symposium

HUMAN VALUES iy A
TECHINGLOGICAL SOCIETY

Joshua Lederberg Will Herberg Harold P. Green

 

 
Joshua Lederberg

I. Technology as Diabolism

Monctheism, rooted in the Jewish religious tradition, and
its most durable contribution to world culture, may seem
to be irrelevant to a discussion of the human impact of mod-
ern technology. It may also be the most improbable allusion
to expect from a geneticist. Consider, however, that mono-
theism liberated the human thinking from polytheism, or
animism—the interpretation of the world and every process
in it as the work of spirits, demoniacal or beneficent, fabri-
cated essentially in man’s image. Like man also they tend
to caprice and unruliness.

Today we no longer deify the sun, the planets, the
oceans, or the volcanoes. The One God of the Jewish tradi-
tion is inseparable from a universe ruled by law, and the
skeptical strain of Jewish thought has never suffered scien-
tific inquiry to be submerged under a demand for faith as
the only legitimate source of knowledge.

Animism is still a convenient metaphor and shortcut to
detailed analysis. It is convenient, at times, to regard a
computer as if it were a quasi-intelligent being, responding
to instructions and replying to inquiries like a willful child.
The scientist can better design certain experiments if he
visualizes a molecule as a perceptive organism, and thinks
how it can “be aware of” the physical and chemical details
of its local environment. The most literal acceptance of the
Darwinian theory does not hinder the experienced biologist
from speculating about the “purpose” of an organ, as a
shorthand for a description of its evolution under the shap-
ing influence of utility tested by natural selection. These
are nevertheless metaphors, consciously preserved, which
are well known to be able to lead to error, folly, and disaster,
if they are misapplied to outside the range of the appropriate
analogy. We do not allow computers to vote, and we do not
expect man painlessly to improve his genetic makeup by
merely wishing for the good, or needing to achieve it.

If we are not careful, the very theme of this symposium
may lead us into serious moral and logical difficulties if we
animize “technology,” as so many authors have done. Useful
metaphors may be drawn, for example, by hypothesis that
a technological society behaves as if technology were an
autonomous, malevolent force within it, i.e, a devil, but
this is a subject requiring careful definition and investiga-
tion and it is promptly obscured by taking the metaphor for
granted, The hypothesis can be made into a self-evident
axiom, by labelling the collective imperfections of society
as “‘technology’—as Roszak does, when he attributes Play-
boy’s derogation of meaningful sexual relationship to tech-
nocracy. The privilege of defining one’s terms cannot be
denied one’s debating opponent, but such a definition does
not help very much to discover who is a “technologist.”

Among engineers and scientists, technology means the
concrete application of scientific knowledge to problems of
human significance. By extension it also means the organi-

 

Dr. Lederberg is director of the Kennedy Laboratories for
Molecular Medicine, Stanford University, and a recipient
of the Nobel Prize in Medicine (1958). This article is dedi-
cated to the memory of his father, Rabbi Zwi Hirsch Leder-
berg (1903-1969, Jerusalem).

WINTER 1971

zational structure, the body of experience, the operational
hardware, and the people who design and man it, and the
end product. By further extension, technology may also be
taken to mean science itself (knowledge about the natural
world) and the community of scientists. The term tech-
nology conjures images of computers, suspension bridges,
freeways, factories, nylon, jet planes, telephones, nuclear
bombs, auto exhausts, pacemakers, television, penicillin, and
DDT. These are the products that are unique to the tech-
nology of the present century. It should also include the
abundance of our crops for food and fiber, fire, and the
domestication of dogs and horses. It also means cheap paper
back books, and a progressive relief of the burden of labor,
a standard of living whereby youth can spend twenty years
at their education, rather than go to the field or factory at
twelve. It is in fact the whole texture of modern life, based
on the level of industrial production that is possible only
through the systematic application of scientific technology.

