Bioethics has been in the news these last few weeks. In the wake of a University of Melbourne seminar about the implications of Assisted Reproductive Technologies to assist parents to select or in the future engineer the genetic characteristics of our children, several articles appeared in the press. Both focused exclusively on the controversial views of bioethicist Professor Julian Savulescu.
Savulescu argues that parents have an obligation to use whatever technology is available to select the best children. In the current climate, this means that parents are obliged to use IVF rather than conceive naturally in order to create embryos that can be biopsied using whatever tests are available to ‘diagnose’ their disease and non-disease traits.
Will the resulting child be female? Have Down’s Syndrome? A propensity to develop cancer in old age? A gene for musical talent or intelligence? Whatever screening can be done should be done, says Savulescu, in order that parents can choose the child that they believe has the best opportunity for the best life.
There are countless worrying implications of Savulescu’s views. For example, in Australian society discrimination against Aborigines is rife. According to the National Report into Aboriginal Deaths in Custody, no matter what social indicators are taken ‘the figures indicate that Aboriginal people are in a highly disadvantaged position’.
In such a society, it surely would make sense for Aborigines to use reproductive technology to create embryos to be screened for Aboriginal appearance, in order to select the one that will become the ‘whitest’ child. Savulescu believes such a choice is not only allowable, but is morally required, as it enables parents to choose the child they believe will have the best life.
Yet many find such a recommendation highly unethical, if not repellent. They would argue that, given racist attitudes and assumptions are driving parental decisions about what is best, the fairer solution to the ‘problem’ of Aboriginal appearance is the elimination of such unjust social conditions. They might also think there was something profoundly unjust about the only ‘solution’ being offered to Aboriginal parents to ensure their children don’t suffer from racism is to choose against a genetic attribute that they possess themselves; one that may be integral to their sense of self and identity. They may also worry that because women bear most of the burdens required to have children using IVF in order that the best can be selected, that Savulescu’s proposal is unacceptably sexist.
The consequences of Savulescu’s recommendations are just as worrying. If even some Aboriginal parents use the technology to have whiter children, it’s likely that in a few generations there will be far less people about who are Aboriginal. This means that those children who still do appear Aboriginal (because their parents couldn’t afford the technology, or didn’t want to use it) will be even more of a minority than is the case today. The less citizens directly affected by racism, one might suppose, the less there are to fight for its elimination meaning that “ arguably anyway, “ tomorrow’s Aboriginal children will be more profoundly impacted by racism and, relatedly, less well-placed to fight it than would be the case if no one was selecting for the ‘best’ kids.
Underlying all such criticisms is a scepticism about the radical individualism that characterises Savulescu’s approach. He fails to acknowledge, to paraphrase a group of widely-respected bioethicists, that not only are individual choices made within an economic, cultural and political context, but that this context is itself affected by the decisions of individuals. This doesn’t mean that individual reproductive freedom isn’t important or worth protecting, only that, to make truly ethical recommendations for how reproductive technology ought to be managed and distributed, decision-makers must take account of how society shapes individual choice and the aggregate consequences of individual choices on society as a whole.
For these reasons and more, Savulescu’s views were under considerable fire from all the bioethicists and other professionals at the seminar, as they are wherever they are presented most recently at several conferences and roundtables in the UK. Yet despite such extensive and trenchant critiques, Savulescu continues to be feted by many in the Australian media to the exclusion of other qualified philosophers with less radical views. Like his mentor Professor Peter Singer, Savulescu has become a Celebrity Bioethicist.
I worry about the cult of the Celebrity Bioethicist. I worry about what it’s doing to bioethics as a discipline, and to the public’s ability to benefit from reasoned and considered bioethical reflection on new medical and genetic technologies. As an opinion piece by Michael Cook in The Age last week (22/11) made tragically clear, there is a link in the public’s mind between what Celebrity Bioethicists say and what bioethics is all about. When the Celebrity Bioethicist promotes ideas that are both poorly reasoned and radically out of touch with the values and concerns of ordinary people, public confidence in the bioethical endeavour is undermined.
Yet bioethics came about because of the desperate need for thinkers to keep tabs on developments in the laboratories, and to stimulate public discussion about their implications and desirability before clinical use began. In the wake of the IVF debacle, in which uninformed and unconsenting women were subjected to untried technologies that for the first time in history subjected conception to direct human control, bioethicists sought to throw the laboratory doors open. They rejected technologically deterministic arguments (of the ‘it’s arrived, so we have no choice but to use it’ sort), and argued for the right of humanity, rather than a small coterie of scientists and clinicians, to decide what technologies should be developed and used clinically, and under what circumstances.
New medical and genetic technologies provoke our most fundamental human values. Over the last decade the use of pre-implantation screening and selection of embryos, the use of donated eggs and sperm to create children and the prospect of using embryonic stem cells to cure disease have forced us to wrestle with complex moral values like autonomy, privacy, consent, respect, dignity, and the right to know. In the future, we face technologies capable of extending women’s fertile years into their dotage, of creating eggs and sperm for sterile couples, and of engineering embryos to specification.
At best, the Celebrity Bioethicist offers just one man’s ideas on how to negotiate such ethical minefields. For the public to gain perspective on such views, they must be balanced by the critiques of others who spend their days reading and thinking about such technologies, or overseeing their use in clinical settings. Without such balance, the inevitable extremism of the Celebrity Bioethicist will continue to undermine much-needed public trust in bioethicists to offer wise counsel, and to capably facilitate productive public discussion of some of the most important ethical issues of our time.
The Age: New meaning to being the best you can be
The Sydney Morning Herald: Create best child possible, as our future depends on it: bioethicist
The Age: Michael Cook’s opinion piece