85. The Bioethical Challenges We Face

“Lead us. Evolution, lead us
Up the future’s endless stair,
Chop us, change us, prod us, weed us,
For stagnation is despair:
Groping, guessing, yet progressing,
Lead us nobody knows where.”
— C.S. Lewis “Evolutionary Hymn”

The daunting pace of advances in bio-technology has far exceeded our ability to grasp the range of possibly positive and plausibly threatening consequences. This presents us with enormous ethical challenges in deciding how to proceed. Today it is hard to name outstanding figures who can speak with the authority of those scientists of a generation or two ago. As you will be able to read at the end of this blog, they most forcefully expressed their ethical concerns and their doubts, fears, and scientific aspirations.

When faced with serious genetic problems ranging from cancer to Alzheimer’s and from blindness to deafness, should scientists simply march ahead and work on ultimately altering the sequences of embryonic DNA produced by afflicted parents? Strong objections to such a course are being raised, arguing that this would interfere with the natural processes of life or even that we are brazenly trying to take over from God! The implications are, that once we start altering our hereditary potentials, there is no end. At first we may only be making corrections on single-cell disorders such as sickle-cell anemia, hemophilia, and Tay Sachs, but before long we would switch to making improvements — ultimately struggling to make humans more perfect or even more compatible with mechanical intelligence. As Herbert J. Muller wrote some 80 years ago: “We will reach down into the secret places of the great universe of its own nature, and by aid of its ever growing intelligence and co-operation, shape itself into an increasingly sublime creation.”1

The immediate challenge at hand is CRISPR. About three years ago, scientists developed a technology that is literally upending our perspective on the limits of biotechnology. It has become known as CRISPR-Cas9 which is similar to a biological word processing system allowing scientists to cut and paste the strands of DNA almost as easily as it is for me to change the lettering in this blog. (FYI: CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeats.) CRISPR involves taking a strand of RNA, a chemical messenger, to target a section of our DNA and using an enzyme (a nuclease) that can cut unwanted genes and paste in the edited RNA. This sequence borrows from a process in nature that scientists have harnessed to snip and splice sections of DNA. To make this possible researchers found a specific slicer enzyme called Cas9.
This technological advance is key to the synthetic biology and gene editing revolution and represents an amazing improvement over existing techniques. However, alarm bells started to ring when scientists in China reported in April 2015 that they had used CRISPR for the first time to alter the DNA in a non-viable embryo. (That is, an embryo that could never have developed into a baby.) A group of 18 eminent scientists, legal experts and ethics specialists published a letter in Science calling for an immediate moratorium on experiments of this kind on embryos. Dr. Jennifer Doudna, one of the co-inventors of the CRISPR technique, wrote that “My colleagues and I felt it was critical to initiate a public discussion of the appropriate use of this technology, and to call for a voluntary ban on human germline editing for clinical applications at the present time.”

Henry Greely, a Stanford law professor and expert in ethics, who was another of the signers of the Science letter, said “You would be insane and criminally reckless to make a baby this way without 15 to 20 years of testing and proving that it was safe.” Many other scientists contended that far from being threatening or wrong, such research has the potential to provide permanent cures for genetic diseases. Further research also holds the potential to correct common disease defects such as metabolic disorders, diabetes and age related problems as well as creating cells that attack tumors or others that are resistant to HIV infections.

The National Academy of Sciences (NAS) and its Institute of Medicine consequently announced it is convening an international summit this December to “explore the scientific, ethical, and policy issues associated with human gene-editing research.” In addition, NAS will appoint a multidisciplinary, international committee to study the scientific basis and the ethical, legal, and social implications of human gene editing. Together this represents a concerted effort to confront the bio-technological challenges now facing mankind. In some ways this conference ultimately could prove as important for our future on this planet as the major Environmental Conference to be held by the United Nations at almost the same time in Paris.

