3:00 – 5:00 p.m.
Michael Sandel, Anne T. and Robert M. Bass Professor of Government, Harvard University; member, President's Council on Bioethics; author of "The Case Against Perfection," The Atlantic Monthly, April 2004
Lee M. Silver, Professor at Princeton University in the Department of Molecular Biology and the Woodrow Wilson School of Public and International Affairs; author of Remaking Eden: How Genetic Engineering and Cloning Will Transform the American Family
E.J. Dionne, Jr., Co-Chair, Pew Forum; Senior Fellow, The Brookings Institution
LUIS LUGO: Good afternoon and thank you all for coming. You're braver than those who were deterred by just a little bit of sprinkling out there. We're delighted that you are here.
My name is Luis Lugo and I am the director of the Pew Forum on Religion and Public Life. The Forum is a non-partisan organization, and we do not take positions on policy debates, including the one you're about to hear today.
It is my pleasure to welcome you this afternoon to "The Pursuit of Perfection: A Conversation on the Ethics of Genetic Engineering." We are very pleased to be cosponsoring this event with our friends here at the Brookings Institution, and I want to, in particular, thank the communications staff here who has been so helpful in working with us and putting this event together and bringing it to you.
We are here today to talk about - dare I say it? - a brave new world. As a growing number of performance enhancing technologies become a practical reality, we confront a new world in which human beings wield increasing power over their own destinies. But to what end? And what are the assumptions that guide this quest for perfection? And at the end of the day, will the benefits outweigh the costs?
We are very fortunate to have with us today two of the leading experts in this field to offer us a window into the possible futures, futures which may be scary, may be hopeful, but which are in any case much nearer than most of us realize.
Now, before I turn things over to the moderator, I do want to acknowledge another Pew funded project that is very much involved in this area of work. The Genetics and Public Policy Center, which is taking the lead in understanding the technologies involved in genetic engineering, assessing public and stakeholder sentiment towards them and evaluating the current legal and political landscape in order to craft policy options that will help guide the development and use of genetic technologies. We are pleased that Joan Scott, the deputy director of the Center, could join us today. Joan, if you could please stand so everyone takes a look at you? Thank you so much. Pleasure to have you.
I will now hand things over to my good colleague, E.J. Dionne, who is a senior fellow here at the Brookings Institution, a columnist for The Washington Post, a professor at Georgetown, and co-chair of the Pew Forum on Religion and Public Life. He will be introducing our speakers and moderating the discussion today.
E.J. DIONNE, JR.: Thank you very much, Luis.
"When science moves faster than moral understanding, as it does today, men and women struggle to articulate their unease." That's what Mike Sandel writes in the first paragraph of this excellent piece in The Atlantic, "The Case Against Perfection." I want to thank The Atlantic for publishing Mike and helping make this event possible and also for all their help with it.
I must say for me this is a particularly exciting moment. I have been a Mike Sandel fan for a very long time, and it's like a Red Sox fan getting to introduce Nomar Garciaparra; if there are any Yankees fans in the audience, I don't apologize for that.
MR. LUGO: E.J., we're bipartisan here - (inaudible)
MR. DIONNE: These are purely my own views and do not represent the views of the Pew Forum, which probably does not want to connect itself in any way to my baseball team. (Laughter)
Many of you in this room have worked with Mike or know his work. I was just looking this morning at some of the reviews of his book Democracy's Discontent, and every adjective you would want has been applied to that book. "A profound contribution to our understanding of the present discontent," said the Wall Street Journal. "One of the most powerful works of political philosophy in recent years," said Fouad Ajami in U.S. News and World Report. Moving from right to left, George Will called the book, "Wonderful." John Judas called it, "An important book that inspires." And that's what Mike Sandel does, and he does it without pandering or trimming.
Indeed, there was a politician who ran under the slogan, "He never ducks the tough ones" - the politician used that slogan because our notion somehow is politicians like to duck the tough ones. As you will hear today, Mike Sandel seeks out the tough ones and tries to help us understand.
We are also so grateful that Lee Silver, Professor of Molecular Biology and Public Affairs at the Woodrow Wilson School at Princeton, has joined us today. I couldn't imagine a better combination to discuss this subject today.
We also have many distinguished bioethicists in the audience. I'd like to welcome Janet Rowley who's a member of the President's Council on Bioethics, who's with us today, and also Dean Clancy and Yuval Levin who are the executive director and the deputy executive director of the Council.
Let me introduce Mike. He is the Anne T. and Robert M. Bass Professor of Government at Harvard University where he teaches both graduate and undergraduate courses in contemporary philosophy, including Ethics and Biotechnology; Markets, Morals and Law; and Globalization and His Discontents. His courses are so popular that Harvard actually thought of moving them to Fenway Park. He also serves on the President's Council on Bioethics. He has received fellowships from the Carnegie Corporation, the Ford Foundation, the American Council of Learned Societies and the National Endowment for the Humanities. His publications include Liberalism and the Limits of Justice, Democracy's Discontent: America in Search of a Public Philosophy and Liberalism and Its Critics.
Lee Silver is a Professor of Molecular Biology and Public Affairs at the Woodrow Wilson School of Public and International Affairs at Princeton University. He has been elected to the governing boards of the Genetics Society of America and the International Mammalian Genome Society. He is a fellow of the American Association for the Advancement of Science. He was a member of the New Jersey Bioethics Commission Taskforce, formed to recommend reproductive policy positions for the state legislature in New Jersey. He has testified frequently before Congress and state legislatures. He is the recipient of National Institute of Health grants on evolution and genetics. He is the author of - this is a wonderful title, as well - Remaking Eden: How Genetic Engineering and Cloning Will Transform the American Family, and Mouse Genetics: Concepts and Practice (which was not published by the Disney Corporation).
It is so great to have you both here. Michael, welcome to Brookings.
MICHAEL SANDEL: Well, thank you, E.J., very much. I want to begin by thanking E.J., who is a friend of long standing and someone whose work in journalism and academia and public life - shaping our public arguments - I very much admire. And he's a good friend. I also want to thank Luis Lugo very much for the role of the Pew Forum in convening us here and Professor Silver for being willing to come and join in this discussion.
E.J. mentioned that I'm a member of the President's Council on Bioethics, so I want to hasten to add that I'm speaking here only for myself and not on behalf of the President's Council. He mentioned - I suppose following his introduction, I should say, too, I'm a Red Sox fan, and I don't speak for the Red Sox for that matter.
The topic of genetic engineering and enhancement as public policy forums go is admittedly an arcane, even rarified subject. I've only just begun to learn about genetic engineering, largely through my being confronted with some of these questions, as we all have been, on the President's Council. What drew me to the subject beyond the intrinsic interest of the question of remaking or reengineering ourselves and our nature is that it forces us to think about some big questions, questions even bigger than genetics and genetic enhancement, questions that really go to the terms of political discourse, questions that go to the way we conceive our public philosophy or a public ethic. And while I will try to lay out an argument here about genetic engineering, I want to do it in a way that at least invites us to have a discussion about those bigger questions of our reigning public ethic.
Just to start from people's gut level reactions to news of genetic enhancement: Most people find at least some forms of genetic engineering disquieting, but it's not easy to articulate the source of our unease. It's not easy to explain exactly what it is that we find troubling about it. That fact has something to do, it seems to me, with the terms in which we think about morality, ethics and politics. In order to grapple with the ethics of enhancement, we have to confront big questions, but old questions, questions largely lost from view these days, questions about the moral status of nature and about the proper stance of human beings toward the given world. So this is the way in which, trying to figure out what it is that troubles us about this or that instance of genetic enhancement, makes us confront these bigger, older questions.
And it ultimately - or this is what I'm going to try to propose - it challenges us to re-examine a dominant impulse of our public philosophy, which has very much to do, across the political spectrum, with a vision of freedom bound up with mastery, dominion and control. That's an abstract idea, so I'd like to work up to it gradually, first by considering four very concrete examples of enhancement that are either available now and practiced or on the horizon.
First, muscles. Researchers have developed a synthetic gene that when injected into the muscle cells of mice makes muscles grow and prevents them from deteriorating with age. So the question arises, should this become possible in human beings? What are the proper uses of genetic alteration of muscles? Should it just be to cure muscular dystrophy and the atrophy of muscles that comes with age? Or should athletes be able to use it to bulk up without steroids?
Now, usually when we think about steroids in sports or other forms of enhancement, the first objections that spring to mind have to do with two things. One is safety - steroids are unsafe, they carry long-term health risks. The other is fairness. Is it a kind of cheating? Suppose for the sake of argument that muscle enhancement were safe. What about the fairness argument? Well, some people might say a genetically altered athlete would have an unfair competitive advantage, but the fairness argument isn't decisive. It's not decisive because it's always been the case that some athletes are better endowed genetically than others. We don't consider the natural inequality of genetic endowments to undermine the fairness of sports. So what would be the difference if genetically altered athletes were to compete?
If genetic enhancement in sports is morally objectionable, in other words, it must be for some reason other than safety and other than fairness, because if it were safe in principle it could be made available to anyone who wanted to use it and the fairness objection would fall away.
