pp. 405-407 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.
F17. Buddhism, Prenatal Diagnosis and Human Cloning
Mahidol University, Thailand
Buddhism is a dominant cultural force in Thailand where 99% of its population adhere to it. Though one may notice the elements of Brahmanism and animhe active concern and effort of others, these newborns so vulnerable cannot service or can live only a minimal existence. But with the possibility of foreknowledge brought about by amniocentesis and with the growing concern with the family costs of care e.g. financial costs and the disruption of life-patterns of family members questions arise as to whether this compassionate attitude will be effected by this procedure and such concern and particularly whether amniocentesis will lead to more abortion or to the erosion of parental willingness to care for the defective child. This needs to be closely watched as it involves the change of social morality.
Genetic Disorders and Thai Attitude
Present evidence, based on interviews with certain number of lay Thai Buddhists consisting of doctors, academics and ordinary people, indicates that Buddhism still continues to serve as the cultural basis for the Thai cultural perception and attitude concerning defective children. From the findings there is consensus among doctors to offer prenatal diagnosis to at-risk pregnant women e.g. women with advanced maternal age or with family history of mental retardation and not to perform prenatal diagnosis solely for sex selection. But such offering puts Thai doctors in ethical dilemmas. They have to decide whether to inform or not inform the pregnant woman about the defective condition of the fetus as such information could threaten the womanfs emotional stability i.e. making her suffer from anxiety, fear and disappointment. On the other hand it may also lead her to seek an illegal abortion.
There is a second consensus about disclosure i.e. that doctors should inform their patients about the defective fetus to help prepare themselves to accept and care for the defective newborn. This is in line with the Buddhist teaching that advocates truth-telling as our social and moral duty and makes no exception for lying in any circumstance. But the question of how to give genetic information without causing harm still remains an issue that each doctor has to tackle.
There is no consensus concerning the morality of selective abortion. Those who oppose abortion are willing to work with the prospective parents to make an adjustment to the defective child while there are those who prefer to advise the patient to abort the seriously afflicted fetus out of compassion i.e. to alleviate the suffering of the patient, her family, and the unborn who, if allowed to be born, is more likely to die an agonizing death. Though such intention is noble the ethical question still cannot be avoided regarding the vocation of the doctor which is to save and not to destroy life. Besides in Buddhist psychology the felt desire to end the other's suffering may derive from our own ability to cope with it, our own anguish in watching them suffer. We basically want to save ourselves from further suffering, not them.
Kamma and Selective Abortion
There is also no consensus among Thai women regarding selective abortion. In case of severely defective fetus some opt for abortion to prevent the birth of a deformed child, following by a feeling of quilt. On the contrary the majority prefer to continue pregnancies to full term even if seriously defective newborns are expected. This is because of the fear of kammic effects of abortion e.g. brevity of life, rebirth as hell beings. After delivery, however, some abandon these newborns at hospitals with the hope that the newborns will be well taken care of by government agencies. Although the self-esteem of the parents is hurtled by the birth of defective newborns the majority of these women decide to bring these newborns up themselves believing that this act of nurture and the meritorious deeds they will make will enable them to avoid the repetition of such agonizing experience. They also believe that these deeds will benefit their offspring as well by mitigating the effects of the previous bad kamma of the defective child. Since in Buddhist understanding appropriate physical and psychological conditions are needed for the kammic effect to take place, the love and care the parents give to the defective child will also prevent the full fruition of the bad kamma the child is suffering from.
Compassion and the First Precept
It is evident that at present the procedures of prenatal diagnosis and amniocentesis enable the couple to know beforehand whether they will have defective child or not and whether the defect is fatal or serious. In the past the couple had to be resigned to the given situation i.e. the defective newborn whereas at present they have the option to decide whether they should accept the situation as it is or find some other remedies such as selective abortion. In any case in terms of the Buddhist teaching the termination of the life of the fetus, however defective it may be, cannot be morally accepted. The good intention of preventing the hopeless misery and suffering the defective newborn will undergo cannot justify such abortion as it is purposeful killing. Killing is killing whether it is done for mercy. This presents a real dilemma for the Thai Buddhists as they are caught between the horn of the dilemma namely the need to observe the first Buddhist precept against killing on the one hand and on the other the prevention of suffering that all parties concerned will undergo should the seriously defective fetus be born.