Getting a clearer picture on the science behind CRISPR is important. So is developing an international guideline for gene editing. But the National Academy of Science’s meetings seem to have overlooked how much work and ethical expertise it will take to identify and assess the ethical issues surrounding CRISPR. There is concern that ethics has taken and will continue to take a back seat to science in discussions about CRISPR. The existing ethical frameworks are simply not adequate for managing the challenges posed by the new gene editing technology.

This is because CRISPR is unlike previous biotechnologies. The ethical frameworks that were developed for dealing with IVF, cloning, and stem cell research a generation ago are not adequate for dealing with the novel ethical concerns raised by CRISPR.

For example: CRISPR can introduce new variations in germlines, making permanent biological changes to future generations. This may be uncontroversial when it comes to preventing life-threatening diseases, but controlled human evolution has been suggested many times since Darwin, often with permanent, racist and disastrous consequences. Equally important, our genetic makeup is the result of changes, mutations, radiation, jumping genes and other additions. Like knowledge, our DNA structure is the result of millennia of additions. There is no natural mechanism which allows for the kind of subtractions involved in CRISPR. Could we now accept any justifiable, ethical philosophical or scientific objections to subtraction?

Deletions made on human genes could have unintentional and unpredictable consequences for future generations who might regret that this was done without their consent. We simply do not understand the operations of the human genome sufficiently to make long-lasting changes to our DNA. Altering just one gene could have unforeseen and widespread efforts on other parts of the genome which could then be passed down to future generations.

Laws in the UK ban genetic modification of embryos for clinical uses, but they are permitted in research labs under license from the Human Fertilization and Embryology Authority provided that the embryos are destroyed after 14 days. In the United States researchers are much freer, but there are deep concerns that genome editing is so simple and cheap that maverick scientists could use the procedure to modify human embryos which could be implanted into women.2 Dr. Francis Collins, Director of the National Institutes of Health, said back in April that the US government would not fund research for modifying the embryo DNA because there were “serious and unquantifiable safety issues” as well as significant ethical questions and no compelling medical reasons to carry out the research. While scientists and lawmakers might be able to control most of the global research taking place, there is little that can be done to stop experimentation taking place in a country like North Korea or corporations that might pursue their narrow commercial interests. The application of CRISPR techniques has resulted in a flurry of investment and commercial activity. Editas Medicine, which was granted a patent (being challenged by other applicants) to use in plants and animals, has raised $163 million from a group of investors over the past two years.3 And the pharmaceutical giant, AstraZeneca, plans to develop its use in cell cultures to explore the function of every gene in the human genome.

When it comes to bio-technology there are no deniers, but many opponents. Edward Lamphier, the founder of Sangamo Biosciences, wrote in Nature that genome editing in human embryos “could have unpredictable effects on future generations.” This makes it “dangerous and ethically unacceptable.”4 In an interview with Gina Kolata of the New York Times he added, “It literally boils down to: How do you feel about the human race and the human species?”5

The psychologist Steven Pinker, writing in an editorial for the Boston Globe, protested that CRISPR was a key to reducing human suffering and incurable diseases. Pinker maintained that bioethicists should not get in the way of progress. As it is, some research scientists already have become bogged down in red tape, bureaucratic restrictions, or sanctions based on unclear consent forms. To then impose moratoria or threats of prosecution based on such sweeping principles as “social justice,” rapidly could slow down progress and ultimately lead to scientists operating outside any agreement.

To the question: “Should we ever move forward with human germline genome editing,” 61% of the polled members of the Science Advisory Board, an international community of tens of thousands of scientific and medical experts, voted in favor and 39% voted against, but when asked: “Should we hold a moratorium on human germline genome editing?” 70% said “yes” and only 30% opposed. The ethical dilemmas facing the experts evidently could obstruct the tools which would give many future generations healthier and longer lives. Even in an impatient age when quick decisions almost have become obligatory and attention spans are on a steady decline, no effective decision on this dilemma is likely soon.

Personally, I would propose that the world put a hold on all laboratory experimentation in this area until and unless it is approved by an international body of experts operating under the aegis of some kind of new biological “security council” with enforcement powers. Nothing less will suffice.


