Who Is Human?
In myriad ways we have all experienced the effects of the accelerating tidal wave of technology. That yet another historic threshold is about to be crossed is not news, given the rate at which new advances are accumulating, but few realize that this threshold, unlike others, will lead to irreversible change in the very nature of humanity itself. I refer, of course, to the emerging technology for altering the genome of our species, homo sapiens. Let us take a hard look at this emerging future, setting quick moral judgements aside for the moment in order to remain clear and dispassionate about what is likely to happen.
Athletes have been augmenting their abilities to perform for centuries, using special training regimens, special diets, slow-acting drugs to improve muscle growth, and fast-acting drugs to improve performance during competitions. The technology of athletic enhancement has advanced steadily along with all other forms of science and technology. Medicine and surgery have been improving as well, even more rapidly and dramatically. We now routinely transplant vital organs, repair malfunctioning joints and tissues, implant electronic pacemakers and medicine dispensers, and manufacture a growing assortment of prostheses and mechanical aids. Almost without exception, humanity has welcomed these developments with gratitude. The repair and augmentation of the mechanical and physiological foundation of individual people is now universally accepted, as commonplace and unquestioned as the repair and augmentation of our automobiles.
Each and every improvement in the technology of human augmentation creates a new problem for our legal and ethical systems to resolve. Let us take a closer look at four such issues, and their evolving outcomes.
Humanity of athletes
In sports, most competitions are now governed by rules that prohibit performance-enhancing drugs. This has not been without controversy, however, and it may well happen that some sporting events in the future will allow unlimited augmentation. In those sports where augmentation of any sort is permitted, the ability of drugs and prosthetics to give athletes a competitive advantage will create a powerful incentive to use them, and to develop new and better enhancements, limited only by the costs incurred. In other words, all the forces of free market competition will come to bear on the development of enhancements designed for this sport, potentially transforming both the sport and its athletes in ways that can only be guessed. When participation in a sport becomes conditional on radical enhancement, are such athletes then, in some sense, more than human?
Humanity of the dying
In medicine, the invention of ever more effective means for prolonging organ life long after the cessation of cortical activity has forced changes upon both medical law and medical ethics with respect to treatment near the end of life. Some new medical treatments are now so expensive that further changes can be anticipated in the very near term, possibly including two-tier or graded health care systems, in which certain treatments are conditional on ability to pay, or on physical condition. Whether this is good or bad is a subject for a different essay; what is important here is the question of the right to treatment. Medical ethics since the time of Hippocrates in effect grant every suffering human the unconditional right to medical attention. If medical attention becomes conditional on means to pay, or on physical condition, are we then treating the poor and the desperately ill as less than fully human?
Humanity of the fetus
Turning now from end-of-life issues to start-of-life issues, steady advances in the care of premature infants have led to ethical conflicts and concerns about the proper balance between maternal and fetal rights during each epoch of gestation. The cultural battles over abortion are, I believe, driven by advances in medical technology. These advances will only continue, because our relatively free market for medical innovation quickly translates the urgent demands of anguished parents of premature babies into a powerful economic incentive for technological innovation. Again, whether this are good or bad is not the subject of this essay. What is important here is that we have been forced by these developments to rethink and redefine the beginning of human life, and the competing rights of mother and fetus. Does a viable human fetus have less than full human rights, and if so is it then, in some important sense, less than fully human?
It is one thing to use chemicals or genetic manipulation to alter your own personal development and performance, but it is quite another to change the genes that you pass on to your children, a process known as germ-line engineering. Such feats of genetics are now visibly on the horizon, no longer the domain of science fiction. There are at least three groups who can be expected to push hard for germ-line enhancement: (a) parents anxious that their children have the very best advantages that money can buy, (b) athletic organizations who will profit from the production of genetically superior athletes, and (c) military and paramilitary organizations who wish to develop genetically superior soldiers. Each group will be asking themselves, "What if we don't make use of this technology? What chances will our offspring/athletes/soldiers have then?" This inexorable logic, pursued by millions of independent decision-makers around the globe, will ultimately overwhelm any attempts that governments may make to eliminate, regulate, or curtail germ-line engineering.
In short, germ-line manipulations will soon have an effect on the human genome, as new genes are introduced and old unwanted genes are suppressed and pruned away. As Bill McKibben pointed out in his book Enough: Staying Human in an Engineered Age, parents who tinker with the genes that they pass to their children are exercising a choice, but the ones most affected by this tinkering the children themselves do not get a choice. For better or for worse, they must live with the genes that they have received. This feature alone complicates the ethical landscape of germ-line decisions, but there is more, much more.