Second example: memory. Researchers are now able to produce smart mice by inserting extra copies of the memory related gene into mouse embryos. Now, human memory is much more complex, but there are biotech companies now in hot pursuit of memory enhancing drugs or cognition enhancers. They're aiming at not only the market of those who lose memory due to Alzheimer's, but also the many millions of baby boomers who are beginning to experience age-related memory loss. If they could come up with a cognition enhancer of the kind they're seeking, it would be a bonanza for the pharmaceutical industry, a Viagra for the brain.
What about that? Would that be objectionable? Let's assume for the sake of argument it could be done safely. What about fairness? Some might worry, Well, this will be expensive, won't it? And won't that mean that it'll exacerbate the gap between rich and poor? If you're wealthy, you'll be able to afford cognition enhancement, and if you're not, you won't.
And there is a point to that worry, but it's not the fundamental worry. Think about it: Why would that scenario be objectionable? Would it be objectionable because the unenhanced poor would be denied the benefits of bioengineering their memories? Or because the enhanced affluent are somehow dehumanized by going in for this? So the first question, the fairness objection, is a real objection, but it's not the first, not the most fundamental question about these technologies. The fundamental question is not how to assure equal access to the thing, but whether we should aspire to it in the first place.
We can see this by considering the third example that's already available: height enhancement through the use of human growth hormone. Since the '80s this hormone has been approved by the FDA for abnormally short children who suffer from hormone deficiencies or other illnesses. But parents of short but otherwise healthy kids come along and say, Why not for our kids, too? They suffer taunting on the playground. Why can't they be taller? It's true they're not ill. They just have short parents. And the FDA wrestled with this, and this summer the Eli Lilly pharmaceutical company persuaded the FDA to approve its human growth hormone for healthy children whose projected adult height would be in the bottom one percentile.
That immediately raises the broader ethical question. Why not other short children? Why only very, very short ones? And for that matter, why shouldn't it be available to all children? There might be those who are average or above average in height who want to be even taller. Maybe they want to make the basketball team. Is there anything wrong in principle with height enhancement through the use of growth hormone - cosmetic height enhancement; that is to say, not connected with any underlying medical illness or ailment?
Well, some might say, Yeah, there's something we're not quite comfortable with about that prospect. But what is it? Maybe it's fairness or a related thing. Height enhancement, if you imagine this going on, motoring along on a large scale, would ultimately be collectively self-defeating. As some people become taller, others become shorter relative to the norm, and so as the unenhanced begin to feel shorter, what would they do? They might, if they care about it, begin to seek treatment, and then there'd be a kind of hormonal arms race. That would leave everyone worse off, especially those - this is the fairness worry - who can't afford to buy their way up from shortness.
But here, too, the fairness objection doesn't really get at what's worrying about this. If we were bothered only by the injustice of adding shortness to the problems of the poor, we could remedy that unfairness by providing publicly subsidized height enhancements. So the real question is not fairness, is not access - those are serious questions - the prior question is whether we want to live in a society where parents feel compelled to spend a fortune - and this is not cheap, this height enhancement - to make perfectly healthy kids a few inches taller.
One last example before delving into an objection that lies and projects us beyond safety and beyond fairness: sex selection. It's now possible to go to a clinic in Fairfax, Virginia, and select in advance the sex of our your child. They are ways of doing it through embryo screening and pre-implementation genetic diagnosis, but this company in Fairfax, Virginia, can do it by sperm sorting. They have a machine that sorts sperm and separates y-bearing sperm that would produce a boy from the x-bearing sperm that would produce girls. It's a flowcytometer, this machine, and it's pretty successful, 81 percent success rate for girls, 76 for boys. The technology is called, quaintly, MicroSort, and they licensed it from the U.S. Department of Agriculture, which developed it for breeding cattle. Now you can use it to select the sex of your child.
What about this? Is that fine? Do you like that idea? Maybe everybody does. But insofar as people are uneasy about this, what would be the objection? One obvious objection is people might worry about sex discrimination. If you look at some societies around the world - India, China, for example - there has been in the last 15 years a huge skewing of sex ratios, where the ratio of boys to girls is 120 to 100 - in northern India in some places, 140 to 100.
For the sake of this exploration, put aside the issue of sex discrimination, as this MicroSort-using company does. They have a rule to fend off that objection. You can only go there and use that sperm sorting technique if you already have kids and you want to use it for family balancing. They won't let you use it to stock up on boys or on girls, and you can't even use it for your first child. So they've found a very clever way to put the sex-discrimination argument, the sex-skewing argument to rest.
That poses the question very clearly. Insofar as there is something troubling about this, beyond safety, beyond fairness, what is it? It seems to me something morally troubling does persist in each of these cases. And what is it?
Think back to the case of genetically enhanced athletes. Some people say what's wrong there - it's a moral wrong beyond fairness - is the genetically enhanced athletes running three-minute miles or hitting 700-foot home runs routinely. There is something about enhancement that undermines effort, the nobility of effort, the sober, hard-forged virtues that attend really working and striving and training so that your accomplishments, be they athletic or otherwise, are really your doing. It's one thing to hit 70 home runs as the result of discipline, training and effort, this argument goes, and something else, something less, to hit them with the help of steroids or genetically enhanced muscles.
There is something in this idea, but I would argue the problem with enhancement is not that it erodes effort and undermines human agency. In fact, it's something closer to the opposite. The deeper danger is that genetic enhancement and bioengineering represent a kind of hyper-agency, a kind of Promethean aspiration to remake nature, including human nature, to serve our purposes and to satisfy our desires. The problem is not the drift to mechanism, where we imagine even robotic athletes. The problem is the drive to mastery. 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 efforts we expend to develop and to exercise them. Appreciating the gifted quality of life constrains the Promethean and conduces to a certain humility. This sense of giftedness is in part a religious sensibility, but its resonance reaches beyond religion, and there are ways of understanding this idea, this ethic, that don't depend on religious notions.
To go back to the athletic example, consider two types of athletic achievement. There are players like Pete Rose who aren't blessed with great natural gifts but who manage, somehow, through effort and grit and determination and striving, to excel in their sport. But we also admire players like Joe DiMaggio, whose excellence consists in the grace and effortlessness with which they display their natural gifts. Now do a thought experiment. 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 the drug is that it's a short cut. It's a way to win without the effort and without the striving. But effort and striving are 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 because we want to believe that in life and in sports success is something we earn, not something we inherit. And so 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.
And so in the face of this embarrassment we inflate the moral significance of effort and striving and we depreciate giftedness. We can see this, for example, in the television coverage of the Olympics, where they focus less on the feats the athletes perform than on those heart-rending stories of the hardships they've overcome, the obstacles they've surmounted, the struggles they've waged to triumph over an injury or political turmoil in their native land. That's all about the valorization of effort over giftedness, and it reflects our uneasiness in a democratic, meritocratic society with that ethic.
But effort isn't everything. No one believes that a mediocre basketball player who works very hard, even harder than Michael Jordan, deserves greater acclaim or a bigger contract. And so 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. If this is what's at stake, crowding out the ethic of giftedness in favor of a kind of overbearing, strenuous striving, it isn't only genetic enhancement that raises these objections.
In the National Football League over the past 30 years there has been a dramatic increase in the average size of players, especially linebackers. In 1972 in the Super Bowl, the average weight of an offensive lineman was - anyone care to hazard a guess? - 248 pounds - already pretty big. That was in 1972. Today the average Super Bowl lineman weighs 304 pounds. And a year ago the Dallas Cowboys boasted the NFL's first 400-pound player. Now, this isn't all accounted for by steroid use, because the NFL banned steroids in the 1990s. What produced these gargantuan athletes was a very low-tech thing: huge amounts of food. (Laughter.) A reporter for The New York Times looked into this and said, "As the pressure increases to add pounds, the science of size comes down to a cocktail of unregulated supplements and a bag of cheeseburgers."
So the phenomenon I'm describing is not solely a question of high-tech. There is nothing high-tech about a mountain of Big Macs. And yet encouraging athletes to use mega-calorie diets to turn themselves into 400-pound human shields and battering rams is as ethically questionable - is questionable in the same way as encouraging them to bulk up through the use of steroids or human growth hormone or genetic alterations. Whatever the means to push for super-size players is degrading to the game and to the dignity of those who transform their bodies to meet its demands.
So we have the ethic of giftedness, which is under siege in sports. It persists, though it's also under siege in the practice of parenting. 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. And this goes to the issue of sex selection, but not only sex selection, also, in principle, down the road, the use of genetic technologies to select other traits of children, whether height, eye color, hair color, or ultimately, though not anytime soon, intelligence, athletic prowess, musical ability and the like.
So here, too, is a pressure on the ethic of giftedness. We choose our friends and spouses at least partly on the basis of qualities that we find attractive, but we do not choose our children. Their qualities are unpredictable, and even the most conscientious parents can't be held wholly responsible for the kind of child they have. That's why parenthood, more than other human relationships, teaches what my friend, theologian and bioethicist William May calls "an openness to the unbidden."
