Dodging the Issue

by Susan Webber

Reluctant to take stands, " From Chance to Choice" forgoes an opportunity to contribute to the public debate on genetic engineering

Human genetic intervention promises tremendous benefits but also carries considerable risk. As a result, deployment of such a potent technology is inevitably, and correctly, held in check by public policy concerns, played out in controversy, legislation, regulation, and legal battles. It therefore behooves anyone interested in this arena to understand the broader social issues. Those who ignore them do so at their own peril.

Witness how Monsanto Co., in commercializing genetically engineered crops, tried bulldozing its way into Europe. Its complete misreading of public sentiment not only led to broad-based protests and calls for labeling of genetically-modified products, but also hurt Monsanto's stock price and drove it into Pharmacia & Upjohn's arms, producing Pharmacia Corp. And fiddling with human genes is a lot scarier than creating new types of corn.

Thus a work like "From Chance to Choice: Genetics and Justice," by Allen Buchanan, Dan W. Brock, Norman Daniels, and Daniel Wikler, which examines the ethical issues involved in human genetic engineering, has the potential to inform the debate. The authors are philosophers, professors, and leading bioethicists.

"From Chance to Choice" proved to be a singular experience. Never before have I read so much and emerged with so little sense of what the authors were trying to say. One could argue that book was written for academics, so its meaning may be more accessible to them. But the authors state they want to engage a broader audience.

The writers seem tremendously leery of reaching any conclusions, but nevertheless ventured a few. Even though they favor freedom of choice, particularly reproductive choice, they are wary of free markets: "It is no secret that the virtues of the markets, from the point of view of some participants, are simultaneously vices from the point of view of social justice....Markets permit the lucky, less vulnerable participants to detach their fortunes from those of their unlucky fellow citizens."

They advocate focusing genetic intervention on achieving "species normal" function, rather than on "enhancements," although they observe that the standards for normalcy are likely to rise as gene therapies become more prevalent. They grapple with the concern that these new treatments will further stigmatize the disabled. And they warn of the need for education, information, and counseling, particularly given how deterministic genetic information can seem (some individuals, when told that they had a genetic predisposition to Alzheimer's disease, have committed suicide).

Although "From Chance to Choice" intermittently has lucid sections, it is too often a stupefying read and fails its objective of serving non-academic readers. The writing is frequently turgid and repetitive. For example, they turn several times to the question of "wrongful life" (can a life ever be so bad as to be not worth living?) and each time, they start virtually from first premises, each time to reach the same answer (no).

The authors spend considerable portions of the book tracing arguments down to great levels of specificity to show that subtle changes in assumptions can produce different ethical situations. But from these elaborate examinations, they observe too often that it is difficult to draw "bright lines." They would have served their readers better by pushing their thinking to develop guidelines at a higher level of abstraction. They claim that there is value in this exercise, for it demonstrates that there are no easy answers, yet they also acknowledge that public policy debates do not lend themselves to complex, nuanced analysis.

Not only do they fail to make the structure of their argument explicit, but they also appear to have neglected to review their logical structure to determine whether there were more elegant ways of performing the analysis. The authors have lost sight of the forest for the trees - and lose their audience as well.

The best way to approach "From Chance to Choice" is to read the introduction, Chapter 2, on eugenics, and Chapter 8, "Policy Implications." Chapter 8 is cross-referenced, so you can find more details if needed.

The real irony is these bioethicist's reluctance to take firm positions. Yet ethics is a discipline that develops principles for determining what is good and bad. It appears that the writers have been infected by the diseases of cultural relativism and political correctness, which reject notions of absolutes, including connoisseurship, morality, and objective truth.

This book illustrates that one response is for academics to operate in a quasi-shamanisitic manner, using forms of discourse and analysis that are not readily understandable by the layman, and therefore not readily challenged. Yet even though some of the leading minds of modern philosophy, such and Kant and Kierkegaard, are notably impenetrable, the example of A.J. Ayer (or even Einstein's paper on relativity) shows that cutting-edge thinking on difficult subjects can be presented in an accessible manner.

"From Chance to Choice" asks many of the right questions, but comes up with far too few answers. But perhaps being a philosopher in the modern world is more about avoiding error than seeking the truth.