Contested Reproduction: Genetic Technologies, Religion, and Public Debate
280
Contested Reproduction: Genetic Technologies, Religion, and Public Debate
280Overview
Scientific breakthroughs have led us to a point where soon we will be able to make specific choices about the genetic makeup of our offspring. In fact, this reality has arrived—and it is only a matter of time before the technology becomes widespread.
Much like past arguments about stem-cell research, the coming debate over these reproductive genetic technologies (RGTs) will be both political and, for many people, religious. In order to understand how the debate will play out in the United States, John H. Evans conducted the first in-depth study of the claims made about RGTs by religious people from across the political spectrum, and Contested Reproduction is the stimulating result.
Some of the opinions Evans documents are familiar, but others—such as the idea that certain genetic conditions produce a “meaningful suffering” that is, ultimately, desirable—provide a fascinating glimpse of religious reactions to cutting-edge science. Not surprisingly, Evans discovers that for many people opinion on the issue closely relates to their feelings about abortion, but he also finds a shared moral language that offers a way around the unproductive polarization of the abortion debate and other culture-war concerns. Admirably evenhanded, Contested Reproduction is a prescient, profound look into the future of a hot-button issue.
Product Details
| ISBN-13: | 9780226222707 |
|---|---|
| Publisher: | University of Chicago Press |
| Publication date: | 10/15/2010 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 280 |
| File size: | 593 KB |
About the Author
John H. Evans is professor of sociology at the University of California, San Diego, and the author of Playing God? Human Genetic Engineering and the Rationalization of Public Bioethical Debate, also published by the University of Chicago Press.
Read an Excerpt
Contested Reproduction
Genetic Technologies, Religion, and Public DebateBy JOHN H. EVANS
THE UNIVERSITY OF CHICAGO PRESS
Copyright © 2010 The University of ChicagoAll right reserved.
ISBN: 978-0-226-22265-3
Chapter One
Introduction
There is a revolution under way in how babies come into being that may change our entire society. Some commentators assume it will "only" create forms of social inequality built into our bodies. For example, a Republican operative, writing about Republican strategies toward societal inequality, mentions that "the trend to inequality will grow even stronger in the years ahead, if new genetic techniques offer those with sufficient resources the possibility of enhancing the intelligence, health, beauty and strength of children in the womb." Some make stronger claims about this revolution, such as that it will change our ideas about what it means to be human and result in the creation of a posthuman species. This is all because new procedures that I will call reproductive genetic technologies (RGTs) allow parents to influence the genetic qualities of their offspring more precisely than through "normal" fertilization by a sperm and an egg after sex. Among the currently possible and potential technologies are genetic carrier screening, fetal testing followed by abortion, preimplantation genetic diagnosis, sex-determining sperm sorting, human genetic engineering, and reproductive cloning.
I will briefly explain these technologies with an example. Imagine a couple who are both carriers of the Tay-Sachs gene, and they want to ensure that their offspring do not have this gene. (Tay-Sachs is a genetic disorder that causes the destruction of a child's central nervous system by the time the child is five years old.) Choosing one of the simplest technologies, genetic carrier screening, the couple could find out whether they are carriers for the Tay-Sachs gene, before deciding to try to have children. If carriers, they could adopt instead of having biologically related children. Alternatively, the woman could become pregnant and then have fetal testing through amniocentesis to determine whether the fetus has the trait and then have an abortion if the fetus is afflicted with the disease. The woman could also use preimplantation genetic diagnosis by creating multiple embryos through in vitro fertilization and then have the embryos tested for the Tay-Sachs gene. Those embryos that express the Tay-Sachs trait would be discarded and one or more that either lack the gene or would only be a carrier would be implanted in her uterus. Another option in the future might be to simply replace the Tay-Sachs gene with a properly functioning gene in the sperm, egg, or early embryo through human genetic engineering, thus removing Tay-Sachs from the family tree forever. Finally, and equally futuristically, the parents could create an embryo that is a genetic clone of someone they know who does not have Tay-Sachs and bring that embryo to term. (For definitions of these technologies and acronyms, see table 1.)
The least controversial application of RGTs is to make sure that children do not have deadly childhood diseases like Tay-Sachs. But what about using the technologies to ensure that children do not have a gene that would make them slightly more susceptible to cancer as adults? Or to Alzheimer's disease when they are fifty years old? Or, to have children with blue eyes and blonde hair? Or, perhaps one day, using RGTs to make your children taller or more intelligent? These questions refer to a commonly used spectrum of applications of RGTs, with "health" applications on one end and "enhancements" on the other. A health application is one that ensures that the offspring has a normal state of health and fitness, lacking known diseases, disabilities, and impairments. An enhancement augments or improves the capabilities of the child. Each person will have a different notion of what is "normal," a "disease" or an "enhancement." What often matters in public debate, as well as in this book, is where an individual draws the line between health and enhancements.
