THE SPIRIT: Who Will Make the Choices of Life and Death?

The quantum leap in man's abilities to reshape himself evokes a sense of uneasiness, a memory of Eden. Eat of the forbidden fruit, God warns, and "you shall surely die." Eat, promises the serpent, and "you shall be like God."

That temptation--to be "like God"--is at the root of the ethical dilemmas posed by molecular biology. In one sense, the new findings have continued the work of Newton, Darwin and Freud, reducing men to even tinier cogs in a mechanistic universe. At the same time, it was man himself who deciphered the code of life and who can now, in Teilhard de Chardin's phrase, "seize the tiller of the world." If he is only a bundle of DNA-directed cells, more sophisticated but hardly dissimilar from those of animals and plants, he can at least use that knowledge to improve, even to re-create himself. But should he?

In his persuasive 1969 book Come, Let Us Play God, the late biophysicist Leroy Augenstein argued that man takes the role of God by default or design and has always done so. Ecologically, he changes the very face of the earth: first with plows, then with dams, insecticides and pollution, he has seriously upset the balance of nature. His humane instincts and scientific curiosity team up to preserve life so well that the world faces a population crisis. Moreover, by extending the lives of those with defective genes, science increases the chance that damaging genes will be passed down to ever-larger portions of succeeding generations. Germany's pre-eminent Protestant ethicist, Helmut Thielicke, notes that men must recognize how "the act of compassion to one generation can be an act of oppression to the next." Thielicke argues that men must be willing to make hard choices. If society intervenes to keep alive the hereditarily ill (as he believes it should), then it must also be willing to intervene again, perhaps even sterilizing some with hereditary diseases.

THIS IS ONLY ONE kind of ethical problem raised by the new genetics, and it is already close at hand. Other problems are still in the far future, but how the dilemmas of population control are handled will set important patterns for later issues.

Population pressures increase the likelihood of widespread government drives, or even coercion, to limit births. Couples who are warned by genetic counseling that they risk producing deformed offspring would face far greater pressure than they do now to avoid having children; those with defective genes could become, in effect, second-class citizens, a caste of genetic lepers.

One current example illustrates the problem. Amniocentesis can now quite accurately predict whether a fetus is mongoloid; women carrying such abnormal fetuses are now encouraged, where it is legal, to have abortions. Already a number of medical planners are pointing up the cost-effectiveness of abortion in those cases. Unless the birth rate of mongoloid children is reduced, their care by 1975 may well cost some $1.75 billion nationally.

Methodist Paul Ramsey, Professor of Religion at Princeton and one of the top Protestant ethicists in the U.S., protests the aborting of such abnormal fetuses as an unjustified taking of human life. But he does not think moral men can avoid the problems of population and genetic crises. Indeed, he urgently recommends that society develop an "ethics of genetic duty." The right to have children can become an obligation not to have them, Ramsey asserts; it is shocking to him that parents will refuse genetic counseling and take the "grave risk of having defective children rather than remain childless." Dead set as he is against abortion in all but the most serious cases, Ramsey would prefer to see one parent undergo voluntary sterilization. "Genetic imprudence," he says, "is gravely immoral."

To Ramsey and others, genetic surgery--repairing, replacing or suppressing a "sick" gene--could be profoundly moral. Depending on the defect, genetic surgery before or after birth could prevent abnormality, and also insure that it was not passed on. Moral Theologian Bernard Haering of Rome's Accademia Alfonsiana applauds basic remedial intervention as "corrective foresight."

BUT HAeRING IS ONE among many, both scientists and ethicists, who find it considerably harder to justify "positive" genetic engineering, restructuring the genes to make the "perfect" man. The prospect suggests apocalyptic possibilities: M.I.T. Biologist Salvador Luria approaches it "with tremendous fear of its potential dangers." Biologist Joshua Lederberg of Stanford University disowns such Utopian aims as a proper goal for serious biology, and even doubts that techniques sophisticated enough to achieve them could be perfected in the near future. But the possibility nonetheless tantalizes: Who would decide what qualities to preserve, and by what standards? Even remedial genetic engineering could pose a distressing problem if it achieved the ability to remove "undesirable" behavior tendencies. Asks Thielicke: "Would one try to eradicate Faust's restlessness, Hamlet's indecision, King Lear's conscience, Romeo and Juliet's conflicts?"

Human cloning, the asexual reproduction of genetic carbon copies, raises similar questions. Who shall be cloned, and why? Great scientists? Composers? Statesmen? When Geneticist Hermann J. Muller first broached the idea of sperm banks in Out of the Night (1935), he suggested Lenin as a sperm donor. In later editions, Lenin was conspicuously absent, replaced on Muller's list by Leonardo da Vinci, Descartes, Pasteur, Lincoln and Einstein. Society could well be as fickle--or worse--about cloning. It might create a caste of subservient workers, as in 1984, or a breed of super-warriors out of a "genetics race" between the U.S. and the U.S.S.R. An even more hideous nightmare would be the "clonal farm," where anyone could keep a deep-frozen identical twin on hand for organ transplants.

