Tag Archives: ethicists

Obligation to Future Generations

January 2016 Pulse

One of the most significant and yet controversial developments in genetic science in recent decades is the Human Germline Genetic Modification (HGGM) technology. By employing a set of techniques, scientists hope to be able to change the genetic composition of the human germline (i.e., eggs, sperm, the cells that give rise to eggs and sperm, or early embryo) for the benefit of future descendents who will inherit them.

The main purpose of HGGM is to ‘cleanse’ the gene pool of ‘deleterious’ and inheritable genes that would predispose people to certain diseases. This approach, according to some scientists, is to be preferred to traditional therapeutic strategies. For example, molecular biologist Daniel E. Koshland, Jr. could argue that ‘keeping diabetics alive with insulin, which increases the propagation of an inherited disease, seems justified only if one ultimately is willing to do genetic engineering to remove diabetes from the germline and thus save the anguish and cost to millions’.

The ultimate goal of HGGM is therefore to eradicate harmful genes responsible for diseases like cystic fibrosis from the whole population.

In this sense, HGGM must be distinguished from somatic cell therapy that involves the genetic modification of cells in the body apart from the reproductive cells. Somatic cell therapy treats the person with a genetic disease in a way that does not affect his or her offspring. While there is currently an international moratorium on HGGM, many countries in the world allow somatic cell therapy.

Although it is the intention of many scientists to use HGGM for therapeutic purposes, some are advocating that it should also be used to enhance certain desirable traits in the future generation. While many theologians and ethicists are opposed to this, the debate is complexified by the fact that the distinction between eliminating harmful genes and improving hereditary is very often blurred.

The main concern about HGGM is safety. Because these techniques edit the genetic makeup of the gametes, the changes inherited by future generations are deemed irreversible. Thus, the European Council for the Protection of Human Dignity states in its 1997 document that ‘Whilst developments in this field may lead to great benefit for humanity, misuse of these developments may endanger not only the individual but the species itself’.

Many scientists and ethicists maintain that it is simply impossible to envision the consequences of HGGM at this point. The debate sometimes gravitates to the question about the acceptable criteria for ascertaining whether it would be safe to proceed with HGGM. Although the current standard and protocol for research states that an intervention is considered adequate if it enjoys 70% success, some are arguing (for obvious reasons) that in the case of HGGM the requirement should be no less than a success rate of 100%.

In 1979, the influential philosopher and ethicist Hans Jonas in his remarkable book, The Imperative of Responsibility reminded us that in the midst of the tantalising progress of science and technology we must always pause to consider our responsibility to the future generation. The advance of science should not only fill society with a sense of hope, Jonas argues. It should also fill us with a sense of fear.

It is only when fear has its rightful place in our reflections on the promises of science and technology, he wisely counsels, that we will come to see that the ‘starry-eyed ethics of perfectibility has to give way to the sterner one of responsibility’.

Because the long-term adverse consequences of HGGM for future generations are not yet known or fully understood by scientists, and in light of the ethics of responsibility that Jonas emphatically advocates, both religious and secular institutions are opposed to the use of this technology on humans.

Dignitatis Personae, issued by the Roman Catholic Church in 2009, states that ‘Because the risks connected to any genetic manipulation are considerable and as yet not fully controllable, in the present state of research, it is not morally permissible to act in a way that may cause harm to the resulting progeny’.

This is echoed in a statement on HGGM issued by the United Methodist Church in 2012, which states quite categorically that ‘We oppose human germ-line therapies (those that result in changes that can be passed to offspring) because of the possibility of unintended consequences and of abuse’.

‘With current technology’, it continues, ‘it is not possible to know if artificially introduced genes will have unexpected or delayed long-term effects not identifiable until the genes have been dispersed in the population’.

In similar vein, the International Society for Stem Cell Research (ISSCR) calls for a moratorium on HGGM in a statement issued in 2015: ‘The ISSCR calls for a moratorium on attempts to apply nuclear genome editing of the human germ line in clinical practice. Scientists currently lack an adequate understanding of the safety and potential long-term risks of germ line genome modification’.

The call to acknowledge our responsibility towards future generations serves to remind us that no human being – present or future – should be excluded from our moral community or moral consideration. It must therefore be taken very seriously.


Dr Roland Chia


Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor of the Ethos Institute for Public Christianity.

 

A Life Deemed ‘Useless’ – The Terri Schiavo Case

As I write this essay, a woman’s body is shutting down from starvation and dehydration because of the decision made by her husband and a court order issued by Florida judge, George Greer. Terri Schiavo collapsed on 25 February, 1990, when her heart stopped momentarily, resulting in severe brain damage. Fifteen years later, her husband, Michael Schiavo, who now has two children with another woman, is insistent that his wife would not want to be kept alive. He succeeded in obtaining a court order from the Florida Supreme Court to have the small feeding tube removed. Terri’s parents, Bob and Mary Schindler, fought the court order but were unsuccessful at overturning the decision, and on 18 March, the feeding tube        that supplied nourishment and hydration to the 41- year old patient was removed. Despite appeals by Governor Jeb Bush, the Florida judge refused to allow Terri Schiavo to be taken into protective custody. President George Bush and the Republican leaders of the U.S. Governor said that all legal options have been exhausted and that they would not go any further. Barring a miracle, Terri Schiavo will be starved to death.