There is a great deal wrong with modern life, and our
projections for the future are not more optimistic. The
most cogent symptoms are the misapplication of technol-
ogy. We have still to analyze the sources of that misdirec-
tion, for technology is a tool in the hands of man. This is
neither to deny nor affirm the hypothesis that such a mis-
direction is inevitable, given the power of technology to
amplify discrepancies of wealth and opportunity or the
ideological impact of scientific skepticism on the shaping
of human goals and aspirations. Nor can we give perfect
marks to scientists and technologists for doing all that
they might do to apply their special insights about, as well
as of, science and technology for human welfare.

As a matter of personal honor, I must however protest
the allegation that we live in a “technological society,”
if by that is implied that the major decisions are made
by the consensus of technically and scientifically trained
citizens. Exactly to the contrary! It was the President of
the United States, against the advice and urging of many
physicists, who decided to end the war against Japan in
1945 by dropping the A-bombs on Hiroshima and Naga-
saki (a decision easiest to criticize in hindsight). Indeed
it would be an intolerable arrogation of authority if scien-
tists were to make such decisions against the informed
conclusions of politically responsible leaders in a democ-
racy. In recent months, scientists have been vehement in
their denunciations of the SST and the ABM, and have been
in the forefront of many other campaigns for the restoration
of the quality of the environment. In the Soviet Union, they
are the one irreducible focus of liberal thought, breaching
national barriers to form the only effective world community
functioning today.

HE anti-technologist can, of course, find many texts to
support his condemnations. The architect, Albert Speer, is
much quoted for his remark, “That some day the nations of
the world may be dominated by technology—that nightmare
was very nearly made a reality under Hitler’s authoritarian
system.” But if we look more closely at his meaning, we find
he refers above all to the radio and the telephone, systems
by which a central authority could readily diffuse its com-
mands without requiring the personal presence of the dic-

9

 

 
  
  
  
 

 

tator. In fact, the Hitlerian regime did its utmost (and in
many fields quite succeeded) in eradicating free scientific
inquiry, allowing only that work judged relevant to the
superiority of the German race to flourish. The technicians
to whom Speer refers as blindly following orders are simply
bureaucrats, but this is mainly a pun on technician/tech-
nology, at the same time as it refutes the concept of technoc-
racy, i.e., government by the technical elite. Was Hitler an
example of a pro-scientific ideology, or of the repudiation
of reason?

We could still profitably pursue parallel investigations
that would help us to illuminate the sources of technopathy
(the pathology of science and technology). Consider how
many of the world’s ills are attributable to language or to
law out of control!

Language is of course the instrument of every deception
and manipulation, as well as of man’s utmost achievements.
It is the means of reason and poetry alike, and confines them
both. Should we not offer the same complaints against lan-
guage that we do to technology? We could argue that
language is the fundamental technique of the human species,
which makes all others both possible and inevitable, through
the processes of culture. And could we not make a parallel
argument about law—how it liberates and enslaves man
at the same time?

These analogies have too much substance to be dis-
missed but, even apart from the obscene confusion of tech-
nician and technocrat, a valid indictment emerges not in
spite of, but as a consequence of, the exoneration of “tech-
nology.” Technology, like law and language, is an institu-
tion whose realization depends on a particular community.
Language on the contrary comes closest to being a product
of the whole community, and we share a collective burden
for its advance and misuse; we do not confuse the linguists
who merely study language with the whole culture that in-

Calculating machine invented by Blaise Pascal (1623-1662).

 
  
  

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10

vents and enriches it. Law, at the other extreme, is shaped
by a body of mcn—the legislators, lawyers, and judges, who
are professedly responsible to the culture, for its defects
as well as its virtues. The legal, like other organized pro-
fessions, is also ruled by its own code. This is far from per-
fect. but it still serves as a specific nexus of confrontation
with the culture’s demands and an indispensable protection
to the morale and efficacy of its individual members. A
definite though less tangible standard binds the behavior
of the basic scientists, who are dedicated to the exhibition
of publicly verifiable discoveries. The technologist, how-
ever, sells his services to the highest bidder—producing
whatever design a customer has the means to support. (In
Speer’s case, Mephisto was Hitler as patron of architectural
grandiosity.) He thereby transfers responsibility on to other
shoulders, and, in this particular sense, the technologist (as
distinct from scientist) is a mere technician serving another
master. This elusive irresponsibility of the technologist, in
the face of the enormous amplification of power his work
conveys, may be the ultimate exasperation that enfuels the
aquarian crusade. In one sense, “technology” is too. ill-
defined to be a legitimate target; in a deeper one, this is
precisely the problem, given its undeniable disturbance to
the complacency and placidity of life that we all cherish.
Science is somewhat better organized as a community, but
suffers from the same vacuum of responsibility for the tech-
nical elaboration of discovery.

