Introduction
1. Marx (1972). What Marx actually said was: “The philosophers have only interpreted the world, in various ways; the point, however, is to change it.”
2. Russell (2005, p. 91).
3. This I have examined at length elsewhere (see Harris 1985).
1 | Has Humankind a Future?
1. See Harris (1992, 2000a).
2. An extended argument for these assertions was given in Harris (1980).
3. Harris (2001b).
4. Russell (1961, pp. 13–14).
5. The quotations from Russell might be taken as an exercise in citing authorities in support of my position. Never! The only authority is compelling evidence and argument. In citing Russell and indeed Tomasi de Lampedusa I am not appealing to authority but attempting to place myself in a tradition of thought and reflection on the nature and desirability of change, on the balance between conservatism and revolution.
6. Russell (1961, p. 121).
7. Otherwise we are like the ape in the example that follows. Here I am indebted to Nir Eyal for helping me to clarify my ideas.
8. Lampedusa (2005).
9. The Prince of Salina remembers with approval Tancredi’s remark (Lampedusa 2005, p. 28) and later votes for change in the famous plebiscite, and his acceptance of Tancredi’s wisdom is revealed not only by his wistful “if we want things to stay as they are…” but by his acknowledgment that “Tancredi would go far: he’d always thought so” (Lampedusa 2005, p. 28) and also by his priest, Father Pirrone, who, when asked what the “prince of Salina feels about the revolution,” replies “I can tell you that at once and in a few words; he says there’s been no revolution and that all will go on as it did before” (Lampedusa 2005, p. 161).
10. James Hughes has made this point strongly (personal communication, March 15, 2006).
11. Brutus in Shakespeare’s Julius Caesar justifies the murder of Caesar by reasoning that although Caesar is only a potential and not an actual danger, the prevention of the danger is justified: “Fashion it thus; that what he is, augmented / Would run to these and these extremities; / And therefore think him as a serpent’s egg / Which, hatch’d, would, as his kind, grow mischievous, / And kill him in the shell” (act 2, scene 1).
12. See the table “Adult and youth literacy rates,” at http://portal.unesco.org/education/en/ev.php-URL_ID=41637&URL_DO=DO_TOPIC&URL_SECTION=201.html. For a table of data concerning “Estimates and projections,” see www.uis.unesco.org/TEMPLATE/html/Exceltables/education/
View_Table_Literacy_Country_Age15-24.xls; see also http://www2.unesco.org/wef/en-leadup/findings_excluded%202.shtm for a chapter called “Patterns of exclusions: causes and conditions,” from “Education for all and children who are excluded,” by Anne Bernard, coordinated by the United Nations Children’s Fund. The main site for the World Education Forum is http://www2.unesco.org/wef/en-leadup/findings.shtm. (All sites were accessed on May 30, 2005.)
13. In 2003 a paper published by a group from University College London (Maguire et al. 2003) showed that the volume of gray matter in the posterior hippocampus of London taxi drivers increases due to the navigational expertise and knowledge that they acquire through their jobs.
14. Dawkins (2004, pp. 23–31).
15. See, for example, Fukuyama (2002), Sandel (2004), and Annas’s “Genism, racism and the prospect of genetic genocide” (www.thehumanfuture.org/commentaries/annas_genism.html; accessed August 11, 2006; link now discontinued; updated version available at www.thehumanfuture.org/commentaries).
16. Harris (1992).
17. Much, of course, remains impossible.
18. Russell (2005, p. 1).
2 | Enhancement Is a Moral Duty
1. I first used this analogy at a public meeting in Cheltenham Town Hall on November 18, 2005. Steven Rose (2006) has recently used the same idea in his “Brain gain?”.
2. Boorse (1981).
3. Daniels (1996, p. 185).
4. Rather than to make an excuse for the order he was continuing to disobey (or perhaps to claim priority in the debate about enhancement!).
5. Rose (2006, p. 74).
6. For some verses (if not chapters) see the collection of quotations, allegedly from those “Calling for Bans on Species Altering Technologies” assembled at http://www.genetics-and-society.org/overview/quotes/opponents.html (accessed August 11, 2006). I am grateful to Dr. Sarah Chan for pointing this out to me and for the source of Annas’s other excursions into this debate.
7. See Baltimore (2003) for a conference presentation and his “Engineering immunity: a proposal,” at www.fastercures.org/printable.php?page_name=essay_baltimore (accessed March 1, 2006).
8. Fukuyama (2002, p. 160).
9. Ibid., p. 101.
10. Ibid., p. 149.
11. Glover (2006).
12. I am indebted to Nir Eyal for this suggestion.
13. “Genism, racism and the prospect of genetic genocide” (for details see chapter 1, note 15).
14. Ibid.
15. Indeed, elsewhere, Annas, along with Lori B. Andrews and Rosario M. Isasi, calls for an international treaty to ban the use of such technologies (see Annas et al. 2002). For the record I have dealt with Annas-style objections to cloning elsewhere (see Harris 2004a).
16. See Harris (2004, p. 50).
17. Personal communication, March 25, 2007.
18. See Harris (1980, p. 50). I say there and still maintain that “I think the conclusion to be drawn is that ‘intention,’ which lends itself to such sophistical arguments, is not much help in determining moral responsibility or in distinguishing the moral quality of different actions with the same consequences. It looks as though intention can be so narrowly defined as to yield any moral answer that is wanted.”