Such fanciful fears tend to obscure deeper ethical and practical objections to cloning. The process could be used, for example, to allow a woman to produce a child without passing on her own or her mate's defective gene. A cell nucleus from the genetically sound parent could be substituted for the nucleus in her egg. But even that quite reasonable application could introduce a novel set of complications. Would the cloned child develop a sibling rivalry with its biological parent? Would he face a severe identity crisis, being someone else's "duplicate"? Beyond such considerations, a number of scientists and ethicists would list cloning among those things that men should never do, even if they can. Says Embryologist Robert T. Francoeur, author of Utopian Motherhood: "Xeroxing of people? It shouldn't be done in the labs, even once, with humans."

TO MANY CRITICS cloning is only one of several biological developments that threaten what Paul Ramsey calls "a basic form of humanity": the family. Ramsey thinks that artificial insemination by a donor, which is already fairly common, has opened the door to further invasions of family integrity. In his recent book Fabricated Man, he mentions other possible developments: artificial inovulation (the "prenatal" adoption of someone else's fertilized egg), "women hiring mercenaries to bear their children," and "babies produced in hatcheries." Beyond finding some of the possibilities repellent, Ramsey argues that they violate "covenant-fidelity," a bond of spiritual and physical faithfulness, between wife and husband or parent and child.

Francoeur, on the other hand, feels that the new embryology can lead to a fresh flexibility in the family structure. He favors host mothers (Ramsey's "mercenaries") because some women want children but cannot carry them to term. In an opposite way, artificial inovulation could be the means for a sterile mother to bear a child, even if not from her own egg. But he draws the line at artificial wombs, which, he says, "would produce nothing but psychological monsters." Others emphasize that the family itself must survive to fill important psychological needs. Molecular Biologist Leon Kass, who left the research labs to become executive secretary of the National Academy of Science's Committee on the Life Sciences and Social Policy, puts it effectively: "The family is rapidly becoming the only institution in an increasingly impersonal world where each person is loved not for what he does or makes, but simply because he is. Can our humanity survive its destruction?"

Beyond population control, beyond "Xeroxing" and patterning people, beyond the survival of the family lies the ultimate ethical question: the sanctity of life itself. The move toward new knowledge requires experimentation. The new generation of experiments, however, involves human life, and many moralists suggest that many of those experiments are intrinsically evil because they toy with life. They point, for example, to the experiments by Italian Biologist Daniele Petrucci, who in 1961 announced that he had kept a fertilized egg alive for 29 days in vitro (in the glass) before letting it die because it was monstrously deformed. Another Petrucci embryo lived for 59 days before it died because of a laboratory mistake. The Vatican, which sternly forbids all experimentation with fertilized eggs, demanded that Petrucci cease his investigations. He agreed to comply.

IN A RECENT experiment conducted by Landrum Shettles at Columbia University, a 100-cell human embryo growing in a petri dish was unceremoniously pipetted in a salt solution onto a glass slide. For those who believe that human life begins with fertilization, Shettles' simple laboratory procedure was an act of unjustifiable killing, even though such experiments might help perfect a morally justified technique like genetic surgery. Even in the case of laboratory mistakes that might produce monsters, argues Bernard Haering, only those that are clearly inhuman should be destroyed. A number of scientists, on the other hand, subscribe to an alternate ethical view that an embryo is not human until later in its development--perhaps as early as two months or as late as six months.

Most scientists, naturally, fight what they see as arbitrary limits on their right to experiment. But not all. Testifying before the House subcommittee on science in January, Molecular Biologist James Watson took time off from his cancer investigations to express concern about developments in embryo research. Predicting that many biologists would soon join Britain's R.G. Edwards in experimenting with human eggs, Watson suggested that one course of action could be to prohibit all research on human cell fusion and embryos. Failing that, he proposed international agreements limiting such research before it becomes widespread and irresponsible, and before "the cat is totally out of the bag."

Watson is not alone in his worries. Last summer Biologist James Shapiro, one of three young scientists who successfully isolated a bacterial gene, gave up his promising career to take up social work because he feared government misuse of genetic achievements. An Episcopal priest, Canon Michael Hamilton of Washington (D.C.) Cathedral, called Shapiro's action a "loss of nerve." Yet the looming issues are enough to test the nerve of any thoughtful man. Central is the question: Who will decide? Who will make the choices not only of life and death, but what kind of life?