This helps us see that the deepest moral objection to enhancement or to the pursuit of designer children lies not in the perfection that it seeks, but in the human disposition that it expresses and promotes. The problem is not that parents usurp the autonomy of the child whose sex they choose or whose traits they design, because the child wouldn't otherwise choose her genetic traits for herself. Autonomy is not what's at issue. The problem lies in the hubris of the designing parents in their drive to master the mystery of birth. Even if this disposition doesn't make parents tyrants to their children, still it disfigures the relation of parent and child and deprives the parent of the humility and of the enlarged human sympathies that an openness to the unbidden can cultivate.
Now, it's tricky, this ethic of giftedness, because it doesn't mean that it's not our place to try to mold or cultivate or to improve our children. We admire parents who seek the best for their children, who spare no effort to help them achieve happiness and success. Some parents do this by sending their kids to expensive schools, hiring private tutors, packing them off to tennis camp, giving them piano lessons, ballet lessons, swimming lessons, SAT prep courses and so on. We all know about that, don't we? And so here's the question: If it's permissible for parents to help their children in these ways, why isn't it equally permissible and admirable for parents to use whatever genetic technologies are around, provided they're safe, to enhance their child's intelligence or musical ability insofar as that became possible?
The defenders of enhancement point out that analogy, and they're right to this extent: Improving children through genetic engineering is similar in spirit to the heavily managed, high-pressure childrearing practices that have become common these days. But this similarity doesn't vindicate genetic enhancement. To the contrary, it highlights a problem with the trend toward hyper-parenting. And we're familiar with this trend, even apart from the high-tech expressions of it.
Consider sports-crazed parents bent on making champions of their children. Never mind the sidelines of the weekend soccer games that so many of us populate, and the crazed parents alongside us - not us, but they're the crazed ones. (Laughter.) Richard Williams, the father of Venus and Serena Williams, the great tennis champions, reportedly planned the tennis careers of his daughters before they were born. Or Earl Woods, the father of Tiger Woods, handed a golf club to the young Tiger while he was still in the playpen. But it's not only parents bent on making champions of their children in sports. More pervasive still is the frenzied drive by parents to mold and manage their children's academic careers. When I was in high school I didn't know anyone who went and took a SAT prep course. Now just about everybody seems to do that. It's a $2.5 billion industry now.
And SAT prep courses aren't the only way that the anxious affluent polish and package their college-bound progeny. After all, hyper-parenting is strenuous and time consuming, so some parents subcontract the job to private counselors and consultants. There is a firm in Manhattan - it would have to be in Manhattan - (laughter) - called IvyWise. They offer a two-year platinum package of college admissions help for - how much do you suppose? - $32,995. Over 10 percent of today's college freshman have used paid counselors of one kind or another, up from 1 percent in 1990. And it's not only to get kids into college. IvyWise has a service for kids that caters to parents eager to win spots for their children in the coveted private elementary schools in New York. And we heard a year or two ago about this guy, Jack Grubman, a Wall Street stock analyst, who upgraded his rating, allegedly, of AT&T stock to curry favor with his boss who was helping get his twin two-year-olds admitted to a prestigious nursery school.
We've strayed from the issue of high tech, and even genetic enhancement, but the ethic at stake, the drive for designer children to mold and manage, is the same, and it's objectionable. It's animated by the same kind of ethic and impulse of mastery and control, and it's objectionable, it seems to me, on the same grounds. Mr. Grubman's willingness to move heaven and earth, and even the market, to get his two-year-olds into a fancy nursery school is a sign of the times. It tells of mounting pressures in American life that are changing the expectations parents have for their children, and increasing the demands placed on children to perform.
And so it's no wonder that as the pressure for performance increases, so does the need to help distractible children concentrate on the task at hand. Enter Ritalin. Ritalin prescriptions for children and adolescents have tripled over the past decade, but not all users suffer from ADHD. It's also possible to use Ritalin to enhance one's performance on the SAT or on college exams.
So those who argue that bioengineering is similar in spirit to other ways that ambitious parents shape and mold their children have a point, but this doesn't give us a reason to embrace the genetic manipulation of children. Instead it gives us reason to question the low-tech, high-pressure childrearing practices that we increasingly accept. The hyper-parenting, familiar in our time, represents an anxious excess of mastery and dominion that misses the sense of life as gift, and this draws it disturbingly close to eugenics, which is what gets at the fundamental moral stakes.
The shadow of eugenics hangs over today's debates about genetic engineering and enhancement. Critics say what we're witnessing with enhancement is nothing more than privatized or free-market eugenics. Defenders of enhancement say, No, no, it's not eugenics, provided there is no state imposition; provided there is no coercion. Historic eugenics involved forced sterilization, coerced by the state, and ultimately, with the Nazis, genocide. The Nazis gave eugenics a bad name, but the question remains now, what was wrong with eugenics? Was it just the coercion and the state imposition, or is something wrong with eugenics even if there is no state imposition, even if there is no coercion? That's another way of framing the question about genetic enhancement.
James Watson, who with Francis Crick discovered the structure of DNA, has argued that there is nothing wrong with genetic engineering and enhancement, provided they are freely chosen, not state-imposed. A couple of years ago, he stirred up a controversy by saying that if a gene for homosexuality were discovered, a pregnant woman who didn't want a homosexual child should be free to abort a fetus that carried it. When his remark provoked an uproar, Watson replied, he wasn't singling out gays but asserting a principle, namely that women should be free to abort fetuses for any reason of genetic preference, whether the child would be born dyslexic or lacking musical talent or too short to play basketball.
The furor over Watson's remark poses starkly this question about free market eugenics. Even for those who don't subscribe to the pro-life position, Watson's scenario raises a hard question. If it's morally troubling to contemplate abortion to avoid a gay child or a dyslexic one, doesn't this suggest that there is something wrong with acting on eugenic preferences, even where no state-imposed coercion is involved?
Take a tamer example. There are ads that run in campus newspapers, including those on my campus, looking for egg donors. A few years ago a fertility clinic ran an ad in some Ivy League college newspaper seeking an egg from a woman who met certain qualifications: at least 5'10" tall, athletic, without major medical problems, and with a combined SAT of 1400 or above. And in exchange for an egg from this donor, they were willing to pay - the ad offered - do you remember how much? - $50,000 for that designer egg.
What about that? How does that strike you? If it bothers you somehow, doesn't it suggest, as with Watson's scenario - now here there's no coercion, there's no state imposition - isn't it the eugenic character of the ad, of the practice that's troubling? The problem, then, with eugenic and genetic engineering is that both represent the one-sided triumph of willfulness over giftedness, of dominion and mastery over reverence and restraint.
Now why should we worry if the ethic of mastery and dominion and control crowds out the ethic of giftedness? We should worry because if the genetic revolution erodes our appreciation for the gifted character of power - human powers and achievements - it would transform at least two key features of our moral landscape, and they're connected. One is humility, and one is solidarity.
In a social world that prizes mastery and control, like ours, parenthood is a school for humility. That we care deeply about our children and yet can't 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, because it invites us to abide the unexpected, to live with dissonance, to rein in the impulse to control. A world in which parents became accustomed to selecting the sex and genetic traits of their children would be a world inhospitable to the unbidden; it would be a gated community writ large.
But this aspect of humility is connected to the moral basis of social solidarity. Why, after all, do the successful owe anything to the least advantaged members of society? The best answer to that question leans heavily on the notion of giftedness. It goes like this: The natural talents that enable some of us to flourish and get ahead, make a lot of money - those talents aren't wholly our own doing, but rather in large part our good fortune. If our genetic endowments are gifts rather than achievements for which we can claim credit, then it's a mistake and a conceit to assume that we are entitled to the full measure of the bounty our talents reap in a market society. Therefore, we have an obligation to share our bounty with those who, through no fault of their own, lack comparable gifts.
So here's the connection between solidarity and giftedness. Those who retain a lively sense of the contingency of their gift, those who realize that we aren't wholly responsible for our success, are more likely to take a more generous stance toward those who lack the talents the market happens to prize. Giftedness, in other words, saves a meritocratic society from sliding into the smug assumption that the rich are rich because they are more deserving than the poor.
But what happens when genetic engineering enables us to override the results of the natural lottery, to replace chance with choice? The gifted character of human powers and achievements would recede and with it, perhaps, our capacity to see ourselves as sharing a common fate. The successful, thinking themselves wholly self-made men and women, would become even more likely than now to view themselves as self-sufficient and, hence, wholly responsible for their success.
Those at the bottom of society would no longer be viewed as disadvantaged and so worthy of a measure of compensation, but simply as unfit and so worthy of eugenic repair. The meritocracy, less chastened by chance, would become harder, less forgiving. So here's how solidarity is connected to, draws upon, requires a certain ethic of giftedness and a certain sense of the chance, an appreciation of the chanced nature of our lot.
But against it is arrayed a powerful project of mastery, control and self-making. 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's often assumed that the powers of enhancement we now possess arose as an inadvertent byproduct of biomedical progress. The genetic revolution came, so to speak, to cure disease and then stayed to tempt us with the prospect of enhancing our performance, designing our children and perfecting our nature.
