To the Editor:

In “The Moral Meaning of Genetic Technology” [September], Leon R. Kass recognizes the enormous potential of genetic technology to alleviate human suffering and so will not condemn it—but neither will he endorse it. His worry is that it portends some fundamental change in man’s view of himself and his power of self-transformation. He fails to show, however, that such a change is implicit in the new technology.

Indeed, our rapidly advancing genetic technology differs merely in degree from knowledge and practices that have existed for millennia. Does Mr. Kass believe that his grandchildren should feel diminished as human beings because he can conclude, based on his own family and racial history, that they are infinitely more likely to become professors at the University of Chicago than power forwards for the Chicago Bulls? If not, then how will more specific chemical knowledge of the base pairs that comprise their genes substantially narrow their view of life’s possibilities?

Does Mr. Kass lament the power that is already at his disposal for shaping the genes of his offspring? After all, it did not require Crick and Watson’s discovery of the double helix for human beings to understand that the characteristics we value in our offspring—health, beauty, intelligence—are profoundly affected by our choice of mate. If the moral issue is the propriety of exercising control over the likely characteristics of our progeny, then such concern should rest more squarely on the conscious choice of mates than on some limited prospect for genetic manipulation.

Lloyd Cohen
Clifton, Virginia

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To the Editor:

It is hard to understand how a trained physician like Leon R. Kass could argue that ordinary medical practice “treats only existing individuals, and it treats them only remedially.” What about preventive medicine, prenatal care, and genetic counseling, which are not remedial, and affect future generations?

As for Mr. Kass’s referring to a child with spina bifida as “intelligent and otherwise normal,” this is disingenuous. Children with severe forms of the disease have paralysis and deformities of the legs, recurrent urinary-tract infections, meningitis, and generally miserable lives. Far from strengthening Mr. Kass’s argument, such children demonstrate the need for genetic research.

Lawrence I. Bonchek, M.D.
Lancaster, Pennsylvania

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To the Editor:

What has happened to Leon R. Kass’s optimism? In The Ethics of Human Cloning, the book he recently co-authored, he observed that we naturally recoil from the notion that the technology made famous by Dolly the lamb would be applied to people. He seemed confident that this instinct, which he called “the wisdom of repugnance,” was potent enough to prevail against “rational” arguments in favor of human cloning.

Now, as we confront the undesirable byproducts of future genetic technologies, Mr. Kass seems less sure of our ability, or even our desire, to raise moral objections. He concludes his article by warning that

unless we mobilize the courage to look foursquare at the full human meaning of our new enterprise in biogenetic technology and engineering, we are doomed to become its creatures if not its slaves.

Mr. Kass need not worry so much. The “wisdom of repugnance” is not dead, despite reports in the media of its seeming demise. Stories about infertile couples enthusiastically embracing reproductive technologies—particularly in-vitro fertilization and selective pregnancy reduction—may give the impression that these methods are universally accepted. They are not We seldom get to hear from the many infertile couples who object on moral grounds to even these relatively low-tech interventions.

Robert P. Lindeman, M.D.
Brookline, Massachusetts

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To the Editor:

Leon R. Kass lays out with shattering clarity the threat that genetic technology poses to man’s sense of freedom and dignity. I, too, fervently hope that “the technological way of approaching both the world and human life” will be “brought under intellectual, spiritual, moral, and political rule,” though I am none too sanguine.

I disagree, however, with Mr. Kass’s claim that “reductionism, materialism, and determinism,” considered “as philosophies,” have seemingly been “vindicated by scientific advance.” Biologists may think this is so, believing, as he writes, that “man is just a collection of molecules . . . a freakish speck of mind in a mindless universe,” but they do not really have the slightest idea how thoughts and feelings could arise from electrochemical brain processes. The origins of mind and consciousness and their interplay are still essentially a mystery.

Michael Kellman
Eugene, Oregon

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To the Editor:

As one reads Leon Kass’s “The Moral Meaning of Genetic Technology,” the specter of Hitler’s genetic-purification program appears. Of the several contributions Mr. Kass makes, it seem to me that two are most important: first, it is the benign and well-intentioned genetic scientist, along with his legislative and bureaucratic cohorts, from whom we, in our liberal society, have the most to fear; second, that genetic engineering is qualitatively different from all previous technological advances, and that the fear of this technology cannot be compared to obscurantist opposition to earlier advances.

Mr. Kass’s position is of moral importance, but his argument raises some questions. For instance, he entitles one of his sections “Playing God,” but we humans are not capable of playing God. In the sense Mr. Kass intends, however, human beings have always played God. Both military and civilian hospitals triage emergency patients. Young patients are more apt to receive organ transplants than elderly patients. Capital offenders are judged unworthy of life. Soldiers shoot the enemy. Life-and-death decisions, and decisions with destructive or constructive implications for society and human well-being, are indeed Godlike, but that simply means they should be topics for moral and ethical debate.

