Dignity of the human person and ethical issues in genetics: A Catholic perspective

I recall, some years ago, receiving a phone call from a distraught couple. They had been married for many years but were not able to conceive a child

Nov 21, 2018

By Fr Dr Clarence Devadass
I recall, some years ago, receiving a phone call from a distraught couple. They had been married for many years but were not able to conceive a child naturally. They finally resorted to Invitro Fertilisation (IVF) and, after one year, had their first child. Since they had intended to have more than one child, they had frozen some of the fertilised eggs so as to be able to use them at a later stage. Two years after their first child, the mother was diagnosed with stage four cancer which gave her very little time to live and this meant that she would not be able to use those fertilised eggs which she had kept to be used at a later stage. They were distraught not only because of the discovery of the cancer but, also what to do with the fertilised eggs, which not only had the potential to life but was life itself. Give up for adoption? Discard?

A moral dilemma such as this would not have confronted many people either in the early eighties or even in the nineties when such technology was extremely expensive and could only be afforded by a few. However, today it is available and can be afforded by many people. What this shows is that medical technology had increasingly improved, efficient and affordable in such a short span of time in the history of human life.

Everyday we are confronted with far more intricate and complicated advances in human life — all with the intention of living longer, avoiding pain and suffering in that process. Most adults consume some form of supplement and we are part of this billion dollar industry. The total dietary supplements market size worldwide is expected to rise from USD 133 billion in 2016 to USD 220 billion in 2022… an increase of USD 87 billion in a short span of. This simply indicates that we all want to live longer and to live free from illness, suffering and pain.

Medical science and technology have not only afforded us the ability to create human life, but now also the potentiality to prolong life. Not only that, to tweak life to an extent that we can be free from certain illnesses and shielding us from experiencing pain.

One recent study shows that researchers at Oregon Health and Science University have successfully used a gene editing technique to repair gene causing diseases in the human embryo.1 Many have hailed this development as ground breaking because the cycle of passing life threatening diseases from one generation to the next may soon come to an end. Does this mean that the human being can look forward, whether in this or in generations to come, to a long life of good health while being able to avoid many diseases that before this was considered unavoidable? Could this be our future, looking at how fast advance medical technologies are progressing?

Many people seem to think that the Church is outrightly against advanced medical research. On the contrary, the Catholic Church encourages scientific research, especially with regard to human life, that is ethical and, ultimately, serves the human good. However, the caution that the Church places given that we now have the ability to create and prolong life, is founded on the fact that we are not prepared to cope with many of the consequences (known and unknown) these technologies bring with them and how they impact our lives.

Therefore, for research on human beings to be ethical, it must respect the dignity and sacredness of human life and be strictly therapeutic. When dealing with ethical issues in genetic technology, there are three key principles that one has to keep in mind: dignity, sacredness, and therapeutic.
Dignity of the Human Person

The starting premise about human life is that it is a gift from God and in ways that escape the human understanding, the human life also belongs to God. In this sense then, the Catholic Church proclaims that human life, at any stage, is sacred and that the dignity of the human person is the foundation of a moral vision for society.

Dignity is defined as ‘the state or quality of being worthy of honour or respect.’ In other words, there is an intrinsic value to human life that cannot be acquired but only granted / implanted by the one who is the ‘maker of life.’ The intrinsic worth of human life somewhat shares in the metaphysical properties of life and humanity.

The dignity of the human person is rooted in man’s creation in the image and likeness of God.

From Christian Scripture, there are two references that point to the intrinsic value (dignity) of the human person. Firstly, it is in the very beginning of the Bible, in reading the creation account, it is stated: “God said,

‘Let us make man in our own image, in the likeness of ourselves…” (Genesis 1:26). For this reason then, the dignity of the human person is rooted in his creation in the image and likeness of God… it is fulfilled in his vocation to divine beatitude.2 Secondly, the Christian understanding about the incarnation (Jesus becoming man) brings to completion the sacredness of human life where God Himself enters the human world as True Man: “The Word became flesh, he lived among us, and we saw his glory, the glory that he has from the Father as only Son of the Father, full of grace and truth” (John 1:14).

In the creation and incarnation, we find that, of all creatures that God has created, only human beings share in his image and likeness and are given the ability to know, receive and return the love of God. The dignity of human life is determined by God and thus is always to be protected.

Since life then is a gift from God and imbued with inviolable value (dignity), nothing should be done to reduce the human person to anything other than a subject to be loved and led to love others in the way God intended from the beginning of time.

Sacredness (Sanctity) of Life
Since we have already established that life is created by God, it is then inherent within life itself that something which God has created carries with it an element of the sacred.

