Reason Magazine - Contributors

Clones, Gays, and the Elderly

info@reason.com (Gregory Stock) — Fri, 22 Mar 2002 00:00:00 EST

I'm glad Francis Fukuyama agrees that sex selection here poses no serious threat. To me, this means it should not be regulated. Moreover, we should also hold off on passing legislative protections against other such technologies until actual problems show up. Fukuyama may worry about rapid "population-level effects with serious social consequences," but his example of Korea's success at handling the sex-ratio imbalances that arose there is not an invitation to regulate, but evidence that we can afford to wait.

Outlawing a whole realm of benefits not injurious to others -- namely enhancements -- would be tyranny. Potent regulatory structures that pass judgment on the morality and social cost of future technologies would move us in this direction. Judging from the composition of President Bush's Bioethics Advisory Commission, many potential regulators would be less moderate than Fukuyama and quite willing to abridge people's choices.

Consider Fukuyama's argument about cloning. It is one thing to worry about the obvious medical dangers of so unproven a technology, another to justify a complete ban with stories about a future father's possible sexual attraction for his wife's budding clone-daughter. Kids hardly need to resemble a parent to inspire incest, as many adoptees and stepchildren can no doubt confirm. If we start regulating families on the basis of hypothetical sexual attractions and perversions -- and we can conjure ones more lurid and likely than Fukuyama's clone love -- we will ultimately damage rather than protect the family. We have laws governing child abuse; let's content ourselves with enforcing them.

As to gays, if there are fewer in the future because of people's choices about the genetics or rearing of their kids, so be it. But I am not at all convinced it would play out that way. Fukuyama asserts that gays can't reproduce, but they do so all the time using donor eggs or sperm, surrogate mothers, and partners of the opposite sex. Moreover, such reproduction will get ever easier. If we want to be sure to maintain our gay population, additional AIDS research would accomplish more than bans on embryo screening.

I'm glad to hear that Fukuyama doesn't oppose anti-aging interventions; I've previously heard him say only that government would be unable to block such enhancements. He is right, of course, that advances in health care bring many challenges, and that the needless prolongation of a dying loved one's pain and decrepitude is nothing to boast about. But my reaction is not to deny the value of the good added years that modern medicine has brought so many of us, but to recognize that we must find better ways for individuals to reach death with dignity when it draws near. Why must so many of our elderly try to squirrel away a stash of lethal drugs in case they might be captured by a medical system that would torture them for their final few weeks or months? The issue of cloning pales alongside this cruelty.

Fukuyama says he is urging only a harmless extension of existing institutions. I disagree. The relegation of decisions about human reproduction to a political process typically driven by impassioned zealots on either side would invite disaster. New agencies with the power to project abstract philosophy, social theory, and even religious dogma into family life would be a frightening development. And when lawmakers on Capital Hill start telling medical researchers not to do certain types of embryonic stem cell research because adult stem cells will work just as well, something is very wrong. These legislators are micromanaging a realm they do not understand, assaulting our freedom of inquiry, and ignoring the entreaties of those afflicted with serious diseases. These steps are not small.

Biotech Tyranny

info@reason.com (Gregory Stock) — Wed, 20 Mar 2002 00:00:00 EST

I have no problem with attempts to address serious externalities that arise from otherwise harmless personal activities. But if government does not bear a heavy burden of proof when justifying such intrusions into our lives, it can employ vague arguments about social harm to take away our basic freedoms. Francis Fukuyama would push us towards just such intrusions by erecting a powerful regulatory structure charged with ensuring the ethical and social desirability of future technologies.

Fukuyama is so suspicious of change in general and new technology in particular that he won't even acknowledge the desirability of allowing people to use safe and beneficial interventions that would almost certainly improve their lives. He will only admit that if a technology is "safe, cheap, effective, and highly desirable," government probably [my emphasis] should not try to stop it." If he won't even embrace technologies that meet this high threshold, he would never allow the far more problematic possibilities of the real world. But facing such possibilities is precisely what has improved our health and raised our standard of living so greatly during the past century.

