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