Issues Magazine

The Future of Humanity

By Hiram Caton

Bioethics is a thriving activity whose synoptic vision includes the promise and peril of engineering a higher human type.

The science–technology fusion has been a major factor in cultural change for two centuries. The steam engine, heavier-than-air flight and nuclear energy are some landmarks. Medicine was also a beneficiary – penicillin came on stream during the 1940s – but it wasn’t until the 1960s that medicine captured public attention.

Organ transplantation was first achieved in 1967 by Dr Christiaan Barnard in Cape Town, South Africa. Barnard transplanted the heart of a comatose accident victim to the gravely ill Louis Washkansky. When images of the smiling patient flashed across the world, Dr Bernard became a hero. On his American media tour he was received even by President Lyndon Johnson. Washkansky lived only two weeks (due to a medical error in his post-operative treatment), but Barnard’s third patient lived for 18 months.

In 1968 Dr Denton Cooley performed more than a dozen heart transplants. The survival rate was low – death usually came in six months – but by 1985 two-thirds of heart transplant patients survived for five years or more. Multiple organ transplants were also explored; the first successful heart–lung transplant was carried out by Dr Bruce Reitz in 1981. Reitz also pioneered the coronary bypass operation.

Bioethics incubated from the linkage of ever-developing technology to medical practice. The first institutional establishments were the Hastings Center in New York (1969) and the Kennedy Institute for Ethics at Georgetown University (1971). The activities of these two organisations have been a major stimulus to the expansion of bioethics. Let us consider two landmark publications on bioethics.

In 1963 the CIBA Foundation published a volume of essays, Man and His Future: Provocative Commentaries By Sir Julian Huxley, J.B.S. Haldane, Carleton Coon and Other Distinguished Scientists. Huxley and Haldane were longstanding exponents of the improvement of our species. In 1924 Haldane published a remarkable science fiction, Daedalus; or, Science and the Future, which forecast many discoveries and launched that classic futurist icon, “test tube babies” – foetal development in an artificial womb (ectogenesis).

Another contributor, Nobelist Joshua Lederberg, described current biological discovery paths that might lead to an astonishing repertoire of manipulations based on gene exchange between organisms. There might be created a new species that was a fusion of two existing species, for example the cat-man expressing the morphological and genetic fusion of some feline species. Lederberg’s discovery of extra-chromosomal particles (plasmids), his elucidation of transduction, and his contribution to the creation of the first biotech drug, insulin, were important contributions to genetic engineering and biotechnology. He was indeed a consultant to the original biotechnology companies, Syntex and the Cetus.

Another landmark was Paul Ramsey’s Fabricated Man: The Ethics of Genetic Control (1970), which toured innovative medical technologies, assessed the views of their advocates, and defended Christian beliefs about the spiritual importance of family integrity. Most of his fellow theologians, among them Anglican bishop J.A.T. Robinson, Methodist theologian Harvey Cox and Episcopalian theologian Joseph Fletcher, had abandoned this position to remould Christian ethics as humanism. They tended to support gender equality, civil rights, abortion, euthanasia, voluntary sterilisation, eugenics and a technology then in the making, in vitro fertilisation.

The core of Ramsey’s analysis focuses on what he styles “the genetic apocalypse”, in which modern civilisation has eliminated, or greatly reduced, “survival of the fittest” by enabling many persons bearing heritable diseases to live and have children. Consequently each generation spreads the genetic load of heritable disease. It also spreads the load of heritable emotional and behavioural dysfunctions. Paradoxically, then, the progress curve is not an upward path to a better world of improved people, but a downward path of deterioration, unless a large-scale eugenics agenda is implemented. He thoughtfully explored the pessimism and despair of eugenicists to establish doubt that the hoped-for correction could be implemented, or would succeed if it were tried. Science therefore confirms the Revelation of St John: the world will end in destruction (Fabricated Man, pp. 22–32).

This startling possibility was prominent in a 1971 Time Magazine cover story, “Man into superman: the promise and peril of the new genetics”. The ethics portion of the article begins with a reminder of the choice made by Adam and Eve in the Garden of Eden. In yielding to Satan’s promise that by eating the forbidden fruit of knowledge they would become like God, they acquired mortality. Knowledge is ambiguous. While it bequeaths power, it doesn’t prevent its misuse to waste the natural environment, pollute the water we drink and the air we breathe with toxic chemicals. It also inflicts the humiliation of recognising that the child of God is merely another primate whose biological make-up scarcely differs from other primate species.

