Hold onto your socks, it’s time to think calmly about a topic that quickly, and sometimes frighteningly, blurs the line between science and science fiction: directed evolution — altering our genetic makeup in ways that can be passed down to future generations.

Want to hear the scary part first? Consider that in a matter of years, we will most likely have the ability to change snippets of genetic information in an early stage embryo (created by in-vitro fertilization and then implanted in a mother’s womb) and thereby create a child who is taller, or stronger, or less at risk for cancer, or, more controversially, less likely to be homosexual.

Even for people who aren’t religious conservative or environmentally radical, that degree of power over a child’s genetic endowment can seem frightening and too open to abuse. Will those with money and access create über-offspring who eventually rule over the genetically inferior? Will children become commodities, with parents picking and choosing traits from a genetic menu? Will scientists unwittingly damage such children even as they seek to enhance them?

These monstrous scenarios are explored by Ron Green, director of the Ethics Institute at Dartmouth College (and former undergraduate thesis adviser to ReligionWriter), in his new book, Babies by Design: The Ethics of Genetic Choice. But as scary as these possibilities are, Green takes a progressive view and firmly asserts that the benefits of such genetic intervention may, in some cases, outweigh the risks. These ethical questions are not simply academic brain-teasers, asserts Green, founding director of the NIH’s Office of Genome Ethics, because scientific advances are rapidly bringing the hypothetical to life. He writes:

Whether in ten, twenty, or thirty years, the first deliberate inheritable modifications of human genes will take place. … Having vastly expanded our control over the world around us, our species is now rapidly developing the ability to alter the world within. The question is not whether we will do this but when and how.

[Most people, of course, don’t keep up with the latest developments in genetic engineering, but Green shares at least one breakthrough that shows how truly amazing the progress is. He describes how University of Utah researcher Mario Capecchi and fellow scientists have discovered a way to not only add specific genetic material to targeted areas of the human genome, but also “unzip” and remove the added material at a later date. Previously, genetic interventions were both cruder and permanent. (Not coincidentally, Capecchi was awarded the Nobel Prize in Medicine in October.)]

Does Genetic Intervention Infringe on God’s Power?

But back to the headline question: What would God do? That is, does religious faith or compassionate humanitarianism obligate us to improve lives and relieve suffering? According to Pope John Paul II, the answer is yes.

Writes Green: Although that pope “took a very conservative position on many new bioethical questions, [he] repeatedly approved of gene therapies so long as they respected other Catholic reproductive norms (such as the bans on contraception and IVF) and were aimed at curing or preventing disease.” Of course, the former pope’s word is not the be-all and end-all on religio-ethical debates for most people, but it is certainly significant that a leader of such stature gave the green light to genetic modifications, even those that can be inherited.

In spite of such religious A-OKs, however, many people — regular folks and bioethics professionals alike — have serious reservations about tinkering at all with the human genome, which the United Nations has declared the “heritage of humanity.” Writes Green:

According to a long tradition in the Jewish, Christian and Muslim faiths, the original divine act [of creating Adam] repeats itself every time a new human comes into existence. … For those influenced by these traditions, human control of genetic makeup represents a Promethean seizure of God’s power. Some, like Leon Kass, the former head of President Bush’s bioethics council, regard genetic intervention … as the effort by limited and puny creatures to seize control of the one domain that is God’s alone.

RW agrees with Green that this conservative view, that genetic intervention is inherently blasphemous, is problematic. Green points out that even the very conservative are comfortable with other modifications of God’s creation, such as surgery. To RW, however, this conservative view also has some theological problems.

If you believe that God is all-powerful, then how can “puny” human power ever threaten that power? Omnipotent means omnipotent, right? RW sees this same theological problem on the Catholic ban on birth control — can God’s will really be thwarted by a condom? As many parents know, even the best-laid birth control plans can be overturned with a surprise pregnancy.

Is It Right to Enhance Our Children?

Where Green intentionally pushes the envelope is his argument that gene intervention for enhancement, rather than just therapeutic, purposes should be considered. Think plastic surgery rather than heart surgery. Plastic surgery, of course, is often looked down upon as a shallow pursuit of skin-deep beauty. Yet procedures like LASIK, which correct vision, are considered more acceptable.

What if you could have an operation to improve your memory? That might not seem like such a bad idea, if the associated risks were low. If so, what is your argument against a genetic intervention that would give your unborn child — and his or her offspring — enhanced mental capacities?

Green argues that most of us suffer from a “status quo bias” when it comes to thinking about changing our DNA. If it seems unfair to genetically enhance a child’s athletic abilities, Green invites us to consider the fact that genetic endowments are already unfair. Athletes like Lance Armstrong, Green points out, have been shown to have key inherited traits — long femur bones, lungs capable of taking in large amounts of oxygen — that give him an inborn advantage over competitors. In other words, the current playing field is not as level as it seems, and genetic enhancement could, in some cases, even work to make things more fair, writes Green.

