The morality of assisted reproduction
and genetic manipulation
A mo ralid ad e d a re p ro d uç ão assistid a
e d a manip ulaç ão g e né tic a
1 Dip artim en to d i Filosofia, Un iv ersit à d i Pisa . Pia z z a Torricelli 3/a , 56126, Pisa , It a lia . m a u m ori@d igicolor.n et 2 Bioetica.
Riv ist a In t erd iscip lin a re, Z a d ig Ed it ore. Via La n in o 5, 20144, M ila n o, It a lia . z a d ig@m icron et .it
M a u riz io M ori 1,2
Abst ract Th e a u t h or a n a lyz es t h e p ros a n d con s of v a riou s form s of a ssist ed rep rod u ct ion , in -clu d in g t h e u se of so- ca lled ‘gen et ic m a n ip u la t ion’. He sh ow s h ow in et h ics t h e on ly a rgu m en t s w it h an y ch an ce of reach in g a con sen su s (or at least an agreem en t ) are t h ose of t h e rat ion al t yp e, b a sed on u n iv ersa lly a ccep t a b le et h ica l p rin cip les or corrob ora t ed b y em p irica l fa ct s a n d rea l life ex p erien ce (as t h e st art in g p oin t for id en t ifyin g p roblem s requ irin g an alysis). Aft er an an aly-sis in w h ich h e id en t ifies t h e in coh eren ce an d in con aly-sist en cy of argu m en t s again st asaly-sist ed rep ro-d u ct ion , t h e a u t h or ro-d efen ro-d s t h e righ t of h u m a n b ein gs t o ro-d eciro-d e a u t on om ou sly a b ou t t h e m ost h ealt h y form s of p rocreat ion , in clu d in g t h ose in volv in g gen et ic m an ip u lat ion . His st art in g p oin t is t h e m ora l p rin cip le by w h ich it is m ora lly p refera b le t o in t erv en e in n a t u ra l p rocesses (a s op -p osed t o n ot in t erven in g) w h en ever t h is im -p lies -p reven t in g an d red u cin g d isease an d su fferin g. Key words Rep rod u ct ion ; M ed ical Gen et ics; Bioet h ics
Resumo O a u t or se p rop õe a a n a lisa r os a rgu m en t os p ró e con t ra a s v á ria s form a s d e rep rod u -ção assist id a, in clu sive aqu ela d ep en d en t e d a assim ch am ad a m an ip u la-ção gen ét ica. M ost ra co-m o os ú n icos a rgu co-m en t os coco-m ch a n ce d e ch ega r a o con sen so, ou , p elo co-m en os, a u co-m a cord o, se-ja m os a rgu m en t os ra cion a is, em b a sa d os em p rin cíp ios ét icos (u n iv ersa lm en t e a ceit á v eis), ou corroborad os p or fat os em p íricos e ex p eriên cias d e v id a (com o p on t o d e p art id a p ara id en t ificar os p roblem as qu e requ erem an álise). Ap ós u m a p art e d escon st ru t iva, n a qu al ap on t a a in coerên -cia e a in con sist ên -cia d os a rgu m en t os con t rá rios, o a u t or d efen d e o d ireit o d os h u m a n os em d e-cid ir a u t on om a m en t e a cerca d a s form a s m a is sa u d á v eis d e p rocria çã o, in clu siv e a q u ela s q u e en v olv em m a n ip u la ções gen ét ica s. Pa ra t a n t o, b a seia - se n o p rin cíp io m ora l segu n d o o q u a l é m ora lm en t e p referív el in t erferir n os p rocessos n a t u ra is q u e n ã o in t erv ir q u a n d o isso im p lica p reven ir e red u z ir d oen ças e sofrim en t o.
Preliminary remarks
By ‘m orality’ I m ean a set of d eep ly in tern alized ru les an d con viction s or stron g feelin gs th at an in d ivid u a l b elieves to b e ra tio n a lly ju stified . Wh ile ta ste a n d esth etic p referen ces n eed n o ration al ju stification an d th e p resen ce of a feelin g is selfju stifyfeelin g, m o ra l a ttitu d es a re su p -p osed to b e su -p -p orted by u n iversally acce-p ted
reason s. Su ch reason s are eith er em p irical facts
releva n t to th e issu e o r et h ica l p rin cip lesa c-cep ted b y ever yo n e o r a t lea st b y so ciety a s a wh ole.
Th e em otive asp ect im p licit in m orality ex-p la in s wh y m o ra l co n troversies a re o ften so h otly debated an d wh y th ey u su ally in volve rad -ical d isagreem en ts, m akin g p eacefu l d ialogu e on th e issu e im p ossib le. However, I th in k th at n o m atter h ow stron g feelin gs m ay b e, th ey can n ever b e co n sid ered ‘m o ra l’ u n less th ere a re good reason s to ju stify th em . To b e m orally re-sp ectab le, an attitu d e m u st b e tested by ration a l scru tiration y, a ration d we sh o u ld b e a b le to a rticu -la te va lid rea so n s o n its b eh a lf. Th is b rin gs u s to a cru cia l d ivid e o n d ifferen t a p p ro a ch es to m o ra lity. Acco rd in g to so m e a u th o rs, certa in m o ra l feelin gs a re so d eep th a t th ey a re self-ju stifyin g, an d th ere is n o way to m ake th e rea-so n s fo r th em clea r. In o n e sen se, su ch d eep feelin gs resist ra tio n a l a n a lysis, a n d a n y a t-tem p t in th is d irection is m islead in g. Leon Kass (1997) h old s su ch a view wh en h e writes: “ Re-vu lsion is n ot an argu m en t, an d som e of yester-d a y’s rep u gn a n ces a re t oyester-d a y ca lm ly a ccep t eyester-d – th ou gh , on e m u st ad d , n ot alw ays for th e better. In cru cia l ca ses, h ow ev er, rep u gn a n ce is t h e em ot ion a l ex p ression of d eep w isd om , b eyon d reason’s p ow er fu lly to articu late it” (Kass, 1997:
20). Kass goes on to say, “Th e rep u gn an ce at h u -m an clon in g belon gs in th is category. We are re-p elled by th e re-p rosre-p ect of clon in g h u m an bein gs n ot becau se of t h e st ran gen ess or n ovelt y of t h e u n d ertak in g, bu t becau se w e in tu it an d feel,im -m ed iately an d with ou t argu -m en t, th e violation of t h in gs t h a t w e righ t fu lly h old d ea r. Rep u gn agn ce, h ere as elsew h ere, revolts agaign st th e ex -cesses of h u m a n w illfu ln ess, w a rn in g u s n ot t o tran sgress w h at is u n sp eak ably p rofou n d” (Kass, 1997:20, em p h asis ad d ed ).
