2.8. Advancing Biotechnology and the Crisis of Purpose
pp. 93-98 in
Bioethics in Asia
Editors: Norio Fujiki and Darryl R. J. Macer, Ph.D.
Eubios Ethics Institute
Copyright 2000, Eubios Ethics Institute
All commercial rights reserved. This publication may be reproduced for limited educational or academic use, however please enquire with the author.
R. R. Kishore.
Chief Medical Officer, Ministry of Health & Family Welfare, Government of India
President, Indian Society for Health Laws and Ethics (ISHLE), New Delhi - 110023, INDIA
In a world where every religion and culture contemplates continuance of life after death despite total absence of its proof the human endeavours can not be evaluated in the context of material perspectives alone. They are intimately linked with emotions, beliefs, faith, and traditions and require to be handled accordingly. Science, no doubt, has significant impact on human behaviour and relationships but it is not sufficient to sever the religious anchorage which acts as a great force to determine the moral content of human acts. On the biological plane, inspite of having a distinct genetic make-up, we are similar to other forms of life. All of us are born, live and die. But we are different from them inasmuch as we are persons. The human personhood is an emotional and value-based entity. All of us experience pain, misery, love, and joy. Human emotions are same everywhere and they have been same in all ages. This is a sign of human universalism and forms the basis of all human acts. This brings babies, discoveries, wars, and peace. This creates families, societies, and nations. But inspite of this intrinsic similarity the individuals can not be confined to a world of generalized standards, as the expressions differ. They reflect an individual's response to the situation in which he is placed. Different people react differently to the same environment and expect different responses from others. But despite these varied attitudes and expectations there has not been much dispute over the concepts of 'right' and 'wrong'. What is right and what is wrong? How do we learn it? From where did it come, why and when? It is difficult to answer these questions but one thing is certain: It is present in all human beings and has been with them since very long. It is deeply embedded in our thoughts. It is this concept, coupled with human emotions, which has assigned purpose to our actions. Biotechnological advancement has shaken this inherent edifice and the existing realities are no longer compatible with the emerging developments. Contemporary milieu therefore calls for answers at a much deeper level as the problem is not only medical, legal, technological or economical but involves questions of values, convictions, and human emotions.
1. What is the harm if genetic structure of Homo sapiens is modified and a different phenotype is created? After all, there was a time when we were grossly different from our present shape. Are we the sufferers because we failed to maintain our original form? We take pride in our present form rather than grieving over our lost identity. We call ourselves most evolved living beings. Those who failed to keep pace with the change died like Dodo and Dinosaurs. To resist change means to force extinction on our future generations. We have no right to compel the future generations to live in racial prejudice, impoverishment, disease, debility, and premature death. Our ancestors have never done it. What is the harm if a human being is created who consumes less resources, is more resistant, and more compatible with nature? Rather, this will provide more security and endurance to our future generations. Wisdom lies in vision and imagination and not in sticking to the present and the status-quo. Human race is already under pressure of dwindling resources, moral deficiency, and ecological disharmony. If the genetic intervention leads to creation of human species which requires less resources, lives under diverse whether conditions and is more compatible with other forms of life it should be treated as welcome change.
2. What is wrong in having parentless children? Our social and family concepts developed when biological processes were beyond human intervention. Today, when we have learnt the art of framing our biology the human relationships need redefinition. We have so far been synonymising parentage with origin without realizing that parentage is only a social and emotional expression. The advancing biotechnology mandates separation of this component from the biological element which is only confined to genetic linkage but our failure to reconcile with the emerging reality has led to the ethical miscarriage of concealment of genetic identity of the babies born out of donated gametes. Furthermore, an individual may not like to be created out of borrowed or donated gametes. Rather he/she would like to have been produced in the natural manner. But we have been making babies by artificial means. How are we competent to take decision in this regard? Why should an individual be a victim of hidden origin in order to satisfy the urge of others to own him as their child? And since the individual has already paid the price by being born why should his interests not prevail over the parents and why should his roots be concealed from him? Morality is intimately linked to science. Secrecy breeds mistrust and the moral structure raised on such false foundations cannot be stable. Transparency is the manifestation of truth and purity and affords the surest guarantee for rational and orderly human conduct.