Human Cloning and Buddhism
Apart from prenatal diagnosis and amniocentesis, cloning is another component of the new genetics that Thai Buddhists are concerned with. The creation of Dolly has been greeted with admiration particularly in the Thai academic circle. It opens up the possibility of human cloning which; particularly for infertile couples, gives new hope beyond artificial insemination. If this new technique could satisfy the parenting desire of childless couples and if it does not cause pain and suffering to all parties concerned nor destruction of life, Buddhism will have no difficulty in accepting it. But before proceeding with human cloning there are some questions Buddhism wants us to consider. For example, could we embark on a course of action that will have unforeseeable but unalterable consequences in the future? Could we be sure of the rightness of the desire to experiment with human cloning? Could this be the product of our selfish desire to perpetuate ourselves by interfering with natural reproduction, and by indulging in self-delusion? Is it an attempt at bending nature to conform to our will, our self-image?
At this stage we cannot be certain about the social and psychological ramification that such experiment may bring on the already fragile fabric of familial and social relationships in our world. In Buddhist perspective every action has an equal and opposite effect. This is the most basic universal law which no one can escape. Should we act, them, on the basis of ignorance of future consequences in matter that affect men, women, children and families? The unforeseeable and unalterable consequences of human cloning can be the first step eventually down a slipping slope. Accordingly the possible negative consequences will outweigh the benign ones.
The Buddhist response to the New Genetics and its procedures of prenatal diagnosis and amniocentesis is cautious because despite their benefits they may lead to more abortion. While the Thai Buddhists welcome the advance in the field of genetics they raise questions concerning its application particularly in human cloning. There is no doubt that they want scientific and medical progress to go on, but want its perils to be heeded. They foresee the possibility of human cloning in the not too far future. But they question whether such possibility needs to become reality. Just because somethingfs may be done, it is not on ethical reason for making it an actuality. There are too many cases of scientific and medical people pushing to actualize a possibility which later caused more social problems---that the cure was worse than the disease. Living in an interdependent world where all are related to one another we should take extra care before losing the beliefs and customs of Thai people. Buddhism remains the basis in the mounding and development of Thai cultural values. And one cannot understand or appreciate Thai culture without having some basic comprehension of Buddhist beliefs and values. Among these are beliefs in the perpetual cycle of rebirth (samsara), the correlation of deed and its consequences (kamma), absolute emancipation (nibbana) and the value of compassion (metta). The cycle of rebirth is alluded to the round of existence in which all beings revolve according to the quality of their deeds. Good deed brings good result while bad action leads to bad result. In other words from the Buddhist viewpoint rebirth of all beings are the natural results of their own deeds, good or bad. For they reap what they sowed in the past, and will be reborn according to the nature of their present deeds. When a being dies, the kammic result acting as the individual life-force passes to other forms of existence, endlessly exalting or degrading successive rebirths. This kammic life-force will be terminated by the cessation of craving (tanha) and self-delusion that tie each person to the endless cycle of rebirth. Such cessation is referred as nibbana. And since existence, in Buddhist view, is suffering (dukha) compassion is given an important and crucial role in Buddhist teaching. It is an important means for the accumulation of merit to benefit present life and rebirths.
Prenatal Diagnosis and Their Buddhists
In Thailand the New Genetics and particularly the procedures known as prenatal diagnosis and amniocentesis which were introduced in the last few years have been enthusiastically accepted because of their potential benefits, e.g. to prevent, treat, or cure genetic disease. Buddhism has no objection to these procedures so long as they can alleviate human suffering caused by genetic disorders and does not involve the destruction of life. Prenatal diagnosis is acceptable as a means to provide information to the couple at risk about what they can expect so that they will not be tormented by anxiety at the time of birth. This knowledge gained will enable them to prepare themselves to make an adjustment and to provide adequate care to the newborn should it be defective. However, it is also possible that an opportunity to obtain prenatal diagnosis may lead to the decision to abort the severely defective fetus, for example, to prevent the birth of a child with spina bifida cystica.
Before the availability of prenatal diagnosis and amniocentesis there was social acceptability of defective newborns. No researches have been done to find out whether this acceptability is based on consideration of the family and social costs which the defectivefs family and society have to bear. But there is Buddhist ground for it i.e. the belief in the preciousness of human life, perfect or imperfect, the importance of merit-making and the practice of compassion. These defective newborns are vulnerable and rely upon, are dependent upon, others to help them and care for them. Without taunching out any new scientific venture which can have devasting effects on the self, family and society.