To consider such issues, Roman Catholic Lay Theologian Daniel Callahan and a number of like-minded ethicists and scientists have set up the Institute of Society, Ethics and the Life Sciences. Among the 70 members are Geneticist Theodosius Dobzhansky, Psychiatrist Willard Gaylin, Theologian John C. Bennett, and U.S. Senator Walter F. Mondale of Minnesota, who three years ago introduced a bill to establish an interdisciplinary committee to examine new scientific problems. It did not pass, but Mondale is trying again this year. "There may still be time," he says, "to establish some ground rules."

The long-term goal of the institute, says Callahan, is "legitimizing the problems," making the study of ethical issues a respectable part of the scientific curriculum. Too many scientists, says Gaylin, "see this as something mushy, something for Sunday morning, beyond the realm of science." To change that situation, the institute is trying to educate legislators on the importance of ethical considerations, and is encouraging universities to offer a solid background in ethical studies for "every scientific professional." At the Texas Medical Center in Houston, a similar interdisciplinary effort has been started by the Institute of Religion and Human Development and the Baylor College of Medicine. The Sunday School Board of the Southern Baptist Convention has developed a thorough adult-education course on biomedical issues as one of its electives for this spring.

Cancer Researcher Van Rensselaer Potter of the University of Wisconsin has suggested in a new book, Bioethics, that the U.S. create a fourth branch of Government, a Council for the Future, to consider scientific developments and recommend appropriate legislation.

Indeed, some form of superagency may be the only solution to the formidable legal problems sure to arise. Already, laws relating to artificial insemination by a donor are in confusion; developments such as donor mothers and cloning will raise even more complicated questions. If a mother had herself cloned without her husband's permission, for only one example, would he be legally responsible for the child?

SOME SCIENTISTS, however, frankly believe that laymen are ill equipped to discuss issues with them, let alone share control of what they do. The matters, they contend, are technical and should be decided by the technical men who understand them. Even if government does enter the field, points out Daniel Callahan, much of the success of any ethical policy will depend on a responsible professional code. "If you depend solely on laws, sanctions and enforcements," says Callahan, "the game is over." Molecular Biologist Francis Crick is confident that basic morals and common sense will prevail. Some of the wilder genetic proposals will never be adopted, he claims, because "people will simply not stand for them."

Some ethicists and scientists argue that the worries, the plans and the proposals are premature, that ethics has always been an ad hoc thing, dealing with the world as it is, not as it might be in the future. Given the enormousness of the new problems and the speed of change, that attitude may be a luxury.

Beyond the sanctity of human life, the single criterion that ethicists most often mention as an absolute, or nearly one, is human freedom. Scientific advances, as they see it, can either promote freedom or inhibit it, but the distinctions are not always obvious or easy. The danger is that a democratic society might therefore fail to act at all, and by default pass the problems--and the solutions--to a small, uncontrolled elite, leading perhaps ultimately to a totalitarian government. The late author C.S. Lewis warned more than a quarter century ago that "man's power over Nature is really the power of some men over other men, with Nature as their instrument."

Despite the urgency, there can be no single ethical approach to the problems posed by the new genetics. The mechanists may want simply to deal with the facts of molecular biology, exploiting its discoveries as well as they know how, but not quite willing to look beyond to spiritual considerations.

AMONG MANY religious thinkers, there is an affection for the futurist philosophy of Teilhard de Chardin, who wrote glowingly of a coming scientific age when men would exult in "fathoming everything, trying everything, extending everything" on their road to an ultimate Omega Point of shared godhood. Finally, there are those, believers and unbelievers, who know man to be a victim of what might still be called original sin. Those in the religious community, especially Roman Catholics, warn that man must not tinker with such sacred values as life and the family for fear of disturbing the natural order of things. Those in the scientific world, more pragmatically, tend to mirror Potter's warning about "dangerous knowledge"--knowledge that accumulates faster than the wisdom to manage it.

There is hardly a chance for complete consensus among the three schools, but it may help to borrow a lesson or two from each. From the mechanist, his conviction that there is an order in the physical world, discoverable and manageable if it is approached with enough humility to comprehend its mysteries. From the Teilhardians, the confidence that God, whoever he is, has something to do with the future and may yet meet man there. From those who still believe in man's propensity for error, the willingness to put on the brakes a bit and reflect on values and consequences--but also, as Helmut Thielicke counsels, the courage to act despite almost certain knowledge that man will make serious mistakes.

As they look back toward the time when man stood on the threshold of a biological revolution, troubled and uncertain, but determined to push ahead, what will the beings of the future say about their ancestors? Caltech Biologist Robert Sinsheimer suggests an optimistic--and poignant--answer in his essay "The Mind of Pooh": "Perhaps, when we've mutated the genes and integrated the neurons and refined the biochemistry, our descendants will come to see us as we see Pooh: frail and slow in logic, weak in memory and pale in abstraction, but usually warmhearted, generally compassionate, and on occasion possessed of innate common sense and uncommon perception."

This file is automatically generated by a robot program, so reader's discretion is required.