I realize th at h avin g reach ed su ch a p oin t, it is d ifficu lt to ob tain an y kin d of agreem en t, an d p ossib ly d ifferen t views are in com m en su rab le (to u se a fash ion ab le word ). In an y case, I reject th e a lleged in trin sic ‘wisd o m o f rep u gn a n ce’, b ecau se we h ave n o criteria to d istin gu ish b e-tween so m e ca ses in wh ich d eep feelin gs a re sim p ly u n ju stified gu t reaction s to be overcom e a n d o th er ca ses wh ich a re n o t. So, m y view is
th at in ord er to h old a m oralp osition we m u st
b e ab le to fu lly articu late good reason s for ou r fa vora b le or a versive a ttitu d es. Oth erwise, we m ay keep su ch feelin gs as p rivate p referen ces typ ical of ou r own p erson al way of life, b u t we can n ot claim an y stron ger valid ity for th em .
Th ese p relim in ary rem arks seem ed n eces-sary b ecau se th ere are qu ite d ifferen t attitu d es a n d feelin gs towa rd s a ssisted rep ro d u ctio n . Som e p eop le th in k it is a h orrib le in terferen ce in th e n atu ral p rocreative p rocess an d a violatio n o f so m eth in g wh ich is ‘u n sp ea ka b ly p ro fo u n d ’ (to u se Ka ss’s wo rd s) to b e left to ra n -d o m selectio n . Oth ers h o l-d th a t it is a sign ifi-can t ad van ce fosterin g con trol over rep rod u c-tio n a n d th erefo re in crea sin g p a ren ta l free-d om . Given su ch a con trast, we m u st fin free-d rea-son s to ju stify a p ossib le lim itation to (or even p ro h ib itio n o f ) a ssisted rep ro d u ctive tech n iq u es. If we a re u n a b le to id en tify su ch rea -son s, we m u st realize th at n o m oral p roh ib ition of assisted rep rod u ction can b e m ad e.
Against the principle of inseparability of sexuality and reproduction
Wh a t rea so n s m igh t su p p o rt a m ora lo p p o si-tio n to a ssisted rep ro d u csi-tio n ? Th e first a n d m ost gen eral on e is th e p rin cip le req u irin g th e in sep a ra b ility o f th e u n itive a n d p ro crea tive m ean in gs im p licit in h u m an sexu al in tercou rse. Th is is th e m a in u n d erlyin g a rgu m en t in th e Rom an Cath olic p osition . As we read in th e In -stru ctionDon u m Vitae: “Th e Ch u rch’s teach in g on m a rria ge a n d h u m a n p rocrea t ion a ffirm s th e‘in sep arab le con n ection , willed by God an d
u n ab le to b e b roken by m an on h is own in itia-tive, b etween th e two m ean in gs of th e con ju gal a ct: th e u n itive m ea n in g a n d th e p ro crea tive m ean in g. In d eed , by its in tim ate stru ctu re, th e co n ju ga l a ct, wh ile m o st clo sely u n itin g h u s-b an d an d wife, cap acitates th em for th e gen er-ation of n ew lives, accord in g to laws in scrib ed in th e very b ein g of m an an d of wom an’ (Pop e Pa u l VI, En cyclica l Let t er Hu m a n a e Vita e, 12). Th is p rin cip le, w h ich is ba sed u p on t h e n a t u re of m arriage an d th e in tim ate con n ection of th e goods of m arriage, h as w ell-k n ow n con sequ en ces on th e level of resp on sible fath erh ood an d m oth -erh ood . ‘By sa fegu a rd in g b o th th ese essen tia l a sp ects, th e u n itive a n d th e p ro crea tive, th e con ju gal act p reserves in its fu lln ess th e sen se of tru e m u tu al love an d its ord in ation toward s m a n’s exa lted vo ca tio n to p a ren th o o d’ (Hu -m an ae Vitae, 12).
be-tw een th e good s of m arriage th row s ligh t on th e m ora l p rob lem of h om ologou s a rt ificia l fert il-iz ation , sin ce ‘it is n ever p erm itted to sep arate th ese d ifferen t asp ects to su ch a d egree as p ositively to exclu d e eith er th e p rocreative in ten -tion or th e con ju gal rela-tion’(Pop e Piu s XII,
Dis-co u rse, M a y 19, 1956). Con t ra cep t ion d elib er-ately d ep rives th e con ju gal act of its op en n ess to p rocreation an d in th is w ay brin gs abou t a vol-u n tary d issociation of th e en d s of m arriage. Ho-m ologou s a rt ificia l fert iliz a t ion , in seek in g a p rocrea t ion w h ich is n ot t h e fru it of a sp ecific act of con ju gal u n ion , objectively effects an an al-ogou s sep a ra t ion b et w een t h e good s a n d t h e m ea n in gs of m a rria ge” (Co n grega tio n fo r th e Doctrin e of th e Faith , 1987:26-27).
