Tag Archives: ethics

In-Vitro Gametogenesis

June 2018 Pulse

In its May 18, 2017 issue, The Straits Times reported that researchers in Japan have succeeded in creating viable eggs from the skin cells of adult female mice. Using a technique known as in-vitro gametogenesis (IVG), the team led by Professor Katsuhiko Hayashi of Kyushu University in Fukouka was able to create eggs ‘outside the mouse’ for the first time.

IVG is used to generate sperm and egg cells in a petri dish from adult or pluripotent cells that are capable of becoming any cell type in the body. This includes embryonic stem cells (in this case, induced pluripotent stem cells or IPS cells) that are found in the blastocyst or zygote. Scientists believe that these cells may have therapeutic potentials, such as treatment for Alzheimer’s disease.

Currently, scientists are able to derive sperm-like and egg-like cells from murine (mouse) embryonic stem cells (mESCs). It has been reported that a live offspring has been produced after fertilizing natural mouse eggs with sperm-like cells derived from mESCs.

Although progress in humans has been slow, scientists believe that not very far down the road, the success that they have had with mice can be replicated in humans. As Glenn Cohen, Eli Adashi and George Daley state in their paper on IVG: ‘These findings suggest that experimental refinements likely will permit derivation of functional eggs and sperm from [human stem cells] in the not too distant future’.

There are a number of foreseeable applications of IVG.

This technique would enable scientists to study human gametogenesis (that is, the formation of gametes) in vitro as well as diseases of the germline. The technique would also enable scientists to create a vast supply of gametes that can be used either for research or fertility treatment. Finally, it will enable scientists to genetically manipulate the human germline.

As Léa Suruge puts it, IVG has the potential to redefine ‘the notion of what is possible in reproductive and regenerative medicine, as it opens up the possibility of creating human sperm and eggs from induced pluripotent stem cells’.

For example, patients whose reproductive functions have been lost – for instance, because of chemotherapy – could possibly have a child through IVG. Furthermore, when used together with the rapidly advancing genome editing techniques, future scientists and physicians could root out inherited diseases even before fertilization.

However, despite these exciting prospects IVG does present scientists and ethicists with very grave ethical and social concerns. Even the seemingly positive application of IVG may prove deeply vexing for policy makers, ethicists and society.

Take the production of gametes, for instance. As Cohen, et al., have perceptively pointed out, ‘There’s something troubling about an inexhaustible supply of gametes that can be fertilised into an inexhaustible supply of embryos’.

With its potential of creating an almost unlimited supply of eggs or embryos, IVG may raise the sceptre of embryo farming and commercialisation on a scale that is hitherto unprecedented. From the standpoint of Christian ethics, this would result in the unconscionable devaluation of human life.

In addition, because of the ease with which embryos can be created by this method, parents (especially wealthy ones) could opt to generate scores of embryos from which to select the ‘best’ for implantation. ‘IVG could’, write Cohen et al., ‘depending on its ultimate financial cost, greatly increase the number of embryos from which to select, thus exacerbating concerns about parents selecting for their “ideal” future child’.

The ‘rejects’ would either be destroyed or used for research (which would result in their eventual destruction).

When IVG is seen within the framework of the so-called Principal of Procreative Beneficence (PB), the outcome is nothing less that a form of disguised eugenics.

According to Hannah Bourne, Thomas Douglas and Julian Savulescu, PB ‘holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life’.

Among the ethical objections to PB (and there are many), arguably the most serious is that it creates a eugenics mindset – an ‘arms-race’ as parents iteratively seek to ensure that their child is not placed at a competitive disadvantage.

There are also other serious ethical and social concerns surrounding IVG that must not be ignored. For instance, it could change the meaning of parenting and the received and conventional structure of the family.

IVG could result in ‘single-parent babies’ (not to be confused with single parenting). The cells from a man or a woman could be used to create both sperm and egg that could result in a baby. Such a baby would have only one genetic parent.

Although with the current state of the technology it is unclear whether this will in fact be possible, but if it were possible serious ethical and social implications are not difficult to imagine. Furthermore, it is also not clear if such single-parent babies would have the same health issues that arise from having closely related parents.

IVG would also allow older women to become a parent. Many of these women chose to delay pregnancy in order to pursue their career or find the right partner. Once the technique is perfected, IVG would be a more convenient way to achieve this than social egg freezing, which require the painful and dangerous process of egg procurement.

But there are serious ethical and social implications for women who choose to be mothers in their 40s, 50s and 60s. These issues have to do with the ability of these older mothers to properly nurture their young children and also the burdens their children may be subjected to.

Finally, because IVG enables scientists to generate egg and sperm cells from cells obtained from shed skin flakes, it might be possible for people to become parents without even knowing it. Again this raises serious and profound ethical and social concerns that must not be ignored.

As a ‘frontier biotechnology’, IVG would be accessible only to the wealthy in technologically advanced countries. This would exacerbate the already widening inequality in medicine and healthcare.

It is impossible to put a halt to this developing technology. The therapeutic potentials would spur scientists to pursue this technology to its very limits. Policy makers would be more inclined to introduce rigorous safeguards and protocols rather than imposing a ban or even a moratorium.

