Siep, Normative Aspects of the Human Body, 4 The Human Body as Common Heritage and the Justification of Its Alteration

by Corry Shores
[Search Blog Here. Index-tags are found on the bottom of the left column.]

[Central Entry Directory]
[Posthumanism, Entry Directory]
[Siep's "Normative Aspects of the Human Body", Entry Directory]


[The following is summary. The full text is available here or here.]

[Directory of other entries in this series.]

Ludwig Siep

Normative Aspects of the Human Body

IV. The Human Body as Common Heritage

and the

Justification of Its Alteration

(3) We have been speaking of the human body's common heritage. Siep wonders now what it would mean if we regarded the following also as belonging to this heritage:

a) the human species' genetic program

b) the species' random combination in heterosexual reproduction,

c) the range of phenotypic variety produced by this random reproduction.

And he wonders, what would the moral consequences be of regarding the human genetic program as part of our common human heritage?

Soon Siep will outline those consequences. But in genetic engineering there is also the issues of autonomy and paternalism. So first he will differentiate the degrees of this autonomy and paternalism. Today it is really not possible for someone to alter their own genes. But such technologies are pending. Some even predict that we are close to having genetic doping technologies for athletes. In these cases, one autonomously chooses to enhance one's own body. We should discuss the ethics of these near-future possibilities.

But genetic technologies will also allow us someday to alter the genetic properties of future human beings. This is one step further than the above instance of autonomous use. Presumably we would alter future humans' genes for their benefit. We might eradicate hereditary diseases or the genetic causes for aging. But there are paternalistic uses of genetic technology as well. Parents might engineer their child according to their personal wishes. Or perhaps even the state would enforce its wishes for our offspring by tampering with their genes.

Consider parents who have lived with their own hereditary diseases. They know best whether they should allow these genes be passed-on.

Our first case was autonomous enhancement. This seems to be a matter of informed consent. And some enhancements appear trivial and unnecessary. For example, someone might have their growth increased so that they can see better at a sports arena. But then if there were such people who made this decision, we might call for regulations to prevent them from interfering with other peoples' view. For example, rules could limit them to only the rear rows where they will be in no one's way. But of course we would not impose these rules on people who were born exceptionally tall, even though we think it is reckless when they insist on sitting in the front rows. The subtle but crucial difference is that the genetically altered people are tall by choice, and not by the contingent combination of parent genes. So they should live with the consequences of their decision. But those who are born that way cannot be blamed for their condition.

Another issue would be the inequalities that genetic enhancements would create. Consider if someone wanted an additional eye to have superior sight or more brain for a stronger intellect. Genetic modifications could create social competition. They could also increase the social impact of wealth and influence. So there are no private changes in the human genome. The consequences affect all of society. And if they do not, it is up to the person undergoing the alteration to prove that it will not damage public standards of fairness.

We attribute value to

1) the human heritage in the arts or historical buildings, and

2) the natural heritage of landscapes and species. (180bc)

So we value these human and natural heritages. Should we not also value the human body's "traditional" shape that we all naturally inherit? We preserve the integrity of historical buildings. For, we think people have a right to enjoy them as they have always been. So if we have a bodily heritage just as we have a cultural heritage, then we should also preserve our body's shape. People have a right to enforce the integrity of the human body, so that it is not destroyed like a blighted historical building or a despoiled natural landscape.

We are familiar with other people's bodily appearance. This allows us to trust in the constancy of their behavior. "And to whatever little degree we trust in humanity certainly also depends on what we know about human bodies." (180c)

Yet, we admit that the human body will inevitably change as humans adapt to new ways of living, nourishment, medicine, as well perhaps as communication and entertainment. Consider for example the music that entertains us. Most of it now is produced for electrically amplified sound systems. Siep says that our ears have become more tolerant to music's higher volumes. But these sorts of changes are not drastic. And they do not really change the human body so much. Rather, they support it by "technical insertions." And they enlarge the "realm of bodily variations and physical states." Nonetheless, the changes allow us to live a normal human life. And, we note something else about these changes. They do not come about by means of non-therapeutic single interventions in the body. "I think we have good reasons to regard the traditional genetic equipment of the human body and its contingent evolution as an important part of our natural heritage." (180d)

Siep has also mentioned paternalistic genetic interventions. They are related to his fourth thesis. So he addresses them in the following.

(4) These genetic advances seem like science fiction. And it probably does not matter if we can change one or two of our genes. Because there are probably many that are responsible for such qualities as our height, sight, organ production, and so forth. As well, even if we could change them, there would probably be unforeseeable risks. Thus it is not likely we will ever be able to change our body's major properties, at least not in a fully developed adult body. This would save us from dealing with the social consequences of genetic manipulation. But Siep says we cannot be certain.

There still are likely genetic advances on the horizon. For example, we probably will be able to protect our descendants from hereditary diseases. Just a step away from that is making genetic adjustments to protect us from illness and aging. Some scientists are certain these technologies will come. For, they have already declared our responsibility to block their implementation once they arrive.