Fukuyama speaks of safety, but his reluctance about even safe and highly desirable technologies suggests that his major concern is neither safety nor aberrant misuse. Moreover, he admits that these dangers are well covered by existing agencies and institutions. He makes his primary focus explicit in his book when he complains that the FDA is charged only with establishing "safety and efficacy," whereas we need institutions that can look at ethical consequences.

For the most part, Fukuyama is vague when it comes to precisely what we should prevent. This may be good strategy, because notions of safety, caution, and minimized externalities are so appealing. However, it is deceptive because it is in the details that the rubber meets the road.

In fairness, he is specific about banning human cloning, which in today's climate is about as risky as coming out for motherhood. However, his reasoning here is faulty. To liken a blanket ban on reproductive cloning to a ban on incest is not even fathomable if one considers the cloning of a deceased child or someone other than the parent. But as I said, cloning is a sideshow.

A more interesting situation is sex selection. I argued that in the U.S, 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 likely benefits them when a child of the "wrong" sex would seriously disappoint his or her parents. Fukuyama brings up the imbalance in sex ratios in China, but this does not justify regulating the practice here, where such imbalances do not arise from the practice. Moreover, the problem in China is hardly an argument for government regulation, since sex selection there has long been illegal. Indeed, government regulation in China - namely, its one-child policy - exacerbates the problem of gender balance by pushing parents who want a boy toward aborting a girl, since they can't try again. Fukuyama opposes sex selection here and has proposed the formation of a review board like the one in Britain that has barred this procedure, but does he have anything better to offer than a fear that the practice would be a step down a slippery slope? If he sees a serious externality to sex selection in the U.S., it would be worth hearing.

In response to my comments about the obvious appeal and benefit of future anti-aging medications, Fukuyama points 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 (as opposed to decisions regarding government-funding). I shudder to think about regulatory boards tasked with balancing the additional years that an individual seeks against the social cost of those years. To see the peril, we need only apply Fukuyama's logic to medicine generally.

If he does not want to allow interventions to slow the onset of aging and bring longer lives of relative health (though presumably not matching the vitality of youth itself), 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 our ailing Social Security system. It isn't much of a step to go even further and block medical interventions that save accident victims who suffer crippling injuries.

Fukuyama no doubt feels that a sharp line between therapy and enhancement will avoid such perversions, but this distinction does not stand up to scrutiny. This line will increasingly blur in the years ahead. Anti-aging interventions, for example, fall in a large realm that is best labeled therapeutic enhancement. If we could gain an extra decade by strengthening our immune system or our anti-oxidation and cellular repair mechanisms, this would clearly be a human "enhancement." But it would also be a "preventive therapy," because it would delay cardiovascular disease, senile dementia, cancer, and other illnesses of aging, which we spend billions trying to treat.

Banning enhancement from sports competitions can obviously be justified as a violation of the agreed rules of the game. But neither Fukuyama nor our democratic political institutions have a recognized right to set the rules of life. Outlawing a whole realm of benefits that are not injuring others is not just impractical, it is tyranny. Enhancement is not wrong, and when such possibilities become safe and reliable, large numbers of people will seek them. Fukuyama is right about the ambiguities of "improvement," but I have not suggested some grandiose government project that seeks human perfection. I have spoken only of freely made parental choices, and I argue that such choices are likely to lead towards great diversity.

I do not argue that parents need no oversight in the use of advanced technology for the conception of children, just 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 judgment of individual parents more than that of political or judicial panels. Most parents are deeply concerned about the welfare of their own children, whereas such panels are composed of individuals who are more oriented towards larger social and philosophical concerns than the well-being of particular individuals.

