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November 2008 New reproductive technologies and limits to procreative libertyTom Frame, Children on Demand: The Ethics of Defying Nature Sydney, University of New South Wales Press, 2008 (217 pp) ISBN 9-78086840-910-8 (paperback) RRP $32.95. John Harris, Enhancing Evolution: The Ethical Case for Making Better People Princeton, Princeton University Press, 2007 (242 pp). ISBN 9-78069112-844-3 (hard cover) RRP $54.95. In September this year, Sydney IVF became the first Australian fertility clinic to be issued with a licence to produce human cloned embryos exclusively for research purposes. This was the culmination of political developments which saw Australia move from a ban on therapeutic cloning in 2002 (under the Prohibition of Human Cloning Act 2002 and Research Involving Human Embryos Act 2002) to restricted permission to produce embryos for stem cell research. Conscience votes, in the House of Representatives in December 2006 and in the NSW Legislative Council in June 2007, were crucial.
The NSW Human Cloning and Other Prohibited Practices Amendment Bill 2007 granted permission for scientists to use somatic cell nuclear transfer (SCNT) to produce human embryos from which to create patient- and disease-specific embryonic stem cell lines. These stem cell lines will be used in research targeting life-threatening diseases such as cancers, Parkinson’s disease, cystic fibrosis and Huntington’s chorea, to name just a few. Strict conditions apply, however. Total bans remain in place in respect of cloning for purely reproductive purposes, no embryo may be implanted into any uterus (human or non-human), and no embryo is permitted to exist beyond fourteen days development. The ability to engage in (appropriately restricted) therapeutic cloning science has been greeted with enthusiasm by stem cell scientists and patient advocacy groups, and allows for Australia to enter the race to be the first country in the world to successfully extract stem cells from a human embryo produced through cloning. These developments are not, however, welcomed by all. The NSW legislative changes were described by Anglican Archbishop of Sydney, Peter Jensen, as a ‘step too far’ and a ‘wrong turn’, while the Catholic Church’s Cardinal George Pell expressed ‘profound regret’ at the ‘morally abhorrent’ development, and intervened in the parliamentary debate to issue a warning to MPs (later widely deemed inappropriate) that they would face ‘consequences’ in their religious lives if they supported the NSW Bill (Dayton 2007). In an open letter to Australia’s governments, signatories including Archbishop Jensen, Cardinal Pell, the Reverend Tim Costello, numerous other church leaders as well as some bioethicists and scientists, opposed the lifting of bans on SCNT. Amongst the objections voiced was a particular concern that human cloning ‘dissociates procreation from the loving union of a man and a woman’ and ‘opens up new possibilities for designing our progeny [and] controlling their genetic destiny ...’ (‘No Human Cloning – Open Letter to Australia’s Governments’ 2002).
Although this new policy proscribes the use of genetic technologies for purposes other than the treatment and potential elimination of genetic diseases and disorders, opponents have been quick to point out that the technologies may also be used for purely reproductive applications. These include cloning as a means to achieving biologically-related offspring, and even the genetic manipulation or ‘genetic enhancement’ of human embryo genomes in order to produce children with desired attributes where this has nothing to do with the avoidance of disease or disability. The moral evaluation of what might broadly be referred to as ‘repro-genetic technologies’ are the subject matter of two recently published books, which defend contrasting views of the role of, and limits to, new reproductive technologies in realising would-be parents’ procreative aspirations. At the permissive end of the politico-moral spectrum is John Harris’ defence of gene technologies, and genetic enhancement in particular, in the production of the best human persons that our capacities and resources will allow, in Enhancing Evolution: The Ethical Case for Making Better People. Harris makes a sustained and passionate argument that not to use whatever safe means are available to improve upon our current capacities as human persons, would be both inconsistent with currently accepted practices and neglectful of important moral duties. Most of Harris’ book is devoted to disarming common objections to genetic enhancement, and this is where the book’s strengths lie. His positive argument in favour of genetic enhancement is less explicitly advanced, but discernable in the detail nevertheless. According to Harris, we have a moral obligation not to cause harm to future generations, and this obligation has both ‘a positive and a negative face’. Thus Harris casts our moral duties in the following light: ‘[w]e must not act positively so as to cause harm to those who come after us, but we must also not fail to remove dangers which, if left in place, will cause harm to future people’ (p. 80). This proposal is in itself not radically controversial, nor are the implications of accepting it likely to impose excessive burdens upon current generations. However, Harris swiftly extends his argument for genetic enhancement beyond a duty of mere harm-avoidance to a considerably more substantial positive duty of benefit bestowal:
Harris’ defence of this view seems to be that both the avoidance of harm and the provision of future goods or benefits lie on the same moral continuum, since both are grounded in the common aim of promoting welfare. To withhold potential ‘palpable benefits’, and thereby refrain from promoting welfare when it lies within one’s capacities to do so amounts, for Harris, to culpable neglect and moral failure to do what lies in a future person’s best interests. The common objection that those future individuals whom we seek to benefit have not, and indeed cannot, consent to such provision does not undermine the moral grounds for doing what is beneficial for future persons. This is because, he says, ‘[i]t is not a violation of someone’s will, nor is it an assault, to give a treatment they have not refused, the withholding of which would constitute an injury’ (p. 82).
