Yudin B. G. Interrelations Between Bioethics and Ethics of Biotechnology
To discuss interrelations of bioethics with ethics of biotechnology we need first of all to draw distinction between these two fields. Yet it is not so easy to make such distinction, first of all because there is no any generally accepted understanding of either field or ethical concern.
Nevertheless, we can find a point of general agreement to start our discussion. As such initial point I am going to advance rather simple supposition: bioethics as a field of concerns, deliberations and more or less systematic studies is more advanced and consolidated than ethics of biotechnology. Ethical issues of biotechnology became an object of special and systematic interest much later than bioethical issues, at the time when bioethics had already been more or less institutionalized as a field of research and other activities. Sure, there are a lot of debatable issues concerning virtually every aspect of bioethics, even to such extent we can speak about it not so much as about the field of approved and verified knowledge but firstly as about the field of acute debates and contentions.
One of premises as well as of consequences of these discussions, which has been carrying on for more than three decades, is that they can take place only due to some commonly shared assumptions and presuppositions. People can have different, sometimes even contradictory views regarding, say, moral status of human embryo or ethical permissibility of human cloning, yet they have a kind of consensus – well-spread understanding of these topics for meaningful and substantive rational controversies. One recent example: Steering Committee on Bioethics of the Council of Europe (CDBI) up to now have not succeeded in preparing legally binding document devoted to the protection of human embryos and fetuses. The main reason of such split was the presence of irreconcilable contradictions in understanding of moral status of human embryo. Yet it turned out possible to create another agreed upon document – report, in which these very disagreements are presented[i]. The report, presenting “result of several years’ work by the Council of Europe, … highlights the numerous different approaches taken in Europe… The various arguments supporting the different existing positions in Europe are clearly outlined”[ii]. So, there is a base of shared knowledge, which was achieved in the course of long lasting discussions.
Having in mind that bioethics is something more elaborated and more definite than ethics of biotechnology, we can use the former as a kind of benchmark for analysis of the latter. Biotechnology – and consequently ethics of biotechnology – is understood in many different senses. For instance, according to “Encyclopedia of Bioethics”, biotechnology “includes any technique that uses living organisms to make or modify products, to improve plants or animals, or to develop microorganisms for specific uses”[iii]. According to such rather broad interpretation of biotechnology, essential part of the whole problem area of bioethics is covered by ethics of biotechnology as well.
So, in this case we have area of overlapping between bioethics and ethics of biotechnology. Along with this area of overlapping there is also another areas of biotechnology and of its ethical issues: such uses of new biotechnologies, which are not immediately applied to humans, for instance, agricultural use of biotechnology, ecological problems generated by its use, influence of biotechnologies on biodiversity. At the same time there is also another area of bioethics. It refers to those issues of caring, which traditionally were the subject matter of medical ethics, or healthcare ethics. This understanding of biotechnology seems logical, yet it is by no means the only existing one.
Another understanding of biotechnology is not so broad in its scope. It is limited by only those uses of it, which do not touch immediately upon humans. Such understanding seems rather widespread in tackling ethical matters of biotechnology and corresponds to the general usage, which lends the word “bioethics” for ethical account of applications of biotechnologies directly to humans. We can say even more: such distinction between bioethics and ethics of biotechnology corresponds also to our intuition. The point is that ordinarily we distinguish between two types of (technological) impacts. The first type is immediate impact on humans, the second – impact on something in the outer world.
The former we usually call intervention. It can be of physical or psychical nature; it can be directed toward achievement of medical or other (such as enhancement, for instance) goals. Moral assessment of these impacts is a problem area of bioethics. Underlying in ethical account of these interventions is initial intention of care for a person (or, more generally, a living creature) in need, who feels pain and/or suffering. Our initial reaction in such situation is emotional, namely – feeling of compassion and empathy to the person. And any our intervention is intended to relieve pain and alleviate suffering. So, it is supposed that the intervention need to be assessed from the point of view of risks and benefits imposed by it to a person, of preserving and respecting for person’s dignity and autonomy, of accessibility the intervention to a person and equitable access for different persons, and so on.
To distinguish impacts characteristic of biotechnology I shall call them not interventions but intrusions. These intrusions are directed toward environment around humans. Sure, they exert influence, often profound one, on humans living in environment modified by these intrusions. Yet such influences are not direct, but mediated ones.
At intuitive level we can easily discern interventions into us from intrusions into world around us. There are two kinds of “givenness”, which are differently experienced by us.
In the first case we have internally given, i.e. given with certainty and authenticity of not only cognitive but first of all emotional nature – of course, this in no way precludes possibility or necessity of subsequent rational assessment. We can say that the deeply rooted consensus characteristic for the area of bioethical discussions is generated first of all not by rational arguments but by our emotions.
