Tikkun Magazine, May/June 1998
The Ultimate Therapy
By Jeremy Rifkin
COMMERCIAL EUGENICS ON THE EVE OF THE BIOTECH CENTURY
While the twentieth century was shaped largely by the spectacular breakthroughs in the fields of physics and chemistry, the twenty-first century will belong to the biological sciences. Scientists around the world are quickly deciphering the genetic code of life, unlocking the mystery of millions of years of biological evolution on Earth. Global life science companies, in turn, are beginning to exploit the new advances in biology in a myriad of ways, laying the economic framework for the coming Biotech Century.
Genes are the raw resource of the new economic epoch and are already being used in a variety of business fields - including agriculture, animal husbandry, energy, bioremediation, building and packaging materials, pharmaceuticals, and food and drink - to fashion a bio-industrial world. Nowhere is the new genetic commerce likely to have a bigger impact, however, than in human medicine. For the first time in history, scientific tools are becoming available to manipulate the genetic instructions in human cells. Human gene screening and therapy raise the very real possibility that we might be able to engineer the genetic blueprints of our own species and begin to redirect the future course of our biological evolution on Earth. The new gene splicing techniques will make it potentially possible to transform individuals and future generations into "works of art," continually updating and editing their DNA codes to enhance physical and mental health. Breakthroughs in genetic technology are bringing us to the edge of a new eugenics era with untold consequences for present and future generations and for civilization itself.
In less than seven years, the global life science companies will hold patents on most of the 100,000 genes that make up the human race as well as patents on the cell lines, tissues, and organs of our species, giving them unprecedented power to dictate the terms by which we and future generations will live our lives. The concentration of power in the global pharmaceutical industry has already reached staggering proportions. The world's ten major pharmaceutical companies currently control 47 percent of the $197 billion pharmaceutical market. The implications of a new market-driven eugenics are enormous and far reaching. Indeed, commercial eugenics could become the defining social dynamic of the new century.
Over the next ten years, molecular biologists say they will locate specific genes associated with several thousand genetic diseases. In the past, a parent's genetic history provided some clues to genetic inheritance, but there was still no way to know for sure whether specific genetic traits would be passed on. In the future, the guesswork will be increasingly eliminated, posing a moral dilemma for prospective parents. Parents will have at their disposal an increasingly accurate readout of their individual genetic make-ups, and will be able to predict the statistical probability of a specific genetic disorder being passed on to their children as a result of their biological union.
To avoid the emotional anguish of such decisions, some young people are likely to opt for prevention and avoid marrying someone of the wrong "genotype" for fear of passing along serious genetic diseases to their offspring. Already, part of the Orthodox Jewish community in the United States has established a nationwide program to screen all young Jewish men and women for Tay-Sachs disease. Every young Jew is encouraged to take the test. The results are made available in an easily accessible database to allow young eligible men and women to choose their dating partners with genotype in mind.
Some ethicists argue that such programs will become far more commonplace, placing a "genetic stigma" on young people. There's ample precedent for concern. Researchers report that when sickle cell anemia was screened for in Greece, nearly 23 percent of the population was found to have the trait. Fearing stigmatization, many of the carriers concealed their test results, believing that public exposure would seriously jeopardize their marriage prospects.
When researchers at the Johns Hopkins Medical Center recently discovered a genetic alteration in one out of every six Jews of Eastern European ancestry that doubles their risk of getting colon cancer, many in the Jewish community began to express their concern that the Jewish population might be singled out and made the object of discrimination. The news of the "Jewish" cancer gene came on top of other discoveries linking breast and ovarian cancer, cystic fibrosis, Tay-Sachs, Gauchers, and Canavan's disease to Jewish blood lines. Of course, scientists point out that other groups are likely to have just as many genetic links to specific diseases, but that the Jewish population has received the most attention to date because "they constitute a well defined, easily identifiable and closely related community - exactly the kind that allows geneticists to start identifying disease-causing genes." Still, the explanations of the researchers were not enough to calm an anxious Jewish community who began to vent their feelings publicly. Amy Rutkin, the director of American affairs for Hadassah, the nation's largest Jewish membership organization, reported that in the aftermath of the colon cancer discovery, the organization has been "receiving phone calls indicating a certain amount of fear and confusion." Rutkin said that "people are asking, is too much research focused on the Jewish community and are we at risk of stigmatization?"
