Biotechnology: Thinking Through the Ethics

Radical developments in biotechnology have been some of the most remarkable and exciting products of the past few decades of science. In the past 20 years, scientists have sequenced the human genome1, made human stem cells from skin cells2, created DNA from almost entirely artificial parts3, transplanted the first organ built from stem cells and 3-D printing4, utilised the gene-editing enzyme CRISPR to experimentally treat a patient with sickle cell disease5, developed high precision foetal genetic analysis to assess for genetic abnormalities in the unborn children, and developed artificial intelligence that is becoming increasingly widespread and human-like by the day… to name just a few. And in this rapidly developing and confusing world of biotechnological research there is a question that is (or rather, should be) raised at every turn: is this ethical?

The ethics of biotechnology is becoming increasingly confusing and challenging, as medical ethicist Prof John Wyatt comments:

“Developments in biotechnology over the last ten to twenty years have contributed to a remarkable sense of uncertainty amongst policy makers and so-called opinion formers. There is a sense of being cut loose from familiar ethical moorings, a feeling of unease at the abyss of runaway technological development, coupled with ethical relativism which threatens to swallow us all. If it is technically feasible to generate an unlimited supply of human embryos for research, should we prevent it or encourage it? If it is possible to create human-animal hybrids or cloned embryos to provide vitally needed human tissue or genetically matched organs for transplant, why should we oppose it? When the potential medical and human benefits are so enormous, what possible grounds can be found to resist?”6

So how do we begin to grapple with the ethical dilemmas produced by biotechnology?

Well, in order to navigate the choppy ethical waters, we need an ethical compass. Or, to unhelpfully mix my metaphors, I believe that we need the anchor of an objective moral authority onto which to tie our ethical thinking. Readers of my blog will know that I am a passionate Christian believer, and a believer that God has revealed both Himself and His will for the world through the bible and ultimately through the man of Jesus Christ. And thus as a Christian, my ethical stances always need to begin with the principles laid out in the bible.

Specifically, there are three key principles which can help us think about Christian bioethics

  1. The Fallacy of Nothing-Buttery
  2. The Art Restoration Model of Medicine
  3. The Definitive Ordered-ness of Creation

1. The Fallacy of Nothing-Buttery

“Nothing buttery” was a term coined by neurobiologist Prof Donald MacKay, and helpful summarised by geneticist Prof James Peterson as:

“Nothing buttery” is when an action is described as “nothing but” a manifestation of genetic drives or some other elemental part. Phenomena often have multiple levels that cannot be reduced to the most elemental. Examining only one aspect at a time to better understand its contribution can be a helpful exercise, but that is quite different from declaring that the whole merely the sum of its smallest parts.7

MacKay, Peterson and others argue convincingly that “nothing-buttery” is a fallacy- one cannot assume that a phenomenon is explicable in terms purely of the behaviour of the smallest component parts. And yet a lot of scientists hold (often subconsciously) to this presupposition.

As a Christian, I have all the more reason to discard “nothing-buttery”. For the bible is clear that the world we inhabit exists in both physical and spiritual realms, and that we as humans are both physical and spiritual beings. For example:

11 Put on the full armor of God, so that you can take your stand against the devil’s schemes. 12 For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.
(Ephesians 6:11-12)

23 May God himself, the God of peace, sanctify you through and through. May your whole spirit, soul and body be kept blameless at the coming of our Lord Jesus Christ.
(1 Thessalonians 5:23)

This biblical model of humanity stands in stark contrast with nothing-buttery. We, as humans, are much more than physical bio-containers of the human genome. We have significant non-physical elements to our personhood.

2. The Art Restoration Model of Medicine

The Art Restoration model of medicine was coined by the afore mentioned Prof John Wyatt. Rooted in the bible’s narrative of creation, fall, redemption and consummation, Wyatt argues the following:

Our bodies used to be the last frontier of the natural world. But development of reproductive technology seems to have broken for ever this last barrier. We do not have to accept the limitations of our bodies as that have been given to us. By understanding the molecular and biological mechanisms of which our bodies are constructed, we can learn how to manipulate them; we can improve on the Mark I original design. This is what I have called the ‘Lego kit’ view of the human body. The essence of Lego construction is, first, that this is no internal or ‘natural’ order to a Lego kit, and secondly there is no single purpose for which the kit is intended by its designers…

In contrast, the Christian worldview takes seriously the concept of the natural order… [Our bodies are] wonderful, original artistic masterpieces which reflect the meticulous design and order imposed by a Creator’s will and purpose… [However] the original masterpiece, created with such love and embodying such artistry, has become flawed, defaced, and contaminated…

What is the responsibility that we owe to this flawed masterpiece?… If a biblical perspective on human beings views them as flawed masterpieces, then our responsibilities are to act as art preservers and restorers. Our duties are to protect masterpieces from harm, and attempt to restore them in line with the original artist’s intentions.8

Wyatt’s model of medicine and medical research as “art restoration” is very helpful in thinking through bioethical dilemmas. We can ask: is this practice acting to glorify God through restoring His flawed masterpieces? Or is it irreverently attempting to improve on God’s original design?

