Het embryo - iets of iemand ?

onder redactie van mgr.prof.dr. E. Sgreccia, prof.dr. W.J. Eijk, P. Garrett, MA, prof.dr. J.P.M. Lelkens, mr.dr. P.W. Smits

Ⓒ  Katholieke Stichting Medische Ethiek 1997

Hoofdstuk V: The status of the human genome: is it ever licit to modify an individual’s genome?

5. The new Genesis: self-creation

Another fruitful approach is persued by Ronald Cole-Turner. (14) He surveys and summarises the writings of six prominent theologians on genetic engineering, subdividing them into two broad groupings: “Karl Rahner, Paul Ramsey and Robert Brungs, who are discussed first, are apprehensive about the direction in which this new technology might take us. Roger Shinn, J. Robert Nelson and Hans Schwarz, by contrast, mix caution with a greater openness to the important benefits that this technology promises.” (15)

That Karl Rahner finds his way into the litany of conservatives will come as a surprise to many readers. This judgment of Rahner is a reflection of Cole- Turner’s own perspective which is adequately summed up in the last sentence of his book: “Only in the most recent moment of creation have we appeared, and already our technology is giving us the power to add to this great work of creation.” (16)

The hermeneutic difficu1ties involved in the interpretation of texts are always considerable, and one aspect of this is brought out most clearly if we compare the views of Cole-Turner and Eijk on the subject of Rahner’s writings on theological genetics.

Cole-Tumer begins by praising Rahner’s work as “in some ways the most thoughtful theological engagement with genetic engineering,” but he later adds the judgment that while the theme of self-determination might appear to lead in the direction of a highly positive stance towards genetic intervention, the theme of the ‘givenness’ of the individual human ‘existentiale’ leads in the opposite direction, for what is given is precisely the genetic make-up at birth. (17) And by way of support for this assessment Cole- Turner quotes from Raher’s seminal article on genetic manipulation (18): Genetic manipulation, however, does two things: it fundamentally separates the marital union from the procreation of a new person as the permanent embodiment of the unity of married love; and it transfers procreation, isolated and torn from its human matrix, to an area outside man’s sphere of intimacy.” (19)

It is, of course, important not to be misled by the phrase ‘genetic manipulation’ whihch for Rahner, writing in 1966, was practically confined to artificial insemination by donor (AID), and while he is prescient of subsequent technological advances his remarks must be interpreted against this backdrop.

Eijk, analyzing the same Rahnerian material forms the judgment that: “The conclusion of this reasoning is that self-manipulation, considered to be an essential new manner of man’s essential freedom of man, must not be rejected as immoral.” (20)

According to Eijk, Rahner, like Häring, does not accurately indicate the limits of genetic manipulation, but simply mentions a few extreme forms of it which are clearly immoral – as when they destroy the ‘vital substrate for genuine human intercommunication.’

Interestingly, before going on to excoriate Rahner for his analysis, Eijk does unearth a useful heuristic from Rahner’s, previously mentioned ‘The Problem of Genetic Manipulation’ and according to this there are four elements for determining the moral quality of any proposal in genetic manipulation. (21)

These elements we may paraphrase as follows:

  1. The subject: it is quite different whether this is done by a married couple or the state (who is the acting person or party?).
  2. The moral quality of the act depends on the premeditated result on the whole human being (intentional outcome).
  3. Moral quality depends on method of employment (means).
  4. Each available step 1), 2), and 3) must be undertaken only if it is appropriate to the true nature of man (reference to underlying anthropology/theology).

To avoid the charge of begging the question, and in order to flesh out the true nature of man, one must either deliver a systematic anthropology or admit, as Rahner does, that the question about the liceity of genetic engineering is ultimately unanswerable. This is because, according to Rahner, any theologian wishing to proceed by way of ontological categories must admit that most of the characteristics of any man are merely contingent and not necessary to his substantial self. Rahner himself gives the examples of hair colour and quantity, but Eijk simply charges that: “Rahner, however, fails to provide more concrete criteria to distinguish whether genetic manipulation is at variance with man’s nature or not.” (22)

That Cole-Turner and Eijk see Rahner’s works from such radically contrasting perspectives provides a valuable insight; namely, that an individual writer’s gen-ethics depends completely upon his basic theological and anthropological beliefs. At one level this is trivially obvious, but at another level it warns us to be circumspect about the evaluations gen-ethicists make of each other’s writings. Stated more bluntly – the hermeneutic problems associated with reading secondary sources are particularly acute in this area, and the cautious reader will want to carefully consult the original texts upon which judgments have been passed.

In fact, there must be as many answers to the question, how much genetic modification of a human genome is licit, as there are theologies and anthropologies in the minds of men. Rahner’s achievement lies in predicting and formulating many of the questions which need to be asked, while Eijk’s achievement, it seems to me, lies in providing us with a beautifully clear taxonomy of bio-medical possibilities coupled with an anatomy for the beginning of moral inquiry in this field.