 

1Herbert J. Muller, Out of the Night: A biologist’s view of the future, (1935)
2Ian Sample: “GM embryos: time to decide,” The Guardian, September 2, 2015, p. 1
3“Briefing Genome editing,” The Economist, August 22, 2015
4“Don’t Edit the Human Germline,” Nature, March 12, 2015
5Gina Kolata, “Gene Editing and Safety: Alarm Grows.” The New York Times, May 10, 2015


 

“Gene splicing and editing are going to change life on earth, both physically and economically. What is at stake in this biotechnical revolution is the ultimate ‘perfectibility’ of plants, animals and people.“ Yorick Blumenfeld Towards the Millennium: Optimistic Visions for Change, (1996) p.382

“[Humanity] will reach down into the secret places of the great universe of its own nature and by aid of its ever growing intelligence and co-operation, shape itself into an increasingly sublime creation.” Herbert J. Muller, Out of the Night: A biologists view of the future (1935)

“When does a ‘repaired’ or ‘manufactured’ man stop being a man… and become a robot, an object, an industrial production?“ Salvador Luria, “Modern Biology: A terrifying Power,” The Nation, October 20, 1969

“The human species is biologically an extraordinary success, precisely because its culture can change ever so much faster than its gene pool. This is the reason cultural evolution has become adaptively the most potent extension of biological evolution. For at least 10,000 years … man has been adapting his environments to his genes more often than his genes to his environment, It may be said that man has escaped from the clutches of his biological past and has become to some extent the master, rather than a slave, of his genes,” Theodosius Dobzhansky, Mankind Evolving (1962 ed.) p. 319

“If this thing is ever possible technologically, it will happen. It is no use expecting international agreements to stop it, or a self-denying ordinance among scientists, In fact, most of us, if the power were given us, would be morally confused, For the first application of genetic engineering almost certainly would be to eradicate the grosser genetic misinstructions — that is the prescriptions that produce dystonia or spina bifida or mongoloidism or other fearful forms of human suffering.” C.P. Snow (1973)

“…instead of shouting “no!” we should examine whether we could direct the course of evolution. We should then ask if- and how- we could control the pace at which we might proceed. And we should ask what we could do to adjust human beings to the personal and social consequences of seemingly unstoppable advances of biotechnology.” Jean Rostand, Can Man Be Modified? (1959)

“In the light of evolutionary biology man can now see himself as the sole agent of further evolutionary advances on this planet…Ever since he first began, man has been groping to discern the features of his destiny more clearly. In the light of the evidence now available, he could come to the realization that his destiny is to participate and lead in the creative process of evolution where new possibilities can be realized for life.” Julian Huxley, Evolution in Action (1953) p. 132

“Finally, consciousness itself may end or vanish in a humanity that has become completely etherealized, losing the close-knit organism, becoming masses of atoms in space communicating by radiation, and ultimately perhaps resolving itself entirely into light. That may be an end or a beginning, but from here it is out of sight.” J.D. Bernal, The World, the Flesh and the Devil, (1929), p. 113.

“What would this Man? Now upward will he soar,
And little less than Angel, would be more
Alexander Pope, An Essay on Man (1733)

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84. Lusso

I am irritated, nay overwhelmed, by encountering the word “Luxury” everywhere I look in the printed media, whether it be for real-estate, hotels, restaurants, cars, watches, clothes, furniture or any holiday escape from reality! But what does “Luxury” really mean today? And where is it headed? Is it beginning to be identified, as it formerly used to be, as something decadent? In effect, “Luxury” is assisted by the fact that its definitions range as broadly as a rainbow: It can encompass grandeur, opulence, preciousness, sumptuousness, lavishness, magnificence, and almost anything that is non-essential! The word has been so marketed that “Luxury” as a concept has almost vanished from both shopping malls and supermarkets. But then suntans in February, around-the-clock music, oranges at Christmas and asparagus for Thanksgiving, are no longer considered luxurious.