“Human life is sacred because from its beginning, it involves the creative action of God and it remains for ever in a special relationship with the Creator, who is its sole end. God alone is the Lord of life from its beginning to its end; no one can, under any circumstance, claim for himself the right directly to destroy an innocent human being.”3

We live in an age where “the criterion of personal dignity – which demands respect, generosity and services – is replaced by the criterion of efficiency, functionality and usefulness: others are considered not for what they “are”, but for what they “have, do and produce”.4 In this context, there is always the tension between that which some consider as ‘quality of life’ over the ‘sacredness of life’.

The never ending discourse of this “so-called ‘quality of life’ is interpreted primarily or exclusively as economic efficiency, inordinate consumerism, physical beauty and pleasure, to the neglect of the more profound dimensions – interpersonal, spiritual and religious – of existence”.5

Therefore, the sacredness (sanctity) and inviolability of human life is to be considered from the moment of conception right to the time of natural death. Even when the outer image of the human person deteriorates, the inner image remains unaltered, that is, the image and likeness of God.

Therapeutic
Integral to the Hippocratic oath that physicians are invited to subscribe to, the principle of nonmaleficence forms the basis of Catholic ethical principles. The principle of nonmaleficence asserts an obligation not to inflict harm intentionally, Primum non nocere (first, to do no harm). In other words, ‘do not kill, do not cause pain or suffering to others, do not incapacitate others, do not cause offence to others, do not deprive others of the goods of life.’

Therapeutic experiments in the form of diagnostic, curative, alleviating, preventive and even research that bring medical benefits to the subject, can certainly bring reasonable hope of success to the human community.

However, non-therapeutic experiments for the sole purpose of furthering biomedical and behavioural research for the future need to be carefully treated so that the human life is not reduced to mere objects of experimentation.

Human Genetic Technology
According to Thomas A Shannon, a leading Catholic ethicist, “Four major developments in genetics in the past 75 years have established the context for our understanding of contemporary genetics. The first was the eugenics movement of the early part of this century, which found horrifying application in the Holocaust. The second development was the discovery in 1953 of the DNA molecule’s double-helix structure, which was key to an understanding of the working of the gene. Third, the discovery in the 1970s of recombinant DNA (rDNA) technology enabled scientists to use chemical “scissors” to snip apart a chromosome and reinsert material from another chromosome, not necessarily from the same species. The fourth development was the inception in 1990 of the Human Genome Project, a multibillion-dollar project to map the entire human genetic sequence.

Such a map will be the basis for learning genes’ function, as well as how to alter them.”6

Since the Human Genome Project, we have come a long way. The application of such “knowledge” is seen today in preimplantation and prenatal diagnosis, genetic testing, gene editing, gene therapy, and I am sure this is just the beginning of what is already being researched currently for the future. The promise is that genetic technology offers us hope for the future but one has to also be aware of the perils that come with it. Just as there is much literature about the advantages of genetic technology, there is, equally, literature on the disadvantages. Proponents of genetic technology commonly speak of reversing the ‘genetic death sentence’ that people didn’t have a choice about it. Now, the possibility of replacing defective cells and eradicating diseases promises a great future to the human life.

Ethical Issues in Human Genetic Technology
With the rapid development of genetic technology, there is a greater need to define the ethical issues that surround this advancement because it now “involves the power to redesign ourselves, including the potential to impact the very essence of what it means to be human, understanding to evaluate or judge”.7 In other words, ‘with great power comes great responsibility’… and with great technology, also comes a greater responsibility to regulate it. Therefore, there is need for an ethical framework that respects the origins of life and the integrity of the human person as a unity of body and soul.

It is clear that genetic technology can be morally legitimate if it has a directly therapeutic purpose for a particular patient in question, and if we are sure that it is going to limit whatever changes to this person. However, the existence of these gene altering therapies raises a question, how much modification and enhancement is permissible, be it somatic or germline gene therapy? The following are only some ethical issues that I have chosen, over others, for the purpose of this discussion.

a) Reduction of Human Life
The current development in gene therapy is still very much at an experimental level and many of the experiments conducted are on human embryos. The creation and destruction of human embryos poses a threat to life at the earliest stage. The creation of a living embryo ultimately requites the destruction of the embryo, which the Church teaches is a gravely immoral act. It is to be noted that, while these embryos are not created in the normal manner, the Church recognises that they, too, are alive, and their destruction is gravely immoral.8

The creation and destruction of human embryos reduces human life to nothing more than an object, similar to that which comes from a manufacturing plant — an “inanimate object” created solely to be used indiscriminately in the name of advancing human life in the future. The means cannot justify the end, even more when it is an “indeterminate future”.

b) Social Justice
We live in a world where there already exists much social inequality. The gap between the first world countries and those in the third world does not seem to be narrowing, given the aggressive, capitalistic drive that dominates the world’s economy. In this light then, the genetic enhancements that we are speaking about could exaggerate existing social inequalities, especially if only the “rich” can afford them. A technology is not just if it neglects the poor or the vulnerable or if it widens the gap between the haves and the have-nots. Even if this technology could be applied safely and without using immoral means, the greater concern would be that naturally-born children would not be able to compete with those who are genetically enhanced.

