Dear Francis
18th March 2002
The current dispute about cloning is a proxy for broader fears about the new technologies emerging from our unravelling of human biology. Critics like yourself imagine that if we can stop cloning, we can head off possibilities like human "enhancement." But as we decipher our biology we learn to modify ourselves-and we will do so. No laws will stop this.
Embryo selection, for example, is feasible in thousands of labs around the world. Any attempt to block it will increase the potential dangers of the technology by driving it out of sight and depriving us of early indications of medical or social problems.
The best reason not to curb interventions that many people see as safe and beneficial is not that such a ban would be dangerous, but that it would be wrong. A ban would prevent people from making choices that are intended to improve their lives and would hurt no one. Such choices should be allowed. It is hard to see how a society that encourages us to stay healthy and vital could justify, for instance, trying to stop people from undergoing genetic therapy or consuming drugs aimed at retarding ageing. Imposing such a ban requires more compelling logic than the assertion that we should not play God or that, as you have said, it is wrong to transcend a "natural" life span.
Also, a serious effort to block beneficial technologies that might change our natures would require policies so harsh and intrusive that their harm would be far greater than that feared from the technologies themselves. If the war on drugs-with all its resources-has failed, the government has no hope of withholding access to technologies that people see as beneficial. Even without aggressive enforcement, such bans would reserve the technologies for the privileged. When abortion was illegal in some US states, the rich just travelled to more permissive places.
Laboratories can now screen a six-cell human embryo by teasing out a single cell, reading its genes and letting parents decide whether to implant or discard the embryo. In Germany, such screening is criminal. But this does not deny the technology to affluent Germans. They can take a trip to Brussels or London, where it is legal. As such screenings become easier and more informative, genetic disease could gradually be relegated to society's disadvantaged. We need to think about how to make the tests more, not less accessible.
If parents can easily and safely choose embryos, wouldn't they pick ones with predispositions toward various talents and temperaments? They might. But policies in Britain to block innocuous choices like the sex of a child are a good example of undesirable state intrusion. Letting parents who strongly desire a girl (or boy) be sure to have one neither injures the resulting child nor causes gender imbalances in western countries. A few interventions will arise that virtually everyone would find troubling, but we can wait until actual problems occur before moving to control them. These coming reproductive technologies are not like nuclear weapons, where large numbers of innocent bystanders can suddenly be vaporised. We have the luxury of feeling our way forward, seeing what problems develop, and carefully responding to them.
The real danger is that vague threats to our values will be used to justify unwarranted political incursions that delay medical advances. If, out of concern over cloning, the US Congress criminalises embryonic stem-cell research that might bring treatments for Alzheimer's or diabetes-and you lent your name to a petition that supported such laws-there would be real victims: present and future sufferers of those diseases.
We are not devoting massive resources to the life sciences out of idle curiosity, but in an effort to better our lives. Of course, the resultant technologies pose challenges: they will alter the way we conceive children, the way we manage our moods and even life spans. We will be forced to confront the question of what it means to be human. Do we have the courage to embrace the possibilities ahead, or will we succumb to our fears and draw back, leaving this exploration to braver souls in other regions of the world?
Yours
Gregory
Dear Gregory
19th March 2002
You offer two arguments against restricting future biotechnologies: first, that such rules are unnecessary as long as reproductive choices are being made by individual parents rather than states, and second, that they cannot be enforced and would be ineffective even if they were to be enacted. Let me respond to both.
While genetic choices made by parents are on the whole likely to be better than those made by coercive states, there are several grounds for not letting individuals have complete freedom of choice in this regard.
The first two are utilitarian. When we get into human germline engineering, safety problems will multiply exponentially. Genetic causation is complex, with multiple genes interacting to create one outcome or behaviour, and single genes having multiple effects. When a long-term genetic effect may not show up for decades after the procedure was administered, parents will risk a multitude of unintended and irreversible consequences for their children. This calls for strict regulation.
A second utilitarian concern has to do with possible negative externalities, the classic ground for state regulation, accepted by even orthodox free-market economists. An example is sex selection. Today in Asia, as a result of cheap sonograms and abortion, cohorts are being born with extremely lopsided sex ratios-117 boys for every 100 girls in China, and at one point 122 boys for every 100 girls in Korea. Sex selection is rational from the standpoint of individual parents, but imposes costs on society in terms of the social disruption that a large number of unattached young males can produce. Similar negative externalities can arise from individual choices, for example, to prolong life at the cost of a lower level of cognitive and physical functioning.
