Tuesday, October 17, 2006

Genetic Justice Presentation

On Friday I presented my paper "Genetic Justice Must Track Genetic Complexity" to the James Martin Advanced Research Seminar here at Oxford. I am grateful for all the useful feedback I received on the paper and presentation.

Oxford is an ideal place to study genetics and justice as they house both the Program on Ethics and the New Biosciences and the Future of Humanity Institute, in addition to The Ethox Centre (not to mention the Centre for the Study of Social Justice). So there are an impressive number (and caliber) of researchers, from different disciplines, addressing a diverse range of social, legal and ethical issues related to the genetic revolution.

My paper addressed the issue of how we ought to modify the currency of distributive justice to include our genetic potentials for the natural primary goods. This is what I mean by developing a theory of "genetic justice". Of course genetic justice addresses only a subset of concerns that arise in light of the genetic revolution. More specifically, genetic justice addresses the issue of how we should regulate direct genetic interventions (e.g. somatic gene therapies). And I attempt to place the demands of genetic justice against the background of a more general account of societal fairness. In other words, we should not address the issue of genetic justice in an insular fashion, as if the duty to directly mitigate genetic disadvantage was the only demand of justice we need to consider.

My research on genetics and justice has had a profound impact on the way I think political philosophers should approach distributive justice more generally. Namely, they ought to function at the level of "non-ideal" rather than "ideal" theory. The reasons for this are many-fold. Firstly, a fact-sensitive account of justice is more likely to lead us to viable prescriptions that we could implement or pursue in the "here and now" (rather than in some imagined, ideal scenario). Secondly, a fact-sensitive account of justice is less likely to rely on contentious arm-chair theorising that political philosophers cannot adequately defend (nor feel they must defend) when they can simply say "I'm talking about ideal theory...". So functioning at the level of non-ideal theory compels a political philosopher to engage in a self-conscious dialogue (and ideally a real dialogue as well!) with others (e.g. legislatures, courts, healthcare administrators, citizens, etc.) and this can enhance the value of a normative analysis of issues of justice. Functioning at the level of ideal theory is unlikely to have this result as the political philosopher will see issues of feasibility (for example) as a distinct (secondary)problem, not one that has a fundamental bearing on the derivation of the principles of justice themselves. This further widens the gap between theory and practice.

Of course ideal theorists will retort that non-ideal theory also has its problems. I agree. So much more attention needs to be given to these issues. But when we weigh up what we have lost (as a result of the ideal paradigm) I think it is worth taking the risk of moving closer towards the non-ideal theory camp.

My concerns about the methodology of political philosophy are important for addressing the issue of genetics and justice. My central worry is that we will be primarily concerned with having a debate at the level of ideal theory. So, for example, we might assume safe and effective genetic interventions will just land on our laps like manna from the heavens. And then all we need to do is just figure out what the just distribution of such interventions would be (e.g. genetic decent minimum, genetic equality, etc.). Or we might ignore the possibility that the duty to prevent harm to our offspring could potentially conflict with respect for procreative liberty. For example, if the mode of intervention was a prenatal genetic therapy. Or we might ignore the fact that the effort to directly mitigate genetic disadvantage will have an impact of the budgets available for redressing other forms of disadvantage (e.g. poverty, etc.). So if we want a normative theory to be of use to us in the "here and now", we must advance a theory of genetic justice that is suitably fact-sensitive. I have posted a few comments about this in an earlier post.

So to return to the paper I presented on Friday... I argued for two things. Firstly, that a necessary condition of a defensible account of genetic justice is that it must track genetic complexity. Genetic complexity encompasses phenomena such as polygenetic traits, gene-gene interactions and complex environmental influences (Alper, 2002, p. 22). By tracking genetic complexity, the principles of genetic justice will (at least for the foreseeable future) be largely indeterminate. Such indeterminacies should not be regarded as a failure to utilise or properly execute the skills of analytic philosophy. Rather, such indeterminacy simply reflects the realities of the complex nature of both human genetics and the demands of justice in the real, non-ideal world. That is, a world that is characterised by both scarcity and pervasive disadvantage.

Secondly, I argue that pluralistic prioritarianism is a theoretical position well-suited for tracking genetic complexity. Prioritarians maintain that benefiting people matters more the worse off these people are (Parfit, 2000, p. 101). But a defensible version of prioritarian justice needs to be pluralistic in the following two ways. Firstly, it must recognise that diverse forms of disadvantage pervade our societies (e.g. genetic disease, poverty, crime, accidents, etc.) and there are a plurality of ways of redressing disadvantage. Mitigating these diverse disadvantages will come from the same inevitably limited budgets. Secondly, prioritarians must be pluralistic in that they seek to balance their prioritarian commitments with other values, such as utility and freedom. Consideration must be given to the severity and pervasiveness of different forms of disadvantage, the costs of mitigating these different disadvantages, and the likelihood that the benefits of mitigation will be realised.

So what principle of genetic justice can emerge from all of this as a viable and attractive distributive principle? I believe it is what I call the lax genetic difference principle, a principle I defended here. This principle states: "inequalities in the distribution of genes important to the natural primary goods are to be arranged so that they are to the greatest reasonable benefit of the least advantaged". Having a serious debate concerning what constitutes a reasonable and unreasonable benefit to the genetically disadvantaged is the debate I hope we have (rather than an idealized debate). Such a debate would illuminate (rather than ignore or bracket) a number of the difficult issues we face as we attempt to implement a fair distribution of the by-products of the genetic revolution. These issues range from determining how robust genomic intellectual property rights should be to the limits and scope of reproductive freedom. So by tackling the issue of genetics and justice one addresses complex concerns about how we ought to regulate biotechnology, but one also raises interesting methodological questions concerning how we ought to construct normative theories and what such theories are for.