Better than Nature?

Of all the medical technologies that have come along in the past fifty years or so, few have seemed more provocative than advances in genetic technologies. For some they are exciting; for others, abhorrent. Other advances—for instance, ICUs, organ transplantation, and kidney dialysis—are designed to achieve the traditional medical goals of producing or maintaining good health. The new reproductive genetic technologies (RGTs), by contrast, aim to enhance human life, to do better than nature or traditional medicine does. As John H. Evans writes in Contested Reproduction, RGTs aim to “allow parents to influence the genetic qualities of their offspring more precisely than through ‘normal’ fertilization by a sperm and an egg after sex.” The techniques include preimplantation genetic diagnosis of embryos, human genetic engineering, reproductive cloning, sperm sorting for sex selection, amniocentesis, and in vitro fertilization (IVF), among others.

Abortion is not a genetic technology, but many, maybe most, of those opposed to abortion are no less opposed to RGTs, though often for different reasons and with various degrees of intensity. Indeed, Evans discerns an effort on the part of some prolife groups to move deliberately beyond abortion and expand their project to include opposition to RGTs. Generally speaking, those on the secular—or very liberal religious—side are ethically libertarian and so have few problems accepting abortion or most RGTs (though some of them are ambivalent about cloning). The clash between the two groups is an important element of the culture wars.

Evans’s main aim is an interesting one: to determine, through nationwide interviews with a wide range of ordinary religious believers, just how strongly they oppose RGTs, and for what reasons. Assuming, correctly I believe, that RGTs will expand their reach and power in the years to come, and that religious opinion will be important in ongoing conflicts over these technologies, Evans wants to know what these conflicts will look like. He is interested in how believers distinguish between genetic techniques that can be understood to achieve a traditional health goal (such as IVF, which can be understood as a treatment for infertility) and those techniques that enhance genetic choices (such as sex selection). According to Evans, just where “an individual draws the line between health and enhancements” is a crucial marker of his or her attitude toward RGTs.

Evans notes that religious groups speak in more than one way about reproductive technology. To get at their reasons and ways of talking, he makes use of four categories drawn from his research. First, there is the belief that “life begins at conception” and that to destroy human life is always wrong. For this reason, many people oppose any RGT technology that destroys embryos. Second, there is what Evans calls “Promethean fatalism,” the belief that God has a plan for every individual, and that to try to avoid having a child with cystic fibrosis, for example, is to interfere with his plan. Third, there is the belief in “individual human dignity and equality” regardless of condition, which turned out to be less common than Evans had guessed it would be. And, finally, there is the idea of “meaningful suffering”—the belief that suffering is not always to be avoided and can teach us something important. Some of Evans’s respondents cited just one of these beliefs, others combined them.

Evans, a sociologist at the University of California, San Diego, does not take up a question that has long intrigued me: how religious people themselves come to think of their beliefs on RGTs as “religious.” For, unlike abortion, which has been debated for centuries, RGTs are all new. One will find no biblical references to them or any well-established church teachings on them. Is the reason for describing them as “religious” simply that religious believers hold them, or is there something about all four of the reasons Evans finds for opposition to RGTs that connects them to religious faith? Something certainly seems to connect them in the minds of many believers, but the very diversity of the four reasons makes it hard to see what exactly this something is, and whether some of the reasons are better grounded than others.

I mention these questions because for many secularists all religious opposition to reproductive technology is taken to be obscurantist and irrational. The fact that the reasons for such opposition are so vaguely related to one another doesn’t help. Of course there is a fair question believers can put to secularists: Why is it that a desire on the part of some to make use of RGTs is by itself enough to warrant them, without any need to show that they serve some deeply rooted human good? Health is one such good, as religious believers would concede. But the desire to have a child of a certain height or with a certain eye color? Is there any evidence of human benefit in fulfilling such desires? Not that I have heard of.

Evans’s ultimate ambition is to show that a debate that may at first seem hopeless could become fruitful in the future. He is thus at pains to disagree with the conclusion of James Hunter’s influential 1991 book Culture Wars, according to which a civilized and mutually educational public discussion about such matters as abortion and homosexuality is unlikely, if not impossible. Hunter’s claim that there are only two dominant worldviews in American society, that of the “orthodox” and that of the “progressives,” seemed to shut the door on discussion across the borderlines. Evans rejects that claim, arguing that ordinary citizens and religious believers have a complex way of grappling with bioethical issues. The variety and subtlety of the views expressed by his survey respondents, as well as their ability to talk in a friendly way with those who hold sharply different positions, gives support to Evans’s argument.

I wish Evans had also examined the impact of the media as a rising impediment to civic dialogue. The blogosphere and cable news channels thrive on black-and-white stereotypes and ad hominem arguments; they play to a constituency that wants to win, not talk. Nevertheless, Evans’s book makes a significant contribution to understanding a serious source of incivility in our society. I only wish I could share some of his optimism about the future of the RGT debate.