It has then been suggested that technology, and by ex-
tension science, should be brought under more explicit social
control. The real need may be to liberate it, ie., to bring
the institution of technology under more effective self-
control, in the sense that medicine is, so that it may be col-
lectively more responsible, while entrusting the detail of its
work to the only community able to judge it well, itself.

N the most extreme form, this would paralyze govern-
ment and industry, if we meant that every technically trained
employee in large organizations had the right and respon-
sibility to judge every consequence of his efforts, and to
sabotage whatever he deprecated. Furthermore, it goes be-
yond human reason to know the full outcome of any tech-
nological innovation. Shall we indict Alexander Graham
Bell for the telephone that made Hitlerian totalitarianism
possible? Shall we indict Mueller for DDT? And if so, be-
cause of damage to wildlife or because the control of malaria
accelerated the population explosion? Would fewer lives
have been ground up in war since 1945 had the airplane or
the atomic bomb not been developed? Or more? And what
in future?

There are nevertheless two major forms of socially useful
control that a well organized profession of technologists
would advocate and could enforce.

b. Major technological projects could be subject to dis-
interested review and licensure, to be certain that the in-
tended profits in one area of the economy are not simply
stolen, covertly, from another. This is the much discussed
function of technological assessment—it deals with ques-

DIMENSIONS
 

tions like the true cost of the SST or of electric power, taking
full account of the threatened impairment of the environ-
ment. It can equally well concern the full costs of techno-
logical displacement or monotonization of labor, invasion of
privacy, or any of the other cherished values of life. Almost
all of the tangible grievances against technology can be cov-
ered by the extension of our economic system to take
broader account of the values that make life worthwhile.
It is furthermore within the power of a democratic society
to insist on this—and scientists and technologists are just
beginning to exercise their responsibility for systematic
efforts to press public policy in this direction. The technology
assessment need not all be delegated to a central authority,
which may fall into the perennial ruts of the regulatory agen-
cies, after their first flurry of reform. For example, we
should consider the chartering of pluralistic consumer and
environmentalist organizations to allow them a standing in
court as representatives of large groups with grievances that
cannot be pursued on behalf of any one individual. There is
already considerable momentum today by groups for con-
servation law, and for consumer class actions, to make equit-
able law in the courts. They would be greatly helped, how-
ever, if they had a firmer legal standing to match that of the
corporations and the labor unions. If such groups could re-
cover compensatory and penalty damages, on behalf of their
constituencies, we would see an entrepreneurship directed
to balancing the interests of the consumer and inhabitant, to
balance the entrepreneurship so effectively mobilized for
the producer, distributor, and extractor.

The development: of effective technology assessment
would, furthermore, dilute any need to “control” technologi-
cal innovation at its scientific roots, which is both imprac-
tical and tyrannical in its implications.

 

c. Since technology assessment can only be applied
where the costs can be anticipated. much research is needed
at earlier stages of development to look for unforeseen
troubles, and to develop antidotes. Without implying their
right to specific control of the direction of technological
changes, which is best left as a primary function of govern-
ment support and regulation, and the market economy, tech-
nologists could insist that every project be taxed to support
critical investigations of its consequences. Without the same
kind of expertise that can invent a DDT or high energy fuels,
we would not have known that DDT has deeper ecological
effects than wiping out insect pests, or that LA smog is a
consequence of unburned fuel in auto exhausts (rather than
industrial pollution as would have been supposed by the
naive observer), Technology has generated the environ-
mental crisis, but science has discovered it and is indispens-
able for planning the rational remedies. The closer some of
this countertechnology can be placed in time, place, and
motivation to the original sources of trouble, the more effi-
ciently the latter can be neutralized.

