In October 2003, the President’s Council on Bioethics published Beyond Therapy: Biotechnology and the Pursuit of Happiness. This three-hundred-and-some-odd-page report summarizes the Council’s reflections on a wide variety of ethical issues that recent advances in biotechnology—from gene therapy for fetuses to the development of psychotropic and “age-retarding” drugs—have forced upon the public’s attention. This volume now has a mate: Being Human: Readings from the President’s Council on Bioethics.
Each of these books is surely among the most unusual of documents ever to roll off the presses of a government printing office. (Both, incidentally, are available upon application from The President’s Council on Bioethics, www.bioethics.gov.) Beyond Therapy does address a number of pragmatic questions. For example, health care already accounts for about one-sixth of our GNP; many new and promised biotechnological innovations are immensely expensive: how can we make advanced health care both equitable and affordable? But the real interest of this book lies elsewhere—where the practical and pragmatic meet the spiritual. Beyond Therapy is a work of earnest ethical and philosophical inquiry, replete with chapters devoted to such questions as “What Are ‘Happy Souls’?” and such subjects as “The Roots of Human Happiness” and “What Sorrow Teaches, What Discontent Provokes.” It is not, in other words, your typical farm report, legislative digest, or statistical summary.
Being Human is a source-book for informed reflection on the constellation of issues that Beyond Therapy broaches. A plump six-hundred-page chrestomathy of literary, philosophical, scientific, and religious writings, it ranges from Nathaniel Hawthorne’s story “The Birth-Mark” to selections from René Descartes’s Discourse on Method and Kant’s ethical philosophy, from writings by contemporary scientists such as E. O. Wilson, Richard Feynman, and James D. Watson to classic passages from St. Augustine, Homer, Tolstoy, the Bible, John Ruskin, Robert Louis Stevenson, Flannery O’Connor, Francis Bacon (the philosopher, not the painter), and many others. It’s a rich mélange of a book, traveling over multifarious topics, genres, and moods as well as several millennia.
Together, these books offer a profound meditation on the knot of questions that must be raised before one can make anything like an informed decision about the momentous issues with which our burgeoning biotechnical prowess confronts us. What does it mean to be human? To be a finite, mortal creature, tied to the past by traditions and ancestors, to the future by one’s tasks, progeny, and aspirations? What is the aim of medicine? The Hippocratic Oath admonishes doctors: “first do no harm.” Is that ethical imperative compatible with some common medical practices to enhance fertility or terminate unwanted life through abortion or euthanasia?
The chief mandate of the President’s Council on Bioethics is “to conduct a fundamental inquiry into the human and moral significance of developments in biomedical and behavioral science and technology.” The Council includes several distinguished scientists, doctors, and scholars. But the tenor of these publications owes a great deal to its chairman, Dr. Leon R. Kass. In Toward a More Natural Science: Biology and Human Affairs (1985), Dr. Kass meditated on “the relation between the pursuit of knowledge and the conduct of life,” articulating along the way many of the principles that Beyond Therapy applies to particular ethical problems. No one familiar with Dr. Kass’s work will be surprised that Beyond Therapy proceeds more in an interrogative than an apodictic tone: “the wisdom-seeking,” as Dr. Kass writes, “rather than the wisdom-delivering” spirit. At the same time, no one familiar with Dr. Kass’s work will be surprised that the interrogative spirit he adopts is also a troubled spirit: behind the inquiry of Beyond Therapy is the concern that “tremendous new biotechnical powers may blind us to the larger meaning of our own American ideals and may narrow our sense of what it is, after all, to live, to be free, and to pursue happiness.”
Towards the end of Beyond Therapy, in a section of “General Reflections,” the authors articulate the underlying view of humanity that guides their inquiry. “When it comes to human biotechnical engineering beyond therapy,” they write,
only if there is something inherently good or dignified about, say, natural procreation, the human life cycle (with its rhythm of rise and fall), and human erotic longing and striving; only if there is something inherently good or dignified about the ways we engage the world as spectators and appreciators, as teachers and learners, leaders and followers, agents and makers, lovers and friends, parents and children, citizens and worshippers, and as seekers of our own special excellence and flourishing in whatever arena to which we are called—only then can we begin to see why those aspects of our nature need to be defended against our deliberate redesign.
Descartes promised that science and technology would some day render man “the master and possessor of nature.” By treating nature as material to be manipulated, mankind could gain tremendous power over nature, including human nature. Indeed, Descartes looked forward in particular to great advances in medical science which would free mankind from “an infinitude of maladies both of body and mind, and even also possibly of the infirmities of age.” There is clearly a sense in which Descartes’s promise is being fulfilled. Antibiotics; organ transplants; genetic screening; anesthetics; drugs to enhance various faculties or diminish various incapacities; cloning; stem-cell research; nanotechnology. The advances have been staggering, and are only accelerating. But at what price? Are there limits that scientists should respect when it comes to manipulating human reality? Francis Bacon looked to science “to relieve man’s estate.” But what if our power over nature—including human nature—should allow us to transform man’s estate? Should we intervene not just to relieve “sickness and suffering,” but also “such things as nastiness, folly, and despair?” Should improvement be limited to removing evils? Or should it seek to “enhance” people: to improve memory, say, or blunt or erase memory for those who suffer from painful recollections?
