexpected, to live with dissonance, to rein in the impulse to
control. A Gattaca-like world in which parents became accustomed
to specifying the sex and genetic traits of their children would be a
world inhospitable to the unbidden, a gated community writ large. The
awareness that our talents and abilities are not wholly our own doing
restrains our tendency toward hubris.
Though some maintain that genetic enhancement erodes human agency by
overriding effort, the real problem is the explosion, not the erosion,
of responsibility. As humility gives way, responsibility expands to
daunting proportions. We attribute less to chance and more to choice.
Parents become responsible for choosing, or failing to choose, the right
traits for their children. Athletes become responsible for acquiring, or
failing to acquire, the talents that will help their teams win.
One of the blessings of seeing ourselves as creatures of nature, God, or
fortune is that we are not wholly responsible for the way we are. The
more we become masters of our genetic endowments, the greater the burden
we bear for the talents we have and the way we perform. Today when a
basketball player misses a rebound, his coach can blame him for being
out of position. Tomorrow the coach may blame him for being too short.
Even now the use of performance-enhancing drugs in professional sports
is subtly transforming the expectations players have for one another; on
some teams players who take the field free from amphetamines or other
stimulants are criticized for "playing naked."
The more alive we are to the chanced nature of our lot, the more reason
we have to share our fate with others. Consider insurance. Since people
do not know whether or when various ills will befall them, they pool
their risk by buying health insurance and life insurance. As life plays
itself out, the healthy wind up subsidizing the unhealthy, and those who
live to a ripe old age wind up subsidizing the families of those who die
before their time. Even without a sense of mutual obligation, people
pool their risks and resources and share one another's fate.
But insurance markets mimic solidarity only insofar as people do not
know or control their own risk factors. Suppose genetic testing advanced
to the point where it could reliably predict each person's medical
future and life expectancy. Those confident of good health and long life
would opt out of the pool, causing other people's premiums to skyrocket.
The solidarity of insurance would disappear as those with good genes
fled the actuarial company of those with bad ones.
The fear that insurance companies would use genetic data to assess risks
and set premiums recently led the Senate to vote to prohibit genetic
discrimination in health insurance. But the bigger danger, admittedly
more speculative, is that genetic enhancement, if routinely practiced,
would make it harder to foster the moral sentiments that social
solidarity requires.
Why, after all, do the successful owe anything to the least-advantaged
members of society? The best answer to this question leans heavily on
the notion of giftedness. The natural talents that enable the successful
to flourish are not their own doing but, rather, their good fortune — a
result of the genetic lottery. If our genetic endowments are gifts,
rather than achievements for which we can claim credit, it is a mistake
and a conceit to assume that we are entitled to the full measure of the
bounty they reap in a market economy. We therefore have an obligation to
share this bounty with those who, through no fault of their own, lack
comparable gifts.
A lively sense of the contingency of our gifts — a consciousness that
none of us is wholly responsible for his or her success — saves a
meritocratic society from sliding into the smug assumption that the rich
are rich because they are more deserving than the poor. Without this,
the successful would become even more likely than they are now to view
themselves as self-made and self-sufficient, and hence wholly
responsible for their success. Those at the bottom of society would be
viewed not as disadvantaged, and thus worthy of a measure of
compensation, but as simply unfit, and thus worthy of eugenic repair.
The meritocracy, less chastened by chance, would become harder, less
forgiving. As perfect genetic knowledge would end the simulacrum of
solidarity in insurance markets, so perfect genetic control would erode
the actual solidarity that arises when men and women reflect on the
contingency of their talents and fortunes.
Thirty-five years ago Robert L. Sinsheimer, a molecular biologist
at the California Institute of Technology, glimpsed the shape of things
to come. In an article titled "The Prospect of Designed Genetic Change"
he argued that freedom of choice would vindicate the new genetics, and
set it apart from the discredited eugenics of old.
To implement the older eugenics ... would have required a massive
social programme carried out over many generations. Such a programme
could not have been initiated without the consent and co-operation
of a major fraction of the population, and would have been
continuously subject to social control. In contrast, the new
eugenics could, at least in principle, be implemented on a quite
individual basis, in one generation, and subject to no existing
restrictions.
According to Sinsheimer, the new eugenics would be voluntary rather than
coerced, and also more humane. Rather than segregating and eliminating
the unfit, it would improve them. "The old eugenics would have required
a continual selection for breeding of the fit, and a culling of the
unfit," he wrote. "The new eugenics would permit in principle the
conversion of all the unfit to the highest genetic level."
Sinsheimer's paean to genetic engineering caught the heady, Promethean
self-image of the age. He wrote hopefully of rescuing "the losers in
that chromosomal lottery that so firmly channels our human destinies,"
including not only those born with genetic defects but also "the
50,000,000 'normal' Americans with an IQ of less than 90." But he also
saw that something bigger than improving on nature's "mindless, age-old
throw of dice" was at stake. Implicit in technologies of genetic
intervention was a more exalted place for human beings in the cosmos.
"As we enlarge man's freedom, we diminish his constraints and that which
he must accept as given," he wrote. Copernicus and Darwin had "demoted
man from his bright glory at the focal point of the universe," but the
new biology would restore his central role. In the mirror of our genetic
knowledge we would see ourselves as more than a link in the chain of
evolution: "We can be the agent of transition to a whole new pitch of
evolution. This is a cosmic event."
There is something appealing, even intoxicating, about a vision of human
freedom unfettered by the given. It may even be the case that the allure
of that vision played a part in summoning the genomic age into being. It
is often assumed that the powers of enhancement we now possess arose as
an inadvertent by-product of biomedical progress — the genetic
revolution came, so to speak, to cure disease, and stayed to tempt us
with the prospect of enhancing our performance, designing our children,
and perfecting our nature. That may have the story backwards. It is more
plausible to view genetic engineering as the ultimate expression of our
resolve to see ourselves astride the world, the masters of our nature.
But that promise of mastery is flawed. It threatens to banish our
appreciation of life as a gift, and to leave us with nothing to affirm
or behold outside our own will.
ACKNOWLEDGEMENT
Michael
J. Sandel. "The Case Against Perfection." The Atlantic
Monthly Vol. 293, No. 3 (April, 2004).
Republished with permission of the author, Michael J. Sandel and
The Atlantic Monthly.
THE AUTHOR
Michael
J. Sandel is the Anne T. and Robert M. Bass Professor of Government at
Harvard University, where he has taught political philosophy since 1980.
His publications include
Liberalism and the Limits of Justice (Cambridge University
Press, 1982, 2nd edition, 1997; translated into seven languages),
Democracy's Discontent: America in Search of a Public Philosophy
(Harvard University Press, 1996),
Liberalism and Its Critics (ed., Blackwell, 1984), and articles
in scholarly journals, law reviews, and general publications such as
The Atlantic Monthly, The New Republic, and The New York
Times. Sandel teaches graduate and undergraduate courses in
contemporary political philosophy, including "Ethics and Biotechnology,"
"Markets, Morals, and Law," and "Globalization and Its Discontents." The
recipient of three honorary degrees, he has received fellowships from
the Carnegie Corporation, the National Endowment for the Humanities, the
Ford Foundation, and the American Council of Learned Societies. He
currently serves on the President's Council on Bioethics, a national
body appointed by the President to examine the ethical implications of
new biomedical technologies. A summa cum laude, Phi Beta Kappa graduate
of Brandeis University (1975), Sandel received his doctorate from Oxford
University (D.Phil.,1981), where he was a Rhodes Scholar. He lives with
his wife and two sons in Brookline, Massachusetts.
Copyright © 2004 Michael J. Sandel
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