To be sure, there are equally insidious social and eco-
nomic roots to the environmental-technological crisis. and
these may not be redirected without some major readjust-
ments in the distribution of wealth and in our ideology about
the meaning of human life and work. However, political
solutions to these problems will be accelerated if we can
expose and document the social costs of particular technolo-

WINTER 1971

gies, There is nothing in the scientific ethic to oppose the
re-equilibration of values, and a great deal in its technique
to help support it. And the technologists will work even more
happily for consensual goals than for narrower ones. The
trouble is that the consensual judgment does not always co-
incide with the most advanced insight, e.g., on costs and
pleasures of smoking cigarettes, allowing handguns to be
freely available, investing in recreational and strategic de-
fense systems, building freeways and dams, or making wars.
The technologist is then caught in the middle, the most ex-
posed target in the crossfire of social conflict. That the uni-
versity has been the chosen battleground is partly a byprod-
uct of its role as the seat of skeptical inquiry and to a smaller
degree of misconceptions about the potency of academic
opinion on national policy. But this is the game of liberals.
Radicalism sees the university as a place where bewildered
and resentful youths, with unformed ideologies, can most
efficiently be recruited as shock troops of revolution, with
expert assistance from indiscriminate doses of law and order.

s for the process of countertechnological inquiry,
there are many kinds of incentives, taxes, and penalties that
could encourage this kind of harmony, but none of them will
be implemented if the technologists themselves do not re-
spond to a crise-de-conscience in demanding it. At the
very least, professional groups could accredit and rate tech-
nological organizations in accordance with their acceptance
of this responsibility, and government contracting and tax
policy could take account of the ratings. Needless to say,
the federal establishment itself requires the closest atten-
tion: It is idiocy that radiobiological research within the
AEC should have been cut back, as it has been, at a time

This molecular electronic circuit contains as many as 50 elec-
tronic components and is used in Minutemen ballistic missiles.

 

11

 
of increasing commitment to nuclear power development,
and militant, if highly controversial, complaints about the
reliability of standards of public exposure to radiation.

What of the basic scientist, the investigator who seeks “the
truth for its own sake,” though sharing the well-placed con-
fidence that it will fit somehow into the machinery of techno-
logical power?

Modern science was founded as a response to questions
of everyday life—the motions of the stars, the forces of grav-
ity and of magnetism, the continuity and evolution of life,
the composition of familiar matter. It promptly dispelled the
remaining relics of animism, and did a great deal to shatter
faith in revealed religion, insofar as these misguidedly justi-
fied themselves by assertions of a scientific nature. Well into
the nineteenth century, science could be regarded as a liber-
ating or counter-religion, wiping away many naive super-
stitions.

My own education, in the early thirties, was still colored
by this function of science as a general world-outlook; but by
then it was in fact already hopelessly fragmented into innu-
merable specialities in very poor communication with one
another. By then already, a man who wished to understand
nature could function far more efficiently by learning more
of what was already known than attempting to carve new
facts and interpretations out of the unknown. The process
today has reached the point where very few scientific re-
ports, apart from the jargon in which they are phrased, tell
of insights that can have any significance to the layman—he
would have to know more than he cares to about the back-
ground, and the telling of it would already be more informa-
tive, before he can ‘understand why this particular fragment
would interest the specialist.

The contemporary work of science is then hard to justify
in terms of individual man’s “need to know.” Yet the body
of scientific knowledge would be a sterile scholasticism if it
were not constantly challenged and restructured. It still con-
tains many inconsistencies, and merely to resolve them, as
discovered, would already require constant resort to new
tests. No two men can learn quite the same material; except
for rote parroting, learning is already thinking and question-
ing and speculating, and, without the criterion of experi-
mental verification, ‘accumulated learning would again (as
has happened at times in the past) become dry rot. It is for-
tunate then that the thrill of discovery, as much as of learn-
ing, motivates the researcher. We cannot ignore, as well, the
motives of competition for prestige and for material rewards
that help label scientists as part of the human breed.