But, as experience has repeatedly taught us, international protocols and safeguards, important though they are, are unable to prevent transgressions and abuses that have serious social consequences.



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

Sexbots

December 2017 Pulse

In its September 24, 2017, issue, The Mirror reported that a sex robot called Samantha has gone on sale in the UK for £3,500. Samantha, which can be purchased at Vibez Adult Boutique in Aylesford, Kent, ‘has a brain and can interact with you’, write Stephen Beech and Natalie Tipping. She can even switch ‘between a family mode and a sex mode setting’.

The idea of fabricating a woman to meet the needs of a man is not new; its origins can be traced to ancient Rome. For example, In Metamorphoses the Roman poet of erotica, Ovid, tells the story of the sculptor Pygamalion, who fell in love with the ivory statue representing perfect womanhood, which he names Galatea. The goddess Venus brings the statue to life and Pygamalion marries her.

With the ascendance of AI and social robotics, the Galatea myth has become a reality.

The philosophical, ethical and social issues generated by the advent of sex robots or sexbots have received serious attention by roboticists and ethicists in the rapidly expanding branch of ethics called roboethics.

Writers in this field have identified three possible uses of sexbots. Some have argued that sexbots can be used to help with the treatment or therapy of patients with diverse conditions in hospitals or homes. It has even been suggested that these robotic dolls could be made available to sex offenders and paedophiles during their incarceration.

Others have suggested that some individuals might find these lifelike silicon androids useful for physical or emotional companionship. Still others maintain that sexbots could one day replace human sex workers and prostitutes.

Very few Christian ethicists have thus far reflected on the theological, spiritual and ethical issues surrounding this application of social robotics. This would require nothing less than a robust account of the Christian understanding of sex and sexuality.

For the purposes of this article, however, it is sufficient to stress that the Bible and Christian tradition teach that sexual relationships must be confined to a man and a woman – a husband and his wife – who are joined together in the covenant of marriage.

More to the point, the Bible clearly teaches that humans are allowed to engage in sex only with other humans. The Bible therefore prohibits and condemns bestiality as the perversion of nature and an abominable sin (See Exodus 22:19; Leviticus 18:23; Deuteronomy 27:21).

While the Bible does not deal specifically with the question of having sex with a machine – for obvious reasons – what it has to say about human sexual relationships can be brought to bear on this issue.

What follows is an attempt to highlight some of the grave concerns of this particular form and application of social robotics.

The first thing to note is that the relationship between the human user and the sex robot is an ‘I-It’, not an ‘I-You’ relationship. The interaction between the human and the sexbot is unidirectional and asymmetrical in that the machine is entirely oblivious of the overtures, desires and affections of its human user.

AI and sophisticated robotics can create what scholars have described as ‘an anthropomorphic illusion’ that may fool the user into thinking that the simulacrum is the real thing – that the sex robot is human ‘in some sense’. But the fact remains that the sexbot is a machine, albeit one that is programmed to mimic human responses and expressions.

Robot ethicist John Sullins asks if it is ethical to create humanlike robotic sex dolls in the first place. It would be ethically objectionable, Sullins argues, if the illusion of humanness is used to ‘fool people into ascribing more feelings to the machine than they should’. Put differently, from the standpoint of ethics, the illusion of humanness that sexbots present can be said to be in some profound ways disrespectful of human dignity and agency.

This brings us to the question whether the use of a robot for sexual gratification can be properly described as ‘having sex’ in the conventional sense at all. At its most fundamental level, the sex robot is nothing more than a very sophisticated version of cruder forms of sex toys. This has led ethicists like Sullins to argue that using a robotic sex doll (with low level AI) is just an elaborate act of masturbation.

A number of ethicists have argued that sex robots have accentuated harmful stereotypes of women, especially women’s bodies. Roboticist Kathleen Richardson has pointed out that the representation of sex robots is usually based on pornographic images of women. She added that these robots reinforce the view of the female body as a commodity and encourages coercive attitudes towards it.

In a paper presented at a robotics conference, Sinziana Gutiu argues that ‘sex robots, by their very design, reinforce the idea that women are subordinate to men and mere instruments for the fulfilment of male fantasies. This type of harm has been explored in the context of pornography and is reproduced by the advent of sex robots. Like pornography, use of sex robots sexualises rape, violence, sexual harassment and prostitution and eroticizes dominance and submission’.

Scholars argue that the use of a sexbot is in many ways more harmful than viewing pornography because the user is physically and emotionally more intensely engaged. Sex robots provide a nearly complete sexual experience in a way that viewing pornography does not. Consequently, as Gutiu points out, ‘The user is therefore more likely to ascribe and internalise a primarily sexual and submissive purpose for women, through direct sensory experience’.

Sex robots will not only harm the user but also the wider society. The individual who uses a sexbot is engaged in a dehumanised form of sex and intimacy. Repeated exposure to this perverted form of sex would dehumanise the user. In fact, the more ‘humanised’ the android – that is, the more powerfully it presents the anthropomorphic illusion – the more dehumanising it is for the user.

Gutiu provides a list of possible harms: ‘Negative effects include alienation and seclusion from society, stunted emotional development, and an inability to compromise or handle rejection. A person’s need for sex with a robot could suggest a sign of physical and emotional withdrawal from efforts to connect intimately with humans’.