As the human genome is shaped and diversified and pruned over succeeding generations, there may arise a subpopulation who will have diverged so far from standard humanity as to be unable to breed successfully with people outside their subgroup. This is called speciation: a new species of genus homo will have emerged, something other than our familiar homo sapiens. They may be superior or just different in critical ways, but there is another possibility too. They may be designed to be inferior, with subhuman intelligence and a docile manner, intended for use as utility drones, domestic servants, or even slaves. If such new subgroups represent new species within genus homo, will they be considered fully human? Will humanity expand its self-definition to be inclusive of all parallel species, or will its self-definition fracture into violently-defended narrow confines?
Who, in the end, will be human?
If the past history of humanity is any guide, then we can say with perfect confidence that there will be people on every side of these issues, each claiming the moral high ground and arguing vociferously against all others. Some will argue for strong government regulation and careful scientific testing, others will argue for an absolute ban on all germ-line genetic engineering, and yet others will demand free and unfettered genetic experimentation. Many nations will pick one of the first two options, but it is likely that a few will pick the third, and that many will turn a blind eye towards clandestine experimentation. Very slowly at first, then with accelerating speed, the gene pool of humanity can be expected first to expand and then to bifurcate repeatedly into an astonishing exfoliation of new species and genera. We will have entered a transhuman future, no matter which side gained the advantage in the debate over morality and ethics.
Will this development be a biological catastrophe for humankind, or the dawn of a new and glorious future? I submit that we cannot even approach an answer to this question, based on what we know now. Nevertheless, there is one crucial moral and spiritual aspect of this visible future that we must decide, as rapidly as possible, because the answer will indeed make a difference. It concerns this single most important question: Who is human? If, as has happened from time to time in the past, one part of humanity labels another part non-human, then civil war and mass killings will follow. The world needs enlightened moral leadership on this point, and it needs it now. If we ignore this question then transhuman racism and bigotry will make our social conflicts over slavery, women’s suffrage, and abortion look like a walk in the park.
For the record, I strongly support a very broad biological definition of human life, to include every new species and genus descended from genus homo that is capable of conscious thought, and any human augmented with artificial organs or computers, regardless of intelligence or wealth or physical or mental condition. I define the end of life as the irreversible loss of consciousness. For the start of life I prefer a graded definition: the extent to which a fetus is alive and fully human is measured by its probability of survival outside the womb.
Ethics versus Economics?
Alas, I fear that those concerned about the pace of development of biotechnology will simply recapitulate the failed attempts of recent years to stop genetic engineering, employing a dismal combination of moral denunciation and fear mongering. It’s time for a new approach.
If there is one thing that economic research has taught us, it is that people and institutions tend to make decisions based primarily on the pattern of incentives they face (costs, benefits, risks), and only secondarily on moral principles. Yet too many religions still persist in their age-old behavior: they rush to moral judgement on every issue while ignoring the incentives faced by real people in difficult situations, and in so doing place themselves on the periphery of the real debates and decisions. If morality and ethics are to gain any traction at all in the evolution of biotechnology, it will be because we will have finally taken to heart the way real people make real decisions. Our choice need not be Ethics versus Economics, as it has been seen so often in the past. Instead, it can and should be Ethics with Economics. Here is another way of saying it: alter incentives and behavior will change; beat the drums for morality and nobody will listen. This is one of the topics we will be exploring in future letters of The Quaker Economist.
Sincerely your friend,
Interested in some readings? Here are three from the go-slow line of thought:
Here are three from the full-speed-ahead line of thought:
And here is a good medical article on the definition of death:
I am writing anyway to tell you how enthusiastic I am about this issue. Wonderful!
Since working in Africa 15-18 years ago, I have tried to talk about the absolute hatred and demonization of one tribe by the others (even among many African Quakers) and the history of strife and even genocide between tribes. American Quakers and many others don't want to hear it or believe that it is possible. Often, they have visited or even worked in Africa and have been shown only the F/friendlier side of African culture. That face has been the one shown to "misungu" (foreigners, in Swahili) since the early days of Colonialism. They say my observations must be the result of racism on my part (I'm a born Southerner with an accent). I see HIV policies as examples of choices being made along tribal lines right now, as well as ongoing genocide in some parts of the continent. Given the opportunity, I'm quite sure that many Africans would choose genetic modification to achieve tribal power and control. Often the answer to your "Who is human?" question in Africa actually depends on which tribe (and economic condition) a person happens to have been born into.
