- BIOETHICS FORUM ESSAY
Choosing Chance: Sandel’s The Case against Perfection
I consider myself a typical baby boomer. War protester, flower child, and a believer in the new feminist movement, I adopted its mantra of choice to influence many decisions that followed. Specifically, I became a poster child for what became known as “reproductive choice.” When I was offered the dangerous Dalkon shield for birth control, I chose it. When the momentous decision regarding an unwanted pregnancy arose, I chose the available abortion. When I entered my late thirties, I finally chose to have a child, but following my son’s birth, I chose sterilization and had my tubes tied. Later, wanting another biological child, I chose to undergo surgery to undo the results of my previous decision. Still having difficulties and having reached the age of 40, I chose all available methods to increase my chances to become pregnant: fertility drugs and then in-vitro fertilization, at that time a brand new and fairly untested treatment. When the IVF failed, I ran out of reproductive choices; my second pregnancy occurred without technological assistance, a gift. My second son had chosen me.
As I’ve looked back on my history, I’ve come to doubt that some of these “choices” were truly choices at all. Although I adamantly believe in the legal rights of a woman to determine her reproductive destiny, I realize that many of the decisions I made, to be absolutely honest, were not the result of measured and considered thought – not a careful weighing of options based on deep introspection. Instead, certain of these decisions reflected the trends of the times, the prevailing cultural winds, which influenced my views about how I, as a young woman, should live and how my priorities should be ordered. These were not truly “choices made”; they were the too-quick and impulsive adoption of services offered and even sold to support a certain lifestyle, as opposed to a life, of the times.
If I imagine myself as a young woman in today’s world, lacking the benefit of such hindsight, I have no doubt that I would be reacting similarly to the zeitgeist. Deep personal questioning might still be rare among the young. If I were offered options regarding birth control, I probably would succumb to glossy advertisements telling me I should not be bothered by my monthly period, and I might opt to change the natural cycles of menstruation and avoid the hassle. Instead of the tedious and endless waitress jobs to help support a college education, I might opt to sell my eggs. Even though I would be squeamish about the medical procedures, the chance at such huge payments would no doubt be alluring. If told I could profit by selling my eggs for research without the psychological burdens of knowing I was helping to produce a child, I would be clamoring to be able to assist.
When the time came for me to have a child, if still single, I might enjoy shopping for a sperm donor based on his genetic makeup. Single or married, I would be availing myself of absolutely every known medical technique to assure that my child would be born free of genetic illnesses. Selecting the sex of a child might be a given, as easy as finding out the sex during pregnancy. Finally, I would be likely to use genetic engineering, if available, to enhance my child’s physical and mental characteristics. Unquestionably the techniques would be considered fashionable, and it would be hard to disregard pitches in the New York Times Style section and Vogue. After all, so many of my friends would be doing it. This quest for perfection would be another proclaimed choice, a herald for the ultimate in reproductive liberty.
This is a picture, that, with the benefit of hindsight, I find unsettling, even alarming – that the dominant culture might lead us into more “choices” that aren’t really choices at all, especially in an era of rapidly increasing technological offerings, in which the mantra of choice justifies the genetic manipulation of human nature.
The thesis of Michael J. Sandel’s pure and pristine book, The Case against Perfection: Ethics in the Age of Genetic Enhancement, speaks directly to my discomfort. Sandel offers a philosophical case against the prospect of genetic engineering, and the hubris involved in the notion of the choice becomes the work’s underlying theme. Sandel does not believe that the ethical and philosophical problem of genetic enhancement, the ability to “manipulate our own nature,” lies principally with the undermining of human effort and erosion of individual human agency, with achievement becoming attributable to the designer rather than the individual designed. He describes a “deeper danger.” He worries that we will be caught up in “a kind of hyperagency, a Promethean aspiration to remake nature, including human nature, to serve our purposes and satisfy our desires. The problem is not the drift to mechanism but the drive to mastery. And what the drive to mastery misses, and may even destroy, is an appreciation of the gifted character of human powers and achievements.”
Anyone who thinks our culture is too competitive and consumer-driven should find that Sandel’s diagnosis resonates. He provides not only a warning about the shape of the future, but equally an indictment of – or at least a call to examine – our individual moral lives and our contemporary social values. Those who support the practice of genetic enhancement argue that the technology is not substantially different from other forms of “enhancement” we use to improve our lives and the lives of our children. Sandel agrees, but he does not base his argument on any particular distinction about the means of enhancement; rather he is deeply concerned about the underlying impetus of mastery and dominion. He worries about the diminishment of our wonder, respect, and sense of our “giftedness,” of the sense “that our talents and powers are not wholly our own doing, nor even fully ours, despite the efforts we expend to develop and to exercise them.”