The growing possibility of practical application of genetic tests and therapies raises a key issue of social justice: Should we continue to channel our resources and emphasize forms of medical intervention — for example, gene therapy — that are very expensive and that will benefit a very few, or should we begin to shift our resources toward pre-emptive interventions that will benefit the larger human population?

c) Identity
Every child born into this world carries the DNA of both the mother and the father, which we traditionally term as biological parents. Today the term ‘biological parents’ has become more grey when a child is born in a situation of donor sperm / egg and even surrogacy. Already in such a shifting context, the biological identity of a child is in question and, at times, being redefined.

The advancement in genetic technology has now brought another dimension with the introduction of Mitochondrial Replacement Therapy (MRT) where techniques essentially swap a woman’s defective mitochondrial DNA with that of a donor. The resulting embryo’s DNA will mostly come from the two parents who supplied the egg and sperm, but a tiny proportion – a fraction of a percentage – will come from the donor… thus creating a ‘three parent embryo’. While we continue to discuss these issues, genetically modified babies have been given the go ahead by one UK ethics body earlier this year.9

d) Custom babies
As much as advancement in genetics presents us with a promise of being able to treat or, even better, to prevent a series of genetically caused diseases, the predicament that this new found knowledge poses is: how far do we want to manipulate our own nature to the point of “our muscles, memories, and moods; to choose sex, height, and other genetic traits of our children; to make ourselves better than well?”10 Not only is society today being pressured into aesthetic enhancements, genetic enhancements would create unnecessary standards that may not manifest the true character of human nature.

In short, gene editing also raises the possibility of “designer babies”, where the genetic code of embryos created through standard IVF is rewritten so that children have traits the parents find desirable. The question before us is: what will be considered “desirable” and who determines this? Since ‘beauty is in the eye of the beholder,’ customised babies can never be perfect in the eyes of every person.

Conclusion
As much as there is a bright promise of what genetic technology could offer the human community, there are “considerable, and not yet fully controllable, risks to genetic manipulation. A person conceived with edited genes could experience a range of “unintended, perhaps harmful, side effects that can now be transmitted, inherited by other individuals down the line.” An embryo who experiences gene modification could also carry and pass on edited genes, particularly if edits were performed before his or her reproductive cells began to differentiate themselves.”11

In this context then, the dignity and the fundamental and inalienable rights of every human being, including those in the initial stages of their existence, to state explicitly, need protection and respect which this dignity requires of everyone.

1 cf. Belluck, Pam. “In Breakthrough, Scientists Edit a Dangerous Mutation From Genes in Human Embryos.” New York Times, 2 Aug. 2017, www.nytimes.com/2017/08/02/science/gene-editing-human-embryos.html.
2 cf. Catholic Church. Catechism of the Catholic Church, n. 1700. 2nd ed. Vatican: Libreria Editrice Vaticana, 2012. Print.
3 Congregation for the Doctrine of Faith. Donum Vitae (Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day), n. 5. 1987, http://www.vatican.va/roman_curia/ congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html
4 Pope John Paul II. Evangelium Vitae (The Gospel of Life), n.23, 1995, http://w2.vatican.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae.html
5 Ibid.
6 Shannon, Thomas A. “Ethical Issues in Genetics.” Health Progress (Journal of Catholic Health Association of the United States), 1999, www.chausa.org/publications/health-progress/article/september-october-1999/ethical-issues-in-genetics.
7 Coors, Marilyn E. “Genetic Enhancement: Custom Kids and Chimeras.” 2005, www.usccb.org/about/pro-life-activities/respect-life-program/upload/05-rlp-pamphlet-Coors-Genetic-Enhancement.pdf.
8 cf. “Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells,” August 25, 2000, the Pontifical Academy for Life.
9 cf. The Guardian, 17 July 2018, https://www.theguardian.com/science/2018/jul/17/genetically-modified-babies-given-go-ahead-by-uk-ethics-body
10 Sandel, Michael J. “The Case Against Perfection.” The Atlantic Monthly, vol. 293, no. 3, Apr. 2004, www.catholic education.org/en/science/ethical-issues/the-case-against-perfection.html
11 Mena, Adeline. “Catholics Shouldn’t Totally Reject Human Gene Editing – but It Still Has Ethical Problems.” www.catholicnewsagency.com/news/catholics-shouldnt-totally-reject-human-gene-editing--but-it-still-has-ethical-problems-29961. Catholic New Agency, 23 Feb. 2017

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