Yet Satan’s promise has acquired a plausibility hitherto missing because science is assembling the power to reshape the species. It is a daunting task, Time would have us believe. The human population is large and burdened by a genetic load that diminishes its fitness. Yet this threat heightens the opportunity of the new sciences. Sterilisation of persons carrying identified heritable diseases is an option. A woman unable to carry her own child may turn to a surrogate to carry it for her. Frozen embryos may be kept indefinitely, donated or used for experimentation. Such opportunities should persuade us that the promise of the new genetics is more uplifting than the perils.

The driver of much speculation on our biological future was “test tube babies”, or in vitro fertilisation. The procedure is to remove eggs from the ovaries and place them in a Petri dish to be fertilised by sperm. Once the embryo is established, in three to five days, it is implanted in the womb for normal development.

Experimentation commenced in 1959 using rabbits. Human experimentation began a decade later, but it wasn’t until 1978 that the first IVF child, Louise Brown, was born in London. The second birth was Candice Reed, born in Melbourne under the supervision of the Monash University IVF team in 1980. The team produced nine more births in the next year.

According to John Leeton in his historical article on IVF (ANZ Journal of Obstetrics and Gynaecology, 2004) the Monash team was probably the world IVF leader during the 1980s. It achieved the first donor egg pregnancy, the first frozen embryo pregnancy and the first IVF multiple pregnancies.

Monash also established, in 1980, the Centre for Human Bioethics under the leadership of Peter Singer. The centre quickly turned into a major avenue for teaching bioethics, especially to members of institutional ethics committees responsible for approving medical experiments. Singer and his deputy, Helga Kuhse, propagated the utilitarian belief that replaced sanctity of life ethics with pleasure and pain as the measure of worth or goodness. Thus, a life burdened by irremediable pain should be relieved by euthanasia. Again, entities that do not experience pleasure or pain, such as embryos, have no ethical claim (Should the Baby Live? The Problem of Handicapped Infants, 1985). Unused frozen IVF embryos may therefore be discarded. The same logic applies to severely handicapped infants. IVF scientists who wrote on the ethics of their practice followed the same line.

The public response was a sense that the loss of the sanctity of life threatened conscience. The threat came initially not from IVF, but from abortion. The liberalisation of Australian abortion law commenced in 1969 with the Victorian Supreme Court Menhennitt ruling, which allowed an abortion if it was necessary to preserve the pregnant woman from “serious danger” either to her life or her “mental health”. A New South Wales district court endorsed Menhennitt 18 months later. The ruling does not confer a right to abortion at a pregnant woman’s discretion, a position advocated by Planned Parenthood and other organisations. But in practice Menhennitt placed few limits to the pregnant woman’s choice so that abortions increased markedly during the 1970s. This is the background of the strong public response to IVF.

In 1984 the Queensland and Victorian governments established committees to report on the ethics of artificial insemination and IVF. The federal government did the same through its Family Law Council. A year later the Commonwealth Senate established the Senate Select Committee on the Human Embryo Experimentation Bill. The committee’s task was to make recommendations on a private members bill that would place the regulation of IVF practice under statutory authority, subject to felony law. It would also prohibit the use of embryos in destructive non-therapeutic experimentation. The embryo was defined as a “genetically new human being” from the moment of fertilisation. The Bill was supported by a petition bearing 132,000 signatures and the committee received 270 submissions, which confirmed widespread community concern about the social and ethical influence of reproductive technologies.

All three of the Bill’s recommendations were at odds with the IVF community and with the recommendations of the National Health and Medical Research Council (NHMRC). The embryo commences they said, only at the 14th day of conception, when implantation occurs. Prior to that it is a “pre-embryo”. Destructive non-therapeutic experimentation should be permitted up to that date. Finally, regulation of IVF practice should be self-regulation conducted by a committee elected by IVF clinics.

While all three of the Bill’s provisions antagonised IVF practitioners, the most egregious was subjecting IVF practice to criminal penalties. By what logic, practitioners complained, can the destruction of pre-embryos for the improvement of reproductive medicine be declared unlawful when abortion on demand is available?

The committee conducted hearings in all capital cities and compiled a 2200-page report, most of it the record of testimonies. It recommended that Parliament approve the Bill. However, the Hawke government decided that a set of recommendations to the NHMRC was better than restrictive legislation.

Nevertheless, 17 years later, in the wake of international ethical concern about IVF and stem cell research, Parliament approved two restrictive laws, the Research Involving Human Embryos Act 2002 and Prohibition of Human Cloning Act 2002, both of which incorporated felony penalties (http://www.nhmrc.gov.au/publications/synopses/_files/embryact.pdf).