In the second case we have externally given, i.e. given firstly through perception of some (rationally) constructed data. We need some kind of theoretical account, however loose. Such account would allow us to grasp that some events and processes in world around us, which are initiated by our biotechnological intrusions, could cause some adverse effects on us. At the same time we should not to sink into reflections for grasping the fact that any immediate intervention into us is fraught with possible risks, benefits, and dangers. It is known, for instance, that after Chernobyl’s accident many inhabitants of radioactive contaminated areas did not want to leave their place of residence. One of the main reasons was that they could not properly perceive those risks and dangers related with such indiscernible entity as radioactivity, influence of which becomes evident only in the long run.
Interrelations between intervention and intrusion described in such a manner can be compared with interrelations between time as a form of inner sense and space as a form of outer sense in Kant’s “Critique of Pure Reason”. It is worth to mention that for Kant time as inner contemplation has priority over space.
So, contrary to interventions, there is no such concentrated and clearly distinctive intention, which directs our ethical concerns in relation to biotechnological intrusions. Yet I would like to suggest that in this case we have another, more diffuse intention, namely, concern for general systemic coherence, interdependence, orderliness of cosmos, as ancient Greeks perceived it, i.e. the whole world around us (including, in our case, not just natural, but social world as well). And one more important point: these biotechnological intrusions touch us mainly not as individual persons but as members, as representatives of some communities, not just human ones. Roughly speaking, if in the first case our ethical concerns will push us into depth of human’s inner experience, in the second case they will direct us in breadth of surrounding world.
It means that we need to seek grounds for moral assessment of these biotechnological impacts in our knowledge about the world outside us and in our relations with this world. This knowledge and these relations get their expression in such fields of moral reasoning as ethics of (natural) science and technology or environmental ethics. Such conclusion may appear as something self-evident, but I think it is important to see that our ethical concerns in cases of internally given and externally given have rather different nature and different directedness.
Consequently, bioethics and ethics of biotechnology can be understood as two distinct ways of moral deliberation. Bioethics ultimately discusses diverse ethical issues at the level of single persons (or, more general, of single living beings) and their interests. Ethics of biotechnology transcends this level for more generic levels, such as level of population, of species, etc. and their well-being. It does not mean that there is impenetrable borderline between these two kinds of ethical analysis. Rather we must understand them as ideal types in M. Weber’s sense.
Indeed, it is possible and sometimes even very useful to view and to assess biotechnological developments through prism of bioethics. In such case we treat ethics of biotechnology as prolongation and expansion of bioethics, when, say, our planet, or biosphere, or an ecosystem, etc. are treated as a kind of a single individual. However, such approach would cause missing of some essential ethical problems of biotechnology. And vice versa, many problems of bioethics can be productively (with the same reservations) approached from the point of view of ethics of biotechnology. In these cases we try to perceive them in more impartial and alienated, less emotional manner. It is also possible that such change of perspective would allow to get more unbiased, balanced decisions, but these decisions usually would loose more or less essential part of mobilizing potential which is so important for their implementation.
We can have different positions regarding role of emotions as a base for moral, but in any case public perception of bioethical issues, as a rule, sharper than perception of issues in ethics of biotechnology. Or, to say it in more general terms, medical ethics appears as more magnetizing and more urgent than ethics of science (and technology).
So, ethics of biotechnology, as it is presented here, discusses interrelations between an individual and world around her/him, or place and even destiny of human being in cosmic order. There are two different value orientations in perceiving of these interrelations and in evaluation of meaning of our intrusions.
The first one stresses values of preservation of the surrounding order of things, which can be easily and irreversibly destroyed by our rash and unreasoned actions. These motives are particularly evident in tackling ecological problems arising in the course of biotechnological intrusions, such as introduction of genetically modified organisms into environment and necessity of its protection. By the way, it is this concern about preservation of life on the Earth that was pre-eminent in the initial project of bioethics as V. R. Potter developed it[iv].
Values of preservation dominate as well in more widely accepted concept of bioethics which goes back to the Hasting Center – in this case at stake is preservation of human life, health, rights, dignity, autonomy, etc. To essential degree this bioethics also is ethics of protection of some existing entities, especially in the face of new and often aggressive bio(medical) technologies. Sure, for the sake of preservation we need to produce a lot of changes; yet all these changes are directed toward restoration of some impaired (presumably natural) conditions, states, structures, processes, functions.
So, this bioethics has a lot in common with ecological ethics – main concern for both of them is dangers, which can arise as results of our impacts (interventions or intrusions), usually positively motivated, on natural course of events. These intentions can be discerned in so called “precautionary principle”, which was as a matter of fact groundwork for directives issued by the European Commission in 1990 about use of genetically modified microorganisms (Directive 90/219) and about release into the environment genetically modified organisms (Directive 90/220). According to F. Fukuyama, these directives do not mention this principle as such, “but their language is not inconsistent with it. The first explicit mention of the precautionary principle is made in the Maastricht Treaty of 1992”[v]. The precautionary principle is used as means for distribution of responsibility between proponents and opponents of new biotechnologies. It presumed that its responsibility of proponents to prove safety of every potentially dangerous technology. In my opinion, the precautionary principle expresses essence of ethics of biotechnology if the latter is understood as embodying value of protection, preserving world around us. It is worth to note, however, that “The United States has not accepted the precautionary principle as a risk standard, arguing instead that the burden of proof must lie with those who claim that safety or environmental harm exist, rather than with those who claim they do not.”[vi]
During last years problem of safe use of new biotechnologies as well as precautionary principle receive new expression due to dangers of bioterrorism. Usually we presume that biotechnologies are conceived and developed for the benefit of people (biological weapon presents special case which I am not going to discuss here), however intricate share of the benefits could be. Consequently any misuse or abuse of these technologies is generated by lack of precautionary on the part of their creators who either were not enough worried or not able to foresee possible adverse effects. In other words, these adverse effects are not intended – those who developed such technologies have not intended to use them for destructive goals.