But that may have the story backwards. It's more plausible to view genetic engineering as the ultimate expression of the ethic I've been describing, of the resolve to see ourselves astride the world, the masters of our nature. What I've tried to suggest is that that premise of mastery is flawed. It threatens to banish our appreciation of life as a gift and to leave us with nothing outside our own will, our own resources, our own effort to affirm or behold.
Thanks very much.
MR. DIONNE: Thank you very much.
While Dr. Silver sets up, when you talked about the search for that egg-based on SAT scores, I thought you had stumbled across a joint venture between IvyWise and MicroSort - (laughter). It was extraordinary.
Sir, welcome. Thank you so much for being with us.
LEE M. SILVER: I want to thank the organizers of this conference for giving me the opportunity to respond to Professor Sandel's analysis of the rights and wrongs of parents choosing which genes their children receive and the modification of nature in general.
I have to confess I have no background in bioethics. I was trained as a physicist, and I did molecular biology most of my life, and I don't pretend to have any answers to the hard questions. I see my role as a provocateur - to raise the questions even though I can't answer them. And I do this because I enjoy it, but also because most scientists try their hardest not to provoke. Jim Watson and Francis Crick are notable exceptions because they became historical figures in their own time, and they didn't have to worry about anything. Jim Watson discovered the double helix at the age of 25.
I don't like where all of this competition leads. I have a daughter in 11th grade, and I was forced to put her into a $1000 SAT prep course because most other parents were advantaging their children in the same way. I don't like the fact that 50 percent of Princeton University undergraduates seek psychological counseling at some point during their four years on campus. But I don't think it's just the parents who are to blame. It's also our modern American society, where success is based ever more on achievement and even less on who your father is, although our president is a glaring exception to that rule. (Scattered laughter.) And so we end up with what biologists call the red queen effect, which biologists have known about for a long time. It's based on the Lewis Carroll character, who has to keep running just to stay in place.
In evolutionary biology, it's impossible to escape the red queen. Darwin was the one who said that every species is going to go extinct because some individuals within that species would out compete other individuals in that species with new genes, and so if we look just back at our recent evolutionary past, homo erectus went extinct, homo Neanderthal went extinct, homo habilis went extinct. All those species were in our past. They didn't survive; they all went extinct. I homo sapien is different, but we'll get to that later on.
So I agree with Professor Sandel that this is a very worrisome trend. I don't like it, but it's not clear to me how we can stop it in a democratic society. I also agree with him that to understand the ethics of enhancement of any kind, we must ask questions about the moral status of nature and about the proper stance of human beings toward the given world. And I think that secular academics often engage this debate with one hand tied behind their back because they ignore an area which is very important to most people, which Professor Sandel has not ignored, actually. As he explains, the political leanings of a person do not necessarily provide insight into that person's answers to moral questions about the modification of nature. Some on both the right and the left of the political spectrum are opposed to human tampering with genes, and Professor Sandel presents a carefully reasoned and sincere liberal argument against gene control. But even further to the left are people who are more vociferous in their opposition to all forms of plant, animal and human biotechnology.
In contrast, some thoughtful people, both conservatives and liberals, fail to see a problem with genetic enhancement as long as it doesn't restrict the child's autonomy. Indeed the well-known, left-wing, Harvard scientist-authors Richard Lewontin and Stephen Jay Gould couldn't even figure out why there was such a big fuss about reproductive cloning. They didn't see it raising any new ethical issues. That's contrary to what almost everybody else in the country believes. I'm not going to talk about cloning, but I think it shows that there's a fundamental distinction between the way that people view life. It's not politics. In my opinion, the answer is based fundamentally on different conceptualizations of spirituality.
Now I had a religious upbringing, and I didn't question it when I was being brought up. But then I became an adult and a molecular biologist, and people didn't talk about religion any more - in molecular biology, or actually anywhere else I talked to secular academics. And I remember bringing up this in discussion with my molecular biology colleagues at Princeton, talking about spiritual beliefs at a faculty lunch, and Leon Rosenberg, who is a esteemed colleague of mine, said, quote, "No educated person believes in souls." I went home that evening, and I remember having dinner with my father-in-law, who is a very educated person, and he said, quote, "No educated person denies the existence of souls." So here was clearly a contradiction. What was the truth?
Spiritual beliefs, whether admitted or not, are nearly universal, but the details of such beliefs can vary tremendously from culture to culture, from person to person, even within the same religious tradition. I traveled across Asia and North Africa and Europe and asked people what they thought about the soul.
Westerners especially don't like to use that word, and so they use euphemisms for the soul. Most non-Westerners think the soul is a wispy, spatially localized material substance that leaves the body and goes somewhere else after death, but it's not just non-Westerners. In 1907, The New York Times headlined an article, quote, "Soul Has Weight, Physician Thinks." Now, forget about the use of the English language there, it was based on an experiment published in a journal called American Medicine, which doesn't exist anymore, and he weighed people. He put people on a giant balance while they were dying of tuberculosis and weighed them and claimed in his results that they lost 21 grams at the moment of death. That's not an urban legend; that's a real experiment that was published in a medical journal.
Now, Descartes, who lived before then, understood the scientific implausibility of a material substance that had a mind of its own which could leave the body, so Descartes said the soul is not a material substance, it's a different kind of substance - a spiritual substance without location or mass. But the material soul and Cartesian souls were both immortal. They survived the death of the body.
The third category of soul, which originated with Aristotle, is not immortal. In modern language this type of soul is an emergent property of the human body, or just the human mind. It can't possibly exist in isolation from the body, so when the body dies, it dies.
And the fourth category of soul is what Francis Crick made famous when he said you are nothing but a pack of neurons in his book Soul as a Metaphor. The soul is a metaphor for whatever you want it to be.
These are very, very different views of the soul.
At the invitation of the Council of Catholic Bishops Committee on Science and Human Values, I had the opportunity last fall to speak with a group of American bishops at an informal lunch, and I asked them to explain the Catholic notion of soul to me. I was surprised when they disagreed with each other. Some thought the human soul survived as an immaterial spirit, and some thought it didn't - that it would only come back when the body was resurrected. That the leaders of a religious culture disagreed on this fundamental issue suggests to me that they didn't talk about it with each other very much.
In a poll I conducted at Princeton University, 66 percent of Princeton University students said they believed in a human soul of some kind; 53 percent believe specifically in immaterial soul; 27 percent had no idea what they thought. And many of the students were very disturbed that I actually forced them to consider the answer to this question.
I think this is a product of our scientific culture. Pre-scientific people are not confused. When I was in Bali watching a cremation ceremony where the soul is supposed to go up in the smoke to heaven, people were happy. They didn't fear death. They weren't upset. They were all very happy that this old woman's soul was going up to heaven. In the Mayan culture in Central America that I visited, they bury the dead and the soul seeps out into the ground. It has to fight off the underworld before it gets into heaven.
Science causes anxiety and confusion in moral beliefs. It's science starting from the Enlightenment period that suggested that God is not needed to explain the revolutions of the planets around the sun; and in the 20th century, biochemists have not needed God to explain the workings of living cells. Professor Sandel worries about what he calls the deeper danger of Promethean aspiration to remake nature, including human nature, and satisfy our desires. But every human civilization came into existence only when people acquired a primitive understanding of heredity, which allowed them to remake nature. The Mayans in Central America took a weed and turned it into corn. Asians took wild oxen and turned them into docile milk factories we call cows. Most people think that cows and corn were here at the origin as a gift, but in fact they are human inventions.
Today, 36 percent of the land mass of the earth is dedicated to agriculture, and the UN thinks it will be 50 percent by the year 2050. In most populated areas of the world there is nothing left of the nature that existed before humankind invaded. So I'm not happy about that either, but if you look at the alternative, we have six billion people on Earth. If we didn't use a significant amount of land mass, there'd be massive starvation, so that's the alternative.
It's fascinating to me that if you look at American spiritual beliefs, European spiritual beliefs, they give you some insight into what kinds of biotechnology are disliked. In America there's a very strong traditional Judeo-Christian ethic, and in Judeo-Christian ethic only human beings get souls, not animals and plants, and that has a very strong impact on our political system, I believe. So we don't worry too much about genetically modified crops because crops were given to us to benefit humankind.
In Europe, many of left-leaning European intellectuals have a different version of spirituality, which encompasses all of Mother Nature, and in that kind of spirituality, they categorically reject genetically modified foods. Liberal society has functioned and tried very, very hard to make the claim that genes really don't matter. My children were taught in public schools that they could accomplish anything their hearts desire. Brilliant leaders of the Human Genome Project like Eric Lander and Craig Venter argue that genetic analysis shows that we're all 99.9 percent identical to each other, which is true, which means that there are three million genetic differences between individuals, so it's a question of how you look at that.
As Professor Sandel knows, and we all know today, we can't hide the fact that there are differences in genetic distribution. The human species is not monolithic. Each child is born with different degrees of genetic advantage and disadvantage at the starting points along thousands and thousands of curves. As the child grows up, they can push up and down from the starting points, I believe, but the genetic mythology has always been, in liberal society that anybody can do anything they want. That's simply not true. In fact, most people - especially today - have no chance of being a professional athlete or an Olympic contender or a violinist in the Boston Symphony Orchestra. Today you can't compensate just with strong work. You have to be born way, way, way out along the curve on your profession. And I suspect even Pete Rose was not average. I would say that he was probably in the 95th percentile perhaps and that's - and then his effort allowed him, but probably wouldn't be able to succeed today because you have to be in the 99.99 percentile.