6. Man as Imago Dei

We may also profitably journey outside the broad confines of Catholic treatments of the matter in hand to appreciate approaches such as that taken by Karl Barth when discussing the Imago Dei in his monumental Church Dogmatics (23) An accessible introduction to how Barth’s work impinges on the issue of genetic engineering is to be found in Geoffrey Brown’s chapter within Bioethics and the future of Medicine. (24)

Brown establishes a geometric model for the exposition of Barth’s views. Within this model there are three concentric circles: the innermost circle corresponds to the ‘order of obedience’; the middle circle represents the order of creation; and the notion of a closed deposit of absolute truth from which unchanging ethica1 principles may be derived.

According to Brown: “The outer circle involves Barth in a discussion of The Imago Dei which is a divine prototype, a divine pattern of being in relationship according to which the human is made and after which human life should be fashioned. The human being is in God’s image because the man-woman relationship is like the harmonious confrontation between the Persons of the Holy Trinity. Barth’s doctrine of the Imago Dei is Christological which implies that real humanity in the image of God is Christologically known: Jesus is true human being, authentic human being, ideal human being.” (25)

Within the middle circle (order of creation) Brown explains: “As there is an I-Thou intra-trinitarian relationship, a community of disposition and act in the divine essence, similarly there is in humanity as male and female an I-Thou relation, a ‘face-to-face’ relation. Thus, the pattern of his life is analogous to that of divine life: this is God’s image and likeness in humanity therefore within the order of creation the Imago Dei consists in a band of freedom, mutual respect, and willing helpfulness.” (26)

Barth’s view may be encapsulated within three objections to the idea of using genetic engineering in a non-therapeutic manner. Barth views such attempts as an unwarranted overruling of the interpersonal requirements of the nature of the human as made in the image of God because it:

  1. denies human freedom,
  2. disregards the demands of respect for life and
  3. violates the I- Thou relationship to which’a person is called as made in the image of God. For Brown: “Human freedom before the determining command of God is the most conclusive of the three emphases of the argument in that it is the least negotiable and vulnerable of the three … and a theologically true doctrine of the Imago Del implies mutual affirmation of God-given freedom of self-determination before the command of God.” (27)

And quoting again from Church Dogmatics: “[Life should be seen as a loan] – responsibie to God and fellow humanity in patterns of freedom, care and love. Consequently, any genetic tampering that violates such freedom in vitro must be rejected. If our humanity is to be after the humamty of Christ which was for others.” (28)

There is at least an echo within these Barthian proscriptions of the call by the present Pope that genetic engineering must “respect and realise in its fullness the dignity of man” (29) and that genetic engineering must not “expose man to the caprices of somebody else, depriving him of his autonomy.” (30)

Of course violating the autonomy of an individual’s God-given freedom deforms both object and subject (moral agent). This is treated with great clarity by Oliver O’Donovan in his book Begotten or Made. (31)

“Unless we approach new human beings, including those whose humanity is ambiguous and uncertain to us, with the expectancy and hope that we shall discern how God has called them out of nothing into personal being, then I do not see how we shall ever learn to love another human being at all.” (32)

Any decision about the liciety of a particular genetic intervention should be taken with reference to O’Donovan’s observation, but of course fleshing out the content of ‘how God has called them out of nothing into personal being’, and more importantly, for what ordained purpose he has done so, will require excavation of systematic theological approaches to anthropology, and may well rely upon Christological insights of the type developed by Barth.

7. The risk of under-valuing the disabled already born or unborn

While recent committees of inquiry, at least in the Anglo-Saxon world, appear to have learned from, and been informed by, many of the analyses already mentioned, it is worth noting one particular tension which bedevils those addressing themselves to this area. Namely, that to argue that a genetic defect should be genetically treated, without making those already born with that defect – phenotypically expressed in them – feel that permission to under-value them is being implied, is a very difficult task.

Having argued that licit genetic treatments may in principle include germ-line therapy as well as somatic therapy, the Working Party reporting to the Catholic Bishops’ Joint Committee on Bio-ethical Issues in the UK goes on to remind us that: “Those who are already parents of disabled children, whether born or unborn, should be supported by society in accepting and caring for their children. Those who decide, for good reasons, to accept the possibility of conceiving children with genetic disorders should be similarly supported, and should not be subjected to social disapproval.” (33)

This type of statement is important for those worried by such comments as Gormally’s that: “There are, then, limitations of our bodily constitution which I believe we should accept as the conditions of accepting the particular life each of us has been given. But there are other limitations which we may have good reason to think should not be there: those that arise from failures of function (or structural formation) which should not exist in any living body. These are all the failures characteristic of ill-health, for health is to be understood as the well-functioning of the bodily organisation as a whole.” (34)