Health professionals worry about genetic stigmatization and especially the prospect of selecting potential mates based on genotyping, but argue that it is still less onerous than selective abortion or sentencing a newborn to premature death or a life of chronic or debilitating illness. Not surprising, there is increasing talk of government mandated genetic testing of couples seeking marriage licenses. Even without a government requirement, it's likely that a growing number of potential marriage partners will want their future partner screened before committing themselves to a life-long relationship.
While genetic screening is already here, human genetic engineering - gene therapy - is just around the corner. Genetic manipulation is of two kinds. In somatic therapy, intervention takes place only within non-sex (somatic) cells and the genetic changes do not transfer into the offspring. In germ line therapy, genetic changes are made in the sperm, egg or embryonic cells, and are passed along to future generations. Somatic gene surgery has been carried out in limited human clinical trials for more than seven years. Germ line experiments have been successfully carried out on mammals for more than a decade and researchers expect the first human trials to be conducted within the next several years.
Despite years of favorable media reports on various somatic gene therapy experiments and the high expectations voiced by the medical establishment and the biotech industry, the results have, thus far, been so disappointing that the NIH itself was recently forced to acknowledge the fact and issue a sober warning to scientists conducting the experiments to stop making promises that cannot be kept. In an extensive survey of all 106 clinical trials of experimental gene therapies conducted over the past five years involving more than 597 patients, a panel of experts convened by the NIH reported that "clinical efficacy has not been definitively demonstrated at this time in any gene therapy protocol, despite anecdotal claims of successful therapy." Even Dr. Leroy B. Walters, a philosophy professor at Georgetown University and the chairperson of the NIH oversight committee that reviewed and approved all of the clinical trials, remarked in a moment of candor that he and the committee had not seen "any solid results yet" after years of experiments. Still, many of the staunchest supporters of the new gene therapies remain convinced that the techniques will bear fruit as methodologies and procedures are honed and new knowledge of the workings of the genes become more available to researchers and clinicians.
Far more controversial is the prospect of conducting human germ line therapy. Debate over genetic manipulation of human eggs, sperm, and embryonic cells has raged for more than fifteen years. In 1983, a cross-section of the nation's religious leaders and prominent scientists announced their opposition to such experiments, on eugenics grounds, and urged a worldwide ban. (The coalition was put together by The Foundation on Economic Trends.)
Programming genetic changes into the human germ line to direct the evolutionary development of future generations is the most radical human experiment ever contemplated and raises unprecedented moral, social, and environmental risks for the whole of humanity. Even so, a growing number of molecular biologists, medical practitioners, and pharmaceutical companies are anxious to take the gamble, convinced that controlling our evolutionary destiny is humankind's next great social frontier. Their arguments are couched in terms of personal health, individual choice, and collective responsibility for future generations.
Writing in The Journal of Medicine and Philosophy, Dr. Burke Zimmerman makes several points in defense of germ line cell therapy over somatic cell therapy. To begin with, he argues that the increasing use of somatic therapy is only likely to increase the number of survivors with defective genes in their germ lines-genes that will continue to accumulate and further "pollute" the genetic pool of the species, passing an increasing number of genetic problems onto succeeding generations. Secondly, although somatic therapy may be able to treat many disorders in which treatment lies in replacing populations of cells, it might never prove effective in addressing diseases involving solid tissues, organs, and functions dependent on structure - for example the brain - and therefore, germ line therapy is likely the only remedy, short of abortion, against such disorders.
Zimmerman and other proponents of germ line therapy argue for a broadening of the ethical mandate of the healing professions to include responsibility for the health of those not yet conceived. The interests of the patient, they say, should be extended to include the interests of "the entire genetic legacy that may result from intervention in the germ line." Moreover, parents ought not to be denied their right as parents to make choices on how best to protect the health of their unborn children during pregnancy. To deny them the opportunity to take corrective action in the sex cells or at the early embryonic stage would be a serious breach of medical responsibility. Proponents of germ line therapy ask why millions of individuals need to be subjected to painful, intrusive, and potentially risky somatic therapy when the gene or genes responsible for their diseases could be more easily eliminated from the germ line, at less expense, and with less discomfort.