Green’s message throughout the book seems to be: Yes, the new world of genetic modifications presents complex and sometimes scary possibilities, but we don’t need to reject them out of hand; we can think rationally about them. Such a calm, careful and even hopeful voice serves an important purpose — but as divisive public debates over stem cell research, abortion and Terry Schaivo have showed, such thinking often becomes lost in the shouting.

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Should dying Americans have the legal right to end their lives with help from their doctors? In Oregon, they have already had the right for the last ten years, since the state passed its “Death with Dignity Act,” after great controversy, in 1997.

Last week the Pew Forum on Religion & Public Life hosted a polite but pointed debate between two formidable players with very different points of view. ReligionWriter, attending the event, watched the two expertly zing the argument back and forth across the court, as Pew senior fellow David Masci umpired the match. And the winner? You’ll have to decide for yourself.

Autonomy vs. the Slippery Slope

The debate was not about religion per se. Leon Kass, former chair of the President’s Council on Bioethics, who opposes legalized aid in dying, asserted that his objection was not theological:

For me, it’s not a religious argument that your life is not yours, and therefore you submit to whatever comes your way, though I suspect if one thought that there might be less mischief done.

Rather, said Kass, his objection was not only that the Hippocratic Oath specifically forbids doctors from giving “deadly drugs” to those who ask for them, and that, in his view, the State of Oregon does not adequately ensure the law is not abused, but also that legalization of aid in dying leads to a slippery slope, at the bottom of which is a society where old or disabled people are encouraged to see themselves as “better off dead.”

Barbara Coombs Lee, president of the pro-aid-in-dying organization, Compassion & Choices, argued that the slope is not slippery at all, that ten years of Oregon’s Death with Dignity Act have not led to involuntary euthanasia or other horrors, and that many people simply take comfort in knowing they have an option and the right to exercise it. Said Coombs Lee, Oregon’s current law

assures that moral authority resides with individuals. … To assume moral agency for our own important life decisions from the time we achieve decision-making capacity to the time we die, that is what dignifies us as human beings, not the decision that we make.

Choosing to take life-ending medication prescribed by a doctor is not suicide when you are already facing an imminent and painful death, said Coombs Lee. She referred to Tom McDonald, a cancer patient who testified before California’s Senate Judiciary Committee when it was considering a right-to-die law (the law did not pass.) McDonald told the committee he would rather end his own life peacefully with doctor-prescribed drugs than face a death that, according to his doctor, will involve him drowning in his own blood when his tumor ruptures his pulmonary artery. Coombs Lee remarked at the Pew event: “I think McDonald deserves a right to determine the memories that his family will be left with when he dies.”

Parallels: Entering the World, Leaving the World

Far from such rarefied Washington D.C. discussions, a very different yet strangely similar debate goes on, this one among pregnant women on messages boards at popular sites like iVillage and BabyCenter.

The question facing those in advanced pregnancy is often this: Whether or not to hasten the birth of their child. Medical inductions are on the rise in the U.S., as are elective Cesarean sections. Parents talk about their desire to control the circumstances of the birth, for any number of reasons, such as avoiding perceived health risks or scheduling the birth for family convenience.

For those who believe in “natural childbirth,” however, something is not quite right about elective inductions or c-sections. Proponents argue that children should come in their own time, not on someone else’s schedule. And, as in the end-of-life debates, for religious people, there is just something that feels like God’s will about letting birth happen “naturally,” even if it’s messy or painful or inconvenient.

The debate about elective inductions and c-sections tends to swirl around the pragmatic question of whether they pose any risks to mother or child, just as the right-to-die debate tends to focus on issues like oversight and use-rates. But the philosophical issue at the heart of both debates is: Does human power threaten divine power? Is there a limit to what humans should be able to control? People are generally comfortable with hastening or intervening in other biological processes — pulling out baby teeth or installing a Pacemaker — but when it comes to birth and death, the issue seems to become more fraught.

Inevitably every woman in late pregnancy has to make certain decisions about how and when to have her baby (and there are some further interesting parallels between “birth plans” and living wills, and how both are often ignored or deemed irrelevant in the actual event,) but in this case all the options are legal.

And this is the nub of the right-to-die debate. You may believe that choosing to end your life under any circumstances is tantamount to an immoral or illegal suicide, or you may believe that the very value of your life is represented in your own choice to die peacefully. But should your own preference become law?

As Leon Kass acerbically noted during the Pew Forum discussion, anecdotes make bad policy. How can you create a law that gives everyone a chance to do what they think is right? If you’ve got a good answer to this one, please let the rest of us know — advice is needed.

Note: While ReligionWriter does contract work for the Pew Forum, including work related to the right-t0-die  event transcript, the above posting represents only her views, and not the views of the Pew Forum.
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