|Bioethics and Medical
Genetic Enhancement of a Childs Memory:
ABSTRACT: Prospects of human genetic modification raise the question of genetic enhancement of memory. A moral framework that takes into account the tension between the roles of parent and citizen on the question of genetically enhancing a childs memory is presented. Weaknesses of both moral liberalism and moral communitarianism are addressed: a tyranny of a powerful minority of liberalism, while a tyranny of orthodoxy and a tyranny of perfectionism plague different forms of communitarianism. A position is advanced that draws on the strengths of both a Rawlsian form of contractarianism and a moderate version of communitarianism. I argue that genetic enhancements of memory in children pose such serious wrongs and threats to general well-being that the practice should be decided from behind a Rawlsian veil of ignorance. With the cards down, as Ronald Green describes the veil of ignorance, a basic right to nondiscrimination on the basis of genotype would be negotiated. With this right in place, conflicts between the parental role and the role of citizen would be managed by the negotiated prohibition of parental decisions genetically to enhance the memory of children.
Let me imagine myself some years from now as a citizen and a parent who also happens to be a philosophy teacher facing the question of whether I should choose various enhancements for my young child. Orthodontics, music lessons, soccer leagues, and genetic enhancement of an average memory are among the practices I am considering. I soon discover an internal tension.
Ronald Green, in an article called "The Rawls Game," (Teaching Philosophy, 1986, 9:1, 51-60) provides an elegantly simple metaphor that helps partially to explain my tension. He describes two moral perspectives with the image of a decision-making game played with cards. The first perspective has decisions made with the cards turned upward, so that I know my conception of the good life, my talents, my social situation, and the like. The second perspective has decisions made with the cards turned down. From this perspective, I have some general knowledge about human society and motivation, but I know none of the particulars of my own circumstances.
The first perspective, according to Green, is present in two forms of moral liberalism libertarianism and utilitarianism. As I consider enhancements for my child, the cards-up approach of liberalism is initially attractive. With the cards facing up, libertarians know their own interests and seek to protect those interests. Genetic memory enhancement in children seems to be a mere extension of other ways that parents have given their children special advantages through sports leagues, music lessons, and braces on their teeth.
Green recounts how this position can quickly lead to a tyranny of the minority. In the libertarian version of the game, a unanimous vote for policy decisions is required to protect each persons liberty. If everyone favors a policy, no one is forced to follow its dictates against his or her will. The virtual impossibility of achieving a unanimous vote, however, points to a major problem with libertarianism. A few are likely to vote against proposals to redistribute resources for the majoritys benefit when those few are disadvantaged by the redistribution. Green describes this outcome as a tyranny of the minority.
As I consider libertarian grounds for decisions on enhancing my childs life, I envision a host of problems. As parents try to gain advantage for their children, a competition could set in that would parallel a Hobbesian war of everyone against everyone. Families that enjoy special access by virtue of wealth or status could gain even further advantage if the memories of their children were successfully enhanced. Finally, a floodgate of charges could be opened by people who claim discrimination: those who were considered above average and thus received no enhancement, those who claim they were insufficiently enhanced, and those who although eligible received no enhancement at all. When self-interest is held to be the main motivation of parents, unanimous agreement on the issue of enhancing a childs abilities is clearly an impossibility.
These problems with libertarianism lead me to turn to a utilitarian justification and ask whether a policy of the greatest good of the greatest number would work. Green describes utilitarian decision-making in the card game as a majority vote cast with the cards up. Utilitarian decision makers are motivated primarily by benevolence, but this too has its problems. The greatest good of the greatest number can, under some circumstances, produce a tyranny of the majority. The views of a minority that conscientiously objects would not be heard, for example, if the majority of parents favored genetic memory enhancements for their children. This would raise a serious issue of fairness if the children of the majority were to enjoy a social advantage due to their enhanced memories.
