Doctoral Dissertations

Date of Award

12-1989

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Philosophy

Major Professor

Glenn C. Graber

Committee Members

Charlie Reynolds, Betsy Postow, George Brenkert

Abstract

A primary concern of bioethics deals with setting moral limits to applications of newly emerging biotechnologies on human beings. That task is at the center of the debate on gene therapy. The aim of this dissertation is to discuss some of the prominent considerations affecting the nature of moral limits set in this area of innovative research medicine. Any discussion of these issues presupposes some normative commitments that must ultimately be judged on their own merits. That exercise, however, is not the primary aim of this study. Rather, throughout this essay, the author assumes the perspective of the traditional conscience in order to identify ethical considerations affecting advances in the biomedical sciences.

Our contemporary moral confusion is commonly attributed to the collapse of the traditional conscience. Since "secular bioethics" is said to replace older patterns of thought, it is necessary to inquire about its normative structure. The interpretation given to it in this essay is to understand the modern ethical mind as comprised of two spheres. One realm presumes that ethical thinking is exhausted by the dictates of consequentialist reasoning. Beyond this realm is a moral sphere which is deeply personal and private, characterized by profound truths about human reality and incompatible philosophies of life, and therefore, incapable of rational assessment. This is the sphere of autonomy and self-determination. In the course of the early stage of the dissertation argument, this scheme emerges from the broader cultural development typified in the historical exchange between scientific rationalism and romanticism. Scientific rationalism influences contemporary secular bioethics by placing significance on the felt scientific duty to advance biomedical knowledge for the betterment of mankind. By contrast, romanticism places paramount importance on selfexpressivism. Although these two perspectives have a common origin in the beginnings of modern science, they typically divide more or less radically over the role and significance given to autonomy within their respective normative orientations. The crux of contemporary bioethics has been to reconcile these opposing forces. The confluence of these to strands of thought develop along one of two paths. One is a normative system that restricts scientific pursuits to answering questions about the most effective means to a specified end, where the end in view is self-expression. The other approach involves autonomy as an independent side-constraint that prohibits science from developing in ways that would diminish self-creation. Although these two positions are often indistinguishable in practice, it is the latter position that is the primary focus of this study.

It is with the two-sphere perspective that the ethics of gene therapy is examined. This means that the justification for the appropriateness of genetic intervention follows along broadly utilitarian lines. The predominant rationale within this scheme claims that the avoidance of pain that would be brought about by applying gene therapy far exceeds the potential for harm. Although the common-sense moralist is moved by the compassionate use of gene therapy, a consequentialist basis for its application remains disconcerting. The common-sense response to this development is to challenge the inadequacy of this consequentialist logic to establish moral limitations. In order to address this objection, the move has primarily been to introduce the second level of morality. Neo-Kantians attach a side-constraint of autonomy to the basic means-to-end pattern of reasoning. But this move, too, is found to be unsatisfactory. First, autonomy is essentially permissive. It cannot judge between human wants and needs. The policy that flows from this approach is to permit the widest range of genetic selection subject only to minimal social controls established by the utilitarian calculus. Second, its emphasis on self-expressivism as the only or most significant aspect of human nature fragments human existence, and degrades the completeness of being human.

The conclusion reached is that an alternative constraint is required to establish adequate limits to scientific advances in human genetics. The sanctity of human life understood as respect for the entire human person best accounts for the intuitive appeal that many feel toward the purposes of certain types of interventions (e.g., to alleviate pain), and the felt abhorrence for other types of manipulations (e.g., to make physical and mental capacities more suitable to one's personal life pursuit). As a value familiar to everyone reared in the cultural traditions of the West, this traditional moral distinction establishes a genuine moral limit. Indeed this traditional principle is a necessary condition for justifying certain forms of genetic intervention; for in some cases the utilitarian calculus requires the termination of life and not therapeutic intervention, as it is commonly supposed; while in other instances contemporary bioethics permits unrestricted manipulations.

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