It is still true that contemporary science, in its fragmen-
tation, tends to become ever more remote from the basic
questions about nature that were its original invigoration.
The effective practice of a particular science requires an
extraordinary narrowness of focus, and rare indeed is the
man whose inherent abilities and whose training leave any
room for broader education and for philosophical and social
wisdom commensurate with the overall impact that science
has on the human condition. This pattern of use of talent
has been too fruitful to warrant being disturbed. but every-
where the need is also seen for another kind of scholar, the
contemporary humanist, who can understand science in its
original terms, without being engulfed by the detail of one
specialty; the man who, to use a now banal phrase, can also
bridge the two cultures. The social need for this kind of inter-
cultural moderator is not matched by any evident niches in

12

the prestige and career structure of the academy, perhaps
because there is no easy way to measure the quality of his
performance, to select the good from the trash, as we pre-
tend to do in the established studies. We may then stumble
along with the help of the fallout from strict science of elder
scholars, though age is at peril confused with wisdom.

This gap does manifest harm to the understanding of
science by scientists themselves, as well as by non-profes-
sionals and in the corridors of political power. Even the
methodology of science is impeded, for we still await a more
rigorous formulation of scientific thinking in order to do
science, scientifically; that is, in a way that would give us
the full use of computer technology. With rare exceptions,
scientists are remarkably naive about the logical foundations
of experiments and verification and imprecise in their lin-
guistics. That is to say, the scientific specialist usually has
rather naive ideas about the process of science in the large,
and is too enmeshed in detail to have a broad philosophical
perspective about it. The challenge has been left to another
discipline (the philosophy of science) which has remained
so isolated from laboratory workers that, for example, few
students majoring in a particular science will have been
exposed to it.

The prestige of the scientific method, while still impugned
in practical politics, is sometimes overrated and too mechan-
ically applied in some social and humanistic studies. There
are many areas whose complexity and inaccessibility to con-
trolled experiment require more than quantitative measure-
ment, especially when the phenomena under study are inher-
ently not reproducible. Other kinds of insight and analysis
may become even more important. Poetic and other intuitive
visions may be especially important in opening whole new
territories to the human intellect, in which scientific verifica-
tion may still then play a measured part. For example, the
revolution in human psychology ignited by Sigmund Freud
was not a product of the kind of research that we would
know how to program in science policy planning. Science
itself is just such a process, and to speak of “a science of
science” may be justifiable only insofar as one would define
politics and history as “science.” The arrogance of occa-
sional claims that the scientific method can be used to prove
some particular value system include the assignment of a
value to the pursuit of science itself has certainly added to
the embarrassment of science as an institution. It has also
been criticized for being “value-free,” but we do not demand
a commitment to values of other instruments. We do demand
this of men.

Is life really so intolerable today as a consequence of
excessive technology? The main consequence of an im-
proved standard of living has been the liberation of the many
from absolute enslavement to their creature needs. We still
have a proletariat, and we still have poverty in the US.,
but it is shrinking rapidly in absolute terms. Science and
technology have, however, quite failed to provide any sense
of the purpose of life, to go along with material affluence,
except for the small elite minority that can find it in the
processes of inquiry and invention. It is only by contrast
with the possible future, not with historical reality, that
technological culture alsa fails by measures of the quality of
life in objective terms.

Faced with the task of clearing the residue of superstitious
rubble through the nineteenth century, science may have
preempted the task of religious reconsiruction. But it can

DIMENSIONS
 

Giant Soviet ICBM shown during celebration of the 50th anniversary of the Bolshevik revolution.

function only as a critic, and then mainly for the internal
consistency of a rebuilt faith. I do not advocate science as
a basis of religious commitment; but with all their faults,
scientists are among the best-fulfilled people I know. There
is at least no inconsistency between the practice of science
and leading the good life. What scientists have rarely suc-
ceeded at is understanding themselves well enough to make
their ethical and religious commitments a worthwhile source
of leadership for many others, and especially among the
young. Many of their pronouncements and self-reports need
insightful translation. What can be left to isolated discovery
by a pioneering generation must somehow be built into the
education of the next one—for it to be the better equipped
to make its own creative inventions.

il... Amelioration of Genetic Defect—A Case Study
in the Application of Biological Technology*

The first part of this essay concerned some general issues
of science and technology and of the general perception of

WINTER 1971

their values. I now turn to some specific examples in genetics,
the area of my own scientific expertise.