And I just want to show you a picture in the middle of Professor Sandel's article, which is very ironic. This is a picture from The Atlantic. It's an advertisement using Lance Armstrong, who is winner of the Tour de France four times in a row. Lance Armstrong is not a normal human being. When I looked up on the web "superhuman" next to "Lance Armstrong," I got 570 hits. Everybody thinks he's superhuman. He has massive lungs and his heart is 30 percent larger than average. He's in the 99.99 percentile and that's one of the reasons he's always tested clean on drug tests. The reason that he's winning these races, besides the fact that he has put in a lot of hard effort, is the fact that he is genetically gifted.
Now most people in Western societies like people like Lance Armstrong, but they're troubled when you talk about parents being able to give their children exactly the same kind of gene that some other children get naturally. So I'm not talking about running the mile in two minutes; I'm talking about parents who are saying to themselves, Well, my neighbor's kids have genes which allow their children to compete athletically or in some other way; why can't I just give my children the same genes? What is wrong with that? If they're given naturally to him, why can't I give them to myself?
In the United States we have this notion, which was demonstrated in Harper's Magazine index - there was a question people were asked: Who should decide what genes a child gets? And the four possible answers were: parents, doctor, no one, or God. God came in first place with 70 percent; no one came in second place with 16 percent; and the parents came in third place with 11 percent. And then in the very same survey - same poll, same population - they asked people: If you could give your child enhanced genes that would increase his resistance to disease, would you do it? Then 75 percent said yes. So, you know, in the abstract they don't want to think about playing with genes, but then you give them a specific example of how they can advantage their own child and they hadn't thought about that. They'd like to be able to take advantage of that.
The problem is the vision of nature and the notion that nature is spiritual, I think, underlies the feeling that we shouldn't tamper with it - that nature gives us gifts is the word Professor Sandel uses. Molecular biologists and other biologists in related fields don't see nature in the same way, and I think that is the division between the way people think categorically about what the opponents call genetic tampering. Molecular biologists and anybody who has had an evolutionary biology course knows that nature, if you want to be metaphorical, is mean and nasty; that everything is trying to kill everything else; that a turtle lays 1,000 eggs, 1,000 little turtles hatch and 999 of them are going to die before they make it back into the water.
In the book he wrote just before he died, Stephen Jay Gould - and he was no friend of the right wing - wrote, "I would advance the strong claim that Darwin's theory of natural selection is in essence Adam Smith's economics transferred to nature." He only was able to write this right before he died because it went against his political beliefs.
So the point I think I'd like to make is that we ignore something that is an inherent part of most people's personalities, which is some kind of spiritual belief; and spiritual beliefs are not monolithic. They can be all over the place, but scientists especially want to ignore the spirituality. Scientists are the least spiritual, molecular biologists are the least spiritual of all groups of people that I've ever encountered. They want to ignore the spirituality. They want to not provoke people. They want to try to explain it in secular terms. The problem I have is that I don't see a secular reason to stop parents from giving a child a gene that other parents give their children naturally, not in a society where we know that the playing field is not fair to begin with. If a playing field was fair, I think it would be different, and I think that's why the mythology of "everybody starts at the same place," of "the playing field is level," that liberal mythology is put upon us to try to convince people that anybody can get anywhere they want. It's not true we now know, and that causes a severe problem for which I have no answer.
Thank you very much. (Applause.)
MR. DIONNE: Mike wants to reply later in the course of answering questions.
I want to ask one myself, but I'd like to invite William May and Janet Rowley to be thinking if you would like to join in at some point in this discussion, if you wouldn't mind leading off after I ask a question.
By the way, there is an explanation for that Harper's poll finding, which is 90 percent of the parents thought they were God, which is perfectly logical with the data.
Which actually gets to the point: I find myself very sympathetic, as you know, Michael, with your argument. "There but for the grace of God go I" is to me one of the most politically and socially constructive moral sentiments there is, and so I'm sympathetic when you say, "And what the drive to mastery misses and may even destroy is an appreciation of the gifted character of human power and achievements." And you go on: "Appreciating the gifted quality of life constrains the Promethean project and conduces a certain humility."
Here's the problem or the question I have: Why is this objection to this particular technology any different than objections to earlier forms of technology? Did not the fact that some of us live longer than others also produce a sense of the gifted character of life? Could that not be used at any point against interventions by medical science? Christian Scientists, for example, believe profoundly in the very sense of humility which you extol and which I also admire. They would carry it farther down the line to saying that many of the heroic interventions that we engage in are Promethean and arrogant. How do you draw that line and where does a hard line need to be drawn?
MR. SANDEL: Right. Yeah. Really a good and difficult question, and it enables me to say that what I don't want to do is enshrine as a general principle that human beings must not tamper with nature. I think that would be folly and it would be at odds with a great many wondrous and beneficial interventions in nature, and transformations of nature that human beings have undertaken throughout human history. And it would give rise to the very question you put. Well, what about surgery? Does that mean we can't have surgery or anesthesia or any of the very obvious cases, to say nothing of domestic cattle or hybrid corn and so on.
So my brief is not for enshrining nature as inviolable and not open to human intervention or manipulation, so that in a way makes my task more difficult then. How is it possible to work out an ethic of giftedness that carries with it certain restraints, but that doesn't just say whatever's given by nature is to be inviolable? And the kind of first step I would try to offer to answer that question is that in addition to the side of nature as a given we have to add, in any of these cases that we're deliberating or wrestling with, some account - a persuasive account - of the human goods that are at stake in this or that practice.
So there is an account of the human good that I think has to govern any ethic of giftedness - mastery, restraint, intervention; not just the fact that something is given by nature. So in the case of designer children, the argument would have to be not just that it's wrong to tamper with your kids. You should just let them come as they sprang from nature. That I wouldn't say, because then can you give your kid a vaccination? No, not on that account. Or a surgery or any kind of medical intervention? No.
By arguing from a certain account of the human goods at stake in the case of designer children, I would have to be able to show that getting in the habit of specifying the genetic traits - let's say the height, hair color, eye color, as they did in that movie Gattica. I don't - did you see Gattica? It's a great illustration of this where - it's a science fiction movie where they get in the habit of specifying not just to prevent genetic diseases, but also to choose, as consumers would choose, height, hair color, and various physical talents and attributes. My argument would have to be that a society like that, where that kind of designer child rearing became routine, would transform the relation between parents and children in a way that would undermine important goods that attach to the feature of childrearing now that depends importantly on not commodifying or objectifying kids - not viewing them as instruments of our ambition, and when we run afoul of that, even in low-tech ways, we feel guilty about it or can be recalled from it or are aware that were going too far.
So you're absolutely right. It's not just the idea of nature or the given. This ethic of giftedness has to make its case practice by practice in relation to a certain count of the human goods that are present in a practice that would be undermined by this kind of intervention.
MR. DIONNE: Let me just follow up if I could. If I read you right, you would not be opposed to, as it were, fixing genes that might cause cancer.
MR. SANDEL: Right.
MR. DIONNE: Now, let's say we know that obesity can cause premature death, so is there a problem with fixing genes for obesity? Let us say there is significant scientific evidence that in fact shows - we could go either way, but let's say - that tall people actually have significantly longer lives and are less given to disease than shorter people. How does one go from -
MR. SILVER: And they make more money.
MR. DIONNE: Yeah, that, too, but let's say - I'm trying to keep it to the issue of fixing for health.
MR. SANDEL: Right.
MR. DIONNE: As you go along that continuum, where do you stop? How do you know when to stop?
MR. SANDEL: Right. Those are getting into some of the close cases: obesity and height. And there it would depend on what the meaning of the practice were of enhancing the height, which was why we would need to know, are parents really starting now to enhance height because there is this health reason? It's like obesity. If you're too short, you're - it's as if you're at-risk, which probably isn't true. I don't know. But obesity, yes, then it's getting close, but if it really is for a genuine health reason. But height, for just the reason that Professor Silver just suggested - well, it's also to be taller is more prestigious, carries certain social advantages, gives you a higher income. Then it's shading into non-medical reasons and insofar as those reasons come to predominate the practice of height enhancement, to that extent I would say no.
MR. DIONNE: I just want to press you one last time on this.
MR. SANDEL: Yeah.
MR. DIONNE: The scientific data on the relationship between obesity and health problems is quite substantial. Let us say that there were not as overwhelmingly convincing evidence, but a rather substantial set of correlations between height and health. And let us say that my secret desire is to have my kid be a basketball player, but I would give the public reason based on some significant data that I would present you, and you would be the judge and say, Look, this is about health, not about playing basketball. It strikes me that even though I am very sympathetic to the distinction you want to make, I am wondering how we as a society could get to the point of successfully making that distinction.