The Schiavo case has polarised ethicists and the general public alike. Clarity can only be achieved when ideological agendas are set aside and the facts of the case are carefully and thoroughly examined. The first step is to understand Terri Schiavo’s medical condition. She is not brain-dead, but is in a permanent vegetative state (PVS). This means that her brain is severely damaged, and as far as doctors can tell, she is unaware of her surroundings, although she has emerged from a comatose state. It must be added that medical science has yet to fully understand this condition, and doctors are often reduced to resorting to educated guesses – there are no blood tests, scans or other investigations that could confirm the diagnosis. The degree of awareness exhibited by such patients, cannot be ascertained with any exactitude by doctors, and the view which categorically states that such patients have     no awareness of their surroundings is at least debatable. Those who are close to Terri, including her mother, have noticed some responses when they speak to her (see video at www.Terrisfight.org).

Although patients seldom recover after being in a permanent vegetative state for 12 months, there are isolated cases of such recovery. An article by N. L. Childs and W. N. Mercer in the Journal of Neurology, Neurosurgery and Psychiatry (1985, 48: 1300-1303) reports the case of a girl who recovered sufficiently after being in a PVS for six years to communicate with simple sentences.

Terri is not dependent on any machine that artificially enables certain of her organs to function, only a small gastric tube that supplied nutrients and water. In other words, Terri is not hooked on a life-supporting machine. She is a healthy woman with a disability and merely requires to be artificially fed. She is disabled, not terminal. The gastric tube cannot be seen as an ‘extraordinary’ measure or a therapeutic measure; it is an essential means through which Terri receives the required nutrients and hydration. Although Terri is deprived of full consciousness, she must be seen as a living human being, whose judicial rights and dignity must be recognised, respected and defended. As Cardinal Keeler of Baltimore has rightly insisted, ‘Deliberately to remove them in order to hasten the patient’s death … would be a form of euthanasia, which is gravely wrong’.

The American Medical Association defines euthanasia as the ‘act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy’. This is done through ‘the medical administration of a lethal agent to a patient for the purpose of relieving the patient’s intolerable and incurable suffering’. Terri Schiavo is being euthanized by starvation and dehydration.

Her death, however, will not be ‘quick and painless’. In his article published in The Straits Times (28 March, 2005, p.20) Andy Ho describes the harrowing process that a person dying from starvation and dehydration goes through. The mouth dries out while the tongue becomes swollen and cracked. The eyes sink and the cheeks are hollowed out, while the nose bleeds and the skin becomes loose and scaly. The urine gets very concentrated, burning the bladder even as the lining of the stomach dries out resulting in vomiting. The brain cells begin to dry out as the body temperature rises uncontrollably, causing fits to occur. Before the vital organs start to fail resulting in death, the lungs also dry out and they are clogged by their own secretions causing the patient to choke on their own sputum.  This is the process that Terri Schiavo is going through as her body slowly shuts down because it is deliberately deprived of food and water.

The removal of the feeding tube from Terri Schiavo is a direct violation of the commandment ‘not to kill’. No one has the right to take a human life, not even his or her own. Life is never our own possession but is always to be received from moment to moment as a gift from the Creator, and cannot be disposed of as we wish. Supporters of euthanasia have often presented the right to autonomy and self-determination as its justification. This is especially true of voluntary euthanasia, which the AMA Council defines as ‘euthanasia that is provided for a competent person on his or her informed request’. This principle is behind the ‘right-

to-die’ argument, although almost always with the qualification that it applies only to those who are terminally ill and in great pain. The question, however, is that if the right-to-life is so fundamental, why should it be confined only to this category of people? Why should this principle not apply also to those who are not terminally ill, but who feel that their lives are meaningless?

Those who supported Michael Schiavo’s decision have appealed to the quality-of-life argument. Without doubt, the quality-of-life argument in favour of euthanasia is the most harmful for life in society because it works on the basic presumption that there are certain people who have the right to judge whether the lives of other persons are worthwhile or valuable. However, as moral theologian Bernard Häring has rightly observed, their judgement ‘can not only be contemptuous, but it represents a death sentence’.

