Bioethics Forum Essay
He Jiankui’s Genetic Misadventure, Part 2: How Different Are Chinese and Western Bioethics?
When the world’s first research on editing the genes of human embryos by Chinese scientists was published in an international journal in 2015, a report in the New York Times characterised the key issue involved as “a scientific ethical divide between China and West.” Earlier this year, an article in the magazine Foreign Policy by a researcher with Chinese origin put it bluntly that “China will always be bad at bioethics.” Now, He Jiankui’s announcement on gene-edited babies appears to provide more compelling evidence that China is the “radical other” of the West, a wild land where bioethics matters little.
Is this really the right way to look at things? Our answer is, no. The evidence doesn’t bare these beliefs out; it is a misdiagnosis, and it risks obscuring the real issues that He Jiankui’s experimentation raises. Since the news on the gene-edited babies came out on November 26 via Baidu and Google, one of us (Nie) has been closely following reactions to it in journalists’ reports, commentaries, and posts on Chinese and international mass media, as well as on China’s major social media platforms, Weibo and WeChat.
The belief that China is ethically distinct from the West might suggest that He’s news has been widely or even universally welcomed in China. But this is simply false. Almost immediately after He’s announcement, 122 Chinese scientists issued a passionate public statement that they “Firmly oppose!!!” and “Strongly condemn!!!” He’s acts (exclamation marks included in the statement). Within a few days, more than 300 other Chinese scientists and scholars set out to confront the issues through “Ten Questions to He Jiankui.” These two documents have since been widely circulated via mass media and social media.
In wider Chinese society, the responses seem to be more mixed. Chinese people recognize the significance of scientific freedom and the need to advance technology. And of 36,352 readers who responded to the survey question on China’s gene-edited babies at the end of the initial positive report in People’s Daily (now removed, but archived here though without the poll), 25.35% indicated “support for it on the grounds that it may reduce the risk of serious diseases.” These responses are aligned with support for such experiments in the West. Within China, in addition, there are nationalistic considerations (He is a Chinese scientific genius). However, in the same People’s Daily poll, 37.8% did not support He’s experiments, based on reflection on major fears associated with ethical problems, and 36.85% were “neutral for now because one does not know what will happen in opening Pandora’s box.”
So far, the Chinese authorities appear to side with the concerned Chinese scientists and the public. They have vowed to investigate the case, and some top officials have described He’s experiments as “extremely abominable” and have “strongly condemned” them. It has been stated that He should be severely punished. Within two days of He’s public announcement several concerned organizations, including the Southern University of Science and Technology and Harmonicare Shenzhen Women and Children’s Hospital, have disavowed their institutional affiliations with He. While the real purpose of these institutions is perhaps to evade liability for failed governance, their response also indicates their stance that He’s project can be seen as ethically unacceptable or problematic.
In voicing their condemnation, the Chinese words and phrases used by scientists, the authorities, bioethicists, and the general public in China are remarkably similar to the words used in the Western media about He’s experiments. They include more restrained terms such as “unethical,” “immoral,” “wrong,” “irresponsible,” and “reckless.” They also include stronger and more emotive ones: He has been described as “mad,” and a “scientific lunatic,” and his experiments as “monstrous,” “disgusting,” “repulsive,” “inhuman,” “cruel,” “horrible,” “barbaric,” and “atrocious.” In readers’ responses to the journalists’ reports and social media, Unit 731 and Japanese doctors’ human experimentation in wartime China have been evoked time and again. And the title of a provocative long commentary, which first appeared on a popular Weibo site 90’s Tonight, invokes the Western experience with inhuman research, where He is described as a “Contemporary Hitler” who used gene editing to sacrifice babies’ lives for the Nobel Prize. (The Nazi physician Joseph Mengele who also experimented upon twins is far less known in China.)
Underlying these verbal similarities with Western bioethics, the ethical reasons that emerge in the Chinese uproar are highly similar to, if not identical with, those voiced in the West. China doesn’t have a China-specific ethical framework that supports such experimentation. He’s research violates the Chinese national guidelines on the impermissibility of implanting gene-edited embryos. It defies a series of norms of research ethics, established internationally and in China, by risking unnecessary harms to the research subjects, lacking a robust process of ethics approval, having highly questionable informed consent, exploiting a vulnerable population (HIV/AIDS patients), and having huge financial conflicts of interests.
Furthermore, the strong spontaneous responses within Chinese society to He’s research illustrates how Chinese and Western people share some fundamental ethical principles. A stereotype widely held in the West as well as in China is that the value and dignity of human life is not part of Chinese ethical thinking, and that life doesn’t begin until birth. But the widespread Chinese criticism of He’s experiments can be seen as an intuitive appeal to the value and dignity of life, including the life of the fetus and embryo. The Chinese comparison of He’s human experiments to those of Unit 731 is understandable not merely because Japan’s medical atrocities have been deeply implanted in Chinese people’s collective memory. It is also because life has a certain intrinsic value that scientists should respect in principle.
Another deeply-cherished Chinese, Western, and human value He’s research challenges is the ultimate moral goals of science and technology. In China yi nai renshu (medicine as the art of humanity or humaneness) has been the fundamental ethical norm for medicine for centuries. According to this norm, rooted in the moral and political philosophy of Confucianism, biomedical research and science should not serve primarily personal ambition of scientists or the interests of one nation. They should be “the art of humanity.” He’s genetic misadventure violates this age-old Chinese ethical principle for medicine.
The apparent failure to see these evident features of the Chinese response to He Jiankui’s experiments suggests that there are potentially distorting and pervasive beliefs about China that need to be unearthed and critically examined. One root of these beliefs lies in the dichotomization of China and the West as radical others, and the view that this whole incident provides further evidence that there is a divide and clash between Western and Chinese bioethics. Contrary to what this belief implies, China has plentiful resources to condemn He’s experiments.
But if this is the case, then how and why was he able to carry out the experiments? Are there significant features or possibly differences between China and the West that have not emerged in the existing reporting and analysis of He’s November announcement?
We suggest that one of the real issues is his personal ambition, nourished and supported by the Chinese authoritarian nationalistic model of sciences. As a result, we are left with the real but difficult questions: why has ethics failed so remarkably? What are the institutional and socio-political causes? What role have U.S. gene-editing scientists played? What bioethical lessons should China and the international community learn from He’s and his associates’ “historic” violation of ethical norms of biomedical research?
Jing-Bao Nie, BMed, MMed, MA, PhD, is a professor at the Bioethics Centre, University of Otago, New Zealand, and a Hastings Center Fellow. Neil Pickering, PhD, is an associate professor at the Bioethics Centre, University of Otago, New Zealand.
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It’s worth bearing in mind that “bear” (as in “bear these beliefs out”) differs from “bare” (as in naked).