3. Why should we not grow foetuses to harvest organs and tissues? We can liberate millions from disease and agony, improve their quality of life, enhance their contribution to the society and divert resources to other meaningful areas. What is wrong in it? How does it affect us? Does it imperil our survival, disturb our social order or cause economic insecurity? Or does it impart moral impoverishment or transgress our religious domains? Or is it the expression of our emotional vulnerability, without any scientific or metaphysical basis? Millions of people are dying due to organ scarcity. Sizable resources are being spent for curbing organ trade, enforcing prohibitions, maintaining organ banks and waiting lists, and on palliative measures to prolong life of terminally ill patients. Death has been redefined in an attempt to tide over the organ scarcity. Those who did not feel convinced with the new doctrine and perceived it as a premature termination of life had to ultimately concede. Quest to alleviate human misery took over moral mores. But the mere thought of producing foetal crops for harvesting tissues generates abhorrence and self-hatred. This reflects human sensitivities totally independent of scientific and material considerations. One may argue that rights accrue to a 'being', not to those who are yet to be born. Whatever I do i.e., my food, indulgences, priorities, likes-dislikes, job and everything else affects my progeny and in the process they may suffer avoidable harm. Does it mean that I should stop living in order to promote the interest of those who do not exist?
4. What is misery? What is pain? It is an individual's response to the situation in which he is placed and as such it may vary according to his personhood. We want organs to save the ill and dying. The family members do not allow them to be removed from a brain-dead person for fear of mutilation of the body leading to loss of peace to their dear-one in the heaven. Should we dismiss it as absurd, a mere superstition? Similarly, one may feel withdrawing support from a terminally ill patient is inhuman while another may feel it is perfectly in order. Medical decision is not based only on scientific imperatives but is also a matter of personal emotions, feelings and relationships. The decision in clinical and family settings contemplate flexibility. Paradigmatic rigidity in certain situations may lead to ethical miscarriage. Bioethics is a blend of biotechnology and culture and the discipline is further complicated because, in the same value system, different people feel differently.
5. Let us consider the following examples
i. eA', in the terminal stage of renal failure, is fighting for his life and needs immediate kidney transplantation but nobody is prepared to donate his kidney to him. 'B', totally depleted and impoverished requires money to buy food for himself and medical aid for his child, dying of serious sickness but nobody is prepared to provide financial support to him. 'B' gives his kidney to 'A' who in turn extends consideration to 'B' in order to safeguard his and his family's survival.
ii. 'A' is blind and requires corneal transplantation to restore his vision. 'B', under renal failure, needs immediate kidney. 'A' gives kidney to 'B' who donates one of his corneas to 'A'. 'B' survives. 'A' sees the world.
How should the above interaction be viewed? Immorality? Trading? Crime? Exploitation? Human Commodification? Perhaps none. Truly speaking, it is the expression of mutuality and reciprocity based on pragmatic considerations. So long the society is not capable of catering to the genuine and compelling needs of 'A' and 'B' they have the right to look after themselves with the help of each other. The instinct to survive is a biological reality and it is their inherent duty to preserve their life. However, one may argue that there are things worse than death and greater than life and in order to uphold human dignity sacrifices have to be made.
6. We have to ensure that the advancing biotechnology remains a purpose oriented pursuit and the cart is not put before the horse as we have done in the past. We discovered atomic energy without attaining maturity to put it to the right use. We have been exploring space without knowing its impact on the humanity. And now we are involved with human genome. Knowledge in the absence of right attitudes may be dangerous. Time has come when we have to see beyond our scientific achievements. Why are we so deeply involved with biotechnology? What is the purpose behind our tryst with the genes? Why do we want to decode human genome? Who is going to be benefited ? What is meant by benefit? Before searching answers to these questions we have to answer two basic questions-
I. What is a human being?
ii. Why should there be a human being?