3. The Definitive Ordered-ness of Creation

Some bible teachers attempt to split the bible into two types of teaching: prescriptive teaching and descriptive teaching. Prescriptive teaching are simple commands to obey such as “do not commit adultery”, as well as more complex imperatives such as “since then you are raised with Christ, set your minds on things above”. Descriptive teachings are more about explaining events that happened (“During the night Pharaoh summoned Moses and Aaron and said…”), reality at present (“Therefore there is now no condemnation for those who are in Christ Jesus”), and prophecies of the future (“To the one who is victorious I will give the right to eat from the tree of life”).

This division is somewhat oversimplistic, but can be helpful when discussing ethical issues. For example, there are several mentions of polygamous marriages in the Old Testament. But it would be incorrect to argue that the bible condones polygamy, for these references are descriptive rather than prescriptive.

That being said, I believe there is a third grouping of teachings in the bible, what I’ve termed “definitive” teachings. These are aspects of the world that have a clear God-given definition, which would be irreverent to try alter. Let me give you a non-medical and a medical example, both from these verses in Genesis 2-4:

22 Then the Lord God made a woman from the rib he had taken out of the man, and he brought her to the man. 23 The man said,
“This is now bone of my bones
    and flesh of my flesh;
she shall be called ‘woman,’
    for she was taken out of man.”
24 That is why a man leaves his father and mother and is united to his wife, and they become one flesh. 25 Adam and his wife were both naked, and they felt no shame.

Adam made love to his wife Eve, and she became pregnant and gave birth to Cain. She said, “With the help of the Lord I have brought forth a man.” 

Firstly, here we have “definitive” teaching on the meaning of marriage. Marriage (note the use of the word “wife”) is define by God as one man and one woman leaving their respective families to join in emotional and physical union. These verses do not explicitly prohibit homosexual or polygamous marriage (in a “prescriptive” sense). However, marriage is defined by God as heterosexual and monogamous, and thus to bend that definition would be, in the eyes of the bible, to push against God’s created order. (I am clearly glancing over the very sensitive issue of homosexuality. For a proper unpacking of the topic, see my article Is God Anti-Gay?)

Secondly, we have the definitive order of sexual relationship. Sexual union is definitively placed within marital union. And procreation is definitively placed within sexual union. Therefore, removing sex from marriage, or embarking on procreation outside a sexual union, can again be seen as cutting against God’s defined order of creation.

Worked Examples

In the introduction to this article, I listed far too many biotechnological scenarios to go through in any depth. However, my aim with this article was simply to lay down some basic principles that help guide Christian bioethical thinking. To begin thinking about any bioethical question, I think it is helpful to remind oneself of these three principles:

  1. The Fallacy of Nothing-Buttery- human beings are more than their physical component parts
  2. The Art Restoration Model of Medicine- we are to maintain and restore God’s creations, not improve on their design
  3. The Definitive Ordered-ness of Creation- we are to honour God’s defined order in creation

I am now going to go through two worked examples, using these three principles to tackle recent biotechnological developments, both in the past year:

  • Human-animal embryo research (July 2019)
  • The CRISPR baby scandal (February 2019)

Example 1: Human-Animal Embryo Research

In July 2019, a Japanese team (Nakauchi et al.) were the first in world to receive government go-ahead to create animal embryos containing human cells. The aim is to insert these embryos into surrogate animals with the ultimate goal of creating human organs for use in transplantation9.

So is creating animal embryos containing human cells ethical? The answer is far from straight forward, but our 3 principles can come into play.

The Fallacy of Nothing-Buttery

This case really challenges what it means to be human. Is an embryo, with some human DNA, some animal DNA, plus a strange inter-species concoction of enzymatic activity, in the uterus of an animal, a human? This is really tricky, and I don’t have a clear answer.

If the human cells were to be obtained from IVF, they would essentially be human embryos a few cell divisions along. If this is the case, it is worth remembering that regardless of why an embryo was made, where it ends up, and what it is done to it, a human embryo remains a human, for our humanness is not simply in our physical components.

