On the ambiguity of progress from an ethical perspective

Gonzalo Herranz, group of work of Biomedical Ethics, University of Navarra.
lecture in the high school Mayor Montalbán.
Madrid, 21 October 1987.

Words of thanks for the occasion

I

My purpose this afternoon is very simple. I want to plant in the minds of those who listen to me, especially in the minds of young university students, all of them and from all disciplines, an idea: that it is necessary to question the ethical significance of scientific advances.

We all have a logical favourable, even enthusiastic, predisposition towards scientific progress. It makes us live very well and from amazement to amazement. A new computer model staff , whose performance we have to rub our eyes because we don't believe it; or the revolution that is being prepared thanks to recent discoveries about superconductors, which is keeping researchers and captains of business awake at night; or the design of new vaccines through engineering Genetics, so cleverly applied that one smiles for hours in admiration of how far human ingenuity is reaching: all these things make us vibrate and feel lucky to have been born in time to witness so many wonders. One of the reasons for wanting to go on living and losing our fear of old age is the conviction that, just around the corner of the time in which we live, we will find marvels that science, that fairy godmother of our time, will have brought forth with her magic wand. There are very few who are still nostalgic for "pre-war things", who long for the good old days. There is a vast majority of us who look confidently ahead and who take on the typically progressive attitude of hoping that everything will be better, that the future will bring us many good things. reservation .

But there is every reason to believe that not everything is rosy. That same progress, so effective and surprising, gives us a few scares from time to time. We are sometimes shaken by news that undermines our usual justified confidence in scientific progress. We learn that neurosurgeons everywhere are transplanting cells into the brains of human beings, without this decision having a solid scientific basis. We learn that, faced with the need to do whatever it takes to alleviate the anguish caused by the fatal evolution of AIDS, some governments or public agencies have derogated from the requirements safety standards required for drugs or vaccines to be administered to humans, taking risks that could not have been calculated. These news items can be read in scientific journals. But there are others, which appear in the newspapers that we all read, which tell us about the unsafety of nuclear power plants, or the contamination of food by additives and preservatives that damage our cells or cause cancer, or the criticisms from environmentalist sectors that remind us that the problems of environmental degradation continue to overshadow any more active use of natural resources, which is the price that must be paid for all progress.

There are, in all this, sufficient grounds for reasonable concern. But perhaps it is not these accidents or unforeseen events that should concern us. It seems to me that the problems that justify, not a suspicious attitude, but a calm and critical consideration, are those that come from the immediate and tangible possibility that we already have today of manipulating man himself with the instruments that scientific progress has given us: today we can produce human beings on the laboratory to destine them to live or to sacrifice them for the sake of the research; we can select them through the application of gene probes, to allow the life of those who pass the quality tests and destroy those who are stigmatised as undesirable; we can, through the handling of certain drugs, drive them mad to punish their political dissidence or gratify them with a paradise of psycho-pharmacological pleasures.

Little or none of this was known a few years ago. Scientific progress, it is clear, is a vehicle of formidable power and enormous versatility. Depending on who gets behind the wheel of the machine, it will go one way or another. Progress, with all its wonders, is blind. Rather, it is ambiguous: it is an instrument and a cause of countless benefits, but it can also be a cause of domination and destruction.

II

We must therefore ask ourselves why this is so, why progress is ambiguous. Last year, at a medical congress in a Scandinavian country, a Lutheran theologian was invited to offer the attending neurosurgeons some ethical considerations on the prenatal treatment of foetuses with anomalies of the development nervous system. He began his lecture by recalling the words of President Kennedy: "If anyone asks why we want to go to the moon, the answer is simple: because we can. No other answer is needed. These words, in the eyes of our theologian, represent the culmination of a process that began, 300 years earlier, when Francis Bacon declared that human reason, thanks to the new logic, had come of age. Reason was emancipated to undertake on its own the improvement of the world and the unfolding of its power over nature. For Bacon, Adam's fall had meant the loss of both his state of innocence and his dominion over creation. The life of mankind since then, thought the chancellor of James I of England, is the story of attempts to repair these two tremendous losses: the loss of innocence through religion, the loss of mastery of the world through the financial aid of science and craft.