Go Ahead and Clone

info@reason.com (Gregory Stock) — Mon, 18 Mar 2002 00:00:00 EST

There has been a lot of hand wringing recently about cloning. Considering that not a single viable cloned human embryo has yet been created, that the arrival of a clinical procedure to do so seems quite distant, and that having a delayed identical twin (which is, after all, what clones are) has limited appeal, why all the fuss?

The fuss arises because cloning has become a proxy for broader fears about the new technologies emerging from our unraveling of human biology. Critics like Dr. Francis Fukuyama imagine that if we can stop cloning, we can head off possibilities like human enhancement, but they're dreaming. As we decipher our biology and learn to modify and adjust it, we are learning to modify ourselves--and we will do so. No laws will stop this.

Embryo selection, for example, is a mere spin-off of widely supported medical research of a sort that leaves no trail and is feasible in thousands of labs throughout the world. Any serious attempt to blockade such research will simply increase the upcoming technologies' potential dangers by driving the work out of sight and depriving us of early indications of any medical or social problems.

The best reason not to curb interventions that many people see as safe and beneficial, however, 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 for me to see how a society that pushes us to work at staying healthy and vital could justify, for instance, trying to stop people from undergoing a genetic therapy or consuming a drug cocktail aimed at retarding aging. Imposing such a ban requires far more compelling logic than the assertion that we should not play God or that, as Dr. Fukuyama has suggested, it is wrong to try to transcend a "natural" human life span.

Also, a serious effort to block beneficial technologies that might change our natures would require policies so harsh and intrusive that the harms the effort would inflict would be far greater than the harms feared from the technologies themselves. If the War on Drugs, with its vast resources and sad results, has been unable to block people's access to deleterious substances, the government has no hope of withholding access to technologies that many regard as beneficial. It would be a huge mistake to start down this path, because even without aggressive enforcement, such bans would reserve the technologies for the affluent and privileged. When abortion was illegal in various states, the rich did not suffer; they just traveled to more permissive locales.

Restricting emerging technologies for screening embryos would fuel deep class divisions. Laboratories can now screen a six-cell human embryo by teasing out a single cell, reading its genes, and letting parents use the results to decide whether to implant or discard the embryo. In Germany, such screening is criminal. But this doesn't deny the technology to affluent Germans who want it. They 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 start thinking about how to make the tests more, not less accessible.

But let's cut to the chase. If parents can easily and safely choose embryos, won't they pick ones with predispositions toward various talents and temperaments, or even enhanced performance? Of course. It is too intrusive to have the government rendering such decisions. Policies in Britain to block innocuous choices like those about the sex of a child are a good example of undesirable government 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. Sure, a few interventions will arise that virtually everyone would find troubling, but we can wait until actual problems arise before moving to control them. These coming reproductive technologies are not like nuclear weapons, where large numbers of innocent bystanders can suddenly be vaporized. We have the luxury of feeling our way forward, seeing what problems develop, and carefully responding to them.

The real danger we face today is not that an occasional injury will occur from new biological technology, but that opponents will use vague and abstract threats to our values to justify unwarranted political incursions that delay the medical advances accompanying today's basic research. If out of concern over cloning, the U.S. Congress succeeds in criminalizing embryonic stem-cell research that might bring treatments for Alzheimer's disease or diabetes--and Dr. Fukuyama lent his name to a petition that supported such laws--there would be real victims: present and future sufferers of those diseases.

We should hasten medical research, not stop it. We are not devoting massive resources to the life sciences out of idle curiosity, but in an effort to penetrate our biology and learn to use this knowledge to better our lives. We should press ahead. Of course, the resultant technologies will pose challenges: They stand to revolutionize health care and medicine, transform great swaths of our economy, alter the way we conceive our children, the way we manage our moods, and even our life spans.

The possibilities now emerging will force us to confront the very question of what it means to be a human being. But however uneasy these new technologies make us, if we wish to continue to lead the way in shaping the human future, we must actively explore them. The challenging question facing us is: Do we have the courage to continue 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?