Harris also offers a sustained argument for reproductive choice and procreative autonomy. He joins writers like John A. Robertson (1994), Ronald Dworkin (1993) and Julian Savulescu (2002a; 2002b) in defending what he terms the ‘democratic presumption’ in favour of ‘the liberty to access reproductive technologies and other means of founding families unless good and sufficient reasons can be shown against doing so’ (p. 74). Sufficient reasons are defined as showing that the proposed reproductive practice will either infringe upon the like liberty of others, or cause significant harm either to individuals or to society. The harm must be sufficiently direct and serious to outweigh the potentially attainable benefit of allowing the reproductive practice in question:
Underlying this presumption is a more general belief that intrusions on human liberty always constitute harms and impose moral costs. For that reason, argues Harris, it is those who would deny liberty, rather than those who defend it, who carry the burden of justification. Moreover, the harm of any intrusion on liberty must never be greater than the expected moral costs of allowing maximal freedom. Thus, for Harris, the causing of offence is never on its own sufficient to justify the restriction of important freedoms, including reproductive freedoms:
With this statement, Harris demonstrates his close alignment with the liberal views defended by John Stuart Mill in his famous 1859 essay, ‘On Liberty’. Mill decries any alternative to the strong presumption of liberty as a ‘tyranny of the majority’, and eschews the use of criminal law to uphold the moral convictions of a society, sometimes referred to as ‘legal moralism’. The paternalistic restriction of any person’s liberty on grounds not of harm prevention but of promoting that person’s own interests, or avoiding offence to others, is unacceptable. For Harris, the case for concluding that use of genetic technologies like enhancement will inevitably cause harm, is far from proved. There is, therefore, no justification for paternalistic restriction of the freedom of prospective parents to use such technologies if they desire.