But Bacon's optimistic forecasts have result failed. There is ample evidence of this, the most eloquent of which is the dominance of some people over nuclear energy. It should be stressed: the problem is not so much that atomic energy has been liberated. What is worrying is that it is only a few people who own status. The vast majority of people are oblivious to the magnitude of the threat of nuclear holocaust that hangs over us all. It only takes a few seconds of reflection to conclude that "If someone were to ask why we stockpile nuclear weapons", the answer cannot be: "because we can. No other explanation is needed".

This, and much other evidence, clearly shows that the technological imperative - you can morally do what you can physically do - is a source of misfortune, even if you try to disguise it under the guise of undisputed progress.

There is no need to insist on topic and to make an inventory of threats unfortunately linked to progress. I have already given a small sample a moment ago. I prefer to pause for a moment to consider the causes of this status and the remedies we can apply to it. Science is blind to ethical values. However much some scientists, very respectable as they are, may pretend to do so, natural science cannot be the foundation on which ethics can be built: it cannot produce apple blossoms.

In my opinion, in order to give an explanation of the blindness of scientific progress to moral values or disvalues, we can start from Bacon's phrase quoted above. He speaks of the twofold loss of Paradise: the loss of innocence and the loss of dominion over nature. Each has its specific remedy: one, religion, the other, science. But it is evident that he and those who succeeded him in the cultivation and application of the sciences were more concerned with regaining mastery over things, which is where progress has come from, than with restoring order within their consciousness and recognising that some things come first and others second. Scientists have been so absorbed by their work of dismantling, analysing and recombining, that they have not had time to spend on reconquering innocence. That is, by neglecting the primary task of learning to do no harm, which means innocence, the capacity for moral judgement of many cultivators of science has atrophied. But then, in direct proportion to this neglect, the adventure of mastering nature ceases to be an unequivocal advantage and becomes ambiguous, a tree that bears both sweet and bitter fruit.

It is not easy to convince very intelligent colleagues that the natural sciences without the guide of Ethics are lost, without orientation, that the scientist must insistently ask himself about the ultimate meaning of the things he does and applies. Many of them declare that their creed is science, but, apparently, their faith seems no more enlightened than that of the charcoal burner. They are naively persuaded that, in the twentieth century, science has won the day over religion in every field in which they have clashed. If it is a matter of working wonders, they tell us, there are so many diseases conquered; there is the genuine multiplication of the loaves of bread that is the green revolution; there is the miracle of information technology. If the purpose of religion is to bring all men together in a communion and fuse them into a unity, there are, among so many products of progress, the news or travel agencies that have turned the world into a handkerchief, or Coca-Cola, or billions of television viewers watching the Olympic Games. What is really important, however, is to know whether science is better than religion in preparing us to lead an intense and abundant moral life, not relegated to the back of the mind, but present in every moment in which we relate to things or people.

One can answer this question about the relative capacity of Science or Religion to elevate us morally by saying that, fortunately, things are changing for the better, for, in recent years, Ethics and its representatives - theologians, philosophers and Bioethics professionals - have burst with great force into the laboratories of Universities and Industries, in hospitals and Sociology offices, in Ministries and in the Foundations that finance the research. This is true. But, I insist, Ethics is the great absentee. Concern for it is neither sufficiently strong nor extensive. I will adduce a couple of examples from today, with the aim of making everyone's sensibilities more sensitive. purpose .

a) Many weeks ago, the back page of the British Medical Journal featured a article in the Scientifically Speaking series by signature Bernard Dixon. The article which appeared on a recent issue commented on an International Symposium held in Zurich on Biosafety. The Symposium brought together scientists and philosophers to study together some issues of public interest, the kind that too easily escape the attention of "narrow-minded experts".

The Symposium, in Dixon's view, failed miserably. Philosophers talked about Philosophy, without landing on familiar ground for biologists, while biologists talked, with their infinite capacity for small details, about the contamination of bioreactors, safety measures in recombinant DNA experimentation laboratories, and so on. But it seems that the desired meeting did not take place, nor was there any discussion of the ethical aspects of the problem, which was the purpose that had inspired the meeting.

Now comes the example: Dixon recounts the astonishment provoked by the communication of a German group who has elucidated the factors that govern the virulence of Escherichia coli. In a fascinating work , they have revealed how these germs, ordinary and peaceful inhabitants of our bodies and those of many other animals, become rabidly aggressive and cause very serious diseases when certain gene-mediated pathogenicity factors coincide. Researchers at group in Würzburg have been able to clone some of these genes and have succeeded, thanks to the precise tools available to molecular biologists today, in converting harmless strains of E. coli into virulent strains at laboratory . It seems to be working like a charm. The way is now open for the people at laboratory to produce terribly aggressive germs and even to add deadly toxin-producing genes to them.