I h a ve in clu d ed th is lo n g q u o te b eca u se it m a kes clea r b o th th e rea l co re o f th e Ro m a n Cath olic p osition an d th e p rin cip le on wh ich it d ep en d s. Too often th e d iscu ssion on th e issu e is m isleadin g, p oin tin g to oth er asp ects of p rac-tice, wh ile th e p a ssa ge q u o ted a b ove clea rly id en tifies th e p rin cip le in vo lved in th e m o ra l ju d gm en t, i.e. th e socalled ‘p rin cip le of in sep a ra b ility of th e u n itive a n d p rocrea tive m ea n -in gs of sexu al act’. Th is p r-in cip le is p ractically eq u ivalen t to a gen eral p roh ib ition of an y arti-ficia l in ter ven tio n in th e n a tu ra l p ro cess a n d ward s off an y sort of assisted rep rod u ction . To b e p recise, th is p osition allows for so-called ar-tificia l rep ro d u ctio n im p rop rie d ict a e, i.e. a n in ter ven tio n a im ed a t h elp in g th e n a tu ra l p ro cess with o u t su b stitu tin g o r rep la cin g it. However, I d o n o t co n sid er su ch a p o ssib ility b ecau se th ere are so few cases to b e treated in su ch a wa y th a t th is so rt o f in ter ven tio n is p ractically irrelevan t an d u seless.
Acco rd in g to th e Ro m a n Ca th o lic Ch u rch th is p rin cip le co n fo rm s to (o r d ep en d s o n ) ‘laws in scrib ed in th e very b ein g of m an an d of wo m a n’. However, th e n a tu re o f su ch la ws is n ot clear: if th ey were n at u rallaws like th at of
gra vity, fo r in sta n ce, th ere wo u ld b e n o p ro b -lem at all, an d th e situ ation wou ld b e clear an d u n d isp u ted . If, o n th e o th er h a n d , th ese la ws a re su p p o sed to b e m ora lla ws, th en th e co n
-troversy b egin s a ll over a ga in . As a m a tter o f fa ct, m a n y p eo p le b elieve th a t su ch la ws a re n o t in d isp u ta b ly d erived fro m a self-evid en t p rin cip le (n or are th ey a self-evid en t p rin cip le th em selves). In th is sen se, n ew reason s sh ou ld b e given to su p p ort th ese ‘laws’ wh ich alleged -ly a re ‘in scrib ed in th e ver y b ein g o f m a n a n d o f wo m a n’. I ca n n o t see wh ich rea so n s ca n b e referred to, u n less resortin g to som e qu ite sp e-cific a n d p ecu lia r m et a p h ysica l view o f th e world . I em p h asize th is asp ect b ecau se th e in -se p a ra b ilit y p r in cip le is st e a d fa st ly a ffir m e d
b y th e m a gisteriu m o f th e Ro m a n Ca th o lic Ch u rch , b u t th ere are m an y Cath olic b elievers an d th eologian s wh o reject it, eith er in tellectu -ally or in p ractice. Moreover, m an y oth er Ch ris-tian ch u rch es are again st or d o with ou t su ch a p rin cip le. Th u s, we can n ot say th at th e alleged in sep arable con n ection between th e two m ean -in gs o f th e m a rita l a ct is rea lly d ep en d en t o n eith er revela tio n o r Go d ’s will. In th is sen se, faith as su ch d oes n ot requ ire th e in sep arab ili-ty p rin cip le, b u t it m a y d ep en d o n a p ecu lia r m etap h ysical view of th e world. In an y case, ou r qu estion wou ld b e wh eth er th is m etap h ysics is accep tab le.
It is n ot m y task to en ter in to su ch th eologi-cal or m etap h ysieologi-cal d isp u tes, b u t I d o th in k it is im p ortan t to rem ark th at for m an y p eop le th e in sep arab ility p rin cip le is n ow m erely an ob so-lete an d ou td ated h istorical con stru ction h av-in g d a n gero u s co n seq u en ces fo r so cieties. In o rd er to reject th is p rin cip le it is su fficien t to rem ark th at it clearly forb id s an y form of cial con tracep tion as well as an y form of artifi-cia l in sem in a tio n . Th erefo re, a n yo n e h o ld in g th at con tracep tion is m orally p erm itted rejects su ch a p rin cip le. On th e o th er h a n d th ere a re m an y reason s su p p ortin g th e m orality of con -tra cep tio n . It a llows fo r th e co n tro l o f fertility a n d is th u s b en eficia l to b o th th e p a ren ts a n d fu tu re ch ild ren wh o a re a b le to co m e in to life in a m ore favorab le fam ily situ ation , i.e. wh en th ey are d esired . In th is sen se, I th in k th at th e in sep arab ility p rin cip le can n ot claim an y seri-o u s resp ecta b ility frseri-o m a m seri-o ra l p seri-o in t seri-o f view, b eca u se it im p ed es p o ten tia l h u m a n fru itio n . An exam p le is th at of h om ologou s artificial in -sem in ation , wh ich is also ab solu tely forb id d en by th e p rin cip le. How can we ju stify su ch a p ro-h ib itio n ? Wro-h y sro-h o u ld a co u p le b e p reven ted fro m h a vin g ch ild ren (o r wh y sh o u ld th ey b e forced to ad op t)? Is su ch a h eavy b u rd en really ju stified b y th e id ea th a t sh o u ld n o t sep a ra te th e alleged two m ean in gs of sexu al in tercou rse? In d eed , I can fin d n o good reason for th e in sep -arab ility p rin cip le an d th u s h ave n o d ou b ts in rejectin g it.
Of course an yon e can adhere to it as a gu id e-lin e for in d ivid u al con d u ct, b u t it can h ard ly b e a va lid m o ra l p rin cip le fo r ever yo n e o r to b e a d o p ted b y a so ciety. In a n y ca se, sin ce we m u st realize th at th ere is a situ ation of con flict-in g a n d flict-in co m m en su ra b le p rflict-in cip les, I th flict-in k th a t th e righ t so lu tio n is to let p eo p le b eh a ve a cco rd in g to th e esp o u sed p rin cip le, a t lea st in sofar as th is d oes n ot d irectlyh arm an yb od y else. We m u st a d m it th a t a m o ra l p rin cip le is very m u ch like a religiou sview of th e world in
th e m o ra l a gen t is to ta lly in vo lved in h is/ h er own m o ra l view. In th is sen se, sin ce m o d ern societies are fou n d ed on religiou s freed om, we m u st a llow p eo p le to live a cco rd in g to th eir m o ra l views, ju st a s we a lrea d y a llow th em to live accord in g to th eir religion s. Th erefore, n ot o n ly is th ere n o rea so n to fo rce p eo p le to a d -h ere to t-h e in sep arab ility p rin cip le, b u t su c-h a solu tion m igh t b e d an gerou s, sin ce it im p oses stron g an d u n ju stified lim its on p erson al free-d om .