Blay Whitby and Kathleen Richardson concur.

‘An individual who consorts with robots rather than humans’, Whitby asserts, ‘may become more socially isolated’. Richardson maintains that the reason why intimate relations with robots will lead to isolation is because ‘robots are not able to meet the species specific sociality of human beings, only other humans can do that’.

‘User’s repeated interaction with sex robots’, Gutiu adds, ‘will solidify antisocial habits and confirm their fragility and unwillingness to overcome personal social challenges’.


 

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

The Third Sex

August 2017 Pulse

In the past few decades, scores of books on homosexuality and transgenderism have poured out from the Christian presses in America, UK and Europe. However, works by Christian theologians and ethicists on intersexuality – a condition which affects 0.1 – 0.2 percent of the population – remains scant and sketchy.

‘Intersexuality has not been properly addressed within recent ethical discussions about sexuality, writes John Hare. ‘One consequence of this omission has been that the rigid and polarized view that humans are clearly and discretely either male or female has gone unchallenged’.

The term ‘intersex’ covers a wide range of conditions that present atypical physical sex in one form or another. These include people (1) with ambiguous genitalia, whose physical appearance is between the male and female genitals; (2) whose genital appearance is not matched with some other physical aspect (e.g., a female vulva with testes); and (3) with unusual chromosomes (e.g., XXY or combination of XX and XY).

Intersex must not be confused with transgender. Transgendered people experience a dysphoria between their biological sex and gender identity, while intersex people have physical features that make their biological sex ambiguous. In the same way, intersex should not be mistaken as homosexuality because it does not have to do with sexual orientation but with biological sex.

In the past – between 1960 and 1990 – it was not uncommon for children born with atypical genitalia to undergo corrective surgery soon after birth. This approach, however, has been largely abandoned because of the serious ethical and psychological issues it presents.

Current approaches include delaying surgery until the children are old enough to understand their condition and explore options for their own bodies. In some cases, treatment does not involve surgery at all because of the belief that intersex people can achieve psychological security about their gender without the need to have a typical genital anatomy.

Intersex has called to question current definitions of biological sex. For example, many legal commentators have pointed out that English law’s emphasis on chromosomes as the decisive factor in determining sex is problematic when it comes to intersex people.

This in turn has created problems in ascertaining the legal status of people with genital anomalies. Needless to say that this has profound implications for marriage law.

In some European countries (e.g., Finland, Portugal and France) the sex of the child can be registered at a later date if it cannot be determined from birth.

Intersex people pose a challenge to the Christian understanding of sex because they do not fit into the neat categories of ‘male’ or ‘female’. This has led some intersex people to think that they are a ‘third sex’.

John Hare echoes the views of some Christian writers when he writes: ‘The existence of intersexuality confounds the tidy categories that some Christian ethicists and church leaders work with and challenges us all to think more deeply about the God-given nature of our sexuality … The condition of intersexuality … draws our attention to the complexity and diversity in the development of human sexuality’.

In similar vein, Susannah Cornwall of the University of Manchester asserts that ‘Theologies which assume everyone is clearly male or female may find themselves uncomfortably stretched when they begin to take into account the experiences of people whose bodies do not fit either category’.

However, despite the undeniable theological and pastoral complexities associated with intersex, the biblical or creational norm of human beings created as either male or female (Genesis 5:2) must be upheld.

As Dennis Hollinger has rightly argued in his book entitled, The Meaning of Sex: ‘Natural sexual conditions and anomalies in no way undermine the creational norms. All distortions in the world must be judged against the divine creational givens’.

‘In a fallen world’, he adds, ‘there will be chaos and confusion that extends even to human sexuality. But the normative structure toward which God calls humanity is not the fallenness of nature; it is, rather, God’s created designs’.

To argue that intersex is one of the distortions of our sin-scarred and fallen world is not to say that atypical genitalia is the result of the personal sins of the people with this condition. It is rather to emphasise that they – like all of us – are part of a world fractured by original sin, a world that is radically different from what the Creator had originally intended it to be.

Christians must regard intersex people as bearers of the image and likeness of God, who must be accorded with equal dignity and value. Christians therefore can never tolerate the discrimination or humiliation of intersex people.

More reflection is needed on the part of theologians, Christian ethicists and pastors on the theological and pastoral issues associated with intersex Christians – issues such as marriage, having children and their full involvement in the life of the Church, including leadership and ordination.

In addition, we must listen very attentively to the experience of intersex people so that we may achieve a deeper appreciation of their struggles and aspirations.

But most importantly, we must accept intersex Christians as members of Christ’s body, the Church. For as Christians, our identity is established in Christ.

As the Apostle Paul puts it: ‘For as many of you as were baptised into Christ have put on Christ. There is neither Jew nor Greek, there is neither slave nor free, there is no male or female, for you are all one in Christ Jesus’ (Galatians 3:26-28).


 

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

The Betrayal of Medicine

May 2017 Pulse

One of the reasons that the National Council of Churches of Singapore gave for rejecting physician-assisted suicide (PAS) and euthanasia in its 2008 statement is that these actions are “against the very ethos of medical practice”.

The betrayal of medicine’s noblest purpose that the growing acceptance of PAS and euthanasia signifies and accentuates is of course the result of many different but profoundly related developments.

