(00:00:00) Most of us know that within each cell in our bodies are microscopic structures called chromosomes. They are small fibers bundles containing other even smaller structures called genes genes determine whether a baby will be born with blue eyes or brown light hair or dark white skin or black even whether the baby will be normal or abnormal genes have been under scientific scrutiny for many years. And we now know how to change or manipulate these structures of genes in man and other animals genetic manipulation is little understood outside scientific circles and too many of us may seem only the stuff of Science Fiction, but it is true that genetic research can now add the diagnosis and treatment of epilepsy mental retardation psychotic disorders and other human behavioral problems. Although genetic manipulation can be helpful to mankind. There are some serious ethical questions involved genetic control and human values was the topic of a lecture given recently by Dr. V elving Anderson acting director of the diet Institute for human genetics at the University of Minnesota in Minneapolis. Anderson says that before we can seriously change the makeup of human beings. We will first have to Define our Humanity then we will have to answer these questions what constitutes an improvement in human nature and who decides here are excerpts from his address (00:01:30) when I entered into the field of genetics. There was a sense of fatalism If something is genetic, what can you do about it? At least that was the feeling that I can remember? And now the topic about genetics elicits this kind of concern at the present because people are fearful that we might do too much. There's been a shift in the techniques and the understandings in genetics. Genetics illustrates the functions of Science and I will list those there are other ways of listing them but I will describe them as explanation prediction and control. Explanations in genetics are on the one hand biochemical. The genes are biochemical in nature and the role of the genetic material. The DNA is to specify the sequence of amino acids. But they also involve thinking about chromosomes. The genetic material in fact is carried in structures. The DNA is highly compressed. And so we need to think at the chromosomal level those two means of explanation. The predictions in genetics can sometimes be fairly simple. And they are made up of the fraction 1/2. This comes from the fact that chromosomes come in pairs. For any particular pair of chromosomes one comes from your mother and one from your father. And so for certain modes of inheritance, the risks are in fact 1/2. If however the trait appears only when a gene comes from both the mother and father the prediction is 1/2 times 1/2 or 1/4 for the next pregnancy. There are other circumstances which are more complex. We cannot then use a simple ratio. We have to use empiric risks that is to find out what has happened in other families and here are the estimates might be 8% for the next child or 3% something of that order. It's not a nice round figure. It simply is the review summary of what's happened. In other cases the third function of science then that of control. when this is applied to genetics it is possible to control the effects of the genes. For certain conditions a modification of diet will take their take care of this. For other conditions the defective Gene means that a gene product is missing. This can be supplied. For example, there are some genetic causes of low thyroid levels and the treatment is to provide the thyroid hormone. There are a number of other manipulations then of this sort. A second mode of control would be to change the frequency of the gene by some control of the reproductive process. If people who carry a harmful Gene would not reproduce it would not be transmitted and the frequency would be lowered. A third option would be to change the genes themselves not so much is to change the genes that are already there. But the theoretical possibility remains of introducing a gene Let's consider the sequence that might be true for one of the causes of mental retardation called PKU. In this state and almost all other states newborn children are screened for this condition. If they get a double dose of a harmful Gene the child cannot handle one of the amino acids that's common in the diet. The treatment then is to give a diet low in that amino acid. Theoretically a different approach would be to give the enzyme that's missing or defective. But the enzyme therapy is more complex. Enzymes are rapidly cleared from the blood. Enzymes have to get into cells for the most part to have their function. There are experiments with this. There are some successful attempts. But that is still in the future. The third possibility would be to introduce the gene. That would make the enzyme that would take care of the amino acid. This is not now possible. I want you to be thinking as I talked about how values could enter in to this kind of discussion. The underlying issues are what does it mean to be human? What does it mean to dehumanize I will apply or raise questions of values at three levels? The level of individual Choice how much Choice can we tolerate on what grounds do we make choices what happens if two values that we Cherish come into conflict or tension? A second level would be that of public policy how much discussion about genetic should be public how much of it should be left to the scientists dare. We trust the scientists in their work. And the third how would these values affect the nature of research that is going on notice. I've said that we are developing the ability to detect genetic problems much sooner in a great deal more the tail. What could be the difficulty with that? But one problem is that the ability to detect always runs ahead of the ability to treat. As we learn to treat one condition then we detect some others this leaves a shifting category of diagnosable, but inadequately treated conditions. Families will differ in their ability or willingness to cope with conditions that are in this intermediate range a related problem is that the identification of human variability May label or stigmatize and individual this has occurred with reference to the Sickle Cell condition. It is now possible to detect the Sickle Cell carrier. The presence of a single dose of that Gene has little if any consequence for that person. Yet persons have been denied jobs or education. or insurance on the basis of that information That should not have become public information. But in the earlier days it did. But notice that this hat does have an impact upon the person who finds out. If you found that you were a carrier of this at what point in dating someone would you say now by the way? I'm a carrier. Are you? A rapidly advancing technology tends to increase the level of expectation. I have had people come to me and say we're about to be married and we want to be tested for what? for everything and I have to say there are not many conditions for which there is a simple accurate test. It's now available. There is no way that we can guarantee. The birth of a child that is healthy in every way. And so the right of a child to be healthy. Well, I can't guarantee that. What is the expectations that we have? Perhaps of more concern is the discussion that we might use techniques of this side of this type not only to detect and treat but to improve human kind. to improve to make man better Now that means we have to Define what we mean by being human and what we mean by Improvement. What kind of Gene could be introduced that would be such an improvement? Well, let