- Irina Pollard, School of Biological Sciences, Macquarie University,
Sydney, NSW 2109, Australia.
- Steven Gilbert, Institute of Neurotoxicology and Neurological
Disorders, 8232 14th Ave NE, Seattle, WA 98115-4330, U.S.A.
Eubios Journal of Asian and International Bioethics 7 (1997), 131-133.
The debate surrounding ethical issues arising from the reproductive revolution, has, mostly, been dominated by moral philosophers, theologians and government/private interests. As a result, the concerned citizen was made knowledgeable about various definitions of morality with doctrinal, philosophical, medical, legal and financial overtones. The tragedy has been that biological understanding in the debate, has been severely neglected or distorted. To illustrate, let us go back to our cloning story. It is a distortion to claim that cloning technology is directed towards the recreation of dead people without balance against the realistic scientific goal, which is directed towards medical and agricultural benefit. It may be interesting to know how many of us following the Dolly media frenzy learnt, for instance, that genetically engineered domestic animals, producing drugs such as interferon, already exist. Cloning of these animals will enhance the mass production of cheap, quality controlled, life-saving drugs and other pharmaceuticals. It may also be interesting to know how many of us accepted the claim that Dolly is an exact replica of Dolly senior. If you believe that Dolly is an identical replica, then you are misinformed. Genes are one thing but the environment in which Dolly developed and now lives in, is another. Strictly speaking, Dolly is no-one's replica - she is a unique creation, a testament to the power of the human brain's exceptional evolution. The phenomenon of genomic imprinting has shown us that DNA is not passed on through generations intact because the environment also produces lasting inheritable changes in the way DNA works. Genomic imprinting is defined as gene expression based on the gamete of origin, that is, mammalian embryos need both maternally and paternally inherited genomic contributions for normal embryonic development to proceed (in other words, the phenomenon of virgin birth or parthenogenesis occurs in every vertebrate class, except in mammals). The combination of in vitro treatments to manipulate a somatic cell to begin developing into another individual together with the influences of the surrogate's unique uterine environment, similarly bestows an environmental or epigenetic mark. What this imprint may represent is totally unclear but Dolly, if and when she produces her own offspring, may provide some clues.
Biologically trained scientists can easily separate hype from substance, and, should, therefore, be given a greater opportunity to contribute more fundamentally to the diversity of bioethical debate - after all, it is they who understand better than anyone else what their research and resultant technology is about. We acknowledge that this is already happening to a greater or lesser degree depending on the subject and circumstances. We all know that the world is a better place thanks to the efforts of biologists like David Suzuki, Paul Ehrlich and many others who have reminded us that not to challenge existing cultural mores, particularly in matters of conservation and the need for human population control, may jeopardize our very survival. Our survival, and the survival of all complex large animals and plants as we know them, is the business of bioethics. It is high time that the diversity of bioethical discussion be further enriched by extending the unique contributions that the scientific community can make. The moral development of scientists, often, differs from those without a scientific training because of their differing socialization, as they spend most of their lives concentrating on understanding natural or abstract phenomena. It is they who can provide another approach, it is time for them to be more engaged with society, to be more personally involved in the bioethical dilemmas created by science-based technologies. It is probably useful to point out that, just as diversity of species gives biological stability, so, diversity of ideas provides cultural stability. Formal mechanisms for biologically-based ethical decision making do, of course, exist through institutionalized Medical Research Ethics Committees, Hospital and Community Health Services Institutional Ethics Committees and similar institutionalized bodies. However, despite the excellent efforts of individual committee members, these committees as institutions lack flexibility and are not highly visible in the general community. But the biggest drawback, in the opinion of many, is that institutional committees respond reactively to public concerns rather than proactively anticipating future crises and needs.
The present article challenges the status quo and proposes a practical frame work for ethical decision making which aims to balance professional expertise and the resultant personal values. This frame work is the unifying concept developed in our forthcoming book (1) and for expedience's sake, we have given the concept a name, bioscience ethics, because when an idea (however imprecise at first) has a name-tag, then the evolutionary focus can proceed. Bioscience ethics, in its most fundamental aspect, places biological understanding onto existing moral philosophy. By reversing convention (in which biological practice is grafted onto moral reasoning) bioscience ethics can incorporate the best of the traditional/cultural ethical principles, reject false beliefs/misinformation and by-pass elaborate, esoteric deliberations. It is hoped that, in time, bioscience ethics will achieve meaningful discourse, be helpful in contemporary ethics and be derived directly from scientific, social and environmental perspectives. New priorities may develop because bioscience ethics, by concentrating on long-term social goals made possible by good biological understanding, will reduce urgent, short-term crises - especially in the areas where scientific technology has irreversibly changed our relationship with the natural world, and has rendered many old belief systems inappropriate. A good understanding of biological principles can serve as a sound basis for the development of a bioethical system that is appropriate for the maintenance of a healthy human society in harmony with the environment. For example, juxtaposing our specialist understanding of reproductive mechanisms on the four bioethical principles of autonomy, nonmaleficence (or causing no harm), beneficence (or doing good) and justice, we find ourselves in bioscience ethic's territory. Examples are plentiful but we would like to use specific examples centred around issues of preventable drug-induced disability in children. Epidemiological studies have repeatedly demonstrated that drug-abuse during the preconceptual period leading up to fertilization and during pregnancy, is a universal social problem with countless potentially healthy children being needlessly handicapped (2 for review). That most parents love their babies is irrelevant: the fact of the matter is that some of them will inadvertently cause their children grave irreversible harm. Common preventable drug-induced adverse outcomes of reproductive function include greater infertility (increasing the demand for assisted reproductive technology), increased birth defects in the newborn baby, low infant birth weight due to inadequate fetal growth, and increased risk of neonatal intensive care intervention. Long-term effects include defective growth, compromised mental and behavioural development and low resistance to some illnesses, such as cancer and depression. A relationship between drug-induced low infant birth weight and Sudden Infant Death Syndrome (SIDS) has also been documented with the risk related to the extent of parental drug consumption (2). The most widespread damage caused by parents is through the most frequently used drugs which are nicotine (smoking) and alcohol (excessive drinking).