19. I pointed this out in Harris (1980).
20. For more on double effect see Harris (2000b).
21. Jones et al. (2005).
22. Rose (2006).
23. See, for example, Savulescu et al. (2004).
24. I believe this despite many powerful arguments to the contrary. For more on the moral permissibility and impermissibility of advantage in education see Swift (2003, 2004a,b) and Brighouse (1998, 2000a,b, 2002, 2005). For a critique of Brighouse’s arguments see Foster (2002) and Tooley (2003).
25. Statistics from Eurotransplant seem to suggest that waiting lists do still exist in Belgium and Austria (Eurotransplant does not extend to Spain), although they may be greatly reduced.
26. The resulting loss of life is of course due to a number of factors including the shortage of donor organs, lack of dialysis facilities and material resources, etc.
27. See Harris (1980).
28. For one example of the necessity or at least desirability of such a system see Erin and Harris (1994).
29. Resource allocation is something I have worked on in the past, and further work will result in a book entitled The Safety of the People (forthcoming). For further thoughts on these issues see Harris (1987, 1996, 1999) and Erin and Harris (1994).
30. Porter (1999).
31. See Bodnar et al. (1998) and also Weinrich et al. (1997) and McBrearty et al. (1998). For a comprehensive roundup of related work see de Grey (2004b).
32. See Harris (2000c, 2002, 2004b).
33. Søren Holm and I discussed this principle in Harris and Holm (2002), and I draw on this reference where we detail the problems to which I refer in this section.
34. UNESCO Press Release no. 97-29; see also UNESCO “Universal Declaration on the human genome and human rights,” December 3, 1997.
35. While some maintain that human evolution of the Darwinian sort is at an end because most humans now survive long enough to reproduce, this view overlooks the role of parasites in evolution. It also of course ignores our deliberate interventions in the evolutionary process.
36. Cornford (1908).
37. Harris (1985, p. 38).
38. Hobbes (1960, p. 82). Julian Savulescu and I made similar points in our paper “The creation lottery: final lessons from natural reproduction: why those who accept natural reproduction should accept cloning and other Frankenstein reproductive technologies” (Savulescu and Harris 2004).
3 | What Enhancements Are and Why They Matter
1. Literally to “raise up.” As I use the term it means anything that, nondetrimentally, raises the powers or capacities of humans. See The Shorter Oxford English Dictionary, revised and edited by T. E. Onions, 3rd edn (Oxford University Press, 1965).
2. Harris (1992).
3. Daniels (2007).
4. Buchanan et al. (2000, chapter 3).
5. See Harris (1992, chapters 7–9).
6. I am indebted to Nir Eyal for his comments here.
7. Although of course, since they would, being my children, have had a sense of humor, they wouldn’t have been laughing.
8. UNESCO Press Release no. 97-29; see also UNESCO “Universal Declaration on the human genome and human rights,” December 3, 1997.
9. Daniels (2007; see below).
10. Ibid.
11. Harris (1992); I quote from chapter 9.
12. Ibid., pp. 201–2.
13. Boorse (1981).
14. Daniels (1996, p. 185).
15. Harris (2001b).
16. See chapter 4. This remark was made by Tom Kirkwood (see Harris 2000c, 2004c).
17. Daniels (2000, p. 313).
18. Buchanan et al. (2000, p. 71).
19. See Dworkin (1981a,b), both reprinted in Dworkin’s Sovereign Virtue, pp. 11–120 (Harvard University Press, 2000), and Scanlon (1989).
20. Buchanan et al. (2000, p. 74).
21. Ibid., p. 73.
22. Harris (1980, 1985).
23. Buchanan et al. (2000, p. 74).
24. This way of defining health and illness is derived from Boorse (1981) but is used also by Daniels (1996, p. 185), and many others.
25. Buchanan et al. (2000, p. 75).
26. The obsession with equal opportunities exemplified by these and other writers on health seems to be an unhealthy legacy of Rawls and the prestige of theories of (or even theories mentioning) justice. Justice is of course part of ethics but some write and appear to think that it is all of ethics.
27. “The office of the sovereign, be it a monarch or an assembly, consisteth in the end for which he was trusted with the sovereign power, namely the procuration of the safety of the people; to which he is obliged by the law of nature” (Hobbes 1960).
28. Daniels (2007).
29. Harris (1999a, 2005c).
30. See World Medical Association (1964), with the note of clarification of paragraph 29 added by the WMA General Assembly, Washington, 2002.
31. See chapter 11, below.
32. This is the view of Aubrey de Grey (personal communication, March 21, 2005). See also de Grey (2004a), in which he speculated that “the first 1,000-year-old is probably only 5–10 years younger than the first 150-year-old.”
33. To those to whom it is acceptable.
34. I discuss these issues in the next chapter but also in Harris (2000d) and the similarly titled but fuller treatment (Harris 2002a).
35. This is indeed how I would characterize it.
36. Some indications as to how I would address these issues are to be found, inter alia, in Harris (1980, 2005d) and Harris and Sulston (2004).