I'm sure, too that on the basis of racial/ethnic/economic differences the same sorts of hatreds exist and are determining economic, social, medical and military choices and policies in the rest of the world as well. Having resettled refugees and immigrants for many years I know a great deal about some of those differences and issues, but I am met with disbelieving stares and suspicion when I speak publicly about them. Often, people understand some ethnic issues but cannot generalize that understanding to other populations. Even more often, people understand economic oppression of one group of people and cannot see it operating against others.
I am also deeply concerned about the effects of widespread cultural preference for boys over girls in much of the world. We already have a considerable problem with imbalance between the male and female populations in many countries which is likely to lead to wars and strife when huge numbers of young men cannot afford the bridal price of the diminished number of women left in their area of the world. Genetic modification could make that situation far worse. The "Who is human?" question has included sexual differences since the dawn of recorded history.
Years ago I worked in medical research and healthcare management, mostly in maternal and child health and handicapped children's services. In the course of that work I encountered many issues, often embodied in handicapped children who were kept alive by well-meaning parents, doctors, and nurses only to live lives of excruciating pain and torture, who should have been allowed to die at birth. I truly understand how hard the decision making process is, how full of pain and emotion for both families and medical professionals. I supported the development of trained and empowered patient advocates, even for tiny and often premature babies, so that everyone involved would have to face the consequences of their decisions and be required to participate in frequent reevaluations if those decisions proved ultimately to be questionable.
I strongly support both your conclusions and your intention to continue exploring these tough issues and hard questions. However unpleasant, these are the issues which must be addressed and thought through, especially by Friends.
Janet Minshall, Anneewakee Creek Friends Worship Group, Douglasvillle (GA).
I'd like to hear more about how we make decisions on these ethical dilemas. The hard part is not in describing the issues but figuring out how to reach a helpful solution to them. I'm not sure how your final 'Ethics and Economics' formulation would work to solve any of them.
In addition, is there a particularly 'Quaker' way to look at them? And, what if the economic ways diverges from a Quaker or Catholic or Hindu way of seeing an issue? How do we decide? Perhaps you could spin out a scenario about how you might see your combo-plan solving one of them say the athletes and drugs issue.
Good points, good questions! I will elaborate further, with examples, in future letters. Meanwhile, I will simply say that I do believe there is indeed a particularly Quaker way of looking at these issues, one which complements and enhances the purely economic approach. Loren
A splendid analysis of the issue, Loren! Thanks for stating your position clearly at the end. Concerning your concluding dictum: by "incentives" are you implying economic incentives? And by "morality" are you giving this little weight as an "incentive?"
Thanks for picking up the torch of TQE.
Norval Reece, Newtown (PA) Meeting.
In the late 1950s there was a great seafood restaurant in Louisville called Leo’s Hideaway. A black couple came in and was seated and a table of white folks stormed out cursing. Leo went to the door and said to his remaining customers, “Well, my friends, I guess there is some business I just plain don’t need.” The next time we went in Lincoln’s Emancipation Proclamation was on every table and we had the first integrated restaurant in Louisville.
Lee B. Thomas, Jr.
I am disappointed that TQE #114 had the words "tidal wave" in the first sentence and was posted on January 5, 2005, but yet did not address the much more relevant tsunami disaster. I realize that editing deadlines and time commitments are what they are, but I exhort you to pull TQE #114 off the shelves immediately in order to write an essay to comment on the economics of governmental foreign aid and private foreign aid. How can this not demand your full attention over the importance of bioethics?
David Myers, Westbury Monthly Meeting, Long Island, NY
If only the religious moralizers, both sacred and secular, could realize how their posturing marginalizes them. I was in a meeting with the Secretary of the Interior once upon a time to present the results of some policy analysis on an offshore oil field issue that had to be resolved. All of the Assistant Secretaries had gathered except for the guy from Fish and Wildlife. After a sufficient wait someone suggested the meeting proceed without him with the justification that "we already know what his position will be!"
Bob Davis, economist in Boulder, CO.
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Copyright © 2005 by Loren Cobb. All rights reserved. Permission is hereby granted for non-commercial reproduction.