Michael Schiavo and the Florida judge have decided to execute Terri on the basis of their evaluation that she does not enjoy the quality-of-life that she should. Because of their evaluation, they are willing to subject Terri to the most inhumane execution. The people who speak so passionately and nobly about the quality of life are willing to force upon an innocent human being such an undignified death. As Cardinal Renato Martino, President of the Pontifical Council for Justice and Peace, puts it, ‘If it is true that the process has been fair, and that all legal avenues have been exhausted, how is it that this woman, who has done no wrong, will suffer a fate which society would never tolerate in the case of a convicted murderer, or anyone else convicted of the most horrendous crimes?’ Because of their verdict they were willing to submit Terri to such acts of cruelty from which even animals are protected by law. For in the State of Florida it is unlawful to keep an animal in a place while failing to supply ‘a sufficient quantity of good and wholesome food and water ’.

The case of Terri Schiavo brings much darkness to our modern society. Are we so blinded that we fail to see that we cannot inflict this sort of death on a human being without each individual and society as a whole suffering its terrible consequences?

*** Terri Schiavo died on 31 March, 13 days after her gastric tube was removed. This essay was written three days before her death.


Dr Roland Chia


Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor of the Ethos Institute for Public Christianity.
This article was originally published in the Trumpet (TTC).

Fabricating Life

April 2015 Pulse

According to an article in the May issue of The Scientist, an international team of researchers has successfully synthesised from scratch one of the sixteen chromosomes in the yeast Saccharomyces cerevisiae. Despite altering one-sixth of its base pairs, the scientists found that the yeast cells from artificial chromosome SynIII were indistinguishable from the original version. Tom Ellis from Imperial College, London, who is one of the researchers, opined that this discovery is “a landmark in synthetic biology”.

Synthetic biology may be best described as the application of engineering principles to biology, with the view not only of redesigning an existing living system but also creating novel ones. “Synthetic biologists,” writes Markus Schmidt, the founder of Biofaction, “use artificial molecules to reproduce emergent behaviour from the natural biology, with the goal of creating artificial life or seeking interchangeable biological parts to assemble them into devices and systems that function in a manner not found in nature.”

The public face of synthetic biology is geneticist and entrepreneur Craig Venter, the founder of Synthetic Genomics, a private company whose mission is to engineer new forms of life. In 2010, scientists at the Craig Venter Institute created the world’s first synthetic life form at the cost of more than US$40 million in what has been described as “a defining moment in biology”.

Scientists maintain that the promise of synthetic biology is truly staggering.

In the field of biomedicine, scientists could develop complex molecular devices for tissue regeneration, smart drugs and personalised medicine. Scientists could also offer creative solutions to the world’s energy issues by manufacturing custom-made microbes for creating fuels and for performing artificial photosynthesis. Synthetic organisms could be used to detect and remove pollutants from the environment.

Theologians and ethicists have raised a number of grave concerns surrounding this new science.

One of the major concerns has to do with ‘bio-security’ as the new technology could be used to create bacteria or viruses for military or terrorist purposes.

Although some commentators argue that given the complexity and cost of synthetic biology, such abuses are unlikely to occur, the fact remains that with this new technology, the work of ‘bioweaponeers’ has become much easier.

In 2003, the classified US CIA document entitled ‘The Darker Bioweapons Future’ stated that: “Growing understanding of the complex biochemical pathways that underlie life processes has the potential to enable a class of new, more virulent biological agents to be engineered to attack distinct biochemical pathways and elicit specific effects.”

Synthetic biology is accompanied by all the conundrums associated with dual-use technologies: the same science, that may treat some of the worst diseases, could also be used to create some of the most terrible weapons.

Another major concern has to do with safety issues (‘bio-errorism’). There is the risk that the artificial organisms produced in the laboratory may develop unexpected properties that are detrimental to human health.

There is also the risk that these synthetic, self-replicating entities may be accidentally introduced to the natural environment. Moreover, these novel, artificial microbes that enter the environment may evolve, developing properties not found in nature which may cause untold damage to the ecosystem.

One important way to prevent both ‘bioterrorism’ and ‘bio-errorism’ is to achieve the right balance between self-governance within the scientific community and statutory regulations. But, as some commentators have pointed out, given the widespread availability of synthetic biology tools, regulating this new science would prove challenging.

In June 2006, The Guardian announced that one of its journalists was able to purchase a fragment of synthetic DNA of Variola major (the virus that causes smallpox) from a commercial gene synthesis company in the UK without having to undergo any screening process.

According to Richard H. Ebright, a biochemist at Rutgers University, it would now be possible for a person “to produce a full-length 1918 influenza virus or Ebola virus genomes, along with kits containing detailed procedures and other materials for the reconstruction … it is possible to advertise and sell the product”.

Reflecting on the profound risks surrounding this young science, Philip Ball, the consultant editor of Nature, writes: “If ever there were a science guaranteed to cause public alarm and outrage, this is it. Compared with conventional biotechnology and genetic engineering, the risks involved in synthetic biology are far scarier.”


Dr Roland Chia


Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor of the Ethos Institute for Public Christianity. This article was first published in the Methodist Message.