37. See footnote 1 of Daniels (2007).
38. Daniels (2007).
39. Perhaps so that enhancements are easier targets for puerile objections?
4 | Immortality
1. This chapter draws on Harris (2000d, 2004b).
2. Adams (1982, p. 9). For the record, the immortal’s name was “Wowbagger.”
3. And we should note that Wowbagger himself did find something meaningful to do through all eternity.
4. See, for example, Weiss (1985).
5. I am grateful to Simon Woods for insights into the undead.
6. See, for example, Slevin et al. (1990).
7. I have benefited from the incisive comments of my colleague Søren Holm.
8. Bodnar et al. (1998), Weinrich et al. (1997).
9. McBrearty et al. (1998).
10. See Thomson et al. (1998), Pedersen (1999), Mooney and Mikos (1999).
11. Lanza et al. (1999a,b).
12. These possibilities were rehearsed in the BBC TV Horizon program “Life and Death in the 21st Century,” broadcast in January 2000.
13. For a detailed defense of this idea see Harris (1985).
14. This claim is defended in detail in Harris (1980, 1985).
15. I use the terms “immortals” and “mortals” as shorthand for those who do and do not benefit from significantly increased life expectancy; see also Silver (1998).
16. See J. Carvel “North–south life expectancy gap grows wider,” Guardian Unlimited, October 16, 2004 (available at www.guardian.co.uk/northsouth/article/0,2763,1328652,00.html; accessed March 12, 2006).
17. According to the U.S. Census Bureau’s International Database, quoted at http://geography.about.com/library/weekly/aa042000b.htm, accessed March 12, 2006.
18. Harris (2002a).
19. See Jonas (1992), Glannon (2002).
20. Kass (2001).
21. Ibid.
22. This, incidentally, is a problem for all accounts of disability that see persons with disabilities as simply “differently abled” (see Harris 2000a).
23. Glannon (2002).
24. Personal communication, April 8, 2000; see also Austad (1997). Austad has also calculated that at this constant death rate about one person in a thousand would live to be 10,000 years old, which is pretty close to the rate at which people live to be 100 years old today. There may be problems with these calculations, however. Søren Holm has pointed out to me that eleven- or twelve-year-olds may not be at the normal risk for accidents, being somewhat protected by their parents and unlikely to be drivers of motor vehicles. These calculations are also almost certainly only good for high-income countries.
25. S. Austad. Personal communication, October 2006.
26. There is an enormous literature on this; see, for example, Harris (1987, 1997b) and McKie et al. (1998, p. 151).
27. See Harris (1998, pp. 5–37; 1999d, pp. 61–95).
28. I deliberately choose the term “generational cleansing” for its obvious unpalatable connotations.
29. Christine Overall, in her recent book (Overall 2005), has found it difficult to be sure of my attitude toward “generational cleansing.” For the record, I think it would be unjustifiable and therefore it is difficult to see how we could resist death-postponing therapies.
30. Personal communication, April 1, 2004; the calculations are his.
31. Douglas Adams used a similar argument to show that the cost of traveling in time to eat at “the restaurant at the end of the universe” would bring the price of eating at the most expensive restaurant of all time easily within reach of the most humble budget: “All you have to do is deposit one penny in a savings account in your own era, and when you arrive at the End of Time the operation of compound interest means that the fabulous cost of your meal has been paid for” (see Adams 1980, p. 81).
5 | Reproductive Choice and the Democratic Presumption
1. I am assuming, but not arguing for, the idea that only liberal democracies are worthy of the name and that, as I do suggest here at some length, the tyranny of the majority, which some call majoritarian rule, is not democratic or in any sense worth admiring or fighting for.
2. Mill (1962).
3. Feinberg (1984, pp. 9–11).
4. Dworkin (1977, p. 267).
5. Dworkin (1993).
6. Savulescu (2002a).
7. See Harris (1998, pp. 5–37; 2003a, 2005a).
8. Pedain (2005).
9. See Dworkin (1977, note 31, p. 60).
10. For an eloquent argument for the extension of basic rights in new circumstances see State of Washington et al., Petitioners, v Harold Glucksberg et al. Respondents, 117 Sup. Ct. 2258, 138 L.Ed.2d 772 (1997); Dennis C. Vacco, Attorney General of New York, et al., Petitioners, v Timothy E. Quill, et al., Respondents, 117 Sup. Ct. 2293, 138 Nos 5-1858, 96-110 (December 10, 1996). Brief for Ronald Dworkin, Thomas Nagel, Robert Nozic, John Rawls, Thomas Scanlon, and Judith Jarvis Thomson as Amici Curiae in support of respondents.
11. Dworkin (1996, pp. 237–38).
12. Dworkin has produced an elegant account of the way the price we should be willing to pay for freedom may or may not be traded off against the costs; see Dworkin (1977, chapter 10; 1985, chapter 17).
13. See (Dworkin 1996, note 30, pp. 166–67).
14. See Harris (1992, pp. 177ff).
15. See, for example, Harris (1980), Glover (1977), and Rachels (1975, 1979).
16. Despite the best efforts of many, including Frances Kamm (see Kamm 1983, 1992).
17. While it is true that the doctrine of acts and omissions need not say that every harm-doing is worse than similar harm-allowing, it is enough that some harm-doing is worse than similar harm-allowing simply because it involves an act rather than an omission. I have seen no persuasive such examples.
18. Here the argument follows lines set out in Harris (2006).
19. Indeed, doctors at Falkirk and District Royal Infirmary were recently much criticized for so doing (see http://news.bbc.co.uk/hi/english/uk/scotland/newsid_625000/625680.stm).
