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Beyond Therapy

Gregg Easterbrook reviews Beyond Therapy: Biotechnology and the Pursuit of Happiness by the President's Council on Bioethics.

Easterbrook seems opposed to the idea of stopping any of this technology; he certainly believes that any attempts to do so would be futile. But he points out that the possible ethical consequences are real, and that we're unprepared to deal with them because we've refused to squarely confront the issue:

The muddled regulatory structure results in such theater-of-the-absurd actions as an Environmental Protection Agency decision legally to classify some types of corn as a "pesticide," and a Food and Drug Administration ruling on whether genetically engineered salmon is a "drug."

Here's an extended excerpt from Easterbrook's review of Beyond Therapy:

There is surely an absence of reliable legal standards. Congress has enacted almost no laws concerning biotechnology. There is no over-arching statute, nor one agency with clear jurisdiction. Some biotechnological questions fall to the Food and Drug Administration, but its mandate is mainly to determine whether pharmaceuticals are safe and effective, not whether medical technology ought to be used. Some perplexities fall to the Environmental Protection Agency or the National Institutes of Health or even the Department of Agriculture, but may engage regulations enacted in the 1960s and 1970s to govern toxic chemicals. The muddled regulatory structure results in such theater-of-the-absurd actions as an Environmental Protection Agency decision legally to classify some types of corn as a "pesticide," and a Food and Drug Administration ruling on whether genetically engineered salmon is a "drug."

A few specific biotech questions, such as the protocols for federally funded investigation of stem cells, have been addressed by narrow Washington actions; but Congress and all contemporary presidents have avoided tackling biotech head-on in any comprehensive way. So much is happening in biotechnology, and so swiftly, that there is no agreement on what should be permitted or banned. There is also the suspicion that Washington above all wants to avoid two kinds of blame, first for allowing something horrible and second for not allowing the production of disease therapies. (Stem cell research might lead to a cure for Parkinson's, for example.)

The lack of clear federal guidance, moreover, applies only to federally funded research, most of which goes on at universities. In the private sector of science there are no rules. So long as you are not using federal money, you can pretty much do what you want with human cells, human DNA, human embryos, and whatever mutant chromosomes you may casually create. Anything goes in private labs; one reason why the in-vitro fertilization clinic industry blossomed so rapidly is that it is unregulated. (It is worth noting that IVF assistance for couples having difficulty conceiving was once denounced as a dangerous God-playing technology but now is widely accepted, even by most of the religious right.) Many private biotech firms and IVF clinics have ethics advisers, some of whom take matters seriously; but at the private level ethics are optional.

As Beyond Therapy reminds us, society has scarcely begun to grapple with whether it really wants what biotechnology may produce. Commonly it is assumed that all technological developments are inevitable. Technology may be regulated, but to say that society does not want a new thing or a new device, that it should be placed back into the box and the box sealed and dropped into the Marianas Trench, is wasted breath. Historically speaking, the technological imperative seems always to have won out. But Beyond Therapy begs to differ: we must recognize our moral agency in these matters, the report insists, and ask ourselves whether we really want what biotechnological and genetic engineering make possible. I would add that society must ask itself this question immediately, because many of these innovations are coming fast.