Monday, April 03, 2017

Three-Parent Baby

NatureNews reports on the genetic details of the first child created from the DNA of three parents. The study is here.

The January issue of Bioethics has a special issue devoted to this topic.


Monday, March 13, 2017

"Natural" vs "Normal" with Gene Therapy/Enhancement

The National Academy of Sciences has published an extensive document on the ethics and governance of genome editing (see here). This is very timely for me as I am in the process of writing, and I hope completing in the next few months, a textbook on this general topic.

In the chapter dealing with genetic enhancement there is a brief discussion of the conflation of describing particular genetic mutations or constitutions as "natural" with the sentiment that they must therefore be "positive" and "beneficial". This conflation typically occurs when people object to genetic manipulation on the grounds that it is "playing god". The report helpfully explains the problem with this stance:

The word “natural” has similarly taken on a positive connotation reflecting a common view
that nature produces things that are healthier and generally better than anything artificial—this
despite evidence demonstrating that “natural” things can be either safe or intrinsically dangerous.
In the present context, genetic variants that exist in nature may either support health or cause
disease, and the human population contains multiple variants of most genes (see Chapter 4).
Thus, there is no single “normal” human genome sequence; rather, there are multiple variant
human genomic sequences (IGSR, 2016), all of which occur in the worldwide human gene pool
and, in that sense, are “natural,” and all of which can be either advantageous or disadvantageous.
(p. 106)

Given evolution by natural selection has given us genes, and genomes, for both health and disease, the question is whether humans ought to purposefully intervene in the genetic lottery of life to bring about a more desirable outcome than that conferred by the arbitrary process of evolution by natural selection. As the prospect of successful human intervention increases, so too, I believe, does the moral imperative to intervene to improve our biology beyond the confines of what evolution by natural selection has provided.


CFRC interview on the Genetic Revolution

Last week I gave a 40 minute interview for the Right of Reply Show on CFRC. The interview starts around 6 minutes into the link below and covers genetic intervention, aging and justice.

Interview here.


Sunday, February 26, 2017

Book Launch this week!

My department has kindly organized a book launch for Biologically Modified Justice, which takes place Tuesday at Queen's this week. Details are in the attached poster.

Trying to summarize 15 years of research and argument in 30 minutes is proving a challenge for me. Perhaps I can succinctly capture Part 1 of the book by breaking it down into the good news and the bad news.

The good news is humanity has escaped the "Young World", a world dominated by early-life mortality caused by extrinsic risk factors (e.g. infectious disease, poverty, war, etc.). The bad news is the "Aged World" is one of unprecedented levels of chronic disease and suffering, a problem that will continue to get worse unless we successfully increase the biological warranty period of humans.

One major goal of the book is to canvass how the transition from the Young to the Aged world requires a major re-think of what the demands of distributive justice are (especially the importance of well-ordered science).


Sunday, December 18, 2016

2016 Year in Review

Blogging has been light for me again in 2016, so I wanted to remedy that with a year in review post and a promise to return to more regular posts in 2017.

Professionally 2016 was a very important year for me as my book Biologically Modified Justice was finally published with Cambridge University Press in June. It will be interesting to see what reaction this book gets from (1) other political theorists (admittedly it is a topic very few theorists are working on, but hopefully that will change!); and (2) scientists working in the fields of genetics and aging.

The ink wasn't even dry on Biologically Modified Justice and I have starting working in earnest on a textbook on genetics and ethics for Polity Press. Unlike the contextual, pluralistic moral analysis developed in Biologically Modified Justice, this new textbook adopts a virtue ethics/epistemological lens. So I have made much more work for myself by adopting a completely different theoretical foundation for this new work. I am hoping to make the final push to complete this textbook over the next 6 months.

I also completed 2 forthcoming book chapters in 2016, one for a volume on Virtue Ethics (my chapter is on virtue epistemology and democracy) and the second for a book on Ethics and the End of Life (my chapters is on justice and life extension).

I also taught a brand new 3rd year undergraduate course at Queen's on "Law and Politics" to 60 undergraduates. The course was a re-designed version of a graduate-level course I originally taught at UCLA when I was a Visiting Professor there in the Dept of Public Policy 3 years ago. This was the first course I taught with chalk and a black board in well over a decade. I really enjoyed it, and am slated to teach it again this coming winter term.

I wish everyone all the best over the holidays, and may 2017 find you in continued good health and high spirits!


Wednesday, November 30, 2016

Genetics and Ethics Textbook (Post #2)

In this new textbook I am writing on genetics and ethics I employ a virtue ethics analysis of the issues. One of the early chapters details the limitations of invoking principles for tackling the social consequences of the genetic revolution (or any practical predicament).

Over the course of the next few posts I will detail 4 principles adopted by moral and political philosophers to reveal the potential problems they face in terms of enhancing our exercise of practical reason, especially if one is tempted (as I certainly was when I started thinking and writing about these issues) to apply these principles to guide our thoughts on the prospect of genetic intervention.