MR. SANDEL: Well, there's no easy way of making that distinction, but I would just point out that that difficulty isn't distinctive to this issue of genetic enhancement. It's the same kind of difficulty we confront all the time when, for example, we're trying to decide whether a certain kind of proposed law or policy that might have some benefit for religious practice is motivated by the desire to strengthen some religious practices over others or whether it's really justified because there are correlations that show that when these various religious institutions are supported there are other good effects on society.
All the time we have to try to sort out the actual reasons that are given publicly from the real motivations that are operating socially and wrestle with that. So I agree that's a difficulty, but I don't think it's one that's distinctive to this case. I think it's familiar in all kinds of discriminations that we make where questions of moral judgment or ethical principle arise in politics. Even take tax cuts. Is someone really offering a tax cut just to cater to the base, selfish preferences of the people to whom he's promising it, or does he really believe and is there evidence to support that it will increase economic growth? We have this debate all the time. How do we know the answer to that? I could say, Well, it's difficult. We sort of know how to probe that kind of question. I would say that the example you've given is a very good one, but not different fundamentally from what we do all the time.
MR. DIONNE: I will come back to that if I have a chance, but there are too many good people in the audience not to call upon. Janet Rowley, would you like to join us?
JANET ROWLEY: (Off mike.)
MR. DIONNE: William May
WILLIAM MAY: I think Michael has offered an answer to this form of one-sidedness where openness to the unbidden means open to the cancer, this and that, and do nothing about it. Obviously he's not suggesting a quietistic response to the human condition.
You raise the question whether there's a secular way of acknowledging what I would call the two sides to human existence, and I think E. B. White once put it, in that oft quoted line, "Every morning when I wake up I'm torn between the twin desire to reform the world and enjoy the world, and it makes it hard to plan the day." There are two sides to our life. There are two sides to science: beholding nature - the inquiry for the truth - but also molding nature. There are two sides to parenting: molding the child - that's surely our responsibility, surely to fight disease and so forth - but there's a tendency in our society - not simply as a meritarian culture, but an immigrant culture - to overlook simply the savoring. Auden once said there's a terrific pressure in American life because so many came over in order to justify a better future for their kids - to expect their kids to outstrip them and to resort to any and all means to ensure this outstripping of the parents' more constricted life in Europe.
There are all sorts of pressures towards one of the two sides, and I think that's what Michael's paper is about. Now, that doesn't mean we can redo the American character, but one needs to learn how to lean against the weaknesses in our color - our character, our drives, and our dispositions. There's a powerful drive to control.
What one has to deal with - I heard a psychiatrist once say the most difficult thing to expose for people who are very controlling is that in their controlling they're out of control, and one has to curb against that kind of one-sidedness. But it seems to me the two-sided nature of human existence is what Michael wanted to preserve. And admittedly once you admit there are two sides to the life that we live, it's always difficult to make that operational. That's why no matter how much elucidation to the complexity of being human there is, every new generation has to face afresh these difficulties of how you make operational a life that is admittedly, as E. B. White said, very complex from the get go when you wake up in the morning.
MR. DIONNE: Thank you. Did you have a response?
MR. SILVER: I'd like to respond to that. I see nature through a biological lens, since that's what my training was in, and there are a lot of instincts I believe that we have - normal human beings have. We want to see connections to our children, which is actually what I think will avoid the radical abuses of the technology that you're talking about. I wouldn't feel connected to a basketball son, for example. So people generally want their children to be pretty much like them, just a little bit prettier and a little bit smarter. Right? I wouldn't want a child to look totally different from me. I treasure the fact that my children have something from me, and so I don't think that we're going to have this kind of thing where parents are going to run off and there's some ideal beauty, which of course is different all over the world, and we're going to latch onto that.
I think that is normal human nature, and I think the word control may not be the right word, because again there's an instinct among all mammals to provide for the survival and the success of their children - not just human beings, but other mammals as well. So I think parents can be overcontrolling, but I think the basic instinct is because they want their children to succeed because that's the way we're wired.
MR. DIONNE: Michael, do you have a thought? Dr. Rowley
MS. ROWLEY: Well, I'm going to take the refuge of scientists, which is to be more concrete. I certainly appreciated the opening remarks of Dr. Silver because I feel also that bioethics - though I've been educated by my colleagues on the Council now for more than two years, I still feel quite uneasy in discussing many of those principles from the standpoint, say, of ethics or philosophy. I'm going to make two comments.
One is that I think that if you look at the reality of the situation, we're a very, very long way from being able to put genes into embryos or into young children and actually be able to control how those genes function to change complex traits. Simple traits and single genetic diseases - that certainly may come sooner rather than later, but to really think about this as a prospect in that sense, I think, is not realistic. And many of the cultural problems that we've been talking about are just that. They're, as you say, low-tech: eating too much, ways of gaining something rather than from very sophisticated science.
The other remark I want to make, and I will preface this by saying I have the utmost admiration for Michael Sandel, but I do want to take exception to the end of his talk, which is also similar to the end of the article in The Atlantic Monthly, which is the unplanned vision of what we're doing with genomics. He suggests that in fact the story is backwards and we can view genetic engineering as the ultimate expression of our resolve to see ourselves astride the world. Now, that assumes that science is monolithic. That assumes that there is really a plan - that back in the '30s and '40s somebody knew what understanding DNA and manipulating DNA - what it was going to lead to. At least in my own view, nothing could be further from the truth.
Science is chaotic. Science is haphazard and discoveries are haphazard, and then people put them together. The discovery that DNA carried our genetic information was made in the '40s. Watson and Crick and the double helix was in the middle '50s. The discovery that bacteria contain substances - enzymes - that cut DNA and that using these enzymes from bacteria you actually could take DNA and cut it into hundreds of millions of pieces and then identify the gene or the DNA that you want and select it out of these hundreds of millions of pieces - And then finally that you could move DNA - these little pieces of DNA, put them in carriers, put them in other cells, and change those other cells. This was strictly haphazard, and there was no sense that there was a resolve to see ourselves astride the world.
MR. DIONNE: Thank you. Mike, please.
MR. SANDEL: Well, I wouldn't dispute for a moment Dr. Rowley's account of the haphazard unfolding of the genetic revolution. I think it's a more difficult question to know just how the newfound genetic knowledge fit with and reinforced currents in the public culture and in the moral culture and that aspired to a certain kind of project of masteries. So I would not suggest that there was some conspiracy on the part of scientists to come up with this thing for the sake of mastery. No. Scientists were haphazardly making discoveries that then had applications of medicine in cures. Yes, that I wouldn't question. But I am intrigued to notice and at least reflect on the strains in the culture that give a kind of momentum to this, taken as a kind of cultural motif.
And here is where I was struck: the linking of the two I found in this Robert Sinsheimer article, which was written in the late 1960s. He was a molecular biologist at Cal-Tech. About 35 years ago he glimpsed the way this might unfold, and he emphasized both the science and the human self-understandings that were at stake here. And that interested me a lot, and that was really what I was referring to by this suggestion that there might be an interplay here between the science and a petty human self-image.
Sinsheimer first described the benefits to humankind, medical and otherwise, but then he talked very much in terms of the human self-image. He said, "As we enlarge man's freedom, we diminish his constraints and that which he must accept as given." So now he's talking in almost cosmological terms. And he talks about Copernicus and Darwin, who demoted man from his right glory at the focal point of the universe, but the new biology would restore human beings to their place at the center. And so he's going all the way back looking on the history of science in relation to its impact on human self-understandings, and then he concludes: "We can be the agent of transition to a whole new pitch of evolution." This is a cosmic event. That's Sinsheimer. It was really reacting to that prescient in a way and also evocative account of the link between science and human meanings, and even for a certain picture of the cosmos, that led me to offer that speculation.
MR. SILVER: One point I wanted to make is that all of medicine in a sense is enhancement. All of medicine is attacking the problems in nature and medicine's been very good for people who have lived in wealthy countries like ours over the last 100 years. We talked about this earlier, but I think it's very difficult to draw the line between curing disease and enhancement. Would it be enhancement to have a better than average protection against disease? It depends on how you define enhancement.
But I wanted to respond also to what Dr. Rowley said. Different scientists think different ways. In 1970, Jacques Monod wrote a book called Chance and Necessity, and it's a brilliant little book. In the book he predicted that genetic engineering would always be impossible because DNA was too small to manipulate. Three years later, of course, genetic engineering was accomplished with bacteria, and in 1980 genetic engineering was accomplished with mice, and now the tools in the laboratory that we can use with mice - we can switch one base at a time in the mouse genome, so, technically, I would disagree.
If you put a huge amount of money into it, you could figure out how to do genetic engineering with human embryos. I don't think it's going to happen anytime soon because I don't think there's enough there to engineer that we know about at this point in time. I think you're right. We know some things about disease traits, but certainly nothing about the other kinds of things that people might be interested in: intelligence and things like that.
And the last comment I just wanted to make is that it's useful to talk about these things because, just like with Jacques Monod being fooled into thinking something wasn't possible, scientists often overestimate what they can do in the short term and they underestimate what they can do in the long term. I think that's true.
MR. DIONNE: Very interesting.
I have the gift today of being in a room with not just one but two of my favorite philosophers, and I'd like to call on Bill Galston to join the discussion if he would.