Given that the same technologies can be used for both health and enhancement applications, it is easy to see why these technologies provoke controversy. The controversy partly derives from advocates of the extensive use of RGTs. For example, British bioethicist John Harris argues that "Darwinian evolution has taken millions of years to create human beings; the next phase of evolution, a phase I call 'enhancement evolution' could occur before the end of the century. The result may be the emergence of a new species that will initially live alongside us and eventually may entirely replace humankind." After noting that many of the technologies are in place for the emergence of the posthuman and talking of how humans in the future may use RGTs to genetically design their children to live longer and be resistant to disease, Harris writes that "the end of humanity then is not in itself a concern; making sure that those who replace us are better than we are is a huge and timely concern." Harris argues that it is often ethically obligatory to enhance our children through RGTs to make them less susceptible to disease, and it can be acceptable to make your children more intelligent. Harris is not some lonely crank, but an influential figure in these debates-influential enough to be a member of the British government's Human Genetics Commission. Moreover, his advocacy of evolving ourselves into a "better" species is increasingly shared by others in these debates.
This controversy will expand as more technologies become available and the genetic basis of more traits is better understood. Already, many of the technologies I discuss in this book are in use. For example, preimplantation genetic diagnosis has long been an "off-the-shelf" technology for traits that most people would consider to be diseases, such as Tay-Sachs. A reproductive clinic in the United States recently announced that simultaneously testing for fifteen thousand genetic conditions in an embryo will soon be possible. As knowledge of the human genome improves, more traits in embryos, not all typically considered to be diseases, will be identifiable using this technique. For example, blurring the line between a therapeutic application and an enhancement, scientists in the United Kingdom have applied for a government license to use preimplantation genetic diagnosis to screen out embryos that are genetically susceptible to breast and bowel cancer later in life. Embryos are also being screened by couples to make sure they will have children without a strong squint, deafness, or dwarfism. Conversely, some couples who are deaf or dwarves want to use the technology to ensure that their children will be like them and not "normal." Asian Americans are already using RGTs to insure that they have a male child in their family, a pattern that is easily detectable using census data. Finally, in a portent of applications to come, in February 009 a fertility clinic announced that it would now use preimplantation genetic diagnosis to produce babies with the desired eye color, hair color, and complexion.
Even technologies long considered to be in the realm of science fiction now appear to be on the horizon. For example, human genetic engineering has been a futuristic possibility that would allow genes to be changed not only for the recipient of the genes but also for all his or her descendants, essentially changing the genetic makeup of the human species. While this has been the holy grail of RGTs for more than fifty years and was the RGT that first generated intense religious opposition, it has always faced seemingly insurmountable technological hurdles. However, in May 008 scientists passed another hurdle with the creation of the first genetically engineered human embryo. The technology required for our "posthuman" future is increasingly available.
Current and Future Debates about RGTs
By and large there are no laws in the United States that specifically regulate RGTs beyond concerns about safety and efficacy. Although there has been little legislation, there has been an extensive debate among philosophers, bioethicists, and similarly situated people about the morality of RGTs and whether RGTs should be regulated. However, there has not yet been much public debate among ordinary citizens like there has been over issues like abortion.
My presumption is that the lack of extensive public debate can be explained by the fact that RGTs are currently used primarily for what are almost universally considered to be diseases, which as we will see has the support of the majority of the public. However, when the first cloned human is born, or the first enhanced human, a debate of greater intensity will begin. Such a public debate is necessary; Should it not be the citizens who collectively decide whether to replace ourselves with a new "improved" species?
At its broadest, this book evaluates what the initial public debate will look like by examining the current views held by the public. Critically, such a debate will emerge in the public sphere, which I define, following Charles Taylor, as "a common space in which the members of society are deemed to meet through a variety of media: print, electronic, and also face-to-face encounters; to discuss matters of common interest; and thus to be able to form a common mind about these." The public sphere is where we as a society debate matters of collective concern, such as whether we should engage in wars in the Middle East, whether we should be tolerant of different sexualities, or whether we should spend the society's money to combat pollution. Scholars often examine the views of participants in the public sphere and how these debates are influenced by powerful institutions such as the media, social movements, and the state. To fully understand how a debate will unfold in the public sphere, one would have to examine all these influences-clearly an impossible task for one book. Instead, I want to shine an analytic light on how the ordinary participants in the public sphere view RGTs. Although these views will eventually be shaped by powerful institutions as a debate emerges, power is not absolute, and the initial views of the public can only be pushed so far in a short period of time. To paraphrase an old adage: One can make a bowl, a plate or even a chair out of a block of clay, but making a functioning car is not possible.