20. I argued against the relevance of the moral distinction between acts and omissions in Harris (1980). This irrelevance has belatedly been recognized by the highest court in the United Kingdom (see Lord Mustill’s judgment in Airedale NHS Trust v Bland [1993] 1 All England Rep. 821 H.L.).
21. Of course, I am not here endorsing the spurious and thoroughly discredited claims that MMR is linked to autism. But there are remote and very slight risks attached to all medical interventions, including the very safe MMR vaccine.
22. These ideas are further elaborated in Harris and Keywood (2001).
23. Clarke and Flinter (1996).
24. In the recent case of Re C (HIV test) [1999] 2 FLR 1004, it is noteworthy that the High Court did not consider the child’s autonomy interests as part of its determination of baby C’s best interests. Compelling C’s parents to have the child tested for HIV undoubtedly removes the possibility of C deciding at a later date whether to have the test or not, an argument which C’s mother put to the court and which was regarded as a “hopeless programme for the baby’s protection.”
25. There are also arguments which assert and defend a right or entitlement to reproductive liberty to the same effect (Harris 1999d, pp. 61–95; Robertson 1994).
26. Laurie (1999, p. 122).
6 | Disability and Super-Ability
1. This is not of course to say anything about the degree of plausibility.
2. I am of course aware that there are many issues of political correctness concerning the use of terms like “disabled” or “impaired.” While I try to use language that in no way could be considered offensive to any group or individual (indeed I was one of the first writers to randomize the gender of the personal pronoun in my work), I am not persuaded that normal use of English idioms in the present context is in any way prejudicial. I therefore continue, for the sake of variety, to move freely between expressions like “people with disabilities” and “the disabled.”
3. See also Harris and Sulston (2004).
4. Compare the following questions. Is it wrong to prefer to be a woman? Is it wrong to prefer to be a Jew? Is it wrong to prefer to be black?
5. Or for that matter, to wish it for oneself or one’s friends?
6. I discussed this phenomenon in, inter alia, Harris (2000a); see also Spriggs (2002) and Savulescu (2002a).
7. This is of course Derek Parfit’s “nonidentity problem” (see Parfit 1984, part 4, especially pp. 358ff). I discuss this problem in the context of disability in Harris (1992, chapter 3). See also Parfit (1976).
8. This is because insertion of two or three embryos maximizes the chances of one successful pregnancy and hence one live birth, and inserting no more than two minimizes the chances of multiple pregnancy which might decrease the chances of getting even one live birth or increase the chances of complications for the mother or the resulting children.
9. It is just this point about the moral importance of the embryo about which those who accept and those who reject abortion disagree.
10. Harris (1992, chapter 4; 1993).
11. See note 10.
12. I have noted this already in discussing enhancements in previous chapters but another example won’t hurt.
13. Glover (2006).
14. Ibid., p. 25.
15. And hence have no reason to forbear the exercise of any right to reproduce.
16. See Harris (1998, pp. 5–38).
17. Harris (1992).
18. When I talk of valuing individuals in an existential sense, valuing an individual “as a person,” I am talking of the dimension of the individual which entitles them to equal concern, respect, and protection, which speaks to the issue of their dignity and standing as citizens with equal moral and political claims. I have analyzed this notion at some length in Harris (1995, chapter 1).
19. Davis (1988, p. 150). See also Davis (1994) and Harris (1994).
20. See Harris (1985, chapter 1; 1994).
21. I developed the parallel between attempting to eradicate disability and ordinary medical care in, inter alia, Harris (1993).
22. See note 23, below.
23. There is Judith Thomson’s famous article (Thomson 1971) but it is unpersuasive on the subject of self-defense because it does not adequately show why the fetus is not entitled to defend itself (and hence be defended by others) as vigorously as the mother.
24. Unattractive particularly to women, though of course not indefensible on that ground alone. There are other grounds for rejecting it, however. See Harris (1985, chapter 1; 1999b; 2002d).
25. Locke (1964, book II, chapter 27).
26. And I have given one such account on a number of occasions (see Harris 1985, 1992).
27. I personally find the views of anyone who would sacrifice the life of a mother to save the life of a fetus simply repugnant and more so when the fetus will be unlikely to survive to term let alone long after birth. However, I would never consider denying such a person the right to express such views.
28. A rather different point often confused with the alternative formulation.
29. The damage must of course leave me with sufficient brain function for self-consciousness.
30. And even animals for that matter.
31. Although of course even embarrassments of this magnitude do not of themselves demonstrate the error of a position to which they attach.
32. I use Jonathan Glover’s phrase “ugly attitudes” (see below).
33. Glover (2006, pp. 29ff).
34. Ibid., p. 35.
35. See Koch (2001) and Edwards (2001).
36. Koch (2001, p. 372).
37. Edwards (2001).
38. Cited in Albert (2001).
39. Koch (2001, p. 374).
40. See Harris (1992, pp. 179ff).
41. The counterfactuals here are very problematic. Suppose Hitler had never been born—would that have necessarily meant that the world would have been saved from the Holocaust?
42. See Harris (1985, 1999b).
43. I ignore problems about the scope of the personal pronoun here because, insofar as they are problems, they support my argument.