The ‘quasi-principled objection’ of the equality of all humans beings
Are th ere oth er reason s again st artificial in sem in a tion , on ce we h a ve a b a n d on ed th e in sep a -rab ility p rin cip le? If we avoid , as we m u st, an y referen ce to th e in sep arab ility p rin cip le, we are left with o u t a n y o th er p rin cip led o b jectio n . Th ere is n o oth er selfevid en t p rin cip le to su p -p ort th e m oral wron g of artificial re-p rod u ction . However, a t th is p o in t m a n y a u th o rs p ro p o se wh at I refer to as a ‘qu asi-p rin cip led ob jection’, wh ich h o ld s a t lea st fo rin v it ro fertiliza tio n .
Th ere is a sh a rp d istin ctio n b etween in v iv o
a n d in v it rofertiliza tio n , sin ce in th e la tter a n u m b er o f em b r yo s a re crea ted o u tsid e th e wo m a n’s b o d y, m a n y o f wh ich will n ever b e reim p la n ted in a wo m a n’s u teru s. Th u s, wh ile
in v iv oa rtificia l fertiliza tio n ca n b e criticized on ly by ap p ealin g to th e in sep arab ility p rin ci-p le, in v it rofertiliza tio n ra ises m o re serio u s
m oral qu alm s b ecau se of th e loss of m an y early em b r yo s wh ich th is p ra ctice req u ires. In th is sen se, m a n y a u th o rs cla im th a t a p a rt fro m a n ega tive a ssessm en t o f th e p ra ctice itself, d e-p en d in g on th e in see-p arab ility e-p rin cie-p le in th e case of in vitrofertilization it is th e m ean s em -p loyed to rea ch th e en d (th e b irth o f a ch ild ) th at is m orally wron g, b ecau se th e p ractice re-q u ires th e d estru ction of m an y early em b ryos. Sin ce a n a ccep ted m ora l p rin cip le a ffirm s th e equ ality of all h u m an b ein gs an d early em b ryos are h u m an b ein gs, th e con sequ en ce is th at it is m o ra lly wro n g to p erm it a n y lo ss o f d estru c-tio n o f h u m a n em b r yo s, a n d th erefo re m a n y a u th o rs co n ten d th a t in v it rofertiliza tio n is
m orally wron g b ecau se th e m ean s it requ ires is m orally u n accep tab le. An d it is n ow clear wh y th is criticism is a ‘qu asi-p rin cip led ob jection’.
However, th e accep ted m oral p rin cip le con -cern in g th e equ ality of all h u m an b ein gs n eed s to b e clarified accord in g to n ew kn owled ge d e-rivin g from scien tific p rogress in em b ryology. Con sid erin g th e fact th at in th e very first d ays after fertilization th e cells of th e early em b ryo
are totip oten t, so th at th is h u m an life p rocess ca n p ro d u ce two gen etica lly id en tica l twin s, fu se with an oth er p rocess to form a ch im era, or b ecom e a m ole, we realize wh y th e trad ition al syn o n ym o u sn ess is o u td a ted a n d we h a ve to d istin gu ish carefu lly b etween th e m ean in gs of t h e fo llowin g t e rm s: ‘h u m a n b e in g’, ‘h u m a n in d ivid u a l’, a n d ‘h u m a n p e rso n’. Un t il a fe w d eca d es a go, th ese term s were syn o n ym o u s, b u t we m u st n ow rea lize th a t th ere a re m a n y situ ation s in wh ich th ey are n o lon ger eq u iva-len t. Clea r d istin ctio n s m u st b e m a d e. Th ere are h u m an b ein gs th at are (still) n ot in d ivid u -a ls: fo r in st-a n ce, ‘p re-em b ryo s’. An d th ere -a re h u m an in d ivid u als th at are n ot p erson s (for in -sta n ce, em b r yo s a n d h u m a n in d ivid u a ls in a p ersisten t vegetative state). Accord in gly, I th in k th at th e Un iversal Declaration of Hu m an Righ ts m u st b e revised , b ecau se in su ch an im p ortan t d ocu m en t th e th ree term s are con sid ered syn -o n ym -o u s. Th is is b eca u se in th e la te 1940s b io eth ica l p ro b lem s we d ea l with to d a y were n ot on th e agen d a an d d iscu ssion of th em h ad n ot b egu n . We m u st th u s u p d ate ou r reflection . As for th e n otion of p re-em b ryo, see Le Scien z e Qu ad ern ino100, en tirely d evoted to ‘L’em bri-on e e la v it a’ b u t in rea lity d iscu ssin g th e p re-em b ryo issu e (Mori, 1998b ).
In th is sen se, th e ab ove-m en tion ed p rin ci-p le is to b e u n d erstood as claim in g th e equ ality o f a ll p erson s. In o rd er to b e a ccep ta b le, th is o b jectio n sh o u ld p resu p p o se th a t ea rly em -b r yo s a re a lrea d y h u m a n p erso n s, o r a t lea st th a t th ere a re stro n g rea so n s fo r th eir b ein g treated as(if th ey were) h u m an p erson s. If th at is to b e accep ted , we m u st ad m it th at an y fore-seeab le d estru ction of early em b ryos is equ iva-len t to a sort of gen ocid e, a s som e a u th ors of-ten con of-ten d .
