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It is with this fourth reason in particular that the matter of possible conflict of interest arises. An employer may have a legitimate interest in having a drug-free workplace, for example. It is an economic interest, for one's employees may not be able to do an effective job if they have drug-use
420 PART TWO ■ ETHICAL ISSUES
problems. Passengers on public transportation may also have a legitimate interest in seeing that those who build and operate the bus, train, or plane are able to function well and safely. Airline passengers may have an interest in having other passengers and their bags scanned to prevent dangerous materials from being carried on board. It is not clear in whose interest is the drug screening of athletes. In professional athletics, it may be the economic interests of the owners, and in collegiate athletics and nonprofessional competitions such as the Olympics it may be for the sake of the fairness of the competition as well as the health of the athletes themselves.
In cases of conflicts of interest generally, and in the cases given here, we want to know on which side the interest is stronger. In the case of drug testing of airline pilots, the safety of the passengers seems clearly to outweigh any interest the pilots might have in retaining their privacy. In the case of employee drug use, it is not so clear that employers' economic interests outweigh the employees' privacy interests. In these cases, one might well argue that unless there is observable evidence of inefficiency, drug testing should not be done, especially mandatory random drug testing. In the case of genetic screening by life or health insurance providers, the answer also seems less clear. If a person has a genetic defect that will cause a disease that will affect his life expectancy, is his interest in keeping this information secret more important than the financial interests of the insurer knowing that information? A person's ability to obtain life insurance will affect payments to others on his or her death. In the case of health insurance coverage where not socially mandated or funded, the weight might well be balanced in favor of the person because having access to health care plays such a major role in a person's health. In fact, some state legislatures are now moving to prevent health insurers from penalizing individuals who are "genetically predisposed to certain diseases."65 In arguing for these laws, supporters insisted that they were designed to prevent "genetic discrimination." The phrase is apt in the sense that it seeks to prevent people from being singled out and penalized
for things that are not in their power to control— their genes.
In the case of AIDS screening, consequentialist arguments might make the most sense. We would thus ask whether mandatory testing would really produce more harm than good or more good than harm overall. Would mandatory screening lead fewer people to come forth voluntarily? What of the mandatory screening of physicians, dentists, and their patients? Some people argue that "mandatory testing of health workers for the AIDS virus... would be costly, disruptive, a violation of doctors' right to privacy, and the ruination of some careers."66 The well-known case of a Florida dentist infecting a patient who later died caused quite a bit of alarm. However, in one study of patients of a surgeon who died of AIDS, 1,652 of his total of 1,896 patients were found and only one, an intravenous drug user, had AIDS.67 The risk also goes the other way, with patients infecting health care workers. In 1990, the U.S. Centers for Disease Control and Prevention reported that 5,819 of the 153,000 reported cases of AIDS, or 4 percent, involved health care workers. This included 637 physicians, 42 surgeons, 156 dentists and hygien-ists, and 1,199 nurses.68 It is not known whether any of these had other risk factors, but it does raise serious concern for health care workers.
In the case of airport security screening, a "back-scatter" machine has been developed that can see through a person's clothing—that is, down to the skin—so that security personnel can determine better than with metal detectors whether a person is carrying a concealed item that could pose a danger to others.69 Will people mind this invasion of their privacy? They appear almost nude to the screeners. Or would the somewhat better detection achieved by this method not be worth the kind of invasion of privacy that is involved?
This as well as other screening procedures can be evaluated in several ways. However, one of the most reasonable is to compare the interests of the various parties involved in order to determine whether the interest in privacy on the part of the ones screened is stronger or more important morally than the interests of those who wish
Chapter 17 ■ Stem Cell Research, Cloning, and Genetic Engineering 421
or need the information produced by the screening. Whether the privacy interest is stronger will depend on why privacy is important. You can determine this by considering some of the reasons why privacy is valuable as given above.
With every new scientific advance and development come new ethical problems, for there are new questions about what we ought and ought not to do. The areas treated in this chapter that are based on scientific advances in genetics are no different. As new genetic information comes along, still new ethical questions will need to be addressed. However, from the suggestions given for thinking ethically about the problems addressed here, hopefully a ba^is has been provided for future discussions as well.
In the readings in this chapter, Leon Kass provides an example of a geneticist and physician who is deeply concerned about one of these new developments, human cloning. On the other side is Kerry Lynn Macintosh, who believes that, with care, technologies such as human cloning are not as problematic as often thought.
