Brave Good World
by Martha C. Nussbaum
From Chance to Choice:
Genetics and Justice
by Allen Buchanan, Dan W. Brock, Norman Daniels,
and Daniel Wikler
(Cambridge University
Press, 398 pp., $29.95)
I.
Katherine and Bill apply for the same management
position in a large firm. Katherine's application
contains a genetic enhancement certificate from
Opti-Gene, stating that the bearer has purchased
a package of genetic services that improve memory
and boost the immune system. Bill, who could
not afford genetic enhancement, protests that
hiring on the basis of genetic enhancement is
a violation of equal opportunity. He insists
that the job should be assigned on the basis
of merit. Katherine replies that merit means
that the position goes to the best candidate,
and she is the best candidate, so what is the
problem?
Our growing knowledge of the human genome will
pose complex ethical conundrums. Some of them
are extensions of familiar perplexities. Looked
at in one way, the dispute between Katherine
and Bill is not unlike problems of equal opportunity
that we have debated for a long time. Had Katherine
been healthy and mentally sharp owing to a middle-class
upbringing, and had Bill been less so owing
to poverty and unkind circumstances, each would
have had defenders, in the familiar debate over
the meaning of equal opportunity in a context
of social inequality. Had it been clear that
Katherine inherited her good qualities from
her parents' genes and Bill his defects from
his parents' genes, most Americans would have
said, well, that's who they are. But some determined
egalitarians would have insisted that they do
not deserve to reap any advantage from traits
that they got by the luck of birth. They would
have insisted that the job should probably still
go to Katherine, but society's general scheme
of rewards and opportunities must be adjusted
to give Bill extra support. Katherine's talents
are social resources that must be fairly used
for the benefit of all.
But the moral terrain revealed by this case
is not entirely familiar. The dispute between
Katherine and Bill also poses some questions
that are not covered by existing ethical theories.
All existing theories make some sort of distinction
between the realm of nature or chance and the
realm of justice. Although it may be unclear
where that line falls in any particular case,
it looks as if our whole sense of life relies
on there being such a distinction. Some things
that go wrong for people are just tragedies,
beyond human control; other bad outcomes might
have been averted or controlled by better social
arrangements, and so they belong in the general
realm of social justice. Nature does not seem
to be going away just yet, and a bad end still
awaits us all. But the tale of Katherine and
Bill does show us that we are living in a time
characterized (to use the phrase of the fine
philosophers who have produced From Chance
to Choice) by "the colonization of the natural
by the just." Many things that looked like unchanging
accident now look like things that people can
change, and may even have an obligation to change.
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hinking about justice, moreover, will now have
to take a subtly new form. We are accustomed
to thinking about justice in terms of distributing
things to people, where the people remain who
they are and are imagined as sharing a common
set of human needs and abilities. When we are
able to alter people in fundamental ways, however,
we shall have to consider that justice may require
some remaking of people: for Katherine's good
health and quick memory are not just superficial
properties, like a new haircut. And once we
begin to travel this road, we will surely notice
that it is quite unclear what we are promoting,
because the idea of a constant human nature
begins to slip through our fingers. And notions
such as "human flourishing," or the "primary
goods" that all human beings supposedly need
in order to live, seem on the verge of slipping
away with it.
In this eloquent and impressive book, Allen
Buchanan, Dan W. Brock, Norman Daniels, and
Daniel Wikler help us to sort our way through
these perplexities. (Each takes primary responsibility
for particular chapters, and there remain some
subtle differences among them, which they debate;
but the book as a whole is a joint production.)
To put it crudely and briefly, they argue that
we should use our new genetic knowledge to treat
impairments against a baseline of some core
human functions and abilities, but not necessarily
(in most cases) to offer enhancements of human
abilities above that baseline; that we should
zealously protect reproductive freedom, and
oppose most (though not all) attempts to persuade
parents or to require parents to have a particular
sort of child; that genetic counseling and certain
types of genetic services should be offered
in all health-insurance packages; that society
must evolve toward greater respect for and inclusion
of the disabled, but this concern should not
make us shrink from treating serious genetic
impairments to the extent that we can do so.
But the authors of this book are not policy
professionals, they are philosophers; and where
philosophy is concerned, conclusions count for
little without the arguments that lead to them.
The most admirable contribution of From Chance
to Choice lies in the density and the cogency
of its arguments.
II.
hy should we care about what philosophical
argument has to say to us in an era of scientific
change? The authors' answer is that without
it we are in danger of thinking badly. As we
confront the bewildering new possibilities opened
up by the Human Genome Project, three obstacles
to good thought await us. First, we come immediately
upon our fear of change. It is very easy to
shrink back in horror from the whole idea of
genetic treatment and enhancement, simply because
we do not quite know what to say about it. The
very prospect threatens notions that have been
our moral bedrock for centuries. Instead of
thinking coolly and analytically, therefore,
we often warn darkly about the dangers of "playing
God" or departing from "nature."
And yet, as the authors sternly tell us, that
sort of phrase-making is no substitute for serious
systematic reflection. We already "play God"
in countless ways: we give innoculations, we
treat diseases, we find new educational strategies
to address learning disabilities. In so many
areas of our lives, we are not passive before
nature. And "nature" is hardly a moral norm
for any sane person. (As Mill observed, "Killing,
the most criminal act recognized by human laws,
Nature does once to every being that lives.")
So what is needed is not panic or piety, but
a sober and thoroughgoing evaluation of the
new possibilities for improvement opened up
by our new genetic knowledge.
The second obstacle to proper deliberation
in this era of genetic research is a kind of
gene-fetishism that has always had its appeal,
and that has become much more common of late.
People like to say "it's all in the genes,"
meaning that the environment really has nothing
to do with the outcome, and so we have no obligation
to promote good environments. In such a view,
the proper response to biology is resignation,
and inequalities are all the result of fate.
The authors spend a good deal of time tangling
with misunderstandings of genetic causation,
with the aid of an excellent scientific appendix
by the philosopher of science Elliott Sober.
Sober gives a detailed account of the complex
interrelationships between genes and environment,
arguing that the right question to pose is always
what the relative importances of genetic factors
and environmental factors are in any outcome,
since both factors are always causally involved.
"A condition has a significant genetic or environmental
component only relative to a range of genes
and a range of environments." Moreover, genes
often influence an outcome indirectly, by changing
the individual's environment: a physical difference
may cause others to treat a person differently,
for example, thus producing behavioral differences.
Sober is particularly critical of the claim
that a complex human and psychological phenomenon
such as homosexual desire can be plausibly traced
to a single gene.
And no less important is the authors' assault
on the ideological function of genetic determinism.
"If there were an all-powerful and all-knowing
being," they write,
who was resolutely committed to shielding
the existing social and political order from
critical scrutiny, it is unlikely that it
could hit upon a better strategy than implanting
genetic determinist thinking in peoples' heads.
There is, of course, no such evil demon. There
are, however, scientists who sometimes foster
gene-mania by a combination of excessive enthusiasm
for their own projects and breathless public
relations rhetoric aimed at securing social
and financial support. And there are biotechnology
firms poised to unleash sophisticated marketing
techniques that will no doubt encourage unrealistic
hopes for genetic solutions to all sorts of
problems.
Indeed, the authors show that the new genetic
possibilities should make it harder for people
to hide behind the gene as a rationale for quietism.
If we can alter genes, after all, then they
become a part of the social environment like
anything else, and we have to think seriously
about environmental change and its relationship
to justice, whether we are so inclined or not.
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autopsy" on the eugenics movement
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