A fu ll d iscu ssio n o f t h e issu e s u n d e rlyin g t h is cr it icism is b e yo n d t h e sco p e o f t h is p a -p e r, b u t o n ce we st a t e t h e -p ro b le m cle a rly e n o u gh we m u st a d m it t h a t t h is o b je ct io n is com p letely wron g. In fact th ere are n o reason s to h old th at early em b ryos are h u m an p erson s or sh ou ld b e treated ash u m an p erson s. On th e
o th er h a n d , th ere a re excellen t rea so n s to sa y th at an ad equ ate in terp retation of cu rren t b io-logical kn owled ge lead s to th e con clu sion th at th ey are n otp erson s at all, as I h ave argu ed on
On ce we try to m ake sen se of it, we m u st agree with th e grea t Th o m ist p h ilo so p h er Ja cq u es Maritain wh en h e wrote in 1971 th at “to ad m it t h a t t h e h u m a n fet u s, from t h e m om en t of it s con cep tion , receives th e sp iritu al sou l, w h en th e m atter is n ot yet d isp osed to th at op eration , is to m y m in d a p h ilosop h ical absu rd it y. It is as ab-su rd a s sa yin g t h a t a fert iliz ed egg is a lrea d y a baby” (Maritain , 1977:98).
I will n ot fu rth er argu e m y p osition th at th e em b r yo is n o t a p erso n , b eca u se a n y a ttem p t in th is d irectio n wo u ld req u ire to o lo n g a d is-cu ssion . I will m erely m ake on e fu rth er rem ark sh owin g th e a b su rd co n seq u en ces o f th e id ea th at th e em b ryo is alread y a p erson from con -cep tio n o n wa rd s. In o rd er to m a ke th is p o in t clea r, co n sid er th a t th ere is a h u ge n u m b er o f fertilized eggs wh ich a re lo st n a tu ra lly b efo re b irth (som e research ers p u t th e figu re at ab ou t 80%). Th a t is, fo r a n y sin gle b irth th ere a re a t least fou r sp on tan eou s early ab ortion s (p ossi-b ly o f em ossi-b r yo s wh ich a re in co m p a tiossi-b le with life). Th is m ean s th at if early em b ryos m u st b e p erson s, even th ese em b ryos wou ld h ave to b e sa ved (in o rd er to fu lfill th e eq u a lity req u ire-m en ts). We can n ot say th at we are resp on sib le for su ch a loss, sin ce it occu rs n atu rally an d we can n ot b e b lam ed for a n atu ral occu rren ce. Bu t sin ce wek n ow th at fact, if su ch em b ryos m u st
b e con sid ered p erson s like u s, we sh ou ld try to a vo id th eir d ea th . Oth erwise we wo u ld b e u s-in g th em a s m ere m ea n s to o u r en d s. If we d o n oth in g to ch an ge th e situ ation , we are p art of th e grea test ‘gen o cid e’ p erfo rm ed b y n a tu re. We sh ou ld th erefore im m ed iately in vest th e re-so u rces to rescu e a ll n a tu ra lly a b o rted ea rly em b ryos in ord er to sh ow th at we take equ ality seriou sly. Bu t ap art from th e ad d ition al b u rd en im p osed on n orm al p eop le if we take su ch ac-tion , we m ay in crease th e n u m b er of n ewb orn s th at are alread y u n ab le to live au ton om ou sly. Is th a t wh a t we rea lly wa n t? Do we rea lly th in k th at it is good to m od ify th e ord er of n atu re in th is d irectio n ? I h a ve n o d efin ite a n swer to su ch q u estion s, b u t I th in k th at th ese rem arks sh ow h ow d ifficu lt it is to h o ld th e th esis a c-cord in g to wh ich th e em b ryo is a p erson start-in g at th e m om en t of con cep tion (Mori, 1998c). Even wh ile I a m firm ly co n vin ced th a t th e em b r yo is n o t a p erso n , I a m rea d y to a d m it th at we h ave so far at least two d ifferen t in com -m en su ra b le ‘p a ra d ig-m s’ o n th e issu e (Mo ri, 1996c). My view is th at we can d ecid e wh ich is ‘b etter’ a n d ‘m o re relia b le’, b u t I rea lize th a t even m y o p p o n en t th in ks th e sa m e. We th u s h a ve to a d m it th a t th ere a re o p p o sin g ‘p a ra -d igm s’. Bu t at th is p oin t, it is as if we a-d m it th at a sta n d o n th e issu e o f th e em b r yo’s n a tu re is
eq u iva len t to a religio u s view, a n d we m u st th u s allow freed om of b eh avior, for th e reason s th at I alread y m en tion ed ab ove.
If we ab an d on th e id ea th at an y d estru ction of early em b ryos is eq u ivalen t to m u rd er, th en it is d ifficu lt to id en tify an y oth er p rin cip led or q u asi-p rin cip led reason again st in v itro fertil-ization . In fact, assisted rep rod u ction allows for th e b irth of ch ild ren wh o wou ld n ot b e b orn if su ch a tech n iq u e were n ot availab le. From th e p o in t o f view o f th ese ch ild ren , it is certa in ly b etter to b e b o rn h ea lth y a n d in a lovin g h u -m an en viron -m en t th an to n ever b e b orn at all. By b ein g b orn th ey h ave th e ch an ce of a sign if-ica n t life a n d th erefo re sh o u ld b e gla d to b e b orn by m ean s of an artificial tech n iq u e. Th ey m igh t su ffer so m e m in o r p sych o lo gica l p ro b -lem s n ow, sin ce th e p ractice is still n ot rou tin e, b u t su ch p rob lem s ap p ear sim ilar to th ose ex-p erien ced by ex-p eoex-p le in sex-p ecial situ ation s, like th e first girl in a class of b oys or th e first p eop le born by cesarean section s (Filip p in i, 1995). Gen -era lly sp ea kin g, we ca n a ssu m e th a t a rtificia l in sem in ation is in th e in terest of b oth th e n ew-b orn (wh o can on ly en joy life ew-by m ean s of su ch a tech n iq u e) a n d th e p a ren ts (wh o a re a b le to exp erien ce p aren th ood ). In th is sen se, I see n o reason again st th is n ew artificial p ractice.
