Darryl R. J. Macer, Ph.D. Eubios Ethics Institute
1990
Preface x
1. Is There A Problem? 1
New Technology 1
The Gene Scare 3
Outline 6
The Advent of Molecular Biology 10
DNA and Genes 11
Genetic Technology 13
Human Genetic Disease 16
3. General Ethical Concerns 21
The Use of Nature 21
What is Nature? 21
Different Views of Nature 21
Dynamic Nature 23
A Christian View of Stewardship 24
Playing God 27
Interfering With Nature 28
Integrity of Species 28
Reducing Genetic Diversity 30
Slippery Slopes 33
Biological Warfare 34
Public Perception of Science 35
Public Attitudes to Science 35
Public Support for Biotechnology 37
Public Participation in Decision Making 43
Education 43
Government Commissions on Genetic Engineering 44
4. Medical Ethics, History &Culture 45
The Hippocratic Tradition 45
A Profession 47
Philantropy 49
Do no harm 50
Adoption of the Oath by Western
Medicine 53
Competing Ethical Traditions 58
Retaining the Hippocratic Oath 62
5. Status of the Human Embryo 63
Human Embryonic Development 63
Ethics through Embryo Development 65
Fertilisation 67
The First Two Weeks 67
Implantation and Formation of the Primitive Streak 68
The Fetus and Feeling Pain 69
Personhood 70
What is a Person? 70
The Soul and Ensoulment 71
The Beginning of Personhood 74
Workable Criteria Respecting Embryo
Status 76
Abortion Laws 77
Scientific Research on Human Embryos 81
Experimental Goals of Human Embryo Research 81
Alleviation of Infertility 82
Toxicity Testing 83
Embryo Splitting 83
Human Development 84
Development of Contraceptives 84
How Much Human Embryo Experimentation
is Ethical? 85
Regulations are Required 87
Brain Grafts from Aborted Fetuses 91
Making New Strains of Animal 96
Ethical Limits of Animal Use 98
Religious Views of Animal Status 99
Philosophical Views of Animal Status 100
Regulations 106
7. Applied Genetic Engineering 109
Industrial Applications of GMOs 109
Microbial Production of Biochemicals 109
Protein Engineering 109
Production of Chemicals 109
Medical Drugs, Proteins and Vaccines 110
Use of Fungi 111
Using Plants and Animals 111
Mammalian Cell Culture 111
Plant Cell Culture 111
Use of Whole Plants 111
Biopolymers 112
Animals as Bioreactors 112
Production of Biomass 113
Agricultural Uses of Plant Genetic Engineering 113
Expanding Plant Breeding 113
Plant Disease Resistance 114
Pest-Resistant Plants 116
Biocontrol 116
Insecticidal Proteins 116
Digestive Inhibitors 117
Insecticidal Microorganisms 117
Herbicide Tolerance and Weed Control
117
Better Crop Varieties 119
Tolerance of Environmental Extremes
119
Nitrogen Fixation 120
Improved Nutritional Qualities 120
Widening Consumer Choice 121
Ornamental Plants 121
Other Plant Properties 121
Extending Animal Breeding 122
Animal Genetic Engineering 122
Sex Selection 124
Embryo Splitting 124
Environmental Applications of Microorganisms 125
8. Environmental Safety of GMOs 127
Risks from Laboratory Applications 127
Guidelines for Contained Genetic Engineering 128
Field Release of GMOs 130
Degradation of Pollutants 131
Bacterial Mining 132
Nitrogen Fixation 132
Ice Nucleation and Microorganisms 133
Vaccines 134
Biological Pesticides 135
Transgenic Plant Field Trials 137
Release of Animals 138
Persistence of GMOs 139
Transfer of Genes 141
Antibiotic Resistance 142
Eucaryote/Procaryote Transfer 143
Dispersal of Gene Vectors 144
Examples of Gene Transfer During Field Trials 145
Reducing Risks of Transfer 146
Potential Ecological Effects 147
Resistance to Introduced Genes 150
Optimal Procedure 151
Viewing the Product Only 152
Exemptions for GMOs with gene deletions? 154
Case by Case Risk Modelling 155
Public Participation 157
International Regulations 159
Applications to Release GMOs 163
Challenges Facing Regulators 166
Financial Liability for Damage 166
Food Safety & Consumer Rejection 167
Novel Foodstuffs 167
Public Acceptance of New Foodstuffs 170