NOTES
1. Scientific American (July 2005): A6-A27.
2. "British Researchers Grow Heart Tissue from Stem Cells," Agence France Presse, Yahoo News, April 2, 2007; "British Team Grows Human Heart Valve from Stem Cells," The Guardian, April 2, 2007 (at http://www.guardian.co.uk/medicine/story/0,2 048062,00.html).
3. Carl T Hall, "Stem Cell Research Opens New Doors," San Francisco Chronicle, April 16, 2007, pp. Al, A9.
4. Carl T. Hall, "Stem Cell Grants Come with Dash of Criticism," San Francisco Chronicle, March 31, 2007, pp. B1-B2.
5. http://en.wikipedia.org/wiki/Stem_cell_ controversy.
6. Scientific American, op. cit., pp. A12-A13.
7. Ibid., p. A13.
8. The Johns Hopkins Medical Letter (Nov. 2003), pp. 1,2,7.
9. The New York Times, Aug. 24, 2004, p. Dl.
10. Carl T. Hall, "Amniotic Fluid a Promising Stem Cell Source, San Francisco Chronicle, Jan. 8, 2007, pp. Al, A6.
11. Scientific American, op. cit., p. A14.
12. The New York Times, April 27, 2005, pp. Al, A16.
13. George Q. Daley et al., "The ISSCR Guidelines for Human Embryonic Stem Cell Research," Science, vol. 315, February 2, 2007, pp. 603-604.
14. The New York Times, May 12, 2006, p. A12.
15. The New York Times, Feb. 9, 2005, p. A8.
16. Jason Thompson, "Here, Kitty, Kitty, Kitty, Kitty, Kitty!" San Francisco Chronicle, Feb. 24, 2002, p. D6. The project had a Web site (www.missyplicity.com).
17. The New York Times, Oct. 8, 2004, p. A24.
18. Yahoo News, April 14, 2005; www.cryozootech.com/index.php?m=the_horses&d=pieraz_st_ en&l=en.
19. Peter Fimrite, "Pet-Cloning Business Closes—Not 'Commercially Viable.'" San Francisco Chronicle, Oct. 11,2006, p. B9.
20. "Copied Cat Hardly Resembles Original," CNN. com, Jan. 21, 2003. It is also interesting to note that CC has since given birth to normal, healthy kittens that were naturally fathered; see http://en.wikipedia.org/wiki/CC_%28cat%29.
21. Gina Kolata, "Hybrid Embryo Mixture May Offer New Source of Stem Cells for Study," The New York Times, June 5,2002, p. D3.
22. Jose B. Cibel et al., "The First Human Cloned Embryo," Scientific American (Jan. 2002): 44-51.
23. Gina Kolata, "Researchers Say Embryos in Labs Aren't Available," The New York Times, Aug. 26, 2002, p. Al; Marjorie Miller, "New Breed of Cloned Pigs—Organs Wanted for Humans," San Francisco Chronicle, March 15, 2000, p. A3.
24. "California Law Permits Stem Cell Research," The New York Times, Sept. 23, 2002, p. A18.
25. The procedure known as embryo transfer involves flushing the embryo out of the uterus and implanting it in the uterus of another female. Sometimes this is done when a woman is able to carry a fetus but not able to conceive because of damaged or missing ovaries. A man can provide the sperm for artificial insemination of a surrogate. The procedure then transfers the fetus to her uterus, and she undergoes a normal pregnancy and birth.
26. Tom Abate, "Genome Discovery Shocks Scientists," San Francisco Chronicle, Feb. 11,2001, p. Al.
27. The New York Times, Oct. 21, 2004, p. A23.
28. http://en.wikipedia.org/wiki/Human_Genome_ Project#Whose_genome_was_sequenced.3F.
422 PART TWO ■ ETHICAL ISSUES
29. Tom Abate, "Proofreading the Human Genome," San Francisco Chronicle, Oct. 7, 2002, p. El; Nicholas Wade, "Gene-Mappers Take New Aim at Diseases," The New York Times, Oct. 30, 2002, p. A21.
30. Andrew Pollack, "New Era of Consumer Genetics Raises Hope and Concerns," The New York Times, Oct. 1,2002, p. D5.
31. Wade, "Gene-Mappers."
32. "Decoding the Mouse," San Francisco Chronicle, Feb. 24, 2002, p. G2.