‘Empirical’ reasons concerning artificial insemination
Gran ted th at th ere are n o p rin cip led or q u asi-p rin ciasi-p led reason s again st artificial reasi-p rod u c-tio n , I n ow a n a lyze two ‘em p irica l’ rea so n s wh ich u su a lly a re a lleged a ga in st a rtificia l in -sem in a tio n by d o n o r. On e is th a t th e p ra ctice b reaks th e u n ity of th e fam ily. Th e oth er is th at a d o p tio n is a b etter so lu tio n th a n d o n o r in -sem in a tio n . However, n eith er gets th e p o in t. Up o n clo ser exa m in a tio n , o n e m u st rea lize th at th e latter is n ot ‘em p irical’ at all. As a m at-ter of fact, p aren th ood d oes n ot d ep en d on th e p resen ce of a b iological relation , b u t on th e d e-cisio n to b rin g a b o u t th e b irth o f a n ew o ffsp rin g. Fro m th is p o in t o f view th ere is a cru -cial d ifferen ce b etween artifi-cial rep rod u ction an d ad op tion , an d th e latter in stitu tion is rele-va n t to o u r d iscu ssio n o n ly b eca u se it clea rly sh ows th at p aren th ood d oes n ot d ep en d on ge-n etic rela tio ge-n sh ip s b etweege-n th e a ge-n cesto r a ge-n d th e offsp rin g. Bein g a ch ild is a legal rath er th an b io lo gica l rela tio n sh ip (i.e., a so cia l rela tio n -sh ip san ction ed by th e state).
is th at artificial rep rod u ction p resu p p oses a d e-cisionto b rin g a b o u t th e b irth o f a n ew ch ild ,
an d wh at is valu ab le is exactly su ch a resp on si-b le ch o ice. On th e o th er h a n d , a d o p tio n p re-su p p oses th at som eon e else d ecid ed th at a n ew ch ild h ad to com e in to th e world , an d th at th is p erson p roved u n ab le to take care of th e ch ild th at h e/ sh e wan ted to com e in to th e world , so th a t so ciety h a d to ta ke ca re o f th e ch ild in so m e wa y. Ad o p tio n is o n e o f va rio u s wa ys in wh ich society can cop e with th e issu e. Howev-er, th e d ifferen ce b etween th e two p ractices is n ow clear, an d th at can n ot b e p u t on th e sam e level. Ad o p tio n is a lwa ys a rem ed y to a n a l-rea d y sa d o r tra gic situ a tio n in wh ich th o se wh o d ecid ed to h a ve th e ch ild a re u n a b le to care for h im / h er eith er b ecau se th ey d ied su d -d en ly or were u n ab le to -d o so. In th is sen se so-ciety a ttem p ts to fin d a rem ed y b y a ssign in g th e p aren tal role to som e resp on sib le p eop le so th at th e ch ild can receive an ad equ ate u p b rin gin g. Th erefore, ad op tion is th e least worst solu -tion to a tragic situ a-tion , wh ile as an in stitu -tion it clea rly sh ows th a t p a ren th o o d (o r filia tio n ) d oes n ot d ep en d on b iological relation s. On th e oth er h an d , artificial in sem in ation h in ges on a resp on sib le d ecision to create a n ew offsp rin g. In th is sen se it can n ot b e com p ared with ad op -tio n . An y lim ita -tio n to a rtificia l rep ro d u c-tio n m u st b e p rop erly ju stified , an d I th in k th ere is a se rio u s risk t h a t su ch re a so n s m a y a lso b e a p p lied in th e ca se o f ‘n a tu ra l p ro crea tio n’. If th ere is n o in trin sic reason to resp ect th e ‘n at-u ra l o rd er’ a s sat-u ch (sin ce we h a ve a lrea d y re-jected th e in sep arab ility p rin cip le), th en wh at is im p o rta n t resu lts fro m certa in p ro cesses, h owever th ey a re o ccu r, wh eth er n a tu ra lly o r a rtificia lly. If we a d m it th a t a given effect b rou gh t ab ou t artificially is b ad or b lam ewor-th y, wh y n ot p ass sim ilar ju d gm en t in ewor-th e case o f a sim ila r effect b ro u gh t a b o u t n a tu ra lly? I th erefore th in k th at we sh ou ld u p h old an d d fen d rep rod u ctive freed om a n d let p eop le d e-cid e h ow an d wh en to p rocreate.
In fact, h avin g ab an d on ed th e in sep arab ili-ty p rin cip le, I can n ot see h ow we can lim it ac-cess to assisted rep rod u ction with ou t a sim ilar lim ita tio n to ‘n a tu ra l’ rep ro d u ctio n . Ta ke th e case of a sin gle wom an . On e cou ld say th at it is irresp on sib le for a wom an to h ave a ch ild an d rem a in sin gle. Th is co u ld b e a rea so n to d en y access to assisted rep rod u ction . Th en wh y is it a llowed to p rovid e a sin gle p regn a n t wo m a n with m ed ica l ca re d u rin g p regn a n cy o r ch ild -b irth ? If it is irresp o n si-b le fo r a sin gle wo m a n to h ave a ch ild , th en th e alleged tragic situ ation of th e fu tu re ch ild sh ou ld b e su fficien t to ju sti-fy with h old in g an y form of m ed ical care d u rin g
p regn an cy an d ch ild b irth . Bu t if we th in k th ere is a d u ty to p rovid e m ed ical care to th e wom an d u rin g p regn an cy, wh y d en y care even for con -cep tion , i.e., at an earlier stage? I b elieve th ese qu estion s sh ow th at ou r p rim a facieop p osition
rests on ly on received op in ion s from trad ition s with ou t an y valid reason .