BILL GALSTON: Well, in addition to reading Michael's recent article with great attention, I've also read the report of the President's Council, of which Professor Sandel is a member. And as I read that report, it articulates, without quite putting it this way, except once, three kinds of reservations against the thesis that you're advancing. And I'd just like to put them on the table very quickly to give you an opportunity to respond.
The first reservation, which is really up-front in the report, is - and this just piggybacks on what Dr. Silver said - that the distinction between therapy and enhancement, on which a portion of your article conceptually pivots, I believe, is very hard to maintain once you look at it carefully.
The second objection is that many of our judgments about when certain sorts of enhancements are and are not acceptable are relative to the social context within which the proposed enhancement will or will not occur. And the President's Council gives the example of enhancing the ability of soldiers, through the kinds of means we've been talking about this afternoon, so that they can fight more effectively and suggests that we think much better of that possibility than we do of enhancing the ability of athletes, and so that the social context matters.
The third objection is - I think goes to the heart of the argument you're making -a critique of the notion of giftedness and an ethic of giftedness as an adequate guide to our conduct. And the President's Council points out that nature throws up for our inspection all sorts of things, some of which appear quite desirable and some of which much less so. And so beyond the givenness of the natural is a set of judgments about whether what is put forward is good or not good, humanly speaking, and it is those judgments, rather than an ethic of giftedness as such, that ultimately determine what we should do, which I guess brings me full circle to a question that Dr. Silver put on the table, which I'll put this way: Can something be a gift if there's no giver?
MR. SILVER: That's exactly the question that I was asking. In my mind, a gift is given by something or someone, and when we talk about gifts it's usually in the language of God or some other kind of spiritual entity that is giving us the gifts. I've never heard molecular biologists use that language. I'm stereotyping molecular biologists, but they really have a different perspective of the world that people in the social sciences and humanities. So to my mind a gift has to have a giver.
Professor Sandel said we must feel indebted for this gift. Who are we feeling indebted towards? So I'm not denying the importance of religious beliefs in the public arena; I'm just suggesting that that is a kind of religious or spiritual belief and that you can't derive that from secular precepts.
MR. DIONNE: Michael?
MR. SANDEL: Okay, well, a lot of interesting questions there, and I want to come to this in a minute, but to take Bill's first three questions and then to the big question that he dropped upon us here like a bombshell.
It's difficult to distinguish between therapy and enhancement. What's medical? What's non-medical? Does creating a genetic predisposition to be immune from certain diseases - is that medical or non-medical? Therapy or enhancement? (Unintelligible) - or vaccination a genetic form of a vaccination? Would that be therapeutic or would that be an enhancement? Well, I agree that it's borderline, but I would be inclined to say that it's for the sake of health, and so I wouldn't find it subject to the same kinds of objections that worry me.
Now, to say that it's for the sake of health is to say that we do need to investigate the purpose or the good to be advanced by the intervention and the wooden distinction standing by itself between therapy and enhancement can't give us that, so yes, I agree entirely. We have to enquire to the purpose, the point, the end, the good that's being advanced.
As between the soldiers and the athletes, I don't think it's obvious. The soldiers are performing a great good. The athlete is a good, but arguably a lesser one. Still, if the -
MR. DIONNE: Say that to a Quaker baseball fan. (Laughter.)
MR. SANDEL: If the genetic alteration of the soldiers is not for the sake of health - their health - then I think it would be subject to the same kinds of worries that I would have even if my favorite Red Sox player were - I mean, the cause can be great there, too, if it were the last day of the playoff against the Yankees and if only Pedro Martinez had a little more endurance or, if lacking the ability to increase his endurance genetically there were a way of providing a cognition enhancer for Grady Little, I would have been - (laughter) - I would have been tempted.
MR. GALSTON: Be honest. If you could have spliced a new gene into Bill Buckner, would you have? (Laughter.)
MR. SANDEL: Right, but I think the general point is that in all of these cases what matters is not the distinction between therapy and enhancement itself, but an enquiry into the purposes, to the goods, to the ends for the sake of which the intervention is justified. And in that - and the argument does have to hang on that, but having said that, I don't see that as conceding that the ethic of giftedness is not doing moral work here because part of the account of the good that I would bring to bear - part of the account of the human good - is one that sees as impoverished a mode of life that is bent on a certain kind of freedom as mastery or dominion, which is why I try to show how that self-image was implicated in the project of enhancement. Giftedness is a way of beginning to work out at some general level an account of the human good at least insofar as our stance toward nature and our own nature is concerned; though I agree; that general account by itself won't be enough to decide each of these cases.
Finally, doesn't a gift presuppose a giver? I'm not sure. I think that's an open question. At least I wanted to pose that and to leave that as an open question. It seems to me in trying to work out an ethic of giftedness as an ethic of restraint on the kinds of human hubris that lead us to hyper-parenting or to genetic engineering. I think it's possible to give multiple accounts of the source of that ethic and the source of those restraints, and the three leading sources are God, nature and chance. And I agree that trying to pursue each of those three might lead us to different accounts of what it is to try to honor an ethic of giftedness and to generate some restraints on the project of mastery, but I wouldn't want too quickly to decide the question. I don't think it's an easily decidable question whether an ethic of giftedness that gives rise to a certain restraint on human dominion over nature and our own nature does or doesn't require religion.
I do take this project as a whole as a way of trying to bring back into public discourse as a live issue that question. And there's a resistance to bring that into public discourse because we get very uneasy when theological or metaphysical kinds of issues come into public discourse. So I definitely want to lean against that resistance in our culture, but I don't want to do it in a way that just presupposes an answer to the question you posed, in part because I'm not sure of the answer. I want to open that up at least for public argument and debate.
MR DIONNE: Doesn't Bill's question - does there have to be a giver? - help explain why those who are religious, who do believe in God in some way, are far more likely to resist mastery, to endorse humility, then? And that for people who do not believe in God that is a much more difficult argument to make to them the one you're making?
MR. SANDEL: It's a good question, and I'm not sure because there are some religious traditions - and the Puritan tradition in the founding of the American character could be an example - that laid very great emphasis on human initiative and the human vocation to transform the world. That's a powerful part of the American character in a certain idea of the American idea of freedom and mastery. And then there are other very powerful religious sources that emphasize humility, restraint, the restriction against not wanting to play God.
So I think there are religious sources for both ethics and I also think - maybe this is less clear - that there are ways of tapping into secular modes of reflection on both sides, or at least I'm trying to invite even those who don't think of themselves as religious or coming to a notion of giftedness through a faith tradition, trying to invite secular people who have certain intuitions that a way of making sense of those intuitions is via this idea of giftedness.
Put aside genetic engineering. Think of debates around environmental politics about the status of nature and whether the reason for environmentalism is to keep the air clean for our children and to avoid suffocating and so on - greenhouse gas's terrible welfare effects, or is there also something about a certain way of expressing our stance towards nature that is important in its own right? I want to point to features of our moral intuitions and even public debate that already implicate even secular people in something like this idea. That's why I don't want to decide too quickly or in a too hard and fast way how much of this is religious and how much of this is secular. I want to blur that. I want to kind of open that question; not decide it.
MR. DIONNE: If I read the clock right, we have hit 5:00. I think we started late. I'd like to add five minutes to the program. I just want a show of hands to see how many people would like to join the discussion. Could we just take the four people here? Could each of you make very quick comments and then I'll have the -
MR. SILVER: Could I just have one little response?
MR. DIONNE: Sure.
MR. SILVER: I think religion is too narrow a term because there are people who claim to be atheists, but have a belief in a Mother Nature that is a spiritual belief and that drives their attitudes towards things like genetically modified crops, for example, so religion is just one part of a larger sphere of spiritual beliefs.
MR. DIONNE: Indeed a kind of a Mother Nature view, if you will, a certain style of environmentalist is very much opposed to mastery on the grounds that it distorts nature in the same way.
MR. SILVER: Right.
MR. DIONNE: Thank you.
JOHN KECK: Hi. My name is John Keck. I'm actually a physicist, but I've studied a lot of philosophy on my own. I just wanted to observe there's one thing you need to know that without which this whole debate spins into a hurricane, and it also makes the entire history of the 20th century and its incredible loss of blood and all completely incomprehensible. And that fact is that in the scientific revolution one of the babies they threw out with the bathwater is teleology, which is the basis of ethics. And of course the whole scientific conception of nature is it's just matter in motion. It has no purpose, no meaning, no value beyond itself and so, it doesn't matter if I put a bullet in your head - you're just a random agglomeration of molecules.
This is why this discussion is so important, because science for the past, 300 years, 200 years, 100 years has just been completely unguided by any kind of ethical principles. There's a story about an Aeroflot flight and the pilot gets on the intercom and he says, Comrades, I have good news and I have bad news. The good news: we make excellent time. The bad news: we don't know where we're going. I mean, this is America writ large. I mean, writ small.
MR. DIONNE: Could I ask you to just get to your point? I'm sorry to do that, but I want to bring the other folks in.