33. Nicholas Wade, "On Road to Human Genome, a Milestone in the Fruit Fly," The New York Times, March 24, 2000, p. A19.
34. To see a photo of the Belgian Blues go to www.ansi.okstate.edu/breeds/cattle/belgianblue.
35. The New York Times, Aug. 25, 2004, p. A23.
36. See Barbara MacKinnon, "How Important Is Consent for Controlled Clinical Trials?" Cambridge Quarterly of Healthcare Ethics, 5, no. 2 (Spring 1996): 221-227.
37. We will bracket the issue of using aborted fetuses in research for the purpose of focusing on the other aspects of this study.
38. Reported in The New York Times, May 21, 1996.
39. The New York Times, Nov. 22, 1994, p. A1.
40. The New York Times, July 28, 2004, p. A13.
41. The New York Times, Jan. 11,2005, p. D7.
42. TheNewYork Times, July28,2004, p. A13.
43. The New York Times, Jan. 11, 2005, p. D7.
44. Philip Brasher, "Plowing Ahead with Biotech Crops," San Francisco Chronicle, March 30, 2002, p. A4.
45. Carey Goldberg, "1,500 March in Boston to Protest Biotech Food," The New York Times, March 27, 2000, p. A14.
46. Brasher, op cit.
47. See www.csa.com/hottopics/gmfood/oview.html.
48. The New York Times, Jan. 1, 2005, p. D7.
49. Ibid.
50. See www.genewatch.org.
51. Jon Entine, "Starbucks Protest—Coffee, Tea or rbST?" San Francisco Chronicle, Feb. 24, 2002, p. D2.
52. Tom Abate, "Biotech Firms Transforming Animals into Drug-Producing Machines," San Francisco Chronicle, Jan. 17, 2000, p. Bl.
53. Gina Kolata, "Company Says It Cloned Pig in Effort to Aid Transplants," The New York Times, March 15,2000, p. A21; and Marjorie Miller, "New Breed of Cloned Pigs—Organs Wanted for Humans," San Francisco Chronicle, March 15, 2000, p. A3.
54. www.ornl.gov/sci/techresources/Human_ Genome/elsi/gmfood.shtml.
55. See www.greennature.com.
56. "Privacy in the Online World," The New York Times, March 23, 2000, p. A12.
57. "Who's Looking at Your Files?" Time (May 6, 1996): 60-62.
58. Ibid.
59. This is modeled after a "thought experiment" by Richard Wasserstrom in "Privacy," Today's Moral Problems, 2d ed. (New York: Macmillan, 1979); 392-408.
60. Thomas Scanlon, "Thomson on Privacy," in Philosophy and Public Affairs, 4, no. 4 (Summer 1975): 295-333. This volume also contains other essays on privacy, including one by Judith Jarvis Thomson on which this article comments. W. A. Parent offers another definition of privacy as "the condition of not having undocumented personal knowledge about one possessed by others." W. A. Parent, "Privacy, Morality, and the Law," Philosophy and Public Affairs, 12, no.4 (Fall 1983): 269-288.
61. Erving Goffman, Asylums (Garden City, NY Anchor Books, 1961).
62. Charles Fried, An Anatomy of Values: Problems of Personal and Social Choice (Cambridge, MA: Harvard University Press, 1970): 142.
63. "Questions of Privacy Roil Arena of Psychotherapy," The New York Times, May 22, 1996, p. Al.
64. "Who's Looking at Your Files?" op. cit.
65. "Bill in New Jersey Would Limit Use of Genetic Tests by Insurers," The New York Times, June 18, 1996, p. Al.
66. The New York Times, Dec. 27, 1990, pp. Al, A15.
67. Ibid.
68. Ibid.
69. www.usatoday.com/travel/news/2005-05-15-airport-xray-bottomstrip_x.htm; http://en.wikipedia,org/wiki/Backscatter_X-ray.
Chapter 17 ■ Stem Cell Research, Cloning, and Genetic Engineering 423
Reading
The Wis dom of Repugnance
Leon R. Kass
Study Questions
1. What were the unusual conditions of Dolly the
sheep's birth?
2. What does Kass mean by "the inherent procre-
* ative teleology of sexuality itself"?