Few subjects pose more difficulties for rational discussion.
Genetic research is promoted or chastised for its connec-
tions with such inflammatory themes as racism, the decline
of the species, overpopulation, hidden genocide, religious
debates on abortion and contraception, the plight of the in-
dividual in mass society, and “how many generations of
idiots is enough.”

On the other hand, the ultimate reach of genetics is vast,
and relatively predictable. But the time scale of its imple-
mentation may be decades and centuries. Should we in fact
spend much time worrying about the ethical implications of
the genetic findings of the next century, when we must do
this on the basis of a set of assumptions about the human
condition that will surely change dramatically in every other
way?

According to journalistic accounts, we will shortly be
writing prescriptions for human quality to order. “Do you

“Revised from an article prepared for Riosciences, a publication
of the American Institute of Biological Science.

13
 

want your baby to be eight feet tall, or have four hands?
-—just tell the geneticist, and he will arrange it for you.”
goes this line of advertisement. But the most sophisticated
geneticist today is baffled by challenges like Huntington’s
disease. Will the son of an afflicted father be afflicted later
in life? What can he do to assure that his own children will
not have it?

Perhaps some year soon we will know enough at least to
recognize the genotype before neuronal degeneration has
been irreversibly set in motion. But our failure to be able to
provide significant help today is a humbling reality next to
the effusive, though justifiable predictions about future
accomplishments.

What then of the bold claims for a brave new world of
genetic manipulation? Their substance is grounded on the
recent solution of many fundamental mysteries of genetic
biochemistry. Many of the obstacles to genetic engineering.
apart from the moral and political questions that this may
pose, are technological; which is to say that their solution is
consistent with our basic scientific knowledge of the gene.
But this is as if to say that “merely technical obstacles” pre-
vent building a land bridge from San Francisco to Honolulu.
It is safe to predict that this enterprise will never eventuate,
not merely because it would be a million times more costly
than previous bridges, but rather because other challenges
will compete for the energies and resources. And the pre-
sumed benefits will ke achieved by the routes: The image of
the transpacific bridge will persist as a metaphor, reminding
us of technical achievements in other fields of transportation
and communication and of the political prodigy of the evo-
lution of a specific island from dependency to statehood.

Construction works, like bridges, are open to evaluation
and judgment by common sense widely shared. Biotechnical
projects are more likely to be cloaked in an esoteric jargon
that defeats common sense justification. We may then hear
the most absurd generalizations, like “whatever is technically
feasible tends to get done.”

Anyone who has actualy labored to ‘‘do” anything knows
that the more appropriate slogans are “‘almost nothing ever
gets done, especially if it costs money.” Or “when a need
is generally perceived, articulately formulated, and wisely
analyzed. the technical problems will be surmounted. But
this will happen much sooner if a mass advertising cam-
paign can be built around it.”

HERE then does the scientist fit into such a discus-
sion?

He can fairly jusufy his life and work in terms of funda-
mental knowledge about nature. Studies on the impljanta-
tion of nuclei into cegs of different genotvpes are a reward-
ing approach to learning how genes function and how this
relates to egg development. Were they done for the pur-
ported purpose of learning the technology of cloning in man,
we would then be obliged to set a priority (positive or nega-
tive) on it from the standpoint of the human values that
might justify or repudiate the investment.

Alternatively. the scientist can function as the actual or
effective member of a technological team that will address
itself to the solution of grave problems that encumber human
welfare. Then we must and usually do insist that the prob-

14

lems are real ones and that technical solutions are credible.
What is more often obscured is the need to examine all the
side-effects, to inhibit the premature exploitation of new
cures that may be far worse than the disease, to assure that
as much sophistication goes into looking for the side-effects
as was eagerly purchased for the primary solution.

