The Case Against Perfection MICHAEL J. SANDEL
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What's wrong with designer children, bionic athletes, and
genetic engineering? |
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David |
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
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
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
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
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
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
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Michael J. Sandel is the Anne T. and Robert M. Bass Professor of Government
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