Thinking about How We Think about Bioethics

If you suffered from a genetic condition (the degree to which it negatively impacted your life is irrelevant) that would inevitably pass to any biological children, but at the same time, you felt a deep, personal desire to nurture your own, would you find it ethically appropriate to utilize technology that could edit your future child’s genes in the embryonic stages?

If a person’s entire genome, their genetic information, can be accessed and diagnosed via testing, what are the appropriate contexts, if any, of collecting that information, using that information, and sharing that information? Does a fetus have a right not to be tested and subsequently aborted, for example? Or would it be permissible to study the genomes of convicted criminals.

Modern medical science can alter the human body in all sorts of ways. But what counts as acceptable modifications to the body?

Professional ethicists consider these and many other moral conundrums faced by the medical community from a variety of positions with established ethical models. However, these conundrums do not remain in the abstract with the intelligentsia. They confront real, normal people; and real, normal people must respond. With what moral resources will they do so? How does your average Joe process and answer bioethical questions?

To some extent, media and the arts can subtly — or not so subtly — encourage answers to specific bioethical questions. News coverage and opinion pieces take on a certain slant. Late night hosts and comedians satirize what, in their minds, constitute an undesirable position. And books, TV shows, and movies portray certain responses in a positive or negative light. These sources would not have their intended impact, however, if a certain conception of the human body — the center of many bioethical debates — were not already fluttering around in the popular imagination, preparing the mind to be swayed one way or the other.

One needs to critically reflect at this imaginative level before engaging the others. As I contend, what one unreflectively imagines one’s body to be mirrors what one unreflectively imagines the society to be. Historical shifts in the self-conception of society have thus translated into shifts in our own self-conception and have planted in our imagination a certain image through which we filter ethical quandaries. This has occurred, however, with disconcerting results. Reimagining the human body, abandoning the current guiding metaphor, could lead to a more consistent and constructive ethic. 

Organism to Mechanism

Society in the premodern Western world impressed upon the imaginations of common folk differently than it does today. Before the Renaissance, Reformation, Scientific Revolution, and Enlightenment reshaped how people perceive and interact with reality, it was not uncommon to imagine the society to be something like an organism. Society was a whole, complete entity, ordered towards and structured for a specific purpose. The members of the social organism were bound together in a variety of relationships which impinged upon each other. To live well in society might be to take concern for one’s role in the cosmos, to properly consider and adhere to one’s familial, spiritual, and economic positions, for instance. To step outside that social matrix in beliefs or actions could damage the whole organism, as if one’s eyes decided they could be better utilized as knee caps.

Over time (for rather complex reasons — See Charles Taylor’s A Secular Age or James K.A. Smith’s reader’s digest version, How (Not) to Be Secular), this conception shifted. Rather than an organism, people imagined society to be more like a machine, a collection of parts that can be hammered and screwed together into a variety of ways in order to increase efficiency. Fulfilling one’s relational obligation lessens in importance compared to driving forward the economic machine.

How does this come to influence bioethics in the twenty-first century? This mechanical image seeped downward. Not only is the society a machine, so are its individual components. In other words, in a very real sense, people came to think of their bodies in essence as little machines. Calling one’s heart a “ticker” would not have made sense in any other age except one which marks all time by the ticking, mechanical clock. If the body is a machine, that opens the door for numerous practices that might not have been conceived before.

Engineering the Human Machine

While a machine has a specific objective, no one would balk if an engineer made alterations and even assigned it a new task based on those changes. That comes with the mechanical territory. If the organic society, whose purpose inheres the whole and connects the individuals in its social web, becomes mechanized and individualized, however, the purpose of society follows that of the machine. It becomes an externally attached, always tweakable objective, defined by who? A social engineer? Now continue that line of thinking to the personal, bodily level.

Some make the case that such a view can lead and has led to medical breakthroughs which our world is better off having. Heart transplants, cochlear implants, bionic arms, hip replacements — these are ethically unambiguous relatively speaking, and arguably these were made possible by the mechanical turn. If one conceives the body as comprised of parts working instrumentally to accomplish some objective, it becomes easier to consider these as viable options. When a machine fails to work properly, you identify the broken elements or where the causal chain has gone off and replace or fix the issue. 

These examples of implants and transplants essentially follow that framework, and few in the public sphere ethically question these “fixes.” While the purpose of the individual is conceived as living a whole, full life, these practices likewise remain unproblematic. They work towards that end of restoring wholeness. 

But if that purpose becomes a slightly tweaked objective — to live the longest life possible, say — this opens the door to ethical ambiguity. To what extent ought a person go to extend a life? Does the quality of life matter as long as the individual remains alive? Is there a limit to the kind of testing and research that can take place in order to secure longevity?

If, like a machine, one makes another tweak to the human machine so that displaying beauty is its main objective, now all sorts of bodily modifications enter the conversation. Though cosmetic, many of these procedures require extensive medical knowledge. Plastic surgery, botox, and steroids might legitimately increase the quality of life for a person, but for many others the body is being treated like a tricked out car with fancy paint jobs, spoilers, and unnecessarily powerful engines. These practices spread unrealistic expectations of the human body and are for that reason at least ethically questionable. Yet they often remain outside public debate because the belief that parts can be upgraded fits with the body-as-machine model, which has so captured popular imagination.

With an ever-alterable objective that directs the combination of parts which can always be upgraded and recalibrated, the human body could conceivably undergo any number of procedures that result in bodily modification. Currently, that objective tends to be whatever achieves personal fulfillment, and a range of debatable practices have followed. On the one hand, we have those that society more frequently accepts. If you as a female have an undesired part (e.g., fetus), remove it. If you as a male feel that you ought to be a woman, replace the necessary components. But on the other hand, we have practices that more often than not are condemned by society but which follow the same underlying mechanical assumptions. While you might not want horns or a snake-like tongue, some do. Should they be denied these modifications? If the human body is a machine that can be tweaked to match one’s subjective desires, our basis for objection has been relatively neutralized.

On the third hand — because if the body is like a machine, why not? — we have practices which take up an even grayer area. Consider the opening quandary. Altering the genetic code of an embryo to avoid a particular defect might be compared to a software update to remove a computer virus. But then, who determines the identification of a defect? A white supremacist, for example, would have a very different conception of what counts as a defect than most. Even more, why is a defect even needed as an excuse for genetic modification? Very little, ethically speaking, could stop parents from selecting particular traits from a genetic menu if the technology allowed it. If the mechanical view continues its reign over our collective imagination, entire segments of the population would soon be disvalued as their characteristics are bred — engineered, rather — out of existence.

Another Way

If the logic of mechanization underlies such diverse practices, many of which are questionable if not outright harmful, perhaps the logic of the organism can provide a needed corrective. If a sense of intrinsic, natural purpose directed the end of our research and practices along with an understanding that each element serves its particular function for the whole, and is not a component to be upgraded or modified as desired, a way through the ethical haze might emerge.
 The organic metaphor, particularly its medieval form, does carry its own baggage as many utilized that image to uphold hierarchical social systems. Nonetheless, the guiding principle within this image, unhitched from its overly structured variants, could provide that impression which recaptures our imagination and clarifies our ambivalence in bioethical matters. Within the organic conception, we more clearly distinguish truly beneficial medical procedures, which serve our body’s natural purpose by restoring harmony and wholeness, from unnecessary and damaging cosmetic and genetic modifications and mutilations, which vary with each individual fancy.