But in case of bioterrorism we have exactly such inclination and use of human imagination. And due to that work of imagination potential of dangers related to new biotechnologies becomes much wider. That means that scope of our defensive imagination also must be widened to include this new source of threats. It is new direction for deliberations on biosafety: we need to elaborate means and mechanisms for systematic assessment of new biotechnologies to make them not just foolproof, but also evil-intended-proof.
Now I can turn to the second value orientation in relation to new biotechnologies. It seems to me that now this value system becomes more and more visible. It stresses values related with (presumably progressive, positive) changes in existing (natural) order of things, these changes to be directed by our interests, desires and dreams. This kind of ethics of biotechnology poses our interests and desires above imperatives of preservation of nature around us. The nature is perceived first of all as a row material to be transformed by means of our technologies in order to reach our goals.
Of course, aforesaid is related not only to nature around us but to our own nature as well. So, opposition of these two sets of values has relevance to bioethics understood as ethical account of applications of biotechnologies directly to humans. It seems that current debates on therapy vs. enhancement of humans reflect, among other things, opposition of these two sets of values[vii]. Therapy in this case can be interpreted as restoration (or preservation) of the existing human nature, whereas enhancement means its change.
Specific expression of this opposition can be found in the realm of ethics of biomedical research. In its more traditional forms ethics of research stresses first of all risks and burdens for the participants. In every particular case involvement of humans in biomedical research is a risky adventure, which must to be scientifically justified and ethically approved. A researcher has obligation to guarantee minimal or acceptable level of risks for a participant. The latter, in its turn, has a right to choose whether he/she will take part in research or not. This choice can be interpreted in such sense: person in question decides whether to use ordinary, existing, approved methods of therapy, consequently, to preserve the current state of the art, or to promote search for new methods, hence, change.
Yet more modern versions of research ethics tend to stress benefits for a person, which he/she can get due to participation in research through progress in therapy. And some authors even say about obligation on the part of a person to agree to be participant in research, in other words – obligation to be personally involved in promotion of change. As J. Harris stresses: “Where risks, dangers or inconvenience of research are minimal, and the research is well-founded and likely to be for the benefit of oneself or others, then there is some, perhaps very modest, moral obligation to participate.” and: “To fail to contribute to research is against the public interest and may harm others.”[viii] Argumentation in this case is built on premise of gaining common benefit through participation of a person in research, but it is presupposed also that this common benefit can be reached exactly by the way of some changes imposed on the person or data related with the person.
Now I want to make short remarks to conclude this discussion of interrelations between values of preservation and values of change in ethics of biotechnological impacts. We may disapprove biotechnological creation of new organisms as presumptuous disregard for world created not by us, world, in which we are only temporary inhabitants. It is evident that people with different ethical views and preferences will treat this problem differently. Nevertheless, it is worth to note that in any case our existence in this world would be impossible without constant and often rather essential interruptions into “natural”, existing sequences of events. Yet our demiurgic potencies and abilities must not be overestimated – after all, world around us deserves our respect as such.
[i] See http:/www.coe.int./bioethics. Report CDBI-CO-GT3(2003)13.
[ii] Abstract of the 24th meeting of the CDBI. Strasbourg, 17-20 June 2003.
[iii] Newell, Nanette. “Biotechnology”. In: Warren Reich (ed.) The Encyclopedia of Bioethics, Revised Edition, Simon & Schuster, Washington, 1995, P. 283.
[iv] See Potter V. R. Bioethics: Bridge to the Future. Prentice Hall, Englewood Cliffs (NJ), 1971.
[v] Fukuyama F. Our Posthuman Future: Consequences of the Biotechnological Revolution. Farrar, Straus and Giroux, N.Y., 2002, p. 239.
[vi] Ibid., P. 199.
[vii] See, for instance, Kass L. R. Ageless Bodies, Happy Souls: Biotechnology and the Pursuit of Perfection // The New Atlantis. Spring 2003. P.9-28. See also document prepared by the US President’s Council on Bioethics: Distinguishing Therapy and Enhancement. Staff Working Paper. (http://www.bioethics.gov/)
[viii] Harris J. Research Ethics Committees – the future. In: Politeia, Anno XVIII, N. 67, 2002, P. 128.