7 | Perfection and the Blue Guitar
1. In writing this chapter I have been helped by conversations with Dr. Daniela Cutas and Dr. Katrien Devolder.
2. Sandel (2004).
3. Confucius, born in 551 B.C. in the state of Lu, now Shantung, in eastern China had much to say about the role of medicine in the world (see Tsai 2005; Lee 1994). His near(-ish) contemporary Hippocrates (born on Kos in 460 B.C.) is famous for considering related themes. 551 B.C. to 451 B.C. was a good hundred years for bioethics (see also Eliot 1909–1914).
4. W. S. Gilbert, The Gondoliers, act 2 (see Gilbert 1956, p. 543). Andy Warhol’s often misquoted (including by himself) “In the future everyone will be famous for 15 minutes” expresses a related sentiment. The expression is, according to Wikipedia, a paraphrase of Andy Warhol’s statement in 1968 that “In the future, everyone will be world-famous for 15 minutes.” In 1979, Warhol reiterated his claim: “…my prediction from the sixties finally came true: [i]n the future everyone will be famous for fifteen minutes” (see http://en.wikipedia.org/wiki/15_minutes_of_fame#_note-o#_note-o; accessed December 19, 2006).
5. Ignoring one of the most coherent and compelling formulations of the precautionary principle “when you’re in a hole, stop digging.”
6. “And I looked, and behold a pale horse: and his name that sat on him was Death, and Hell followed with him. And power was given unto them over the fourth part of the earth, to kill with sword, and with hunger, and with death, and with the beasts of the earth” (Revelation 6:8, not Keith Reid 1967).
7. A discussion of “closure” in another usage is consigned to the devotees of psychobabble.
8. Those familiar with Uriah Heep will find it difficult to be over fond of humility.
9. In times past cricket might have been an exception, with the likes of two famous exponents of the sport: Colin Cowdrey, not noticeably fit, and Dennis Compton, not noticeably hard working.
10. The phrase “effortless superiority,” which students of Balliol College, Oxford, like to associate with themselves, is usually attributed to Herbert Asquith, who apparently referred to Balliol men (they were only men in those days) as having “the tranquil consciousness of effortless superiority” (see Jones 2005, chapter 16). Anthony Kenny, a recent Master of Balliol, confided to me that unfortunately the undergraduates in his time “found the effortlessness much easier than the superiority.” A further, if anecdotal, reminder that even those apparently endowed with the “gift” of a Balliol education cannot altogether dispense with effort.
11. A much quoted proverb but I have been unable to find an authentic source.
12. Sandel (2004).
13. Ibid.
14. “‘When I use a word,’ Humpty Dumpty said, in a rather scornful tone, ‘it means just what I choose it to mean, neither more nor less’ ” (Carroll 1940, p. 196).
15. See Harris (2005a).
16. I have written about this in many places. See Harris (1980, 1992).
17. Adams (1980).
18. Ibid., chapter 5, p. 28.
19. Which might include being eaten alive by the Ravenous Bugblatter Beast of Traal (see Adams 1979, p. 45).
20. See Harris (1980).
21. See Cohen (1989, 2000) and Temkin (1993, 2003, 2004).
22. I am indebted to Nir Eyal for this point.
23. Carroll (1940, p. 196).
8 | Good and Bad Uses of Technology: Leon Kass and Jürgen Habermas
1. Glover (2006, pp. 83–85).
2. See Kass (2003). This paper reflects views Kass presented to The United States President’s Council on Bioethics in January 2003 (see http://bioethicsprint.bioethics.gov/background/kasspaper.html).
3. Kass (2003, p. 13).
4. Ibid., p. 16.
5. Harris (2004a).
6. Ibid., chapter II.
7. Kass (2003, pp. 18–19).
8. I do not of course endorse the so-called “test of time,” which has given us millennia of despotism, racism, and sexism, not to mention other cultural and religious prejudices against strangers, apostates, and heretics.
9. Boorse (1981).
10. Daniels (2007).
11. I have defended postmenopausal mums from such attacks elsewhere (see Harris 1998, pp. 5–37).
12. Holm (1998).
13. Kass (1997, p. 23).
14. Harris (2004a, chapter 3).
15. Tolstoy (1945, p. 13).
16. Kass (2003, p. 17).
17. Kass (1997).
18. Harris (2004a, chapter 2).
19. See Kass (1997, pp. 17–26). The obvious erudition of his writing leads to expectations that he might have found feelings prompted by more promising parts of his anatomy with which to entertain us.
20. Reliable as sources for the story, not of course for the veridical nature of the story.
21. The Bible is I believe silent on the question of how Eve lost the extra Y chromosome.
22. Dolly was the first mammalian clone (Wilmut et al. 1997; see also text below). Dolly-style clones do not share the mitochondrial DNA which exists in the egg prior to fertilization of nuclear substitution, unless of course the cell nucleus from a woman’s adult cell is used to clone with her own egg.
23. In a letter to Humphrey House, April 11, 1940 (Orwell 1970, p. 583). See my more detailed discussion of the problems with this type of reasoning in Harris (1992, chapter 2).
24. Kass (2003, p. 19).
25. Ibid., p. 20.
26. My evidence for this is anecdotal.
27. Ibid., p. 23.
28. Actually, like Kass, and unlike the Balliol man I am, I quite enjoy and appreciate the effort. But that is not to say that it is appropriate to impose these personal and perhaps eccentric preferences on those who believe in the ethic of “laborsaving” devices that made America great.