(1) Peter Singer, The Principle of Preventing Bad Occurrences
(2) John Rawls, Two Principles of Justice
(3) Robert Nozick, Principle of self-ownership and the slogan: "Liberty Upsets Patterns"
(4) Precautionary Principle

In this particular post I will limit myself to a brief discussion of Singer's principle.

Singer invoked this principle to raise awareness about the problem of global poverty. But one could see how the principle might be employed to mitigate the vulnerabilities of the genetic revolution. Let us re-hash Singer's principle and the famous child drowning case.

The principle of preventing bad occurrences maintains: If it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral importance, we ought, morally, to do it.

Singer asked us to contemplate a now famous thought experiment to demonstrate the normative force of this duty to aid. The example concerns a child who is drowning in a shallow pond. You are walking past the pond and notice the distressed child in need of assistance. The child is not your child, nor is the child a compatriot. They are a citizen from a distant and far away country. Nevertheless, the child is a human being in need of assistance. If the only burden to be incurred by saving the child is getting one’s shoes and trousers wet then there is, argues Singer, a stringent duty to save the child.

Singer then drew an analogy between the example of the drowning child and global poverty. The rich living in the developed world have a stringent moral obligation, he argued, to donate a significant amount of their income to help those living in poverty in distant lands. Singer’s argument spurred much debate on the demands of global justice, a topic largely ignored by philosophers before Singer’s article. Questions like “Do national boundaries have any ethical significance?” are still debated over forty years after Singer’s original article appeared in print.

But invoking the principle of preventing bad occurrences (or a duty to aid) is not, by itself, very helpful in terms of the practical guidance it provides us with. This is not to suggest that appealing to principles has no legitimate role to play in our moral deliberations. Invoking general rules or principles can help us adopt a “bird’s eye perspective” of the moral landscape. However, I believe there are also significant limitations in relying too heavily on moral principles or rules. Most of the bad things in the world, including global poverty, are infinitely more complex and complicated that the example of helping a drowning child in a shallow pond. How do we ensure the actions we undertake to redress poverty actually help others, rather than just wasting our time and energy or, even worse, making the situation even more dire (as can conceivably happen in the case of providing foreign aid)?

The problem of global poverty is not simply, or even primarily, a problem of the rich not donating money to the poor. But it is hard not to form that impression form Singer’s original article. The central moves in Singer’s moral argument are (1) to invoke the principle of bad occurrences, then (2) to link that principle with the badness of poverty, and then (3) to conclude that the solution to this bad is for the rich to donate more money to foreign aid.

Suppose we ran a similar moral analysis to buttress the case for mitigating the genetic lottery of life. Imagine the child in need of assistance was not drowning in a shallow pond. Instead, the source of the threat of the child drowning was internal to her. The child was born with cystic fibrosis (CF), a genetic disorder which impedes the normal functioning of lungs. Left untreated, a child will in effect “drown from within” as the condition fills the lungs with fluid.

In the 1970s a child with CF had a very low life expectancy at birth. Typically a child did not live more than just a few years. However by the 1990s things had improved. The median age of survival for a child born with CF in Canada was nearly 32 years. And that increased to nearly 50 years by 2012. However, a life expectancy of 50 years is still 30 year less than the average in Canada. Inheriting the genes for CF has a profound impact on the life prospects of a person. Dying from CF, like dying from poverty, is a bad thing we should seek to prevent if possible. So why not make the Singerian moves (1) and a modified version of (2) which focuses on the harms of genetic disease, and then conclude that people should be donating all their resources to creating a gene therapy for CF, until the sacrifice risks something of comparable importance to developing CF?

One of the central limitations of invoking the principle of preventing bad occurrences and applying it to one specific form of badness (be it poverty or CF) is that the world has many bad things about it that need to be addressed. So invoking the principle itself doesn’t help us determine how to prioritize among the plurality of problems (i.e. bad occurrences) we need to address, nor does it bring adequate attention to the realities that different kinds of intervention will be more risky, or costly, or effective than other forms of intervention. I believe a shift to the virtue of benevolence and acting from phronesis (practical wisdom) will help remedy these shortcomings. In the next post I will detail some of the problems facing the adoption of the principles in 2-4 to the topic of genetics.


Friday, September 30, 2016

International Day of Older Persons (2016)

Saturday is the International Day of Older Persons.

The concern for the health and happiness of older persons is something close to both my professional and personal life, so I offer some thoughts on the significance of the this day, invoking the parlance of political philosophy!

My Quick Take on this topic: Justice requires we treat all persons as free and equal citizens, and this duty applies to persons at all stages of the lifespan, including the post-reproductive stage of life.