It is no exaggeration to state that millions of kids worldwide suffer from debilitating lifetime alcohol-related defects. For example, alcohol-induced brain damage is now the leading cause of intellectual disability in the western world. And this is despite the fact that the detrimental consequences of alcohol consumption during pregnancy have been known since antiquity. Preventable congenital disorders resulting from parental drug abuse raise many bioethical issues. Preventable congenital disorders also emphasize that parents have, since time immemorial, genetically engineered their own kids. In this light, Dolly the sheep, cloned from an udder cell from its donor mother, is just a passing phenomenon.
Many people would agree that reproduction is a privilege, not a right, yet at the same time, genuinely respect the concept that all of us also have the basic human right for unrestrained reproduction. Bioscience ethics proposes that all rights are accompanied by obligations. Parents who freely choose to have a child, in so choosing are deemed to have assumed ethical responsibility for the future person to be free from preventable harm. Bioscience ethics also proposes that society has responsibilities to the individual helping them fulfill their parental obligations. Exceptionally high reproductive dysfunction is associated with poor living conditions, especially amongst indigenous peoples. The level of infant mortality (three times the national average) and the incidence of low birth-weight (13% compared with 5-8% for white babies) is highest among the Australian Aboriginal population. Inappropriately low birth-weight and high infant morbidity can be traced to reproductive problems relating to alcoholism, drug dependencies, depression and other social factors. This is understandable because of Australia's colonial legacy and existing socio-economic problems. The systematic destruction of forty thousand years of adaptive evolution has started a health crisis that will take much more than good-will to resolve. The view that it is offensive to the individual and society to bring a child into existence without fair prospects, needs to be widely publicised. It also needs to be stated that instead of confronting the so called "child abusers", themselves victims of socioeconomic hardship and neglect, official attention has to be focused on correcting the root problems responsible for the generations of compromised children. Short-term 'damage control' care has not been effective and preventative care education has been frustratingly slow. A new educational framework which accepts the bioethical obligation that each one of us is, to a considerable degree, custodian of the next and subsequent generations, needs to be urgently formulated. If society's priority were to maximize avoidance of preconceptual and prenatal/neonatal harm, the most efficient way would be through improvements to the general quality of life, by eliminating the worst environmental pollution and the socio-economic stresses which impair responsible parental care.
Wearing the bioscience ethic's hat, we want to propose an ecologically-based
model of care. As we have seen, unhealthy habits are highly influenced
by socioeconomic injustices and scientific ignorance. An ecological
model of care would concentrate on lifestyle factors such as diet,
exercise, stress reduction, environmental quality, housing and
workplace safety, all crucial in determining our overall health
and genetic resilience. Understanding the causes of alcoholism,
drug addiction, poverty and ignorance, is more caring than being
judgmental about specific adverse reproductive outcomes. That
the opportunity for high quality education and health is a right
rather than a privilege, is in tune with an ecological model of
care. An ecological approach also recognizes that substance abuse
is part of a dynamic in human behaviour that can be altered through
addressing the many problems which lead to transgenerational poverty,
alienation and addiction. The bioscience ethical principle of
'beneficence' is respected when caring communities promote that
all individuals, women, men and children, have a right of substance-abuse
education, treatment in addiction and, as adults, good preconceptual/prenatal
care. By incorporating biology into ethics, bioscience ethics
acknowledges that parents and their children have common interests,
and that the most challenging decision anyone ever faces is whether
or not to become a parent.
We wish to thank Dr Norman Swan, from the Australian Broadcasting Corporations's Radio National Science Unit, for inviting us to prepare a simple description of bioscience ethics suitable for the radio science program Ockham's Razor. The above article has been modified to accommodate the written for the spoken word but is in all other essentials similar in content.
1. Pollard I, Gilbert S. Love, Life and Children: A Practical
Introduction to Bioscience Ethics. Seattle, Washington University
Press; in preparation.
2. Pollard I. Preconceptual/prenatal care of our children: On the ethics of drug-induced disabilities. Eubios Journal of Asian and International Bioethics 1996;6:2-8.