Why Fear Genetics?

By Marc Lappé

Genetics once again at the crossroads of good and evil. In the past, we evoked genetic ideas to permit atrocities on a mass scale - forced sterilizations, "eugenic" extermination, and ethnic cleansing - all in the name of genetics. Today, the lines between good and evil have become blurred. Many advances in genetics, such as those involving genetic tests of workers in toxic workplaces, performing genetic selection of sperm, eggs or pre-implantation embryos, and designing personalized medicine using "therapeutic cloning," are being promoted for their human benefits. Their proponents have argued for the value of reducing risk at work, minimizing chance in reproduction and eliminating human suffering from disease. But as with previously well-intentioned programs, each has a risk of serious abuse. It is useful to remember history. Not so very long ago, the best minds of European science spoke of the need to identify lives "not worth living," assuring euthanasia of the unfit, and minimizing the future impact of bad germplasm.

Origins

Over its short lifespan, genetics has been transformed from a descriptive science into a technology. "Eugenics," coined by Darwin's cousin Francis Galton, had its origins in the late 1800s. Darwin himself wrote in Plants and Animals Under Domestication in 1868, that only we humans permit the breeding of our worst stock. Less than a century later, we had jumped from a monk using genetic explanations to describe peas to Nazis using markers of genetic inferiority to sort people for gas chambers. In the same period, the United States had sterilized over 120,000 persons in the name of eugenics. Today, genetics is once again in a moral crisis, but one where distinctions are harder to discern.

The word "gene" itself was not coined until 1913 when the English scientist, William Bateson, described the particles he believed carried the information of inheritance. In less than a lifetime, scientists had deciphered the gene's language and structure, sequenced the human genome, and put patented varieties of novel genetic construction into commerce. Now we have used genetic engineering to create a whole new agronomy of gene-modified food crops. We have reverse-engineered human genes to harvest new pharmaceuticals from protein sequences mined from the genome's database. And in the name of national defense, we are once again conscripting genetics to test microbes as agents of war even as we defend against them.

Some would say it is only human nature to want to use new knowledge for human ends, be they selfish, altruistic or belligerent. But our burgeoning knowledge of genes and how to control them has far outstripped our wisdom to use this knowledge for human benefit. Matthew Meselson, one of the most ardent critics of biological warfare, wrote recently that the rapid advances in modifying life not only provide us with new means to destroy life, but also means to manipulate it to alter our thinking and basic development. In pointing to recent efforts to revamp our modes of reproduction and ultimately to control what we inherit from our parents, Meselson predicted "unprecedented opportunities for violence, coercion, repression or subjugation" would follow. Before one dismisses how a contemporary thinker can go from an otherwise neutral, even elegiac appreciation of a new science, to this profoundly pessimistic view, consider how we have used genetics in our recent past.

Short History of Error

In the pell-mell rush to put the new genetics into the service of humanity, even well intentioned people have already made irrevocable mistakes. These mistakes remind us of the vulnerability of genetics to misuse, and to some of the unforeseen consequences of tampering with life.

• The first error has been in failing to recognize the inevitable flaws in the crude, first technologies of gene transfer, leading to genetically modified organisms with distorted genomes and altered chromosomes.

• The second mistake, was in disregarding the biological permanence of manipulating DNA as we move novel genes across species lines. The unfolding tragedy of Mexico's invaluable genetic storehouse of maize varieties, now heavily contaminated with genetically engineered corn, is a current example of horizontal transfer of potentially catastrophic proportions.

• The third mistake has been in permitting the unchecked proliferation of new weapons of mass destruction. Our current catastrophe involving anthrax (apparently from our own laboratories), is a wake-up call of how dangerous a molecularly altered bacteria can be - and how misplaced our own biological warfare program once was.

• And the fourth potential mistake is in the use of genetics to try to alter human heredity, or to create genetically identical clones or stem cell lines.

Commonalities

What each of these examples has in common is the premature use of a new genetic technology, long before its consequences have been fully worked out. In the first two examples, we permitted a tremendous expansion of newly engineered food crops into the agricultural sector before we appreciated the global reach of their genetic contamination potential. In the third, we learned that genetically modified bacteria had been converted into weapons of our own making before we appreciated their heightened infectivity. In the fourth, we are facing a systematic erosion of the protections previously afforded human life in the name of experimentation, leading in at least one instance (that of Jessie Gelsinger) to an unnecessary and tragic death. Some 150,000 pre-implantation embryos from fertility clinics are lying fallow in liquid nitrogen containers without the slightest shred of ethical guidance of how they should be used, honored, or destroyed.

In each of these instances, the use of genetics created an added danger to an already questionable exercise. Unlike prior adventures in agriculture like those of Lysenko in 1920s Russia, agricultural biotechnology produces potentially irreversible effects by altering the heredity of food crops. And what makes us so vulnerable from the possible depredations of biowarfare agents is that we invented genetic variants of naturally occurring agents that could overcome our host defenses - and we did so prior to devising ways to recognize and treat the resulting diseases.