Finally, the health costs to society need to be factored into the equation, say the advocates of germ line therapy. Although the costs of genetic intervention into the germ line to cure diseases are likely to remain high in the early years, the cost is likely to drop dramatically in the future as the methods and techniques become more refined. The lifetime cost of caring for generations of patients suffering from Parkinson's disease or severe Down's syndrome is likely to be far greater than simple prevention in the form of genetic intervention at the germ line level.
In the coming decades, scientists will learn more about how genes function. They will become increasingly adept at turning genes "on" and "off." They will become more sophisticated in the techniques of recombining genes and altering genetic codes. At every step of the way, conscious decisions will have to be made as to which kinds of permanent changes in the biological codes of life are worth pursuing and which are not. A society and civilization steeped in "engineering" the gene pool of the planet cannot possibly hope to escape the kind of ongoing eugenics decisions that go hand and hand with each new advance in biotechnology. There will be enormous social pressure to conform with the underlying logic of genetic engineering, especially when it comes to its human applications.
Parents in the biotech century will be increasingly forced to decide whether to take their chances with the traditional genetic lottery and use their own unaltered egg and sperm, knowing their children may inherit some "undesirable" traits, or undergo corrective gene changes on their sperm, egg, embryo, or fetus, or substitute egg or sperm from a donor through in vitro fertilization and surrogacy arrangements. If they choose to go with the traditional approach and let genetic fate determine their child's biological destiny, they could find themselves culpable if something goes dreadfully wrong in the developing fetus, something they could have avoided had they availed themselves of corrective genetic intervention at the sex cell or embryo stage.
In the Biotech Century, a parent's failure to correct genetic defects in utero might well be regarded as a heinous crime. Society may conclude that every parent has a responsibility to provide as safe and secure an environment as humanly possible for their unborn child. Not to do so might be considered a breech of parental duty for which the parents could be held morally, if not legally, liable. Mothers have already been held liable for having given birth to crack cocaine addicted babies and babies with fetal alcohol syndrome. Prosecutors have argued that mothers passing on these painful addictions to their unborn children are culpable under existing child abuse statutes, and ought to be held liable for the effect of their lifestyle on their babies.
Proponents of human genetic engineering argue that it would be cruel and irresponsible not to use this powerful new technology to eliminate serious "genetic disorders." The problem with this argument, says The New York Times in an editorial entitled, "Whether to Make Perfect Humans," is that "there is no discernible line to be drawn between making inheritable repair of genetic defects and improving the species." The Times rightly points out that once scientists are able to repair genetic defects, "it will become much harder to argue against additional genes that confer desired qualities, like better health, looks or brains."
If diabetes, sickle cell anemia, and cancer are to be prevented by altering the genetic makeup of individuals, why not proceed to other less serious "defects": myopia, color blindness, dyslexia, obesity, short stature? Indeed, what is to preclude a society from deciding that a certain skin color is a disorder? In the end, why would we ever say no to any alteration of the genetic code that might enhance the well-being of our offspring? It would be difficult to imagine parents rejecting genetic modifications that promised to improve, in some way, the opportunities for their progeny.
It is likely that as new screening technologies become more universally available, and genetic surgery at the embryonic and fetal stage becomes more widely acceptable, the issue of parental responsibility will be hotly debated, both in the courts and in the legislatures. The very fact that parents will increasingly be able to intervene to ensure the health of their child before birth, is likely to raise the concomitant issue of the responsibilities and obligations to their unborn children. Why shouldn't parents be held responsible for taking proper care of their unborn child? For that matter, why shouldn't parents be held liable for neglecting their child's welfare in the womb in cases where they failed to or refused to screen for and correct genetic defects that could prove harmful to their offspring?