Better Products? 174
Biotechnology Companies 176
Agricultural Implications 179
Patenting of Life 180
Public Attitudes to Patenting 183
The Ethics of Patenting Animals 184
Patenting of Genetic Material 184
Third World Interests 186
Birth Control Policies 188
Methods of Birth Control 188
Should We Use Contraception? 192
Infertility 194
Is Infertility a Medically Treatable
Disease? 194
Methods Involving the Married Couple Only 195
Should IVF be Publicly Funded 200
Eligibility 201
The Use of Extramarital Gametes 203
Surrogacy 208
Avoid Risks of Harm to Children 209
Changing Family Structure 210
12. Selective Human Breeding 214
Natural Genetic Selection 214
Eugenics in Antiquity 215
Eugenics in Modern Times 217
Sterilisation Programs 220
Nazi Eugenics 222
The Decline of Eugenics 223
Changing the Dominance of the Genes 225
Control of Reproduction 226
Sterilisation of the Mentally
Incompetent 228
Genetic Disease is not Evenly Spread 230
Common Themes 231
The Quality of Life 232
13. Genetic Screening and Selection 236
Genetic Screening With DNA Probes 236
Postnatal Genetic Screening 239
Prenatal Genetic Screening 242
Genetic Counseling 245
What Diseases? 247
Prenatal Diagnosis Without Abortion 255
Reproductive Choice 256
Can Society Limit Genetic Freedom? 258
Sex Selection 260
Genetic Selection for Nondisease Should be Illegal 261
Privacy of Genetic Information 264
DNA Fingerprinting 270
Gene Therapy is Another Medical Therapy 272
Protein Replacement 273
Dietary Treatment 274
Tissue Transplantation 275
Somatic Cell Gene Therapy 276
Diseases Suitable for Gene Therapy? 276
First Approved Trial 276
Enzyme Deficiencies 277
Multiple Gene Disorders 280
Fetal Gene Therapy 281
Results of Animal Gene Therapy 282
Inserting Organoids 284
Ethics of Somatic Cell Gene Therapy 285
Government Guidelines 286
Efficacy of Treatment 287
Safety of Transferred Genes 287
Experimentation and Protecting Human Life 288
Alleviation of Suffering 290
Affect on Family Life 291
Economic Factors 291
Public Attitudes and Fears of Genetic Engineering 292
When We Should Use Gene Therapy? 293
15. Human Genetic Engineering 295
Genetic Selection 296
Germ-line Gene Therapy 298
Techniques for Germ-line Alteration 299
Microinjection of Eggs and Zygotes 299
Embryonic Stem Cell Lines 301
Health and Disease 301
Carriers of Harmful Alleles May Be
"Healthier" 302
Spontaneous Mutations Will Continue to Occur 303
Ethics of Germline Genetic Engineering 304
We Already Change the Genes of
Children 304
Consumer Children 306
Slaves to the New Technology 307
Protecting Future Generations 308 <
Cloning 313
Techniques for "Cloning" 314
Ethical Concerns 314
Human Genome Projects 316
The Scientific Approach 317
Coordinated Data-Sharing is Required 318
Ethical Implications 321
Fears of Genetic Determinism 322
Our Future Obligations 323
16. Bioethics for the Future 325
Medical Ethics and Genethics 325
Professionalism 325
What Ethical Principles? 329
Beneficience 331
Respect for Human Life and Autonomy 332
Justice 332
Confidentiality 333
Proportionality 334
Legislation or Consultation 334
Universal Approaches 335
Sustainable Living 336
Sustainable Agriculture 337
Controlled Progress 339
New Possibilities should be Pursued
345
Changing Our Perspectives 345
Genetic Engineering is a Catalyst for Bioethics 346
Bibliography 348
Glossary 393
Index 409
Key Words: Animal Rights, Bioethics, Birth
Control, Embryo Research, Eugenics, Field Release of GMOs, Genetic Counseling,
Genetic Engineering, Genetic Intervention, Genetic Screening, Genetic Therapy,
Genetically Modified Organisms, Hippocrates, Human Genome Project, Medical
Ethics, Patenting of Life, Reproductive Technology, Risk Evaluation, Sex
selection, Sustainable Agriculture.
Further copies can be obtained by ordering from the Eubios Ethics Institute,
Prof. Darryl Macer,
Email asianbioethics@yahoo.co.nz