His argument is illustrated by today’s use of biotechnology in athletics, where current practices already threaten to change the nature of sport into pure spectacle. Even assuming that genetic enhancements for athletes are proved safe and made widely available, Sandel still finds an ethical problem with their use. Agreeing that the line between cultivating and corrupting natural gifts is ambiguous, it is not the specific means of enhancement to which Sandel objects. Whether improved equipment, diet, supplements, corrective surgery, hi-tech training, drugs such as steroids or EPO, or genetic engineering, these means represent a change or elimination of the rules that were written to define the essence of the particular sport and highlight the skills of the players. An altered athlete corrupts the notion of sport as a human activity that “honors the cultivation and display of natural talents.” The essence of the game changes when altered batters, drugged or genetically engineered, routinely hit home runs. Some have suggested that this trend might produce two types of athletic competition – leagues for the genetically enhanced and for the “naturals.” Sandel does not agree; norms would be changed and audiences would be “re-habituated,” with the allure of spectacle replacing “unadulterated access to human talents and gifts.”
A diminished “ethic of giftedness” is similarly affecting age-old norms of parenting. Sandel draws at least blurry lines between healing one’s child and enhancing her. The distinction matters because “parents bent on enhancing their children are more likely to overreach, to express and entrench attitudes at odds with the norms of unconditional love.” Nonetheless, he acknowledges that our current attempts to “mold, cultivate, and improve” our children make the case against genetic enhancement complex. This use of biotechnology represents the far reaches of a continuum. We are already doing excessive and outrageous things to mold, cultivate, improve, help, and love our children – what Sandel terms “hyper-parenting.”
Surely many readers will recognize their own “Promethean aspirations to remake nature” in this term. Hyper-parenting is impossible to miss in the hysteria accompanying college admissions. SAT test aids and private college counseling have become huge growth industries. It’s impossible to start too early, of course: aggressive parents compete to get their children into the best nursery schools and preschools, and even toddlers are coached on test-taking. Faced with such pressure to succeed, children are feeling the resultant stress. Drug use is common, described as a way to cope with a competitive society’s demands for performance and perfection. Some argue that these practices are intrinsically similar to biotechnological enhancement, and Sandel concurs. But where others see the comparison as a justification for enhancement, Sandel advocates questioning these practices that we now routinely accept, urging a return to a “sense of life as a gift.”
If one thought about biotechnological enhancement from a religious perspective, one might see in Promethean aspirations and a loss of a sense of giftedness a confused sense of the proper relationship to God. Sandel asserts that the secular and moral implications of this loss are equally important. In a world of the genetically enhanced, we would not be grateful for our gifts, but rather feel that we alone had been responsible for our achievements. The necessity of perfection might prove burdensome. Parents might feel a corresponding duty to produce a perfect child. Becoming fully responsible for our own destiny also has the potential to diminish our sense of solidarity with the less fortunate. If our characteristics are not gifts, if we’ve “replaced chance with choice,” then perhaps we would no longer view those less fortunate as disadvantaged and in need of societal help, but rather just “in need of genetic repair.” With all of our intentions based upon improving ourselves, we would no longer be interested in improving our world.
In a seminal 2002 article, “Yuppie Eugenics,” scientists Ruth Hubbard and Stuart Newman anticipated Sandel’s warnings. Writing of the use of genetic testing on embryos created through IVF and not yet implanted in the womb, they lamented that “What was once a preventive choice has become a pro-active entitlement, exacerbated by the sense prevailing among current elites that one has the right to control all aspects of one’s life and shape them by buying and periodically upgrading the best that technology has to offer, be it a computer, a car, or a child.” Sandel agrees that this “market-based” eugenics is identical to state-sanctioned eugenics, to the extent that “both make children into products of deliberate design.”
Nonetheless, it is the guarantee of autonomous choice that similarly motivates supporters of biotechnological enhancement, who argue that as long as the opportunity to choose is distributed fairly, there is good reason to use these methods to improve upon given human nature. Some could consider this liberating – an extension of freedom. Sandel disagrees, noting that the utopia of liberal eugenics could eliminate the “persisting negotiation with the given,” an essential part of freedom. It is also possible that the choices made in a marketplace of genetic characteristics will not really be choices at all, but mere impulses.
If my reproductive struggles taught me anything, it was to revere the given – to accept the giftedness of life. The unknowable, the surprise, the mysteries, the contingencies and miracle of birth had almost been lost to me in my blind allegiance to the dictates of the times. With my children now grown, I’ve come to realize that their imperfections are their most endearing and lovable traits, either nurtured or natured.