With Americans already spending billions of dollars on cosmetic surgery to improve their looks and psychotropic drugs to alter their mood and behavior, the use of genetic therapies to enhance their unborn children also seems a likely prospect. According to a 1992 Harris poll, 43 percent of Americans "would approve using gene therapy to improve babies' physical characteristics." Many advocates of germ line intervention are already arguing for enhancement therapy. They contend that the current debate over corrective measures to address serious illnesses is too limited and urge a more expansive discussion to include the advantage of enhancement therapy as well. As to the oft heard criticism that genetic enhancement will favor children of the rich at the expense of children of the poor-as the rich will be the only ones capable of paying for genetic enhancement of their offspring - proponents argue that the children of well-off parents have always enjoyed the advantages that wealth and inheritance can confer. Is it such a leap, they ask rhetorically, to want to pass along genetic gifts to their children along with material riches? Advocates ask us to consider the positive side of germ line enhancement, even if it gives an advantage to the children of those who can afford the technology. "What about ... increasing the number of talented people. Wouldn't society be better off in the long run?" asks Dr. Burke Zimmerman.
Perhaps not. Despite the growing enthusiasm among molecular biologists for engineering fundamental changes in the genetic code of human sex cells, it should be emphasized that treating genetic disorders by eliminating recessive traits at the germ line level is far different from treating genetic disorders by way of somatic gene surgery after birth. In the former instance, the genetic deletions can result, in the long run, in a dangerous narrowing of the human gene pool upon which future generations rely for making evolutionary adaptations to changing environments.
We learned, long ago, that recessive traits and mutations are essential players in the evolutionary schema. They are not mistakes, but rather variations, some of which become opportunities. Eliminating so-called "bad" genes risks depleting the genetic pool and limiting future evolutionary options. Recessive gene traits are far too complex and mercurial to condemn as simple errors in the code. We are, in fact, just beginning to learn of the many subtle and varied roles recessive gene traits play, some of which have been critically important in ensuring the survival of different ethnic and racial groups. For example, the sickle cell recessive trait protects against malaria. The cystic fibrosis recessive gene may play a role in protecting against cholera. To think of recessive traits and single gene disorders, then, as merely errors in the code, in need of reprogramming, is to lose sight of how things really work in the biological kingdom.
Somatic gene surgery, on the other hand, if it proves to be a safe, therapeutic way to treat serious diseases that can not be effectively treated by more conventional approaches, including preventive measures, would appear to have potential value.
Many biotech libertarians, however, disdain such distinctions. The Economist suggested, in a recent editorial, that society should move beyond old fashioned hand-wringing moralism on the subject and openly embrace the new commercial eugenics opportunities that will soon become available in the marketplace. The editors asked,
What of genes that might make a good body better, rather than make a bad one good? Should people be able to retrofit themselves with extra neuro-transmitters, to enhance various mental powers? Or to change the color of their skin? Or to help them run faster, or lift heavier weights?
The Economist editorial board made clear that its own biases lay firmly with the marketplace. To them, the new commercial eugenics is about ensuring greater consumer freedom so that individuals can make of themselves and their heirs whatever they choose. The editorial concluded with a ringing endorsement of the new eugenics:
The proper goal is to allow people as much choice as possible about what they do. To this end, making genes instruments of such freedom, rather than limits upon it, is a great step forward.
Dr. Robert Sinsheimer, a long standing leader and driving force in the field of molecular biology, laid out his eugenics vision of the new man and woman of the biotech century:
The old dreams of the cultural perfection of man were always sharply constrained by his inherited imperfections and limitations.... To foster his better traits and to curb his worse by cultural means alone has always been, while clearly not impossible, in many instances most difficult.... We now glimpse another route-the chance to ease the internal strains and heal the internal flaws directly, to carry on and consciously perfect far beyond our present vision this remarkable product of two billion years of evolution.... The old eugenics would have required a continual selection for breeding of the fit, and a culling of the unfit.... The horizons of the new eugenics are in principle boundless - for we should have the potential to create new genes and new qualities yet undreamed.... Indeed, this concept marks a turning point in the whole evolution of life. For the first time in all time, a living creature understands its origin and can undertake to design its future. Even in the ancient myths man was constrained by essence. He could not rise above his nature to chart his destiny. Today we can envision that chance - and its dark companion of awesome choice and responsibility.