However, if the cells were to be obtained from differentiated donor tissues (e.g. skin cells) the situation would be very different. In this case, the cells would not have the same claim to personhood as an embryo. Although similar in constitution, a skin cell and an embryo possess radically different non-physical characteristics, and thus hold different intrinsic values in the eyes of God.

The Art Restoration Model of Medicine

This principle is about the intent of the research. Why are the scientists conducting this research? It would appear that the aim is to care for patients with end-organ disease who need transplantation. This appears to be a laudable endeavour. However, it is worth remembering that the end does not always justify the means.

The Definitive Ordered-ness of Creation

It is on this principle that I have significant concerns about this research. The book of Genesis documents a very clear, defined relationship between humans and animals:

26 Then God said, “Let us make mankind in our image, in our likeness, so that they may rule over the fish in the sea and the birds in the sky, over the livestock and all the wild animals, and over all the creatures that move along the ground.”

From this verse, we see that humans are commissioned to be God’s delegated rulers over the animals on earth. I think the merging of human and animal nature in a single life opposes God’s defined distinction between mankind and the rest of the animals.

In addition, this research also breaks the link between sexual union and procreation, which I mentioned already. In having an animal give birth to a partially human embryo, not only have we introduced a third party into the sacrosanct procreative sexual union, we have introduced an animal!

Example 2: The CRISPR Baby Scandal

In February 2019, Prof He Jiankui hit international headlines when it was discovered that he illegally created genetically altered twins in China10. It was also found that he neglected to do adequate safety testing, failed to follow standard procedures in procuring participants and forged ethics reviews. He was promptly sacked from his university, spent almost a year under house arrest, and then on 30th December 2019 was sentenced to 3 years in prison.

He claimed to have disabled the CCR5 gene in the twins, which encodes a protein which allows HIV to enter cells. However, from what I can ascertain, there is actually no evidence he was successful in doing this.

This was the first ever case of children (allegedly) being born with edited DNA, and it shone a bright public spotlight on the ethics of gene editing.

The Fallacy of Nothing-Buttery

One thing that I found reassuring about this case was the international public concern for the well-being of the two (allegedly) genetically-altered twins. Lots of news outlets focussed on the twins, and the potential legal responsibility He would have if the twins suffered health consequences due to He’s research. Even if the embryos were made in a lab, and even if their genes have been altered, we should uphold these twins as fully human, not organisms to be experimented on.

The Art Restoration Model of Medicine

This is the principle that is often most pertinent in the field of genetic engineering. Are we altering someone’s genes to cure a disease, or are we doing so to improve on the original design? In this case, disabling a gene that made someone susceptible to HIV infection appears a worthwhile endeavour. However, as was pointed out by many people, we have very little idea of the possible other phenotypic consequences of altering that gene, for those individuals and also for the gene pool of humanity! I suppose it would be like trying to restore a painting with a chisel- it might work, but the unforeseen consequences could be disastrous, and therefore it is hardly honouring of the original designer.

There may well come a day when we can accurately map out all the major consequences of editing an embyro’s gene. But that appears to be a very distant pipe-dream at present.

The Definitive Ordered-ness of Creation

It seems quite basic a point here, in light of the complex ethical and biological issues raised by this case, but it is worth mentioning that the bible upholds obedience to the law and government, as a form of submission to God’s ordained order11. We are fortunate to have fairly clear national and international law governing biotechnological research. I disagree with many things that are legally permissible. But cases like these do show that people still care about what is ethically right and wrong in biotechnology, and our laws show some reflection of this.

Concluding Thoughts

Bioethics is a massive, expanding and daunting field. But I believe there are some basic biblical and timeless principles on which Christians can build their ethical views. I have no idea what the future holds in the field of bioethics. But what I do know is that we have a growing need for people to thinking deeply and biblically about the challenging ethical issues being raised by biotechnology. And I for one will be trying my best!

 

References:

  1. Rough draft published in 2000, and completed by Celera and NIH in 2003
  2. Yamanaka 2007.
  3. Venter et al. 2008
  4. The first trachae transplant happened in 2008 under Paolo Macchiarini. This subsequently became very controversial due to the mortality of the recipients. click here for BBC news article
  5. Demirci et al. 2019. Patient’s name is Victoria Gray
  6. John Wyatt, Matters of Life and Death, p121
  7. James Peterson, Genetic Turning Points: The Ethics of Human Genetic Intervention, p 32
  8. John Wyatt, Matters of Life and Death, p97-99
  9. https://www.nature.com/articles/d41586-019-02275-3
  10. https://www.nature.com/articles/d41586-019-00673-1, https://www.bbc.co.uk/news/health-48496652
  11. 1 Peter 2:13-16, Romans 13:1-6