Applied to reproductive technology, these were the sorts of questions that Aldous Huxley raised in Brave New World, a dystopian fantasy that seems less and less a fantasy as “test-tube” babies, surrogate mothers, and genetic screening and (in some cases) modification enter the realm of the practicable and even the commonplace. Huxley imagined a world in which babies were not born but designed according to exacting specifications and “decanted” at sanitary depots like The Central London Hatchery and Conditioning Centre. It seemed far-fetched in 1932 when Huxley wrote. How about today? Beyond Therapy quotes a scientist writing in a National Science Foundation report who predicted proudly that
Future humans—whoever or whatever they may be—will look back on our era as a challenging, difficult traumatic moment. They will likely see it as a strange and primitive time when people lived only seventy or eighty years, died of awful diseases, and conceived their children outside a laboratory by a random, unpredictable meeting of sperm and egg.
“Whoever or whatever they may be”?
In many ways, the fundamental concern that underlies Beyond Therapy is contained in a question posed by James Watson, the co-discoverer of the structure of DNA: “If we could make better human beings by knowing how to add genes, why shouldn’t we?” Had it been expressed in Latin, Watson’s question would have used the adverb nonne to indicate that it was a question to which the expected answer was “Yes.” There is no reason, he assumes, why we shouldn’t intervene to make humans “better.”
But what does “better” mean? Stronger? Smarter? More disease-resistant? Longer-lived? Beyond Therapy articulates the cautionary position that many readers hold:
We want better children—but not by turning procreation into manufacture or by altering their brains to gain them an edge over their peers. We want to perform better in the activities of life—but not by becoming mere creatures of our chemists or by turning ourselves into tools designed to win or achieve in inhuman ways. We want longer lives—but not at the cost of living carelessly or shallowly with diminished aspiration for living well, and not by becoming people so obsessed with our own longevity that we care little about the next generations. We want to be happy—but not because of a drug that gives us happy feelings without real loves, attachments, and achievements that are essential for true human flourishing.
In the preface to Being Human, Dr. Kass notes that the term “bioethics” was coined in 1970 to describe an ethics based on biology, on the scientific facts that explain life. But he pushes the term in a different, a deeper, direction, understanding by bioethics “an ethics in the service of bios—of a life lived humanly, a course of life lived not merely physiologically, but also mentally, socially, culturally, politically, and spiritually.”
It is often said about technology that “if it can be done it will be done.” Perhaps so. But the reflections contained in Beyond Therapy and Being Human encourage us to refuse a further step: the step of saying “if it can be done it may be done.”
Being Human opens with Hawthorne’s “The Birth-Mark,” which tells the story of Aylmer, a dedicated “man of science,” who marries Georgiana, a beautiful woman whose physical perfection was marred (if it was marred) only by a birthmark on her cheek. (“It has been so often called a charm,” Georgiana says, “that I was simple enough to imagine it was so.”) Aylmer persuades his wife to let him try to remove the stigma. At last he devises a potion that does the trick. Georgiana wakes from her drug-induced swoon, sees that the birthmark is vanishing, and seeks her beloved husband’s face.
“My poor Aylmer!” murmured she.
“Poor? Nay, richest, happiest, most favored!” exclaimed he. “My peerless bride, it is successful! You are perfect!”
“My poor Aylmer,” she repeated, with a more than human tenderness, “you have aimed loftily; you have done nobly. Do not repent that with so high and pure a feeling, you have rejected the best the earth could offer. Aylmer, dearest Aylmer, I am dying!”
Alas! it was too true! The fatal hand had grappled with the mystery of life, and was the bond by which an angelic spirit kept itself in union with a mortal frame. As the last crimson tint of the birthmark—that sole token of human imperfection—faded from her cheek, the parting breath of the now perfect woman passed into the atmosphere, and her soul, lingering a moment near her husband, took its heavenward flight. Then a hoarse, chuckling laugh was heard again! Thus ever does the gross fatality of earth exult in its invariable triumph over the immortal essence which, in this dim sphere of half development, demands the completeness of a higher state. Yet, had Alymer reached a profounder wisdom, he need not thus have flung away the happiness which would have woven his mortal life of the selfsame texture with the celestial.
Will we have the wit to avoid Aylmer’s fate? That is one of the questions these profound works invite us to contemplate.