Although both of these cards-up perspectives the libertarian and utilitarian have initial plausibility, their difficulties prompt me to consider the second moral perspective that Green describes. This is the cards-down perspective and is identical with the veil of ignorance described by John Rawls, Ronald Greens teacher. Both the tyranny of the minority and the tyranny of the majority can be avoided if people can choose a policy unanimously with the cards down. A right not to be enslaved and a right to religious liberty, according to Rawls, can best be accounted for as products of negotiation from behind the veil of ignorance. Slavery and religious intolerance have been taken off the political agenda. The point of view of the least well off is taken into account when the cards are turned down.
The cards-down approach seems to be an improvement and to provide what I am looking for. Good parenting takes one beyond mere self-interest and even beyond mere benevolence. Humans may be viewed as isolated atoms when self-interest or benevolence is regarded as their primary motivation.
The story that parents along with teachers, clergy, and others try to pass on to the young is received at least in part from ones predecessors. This story includes the capacity of humans to turn the cards down and to work toward justice. It is this capacity that binds humans together and transforms them into something more than separate atoms. The energy to tell and re-tell the story stems from a motive to be linked to the life of the next generation. (I am indebted for this concept to Parker Palmer, who attributes the motive to teachers, in The Courage to Teach, San Francisco: Jossey-Bass Publ., 1998, 50.) Parents as well as teachers, clergy, and others derive moral energy and moral authority from the choice to serve as a link between past and future generations.
Upon reading Green and Rawls, however, I become more cautious. It occurs to me that the cards-down approach has deep historical precedents. From my religious training, I am aware that religions often attempt to take into account the perspective of societys victims in proposing programs of social betterment.
Rawls proposal curiously echoes a religious view. I gradually realize that two forms of tyranny can arise from turning the cards down a tyranny of orthodoxy and a tyranny of perfectionism.
Strict Moral Communitarianism
Some communities adopt a form of elitism and hold that only the few leaders can turn the cards down. This elitism points toward a form of extreme or strict communitarianism. Only the few are regarded as capable of fairly administering a society; the few may be said to adopt the cards-down perspective for all matters concerning the common good. Should the followers disagree with the conception of the good life imposed by the leaders, however, a tyranny of orthodoxy can arise.
The tyranny of orthodoxy can occur if only some people whether they be religious, scientific, or other authorities are regarded as capable of turning down the cards and administering a society. Claims of unprecedented scientific techniques excite anticipation among potential beneficiaries, but they also excite fear among members of various groups who, for historical reasons, do not trust those who invent and apply the techniques. The potential negative impact on medicine should the medical profession engage in enhancements has already prompted the suggestion that a new profession be formed to perform genetic enhancements.
History has shown that the deification of some humans is likely to be followed by their demonization. Deification can occur when the few leaders are regarded as capable of actually turning down the cards. The European clergy of the late middle ages lost the trust of the people, and extensive social reform was the result. Some would say that prior to the Reformation, some forms of Christianity in Europe had collapsed into pseudo-religion. Already one war World War II has been closely associated with a new "religion," scientific eugenics. Should only some make the decisions with the cards down concerning policies of genetic memory enhancement in children, the tyranny of orthodoxy could emerge. In this case, the tyrants would not be arbitrary religious authorities; they would be scientific or, some might maintain, pseudo-scientific authorities.
John Rawls seems to be well aware of the tyranny of orthodoxy, and he responds by placing strict limits on the turning down of the cards. The contract negotiated is to be viewed as a hypothetical, not an actual, contract. The cards-down perspective is to be adopted, according to Rawls, only to address serious wrongs and not to determine the common good. Questions of basic rights and the well-being of the least well off are decided with the cards down, but for other issues the cards remain up.
Moderate Moral Communitarianism
Is there a way out of my tension or dilemma over whether decisions on enhancing a childs abilities should be made with the cards up or down? The tyranny of orthodoxy may be avoided by allowing that everyone is capable of fair-mindedness. The view that all are capable of turning down the cards is compatible with a moderate form of moral communitarianism. On this view, the cards remain up until the common good is threatened. Even granting to everyone the capacity to turn down the cards, however, does not clearly protect against the second form of tyranny that can arise with the cards down the tyranny of perfectionism.