Siep addresses two ethical questions involved in this use of genetic technology.

1) the question of paternalism and autonomy, which is a familiar debate in medical ethics, and

2) Siep's argument. Note first that we can consider the human body as a class or type of things. And we can consider specific instances or 'tokens' of bodies. Siep is speaking of the healthy human body both as type and token (class and instance). He says it it might represent an "objective value." If so, then it would seem that some diseases and bodily properties stand against this this objective value. So we would be right to protect people from such 'evils.' "At least since humanity expresses its feelings and convictions in prayers and poetry, sickness and death have always been wailed and cursed." (181bc)

We might say the same for ageing as we do for sickness. But there are ways to determine the worth of our longevity.

1) It depends on our body's "state of fitness" at that age.

2) Many people already have a diminished valuation for life after the mid-eighties, even if they would be in decent shape.

3) There would be social problems if

a) there are many people who are not dying, and

b) only a small part of the population can afford such genetic enhancement.

The "age pyramid" could deform. And there would be consequences if there is a slowing down of generation changes.

Siep will now address forms of paternalism that he finds justified. He believes it can be admitted only to treat serious diseases. And even then, we must be sure there will be no secondary effects. So we must use a very careful criteria. We find it difficult to precisely define health. Nonetheless, we must "respect the border between health and enhancement." "Only very serious and avoidable deficits regarding health can justify the appeal to objective interests of future persons." (182a)

So we will not treat non-serious illnesses. But does that mean we will treat none? Must we consider all aspects of the human body as equally valuable, whether it be health or illness? Consider certain religious people. They believe that sickness, suffering, and death are inherent to our body's existence. In fact, we should respect and dignify our human limitations. "Many virtues would disappear, if we were to eliminate these aspects of human life." (182b)

Nonetheless, religions have come to terms with medical advances and their implications for the human condition.

It would be too much ‘‘value conservatism’’, if we were to require the protection of the heritage of the human body including all the diseases we would otherwise be able to safely eliminate. (182bc)

So we do not need to preserve every human disease for the sake of maintaining the human body's heritage. Yet, it is also admirable when people cope with their own or with others' handicaps and diseases. Such limitations inhere to our bodies. So we may value them. But our efforts to overcome the body's health weaknesses are part of these values. The next generations will inherit these genetic frailties. It would be acceptable if they as a whole group decide to improve their genetic make-up. But we should not make this decision for them.

But we should better leave to the future heirs the risk of spoiling the good aspects by trying to remove the bad ones.(182c)

So also parents should not be allowed to change their children's genes, with the exception of "a very few clear cases." (182d) Nonetheless, many parents who suffer from such things as short stature think that their children would suffer too. But this is just an assumption.

To spare one’s offspring from the things one has been suffering from is a respectable but dangerous motive. (182d)

Siep is not referring to eugenics. Different people may have different valuations for genetic defects. So German law, for example, no longer allows abortion for the eugenic reason of sparing the child unbearable bodily handicaps. This way parents cannot impose on the child their beliefs for what sort of life is worth living. Yet, there are severe cases where genetic repair might be admitted. Only in these few very serious and clear cases should genetic intervention be allowed. In fact, it could be acceptable to change a child's genes in such a way that all his offspring (and their offspring) continue to pass-on the alteration (as would be the case in germ line thearapy). However, our current technology does suggest that we can make such changes without unwanted side-effects. And if we did develop that capacity, it should only be used for very clear cases of severe hereditary diseases. But if we want to identify a disease as such, we would first need a "rather stable concept of health and disease." To obtain such concepts, we need to establish what is normal for the human body "which we are familiar with." (183b)

So human bodies have a value aspect. Its ethical consequences are norms. These would "bind the genetic improvement of human beings/humanity to health purposes." (183c) To establish these norms, we need to determine the difference between health and severe disease. This requires a scientific and public discussion. In some countries, this will also require that governments employ genetic therapies for the sake of public health insurance. By establishing and upholding these norms, we could protect the human body's natural heritage. This will hold so long as no new genetic technologies develop which will raise additional ethical questions. If they do arise, then the public should again debate the human body's valuable aspects. Countries across the globe have rejected human cloning. This demonstrates the importance of the contingency of genetic combination in human reproduction.

The question of the permissibility of far-reaching changes of the human body are public questions, not simply the private affair of ‘‘free citizens’’ (183d)

[Directory of other entries in this series.]

Siep, Ludwig. 'Normative Aspects of the Human Body.'Journal of Medicine and Philosophy. (2003) 28(2), pp.171-185. Available online at:

http://www.informaworld.com/smpp/content~content=a714017124~db=all~order=page

or

http://jmp.oxfordjournals.org/cgi/content/short/28/2/171

and perhaps

http://pdfserve.informaworld.com/839248__714017124.pdf