What then are the problems to which genetic science can
be applied? Some may think of rescuing man from the pros-
pect of nuclear annihilation by recasting the genes for ag-
gression, or acquiescence, that are supposed to predestine
a future of territorial conflict. Even if we postulate for sake
of argument that we knew the genetics of militarism, we
have no way to apply it without solving the political prob-
lem that is the primary difficulty to begin with. If we could
agree upon applying genetic (or any other effective) reme-
dies to global problems in the first place, we probably would
need no recourse to them in the actual event.

The converse argument applies to the glaomier predic-
tions of totalitarian abuse of a genetic technology. The
scenario of Brave New World is well-advertised by now,
and no one doubts that a modern slave state would reinforce
its class stratification by genetic controls. But it could not do
so without having instituted slavery in the first place, for
which the control of the mass media presents much more
immediate dangers than knowledge of DNA. It is indeed
true that I might fear the control of my behavior through
electrical impulses directed into my brain, but (possibly
excepting television) I do not accept the implantation of the
electrodes except at the point of a gun, and this is the
problem. .

So much for the grand designs of genetic engineering.
There remain the very real tragedies of genetic disease. The
societal interest in preventing or ameliorating mental re-
tardation and other forms of congenital malformation is
obvious. (The true cost of lifetime maintenance of a 21-
trisomy approaches a megadollar.) It is also entirely con-
gruent with the needs of the family, and, if we believe in the
nobility of man and the worth of Auman life, also of the
afflicted child as well.

The most effective avenues of preventing genctic disease
include (1) the primary prevention of gene mutations and
(2) the detection and humane containment of the DNA
lesions once introduced into the gene pool. The “natural”
mutation process in man results in the introduction of a
new bit of genetic misinformation once in every ten gametes.
Most of the human cost of this “mutational load” is paid
during early stages of fertilization and pregnancy, where it
makes up a fair part of the total fetal wastage. But about
2 per cent of newborns suffer from a recogaizable discreet
genetic defect. This is just the tip of the iccberg; the herit-
ability of many common diseases suggests that from one-
fourth to one-half of all disease is of genetic origin, for
there are important variations in susceptibility to the frank-
est of environmental insults.

The direct observation of human populations for evidence
of environmental influences on mutation rates is an almost
hopeless task. We have no way of managing the tangle of
known and unknown environmental influences that bear on
different individuals. Nor do we have tractable assays for
the occurrence of new mutations, whose manifestation may
be delayed (by transmission through heterozygotes) for
many generations, or confused with malformations duc to
preexisting mutant genes, or to non-genetic causes.

DIMENSIONS
UR only recourse is the laboratory experiment, with a
convenient mammal, like the mice, and sometimes even
more efficiently with viruses and microorganisms. Even so,
only the most potent mutagens can be identified with mice,
and many uncertainties will remain that cannot be resolved
given possible differences in metabolism and transport, cell
selection, intrinsic sensitivity, and the duration and style of
life of the human versus the experimental species.

Once a mutation has been allowed to occur in a gamete,
and this then participates in fertilization and the production
of a new individual, we face a much more difficult problem
in any effort at genetic hygiene. For now we must deal with
the destinies of human individuals, not merely the chemistry
of an isolated segment of DNA. Our problem, seen in the
large, is compounded by every humanitarian effort to com-
pensate for a genetic defect, insofar as this shelters the
carrier from natural selection. So it must be accepted that
medicine, even prenatal care (which may permit the fragile
fetus to survive), already intrudes on the question “Who
shall live?” the challenge so often thrust at rational discus-
sions of policies that might influence the frequencies of
deleterious genes. It is so difficult to do only good in such
matters that we are best off putting our strongest efforts in
the prevention of mutations, so as to minimize the heavy
moral and other burdens of decision once the gene pool
has been seeded with them.

