Book Review — Cutting-Edge Bioethics: A Christian Exploration of Technologies and Trends

July-August 2004

REVIEWED BY FR. THOMAS KOPFENSTEINER, STD

John F. Kilner, C. Christopher Hook, and Diann B. Uustal, eds.
William B. Eerdmans Publishing, Grand Rapids, MI, 2002, 201 pp., $22 (paperback)

"Cutting-edge" reflection on the Human Genome Project (HGP) has come to mean one of two things. On the one hand, there are clinical implications to the knowledge gained from the mapping of the human genome. Genetic advances will provide medicine powerfully new diagnostic tools, preventive interventions, and new therapies for disease. On the other hand, there are the social implications of new genetic medicine. Genetic knowledge and medicine challenges theologians and philosophers to go beyond traditional concerns such as privacy, informed consent, and confidentiality to include justice as an explicitly moral concern.

The various articles in this collection treat both aspects of the new genetic medicine. As for the emerging clinical implications, Cardinal Francis George offers an appropriate apologia for a Catholic stance on the dignity of each human person at every stage and condition. This is the cornerstone of his bioethical vision rooted in a Christian anthropology. It guides the use of technology towards therapeutic interventions that have the potential to enhance life. Against a bioethical vision based on the dignity of the person, Cardinal George sees a hostile cultural environment favoring the elimination of the "genetically challenged" through abortion and euthanasia. Though there is no need to doubt the core of his vision, it does not solve all of the dilemmas that will emerge from the practice of genetic medicine.

The most dramatic challenge that genetic medicine will pose to a Catholic moral thought is in the area of reproductive technologies. If and when, for example, biomedical technology becomes capable of producing embryos free of such life debilitating genetic defects as Tay-Sachs, will that good be urgent enough to force us to rethink the traditional relationship of the goods of marriage?

Another clinical issue emerges in light of Daryl Sas's "Reliance on Technology: Stem Cell Research and Beyond." What is the proper response to a couple who, having undergone reproductive technologies, are faced with embryos that are incompatible with human life? Some authors see the use of embryonic stem cells in this case analogous to organ donation after a tragic accident later in life. Sas, however, finds the use of embryonic stem cell contrary to biblical law, making the destruction of the embryo equivalent to murder. This view, of course, entails a debated normative assumption concerning the status of the embryo in its earliest stages. Because, moreover, the use of embryonic stem cells would be for selfish gain, Sas writes, it is also against biblical love, which requires selfless care for the afflicted. Finally, the use of embryonic stem cells is unjust because biblical justice demands that the embryo's need for life outweighs the patient's need for comfort or freedom from disease.

Nevertheess, Sas's critique of technology provides an important insight that needs further development. In one way, the HGP's accomplishments have set the stage for a revolutionary approach in our understanding of disease. We rightly marvel at the possibility of detecting and correcting genetically linked diseases before their effects are manifested in our bodies. Yet, since we all carry genetic errors, we will have to reexamine how we define disease or a defect that is in need of genetic intervention.

In another way, however, the HGP is no revolution at all. It reflects our continued commitment to the belief that technology is the answer to social and personal problems. We lose sight of a more holistic and realistic response to sickness, suffering, and disease. In the era of genomic possibilities, we channel our financial and intellectual resources into high-tech medical interventions — and we lose the link between disease and social conditions; we forget that our most effective intervention can often be a change in lifestyle.

The issue of justice is treated most explicitly by Francis Collins in "Human Genetics" and Scott Rae in "Money Matters in Health Care." Both authors emphasize how the prospects of genetic medicine are complicated by the fact that access to health care is not universal. Who will benefit from the new research in genetics? The short answer is — those who can afford to pay for it or those who have insurance coverage for it. Further, in our present economic system, future research will be carried out in a way that enables the biotechnology industry to make a profit. Not only does the logic of the market insure that future genetic interventions will be costly and limited to the few, but it also guarantees that available resources will be channeled only to the most profitable research.

Is it just, though, for the high-tech benefits of genetics to be limited to the few when so many in the world suffer and die from easily preventable causes like malaria, anemia, and tuberculosis? Should sophisticated technology be used for the service of the few when the many suffer from lack of basic health care services? In an age in which issues of justice have taken global significance, the need to be fair in the research, distribution, and application of genetic technologies is urgent.

Fr. Thomas Kopfensteiner, STD
Chair, Department of Theology
Fordham University
Bronx, NY

 

Copyright © 2004 by the Catholic Health Association of the United States
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