3. According to Kass, how would cloning be a kind of narcissistic self-creation?
4. By what aspects of human cloning does Kass believe people are repelled?
5. How would Kass respond to those who say that emotional repugnance is not an argument?
6. What aspects of human cloning does Kass find morally repugnant?
7. According to Kass, in what three contexts is cloning usually discussed? Explain each.
8. What does Kass find objectionable about applying each to the matter of human cloning?
9. What do biological truths about human generation and the human condition tell us about our common humanity and our genetic individuality, according to Kass?
10. Why does he believe that asexual reproduction is a radical departure from the natural human way of reproducing?
11. To what three kinds of concerns and objections does Kass believe that human cloning is thus vulnerable?
12. What does Kass mean by saying that the "soul-elevating power of sexuality, is at bottom, rooted in its strange connection to mortality"?
Leon R. Kass, "The Wisdom of Repugnance," from The Ethics of Human Cloning (Washington, D.C.: AEI Press, 1998), pp. 3-4, 8-10, 17-31. Reprinted by permission of AEI Press.
| O |
ur habit of delighting in news of scientific and technological breakthroughs has been sorely challenged by the birth announcement of a sheep named Dolly. Though Dolly shares with previous sheep the "softest clothing, woolly, bright," William Blake's question, "Little Lamb, who made thee?" has for her a radically different answer: Dolly was, quite literally, made. She is the work not of nature or nature's God but of man, an Englishman, Ian Wilmut, and his fellow scientists. What is more, Dolly came into being not only asexually—ironically, just like "He [who] calls Himself a Lamb"—but also as the genetically identical copy (and the perfect incarnation of the form or blueprint) of a mature ewe, of whom she is a clone. This long-awaited yet not quite expected success in cloning a mammal raised immediately the prospect—and the specter— of cloning human beings: "I a child and Thou a lamb," despite our differences, have always been equal candidates for creative making, only now, by means of cloning, we may both spring from the hand of man playing at being God.
After an initial flurry of expert comment and public consternation, with opinion polls showing overwhelming opposition to cloning human beings, President Clinton ordered a ban on all federal support for human cloning research (even though none was being supported) and charged the National Bioethics Advisory Commission to report in ninety days on the ethics of human cloning research. The commission (an eighteen-member panel, evenly balanced between scientists and nonscientists, appointed by the president and reporting to the National Science and Technology Council) invited testimony from scientists, religious thinkers, and bioethicists, as well as from the general public. In its report, issued in June 1997, the commission concluded that attempting to clone a human being was "at this time... morally unacceptable," recommended continuing the president's moratorium on the use of federal funds to support cloning of humans, and called for federal legislation to prohibit anyone from attempting (during the next three to five years) to create a child through cloning....
Cloning turns out to be the perfect embodiment of the ruling opinions of our new age. Thanks to the
424 PART TWO ■ ETHICAL ISSUES
sexual revolution, we are able to deny in practice, and increasingly in thought, the inherent procreative teleology of sexuality itself. But, if sex has no intrinsic connection to generating babies, babies need have no necessary connection to sex.... If male and female are not normatively complementary and gen-eratively significant, babies need not come from male and female complementarity. Thanks to the prominence and the acceptability of divorce and out-of-wedlock births, stable, monogamous marriage as the ideal home for procreation is no longer the agreed-upon cultural norm. For that new dispensation, the clone is the ideal emblem: the ultimate "single-parent child."
Thanks to our belief that all children should be wanted children (the more high-minded principle we use to justify contraception and abortion), sooner or later only those children who fulfill our wants will be fully acceptable. Through cloning, we can work our wants and wills on the very identity of our children, exercising control as never before. Thanks to modern notions of individualism and the rate of cultural change, we see ourselves not as linked to ancestors and defined by traditions, but as projects for our own self-creation, not only as self-made men but also man-made selves; and self-cloning is simply an extension of such rootless and narcissistic self-re-creation.
Unwilling to acknowledge our debt to the past and unwilling to embrace the uncertainties and the limitations of the future, we have a false relation to both: cloning personifies our desire fully to control the future, while being subject to no controls ourselves. Enchanted and enslaved by the glamour of technology, we have lost our awe and wonder before the deep mysteries of nature and of life. We cheerfully take our own beginnings in our hands and, like the last man, we blink....
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