Cloning rocketed to attention with a news report, in 1997, that a Finn Dorset sheep named Dolly had been cloned at the Roslin Institute in Scotland. Attention was riveted on the next step, cloning humans. That prospect continues to attract much attention, but it is not warranted by the facts about clones. Cloning is a very chancy procedure. Dr Ian Wilmut, who led the Roslin Institute team, was able to produce but one pregnancy from 28 embryos obtained from 277 donor cells. Pregnancy abnormalities are common, and the clone is likely to suffer defects and illnesses that diminish longevity. Dolly lived for eight years and had three successful pregnancies, but it was only her celebrity that prevented her being put down at an earlier age. (The Dolly story is an extraordinary case of untrammelled distortion of science, ethics, public authority and journalism.)

In a recent book, Dr Wilmut rejects human cloning as unethical and unfeasible. He does, however, approve of experimental cloning of the blastocyst as part of stem cell research whose objective is to create cells that may be used as replacements for diseased tissue. This is the position of Australian, UK and EU legislation on reproductive cloning. The US has to date not passed comparable legislation because conservative senators reject the ethical distinction that allows therapeutic cloning while prohibiting reproductive cloning.

Cloning is a window on a new bioethics field – enhancement – that is an intervention to improve a normal trait. Cosmetic surgery is perhaps the best known example, but steroids and human growth hormones bolster muscle strength for athletes, Ritalin improves concentration, and anti-depressants improve good feeling. With the rapid growth of technological advances, the spectrum of possibilities greatly expands. A child may be treated to grow into an athlete of superior strength; a neuro-implant might boost memory or intelligence; life expectancy might be greatly extended while the ageing process might be cleansed of its current physical and psychological deficits. That ultimate dream of remaking the human species is very much on the agenda.

Consider the Singularity Institute for Artificial Intelligence (http://singinst.org). The “singularity” referred to is the expected creation of an artificial intelligence (AI) that exceeds human intelligence. At first glance this seems disappointing. Artificial intelligence is everywhere and it achieves feats that lie far beyond human capacity. IBM’s Deep Blue computer defeated the chess world champion Garry Kasparov, who had never before lost, in a match that lasted only an hour. But this is not quite what it seems because Deep Blue was “coached” by an IBM team. (Kasparov ascribed his losses to the “unlimited resources” of IBM’s back-up for Big Blue.)

If Deep Blue could coach itself, and if it could create new intelligent machines, it would have crossed the singularity threshold. This intelligent machine could then delete its AI handlers because they aren’t smart enough. It would be able to replicate itself and to create new, better robots, perhaps even biologically based nanorobots merged in the human brain. What will these robots think of their less intelligent AI antecedents? Might they judge that we humans are an evolutionary happenstance whose unstable behaviour has no place in their post-evolutionary garden? The Singularity Institute doesn’t presume to answer this question.

For this we must pass to the Future of Humanity Institute at Oxford University (http://www.fhi.ox.ac.uk). The Institute, led by Nick Bostrum, attends to the “big picture issues of the future of humanity”, specifically to human enhancement by the application of technology to improve cognition and life span. Enhancement includes the creation of superintelligence and even immortality. Ancillary to this objective is the promotion of nanotechnology, synthetic biology and neuropharmacology.

An important ethical dimension is the investigation of decision-making, bias and preferences under conditions of uncertainty and high stakes. These include global catastrophic risks, which range from climate change to induced pandemics, wars and economic breakdown.

The institute cultivates links with related institutes and organisations, beginning on its home ground, for it is part of the James Martin 21st Century School at Oxford University, which is supported by a US$100 million endowment. Another James Martin School is the Institute for the Future of the Mind, which is headed by neuroscientist Susan Greenfield, and the Institute for the Ethics of the Biosciences.

All this is an extraordinary array of well-directed, highly active research from which ethical questions explode. What is the cost of remaking a person through enhancement? Who will pay? Who will approve or disapprove? How will the project be extended to developing nations? What will be the economic and social impact of ageing? What is to be done about those who thrive on violence and suffering?

Let me conclude this essay by recommending, strongly, the James Martin School and its institutes as the leading source for thought and research on the complex dimensions of bioethics.

Discussions of bioethics, including more on several of the examples described here, can be found at Hiram’s website (http://www.whither-progress.org/pages/ethics-and-bioethics.php).