PERFECTING THE CODE
While the notion of consumer choice would appear benign, the very idea of eliminating so-called genetic defects raises the troubling question of what is meant by the term "defective." Ethicist Daniel Callahan of the Hastings Center penetrates to the core of the problem when he observes that "behind the human horror at genetic defectiveness lurks ... an image of the perfect human being. The very language of 'defect,"abnormality,"disease,' and 'risk' presupposes such an image, a kind of prototype of perfection."
The all consuming preoccupation with "defects" or "errors" among medical researchers and molecular biologists puts them very much at odds with most evolutionary biologists. When evolutionary biologists talk of "mutations," they have in mind the idea of "different 'readings' or 'versions'" of a relatively stable archetype. James Watson and Francis Crick's discovery of the DNA double helix in the 1950s, however, brought with it a new set of metaphors and a new language for describing biological processes which changed the way molecular biologists perceive genetic mutations. The primary building block of life was described as a code, a set of instructions, a program, to be unraveled and read. The early molecular biologists, many of whom had been trained first as physicists, were enamored with what they regarded as the universal explanatory power of the information sciences. Norbert Weiner's cybernetic model and modern communications and information theory provided a compelling new linguistic paradigm for redefining how we talk about both physical and biological phenomena. It is within the context of this new language that molecular biologists first began to talk of genetic variation as "errors" in the code rather than "mutations." The shift from the notion of genetic mutations in nature to genetic errors in codes represents a sea change in the way biologists approach their discipline, with profound repercussions for how we structure both our relationship to the natural world and our own human nature in the coming Biotech Century.
The very idea of engineering the human species-by making changes at the germ line level - is not too dissimilar from the idea of engineering a piece of machinery. An engineer is constantly in search of new ways to improve the performance of a machine. As soon as one set of defects is eliminated, the engineer immediately turns his attention to the next set of defects, always with the idea in mind of creating a more efficient machine. The notion of setting arbitrary limits to how much "improvement" is acceptable is alien to the entire engineering conception.
The new language of the information sciences has transformed many molecular biologists from scientists to engineers, although they are, no doubt, little aware of the metamorphosis. When molecular biologists speak of mutations and genetic diseases as errors in the code, the implicit, if not explicit, assumption is that they should never have existed in the first place, that they are "bugs," or mistakes that need to be deprogrammed or corrected. The molecular biologist, in turn, becomes the computing engineer, the writer of codes, continually eliminating errors and reprogramming instructions to upgrade both the program and the performance. This is a dubious and dangerous role when we stop to consider than every human being brings with him or her a number of lethal recessive genes. Do we then come to see ourselves as miswired from the get-go, riddled with errors in our code? If that be the case, against what ideal norm of perfection are we to be measured? If every human being is made up of varying degrees of error, then we search in vain for the norm, the ideal. What makes the new language of molecular biology so subtly chilling is that it risks creating a new archetype, a flawless, errorless, perfect being to which to aspire - a new man and woman, like us, but without the warts and wrinkles, vulnerabilities and frailties, that have defined our essence from the very beginning of our existence.
No wonder so many in the disability rights community are becoming increasingly frightened of the new biology. They wonder, if in the new world coming, people like themselves will be seen as errors in the code, mistakes to be eliminated, lives to be prevented from coming into being. Then again, how tolerant are the rest of us likely to be when we come to see everyone around us as defective, as mistakes and errors in the code.
Already, genetic information is being used by schools, employers, insurance companies and governments to determine educational tracks, employment prospects, insurance premiums, and security clearances, giving rise to a new and virulent form of discrimination based on one's genetic profile. Even more chilling, some genetic engineers envision a future with a small segment of the human population engineered to "perfection" while others remain as flawed reminders of an outmoded evolutionary design. Molecular biologist Lee Silver of Princeton University writes about a not-too-distant future made up of two distinct biological classes which he refers to as the Gen Rich and Naturals. The Gen Rich, which account for 10 percent of the population, have been enhanced with synthetic genes and have become the rulers of society. They include Gen Rich businessmen, musicians, artists, intellectuals, and athletes, each enhanced with specific synthetic genes to allow them to succeed in their respective fields in ways not even conceivable among those born of nature's lottery.
