Bioethics grew out of the need for a code of ethics that contained not only a medical component, but also a social component. As such, bioethics is founded upon three principles: respect for persons, justice, and beneficence. Though the principles are helpful in bioethical debates, how these principles relate to one another, which takes precedence, and how to apply the principles in various scenarios has yet to be unraveled. Various arguments surrounding topics such as cloning, prenatal testing and reproductive technologies, equality, and population control remain at the forefront of bioethical debate. Due to fears that biotechnological advances may lead to new forms of eugenics, bioethicists consider the issues carefully and thoroughly, but consensus is rarely achieved.
The Birth of Bioethics
The earliest medical codes of ethics, dating back to the Hippocratic School between 300-400 B.C., involved physician qualities and behavior and did not begin to involve social concerns until the 1840s with the establishment of the American Medical Association. As the science of medicine was rapidly advancing, an “ethics of competence” stating that “the practitioner’s highest moral duty was mastery of that science for the benefit of the patient” became the focus for practitioners (Irving 2000). Dr. Chaunsey Leake (1896-1978) extended the focus beyond the individual patient toward society as a whole, creating instead a “foundation of moral philosophy”; this move opened the discussion for “benefit” vs. “harm” as it was no longer clear where the ethical boundaries should lie in the medical practitioner’s pursuit of knowledge (Irving 2000). Discussions centering on such topics as genetic engineering, organ transplantation, and human embryo research took place during the 1960s and 1970s resulting in the Belmont Report, the foundation of bioethics. The report focuses on three bioethical principles: respect for persons, justice, and beneficence and remains the standard used in modern bioethical debate.
Cloning and Genetic Modification
With the advent of the first successfully cloned (from an adult cell) mammal in 1996, Dolly the Sheep raised many concerns regarding benefit vs. harm. David Masci writes, “While many Americans support advances in biotechnology for medical purposes, the notion that the same research might lead to ‘designer babies’ or human clones scares them” and reports that a “Time/CNN (2001) poll found that 90 percent of Americans opposed human cloning and that 92 percent were against creating ‘genetically superior human beings.” Reasons given by bioethicists for imposing a ban on genetic human modification include the fear of unintended consequences, fear of creating further class division, and for some, the belief that creating humans is God’s work. Others, however, feel that the benefits outweigh the risks. They believe that “the ability to change human life at its most fundamental level will herald a new age of healthier, smarter, and happier people (Masci 2001).
Trait Selection Through Reproductive Technologies
Perhaps the most compelling argument for continued biomedical research is the idea that the human lifespan can be improved, both in longevity and in quality. Various reproductive techniques such as selection of traits and mitochondrial transfer using in vitro fertilization, as well as amniocentesis and other screening methods with the option of aborting flawed fetuses, allow for selection of only the most viably strong and able fetuses and are supported by bioethics advocates. On the other hand, many fear that any interference with the human genome may reduce man’s pursuit of self and his ability to transform through hardship. The meaning of life is a fundamental concern involved in this debate and questions whether the attainment of health and longevity with resulting material and economic success is a more valid pursuit than that of an individual’s growth and transformation through hardship. Furthermore, Schofield states, “How do we choose which traits are better and more useful? The answer, of course, is that we do not. For our society to exist, many varied skills and personality types are essential and different traits are important to different people” (2011). Some would say that this response not only serves to clarify the intrinsic worth of and respect for persons, but also serves as a protection against the eugenic philosophy involved in the debates concerning (genetic) justice, or ideological equality.
Advocates of genetic engineering frequently argue that distributing specialized traits amongst humankind will put humans on more equal footing. According to Richard Hayes, various groups propose that genetic modification be used to create equality, not by distributing one or two specialized traits to each person, but by standardizing intelligence and health. He warns that even if scientifically possible, it could only be implemented under an extremely authoritarian leadership. The implication of this scenario is that not only would human rights be threatened, but life itself would be devalued; equality would give rise to eugenics, eventually threatening any deemed not valuable to the society (Hayes 2007). In terms of bioethical principles, this argument for justice pits respect for persons against societal benefit.
Often, the argument for ideological equality turns to population control as widespread genetic change remains improbable in a large population base. Population control during the early eugenic movement was achieved by institutionalization and sterilization (negative), and encouragement of hygienic breeding (positive). In the modern age, population control is accomplished through an individual’s choice and includes methods such as birth control and abortion. Bioethical concerns revolve around the concepts of choice and personhood (who and what can be considered a person). Of importance is verifying that choice is not replaced by coercion and that definitions of personhood include all vulnerable groups.
The Future of Bioethics
As biotechnology continues to surge forward, the questions posed to bioethics will expand in quantity and complexity. Protections against eugenic practices will be determined through the ability of bioethicists to unravel the difficult relationships between the three bioethical principles, respect for persons, justice, and beneficence, in relation to the problems which they are called upon to resolve.
Arnason, V. (2014). From species ethics to social concerns: Habermas’s critique of “liberal eugenics” evaluated. Theoretical Medicine and Bioethics, 35, 353-367. http://dx.doi.org/10.1007/s1107-014-9308-2
Clements, C. (2002, March 5, 2002). The new eugenics: bioethics has its own ideology hostile to genetics and accepts, on faith alone, the feasibility of creating social environments which can cure all problems. Medical Post, 38(9), 13. Retrieved from http://search.proquest.com.ezproxy1.lib.asu.edu/docview/228853239?accountid=4485
Dorsey, M. (2002). The New Eugenics. World Watch.
Elshtain, J. B. (2003). A new eugenics? Public Interest, 152, 141.
Fox, D. (2007, March1). The Illiberality of “Liberal Eugenics”. Ratio.
Hayes, R. (2007). Our biopolitical future: four scenarios; emerging genetic technologies could radically reshape the world, for good or ill. World Watch, 20(2).
Irving, D. N. (2000). What is bioethics? Retrieved from http://www.all.org/abac/dni010.htm
Masci, D. (2001). Designer Humans: Will Altering Human Genes Divide Society? CQ Researcher, 11(19).
Prusak, B. G. (2005). Rethinking “Liberal Eugenics”: Reflections and Questions on Habermas on Bioethics. Hastings Center Report
Schofield, K. (2011, April). Psychology and transhumanism: Kerry Schofield explores the existing and future relationship between transhumanism--the application of technology to improve the human condition--and psychology. Psychology Review.
Wilkinson, S. (2007). Eugenics and the Criticism of Bioethics. Ethical Theory and Moral Practice, 10, 409-418. http://dx.doi.org/10.1007/s10677-006-9058-y