Predictive Power of Genetics

At the root of the most dangerous misuses of genetic technologies lies a misreading of the inferred power of genetics to predict and control biological traits. While this is not the first time we have tampered with nature - we have been domesticating plants and animals for years - it is the first time we have gained control over the hereditary material itself, and with it the chance to alter the composition of our own lives and environment irrevocably. We now face a revolution in the human life sciences, where we plan to alter our inheritance, re-program the course of human development, and ultimately practice genetic medicine on a grand scale.

An Old Ethic in New Garb

So alluring is the attraction of personalized medicine, that we are willing to sacrifice basic moral principles in order to obtain the materials needed to realize a new therapy for a select few. This is particularly true in the instance of therapeutic cloning. Here, scientists attempt to create self-compatible, autologous grafts of stem cells through creation of a new "donor" embryo with the genetic material of the patient's own body cells. By dismissing such human life as mere artifact, researchers hope to deflect moral scrutiny from the fact that a potential life is being sacrificed for one already in existence.

Of greatest concern is that we are using this knowledge with our old set of "me-first" values: many scientists and ethicists alike believe that substituting choice for chance events is an intrinsically noble event. More critically, by playing the relief-of-suffering card, ethicists believe they can justify virtually anything, from permitting self-cloning to produce designer stem cell lines, to altering the heredity of our children to eliminate defects and enhance human attributes. If the suffering is sufficiently extreme, the numerator of the benefit/risk equation from an intervention is so large as to swamp piddling concerns about social justice and intergenerational harms.

Relief of suffering surely is a noble enterprise, but one that must be tempered by compassion, justice and a sense of humility. Do we really believe we know enough to permit this type of research? Where do we derive the moral license to take new life in order to salvage an extant one? Until we can answer these questions, perhaps we should let history be our guide: the premature application of new technologies inevitably generates more harm than good.

In the case of genetics, caution should be our guideword. The unthinking use of genetic models of human qualities led us to the gas chambers and sterilization wards of our own hospitals. The promise of pre-implantation selection of genetically "fit" embryos may reduce human suffering, but it also legitimates a model that is a microcosm of these prior horrific events. To engage so facilely in these mental exercises in genetic medicine signifies a marked weakening of our resolve to never again permit the extremes that led to the Nuremberg trials a half-century ago.

For now, the key dilemma of genetic knowledge is that it shatters the bell-shaped curve of assumed normalcy. Once only chance put one of us at the leading tail where health and mental ability triumph, and another at the trailing end where disease or disability is rampant. Now choice seemingly makes the selection of where we or our children may fall along this curve within reach. The old assumption, that the natural lottery distributes attributes and deficits in equally random ways, is defunct. Such a belief was at the core of one of our cherished ethics - that of Rawlsian justice. In Rawls' system, we could always redress inequalities by assuming each of us could be the victim of chance, adverse events. With the appearance of genetic knowledge on the computer screen, the notion of the lottery of chance events is gone.

Genetics breaks the veil of ignorance once and for all. But it forces us to confront a Faustian bargain. In the near future, we may no longer have to accept, at least for our children's fate, that whatever forces of nature got us this far in evolution will be randomly allocated in the mysterious process of meiosis by which our germ cells are formed. With the advances of pre-conceptual and pre-implantation diagnosis, we can know who will be burdened by gene-based disease, who will be susceptible to infection or cancer, and who will ultimately die sooner rather than later.

What is Needed

To make sure that knowledge is used fairly, we need nothing less than a thorough revisiting of the foundations of our convictions about equality, fairness and justice. In the light of new genetic knowledge, we need a new ethic of Intergenerational Responsibility, one that identifies our short- and long-term obligations for the future. Such duties are implicit in gaining control over genetic material. Ideally, the human impulse to avoid harm will trump the impulse for rescue, and temper our unwillingness to allow chance to play out its hand.

To do so, a precautionary approach is critical. In all but a few instances, genetic knowledge about biological fate is still incomplete and imperfect. For now, we are challenged to restructure our health care, insurance and employment industries in advance of knowing these fateful constructs with certainty, and to act accordingly. In time, how we deal with the least well off will no longer be a theoretical construct, but a moral obligation pegged to foreknowledge of who is doomed to suffer, and who is to prosper.

When that knowledge is available in advance of reproduction, prior to implantation, or perhaps even within the first trimester of pregnancy, many may be offered and perhaps will succumb to the temptation of making a new eugenic choice. I for one, would not want the weight of that unbearable knowledge, save for the most egregious human deformities - and there, more often than not, nature and evolution have ensured that spontaneous miscarriage or unsuccessful fertilization will resolve any God-given fate. To do more, and try to improve on nature's choices will ultimately prove to be the greatest hubris. The power of genetics is not the power of the gods.