Luxury today is that which is regarded as rare, difficult to obtain, so expensive it is out of our reach, extraordinarily elusive, exclusive, as well as utterly, nearly and impossibly desirable. The perceptions of luxury and how this has varied over the millennia has been the subject of an exhibition at London’s Victoria and Albert Museum. Walking through this show with its more than one hundred items ranging from fine, modern Swiss watches to an 18th Century gold crown studded with emeralds, diamonds and rubies, I felt uneasy at the gap between my own perspective and the approach of the curators. My preferences and decisions are not based on brands, popularity or mass appeal but on my own particular preferences and desires. When I think of luxury, I conjure a sunny day in my garden, wandering about aimlessly in Paris’ left bank, or spending a quiet evening at home without any ringing or electronic buzz. It seems ironic that the slow-moving time which I cherish is rapidly vanishing in a capitalist dominated world of constant communications, 24/7 pressures and distractions.

Quite rightly the digital revolution is transforming the popular understanding of the value of luxury objects, just as the industrial revolution did when exceptional craftsmanship began to be displaced by assembly line production. It is difficult for us to accept that before then, and starting with ancient Rome, luxury had been both despised and denigrated at various stages. In 2015 BC, Senator Marcus Porcius Cato denounced luxuria as a vice which would not only ruin individuals but could even bring down civilization. Luxuria was seen by the elite of Rome as a form of social denigration by the populace and their decadence was to be controlled by a range of complex sumptuary laws. However, this did not prevent indulgent excesses to prevail in the Empire for hundreds of years!1

The decline that followed the fall of Rome and the invasion of the barbarians effectively destroyed the wealth necessary for luxurious feasts. However, early Christianity clearly opposed excesses of consumption. By the Middle Ages, however, the Catholic Church in Rome gradually accepted different notions of “magnificence,” while its preachers linked ornamentation and fancy clothing by some worshipers to the enjoyment of lustful desires. Such sinful practices were also ascribed to the influence of women.

In the late Middle Ages, new groups of textile workers, tanners, artisanal craftsmen and merchant traders slowly began to emerge in Europe and, with the growth of personal wealth, began to give access to goods which had been previously reserved for the few. The powerful elite unsurprisingly denounced such developments as being decadent, immoral, and even illegal. It was only with the beginnings of the Renaissance in Italy that a shift began to be observed. The celebrated twin weddings of the Sforza and Este families in 1491, orchestrated by no less of a cultural figure than Leonardo da Vinci, were of a lavishness that had not previously been seen but which no one dared to question. Such luxury by the elite was not to be confused with the aspirational, but condemned desires of the population.

During the Italian renaissance, while the Church established the standards of magnificence in architecture, the Medici were to commission on a grand scale what was to be considered luxurious in terms of rare jewelry, sculptures, paintings, and furniture. They also focused on such rarities as the magic of the blue colors of lapis lazuli. However, the luxury of sumptuous banquets by private citizens and the display of jewels and dress by rich (but untitled) women was denounced by prominent figures. Italians were the first to alter the ancient concept of luxury with a new word, “lusso,” which was meant to denigrate the aspirational expressions of the newly rich and in particular to the vices linked to women. The word was coined by the Florentine priest and poet, Leonardo Dati (1408-1472) who wrote in 1441:

By my thought defeated, fails

because foolish pomp, bursting with pride,

together with revolting lusso,

were there inside.

While luxury only began to lose its pejorative implications in 17th century Europe, it continued to be viewed negatively by western philosophers for another two hundred years when discourses shifted from the moral to the economic realm. William Morris, who was strongest of 19th century promoters of craftsmanship, argued that mechanization was both a moral and aesthetic problem and that the “utilitarian ugliness” resulting from machine production was to be seen as a symptom of the “sickness of modern civilization.” A hundred years earlier Voltaire already had observed with incisive humor:

“People have declaimed against luxury for 2000 years, in verse and in prose, and people have always delighted in it.”2

The notion of luxury as it has developed in Western Europe and the United States has never been static. Luxury has been subject to constant change as the desires and attendant beliefs of the middle class grew and then expanded before being dropped as “luxury” because the goods had become so available.3

I think that the tenuous relations between luxury and values may best be examined by looking at the shift which occurred from pocket watches to wrist watches.4 Symbolically, we had pocket watches in the old days when we had more time to enjoy the luxury of grandfather clocks which graced households with their chimes and the tick-tock set a calming pace. Time was under control. The ease of that era is now — with the envy of hindsight — regarded as luxurious. Today speed is the backbone of a competitive economic system where time is money. So watching time has become universal and, ironically, speed has become a great enemy of genuine luxury.