Th e o th er o b jectio n to a ssisted rep ro d u c-tion is m ore ‘em p irical’ in the sen se that it refers to b reakd own of th e fam ily, sin ce d on or in sem -in a tio n co u ld b e a ca u se o f d ivo rce a n d o th er p ath ological fam ily situ ation s. However, su ch a view is em p irica lly fa lse, sin ce th ere a re d a ta sh owin g th a t fa m ilies resortin g to a ssisted re-p rod u ction are u su ally m ore stab le th an oth er cou p les. Th ere m igh t b e oth er reason s to su p p ort su ch a situ ation , b u t it is certain th at fam -ilies relyin g on assisted rep rod u ction are m ore stab le th an oth er fam ilies. In th is sen se th ere is n o rea so n to b e a ga in st su ch a n ew p ra ctice, an d ou r (p ossib le) op p osition is n oth in g b u t a cu ltu ra l a rtifa ct th a t h a s su rvived d esp ite a n y ration al ju stification (Mori, 1995).
Genetic manipulation and its moral implications
Ha vin g a rgu ed fo r th e m o ra lity o f a ssisted re-p rod u ction , I sh ou ld n ow say a word ab ou t th e p ossible p ractice of so-called ‘gen etic m an ip ula-tion’. Th is exp ression ap p ears to b e m islead in g, becau se ‘m an ip u lation’ h as a n egative con n ota-tio n , a llu d in g im p licitly to so m eth in g wich is su p p osed to b e a p rioriwron g. However, I take it a a s a m ere valu e-free lab el in d icatin g th e n ewly gain ed h u m an ab ility to m od ify ou r ge-n etic coge-n stitutioge-n .
A seco n d p relim in a r y rem a rk is th a t a l-th ou gh l-th ey a re rela ted , l-th e two issu es (a rtifi-cia l rep ro d u ctio n a n d gen etic m a n ip u la tio n ) a re q u ite d ifferen t a n d in d ep en d en t. Th e first p rovid es p eo p le with a grea ter p o ssib ility o f h avin g offsp rin g, wh ile th e secon d p rovid es th e op tion of ch an gin g th e gen etic con stitu tion of o u r o ffsp rin g. Fro m a p ra ctica l p o in t o f view, a r t ificia l in se m in a t io n (e sp e cia lly in t h e in v it roform ) seem s to b e a n ecessary step to ge-n etic m a ge-n ip u la tio ge-n , b u t su ch a go a l co u ld b e ach ieved in oth er ways, for exam p le, by killin g an y offsp rin g lackin g certain featu res. Of cou rse it m ight p rove quite difficult to accom p lish su ch a p rogram b ecau se of social op p osition , p ossi-b ly lead in g to riots, ossi-b u t su ch a p ossiossi-b ility p er se
ili-ty of exam in in g early em b ryos, an d th is is a lin k b etween th e two issu es.
Is gen etic m an ip u lation a welcom e op p or-tu n ity for fu or-tu re p aren ts, or is it a n igh tm are for h u m an kin d to com e? A m ajor d ifficu lty we en -cou n ter in facin g th is q u estion is th at it raises so m a n y p ro b lem s th a t it is h a rd to get to th e core of th e issu e. For exam p le, m an y p eop le are terrified by th e p ossib le d isastrou s social con -seq u en ces of som e a b u se of ou r n ew ca p a city to ch a n ge o u r gen etic m a ke-u p. Wh a t wo u ld h a p p en if a d icta to r sh o u ld ga in fu ll co n tro l over th e n ew p ractice? Wou ld it n ot be a real so-cial disaster for fu tu re h u m an kin d? Th ese qu es-tion s are com m on p lace wh en we ap p roach th e issu e o f gen etic m a n ip u la tio n , b u t I m u st sa y th at th ey are m islead in g an d m iss th e p oin t. To sh ow th a t th ey m a ke little sen se, we ca n a sk a sim ilar q u estion . Wh at wou ld h ap p en if a d ic-tator gain ed fu ll con trol over all television , ra-d io, n e wsp a p e rs, t e le p h o n e s, e t c., so t o h o lra-d con trol over all in form ation ? Certain ly it wou ld b e a d isa st e r, b u t d o e s t h is p o ssib ilit y sh ow th at th e in ven tion of television etc. was m oral-ly wron g?
I kn ow ver y well th a t th ere a re p o ssib le ab u ses of gen etic m an ip u lation , as th ere are for a n y o th er p ra ctice, b u t m y co u n ter-q u estio n sh ows th at we m u st distin gu ish clearly between th e socia l p ro b lem co n cern in g th e p o litica l
co n seq u en ces o f su ch a n ew p ra ctice a n d th e
m ora lp ro b lem a s su ch . It is th is a sp ect o f th e issu e th a t I wa n t to co n sid er, a n d it is cru cia l th a t we a sk th e righ t q u estio n . On ce we h a ve ab an d on ed th e in sep arab ility p rin cip le an d re-alize th at th ere is n o in trin sic valu e in resp ect-in g th e alleged ‘n atu ral ord er’ of h u m an rep ro-d u ction , th e real q u estion is th e followin g: is it m o ra lly p refera b le th a t th e gen etic co n stitu tion of fu tu re offsp rin g b e estab lish ed ran d om -ly, or th at it b e d ecid ed by h u m an ch oice?
Th is I th in k is th e rea l q u estio n th a t we
h a ve to a sk wh en co n sid erin g th e issu e o f ge-n etic m a ge-n ip u la tioge-n . Age-n d of cou rse m y a ge-n swer is th a t h u m a n p u rp o se is b etter th a n n a tu ra l ch a n ce, b eca u se th e la tter so o ften ca u ses so m u ch p ain . In som e cases I am in clin ed to h old th a t it wo u ld b e im m ora lto let n a tu re ta ke its cou rse an d ab stain from in terven tion , b ecau se in th is way (by n ot d oin g, an d sim p ly forb ear-in g) we allow som e avoid ab le evil to occu r. We can red escrib e th e situ ation by sayin g th at if we
k n ow(as we p ossib ly d o) th at som e gen etic d
is-ease affects a n ew offsp rin g an d d o n oth in g to p reven t it fro m o ccu rrin g, we u se n a tu re to h arm h im / h er. In th is sen se, I th in k th at gen et-ic m a n ip u la tio n is m o ra lly p erm issib le a n d welco m e, a llowin g th e p o ssib ility o f era d ica
t-in g som e terrib le h u m an d iseases. We can h op e th a t in th e fu tu re o u r o ffsp rin g m a y en joy a b etter b io lo gica l life, b ein g ‘gen etica lly va cci-n a ted ’ a ga icci-n st m a cci-n y d isea ses. It wo u ld b e a m oral traged y if we wou ld m iss su ch an op p or-tu n ity.