The first of these is the subtle shift of the focus of medicine away from the patient.

According to Edmund Pellegrino, the Hippocratic Oath that has served European and American physicians since the dawn of modern medicine is now under attack both from without and within the medical profession. This is because some are of the view that the values it upholds are unable to address the complex ethical issues presented by emerging medical technologies.

But the rejection of the patient-centric tradition exemplified by the Hippocratic Oath exacts a heavy price because it changes the very character of medicine itself.

As philosopher Dianne Irving has rightly observed, once this tradition was weakened, “bioethics began to replace it with medicine practiced for the greater good of society rather than for the individual patient. That threatens patient welfare and denigrates medicine into a business rather than a profession”.

Another possible contribution to medicine’s betrayal is the secularisation of ethics, as a result of which moral reasoning is bereft of the very assumptions and principles that are supposed to govern it.

To be sure, some ethicists – like Leon Kass and Gilbert Meilaender from the Jewish and Christian traditions respectively – still regard human life as sacred and insist that physicians should be committed to the bodily life of their patients. But such views are gradually going out of vogue, supplanted by a utilitarian ethic couched in heady rhetoric about “the greater good” of society, and about individual autonomy and rights.

Edmund Pellegrino and David Thomasma offer a penetrating diagnosis of the modern predicament in medicine as well as in other fields when they write: “Much of the moral desuetude [state of disuse] into which we believe the professions – medicine, law, even the ministry – have fallen is the consequence of ethical claims without a moral philosophy on which to ground them.”

“Moral arguments based on utility, cost-benefit analysis, contract law, economic restraints, unbridled individualism are all symptoms of ‘moral malaise’,” they add.

Utilitarianism has indeed become the new orthodoxy in biomedical ethics.

“All [leading] bioethicists,” writes Anne Maclean, the perceptive critic of bioethics, accept “some version of utilitarianism”. University of Cambridge Law Professor John Keown agrees. In an interview, he asserts that “in modern bioethics, nothing is, in itself, either valuable or inviolable, except utility”.

Ethicists must therefore shoulder some responsibility for the erosion of moral acumen and for the betrayal of medicine’s noblest ideals.

Theologian Richard John Neuhaus put it starkly: “Thousands of ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable, until it is finally established as the unexceptional.”

We see this happening in so many areas in biomedical ethics, from stem cell research to gene therapy, and from the criteria for ascertaining death to the hydration of PVS patients. We also see this in the debate surrounding PAS and euthanasia.

For example, Peter Singer and utilitarian ethicists like him are constantly pushing the envelope with regard to euthanasia.

Singer envisions an ideal world where all terminally-ill patients would be routinely euthanised. He writes: “Perhaps one day it will be possible to treat all terminally-ill and incurable patients in such a way that no one requests euthanasia and the subject becomes a non-issue; but this is now just a utopian ideal, and no reason at all to deny euthanasia to those who must live and die in far less comfortable conditions.”

For the Christian, medicine is a gift of God, the outworking of His common grace in this fallen world. The true goal of medicine is always to help and to heal, never to harm or to kill.

The utilitarian calculus that is so pervasive in the practice of modern health care is not only alien to the character of medicine. It has also seriously undermined and subverted medicine’s true and highest purpose.


 

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

Lebensunwertes Leben

May 2017 Pulse

In his 1983 article published in Pediatrics, the controversial Princeton University ethicist Peter Singer argues unabashedly that nonhuman animals have greater morally significance than a seriously deformed or disabled human infant.

‘If we compare a severely defective human infant with a nonhuman animal, a dog or pig, for example, we will often find the nonhuman to have superior capacities, both actual and potential, for rationality, self-consciousness, communication, and anything else that can be considered morally significant’, he writes.

Preferential treatment is extended to the disabled infant, he argues – again quite unapologetically – not because of some intrinsic worth it possesses but simply because it is a member of the species homo sapiens, an approach he obviously disapproves of.

In the second edition of his influential book, Practical Ethics (1993) Singer sees people with severe disabilities quite categorically as having ‘a life not worth living’.

Singer’s cruel utilitarianism chillingly reminds us of the dehumanising eugenics of the Nazis in the 1930s and 40s that saw the extermination of certain segments of the population, guided by a similar philosophy – that some human lives can be said to be Lebensunwertes Leben (‘life unworthy of life’).

The killing of disabled people, especially newborns, is a practice that can be traced to antiquity. Despite their indubitable brilliance and enduring influence that can still be discerned in a wide range of topics today – from politics to beauty – the great Greek philosophers Plato and Aristotle never prohibited or even called to question the practice, common in classical antiquity, of killing defective babies by exposure.

The Christian writer Miniculis Felix gives us a stark glimpse of the prevalence of infanticide in Greco-Roman society in Octavius where he writes – in a justifiably condemnatory tone – that ‘newly begotten sons [are] at times exposed to wild beasts and birds, or dispatched by the violent death of strangulation …’

In fact, as Darrell Amnundsen has clearly shown, ‘the care of defective newborns simply was not a medical concern in classical antiquity’. Consequently, no law existed in antiquity against the killing of such babies.