A further set of concerns about the ability to "design" children has to do with the ambiguity of what constitutes improvement of a human, particularly when we get into aspects of personality. We are the product of a complex evolutionary adaptation to our physical and social environment. Genetic interventions made out of faddishness or political correctness might upset that balance in ways that we don't understand-in the interests of, say, making boys less aggressive, girls more assertive, people more or less competitive. Would an African-American child be "improved" if we could genetically eliminate his or her skin pigmentation?
The final issue concerns human nature itself. Human rights are ultimately derived from human nature. That is, we assign political rights to ourselves based on our understanding of the ways members of our species are similar to one another, and different from other species. We are fortunate to be a relatively homogeneous species. Earlier views that blacks were not intelligent enough to vote, or that women were too emotional to be granted equal political rights, proved to be empirically false. The final chapter of your book opens up the prospect of a future in which this homogeneity splinters, under the impact of genetic engineering, into competing human biological kinds. What kind of politics do we imagine such a splintering would produce? The idea that our present-day tolerant, liberal, democratic order would survive these kinds of changes is far-fetched: Nietzsche, not JS Mill or Rawls, should be your guide to the politics of such a future.
Your second set of arguments asserts that no one can stop this technology. You are certainly right that if a future biotechnological technique proves safe, cheap, effective and highly desirable, governments would not be able to stop it and probably should not try. What I want, however, is not a ban on wide swathes of future technology, but strict regulation in light of the dangers outlined above.
Today we regulate biomedical technology all the time. People argue about where to draw various lines. But the argument that procedures as potentially unsafe as, say, germline engineering for enhancement purposes, cannot in principle be regulated has no basis in past experience.
We slow the progress of science today for all sorts of ethical reasons. Biomedicine could advance faster if we abolished our rules on human experimentation, as Nazi researchers did, and allowed doctors to inject infectious substances into their subjects. We enforce rules permitting the therapeutic use of drugs like Ritalin, while prohibiting their use for enhancement or entertainment.
The argument that these technologies will move to more favourable places if they are banned in the US may or may not carry weight; it all depends on what they are and what the purpose of the regulation is. I regard a ban on reproductive cloning to be analogous to legislation banning incest. The purpose of such a ban would not be undermined if a few rich people could get themselves cloned outside the country and, in any event, much of the world seems to be moving to a global reproductive cloning ban. The fact that the Chinese may not be on board should not carry much weight; the Chinese harvest organs from executed prisoners without permission and are hardly an example we want to emulate.
I don't think that a set of regulations designed to focus future biomedicine on therapeutic rather than enhancement purposes constitutes oppressive state intervention or goes far beyond the realm of what is done today. You are in effect saying that since rules against doping in athletics don't work 100 per cent of the time, we should throw them out all together and have our athletes compete in the future on the basis of who has the best pharmacologist.
Yours
Francis
Dear Francis
20th March 2002
You are so suspicious of change in general and new technology in particular that you won't even acknowledge the desirability of allowing people to use safe and beneficial interventions that would almost certainly improve their lives. You will only admit that if a technology is "safe, cheap, effective, and highly desirable, government probably should not try to stop it." If you won't even embrace technologies that meet this high threshold, you would never allow the more problematic possibilities of the real world. But facing such possibilities is what has improved health so greatly during the past century.
For the most part, you are vague when it comes to precisely what we should prevent. You are specific about banning human cloning, but that is about as risky as coming out for motherhood. A more interesting situation is sex selection. I argued that in the US, such selection-which can be done by sorting sperm so that no embryos are destroyed-is innocuous. Sex selection does not harm children; indeed, it benefits them when a child of the "wrong" sex would seriously disappoint his or her parents. You bring up the imbalance in sex ratios in China, but this does not justify regulating the practice in the US, where such imbalances do not arise. You oppose sex selection in the US and have proposed the formation of a review board, like the one in Britain that has barred this procedure, but do you have anything better to offer than a fear that the practice would be a step down a slippery slope? If you see a serious externality arising from sex selection in the US, I would like to hear it.
In response to my comments about the obvious benefit of future anti-ageing medications, you point out that "negative externalities can arise from individual choices to prolong life at the cost of a lower level of cognitive and physical functioning." This is true, but it is a frightening basis for legislation. I shudder to think about regulatory boards tasked with balancing the additional years that an individual seeks against the social cost of those years. If you do not want to allow interventions to slow the onset of ageing and bring longer lives of relative health, then why not block all treatments for the aged and debilitated? Their extra years are a net cost, and withholding medical treatment for those over 65 would work wonders on America's ailing social security system. It isn't much of a step to go even further and block medical interventions that save accident victims with crippling injuries.