Understanding Religious Opposition to RGTs
The first and most obvious question about a future RGT debate in the public sphere is what the public currently thinks about RGTs. Instead of looking more thinly across the entire public, I decided to focus on the religiously oriented public because I think this more narrow investigation will make the greatest contribution to a healthy debate about RGTs. This is because many of the people who inhabit the powerful institutions in the public sphere that mediate between the public and government officials, such as the media, are fairly uninformed about the religious people of whom surveys show are the most opposed to RGTs. For example, one mediating institution is public bioethical debate, which is a group of primarily academics who deliberate about issues like RGTs. People in the public bioethical debate often talk with the media, teach in universities, serve on government commissions, and make recommendations to government decision-makers while explicitly or implicitly claiming to be representing the view of the public. In recent years bioethicists have split into mainstream and conservative factions, with the mainstream bioethicists associated with the Democratic Party and, most critically, avoiding religious ideas and arguments. The conservative bioethicists have been associated with the Republican Party and are more sympathetic to religious ideas.
Conservative bioethicists who use the religious ideas that animate a good portion of the citizens of this country were dominant during the eight years of the presidency of George W. Bush. With the election of Barack Obama, the mainstream bioethicists are returning to influence. They will be staffing government bioethics commissions and making recommendations about RGTs to government authorities, again by explicitly or implicitly claiming to know how the public that would be governed by these policies would view medical and scientific issues. While it is admirable that mainstream bioethicists want to represent the views of all the citizens, since mainstream bioethics debates generally lack religious participants, particularly conservative religious participants, I worry that this debate will not describe accurately the religious citizens' views.
Similarly, scientists are often provided with influential roles in debates about genetic issues. Studies have shown that scientists, particularly the scientists at elite Ph.D. granting institutions who are the most influential in the public sphere, are much less religious than ordinary citizens and very much less likely to be from a conservative religious tradition. Studies of these elite scientists reveal a pervasive ignorance about American religion, typically that all religious persons are fundamentalist Protestants-while confusing the statements of fundamentalist leaders with the views of the ordinary fundamentalists. This book will allow the public to determine whether powerful people like bioethicists and scientists are portraying properly the religious public's views. It is important that bioethicists and scientists get this right, or the legitimacy of their role in the public sphere will be threatened.
I will also focus on people's reasons for opposing RGTs, rather than their reasons for supporting RGTs. This is because the scientists and bioethicists are fairly aware of why people would support these technologies like the scientists and bioethicists tend to do. Why people would oppose RGTs is, in my view, often not portrayed well by bioethicists and scientists.
This study is the first of its kind. There have of course been other studies of RGTs, such as studies of the views of the European and Australian public. But, even in the rare instances that these studies discuss religion, they implicitly highlight that religion is more central to the public sphere in the United States, and that a distinct study is required to make claims about the religious public in the United States.
In the United States, many studies of the public's views of genetic science in general have been conducted, such as the public's view of genetic determinism and genetic research broadly construed. A good number of studies also have examined how populations that have some particular exposure to genetic science by, for example, being a clinician or having a genetic disease, view RGTs. These are not studies of the general public, nor are they focused on religion, so these do not cover the same ground as this book.
A number of survey studies have also evaluated the U.S. public's view of RGTs. Although these sometimes have the religious tradition or religious service attendance rate of the respondent as variables in the models and show that certain religious traditions and higher attendance rates lead to opposition to RGTs, it cannot be determined from these studies why this would be so. The few qualitative studies of the public's views of RGTs have used focus groups to look at the public in general and not the religious respondents in particular. These studies may have a religiously oriented focus group in their sample, and religion may become an issue in other focus groups, but they have not focused on religion to the extent I do here.
Therefore, we do not know why religious citizens tend to oppose RGTs. For example, why are evangelicals more likely to be opposed to RGTs than others? The first purpose of this book is then to further our understanding of opposition to RGTs by inductively examining the reasons people give for their opposition to RGTs. I conduct this examination through a nationwide in-depth interview study of members of religious congregations, and a 4,800-respondent nationally representative public opinion poll. These two methods inevitably provide different lenses with which to examine the questions, but by looking through both we can obtain a clearer picture.
Although I am interested in how religious people "think" about RGTs, I am studying how they discuss RGTs, because a person's language about their thoughts, rather than solely their thoughts, influences others in the public sphere. Of course, any theory of why people talk in a particular way must have an assumed psychological model, and my model is discussed below.
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Table of Contents
AcknowledgmentsCHAPTER 1. Introduction 1
CHAPTER 2. The History of Abortion, Reproductive Genetic Technologies, and the Contemporary Public’s Views
CHAPTER 3. Talking About Embryonic Life
CHAPTER 4. Nature, God, Humanity, and Promethean Fatalism
CHAPTER 5. Human Dignity and Equality of Treatment
CHAPTER 6. Meaningful Suffering
CHAPTER 7. Will Religious Discourse about Reproductive Genetic Technologies Limit Debate?
CHAPTER 8. Conclusions
APPENDIX A. Methodological Appendix
APPENDIX B. Religious Respondent Interview Guide
Notes
Works Cited
Index