Yes, the destructive consequences of genetic technology are frightening to contemplate, but it also has a potential for good—and that is pleasant to contemplate.

Norman Siefferman
Fredericksburg, Virginia

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To the Editor:

Technological determinists tell us that there is no way to slow the genetic-engineering juggernaut. If Leon R. Kass’s reflections do not cause us to pause at least momentarily, nothing will.

C. Ben Mitchell
Deerfield, Illinois

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Leon R. Kass writes:

The point of my essay was to articulate and defend the ambivalences and anxieties people feel about the coming power to manipulate the human genome. I sought to show that these concerns are not the product of ignorance, superstition, or a lack of scientific knowledge. Though they disagree with this or that point, none of my correspondents has challenged my major conclusions or argued that the coming of genetic technology should be regarded as business as usual.

Lloyd Cohen comes closest to saying that genetic technology differs only in degree from practices “that have existed for millennia.” He pretends to see no difference between the indirect genetic effects of mate selection, where human partners are selected for reasons different from stud farming and where, in any case, chance still rules in every fertilization, and deliberate, direct genetic engineering to produce offspring with precise biological capacities. He pretends to recognize no difference between seeing children as a gift that we are duty-bound to humanize through speech and example in light of the good, and seeing children as a product whose qualities we determine by manipulating their bodies, consulting only our own subjective prejudices. I accept fully the heritable implications of choosing a spouse. But when I found a woman with whom to make a life and who might be a worthy mother of our children, I paid attention to her character, her tastes, and the things she esteemed and aspired to in life, not merely some morally neutral genetically determined capacity. Mr. Cohen has, perhaps unknowingly, already bought the reductionist view of life, marriage, and child-rearing.

Notwithstanding Lawrence I. Bonchek’s useful reminder about preventive medicine, prenatal care, and genetic counseling, I stick to my claim that ordinary medical practice focuses on remedying the ills of existing individuals who bring themselves to the physician, “seeking to correct deviations from a more or less stable norm of health,” in contrast to genetic engineering that will be able to alter in advance specific future individuals. Prenatal care, while not remedial, serves an existing (albeit invisible) individual, the intrauterine human being. Preventive measures in ordinary medical practice, e.g., in the form of immunizations, likewise treat the individual patient—not some future, as-yet-hypothetical child-to-be. Both of these practices also presuppose and serve an existing standard of health and fitness.

In contrast, genetic engineering, when fully developed, will be able to go to work on the next generation prior to conception, through modification of egg and sperm. And it holds out promise of altered human capacities, hence new and unstable norms of health. Genetic counseling, which is, strictly speaking, an illegal alien in the medical polity, already shows the way to these future and disturbing novelties. Who exactly is the patient and the beneficiary of genetic counseling? And what is its goal? In today’s prenatal diagnosis, followed by abortion, we have the one branch of preventive “medicine” in which disease is prevented by eliminating the patient. Should intrauterine gene therapy become feasible, the matter will be clarified and the therapeutic medical model will again prevail. But what about interventions to “enhance” the product? How will this be medicine? (By the way, Dr. Bonchek, the child with spina bifida in the case I cited was in fact otherwise normal.)

Robert P. Lindeman mistakes my vigorous defense of “the wisdom of repugnance” for optimism that it can prevail against the various technocratic arguments and socioeconomic pressures to practice human cloning. But whatever the efficacy of revulsion in the debate about cloning, the case of genetic technology is different. Here we have a technology that begins by promising cures for specific genetic diseases in specific individuals, and which only later may go on to perform its disquieting eugenic feats. In a culture that already allows people to sell their “eugenic” eggs on the Internet, revulsion alone will not find and keep the boundaries Dr. Lindeman and I would like to preserve.

I, of course, share Michael Kellman’s judgment about the inadequacy of materialist explanations of life, not only about mind and consciousness but even about such lowly matters as nutrition and growth (see my book The Hungry Soul). One cannot understand even animals without notions of form, wholeness, awareness, appetite, and goal-directed action—none of them reducible to matter-in-motion or even to DNA. But the materialism of science, useful as a heuristic hypothesis, is increasingly being peddled as the true account of human life by a new breed of bio-prophets, citing as evidence the powers obtainable on the basis of just such reductive approaches to life. Many laymen, ignorant of any defensible scientific alternative to materialism, are swallowing and regurgitating these shallow soulless doctrines, because, as I said, “they seem to be vindicated by scientific advance.” The result is likely to be serious damage to human self-understanding and the subversion of all high-minded views of the good life.

Norman Siefferman has a point when he likens human willingness selectively to take life to “playing God.” But almost all the cases he cites are justified either by sad necessity (triage, when not all can be saved, and war, when self-preservation is at stake) or by cause (retribution for murder). But these destructive acts are no precedent for the Godlike scientific creation of human life, whose “goodness” will be measured only according to the unlimited subjective will of its human creators. Such powers of “playing God” are surely cause not only for moral and ethical debate but also for worry and concern.

I thank C. Ben Mitchell for his generous words.

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