You no doubt feel that a sharp line between therapy and enhancement will avoid such perversions, but this line will increasingly blur in the years ahead. Anti-ageing interventions, for example, fall in a large realm that is best labelled "therapeutic enhancement." If we could gain an extra decade by strengthening our immune system or our anti-oxidation and cellular repair mechanisms, this would be a human "enhancement." But it would also be a "preventive therapy," because it would delay cardiovascular disease, dementia, cancer, and other illnesses of ageing.
Banning enhancement from sport can obviously be justified as a violation of the agreed rules of the game. But neither you nor our political institutions have a recognised right to set the rules of life. Outlawing a whole realm of benefits that are not injuring others is not only impractical, it is tyranny. You are right about the ambiguities of "improvement," but I have not suggested some grand government project that seeks human perfection. I have spoken only of free parental choices that are likely to lead towards greater diversity.
I do not argue that parents need no oversight in the use of advanced technology for the conception of children, merely that it should be minimal, should address real rather than imagined problems, and should be concerned with the child's safety rather than social order or the personhood of embryos. When it comes to children, I trust the judgement of individual parents more than that of political or judicial panels.
Yours
Gregory
Dear Gregory
21st March 2002
You have misunderstood a couple of the points in my initial response. The issue with regard to sex selection is not that it would be a problem in the US; it is possible now, after all, but not widely practised. The point is that individual choice coupled with the spread of cheap biomedical technologies can quickly produce population-level effects with serious consequences. The problem with eugenics is not simply that it is state-sponsored and coercive; if practised by enough individuals, it could also have negative social consequences.
I suspect that if the US ever gets into something like this in the future, it will have to do with potential "enhancement" targets other than sex. One I speculate about in my book is sexual preference. It seems clear to me that if parents, including ones who are perfectly accepting of gays, had the choice they would select against their children being gay, if for no other reason than their desire to have grandchildren. The proportion of gays in the population could drop dramatically and I'm not sure that society as a whole (let alone gays) would be enhanced as a result.
Governments can intervene successfully to correct individual choices like these. The sex ratio imbalance in Korea that emerged in the early 1990s was noticed, and the government took measures to enforce existing laws against sex selection so that today the ratio is much closer to 50-50. If the government of a young democracy like Korea can do this, I don't see why we couldn't.
The reason I noted that life extension coupled with diminished capability can create negative externalities was not to suggest that we should ban or regulate such procedures. You are perfectly right that we already have adopted a lot of medical innovations that produce this tradeoff. But the reason this is an important issue is that in debates over stem cells and cloning there is an unquestioned assumption that anything that will prolong life or cure disease obviously trumps other concerns.
This is not obvious to me. Anyone who has walked around a nursing home recently can see that past advances in biomedicine have created a horrible situation for many elderly people who can't function at the levels they would like, but who also cannot die. New advances in biotechnology may provide cures for degenerative, age-related diseases such as Alzheimer's or Parkinson's, but the research community is in effect just cleaning up the mess it created. So when we balance near-term rights and wrongs, the argument that more medical advance is necessarily good needs to be treated with scepticism.
You are right in saying that much of my interest in having new regulatory institutions in place has to do with ethical and social consequences of new technology, and not simply safety. States intervene all the time to shape norms and produce social outcomes. The possible benefits of cloning need to be balanced against social harms. Consider the following scenario: a wife decides to clone herself because a couple cannot otherwise have children. As their daughter grows up, the husband will find his wife growing older and less sexually attractive. In the meantime, his daughter, who will be a duplicate of her mother, will blossom into sexual maturity and increasingly come to resemble the younger woman the husband fell in love with. It is hard to see how this situation would not produce a very unhealthy situation within the family; in a certain number of cases, it would lead to incest.
I do not want tyrannical intrusion into private lives. Rather, I am recommending an extension of existing institutions to take account of the new possibilities that will be put before us as a result of technological advance. This may result in regulation irksome to industry and to certain individuals but it will be no more tyrannical than existing rules banning incest or, in the case of the Koreans, banning sex selection. All societies control social behaviour through a web of norms, economic incentives and laws. All I am suggesting is that the law part of the mix will need to be updated and strengthened in light of what is to come.
Yours
Francis
Dear Francis
22nd March 2002
I'm glad you agree that sex selection in the US poses no serious threat. To me, this means it should not be regulated. Moreover, we should also hold off on legislating against other such technologies until problems show up. You may worry about rapid "population-level effects with serious consequences," but your example of Korea's success at handling its sex-ratio imbalances is surely evidence that we can afford to wait.