The early Christians of course rejected and opposed this practice because according to the Scriptures all human beings without exceptions are created in the image and likeness of God’ (Genesis 1:26-27) and must therefore be valued and protected. This includes the young, the old, the vulnerable and the disabled.

The early Christians therefore extended care to the poor, the sick, the marginalised and the disabled in ways that amazed the society of the time. So counter-cultural were they in showing compassion to the people that society had marginalised and rejected that the early Christians were often described as ‘the third race’.

The early Christians would pick up the infants that were left to die on the streets, in drains or in specially designated pits for unwanted children. They would either care for these children as their own or place them in the orphanages they ran.

Thus, unlike the most influential voices of the ancient Greco-Roman world that recommended with impunity the killing of deformed children (Cicero, De Ligibus, 3.8) and the drowning of ‘children who are at birth weakly and abnormal’ (Seneca, De Ira 1.15), Christians roundly condemn such practices as immoral.

Perhaps the clearest Christian voice in antiquity that protested against such inhumanity is that of Lactantius, who in his Divine Institutes writes: ‘Therefore when God forbids killing, no exception whatsoever must be made. It is always wrong to kill a man whom God has intended to be a sacrosanct creature. Let no one, then, think that it is to be conceded even that newly born children may be done away with, an especially great impiety! God breathes souls into them for life, not for death’.

In the darkest period of the history of modern Europe, a young pastor-theologian spoke with inimitable clarity and unparalleled courage against the evil eugenic projects of the Führer that were responsible for the mutilation and murder of untold numbers of Jews and people with disabilities.

In his unfinished book, Ethics published shortly after his execution by the Nazis, Dietrich Bonhoeffer spoke out against the utilitarian principle which demeans human life and violates its God-given dignity: ‘Life created and preserved by God possesses an inherent right, completely independent of social utility … There is no worthless life before God, because God holds life itself to be valuable’.

Bonhoeffer warns of what he called ‘the aristocratic philosophy of life which glorified strength and power and violence as the ultimate ideals of humanity’.

This warning, sounded in the last century, has not lost its relevance and urgency in the present. In fact, we may say that in the wake of the current myth of human perfectability inspired by the bewildering advances in bio- medicine and technology, this warning has taken on a pertinence and currency that Bonhoeffer could not have possibly imagined.

While the Christian Faith rejects the morbid glorification of weakness (which unfortunately can be discerned in some recent discussions about disability – but that’s another story!), with its radical concept of the suffering God, it does suggest another way of looking at and understanding weakness that is truly redemptive.

And it is this way of looking at the other that has led Christians like Lactantius in the third century and Bonhoeffer in the twentieth to speak out against the manifest atrocities of their day and to advocate an ethic of love that regards even the most vulnerable and disabled members of their societies as bearers of the divine image, whose lives must be cherished and protected and whose dignity should never be violated.



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

Is it Ethical?

January 2017 Pulse

In 2006, in an article published in Methodist Message, I argued that gender dysphoria is a form of mental disorder – a view I still hold today. If this judgement is sound, then far from being a helpful correction to the condition, sexual reassignment surgery (SRS) is in fact collaborating with the illness.

In this article, we focus on a different but not unrelated question. SRS is legal in many countries, including Singapore and Iran (because homosexual acts are punishable by death, homosexuals in Iran are forced to undergo SRS – but that’s another story). Countries like Thailand and South Korea have become international hubs for SRS, attracting medical tourists from across the globe.

SRS may be legal, but is it ethical from the standpoint of medical ethics? To answer this question, we must examine what SRS entails and what benefits (if any) it brings to persons suffering from gender dysphoria.

SRS is a major procedure with significant risks.

SRS for the male involves hormone treatment, the removal of the penis and testes, preparation of genital tissue for the creation of pseudo-vagina, the creation of the pseudo-vagina, opening the urethra, breast implants, silicone implants in the hips and buttocks, and cosmetic surgery.

For the female, SRS involves hormone treatments, mastectomy, hysterectomy, the creation of a pseudo-penis and testes, and treatment to increase testosterone levels to stimulate hair and muscle growth.

The pressing question here is whether it is ethical to perform a procedure that not only mutilates but also destroys healthy sexual and reproductive organs.

SRS must be distinguished from surgical procedures to correct or restore deformities in the sexual organs caused by congenital defect, genetic abnormalities, injury or disease. While the latter procedures are performed to correct deformities, it is debatable if SRS could even be described as treatment – although this remains a contentious issue.

One of the most important principles in medical ethics is nonmaleficence. This principle obligates physicians not to cause harm to their patients, encapsulated in the oft-quoted maxim Primum non nocere (“Above all [or first] do no harm”).

Some ethicists have combined this principle with that of beneficence into a broader principle. But Tom Beauchamp and James Childress are surely right to argue that “conflating nonmaleficence and beneficence into a single principle obscures critical moral distinctions as well as different types of moral theory”.

In destroying healthy sexual and reproductive organs, SRS has arguably transgressed this important principle in medical ethics – to “do no harm”.

But does SRS benefit the person suffering from gender dysphoria? Two important points must be made in answer to this question.

Firstly, SRS does not change the sex of the person with gender dysphoria, but only creates an illusion of change. As Richard P. Fitzgibbons, Philip M. Sutton and Dale O’Leary have pointed out in their excellent study: “It is physiologically impossible to change a person’s sex, since the sex of each individual is encoded in the genes – XX if female, XY if male. Surgery can only create the appearance of the other sex.”