29. For those who can afford an oceangoing sailboat and think they can manage without a chronometer or satellite navigation.
30. Ibid., p. 26.
31. Ibid., p. 27.
32. Or at least no loss.
33. Glover (1984, chapters 7 and 8).
34. Stoppard (1972, act 1, p. 24).
35. Kass (2003, p. 28).
36. Habermas (2003).
37. Habermas does not reference this quotation and I have been unable to find it in English.
38. Ibid., p. 48.
39. Ibid., p. 66.
40. Ibid., p. 62.
41. Ibid., p. 63.
42. Ibid., p. 67.
43. Ibid., p. 66.
44. I was told this story by that student, but whether he in turn was told the story by a man who danced with a girl who danced with the Prince of Wales I cannot be sure.
45. Ibid., pp. 75ff.
46. Ibid., p. 82.
47. With deference to Ludwig Wittgenstein (1966, paragraph 6.45).
48. Habermas (2003, p. 86).
49. I have argued for the truth of this claim in exhaustive detail elsewhere; see Harris (1980).
9 | Designer Children
1. An example suggested to me by Jonathan Glover (personal communication).
2. For some answers to this question which are at odds with what is said in this book see Scott (2006), Sandel (2002), and The President’s Council on Bioethics Report on Enhancement (available at www.bioethics.gov/topics/beyond_index.html).
3. I have examined these questions at length on a previous occasion (see Harris 1992, pp. 158ff).
4. I am here indebted to Nir Eyal (personal communication).
5. See Giordano (2007).
6. See Harris (1998, pp. 5–37).
7. Figures for the United Kingdom in 2004 indicate 1,255,000 more women than men. Statistics from the website of the Equal Opportunities Commission (www.eoc.org.uk/Default.aspx?page=14895).
8. See Human Fertilisation and Embryology Authority (2003).
9. Parts of the discussion that follows were published in Harris (2005b,d). See also the response by Baldwin (2005).
10. D. W. Harding, “Regulated hatred: an aspect of the work of Jane Austen,” Scrutiny (1940). The version I have used appears in Lodge (1972, p. 262).
11. “He led his regiment from behind— / he found it less exciting. / But when away his regiment ran, / his place was at the fore, O…” W. S. Gilbert (1956, p. 510), The Gondoliers.
12. Almost certainly different children but not necessarily so.
13. The Human Fertilisation and Embryology Act 1990 (Clause 13.5) states: “A woman shall not be provided with treatment services unless account has been taken of the welfare of the child who may be born as a result of the treatment (including the need of that child for a father), and of any other child who may be affected by the birth.” As it happens I think both procedures would maximize child welfare. I simply doubt the HFEA would agree.
14. I have argued this point at length elsewhere; see Harris (2000c) and Burley and Harris (1999).
15. I owe this characterization of the nonidentity arguments to Julian Savulescu, but from the horse’s mouth you will find it in Parfit (1984, chapter 16). See also Burley and Harris (1999).
16. Baldwin (2005).
17. Habermas (2003); see also the discussion of Habermas in the previous chapter.
18. Parts of this section were published in the “Podium” column, The Independent (London), November 27, 2003, p. 19.
19. Nir Eyal, in his referee report, helped me clarify this point.
20. See Harris (1998, pp. 5–37).
10 | The Irredeemable Paradox of the Embryo
1. This chapter owes much to the work of Katrien Devolder and to the insightful comments of Nir Eyalin in his referee report.
2. See Devolder (2006). Some references to those who have suggested alternative human embryonic stem (hES) cell sources are Hurlbut (2005), Landry and Zucker (2004), Liao (2005), and President’s Council on Bioethics (2005).
3. See Aristotle’s De Anima (book II, no. 1) and Metaphysics (book VII, no. 10) in Barnes (1984).
4. For more on this ambiguity see Harris (1983, p. 132; 1997a, 1999b), and Burley and Harris (1999). Recently Dan Brock has also discussed these issues (see Brock 2006).
5. See Harris (1998, pp. 5–37) and the “Introduction” in Harris (2004a).
6. For elaboration of my view of the problematic nature of attributing moral significance to early embryos see Harris (1985, 2003d).
7. See the section on “rights.”
8. I discuss the distinction between harming and wronging in Harris (1992, chapter IV).
9. See Cohen (1995, p. 68) (this originally appeared in Cohen (1986, p. 109)) and see also Steiner (1994). On rights theories generally, see Sumner (1987), Waldron (1988, chapter 3), Steiner (1994), and Dworkin (1977; 1993, pp. 210–16).
10. See Raz (1986, p. 166). A related conception in terms of welfare rather than well-being is offered by Sumner (1987, p. 47).
11. See The European Court of Human Rights judgment [Case of Vo v. France (application no. 53924/00) Strasbourg, July 8, 2004], and, most recently, [Evans v. the United Kingdom (application no. 6339/05) Judgment, Strasbourg, March 7, 2006].
12. Adapted from Harris and Holm (2003b, p. 112–36). I thank Søren Holm for permission to adapt these jointly authored ideas and present them here.
13. Devolder and Ward (2007).
14. This has been the subject of the debate between Don Marquis, Julian Savulescu, and others; see Marquis (1989; 2005, p. 119) and Savulescu (2002b).