A very different assessment of the potential for future children to be harmed as a result of recent and possibly immanent reproductive technologies is offered by the Reverend Tom Frame, in Children on Demand: The Ethics of Defying Nature. Frame is much less optimistic about the likely yields of the new reproductive technologies; genetic as well as more conventional ones like assisted reproductive technologies (ART), including IVF. His moral purview is limited to harm-avoidance, and perhaps because of that he consistently overlooks and under-acknowledges the potential benefits that may be delivered to future generations, both within non-conventional family settings and using ART. Frame’s comparatively pessimistic view of the welfare-enhancing potential of reproductive technologies coincides with a fundamentally conservative view of both nature and human technology and capacity. Indeed, these two books are distinguished by their quite different understandings of ‘the natural’ and of human intervention into ‘nature’. Their differences on these questions show up the greatest weakness of Frame’s work and the greatest strength of Harris’. Frame’s main argument is that the potential for harm to future children undermines the justifiability of any reproductive procedure that makes it impossible for an individual to know both of their biological parents. He endorses the view that children have what Australian bioethicist Margaret Somerville has referred to as rights to a natural biological heritage, to knowing what that natural biological heritage is, and to being raised by their own biological parents (p. 187). In support he cites statistics and theories of child abuse, as well as phenomena of ‘genealogical bewilderment’ and identity formation difficulty, and argues that the absence of information about one’s genetic inheritance can—indeed should—be seen as a form of disability (p. 188). At most, however, Frame’s arguments provide a reasonably compelling case against reproductive arrangements that preclude a child’s access to information about her/his biological parentage, and in advancing this case he is far from alone. Regrettably, however, Frame combines worthwhile insights like that an individual’s meaning as a person is understood in relation to others, with a degree of unhelpful mysticism that does little to inspire confidence in his argument, such as the claim that ‘[l]ife is enriched in and through connection with other people, particularly those with whom there is a “blood connection”, because something of the essence of a man and a woman is transmitted to their children through procreation’ (p. 28). On the question of whether knowledge about biological parentage might be sufficient for identity formation, or rather children require actual acquaintance with and even rearing by their biological parents, Frame does not give adequate grounds for his conclusion. He is right that stories incorporating our parents and forebears are importantly formative of our identities and individualities. But he doesn’t demonstrate in this book that we must be raised by our biological parents to gain adequate access to those stories. Hence Frame’s effort to defend the traditional, two-parent (one male, one female) biologically-bounded model of the family does not bear him the fruit he seeks.
Indeed the mysticism that imbues Frame’s discussion of biologically-grounded childrearing and raising has its roots in a particular conception of nature and its place within a spiritual, god-centred view of the universe. For Frame, consideration of what is natural and unnatural significantly and appropriately constrains moral debate, and nowhere more than in the domain of human reproduction and childrearing. Stating early on in the book that ‘certain human activities and aspirations seem either intended by nature or constrained by natural processes’ (p. 21), Frame wants us to accept that certain forms of reproduction and family formation actually defy nature. Frame would have done better, however, had he relied solely on his harm-avoidance argument. His book loses considerable rational credibility with claims that essentially confuse sexual with social parenting roles, as in the following:
Frame goes on to argue that in this reproductive arrangement there is ‘an innate moral “logic”’ (p. 21). Rejecting Hume’s definition of ‘the unnatural’ as ‘the unusual’, Frame opts for a conception of nature according to which the unnatural is ‘contrary to, or resisted by, nature itself’ (p. 21). What this might mean is, however, he does not explain. He suggests that we can differentiate between the varied interventions of humans into natural processes according to whether they have worked ‘with or against what we might call “the grain” of nature’; and he argues that human beings ‘lack a mandate to change nature’ (which remains with God). He says that ‘[w]hen human beings defy the constructs of nature, it is not always possible to ensure that the consequences of such defiance can be contained or controlled’, and hence, ‘[u]ntil men and women can claim to have grasped the totality of their complex physical beings, they have no business altering or re-formatting those parts of their ‘operating system’ which they dislike or which do not adequately satisfy their desires’ (p. 22). Frame endorses Jean-Jacques Rousseau’s view of a ‘rightful purpose in nature that ought to be allowed to stand’. Indeed, according to Frame, ‘[n]ature offers ethical insights and provides moral lessons. It is able to instruct and guide’ (p. 22). Frame suggests that any interventions into the means by which children are brought into the world and the circumstances in which they will live, which cause harm or at least pose serious risk of harm to future children, are morally wrong not because of the harm itself—a plausible enough argument—but rather because they defy nature. For Frame, in defying nature we express an inappropriate attitude towards the natural world, one of arrogance and the assumption of a mandate that we do not have. These themes are found elsewhere, including in the work of Michael J. Sandel, not acknowledged by Frame but critically discussed by Harris. Sandel refers to this inappropriate attitude as a form of ‘hyperagency – a Promethean aspiration to remake nature, including human nature, to serve our purposes and satisfy our desires’. Rather than adopting such a stance, we are morally required to cultivate an attitude of humility and gratitude, and to appreciate the ‘giftedness’ or ‘givenness’ of life, recognising that ‘not everything in the world is open to whatever use we may desire or devise’ (Sandel 2004, cited in Harris pp. 109–116). When we restrain ourselves from intervening into nature, we honour rather than desecrate nature, according to Sandel, and this seems to be much what Frame has in mind when he advocates ‘working with nature’s grain’ rather than ‘defying nature’. Although he does not use the term, it is theologian William F. May’s attitude of ‘openness to the unbidden’ that Frame seems to endorse.