Secondly, persons who have undergone SRS continue to struggle with problems of sexual identity. A recent Swedish study showed that persons “after sexual reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population”.

SRS therefore is not a treatment for sexual dysphoria. As Dr Paul McHugh has put it quite bluntly in his article ‘Surgical Sex’: “We psychiatrists … would do better to concentrate on trying to fix their minds and not their genitalia.”

The language that we routinely and very often uncritically use has clouded our thinking on this issue, creating more confusion than clarity.

“Sexual reassignment surgery” is itself a problematic term because it implies that the sex of a person assigned at birth can be reassigned by surgery. This, as we have seen, is not the case at all. The term “transsexual” is equally problematic because it suggests that a person of a certain genetic sex can simply move to the other sex.

With the technical possibility of surgically creating pseudo-genitals, these disturbingly misleading misnomers have given rise to yet another misleading idea: that SRS is a form of treatment for people suffering from gender dysphoria.

Perhaps it is time to re-examine the ethics (and legality) of SRS.



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

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.

 

AI and Society

August 2015 Pulse

In the summer of 1956, a group of scientists gathered at the campus of Dartmouth University for a two-month workshop that would launch the modern artificial intelligence (AI) programme. At the end of the workshop, MIT scientists Marvin Minsky, Claude Shannon and Ray Solomonoff together with six other researchers predicted that ‘Every aspect of learning or any other feature of intelligence can in principle be so precisely described that a machine can be made to simulate it.’

Since then, research in AI has advanced at a phenomenal pace as computers continue to double their capacity in information-processing power every two years. In 1997, ‘Deep Blue’ amazed the world when it defeated world chess champion Garry Kasparov. It is estimated that computers will have capacities equivalent to the human brain in the near future, around the year 2025.

Some scientists even speculate that it would be possible to create computers with advanced AI, which they call superintelligence. Oxford philosopher Nick Bostrom defines superintelligence as any intellect that ‘vastly outperforms the best human brains in practically every field, including scientific creativity, general wisdom, and social skills.’

Scientists even think that it would one day be possible for superintelligent computers to engage in moral reasoning. Insofar as ethics is a cognitive pursuit, they argue, a machine with superintelligence should be able to solve ethical problems based on available evidence and logic better than their human counterparts.

To be sure, the possibility of creating such machines has led some scientists to express hope that they will help to eradicate some of the most crippling problems in our world.

As Bostrom confidently predicts, ‘It is hard to think of any problem that a superintelligence could not either solve or a least help us to solve. Disease, poverty, environmental destruction, unnecessary suffering of all kinds: these are things that a superintelligence equipped with advanced nanotechnology would be capable of eliminating.’

Others, however, are not so sanguine. In fact, some have argued the exact opposite: that the creation of superintelligent computers would spell destruction for humankind.

‘Within thirty years,’ writes Vernor Vinge in his 1995 book, The Coming Technological Singularity: How to Survive in the Post-Human Era, ‘we will have the technological means to create superhuman intelligence. Shortly after, the human era will be ended. Can the Singularity be avoided? If not to be avoided, can events be guided so that we may survive? What does survival even mean in a Post-Human Era?’

Both the optimism and fear surrounding AI are, however, misguided.

Superintelligent machines cannot solve the world’s problems like hunger, disease and poverty because these problems are the result of that destructive form of human inwardness called sin. Although superintelligent machines, like most of the science and technology already available can alleviate human suffering, they are unable to eradicate it.

Science and technology, however advanced, cannot bring about a ‘new heavens and a new earth’ – a man-made utopia, where the evils of the world are vanquished and where the deep fractures they inflict are fully healed.

To think that superintelligent machines can do better ethics than humans is to adopt the most naïve and reductionist concept of ethics. Ethics can never be reduced to a puzzle solving exercise.

Ethics has to do with human relationality, with our appropriate and positive response to each other and to the world in which we live. Only the creatures created to be bearers of the divine image are capable of this set of attitudes, judgements and behaviour we call morality or ethics. Ethical discourse and conduct are epiphanies of human transcendence which no machine, however intelligent, can replicate.

The exaggerated fears about superintelligent machines taking over the planet and orchestrating the extinction of the human species are also misplaced. In fact, they can distract us from the real issues surrounding advanced technologies.

These issues are not new. They have been with us since the dawn of modern science and technology. And they have to do not so much with how superintelligent machines can take over the world and destroy their creators. Rather, they have to do with how such technologies can be misused by some to the detriment of others.

As Joanna Bryson and Philip Kime perceptively point out: ‘The real dangers of AI are no different from those of other artifacts in our culture: from factories to advertising, weapons to political systems. The danger of these systems is the potential for misuse, either through carelessness or malevolence, by the people who control them.’

But there is one other aspect of this debate that perhaps is not given the serious attention it warrants. In reflecting on the development of any technology, it is important not only to ask what it can do for us. We must also ask what it can do to us.

As intelligent machines intrude into our lives and take on significant tasks, the way in which they may change how we perceive our own humanity and our relationships simply cannot be ignored.