MR. KECK: Okay. Well, I mean, I just want to say that Darwinism in general, it's not something you want to argue for radical principle because it eliminates all ethical principles period. And there's also a conception of evolution - they don't take it into account of more cooperative - like Vidaf Kapra (ph) as a concept of evolution.
And then also, I mean, if you look also at the giftedness not only of who we are, but of our political beliefs -a great man wrote a couple hundred years ago, "We hold these truths to be self-evident, that all men are created equal and endowed by their Creator with certain inalienable rights." I would submit to you that you can't derive liberal democracy from secular premises.
MR. DIONNE: Thank you very much. The lady right in front there. Please. And if everybody could stay short because I just want them to have a chance to respond. Thank you.
CYNTHIA COHEN: I'm Cynthia Cohen from the Kennedy Institute of Ethics at Georgetown. I was just wondering how, Professor Sandel, you would translate your ethic of giftedness into social regulations, laws, rules. Professor Silver was saying we live, basically, in a society in which there's not a level playing field, so that to expect people to voluntarily forgo enhancing their children may be asking a bit too much from them. Would you regulate prenatal genetic diagnosis so that parents could not select the sex of their children? Would you regulate the use of hormones so parents could not make their kids taller if they were basically healthy, but only of average size?
What you would be doing in terms of social controls about this?
MR. DIONNE: Thank you for that excellent question. I really appreciate that.
JOAN SCOTT: Joan Scott with the Genetics and Public Policy Center. This was an excellent, excellent discussion and I thank you very much for it. We just completed in this last year focus groups around the United States in six locations - 21 focus groups having similar conversations with general Americans, and you don't need to be ethicists or scientists to be able to hear these very nuanced kind of conversations like we were hearing today being discussed by a lot of different people. And there was this general feeling about overwhelming support for genetic technologies, but this unease that we've been hearing about today when it comes to using these technologies for things that are considered more frivolous. And you hear the word vanity being used a lot and shadiness even.
And we asked the question, If you think there should be limits set around these technologies, who do you trust to set those limits? And people were very troubled about who they felt should have that kind of control around the use of these technologies. So it was a very, very interesting discussion and occurring from a lot of different people at a lot of different levels.
MR. DIONNE: Thank you.
GARY MITCHELL: Thanks. Gary Mitchell from the Mitchell Report. There's one of these in every session, and I guess I'm it, but let me do it quickly. It comes from a non-scientist. I took a college biology course in which I was introduced to the notion of ontogeny recapitulated phylogeny and it was the only thing I remembered, and I tried forever to sort of turn everything into that as the metaphor.
So I'm fascinated by metaphors and in particular the metaphor of the notion of Promethean intervention, and I want to take it far afield and say that as I think about that metaphor and the context in which you're discussing it here today whether it has application in a far afield notion and I was thinking of Iraq as a Promethean intervention and wondering whether it will lead to the, if you will, the introduction of the gene for sustainable democracy in that part of the world. And I don't really mean that in a partisan way, but I really wonder whether there isn't some learning we can do about Promethean interventions in that sense from the level in which you're thinking about it here.
MR. DIONNE: And while we're at it, can we have a gene to create new political parties? Because you could imagine the new line of work for political consultants: sort of fix the election way in advance.
Can you be real fast because we are going over? Thank you.
Q: Ani Dulfig (ph) in Stockholm Institute of Transition Economics. I wanted to bring in an aspect that hasn't really been discussed: the fact of competition between countries. We've talked a lot about what U.S. might try to do. What the policy - what the laws - American opinion, you said in six places in America. But what about the fact that some scientists have left the United States to work on stem lines outside the U.S.? What about Johns Hopkins expanding the campus in Singapore -their medical campus? What about the fact that countries might attempt to use this as a competitive advantage for whatever the purpose is?
So that's something that needs to be included in the debate of how we want to pursue this technology. The U.S. chose to open the nuclear Pandora's box when faced with the danger of Nazis. We do have a future to contend with outside the United States. It's not just our decision.
MR. DIONNE: Thank you. So to all these very good and profound questions, you have a few minutes to reply.
MR. SANDEL: Well, a lot of questions. On overturning teleology at the scientific revolution, that's true, but there may be a way to bring - teleology is just a big name for purpose or end or telos, and what I'm suggesting here, and this goes back to my attempt to respond to Bill Galston's question, I am trying to suggest a mode of political discourse that not only makes room for spiritual and theologically laden questions, but also with that is a discussion of human purposes and ends, the kind of discourse that would also be hospitable for debate about and reflection on the proper purposes, ends, proper telos of human beings and human flourishing.
As in response to Professor Cohen's question about what actual public policies or regulations would flow from the kinds of concerns that I mentioned, well, here I would tread carefully, partly because I don't have a worked out list of regulations to propose for you, but the issue of the human growth hormone for height enhancement was raised. Here is a case where the FDA already regulates the use of human growth hormone and, as I mentioned, just extended the use to go beyond the medical use - but still to a very narrow set of permissible uses. So I point to that example only to suggest that this is not a new question, that we already do regulate not only the practices, but also the reasons for practices, in this case height enhancement. And I think it's sensible that we consider the reasons as well as the practices themselves.
In the case of sex selection, I would draw a distinction between those who want to select the sex of their child through preimplantation of genetic diagnosis to avoid a sex-link genetic disease. I would have no objection to that. If it became a common practice simply for a consumer-based sex selection, then I think that would be worrisome. What would be my public policy remedy? I don't know, but I would probably favor discouraging it in some way or other. I don't know what the right way to do it would be.
Consider the ads and the donor catalogs for sperm banks and for eggs - the designer egg I mentioned. I think it might not be unreasonable if eugenic practices like that became widespread and came to pose more of a threat than they do today, then one thing one might do short of banning those practices, because it's hard to delve into the reasons and the motives, would be to say you can't advertise. You can have a commercial sperm bank, but you can't advertise the eugenic features of the sperm you're selling. That might be a reasonable regulation short of banning, but a way of registering our unease with the catering to eugenic consumerism.
Cosmetic surgery is an example we have now that it exists. I don't admire people who go in for purely elective cosmetic surgery. I don't think it's admirable. I don't think it should be legally banned because I don't think it's a grave enough harm, and I would certainly distinguish it from reconstructive surgery, but here's one idea - I don't even know if I'm for it, but it's the kind of think one could discuss - what about dealing with cosmetic surgery, which is a vice - it's a small vice, it's not a grave vice, it's a small vice - deal with it the way we deal with other vices: with a sin tax. So if you go in for a purely elective cosmetic surgery, we'll tax you and with the proceeds from that tax we will subsidize reconstructive surgery for those who need it and can't otherwise afford it, or other worthy things.
These are some stray thoughts on how this ethic might embody itself in our public life.
MR. SILVER: Yeah, I'd like to make two points and then respond to the question of where morality might be able to come from if not from spirituality. If you go back and read Mary Shelley's Frankenstein, written 200 years ago when she was just 17 years old, there's this whole debate about whether it's moral to cheat death and Victor Frankenstein was trying to cheat death. In fact, that's what we do every day when we apply medicine: We cheat death. And people overcome this initial instinct to think that that was cheating death; meaning cheating what God intended for you.
The second point I'd like to just tell you about because it was a shock to me last year when I discovered it. I'm an asthmatic, which means that I carry around this little medicine with me wherever I go, and I discovered last year when I was teaching my course that a woman who was in my course who was on the women's crew team at Princeton told me that 60 percent of the crew team was asthmatic. Now, I don't believe that's true. I think that what's going on - when I talked to my asthma doctor about this - is this will increase lung capacity for everyone and this is an enhancement; so these kids are pretending that they're asthmatic and it's a continuum and where you draw the line. It's very difficult. Of course you can draw lines, but every line is arbitrary. It's very difficult to draw lines.
The last point I wanted to make is where morality can come from other than from religion, and the other answer is biology. There was a book by Robert Wright called The Moral Animal, which suggests that morality is encoded in our genes because it provided for a benefit - a community benefits and then the individual benefits, which is the whole basis for liberal democracy.
MR. DIONNE: Thank you very much.
Q: (Off mike.)
MR. SILVER: Well, we have no idea how it's encoded.
MR. DIONNE: You can continue this conversation next door, which is what I wanted to say. I don't want to keep anyone from a drink, ever. We are having a reception next door.
I want to close with three things. First, The Economist magazine actually once criticized me for writing such long acknowledgements that they ran it under the headline "Gratitude that Grates." (Laughter.) That's true. I've always been proud of that, in fact, but I must thank Luis of the Forum and Strobe Talbott and Carol Graham of Brookings for being very excited as soon as this idea was promoted. And thanks so much to Kayla Drogosz, who worked so hard on this. Katherine Moore, Sandy Stence and all the folks at the Pew Forum.
This will be available online at www.pewforum.org and at www.brookings.edu and I urge all religious microbiologists to write a letter to Dr. Silver.
The last thing I want to say: One of my favorite lines in the world is the end of Michael Sandel's book, Liberalism and the Limits of Justice, where he makes the case for politics by saying, "In politics we can know a good in common that we cannot know alone." And I think they've shown today - our speakers and our audience - that we can arrive at a greater wisdom in common than we ever can alone, and I thank you all so much.