We still cannot evade an evolutionary legacy of genetic
damage that would remain with us for generations, even if
all new mutation could be stopped by fiat. Our fundamental
resources remain very feeble: In a few cases, we can diag-
nose the heterozygous carriers of recessive mutations, and
the genetic counselor can then advise the prospective parents
of the odds that they will have affected children. Where
voluntary childlessness is unacceptable, it is also sometimes
possible to monitor a pregnancy by sampling cells from the
amniotic fluid. This can then enable the mother to proceed
with confidence, or to request an elective abortion, on the
basis of firm knowledge of the genotype of the fetus. We
can expect a rapid extension of technical facilities for such
diagnosis. At present, they are limited to examination of
the chromosomes and to enzyme assays on cultured cells,
which can diagnose a few dozen rare diseases, with varying
degrees of reliability. We will surely be learning, during the
next décade, how to use much more sophisticated approaches
to the structure of the DNA and RNA of such cells for more
basic diagnostic methods.

Another approach to constructive therapy, which may
mitigate a variety of diseases, is an extension of the existing
uses of specific virus strains. At present, their role in medi-
cine is confined to their use as vaccines. This is a special-
ized example of the modification of cell metabolism by in-
oculated DNA, discovered empirically by Jenner, and still
quite imperfectly understood (our ignorance being con-
cealed by the conceptualizations of clinical virology, which
still fail to explain just how a vaccine works—e.g., to state
just which cells of the vaccinated individual are carrying
the viral genetic information, and in what form.) We can
visualize the engineering of other viruses so that they will
introduce compensatory genetic information, into the appro-
priate somatic cells, to restore functions that are blanked

WINTER 1971

out in a given genetic defect. As with vaccine viruses, this
presumably will Jeave the germ cell DNA unaltered, and
therefore does not attack the defective gene as such. If we
can cope with the disease, should we bother about the gene?
Or may we not leave that problem to another generation?

There has been much to-do about another theoretical
possibility, “‘cloning-a-man,” as might be done by the re-
nucleation of a fertilized egg with a somatic cell nucleus,
from an existing individual. Similar‘ experiments have been
successfully completed with frogs, and are being attempted
with mice. Such experiments with laboratory animals will
surely be very fruitful of basic scientific knowledge if the
technique can be developed. It would also have enormous
value in livestock breeding, just as cloning (propagation by
cuttings) is a mainstay of horticulture. Until such experi-
ments have been pursued in some depth with other animals,
it is merely a speculative game to discuss applying such
reproductive novelties to man. There is no urgent social
problem to be addressed by such a technique. It does serve
as a metaphor to indicate that future generations will have
infinitely more powerful ways than we do to deal with
whatever they may regard are socially urgent issues of hu-
man nature. We can therefore focus, more confidently, on
dealing with the distress of individual human beings in the
immediate generation. The metaphor also suggests that
intrusive genetic engineering, if it is pursued for any other
reason, will have plenty of policy problems to digest even
before the “technology” has reached the point of detailed
synthesis of genotypes by design.

Finally, medical scientists in general are fully aware of
and have fully assimilated ethical concerns about the appli-
cation of new techniques in man, by contrast to experimental
animals. For a long time, it has been known that one could
operate on the brain in such “interesting” ways as dividing
the corpus callosum with the possibility of the development
of autonomous “intellects” in the two hemispheres. It would
be unthinkable to apply such surgical technology to man
without the persuasion and conviction that it would be for
the benefit of the patient-subject. We will not be given the
benefit of the doubt in public discussions of such questions;
there are many influential people who really believe that
“anything feasible will be done,” and we may have to restate
the obvious many times in reviewing the ethical constraints
on possible experimentation. :

To return to the “clone-a-man” metaphor: In my view,
we simply do not know enough about the question, at either
a technical or an ethical level (and these are intertwined),
to dogmatize about whether or not it should ever be done.
Certainly it cannot be thought of, within the framework of
our generally accepted standards of medical ethics, unless
(1) we can make and communicate a reasonably confident
prediction of the outcome and, more important, (2) it has
the informed consent, and serves a reasonable humanitarian
purpose. of and for the individuals who are involved. In
genetic matters, this must include the interests of the pros-
pective newborn, as well as of his parents, and of the com-
munity. If we demand that he be represented in person, then
no one could reasonably be allowed to be born, whether by
“natural” sexual fertilization, by the design of his parents,
or otherwise. The specific question of “cloning-a-man” is
almost the least important one I can think of; the one it
opens up, who must be held to account for the next genera-
tion and how, may,be the most.

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