My Expanded Take: The world has made great (but admittedly uneven) progress in reducing early life mortality. A baby born into the world today has a life expectancy of 71.4 years. This is humanity’s most amazing success story- we have escaped what we can call the “Young World”, a world where most humans died before reaching middle age. Such was the fate of our species for 99.9% of our species’ evolutionary history. Now we have reduced the extrinsic risks of death and disease to a level such that it makes sense to describe the human world as an “Aged Word”. There will be an estimated 2 billion people over the age of 60 by the middle of this century, and life expectancy is projected to rise to age 80 by the end of the century. Our populations are etching closer and closer to the upper limits of the (average) lifespan of approximately 85 years.

This development, while a wonderful success story, also presents enormous challenges for families, health care institutions, basic research on health and the economy. How do we combat the social isolation that many older persons face? How do we fairly manage the caring duties required by aging populations? How should our laws and policies surrounding the end of life be modified? And what can we do to promote healthy aging, so that people can enjoy more health, vitality and independence in late life? I believe these are among the most pressing societal questions facing humanity this century.

So Saturday I am hoping everyone will (1) you reach out to connect with, and express gratitude to, some older persons in their life; and (2) ask yourself what you (and all of us) can do to help make our families, societies and the world a better place for older persons.


Tuesday, July 26, 2016

Genetics and Ethics Textbook (Post #1)

Now with Biologically Modified Justice completely finished, I am turning my attention to writing a new textbook on Genetics and Ethics for Polity Press.

I'm writing this textbook for an interdisciplinary audience, students in both the life sciences and humanities/social sciences (like philosophy). As such I have had to invest a great deal of thought into finding the right balance between how much time to invest on normative/philosophical issues (e.g. what constitutes a morally right action or policy?) vs empirical concerns related to the science (e.g. what role do genes play in the development of disease, health and behavior?).

In order to strike the most optimal (from a pedagogical perspective) balance I have opted for a virtue ethics framework. More specifically, one that seeks to augment (rather than replace) principled accounts of morality (e.g. emphasis on beneficence and autonomy/freedom) by bringing to the fore the "epistemic virtues". So the broad question: "What are we to make of the advances in human genetics?" is to be answered by considering the question: "What would a virtuous agent, who possesses both moral and intellectual virtue (i.e. phronesis), think or do in our circumstances with this knowledge?" Any answer will be highly provisional, as our knowledge is tentative and incomplete. But I do believe the VE lens can yield some very important practical prescriptions (listed below).

In particular I emphasize the virtues of intellectual humility (we are only starting to scratch the surface, and don't know exactly what may be possible in terms of new ways of modulating our biology); adaptability of intellect (evolutionary biology offers new insights into issues like health, longevity and behavior, and new interventions might arise from these insights); and the teaching virtues- understanding how others are likely to respond to these issues (e.g. "don't play god!", "extending the lifespan would be a disaster!", "sex selection will exacerbate patriarchy!", etc.) and being able to fairly, and persuasively, respond to such concerns.

I have 12 months to finish this project, which I feel is a realistic time-frame for a 75 000 word manuscript on a topic I know very well. I will have to undertake new research on genome editing and behavioral genetics to cover the topics I would like to address. That will slow the writing process down a bit on certain parts of the book. But the chapters on past eugenic practices, gene therapy, extending lifespan and sex selection are all topics I know very well and have published on. So I just need to reformulate my thoughts on those topics through the lens of VE and the intellectual virtues.

Here is a list of the (very!) tentative prescriptions I believe a virtuous polity, parent, or person would endorse at this stage of things, given what we currently know about the role genes play in the development of health, disease and behavior:

(1) A virtuous polity ought to supplement the lens of the proximate causal explanation of disease, health and behavior with the lens of the ultimate (or evolutionary) cause of disease, health and behavior. This more expansive understanding of the development of phenotypes will dislodge any intransigent commitment to maintaining the “biological status quo” that arises from evolution through natural selection.
(2) A virtuous polity would see genetic intervention as a possible extension of the duty to aid (beneficence) provided such an intervention proved to be a safe and cost-effective way of preventing or treating morbidity.
(3) Virtuous agents would eschew both genetic determinism and environmental determinism. This has implications for health agencies like the NIH in terms of the scientific research it ought to fund and prioritize, and for parents considering utilizing PGD to influence the traits of their offspring.
(4) A virtuous polity would not necessarily eschew or dismiss eugenics. Instead, it would pursue empirically sound and morally justified aims (e.g. promotion of health) through reasonable and morally justified means that treat all persons as free and equal moral agents.
(5) A virtuous polity would aspire to promote the healthy aging of its population through all possible means (including interventions that extend the lifespan if doing so increased the healthspan). But such measures should be pursued in a responsible manner so that considerations of equity, population size, intergenerational justice and environmental impact are also taken seriously.

I intend the post some substantive entries over the coming year as I make progress on this new manuscript!