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W. French Anderson
What Should We Do?
A line can and should be drawn between somatic cell gene therapy and
enhancement genetic engineering.6Our society has repeatedly demonstrated
that it can draw a line in biomedical research when necessary. The Belmont
Report illustrates how guidelines were formulated to delineate ethical from
unethical clinical research and to distinguish clinical research from clinical
practice. Our responsibility is to determine how and where to draw lines with
respect to genetic engineering.
Somatic cell gene therapy for the treatment of severe disease is considered
ethical because it can be supported by the fundamental moral principle of
beneficence: It would relieve human suffering. Gene therapy would be,
therefore, a moral good. Under what circumstances would human genetic
engineering not be a moral good? In the broadest sense, when it detracts
from, rather than contributes to, the dignity of man. Whether viewed from
a theological perspective or a secular humanist one, the justification for
drawing a line is founded on the argument that, beyond the line, human val
ues that our society considers important for the dignity of man would be sig
nificantly threatened.
Somatic cell enhancement engineering would threaten important human
values in two ways: It could be medically hazardous, in that the risks could
exceed the potential benefits and the procedure therefore cause harm. And
it would be morally precarious, in that it would require moral decisions our
society is not now prepared to make, and it could lead to an increase in
inequality and discriminatory practices.
Medicine is a very inexact science. We understand roughly how a simple
gene works and that there are many thousands of housekeeping genes, that
is, genes that do the job of running a cell. We predict that there are genes
which make regulatory messages that are involved in the overall control and
regulation of the many housekeeping genes. Yet we have only limited under
standing of how a body organ develops into the size and shape it does. We
know many things about how the central nervous system works—for exam
ple, we are beginning to comprehend how molecules are involved in electric
circuits, in memory storage, in transmission of signals. But we are a long way
from understanding thought and consciousness. And we are even further
from understanding the spiritual side of our existence.
Even though we do not understand how a thinking, loving, interacting
organism can be derived from its molecules, we are approaching the time
when we can change some of those molecules. Might there be genes that
influence the brain’s organization or structure or metabolism or circuitry in
6.
W. French Anderson, “Human Gene Therapy: Why Draw a Line?”
Journal of Medicin
and Philosophy
14 (1989): 681 93.