At the center of this new genetic aristocracy are the Gen Rich scientists who are enhanced with special genetic traits that greatly increase their mental abilities, giving them the power to dictate the terms of future evolutionary advances on Earth. Silver says that:
With the passage of time, the genetic distance between Naturals and the Gen Rich has become greater and greater, and now there is little movement up from the Natural to the Gen Rich class.... All aspects of the economy, the media, the entertainment industry and the knowledge industry are controlled by members of the Gen Rich class....In contrast, Naturals work as low-paid service providers or as laborers.... Gen Rich and Natural children grow up and live in segregated social worlds where there is little chance for contact between them ... [eventually] the Gen Rich class and the Natural class will become the Gen Rich humans and the Natural humans - entirely separate species with no ability to cross breed and with as much romantic interest in each other as a current human would have for a chimpanzee.
Silver acknowledges that the increasing polarization of society into a Gen Rich and Natural class might be unfair, but he is quick to add that wealthy parents have always been able to provide all sorts of advantages for their children. "Anyone who accepts the right of affluent parents to provide their children with an expensive private school education cannot use unfairness as a reason for rejecting the use of reprogenetic technologies," argues Silver. Like many of his colleagues, Silver is a strong advocate of the new genetic technologies. "In a society that values human freedom above all else," writes Silver, "it is hard to find any legitimate basis for restricting the use of reprogenetics."
If Silver's predictions about where the new technologies are heading are correct, we face the very real possibility of journeying into a Huxlian world populated by Alphas, Betas, Gammas, and Deltas. In the new scenario, however, it's the global marketplace and consumer desire, not an oppressive government, that will likely be the ultimate arbiter of the new biology. In the final analysis, commercial eugenics, controlled by global life science companies and mediated by consumer sovereignty, might prove every bit as dangerous to the future prospects of our species as the shrill cries on behalf of purifying the best blood of the Aryan race more than half a century ago in Hitler's infamous Third Reich.
The question, then, is whether or not humanity should begin the process of engineering future generations of human beings by technological design in the laboratory. What are the potential consequences of embarking on a course whose final goal is the "perfection" of the human species?
Today, the ultimate exercise of power is within grasp: the ability to control, at the most fundamental level, the future lives of unborn generations by engineering their biological life process in advance, making them a partial hostage of their own architecturally designed blueprints. I use the word "partial" because, like many others, I believe that environment is a major contributing factor in determining one's life course. It is also true, however, that one's genetic makeup plays a role in helping to shape one's destiny. Genetic engineering, then, represents the power of authorship, albeit limited authorship. Being able to engineer even minor changes in the physical and behavioral characteristics of future generations represents a new era in human history. Never before has such power over human life even been a possibility.
Human genetic engineering raises the very real spectre of a distopian future where the haves and have-nots are increasingly divided and separated by genetic endowment, genetic discrimination is widely practiced, and traditional notions of democracy and equality give way to the creation of a genetocracy based on one's "genetic qualifications." The driving force of this new bioindustrial world are giant life science companies whose control over genetic resources and the new transformative biotechnologies give them the clout to act as commercial agents for a new eugenics era.
COMPETING BIOTECH VISIONS
Many in the life sciences field would have us believe that the new gene splicing technologies are irrepressible and irreversible and that any attempt to oppose their introduction is both futile and retrogressive. They never stop to even consider the possibility that the new genetic science might be used in a wholly different manner than is currently being proposed. The fact is, the corporate agenda is only one of two potential paths into the Biotech Century. It is possible that the growing number of anti-eugenic activists around the world might be able to ignite a global debate around alternative uses of the new science - approaches that are less invasive, more sustainable and humane and that conserve and protect the genetic rights of future generations.