I th in k th a t m o st p eo p le a gree with th is view a s fa r a s n ega t iv egen etic in ter ven tio n is con cern ed , i.e., th at with th erap eu tic p u rp oses to sp a re p eo p le fro m d isea se. Bu t wh a t a b o u t th e p ossib ility of p ositivein terven tion aim ed at im p rovin g th e h u m a n ra ce? Is it m o ra lly p er-m issib le o r n o t? Th ese a re d ifficu lt q u estio n s, b u t m y a n swer wo u ld sta rt b y rem a rkin g th a t th e d istin ctio n b etween n ega t iv ea n d p osit iv e
in terven tion s in th is field is n ot a s clea r a s we a ssu m e a t first gla n ce. It is n o lo n ger ea sy to d istin gu ish wh at cou n ts as a d isease (on ce we h ave given u p th e organ ic con cep t of it). For in -sta n ce, is a vo id a n ce o f Hu n tin gto n’s ch o rea a n egative in terven tion or a p ositive on e? A p er-so n with su ch a d isea se ca n live till a b o u t 45 years. Th erefore, sh ou ld we con sid er an in ter-ven tion n egative b ecau se it p reven ts a d isease, o r p osit iv e b eca u se it resu lts in p ro lo n gin g
wh a t is a lrea d y a co n sid era b le life-sp a n ? Th e an swer m ay d ep en d on wh eth er d yin g at ab ou t 45 sh o u ld co u n t a s a p rem a tu re d ea th o r n o t, an d th is sh ows h ow fu zzy (or con ven tion al) th e d istin ction b etween ‘n egative’ an d ‘p ositive’ in -terven tion is.
Bu t let u s a ssu m e th a t given in terven tion s are d efin itely p ositive, like h avin g a m ore b eau
-tifu l d a u gh ter. Are th ey m o ra lly p erm issib le? An d if we a llow th em , wo u ld n’t it b e a so cia l d isa ster? Sh o u ld n’t th ey b e fo rb id d en ? Now, first o f a ll we a lrea d y a d m it p la stic su rger y to im p rove p h ysica l b ea u ty. If we h a d cet eris p a rib u sto a ch ieve th e sa m e effect b y gen etic m ea n s in stea d o f b y su rger y, wh y sh o u ld th e la tter b e p ro h ib ited wh ile th e fo rm er p erm it-ted ? I see n o ob jection to su ch alleged p ositive
iffi-cu lt for m e to con ceive of a wicked p aren t, i.e., o n e wh o wo u ld p u rp o sely wa n t to h a rm h is/ h er ch ild . I gen erally th in k of p aren ts wh o work h ard an d d evote th eir lives to th e good of th eir ch ild ren , even if th ey so m etim es m a ke m is-takes. In an y case, if th ere are wicked p aren ts, as th ere m ay b e, th ey are very few, an d we can fin d ways to p reven t th em . In gen eral, h owever, I h ave th e im p ression th at m ore evil will resu lt if we let n a tu re ta ke its ra n d o m co u rse ra th er th an accep tin g th e n ew resp on sib ility of a p u r-p osefu l ch oice.
We are at th e b egin n in g of a n ew era, an d I th in k we sh ou ld n ot b e afraid to face n ew qu es-tion s th at h u m an kin d h as to an swer.
References
CONGREGATION FOR TH E DOCTRINE OF TH E FAITH , 1987. In st ru ct ion on Resp ect for Hu m a n Life in It s Origin a n d on t h e Dign it y of Procre-ation. Vatican City: Lib reria Ed itrice Vatican a. FILIPPINI, N. M., 1995. La N ascita Straord in aria. Tra
M a d re e Figlio la Riv olu z ion e d el Ta glio Cesa reo (Sec. XVIII-XIX). Milan o: Fran co An geli Ed itore. KASS, L. R., 1997. Th e wisd o m o f rep u gn a n ce. Th e
New Rep u blic, Ju n e 2, p. 20.
MARITAIN, J., 1977. Ap p roch es San s En t raves. Scrit t i d i Filosofia Cristian a. Vol. I. Rom a: Città Nu ova. MORI, M., 1995. La Fecon d a z ion e Art ificia le. Un a
N u ov a Form a d i Rip rod u z ion e Um a n a .Ro m a , Bari: Laterza Ed itore.
MORI, M., 1996a. Is th e h u m an em b ryo a p erson ? No. In : Con ceivin g th e Em bryo. Eth ics, Law an d Prac-t ice in Hu m a n Em b ryology(D. Eva n s, ed .), p p. 151-163, Th e Hagu e: Martin u s Nijh off Pu b lish ers.
MORI, M., 1996b. Il CNB e lo sta tu to d ell’em b rio n e: u n’a n a lisi critica d el d o cu m en to e lin ee d i u n a p rosp ettiva altern ativa. Bioetica. Rivista In terd is-cip lin are,IV:431-460.
MORI, M., 1996c. L’in solu b ile q u estion e d ell’id en tità d ell’em b rion e. La q u estion e: ‘se l’em b rion e sia o n o u n a p erson a’ è l’eq u ivalen te d i q u ella p iù an -tica: ‘se il sole giri o n o attorn o alla terra’? Rivista d i Teologia Morale, XXVIII:493-499.
MORI, M., 1997. A Moralidade do Aborto. Brasília: UNB. MORI, M., 1998a . L’em b rio n e. A p ro p o sito d i u n in -terven to d i M. Lom b ard i Ricci. Rivista d i Teologia Morale, XXX:95-98.
MORI, M., 1998b. Presen tazion e. Le Scien z e Qu ad er-n i, 100:2-4.
MORI, M., 1998c. É razion alm en te sosten ib le la Pro-p osta d i m od ifica d elí articolo 1 d el Cod ice Civile?