me take a somewhat trivial example. We cannot synthesize vitamin C. Thus we drink it. Most mammals can make vitamin C. It should be possible to identify the genes that do this. All right, let's then fix fix us up. Why did why bother drinking orange juice if we can have the enzyme so we can make our own vitamin C? Say nothing about what the advertisers might say. What are the genetic problems? Notice that we would have to know how many genes for sure are involved. It may be more complex than we thought. These genes would have to be inserted into the chromosomes so that they were regulated. a gene making vitamin C without stopping might be very harmful. It could be lethal. So even in this best circumstance that I can imagine it's not now possible to do it and not I'm not sure that it should be done anyway. It is in clear. That it's much easier to reach a consensus about what constitutes a problem then to agree on goals for improvement. Example if we are heading toward times of famine, maybe it's not an advantage to be tall. But how do we decide what's the optimum body height or is it best to take potluck and have a variety of heights? The causes of defects are simpler and more readily remedied while those features which might be selected for improvement are complex and dependent upon a number of factors and perhaps more important the treatment of a defect requires only the consent of the individual or the guardian while General Improvement would need broader social agreement or authoritarian coercion. And I'll let me sort of summarize these thoughts. I'll go back to the three themes of individual Choice public policy and the nature of research. For individual Choice some I think may have hoped that Science and Technology would make life simpler for us. But a more realistic view is that the future will increase our options. Furthermore the mix of choices available to us will continue to change. So this task of weighing Alternatives will never be finished. No, in fact, is it good to have more choices See how much Choice can we tolerate for example, would it be good to be able to select the sex of a child by sums technique? Or would this merely add another source of conflict between husband and wife? Furthermore there may be an increasing number of situations in which there is a tension between several deeply held values. Now this speaks to our view of the process of valuing. It's usually easier to think of moral decisions as involving one principle of time. We are uncomfortable when two values come into tension and no single Choice seems right. My wife brought home a book about home management. And the only thing I remember from that book is that there are three values in the home. He's economy and elegance. But you can't have all three. And your lifestyle depends upon which you choose. A friend of mine a theologian has written this and I quote. We find our authentic existence only in polar situations with their inescapable tension in quote. You agree with it? For a family that knows that they're both carriers of a very deleterious G. Pregnancy is initiated whether planned or not. The tension between preserving the life of that fetus if it can be shown that the fetus does have the double dose and will surely die by age 3. Or the choice of terminating that pregnancy that is indeed difficult. Values that are cherished come into tension at that point. The second area that I mentioned was that about public policy. Some of the earlier programs for sickle cell screening met with much misunderstanding and criticism. But now the geneticists are wiser. They do consult and plan with Community leaders. And the plans and the programs have been much more effective. The discussions about recombinant DNA research at Harvard University eventually involved the Cambridge City Council. Has been disagreement. Was that good or not? It seems clear that the council members were willing to learn and they became surprisingly knowledgeable and sophisticated in a short period of time. Now this may not be possible everywhere. It does seem to me that many kinds of circumstances do deserve public discussion what it made B will differ from time to time and from one Community to another with regard to recombinant DNA my own opinion is and I borrowed this from others that the major Safeguard should be at the national level many states will not have the funds or the expertise to give to the study that's required if there is variation from state to state and there may be some tendency for research merkers to move to states with less rigorous controls. Yet there may be some circumstances where there are compelling reasons and there should be the option of local preemption or local discussion. So I am arguing for some combination of both of these. To what extent? Should the policing of the scientists and research be done within the community of scientists and to what extent should it involve the broader community? Now what about the nature of research? Are there some questions which should never be raised? In the past boundaries have been set for research and they've been disregarded and there has been no apparent harm. I didn't would argue that it's more important to identify the spirit in which research is carried out. This means an awareness of human limitations. Our knowledge is always finite. Therefore we should proceed carefully and reversibly our motives our suspect try as hard we might otherwise therefore proceed with humility. Now some have pointed out that the training of a young scientist tends to produce quite different traits. There is a spirit of optimism about the attainability of research goals There is a tendency to focus on more answerable questions. The tough ones that affect society may be disregarded. Well, Daniel Callahan has then insisted and I quote the scientific researcher has an obligation to be as active in his moral imagination as in his scientific imagination and quote. Would you agree with that? Victor weisskopf a physicist has put it this way. There are two powerful elements in human existence compassion and curiosity. Curiosity without compassion is in human compassion without curiosity is ineffective. It's not an either or it is a both and all right try to put some my own thoughts together. I've written a little chapter about these problems in the future and these are my three conclusions and I'll stop with these. First in general we can accept and use Technologies with gratitude, but Technologies by themselves never will be enough. At the frontiers of knowledge. There will be a band of uncertainty which calls for caution in research and modest expectation by the public. We must avoid the temptation to assume that complex social problems can be solved by biomedical research alone. Second in the future as in the past research workers should be constrained by two boundary conditions. On the one hand is the requirement to avoid harm. The easiest way to avoid harm is to do nothing. Therefore the other each other boundary condition is to do good. If someone knows how to do good and does it not to him it is sin a third point God's command to have dominion should be understood as stewardship carried out in love. Vigorous research and energetic application of results are appropriate but there is no need for arrogance. We might even accept deliberate modification of human biological nature. But only if it will enhance our capacity to behave responsibly toward God and our fellows. (00:23:06) Excerpts from an address by Dr. V elving Anderson, who is the acting director of the diet Institute for human genetics at the University of Minnesota. I'm Alan Cyril.