Well, what surprised Dixon is that in the face of this astonishing, and alarming, finding, no one in Zurich sounded the alarm. This is an extraordinary omission: not a word, either in the course of the Symposium discussions or in the published conference proceedings , about the possible consequences of the work of this subject for the odious official document of biological warfare. No one there seemed concerned about a threat, in comparison to which the bombs loaded with Yersinia pestis, the bubonic plague-producing agent, which the biological warfare laboratories prepared in the 1960s, are amateurishly botched.

This example sample shows us the tremendous and alarming dissociation that exists between the ability of the manipulation wizards to dominate nature Genetics and their rudimentary concern to recover innocence, to limit their ability to do harm. This example sample, moreover, shows how frequent is the probably unintentional forgetfulness of ethical values among scientists. This is the case for the researcher scientist who is only concerned with his scientific research.

But there are episodes that lead us to suspect that, for reasons that are not easy to identify, the deliberate elimination of all ethical considerations in the application of scientific progress is being sought. The obsession with ethical neutrality then prevents us from reaching sensible biological conclusions. Let us look at a second example.

b) People are quite frightened by the AIDS epidemic. When scientists and, much later, politicians realised the seriousness of the problem, given the lack of protective vaccines or therapeutic remedies and the deadly nature of the disease, they launched major health information campaigns and Education , which is excellent in principle. But they have insisted that such a Education cannot be moralising. It is true that no one in their right mind would think of saying that AIDS is a punishment from heaven for the immoral behaviour of its victims or a retaliation of nature against those who pervert the natural order. People, all of us, without distinction, get sick because of our genes, because of micro-organisms that attack us, because of substances we ingest or inhale, and so on. From an ethical point of view, illness can be an irrelevant event, or it can be offered to us as an occasion for self-improvement or moral degradation.

However, it is one thing to reject the far-fetched idea that AIDS is a punishment from Nature to take revenge for moral permissiveness, and another thing, equally irrational, to refuse to recognise that sexual promiscuity is not only morally wrong, but also, and above all from the point of view that interests us now, biologically lousy, epidemiologically disastrous.

Richard V. Lee, whose regular contributions to the American Journal of Medicine are not exactly characterised by their prudishness, commenting on the epidemiology of sexually transmitted diseases and, in particular, AIDS at the congress International Infectious Diseases meeting in Cairo: "The story of human disease caused by the retrovirus and manifested in this epidemic of malignant immunosuppression, lymphoreticular tumours and exotic superinfections is shocking. Not simply because of the dire prognosis of these manifestations, but because of the widespread impression that effective treatment of this new scourge will not come exclusively from science.... None of those who spoke there referred to the need to change people's behaviour".

This echoes the slogan "No moralising". The doctor is nullified as a moral agent. To say that promiscuity is biologically wrong can be taken as an offence staff by sexual liberation activists. Insisting, out of good epidemiological sense, that marital fidelity is the only "safe sex" is seen as an assault on civil and political rights. It seems to have become widely accepted among health authorities that recommending monogamous fidelity is a reprehensible and uneducated intrusion into people's privacy. It also seems that all of them have agreed agreement that the only way out to avoid offending people's moral feelings is to limit themselves to recommending certain hygienic precautions in the sex trade, as the conclusion seems to have been reached that the sociologically normal "lifestyle" includes premarital sex, frequent resource prostitution, homosexuality, etc. But this conclusion is essentially a moral conclusion (even if it has to be described as immoral) and that the package of hygienic recommendations is as moralising in nature (even if it has to be described as immoral) as the more earnest calls for continence or marital fidelity. Morality for morality is here preferable to that which is biologically safer, for the deliberate exclusion of good biological sense from the educational campaigns of some Ministries of Health is a serious lack of biological ethics.

Enough examples. Let us move on to the conclusions

III

I said at the beginning that the purpose of this lecture was to invite everyone, but especially the young people attending it, to take an interest in the ethical implications of scientific advances. This is a universal obligation, which cannot be neglected. It would be much more comfortable for people - and much more irresponsible - to entrust the solution of moral problems to experts. Just as a plumber is called in to repair a broken tap, so we can entrust the solution of ethical problems to experts, who in America are called ethicists. But there are no experts in ethics. Some of us dedicate ourselves to reading and reflecting on what is written about the history of our ethical notions and their philosophical and theological foundations, about the solutions that some propose for such a complicated ethical problem. In particular, we try to get on the list of those invited to participate in symposia or to give lectures on biomedical ethics, or on medical problems covered with thorny moral questions.