The tyranny of perfectionism is the arbitrary treatment of persons based on the notion that some are higher than others on a chain of being. The hierarchical order of the chain is established by a standard of goodness or perfection. The doctrine can lock people into particular classes since, in some versions, it has stated that each should serve within his or her own station in life. According to Alexander Popes version of perfectionism, it is part of the very order of things that some people are greater than others wiser and richer. (Alexander Pope, Essay on Man, Epistle IV, 49-51.)
The tyranny of perfectionism can arise from the unanimous vote of all either for or against the genetic enhancement of memory in children. If all were to agree to allow parents to seek enhancement of a childs average memory, a standard would in all likelihood be set for both the low and high ends of permissible enhancement. Any such standard, however, would serve to reinforce the notion of an ideal or perfect type.
The unanimous vote might go the other way and prohibit the genetic memory enhancement in children. The second form of the tyranny of perfectionism could occur with the vote to prohibit the practice. The problem with this vote would be that prohibiting the genetic enhancement of a childs memory would preserve the genetic status quo. One finds in the status quo a natural lottery apparently rife with inequality the very sort of inequality justified in the doctrine of the great chain of being.
Prohibitionists might reply as follows. It may be true that the prohibitionist position accepts some inequality in the natural distribution of memory abilities. A division of roles in society can be destructive when ones self-worth depends on being more highly placed than another person on a social pyramid. By contrast, however, a division of roles can be constructive when society is viewed not as a pyramid but as a ship in which those aboard share the common goal of trying to keep the ship afloat. Any serious threat to the ship is a threat to all on board, so it is in the interest of everyone to remain vigilant. Roles may be divided to achieve the common goal of keeping the ship in operation. In this model, the individual is not a mere atom. The fate of each is intertwined with the fate of every other.
Both Rawlsian liberals and moderate communitarians may accept a ship-of-state model, since both accept the cards-up as well as the cards-down perspectives. Rather than face a permanent standoff, the two groups may converse with each other. The issues of when to turn down the cards and what practices to decide with the cards down become matters of negotiation and not matters of irreconcilable difference between liberals and communitarians.
With the ship-of-state model of society in mind, I do not have to turn the cards down for some of the decisions on enhancing my childs life. Soccer and music lessons, for example, pose no threat to the common good but rather support it. I find that such sports as soccer can be ways to help my child discover fair-mindedness and achieve fair play in the midst of self-interest and benevolence, so I take her to soccer games. Music, among its other merits, can instruct my child in the positive benefits of discipline and repetition in the learning process. In each of these instances, of course, I must be responsive to the childs abilities and interests in order to avoid coercion.
Orthodontics is more problematic and points ahead to some of the difficulties with genetic memory enhancement in a child. Should braces be necessary to prevent illness or injury, I could approve. If orthodontics is used strictly for aesthetic purposes, respect for the childs autonomy could be increased by waiting until the child is old enough to give more fully informed consent to the procedure. Orthodontics for therapeutic purposes does not require the cards to be turned down.
Decisions on genetic memory enhancement in children may pose threats to the common good as well as serious wrongs. For these decisions, the cards are likely to be turned down to avoid the tyrannies of the majority, the minority, and orthodoxy. I could agree with the cards-down perspective in this case. When the cards are left up for some practices, the ship of state can deteriorate into warfare. They were left up too long on religious intolerance and slavery, and the result in each case was civil war.
When in the past the cards have been turned down following civil wars to address the serious wrongs of slavery and religious intolerance, new definitions of what it means to be a human person have been created. In a hypothetical, unanimous agreement to prohibit genetic enhancement of a childs memory I would join a citizenry that exercises parental autonomy and in the face of a volatile new technology defines a new way of understanding what it means to be a human parent. My choice as a parent to serve as a link between past and future human generations prompts me to pursue a perspective of fairness in the application of this new technology a technology that incorporates self-interest and benevolence but makes neither self-interest nor benevolence my primary motivation as a parent. I could tell a coherent story to my child if I were able to relate to that, with the cards down, people unanimously placed genetic enhancement of a childs average memory off the political agenda.