While the global life science companies favor the introduction and wide spread use of gene therapy - genetic engineering - to cure diseases, and enhance the physical, emotional and mental well-being of individuals, a growing number of holistically minded geneticists and health practitioners are beginning to use the new data being generated by the human genome project in a very different way. They are exploring the relationship between genetic mutations and environmental triggers with the hope of fashioning a more sophisticated, scientifically-based understanding and approach to preventive health. More than 70 percent of all deaths in the United States and other industrialized countries are attributable to what physicians refer to as "diseases of affluence." Heart attacks, strokes, breast, colon and prostate cancer, and diabetes are among the most common diseases of affluence. While each individual has varying genetic susceptibilities to these diseases, environmental factors, including diet and lifestyle, are major contributing elements that can trigger genetic mutations. Heavy cigarette smoking, high levels of alcohol consumption, diets rich in animal fats, the use of pesticides and other poisonous chemicals, contaminated water and food, polluted air and sedentary living habits with little or no exercise, have been shown, in study after study, to cause genetic mutations and lead to the onset of many of these high profile diseases.
The mapping and sequencing of the human genome is providing researchers with vital new information on recessive gene traits and genetic predispositions for a range of illnesses. Still, little research has been done, to date, on how genetic predispositions interact with toxic materials in the environment, the metabolizing of different foods, and lifestyle to affect genetic mutations and phenotypical expression. The new holistic approach to human medicine views the individual genome as part of an embedded organismic structure, continually interacting with and being affected by the environment in which it unfolds. The effort is geared toward using increasingly sophisticated genetic and environmental information to prevent genetic mutations from occurring. (It needs to be emphasized, however, that a number of genetic diseases appear to be unpreventable and immune to environmental mediation.)
Some would argue that, in the case of medicine and any number of other fields, there is no reason why both approaches to applied science can't live side by side, each complementing and augmenting the other. In reality, the commercial market favors the more reductionist approach for the obvious reason that for now, at least, that's where the money is to be made. While there is certainly a growing market for preventive health practices, programs, and products, far more money is invested in "illness" based medicine. That could change, but it would require a paradigm shift in the way we think about science and its applications, with awareness of and support for a science founded in systems thinking and sensitive to the twin notions of diversity and interdependence.
While it might seem highly improbable, even inconceivable, to most of the principle players in this new technology revolution that genetic engineering, with all of its potential promise, might ultimately be rejected, we need remind ourselves that just a generation ago, it would have been just as inconceivable to imagine the partial abandonment of nuclear energy which had for years been so enthusiastically embraced as the ultimate salvation for a society whose appetite for energy appeared nearly insatiable. It is also possible that society will accept some and reject other uses of genetic engineering in the coming biotech century. For example, one could make a solid case for genetic screening - with the appropriate safeguards in place - to better predict the onslaught of disabling diseases, especially those that can be prevented with early treatment. The new gene-splicing technologies also open the door to a new generation of lifesaving pharmaceutical products. On the other hand, the use of gene therapy to make corrective changes in the human germ line, affecting the options of future generations, is far more problematic. Society may well say yes to some of the genetic engineering options and no to others. After all, nuclear technology has been harnessed effectively for uses other than creating energy and making bombs.
Even a rejection of some genetic engineering technologies then, does not mean that the wealth of genomic and environmental information being collected couldn't be used in other ways. While the twenty-first century will be the Age of Biology, the technological application of the knowledge we gain can take a variety of forms. To believe that genetic engineering is the only way to apply our new knowledge of biology and the life sciences is limiting and keeps us from entertaining other options which might prove even more effective in addressing the needs and fulfilling the dreams of current and future generations.
The biotech revolution will affect every aspect of our lives. The way we eat; the way we date and marry; the way we have our babies; the way our children are raised and educated; the way we work; the way we engage in politics; the way we express our faith; the way we perceive the world around us and our place in it - all of our individual and shared realities will be deeply touched by the new technologies of the Biotech Century. Surely, these very "personal" technologies deserve to be widely discussed and debated by the public at large before they become a ubiquitous part of our daily lives.
This article is adapted from Jeremy Rifkin's new book, The Biotech Century: Harnessing the Gene and Remaking the World (Tarchef/Putnam, March 1998). Mr. Rifkin is president of the Foundation on Economic Trends in Washington D.C.
Rifkin, Jeremy. 1998. The Ultimate Therapy. Tikkun 13(3): 33.