Harris has no patience with such an idea. He presents compelling arguments to the effect that there are substantial problems in making sense of an unbidden or ‘given world’ when, as he points out, ‘so much of human history has been concerned with attempts to improve upon the given, whether by animal husbandry, farming, plant breeding, irrigation, architecture, or a myriad or other ways’ (p. 110). Harris rightly points out that such a view necessarily presumes a basis on which we can distinguish one class of ‘unbiddens’—allegedly our ‘natural’ talents, capacities and limitations—with respect to which we are to foster attitudes of openness and acceptance, from another class of unbiddens—accidents and illnesses, parasites and terrorists—with respect to which we are supposedly justified in seeking cure and prevention. Yet it is by no means clear that such a distinction can be upheld. As Harris notes, it was natural for people to die of infections before antibiotics and of smallpox and polio before vaccines were effective, and it is arguably ‘natural’ now for many of us to die from cancer of some type (given the sheer statistical prevalence of cancers): ‘[p]eople naturally fall ill, are invaded by bacteria, parasites, viruses or cancers and naturally die prematurely. Medicine can be described as “the comprehensive attempt to frustrate the course of nature”’ (p. 35, citing Daniels 2007). In these ways Harris reminds us again and again that ‘what is natural is morally inert and progress dependent’ (p. 35). What matters is not whether something is ‘given’, ‘unbidden’, ‘natural’ or ‘normal’, but rather, and simply, whether it is good—meaning beneficial—for humans, individually and collectively. Harris’ account is compelling: what is natural is not normative, and there is no necessary moral priority or superiority of the natural over the unnatural or artificial (indeed, it can be difficult even to conceptually distinguish the natural from the unnatural). Because something can be described as ‘natural’ does not make it good, and certainly does not establish that it is ideal. And Harris is unapologetic in urging us to aim at the ideal, and not merely at normality, normal functioning, or even equal functioning. Indeed he is committed not merely to removing disability and dysfunction as a means to bringing about equality of opportunity or normal functioning, but to taking whatever measures are safe and reliable in order to bring about the greatest levels of human opportunity and functioning that we can manage. He believes we have as great a moral imperative to avoid harm and disability as we have to seek the greatest benefit for ourselves, individually and as a society. Thus, what determines the moral quality of any particular form of human intervention—whether in reproduction specifically or any other attempt to improve the human condition by improving genetic traits—is whether it brings about changes (or traits) that are ‘worth having’ (p. 53). It makes sense, given Frame’s religious commitments, that his ethical appraisal of assisted reproduction is supported by an account of the danger of defying nature. Yet these assertions (for they do not rest on rationally-accessible arguments) are necessarily articles of faith, and as such ultimately serve no rational purpose in his argument. Whether or not one agrees with him, Frame’s analysis of potential harm to future children is perfectly capable of standing alone, and would be enhanced by being permitted to do so.