15. Finnis (1995a,b).
16. Ibid.
17. Harris (1999b).
18. See Takahashi and Yamanaka (2006), Nayernia et al. (2006), Niwa et al. (2005), and Sheng et al. (2003). See also Devolder and Ward (2007). I am indebted to Katrien Devolder for much of the argument of this paragraph (Devolder and Harris 2007).
19. Li et al. (2005a,b); Nagy et al. (1993).
20. Gerami-Naini et al. (2004).
21. Devolder and Ward (2007).
22. Julian Savulescu has advanced this argument (see Savulescu 2002b).
23. Personal communication, January 23, 2007.
24. “Every year an estimated 7.9 million children—6 percent of total births worldwide—are born with a serious birth defect of genetic or partially genetic origin. Additional hundreds of thousands more are born with serious birth defects of post-conception origin, including maternal exposure to environmental agents (teratogens) such as alcohol, rubella, syphilis and iodine deficiency that can harm a developing fetus” (Christianson et al. 2006).
25. In a conversation that, like most human conversations, was memorable for its content and not for time, place, and date on which it took place.
26. See Boklage (1990) and also Leridon (1977).
27. See note 25.
28. See Green (2001, n. 185). A figure of 70% total embryo loss is confirmed by Macklon et al (2002). Edmonds et al. (1982) give a figure of 61.9% loss before twelve weeks, but since this figure does not include embryo loss before implantation or from miscarriage after twelve weeks, the figure of 80% estimated by Winston may not be an unreasonable estimate. See also Hertig and Rock (1973), Adams et al. (1956), Roberts and Lowe (1975), Bovens (2006), and commentary in the New York Times (www.nytimes.com/2006/06/13/health/13rhyt.html?adxnnl=1&adxnnlx=1150199902-j6JDYWmEDy8XogdLASAmNg; accessed July 1, 2006; available via free subscription).
29. While most of those who oppose embryo research oppose abortion in some circumstances (with many exceptions for pregnancies that are a result of rape), many do not also oppose these methods of contraception.
30. Marquis (2005, p. 119). For a thorough account of the debate between Savulescu and Marquis, see Kuflik (2007).
31. See Savulescu and Harris (2004a,b) and Harris (2004c).
32. Harris (2004a, p. 137); I have slightly changed the quotation from On Cloning to sharpen its relevance for the present argument.
33. I have argued some of these points in Harris (2002b, 2003d).
34. Not any means of course, but at least one possible means.
35. For further arguments relevant to these issues see Savulescu (2004), Harris (2004c), and Savulescu and Harris (2004a).
36. Maurizio Mori gives the following account (in a personal communication) of the origin of the expression “the embryo, one of us.” “The story is the following: it was used by Prof. Francesco D’Agostino, Chair of the Italian National Ethics Committee, when he presented the result of the Report of the Italian National Committee for Bioethics to the media in 1996. He said more precisely that the Committee had stated ‘the human embryo is to be treated as one of us.’ Of course it was immediately shortened to the more famous form.” There is, however, at least one book with such a title (see Concetti 1997). The phrase “the embryo is one of us” is now also associated with Pope John Paul II and is widely used in pro-life discourse (see Berthelet (2003) and Congregation for the Doctrine of the Faith “Instruction on respect for human life in its origin and on the dignity of procreation: replies to certain questions of the day” at www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_
cfaith_doc_19870222_respect-for-human-life_en.html).
37. Since on the “embryo is one of us” view the moral imperatives are of high importance and urgency, fertile women have a duty not to be too choosy in their choice of available partners. This is why I earlier described all forms of the potentiality argument for moral value as involving an “exhausting ethic.”
38. Harris (2003b, pp. 99–109).
39. Harris (2003d).
40. It is now accepted that if future 9/11-style hijackings take place, governments will have to face the question of whether to use Air Force jets or missiles to shoot down the hijacked planes, killing all the passengers innocent and guilty The same trade-off will apply.
41. For more on this and, in particular, the role of Pope John Paul II, see Wrong (2005), Toynbee (2005), and Hari (2005). For a rational dissenting judgment see O’Neill (2005). See also Harris (2003b).
42. Parfit (1984, p. 206).
43. I am indebted to my colleague Matti Hayry for many suggestions in these sections.
44. Kass (2001).
45. Adams (1980, p. 79).
46. Crichton (1999).
47. See Glover (1977, p. 57).
11 | The Obligation to Pursue and Participate in Research
1. This chapter follows lines developed in Harris (2005c).
2. Brecht (1986, scene 14, pp. 108–9).
3. Sandel (2004).
4. Karl Marx (1972).
5. See Brecht (1986, p. 108). It should hardly be necessary to state (although experience teaches otherwise) that these endorsements of views of Marx himself and Brecht, often characterized as a “Marxist playwright,” do not imply acceptance of any other of Marx’s views or of any other aspects of Marxist philosophy. I hope that in the future it is not only Marx and Marxists who are prominent in highlighting the social and moral responsibility of the generality of humankind.
6. Benevolent authors should always gift at least one devastating quotation to reviewers in the hope of attracting attention.
7. Harris and Holm (2002).
8. See World Medical Association (1964), with the note of clarification of paragraph 29 added by the WMA General Assembly, Washington 2002.