Let us answer the first question. Had the human being meant only the human genome and its expression the answer would have been simpler. But the human being means human creature plus human personhood. I leave this question here as I would be discussing it further in the next section of this paper, namely, the 'Indian Cultural Thought'. The second seems more difficult. It can be replied by counter-questions. Why should there be a universe? Why should there be anything at all? What will happen if the human being becomes devoid of human entity? What is the harm if I live like a plant? Why blue is blue, and red is red ? Why 2+2 = 4 ? Quest to find an answer to every question leads to nullity. Universe exists on intrinsicality. Analysis and dissection beyond a certain point results into loss of an object. There seems to be no other answer to these questions except that existence is a purpose in itself. To be a human being is a purpose in itself. Without the human genome there can not be a human identity and in order to continue as human species we are bound to preserve human genome.
Indian Cultural Thought
1. In Indian thought the facts are perceived at a level much deeper than the molecular plane. The theme of Indian perception is universality, holism and spontaneity which means that the things exist in a state of mutual interdependence, interlinked with each other and the cosmic forces. The objects owe their integrity to a stable centrality and an interplaying peripherality. This is common to all phenomena, i.e., the solar system, the atom, and the life. In case of living beings the centrality is constituted by the instincts which are basically two: the instinct to survive and the instinct to multiply. In case of Homo sapiens this centrality is impregnated with certain essential traits which distinguish them from other forms of life. These essential human traits are known as dharma (in ancient Indian language Sanskrit), the nearest synonym to which in English is virtue. These virtues are; love, trust, compassion, tolerance, fairness, forgiveness, truthfulness, beneficence, sacrifice, and protection of the weak. The moral values -- justice, equality, autonomy, benignancy, altruism, human solidarity, respect for the dead, respect for other forms of life, and rationality -- emerge out of these virtues. These values guide the individual and the societal conduct and the material concepts like, 'utility', 'quality', and 'economics' reflect an attempt to uphold these values. No other being is embellished with these qualities and this is the reason why human beings are the most advanced mortals in the Nature.
2. The objects in the Nature are identified more by their functional attributes than their physical formation. Sun, a mass of hot gases is perceived as a source of light and heat; Water, a compound of Hydrogen and Oxygen, with coolness and quenching of thirst; Iron, an element of specific atomic structure, with strength and resilience; Rock, a compound of many elements, with firmness and stability; Lion, an animal, with valour and courage; Flower, a shoot, with beauty and fragrance. Similarly, the Homo sapiens, a biological entity comprising of twenty amino acids is perceived as "Human" because of the above virtues. In other words the expression 'Human' synonimises human virtues or dharma. With the loss of this human content he looses the 'Human' personhood and is reduced to a being at par with other forms of life.
3. The Indian thought seeks integration by continuance and spontaneity which means that germination, growth and decay are the phenomenon occurring successively as well as simultaneously, i.e., the one not only preceding or succeeding the other but concurring with the other. Events in the nature are the roots and fruits of each other and this complimentarity is the source of unending sustenance. The termination of life by human intervention (which includes non-intervention) amounts to an adversarial action opposed to Nature's complimentarity. For this reason Indian philosophy discovers the preservation of life as a natural imperative not merely a metaphysical concept and perceives it as an absolute value, not related to abundance or scarcity. The individual autonomy does not include the right to kill or to be killed and that is why killing is always unethical and the will to be killed is always invalid. As such Indian thought provides a clear and distinct message, i. e., the individual's life is to be preserved -- regardless of resources constraints and his desire.