AI may impact our society in radical and sometimes unwelcomed ways. And we must try to imagine how society should navigate around the changes they bring about by embracing some and by averting others.


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.

Having Children

Recently, the Ministry of Community Development, Youth and Sports (MCYS) distributed a consultation paper on the Status of Children Bill jointly prepared by the Ministry of Health (MOH) and the Ministry of Law (MinLaw) to various organisations, including the National Council of Churches, for feedback and response. The goal of the proposed Bill is to protect the welfare of children, especially those born as the result of Assisted Reproductive Technology (ART). Since the birth of the first ‘test tube baby’, Louise Brown, in 1978, the reproduction revolution has advanced by leaps and bounds with the proliferation of a number of controversial reproductive technologies including gamete intra-fallopian tube transfer (GIFT), zygote intra-fallopian tube transfer (ZIFT), subzonal implantation (SUZI), intra-cytoplasmic sperm injection (ICSI) and pronuclear-stage transfer (PROST). The availability of such technologies has no doubt given tremendous hope to many couples who for various reasons are unable to have children naturally.

But ART has also introduced serious ethical and social issues. For example, theologians and philosophers are alarmed by the subtle shift in language, from ‘procreation’ to ‘reproduction’. They worry that the use of a metaphor from the factory, with related concepts like production line and quality control, may lead to the subtle objectification and commodification of children. Thus, Anglican theologian Oliver O’Donovan has emphatically insisted (using the description of the Nicene Creed of the second Person of the Trinity) that children are ‘begotten, not made’. Alongside the rapid advancement of ART and genetic science, the media has also ignited the imagination of the public with talk about ‘designer babies’. These developments have raised many important and fundamental questions. As the editors of a book on new reproductive technologies have put it: ‘Few social or technological developments in history have captivated people’s imagination or raised more ethical questions than today’s reproduction revolution’.

The objectification and depreciation of children is of course not a modern phenomenon. Research has shown that in ancient Greco-Roman society, children are generally regarded as capricious, foolish and quarrelsome. Children are perceived as deficient in many ways, especially in their ability to think and speak rationally. The great Roman philosopher Cicero therefore opines that childhood itself is something not to be celebrated. Viewed as a state of immaturity that must be outgrown, Cicero writes of childhood thus: ‘the thing itself cannot be praised, only its potential’. The NT scholar Judith M. Gundry-Volf points out that in Greco-Roman culture children are considered as ‘fundamentally deficient and not yet human in the full sense’. In Roman society, children are prized not in themselves, but because they are needed to ensure the continuance of the family name. Likewise the state often regards children as indispensable for economic and military reasons.

In the Bible, however, children are always portrayed as a divine gift and a sign of God’s blessing. According to the creation narrative, after God had created the first human beings, he conferred on them the blessings of procreation: ‘God blessed them and said to them, “Be fruitful and increase in number; fill the earth and subdue it”’ (Genesis 1:28). When God called Abraham, he promised him that he would bless him. That children are clearly a central feature of the divine blessings is made obvious by the divine promise: ‘I will make you into a great nation’ (Genesis 12:2). In the OT, children are seen as a great source of joy. Thus, in Psalm 127, we read: ‘Sons are a heritage from the Lord, children a reward from him. Like arrows in the hands of a warrior are sons born in one’s youth. Blessed is the man whose quiver is full of them’ (vv. 3-5a).

When we turn to the NT, especially the Gospels, we find something truly remarkable. Not only did Jesus repeatedly bless children in his ministry (Mark 10:13-16; Matthew 19:13-15; Luke 18:15-17), he also frequently used children as models of the spiritual reality of the kingdom of God. For example, Jesus presented children as models for entering the kingdom of God when he said: ‘I tell you the truth, anyone who will not receive the kingdom of God like a child will never enter it’ (Mark 10:15). Children were also used to portray the meaning of greatness. In answering a question that his disciples raised, concerning who is the greatest in God’s kingdom, Jesus said: ‘Whoever humbles himself like this child is the greatest in the kingdom of heaven’ (Matthew 18:4). In the Gospels, Jesus also spoke of the spiritual perceptiveness of children. In response to the scepticism of the chief priests and scribes, Jesus said: ‘have you never read, “From the lips of children and infants you have ordained praise?”’ (Matthew 21:16).

The presence of children in many ways teaches us what it means to love and to relate to one another. Stanley Hauerwas expresses this poignantly when he writes:

[Children] are basic and perhaps the most essential gifts that we have because they teach us how to be. That is, they create in us the proper need to want to love and regard another. For love born out of need is always manipulative love unless it is based on the regard of the other as an entity that is not in my control but who is all the more valuable because I do not control him. Children are gifts exactly because they draw our love to them while refusing to be as we wish them to be.

As God’s gifts, children must therefore never be seen as the continuation of their parents’ projects. Having children can never be seen as an exercise of one’s right or even a means of self-fulfilment. Rather, it must always be understood in light of God’s grace and providence. The conception and birth of a child is the result of the mutual love and self-giving of a man and a woman united in the covenant of marriage. By the grace of God, their love-giving has become life-giving. Parents must never try to force their children to conform to their own images. Instead, they should recognise in their children God’s image. As the Luther theologian and ethicist Gilbert Meilaender has so eloquently put it, in procreation, ‘[Parents] have not simply reproduced themselves, nor are they merely a cause of which she is the effect. Rather, the power of their mutual love has given rise to another who, though different from them and equal in dignity to them, manifests in her person the love that unites them’.