9. Council for International Organizations of Medical Sciences (2002).
10. See Caplan (1992a) and Glover (1999, part 6).
11. See Angell (1997).
12. Caplan (1992b).
13. Redfern (2001). For a commentary on some of the major issues concerning this case see Harris (2002e).
14. Here the argument is restricted to research projects that are not merely aimed at producing knowledge. Unless an increase in knowledge is a good in itself (a question we will not discuss here), some realistic hope of concrete benefits to persons in the future is necessary for the validity of our arguments.
15. Korn (1998).
16. I set out the arguments for and the basis of this duty in Harris (1980).
17. See Barry (1995, p. 228).
18. Jonas (1972).
19. See Hart (1955) and Rawls (1972).
20. This formulation of the principle derives from Nozick (1974, p. 90).
21. It is perhaps also worth pointing out that there is a separate question about whether this moral obligation should be enforced on those who do not discharge it voluntarily. This is not a question I will discuss here.
22. See, for example, Harris (1997c).
23. There are of course imaginable scenarios which would justify even conscription into highly risky research just as there are imaginable scenarios in which killing the innocent is justifiable. The fact that some unscrupulous individuals or governments are all too willing to overexercise their imagination in this direction, for example, in the “collateral damage” to the innocent that often attends military operations, does not destroy the validity of the point.
24. I owe this formulation of the interest I have in being a moral agent to Søren Holm.
25. See also Harris and Holm (1997).
26. See World Medical Association (1964).
27. Here the argument echoes Harris (1999a).
28. And may also have specific contractual duties to them.
29. For example, in cases of research on young children, mental patients, and others whom it is reasonable to assume may not be adequately competent.
30. See Harris (2002c).
31. I use this term in a nontechnical sense.
32. For use of this principle in a different context see Harris (2003c). Taxation is of course the clearest and commonest example.
33. Those over sixty-five may be excused if they wish.
34. I talk here of minimal risk in the sloppy fashion usual in such contexts. However, “risk” is ambiguous between “degree of danger” and “probability of occurrence of danger.” Risk may of course be minimal in either or both of these senses.
35. If these suggestions are broadly acceptable and an obligation to participate in research is established, this may well become one of the ways in which research comes to be funded in the future.
36. There is of course no such thing as full information.
37. Of course, the historical explanation of the Declaration of Helsinki and its concerns lies in the Nuremberg trials and the legacy of Nazi atrocities. However, we are, I believe, in real danger of allowing fear of repeating one set of atrocities lead us into committing other new atrocities.
38. Figures are for 2003, with an estimated 5 million people newly acquiring HIV in that same year. Source: Joint United Nations Programme on HIV/AIDS (www.cdc.gov/hiv/stats.htm).
39. These residual dangers include the difficulties of constructing suitable consent protocols and supervising their administration in rural and isolated communities and in populations which may have low levels of formal education.
40. For one prominent example, that of Barry Marshall’s work in which he swallowed Helicobacter pylori bacteria, thereby poisoning himself in order to test a bacterial explanation for peptic ulcers (see http://opa.faseb.org/pdf/pylori.pdf and www.vianet.net.au/~bjmrshll/).
41. Introduction to track #6, An Evening (Wasted) With… Tom Lehrer (1990, REPRISE/WEA 6199, compact disc).
42. For an earlier version of this principle applied in the context of genetics see Harris (1999a).
43. As Marcia Angell rightly points out (Angell 1997).
44. See note 43.
45. See Dworkin (1977).
46. World Medical Association (1964, paragraph 19).
47. See, for example, Council for International Organizations of Medical Sciences (1993, guideline 6, p. 22).
48. I make a distinction between humans and persons which is not particularly pertinent in this context but explains my choice of terminology. See Harris (1985, chapter 1; 1999b).
49. Harris and Holm (2003a).
50. For example, because the research is into an illness which only affects children or those with a particular condition that affects competence, or where the point of research is, for example, to check whether the illness or the treatment affect children in the way that they affect adults.
51. Council for International Organizations of Medical Sciences (2002, guideline 7).
52. Ibid., pp. 28ff.
53. The CIOMS gloss on their own guideline creates a kind of catch-22 which is surely unreasonable and unwarranted. Wherever the best proven diagnostic and therapeutic methods are guaranteed by a study in a context or for a population who would not normally expect to receive them, this guideline would be broken. CIOMS guideline 4 therefore surely contradicts and violates not only the Declaration of Helsinki but also its own later guideline 14.
54. An interesting test case here is the level of risk which is acceptable for live organ donation and the question of the degree to which incentives affect this (see Erin and Harris 2003).
55. See also Wilkinson and Moore (1997) and McNeill (1997) and the discussion of commercial exploitation in Harris (1992, chapter 6).
56. See Le Grand (2006).
57. This obligation has been partly endorsed by the Hugo Ethics Committee in its “Statement on human genetic databases,” published in December 2002. However, like so many statements by august ethics committees, the Hugo statement contains not a single argument to sustain its proposals or conclusions. This chapter provides the missing arguments. For a critique of the operation of national and international ethics committees see the introduction to Harris (2001a, pp. 1–25).
58. Of course, since even before Plato and Aristotle, but they constitute a usefully dramatic opening scene and they combine different aspects—the empirical and the theoretical—of what we now think of as research. This idea of course was used by Raphael in his masterpiece The School of Athens in the Stanza della Segnatura in the papal apartments in the Vatican. I have not neglected to note that both theoretical and observational aspects of research were subject to error even in the ancient world.