4. In the Indian cultural thought the concept of common heritage of humanity is well-rooted since long and the entire humankind has been perceived as one big family and those who choose to divide the humanity on the basis of race, religion, consanguinity, personal proximities or any other ground are seen as narrow-minded. The said thought is contained in the following Sanskrit verse- "That person is my own, and the other one is not my own is a thinking of small-heartedness. For the generous ones the entire humanity is one family"
Humanity is the manifestation of human content of Homo sapiens. It is an accumulation of human endeavours, pursuits and attainments. It reflects a collective wisdom, i.e., the wisdom of all people of all ages -- including the future generations, through a composite phenomenon known as culture which is the process of transformation of the raw, primitive and the hidden into finished, advanced and revealed through the development of intellectual and moral faculties resulting into enlightenment and excellence in the form of religion, art and science. The process involves interaction between human virtues and instincts on one hand, and the environment on the other. It is an ongoing process during which the outputs merge with the source leading to further enrichment. All discoveries and inventions are a part of this human process and at the essential level there is no difference between the two. Both constitute the process of knowing the unknown through the known and are basically the search and the revelation involving the faculties of imagination and investigation. But there is one big difference. Inventions have applicability. Applicability involves purpose. Purpose makes all the difference: As wide as between a power-house and Hiroshima or as wide as between a cancer cure and Nazi eugenics.
It must be understood that the humanity is not merely the expression of biological profile of the human species. It is the outcome of interaction of human beings with themselves and the environment. It reflects the content and the impact of human actions and interactions The destiny of the human race therefore does not depend on the genetic characteristics alone. Owing to many factors beyond their control the humankind has a common destiny. But this holds true only as long as there is no interference in the basic structure of human genome, alteration of which may result into loss of human characteristics leading to many distortions in the existing setup, imperiling the survival of human race.
The security and dignity of human race lies in its survival as a distinct entity. For this purpose an intimate and sustained inter-human relationship is the prime requirement. Human solidarity is necessary in order to maintain effective equation with other objects in the Nature The secret of human solidarity lies in similarity emerging out of genetic uniformity. It is therefore imperative to preserve this genetic oneness. It is with this perspective that the human genome has been conceived as a common heritage of humanity.
Continuance of human species as a distinct biological entity is a functional imperative not only in the interest of their own survival but also to ensure preservation of biosphere. The human being endowed with virtues as intrinsic human property constitutes a source of responsibility towards other forms of life and objects of Nature. The saga of human existence displays a continuous quest to win over vulnerability and ignorance by pooling of knowledge, experiences and resources. The orderly conduct, mutuality, reciprocity and optimization of resources has led to further security and enrichment. The human race, after long journey of evolution, has reached the present stage of scientific, religious and cultural attainment, with vast potential of material and intellectual creativity. The Nature can not afford to loose this prized possession.
We may also appreciate that we are always at a particular stage of development in the course of biological evolution. The genetic mutation is a natural and on-going process, and it is because of this process that we are in existence today as a human species. Inevitably, a time will come when we will be replaced by 'higher forms' as we have replaced the 'lower forms' (who knows we might have been the 'lower forms' as there are many missing links in our knowledge about the history of evolution). But we do not feel concerned as the change due to natural process occurs very gradually, spread over a long period of time.
The discovery of genes is the mankind's biggest achievement and we have reached a stage where it is not possible to stop the march of advancing biotechnology because the genetic research is driven much more by curiosity than application. Many questions are still open and a cautious, but pragmatic, approach is required while dealing with a force as strong as advancing biotechnology. Scientific advancement leads to cultural evolution which means change in human thinking, lifestyle and relationships. The existing norms and patterns of human behaviour are redefined. That which appears strange today becomes acceptable tomorrow. The crisis of purpose exists as long as we do not change our conceptual fixations. We must remember that the universe runs on Laws, not on man-made rules, priorities, concepts, likes or dislikes. Those who ignore this truth become incompatible and perish. The essential purpose of biotechnological advancement is to ensure continuance of a virtuous, peaceful, egalitarian, and eco-friendly human race. It is here that the religion plays a dominant role as it keeps reminding man about the constants of his intrinsicality and his relationship with the universe.
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