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 Bible Speaks Today (August 2012).

Economics and Ethics

The recent financial crisis, which began in the summer of 2007, resulted in what some economists have described as the near-death experience of the global economy. In a seminal review published by the Financial Services Authority (FSA) in March 2009, Lord Turner describes the crisis as the ‘greatest … for at least a century, indeed arguably the greatest crisis in the history of finance capitalism’. In an address at a press conference in 2011, US President Barack Obama described the aftermath of the financial crisis in almost apocalyptic language: ‘When the dust settled, and its binge of responsibility was over, several of the world’s oldest and largest financial institutions had collapsed, or were on the verge of doing so. Markets plummeted, credit dried up, and jobs were vanishing by the hundreds of thousands each month’. Much has been written about the financial meltdown that affected so many countries in the world, offering both diagnoses and cures. However, at a very fundamental level the crisis has to do with money (and everything that is wrapped up with this powerful symbol) and our relationship to it.

For many people, money is the most natural and indispensable means of exchange. Standard dictionary definitions of money include ‘current medium of exchange’, ‘wealth’ and ‘resource’. It is interesting to note, however, that Scripture is never satisfied with this portrayal of money as a neutral medium of exchange. It seldom looks at money solely from a monetary standpoint. Rather Scripture presents money as possessing a power and significance that could be described as ‘religious’ and constantly warns of its ability to corrupt. This is seen in Jesus’ description of money as ‘Mammon’ (Matt 6:24), indicating that money, in the hands of fallen human beings it can attain spiritual significance. That is why the Bible has so much to say about greed (Psalm 10:3; Proverbs 11:6; Luke 12:15; Ephesians 4:9; 1 Thessalonians 2:5; 2 Peter 2:3; 2 Peter 2:14). And that is why Paul, following the trajectory of Jesus’ teaching concerning money, could associate greed with idolatry (Ephesians 5:5). Our attitude to money determines how we relate to God.

It is important that we understand how money fosters human relationships. Money creates a transactional relationship that promotes the view that everything in this world can be bought and sold. This includes human beings. The buying and selling relationship that is shaped by the symbol of money is seen acutely in the relationship between the rich and the poor in many countries in Asia and across the world. As the French Christian philosopher Jacques Ellul has perceptively noted: ‘Poverty leads to the total alienation of the poor, an alienation which puts the labour force at the disposal of the wealthy, permitting the wealthy to impose their own law and conception of life, their own thought and religion’.[1] What is alarming is that this transactional relationship has dominated our modern culture, even as the language of customer and provider has wormed its way into virtually every aspect of our social life. What this means is that human relationships are reduced to carefully calibrated and orchestrated ‘business’ transactions. The real significance of this is that people are seen basically as means by which our self-interests can be furthered. ‘[T]he most basic kind of assessment we can make about actions of another’, writes Archbishop Rowan Williams, ‘… is the evaluation of how much they can increase my liberty to negotiate favourable deals and maximise my resources’.[2]

The Bible has much to say about the destructiveness of self-interest. In the Old Testament, the people of God are constantly urged to take their responsibility towards others seriously, especially those who may be at a disadvantage: widows, orphans, the poor, the oppressed and strangers. In the Gospels, Jesus taught his disciples that all the law and the prophets hang on the commandments to love God and neighbour (Matthew 22:36-40). In the parable of the Good Samaritan, the neighbour is defined as someone whom God may bring us into contact. This includes not just people we know, but also the outcast and even our enemies. In his letter to the Philippians, Paul exhorts his readers not to be motivated by pure self-interest when he writes: ‘each of you should look not only to your own interests, but also to the interests of others. Your attitude should be the same as that of Christ Jesus’ (Philippians 2:4-5).

When these moral considerations are taken seriously, we will come to realise that economics is not just about value. It is always also about values. The values that we embrace would determine the way in which we relate with one another in the economic community. Ethics and moral consensus are in fact vital factors for generating economic value. This brings us back to the most basic meaning of the economy, which simply means ‘housekeeping’. Economics therefore has to do with taking care of the household in such a way that everyone who belongs to it – children, adults, the elderly and the vulnerable – can enjoy their common lives together. Christians who are in business or who are able to influence economic policies can set the example. As salt of the earth and light of the world, Christians can demonstrate how economic pursuits can be conducted without ransacking the environment, promoting unfettered hedonism, and exploiting customers and suppliers. As Williams has again put it so well, ‘housekeeping is guaranteeing that this common life has some stability about it that allows the members of the household to grow and flourish and act in useful ways’. Such a vision can only be achieved if economics is not divorced from ethics.


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 Bible Speaks Today, July 2012.


[1] Jacques Ellul, Money and Power (Downers Grove, Ill.: IVP, 1984), 78.

[2] Rowan Williams, ‘Knowing Our Limits’, in Rowan Williams and Larry Elliot (Eds), Crisis and Recovery: Ethics, Economy and Justice (Basingstoke, Hampshire: Palgrave Macmillan, 2010), 20.