But ethical decisions have to be taken by each individual. Monsignor Escrivá de Balaguer insisted that spiritual counsellors, experts in moral questions, must give advice, inform, educate: but they must respect the conscience of those they are advising, they cannot usurp their freedom. "But committee does not remove the responsibility staff. It is we, each one of us, who have to decide in the end and we will have to give an account of our decisions to God" (Conversations, 96). No one can ethically mortgage his or her responsibility and make moral decisions, blindly relying on the committee received.

The same is true in the world of public ethics and bioethics as in spiritual life. One cannot transfer one's responsibility staff to the experts. All of us, if we are truly responsible, have to go through the sometimes severe ordeal of taking sides, of deciding the dilemmas we face, of being an active agent in the fields of ethical tension, where the fate of mankind is being decided day by day. To put it another way: when it comes to making moral decisions, to making ethical judgements, we are all equal, we are all equally expert, we are all decisively important. As in democracy: one man, one vote. In contemporary democracies, bioethical issues (health costs, legislation on scientific technology, on the family and human reproduction, regulation of the practice of medicine, etc.) are becoming one of the most significant chapters in electoral programmes. It is not enough here to say to someone else: go to position and decide for me.

We must be persuaded that in the times we live in, nothing good will come out of abstention. There are people who think, for example, that they do not have an adequate knowledge of the very complex biological sciences; or that the biological sciences are a very solid subject and goal, where there is no room for discussion as there is for discussion of other human sciences, where everyone can give their opinion as they please. This idea of the immutability, the solidity, the almost absolute objectivity of the natural sciences is a widespread error, because it creates a kind of abstention among the common people that leads them to abdicate to the experts. And this error is not only widespread among ordinary people. It is equally widespread among teachers. Lewis Thomas has argued that our ignorance of the sciences, the preliminary nature of our knowledge of any district of them, should be the subject of specific courses that would cure us of the risk of pedantry and make us humble people, persuaded that "there are more than seven times seven kinds of ambiguity in science, which are waiting to be analysed".

I am finishing now. As is proper in ethics, I will end by giving some advice. Let us assume our responsibility staff, each one of us our own. Let us take an interest in bioethics, because we have a great deal at stake here. Let us comment on the news in the newspaper, after giving it some thought. Let us draw each other's attention and let us practise that very university-like official document of contrasting opinions on problems in which serious aspects of our future are at stake. No one has spoken more forcefully or more lucidly on the subject than the Holy Father John Paul II. Point 15 of Redemptor hominis contains these words, which are a whole programme to awaken and wisely guide our responsibility, to keep us awake, that is to say, to be habitually confident and habitually critical in the face of progress and the research of the sciences:

"The first concern relates to the essential and fundamental question: does this progress, of which man is the author and maker, make man's life on earth, in all its aspects, more human; does it make it more worthy of man? There is no doubt that in many respects it does. However, this question must stubbornly be asked again with regard to what is really essential: whether man, as man, in the context of this progress, really becomes better, that is to say, more spiritually mature, more aware of the dignity of his humanity, more manager, more open to others, particularly to the neediest and the weakest, more availableto give and lend financial aidto all". So much for John Paul II's quotation.

We see, in the light of this illuminating text, that we must be concerned, because there are certain fruits of progress that can be poisonous, that can do harm to man. Scientific progress is ambiguous, it lacks the capacity for ethical self-regulation. It has to be guided. Someone has to take it by the hand. And I have the impression that, although some scientists are very interested in the ethical implications of their work research, especially in the field of biomedicine, this attitude does not seem to be sufficiently strong or widespread among scientists.

This is why we must all, without distinction, help in this task. Fortunately, the benefits of scientific progress are becoming an increasingly important part of the election manifestos of political parties and also of the means and aims of the thousand Structuresof our society. It is our duty to ask ourselves tenaciously, obstinately, about the human significance of scientific progress, about its ultimate meaning and its relation to what is really important. The ambiguity of progress is, at final, a stimulus that will always keep us on our guard and enrich our intelligence and our moral sensitivity.

Thank you very much.