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Julian Sheather on playing God – again

21 Jul, 09 | by BMJ Group

So they’ve been at it again, the men in white coats. Putting on their grey beards and playing God, getting the jump on poor old mother nature. There are times when you could almost feel sorry for her. All those pipette-pushers forever tunnelling deeper and deeper into her mysteries. Leave her alone, I can almost hear myself saying, leave the poor old dame a few rags of the unknown to clothe herself in. And while you’re at it, leave us, leave poor bewildered modern us something to wonder at and to revere. But then I remember that this is a piece for the BMJ and it is scientists I am talking to, people who surely demand more from their arguments than soft-eyed sentiment.

This time it’s the making of “artificial” sperm they’ve been up to – I’m not ordinarily a fan of scare quotes, call a spade a spade I say and don’t go using weasely half-words, but it’s the nature of that “artificial” that I’ve in mind to talk about so I’ll let them stand.

A few weeks ago the press was swimming with stories about how Professor Karim Nayernia and a team at Newcastle University had made human sperm using stem cells from a five-day-old male embryo. Cross this with technology to generate stem cells from skin cells and it becomes theoretically possible for infertile men to father their own biological children.

There is an iconography of biotechnical revolutions: The DNA helix; Dolly the sheep; Vacanti’s mouse, a human-looking ear rearing up on its back demurely draped in folds of fine skin. And now we have another: knuckle-headed, tail kinked and swimming in mercurial light, the world’s first artificial human sperm wriggling its way blindly along the river of life – or at least round and round a Petri dish.

Along with a great deal of nonsense about men now being obsolete – most women of my age and acquaintance came to that conclusion long before artificial sperm were invented – the most common critical response is a shudder of revulsion followed by a final and emphatic “it’s unnatural”. The trouble here is that launching an argument for or against anything on the grounds of its being natural or otherwise is notoriously tricky. Used in the sense in which I’ve given it, if unnatural is bad, it must presumably follow that natural is good. Now there are many marvellous things in nature, among them, arguably, ourselves – what a piece of work is a man – there is much that is beautiful, much that is worthy of love. But there is also a great deal that is vile. Mass starvation is natural, as is HIV/AIDS.

Extinction is a natural event, as is Huntington’s chorea…Nature, in fact, cares so little for our individual wellbeing that you could describe much of human – and all of medical – history as uninterrupted warfare against her. If you want to get a sense of nature’s waste, her profligacy, her inefficiency and her sheer blind indifference, read Darwin. And as for men – and women – we’ve all known them fair and foul, often simultaneously.

In a recent collection of essays that meditate in subtle ways on the relationship between the human and natural worlds, the Scottish writer Kathleen Jamie writes:

“They say the day is coming – it may already be here – when there will be no wild creatures. That is, when no creature on the planet will be able to further itself without reference or negotiation with us. When our intervention or restraint will be a factor in their continued existence. Every creature: salmon, sand martins, seals, flies. What does this matter?”

Our relationship with the natural world, whatever we might decide we mean by that term, is obviously going through a period of unprecedented and at times bewildering change. The question Jamie asks is a good one, and worthy of sustained attention. But when we are thinking about the rights and wrongs of medical interventions, we should avoid getting entangled in it. Such an appeal to nature can never do the moral work required of it.

Julian Sheather is ethics manager at the British Medical Association. The views expressed are his own.

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  • Daan

    Dear Julian,

    Thanks for an interesting article.

    I think that the point about something being ‘natural’ or not requires careful distinction. In the philosophical sense of the word the ‘nature’ of something refers to its ‘essence’ or what it ‘really is’. In this sense the ‘natural’ development of a human being refers to that development which is proper to human beings, if they are not somehow disturbed.

    The examples you quote of starvation and illness are in this context disturbances of natural development. This is also a convincing justification for us to apply medicine: it restores the development to its normal – natural – course. The same reasoning would also lead to a condemnation of techniques that lead to the ‘enhancement’ of humans as unnatural.

    With regard to the technique of producing sperm cells from adult cells and using that to create a baby in a test tube – this clearly has nothing to do with the natural way of human procreation. I understand the noble ideal of helping people to have children – but in morality, the end has never justified the means. So do scientists really want to be involved in a technique that distorts the natural way in which humans procreate, and ‘play God’ – as you put it? Or should we focus our attention on ways to assist procreation that are respectful of the nature of human beings?

  • Julian Sheather

    Dear Daan,

    Many thanks for your thoughtful response. While I can see the attraction of the idea of disease or illness being a deviation from ‘natural’ or ‘species-typical’ functioning, and the goal of medicine being to restore such functioning, I think it rapidly runs into problems. You mention enhancements as being unacceptable because ‘unnatural’. Let us take a mundane example – the use of spectacles to correct age-related deterioration in eyesight. Such deterioration is, in one sense, entirely ‘natural’ or species-typical – most of us will experience it. Your approach would seem however to rule out interventions, such as spectacles, to improve upon ‘natural’ or ‘species-typical’ functioning. If you decide that it is legitimate to use spectacles as it restores eyesight to ‘normal’ functioning then what moral criteria do you use to distinguish between spectacles and more sophisticated techniques to return people to ‘normal’ functioning, such as enhanced fertility techniques?

  • Dawn

    It will get worse.
    Darwin already said his theory was spent (if you look at his statements of what make his theory null and void, as you will see it now is).

    However a much more reliable book tells you where we are going.

    Mt 24:37 ‘As in the days of Noah’ (inhuman [nephilim] creatures and corrupted DNA on the earth) ‘[were], so shall also the coming of the Son of man be’.

    However unscientific scientists think it is, God is only going to let them go so far then he is coming back.

    You should check into the other prophecies in the Bible, all the ones come to pass already and the odds against them being impossible, it is fascinating. I am no longer surprised by what is going on in the world, scientific, political, indeed ethical if you can call the grey area we use as ethics.

  • Daan

    Dear Julian,

    Thank you for your reply and for the very reasonable question you ask. I think correcting eyesight with spectacles and using enhanced fertility techniques is clearly different from a natural morality perspective. We need to do some distinguishing.

    First of all it is clearly natural for human beings to have children. But at the same time it is not a necessity that a sexual act always results in a child. Children have always been a ‘gift’, not a necessity; this is also the way most parents describe their experience of having children. Eyesight is not primarily a gift, it is a part of normal functioning. So here is a first clear difference.

    Secondly, in humans there is a natural link between the sexual act and procreation. This has a deep significance, because it means that a union of love between two people lies at the origin of every human being. It is clear that every act of artificial insemination and fertilization separates this natural link between sexuality and procreation. In the case of spectacles improving your eyesight, there is no question of any natural process being interrupted. This is a second clear difference between the two situations.

    In a broader perspective, it is good to reflect further on the fact that procreation is not only concerned with the ‘functioning’ of a human person, but actually with the origin of a new person. In the case of natural procreation, this person is the result of an act of love of two people. In the case of artificial procreation techniques, the person results from a technical act by a biomedical expert. The act of procreation becomes ‘dehumanised’. It therefore profoundly affects the natural origin of the new person. Spectacles have no such implications.

    So natural morality can distinguish clearly between wearing spectacles and creating babies in test-tubes. If people in ecological movements can distinguish what is good for the nature around us, why can’t we apply our reason to distinguish what is proper for human nature? It seems to me that such a path would keep us safe from much ‘natural resistance’ that manipulation would incur – and be the happier for it. Don’t you think that if you applied yourself to the question, you could lead us there, Julian?

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