Despite these deficiencies, on one score Frame offers a more morally mature account than Harris of the way we ought to move forward in this new age of repro-genetic technology. While Harris is committed to an essentially individualistic, laissez-faire conception of the morality of using repro-genetic technologies, Frame is more cognisant of the social and moral imperative of retaining, and perhaps reforging, the moral community around these fundamental questions of human existence and welfare. Frame points out that, within contemporary liberal democratic societies such as Australia, a degree of paternalism (for example, towards incest and bigamy) is tolerated and indeed expected, even in the absence of clear threatened harm. He ultimately endorses what he terms a ‘harm-referenced’ approach to questions of reproductive freedom, but his book conveys greater recognition than does Harris’ of the legitimate influence of the diverse moral views found in a liberal society. His concern is principally with the distinctly moral domain—wherein individuals and communities seek to decide upon and live in accordance with their own endorsed values while remaining within the boundaries and limits imposed by law to prevent harm and protect liberty. He construes communities as themselves ‘moral achievements’ and argues that ‘they have a place in shaping opinion that runs well beyond what should be permitted and what must be prohibited’ (p. 10); and he accords to these communities a responsibility to ‘develop and espouse a moral position which goes beyond the minimalist stance taken by the State for the guidance and benefit of their members’ (p. 10). By contrast, Harris ardently defends a negative conception of liberty according to which those who have no moral objection to a given technology should be permitted freedom in their pursuit of it, since in doing so they impose no obligation on detractors to use these technologies themselves. This is the view enshrined in the ‘democratic presumption’. Yet while the philosophical pedigree of this liberal position is unquestionable, it does not acknowledge adequately the considerable impact, on the moral community, of the pursuit by some of its members of ways of life regarded as deeply immoral by other members. To acknowledge this is not inevitably to advocate a ‘tyranny of the majority’, but rather to accord greater weight and respect to the substantive moral pluralism that exists within liberal democratic societies. Frame is clear from the outset that potential or actual harm alone occasions the legitimate interest and enforcement of the State. On this he is in accord with Harris. Yet one senses that he would allow greater moral ‘space’ and opportunity for voices of dissent to be registered and respected, than seems likely within the laissez-faire moral world of Harris and his supporters, wherein those who approve, do, and those who don’t, just refrain (and, one suspects, preferably silently). But the greatest potential cost of a laissez-faire morality is a community fragmented, disaffected and even retaliatory as a result of deep moral disagreement—in other words, the breakdown of the moral community. Harris seems insufficiently prepared to give attention or weight to this potential cost. That is not to say that any minority opposition should have the power to curtail the non-trivial freedoms of other members of the community. But it is to say that those who wish to pursue a practice about which others have grave moral concerns, do have a moral obligation to constructively defend their claimed entitlements—not brazenly through active assertion of their rights to exercise them, but through patient public argument and discourse aimed at the moral progress of the community as a whole. If the proponents’ arguments are as rationally defensible and sound as they claim them to be, a temporary moratorium on the exercise of their moral entitlements, while opposing viewpoints are fully aired and constructively debated, will be a small price to pay for a moral community that feels genuinely respected in its moral diversity. REFERENCESDaniels, N. 2007, ‘Can anyone really be talking about ethically modifying human nature?’, in Human Enhancement, eds J. Savulescu & N. Bostrom, Oxford University Press, Oxford. Dayton, L. 2007, ‘Scientists welcome NSW stem cell decision’, The Australian, 28 June [Online], Available http://www.theaustralian.news.com.au/story/0,20867,21982334-2702,00.html [2008, Sep 30]. Dworkin, R. 1993, Life’s Dominion, Harper Collins, London. ‘No Human Cloning – Open Letter to Australia’s Governments’, Family Update, January–February 2002, p. 2 [Online], Available http://www.family.org.au/Updates/2002/letter.htm [2008, Sep 30]. Mill, J.S. 1962 (1869), ‘On Liberty’, in Utilitarianism, ed. M. Warnock, Collins Fontana, London. Robertson, J.A. 1994, Children of Choice, Princeton University Press, Princeton. Sandel, M.J. 2004, ‘The case against perfection: What’s wrong with designer children, bionic athletes, and genetic engineering’, Atlantic Monthly, vol. 292, no. 3, pp. 50–62 [Online], Available: http://www.theatlantic.com/doc/200404/sandel [2008, Nov 17]. Savulescu, J. 2002a, ‘Procreative beneficence: Why we should select the best children’, Bioethics, vol. 15; nos. 5/6, pp. 413–426. Savulescu, 2002b, ‘Deaf lesbians, “designer disability” and the future of medicine’, British Medical Journal, vol. 325, pp. 771–773. Dr Mianna Lotz is a lecturer in ethics and applied ethics in the Department of Philosophy, Macquarie University. She has published in journals like Bioethics and Journal of Social Philosophy, and researches primarily in biotechnology and procreative ethics, children’s rights, and parental liberty. She is a member of Macquarie University’s Ethics Review Committee (Human Subjects). |
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