The wristwatch is a technologically driven mechanism which has simultaneously developed as a status symbol, a fashion statement, and the functional purveyor of such desirables as accuracy, precision, durability and robustness. In the 19th century those who were expected to be punctual had a pocket watch. Using such a watch was incompatible with hard labor and signified one’s professional identity and association with managerial duties. However, once in the field, British army officers began to feel uncomfortable trying to use a pocket watch while also holding a horse’s reigns or drawing a sword. The practical response was to sew a pocket watch onto a leather strap which then could be wrapped around the wrist. By the start of WWI all officers in the British army wore wrist watches, which also had become a direct and implicit mark of elevated social status. As a consequence of of this terrible conflict, the wrist watch also became associated with bravery, courage, daring and masculinity. Luxury was only to come much later.

The electronic watch brought about a revolution for the Swiss watch industry as US manufacturers in the 1970s started mass producing $10 electronic watches which had the accuracy of the best of the handcrafted classics. Faced with a crisis, the Swiss started to market their output in terms of luxury. They restricted their advertising to key price points: the lowest price for a luxury watch was set at about $2,500 (or £1,600). In the subsequent tournament of value, price and prestige were intertwined with appreciation by a discerning, highly-select and wealthy elite. Watch-makers Philip Patek boast: “You never own a Philip Patek, you merely look after it for the next generation.”

In part, this intense marketing campaign was successful because a luxury watch is just about the only thing rich males can purchase just by and for themselves. From a psychological perspective, so important in understanding the power of luxury, this boosts their egos, establishes their social status and shows their economic power. In a way the luxury watch has become a symbol of the truly important things men don’t have and can rarely get, such as the time to enjoy life, The successful executive doesn’t have to ask anyone if he can buy a $100,000 watch. In his own mind the watch demonstrates his success, his independence and his position. That is why the advertisements for these luxury watches focus so intensely on HIM.

The challenge facing luxury watch manufacturers is that their products have become promotionally desirable but functionally irrelevant. Their branding as prestige luxuries leaves them open to sudden social rejection, much like the collapse of the luxury fur market or that of ivory. Luxury is fickle. Today we tend to decide for ourselves what our most desired luxury might be. Tomorrow those wearing $100,000 watches might suddenly be subject to pangs of conscience (perhaps sparked by internet exposure) which would convince them to donate socially offensive luxuries to charities of their choice. Not only could this help adrift Syrian refugees, Save the Children, or Oxfam, but it might even uplift the social consciences of the donors.

“Luxury” today overwhelms the striving and aspirational forces of the world. Luxury goods have become one of the driving forces of global capitalism. The mass of humanity at the bottom feel so locked-out that they longer aspire to luxury. The ever growing consumption of goods is not the answer. Luxury today seems to be extending the sense of social inequality but it has yet to regain its formerly pejorative connotations.

The scarcity of both time and space are beginning to turn into luxuries which are increasingly valued in their own right. It’s time that we begin to recognize this just as we are beginning to recognize that fresh air and fresh water are on the way to becoming environmental luxuries. Alas, the song which celebrated that “The Best Things in Life Are Free” is becoming ever harder to appreciate in a world which continues embracing luxury.


 

1See: Catherine Kovesi, “What is Luxury?” Luxury, Volume 2, Issue 1, May 2015

2Voltaire, The Philosophical Dictionary (1764)

3See: C.J Berry, The Idea of Luxury: A Conceptual and Historical Investigation, (1994) Duties of a Christian, XIV).

4Peter Oakley, “Ticking Boxes: (Re)Constructing the Wristwatch as a Luxury Object,” in Luxury Vol.2, May 2015