Consider your argument about cloning. It is one thing to worry about the medical dangers of an unproven technology, another to justify a complete ban with stories about a future father's possible sexual attraction for his wife's budding clone-daughter. Children hardly need to resemble a parent to inspire incest. We cannot start regulating families on the basis of hypothetical sexual perversions. We have laws governing child abuse; let's just enforce them.
As to gays, if there are fewer in the future because of people's choices about the genetics or rearing of their children, so be it. But I am not convinced it would play out that way. Contrary to what you imply, gays do reproduce, using donor eggs or sperm, surrogate mothers, and partners of the opposite sex. Moreover, such reproduction will get easier.
I'm glad to hear that you don't oppose anti-ageing interventions; I've previously heard you say only that government would be unable to block such enhancements. You are right that advances in health care bring many challenges, and that the needless prolongation of a dying person's pain and decrepitude is nothing to boast about. That is no reason to deny the value of the good added years that modern medicine has brought so many, but to recognise that we must find better ways for individuals to reach death with dignity when it draws near.
You say you are urging only a harmless extension of existing institutions. I disagree. The handing over of decisions about human reproduction to a political process typically driven by zealots on either side would invite disaster. New agencies with the power to project social theory, and even religious dogma into family life would be a frightening development. (Judging from the composition of President Bush's bioethics advisory commission, many regulators would be less moderate than you.) And when lawmakers start telling researchers not to do certain types of embryonic stem cell research because adult stem cells will work just as well, something is wrong. These legislators are micromanaging a realm they do not understand, assaulting freedom of inquiry and ignoring the entreaties of those afflicted with serious diseases.
Yours
Gregory
Dear Gregory
23rd March 2002
One of the virtues of your book is that you are willing to take risks in predicting what changes might be in store in the long-run future in terms of enhancement technology. In your final chapter, you suggest a number of things that might happen in a future world in which various forms of enhancement become safe, effective and inexpensive. You suggest that reproduction via sex may disappear altogether as a result of the difficulties of handling artificial chromosomes in vivo. Reproduction could not happen outside a lab. We could freely alter our personalities and moods through drugs and genetics.
But most importantly the human race disappears. You suggest that there will be differentiation within our species and, in effect, new speciation. Some people may decide to enhance their children for musical ability, athletic prowess, or mathematical talent. There will be a social divide between the enhanced and the unenhanced, and in the situation that will emerge, it will be difficult for people not to join in this genetic arms race. Moreover, genetic differentiation will become a cornerstone of international politics. If we and the Germans decide not to take part, the Chinese will charge ahead with self-enhancement and then we as a nation will be challenged to follow suit.
What I don't understand is why anyone thinks that in this kind of world-one in which the existing genetic homogeneity of humans is being undermined-we will be able to continue to live within the nice, liberal democratic framework that we currently enjoy. You argue as if we could presume the continuity of that political world, and that the biggest arguments we will have will concern whether we have a little more regulation and less progress, or the reverse.
But what will happen to equality of opportunity when a non-musically enhanced child aspires to be a musician, which has become not just the territory of a guild of musicians, but of a subspecies of musicians whose genetic identity is tied up in that way of life? Why shouldn't the enhanced start demanding superior rights for themselves and seek to dominate the unenhanced, since they will be superior not just as a result of social status and education, but because of genetic enhancements as well? What is going to happen to international conflict, when other, hostile societies are not only culturally different but not fully human, either?
The fact is that there will be no theoretical or practical reason at that point not to abandon the principle of universal human equality. It is strongly believed today, in part as a matter of faith but also in part because it is empirically supported. When the principle was enunciated in 1776, blacks and women were not granted political rights in North America because it was believed that they were too stupid, or too emotional, or otherwise lacking in some essential human characteristic, to be granted equal rights. This view resurfaced as scientific racism in the 20th century, and one of the great achievements of our time is that both the empirical doctrine and the politics built on it have been discredited.
So if we are going to embrace this technology and the prospect of human self-enhancement, we ought to do it with our eyes open. We should say, with Nietzsche, that this is a wonderful opportunity because we can finally transcend liberal democracy and re-establish the possibility of natural aristocracy, of social hierarchy, of the pathos of distance and otherwise usher in an era of "immense wars of the spirit."
Yours
Francis
Reprinted in edited form from Reason Online. ©Reason Foundation, 3415 S Sepulveda Blvd, Suite 400, Los Angeles, CA 90034 www.reason.com
Francis Fukuyama and Gregory Stock will be speaking at a Prospect/Institute of Ideas event on 30th May. Call 020 7269 9230.
