Biology after the Fall of Man ...


'Horst Seidler Horst Seidler

… the following contribution could be retitled with reference to J. Huber (1985). In the outstanding omnibus volume entitled "Artificial Insemination – Experiment in position finding - the medical, penal and moral-theology view", the contents of which were to be made accessible to as many people as possible, Huber writes about "Biology before the Fall of Man".

In a very factual way, the scientist describes individual problem spheres such as intra-uterine adoption, cryco-conservation, up to the scientific and social-political discussion within the framework of so-called trans-specific gravidity. When Huber, nevertheless, formulates the closing words to his work as "In the ball-cult children were also sacrificed to save the lives of the adults", then the Fall of Man has not merely been already effected mentally in the sense of a science which has already become almost omnipotent and technocratic.

"Is medicine allowed to do everything that it can do?", asks W. Holczabeck, Chairman of the Ethics Commission of the Academic Senate at the University in Vienna, in a foreword for the said omnibus volume and, in doing so, not only expresses his deep concern about possible undesireable developments, but also points out that "this new field must also be thoroughly examined and discussed from a penal, private law, insurance law, social-scientific-psychological and, of course, from a theological point of view". If we remain in the terminology of the title, then the Fall of Man was described as a scientific sensation on the 12th August 1978. On this day, a healthy baby girl was born weighing 2700 grams. The information about this published in the journal "lancet" read: "The pregnancy was achieved following laparascopic removal of a zygote on 10th November 1977, in vitro fertilization and normal division in the culture medium and the transfer of 8 cell embryos into the uterus, 2.5 days later". Huber's argumentation that no ethical postulate could then check scientific progress, stop it or even prevent it, if people were to benefit from the scientific progress, can be agreed with in as much as the new techniques of extra-corporeal insemination are being practised today, all over the world, as routine methods.

The technique has largely been mastered and the urgent need for such intervention is increasingly leading to the improvement and certainty of the method. And here, first of all, without making any ethical-moral considerations, the question as to who among the people can be the actual practical applicant of modern biotechnology, must be discussed: public insurance bodies are not prepared to bear the costs of in vitro fertilization. Has the fulfillment of the dream of having a child become, in this way, a domain of the privileged? At present it is certainly the case that the principle of equality should be placed in the centre of considerations and discussions.

The problem concerning the material side of in vitro fertilization led H. Janisch to write, "not everything that can be done is good and it should be our primary goal that we continue to be doctors and should not let ourselves be refunctioned into technicians or business men". He then added: "This should also be an obligation of the general public".

That all sounds good and proper, but what is to be understood by the term "general public"and are doctors not sometimes really business men, when those who can afford it purchase medical technology or scientific progress in order to make their dream of having a child come true? To obligate the "general public" will only be possible if we succeed in considering and coordinating several factors involving laborious detailed work, simultaneously:

1.
Specific educational work for the general public by means of easy-to-understand and objective information about fundamental biological knowledge; avoiding what is apparently scientific, but really pseudo-scientific, sensationalist reporting; development of an objective, generally accepted terminology which avoids terms such as "artificial insemination", "test tube babies", etc. This has particular priority as many children, the world over, have already been born as a result of in vitro fertilization and to describe them as "test-tube babies" would jeopardize the human way they see themselves. The information in the media about Nobel prize winners' and top-performance sportsmens' semen banks leads to false hopes and socially-politically dangerous ideas.

2.
The timely preparation of social-psychological and social-anthropological coordination concepts for the topics: "partnership, dream of having a child, extra-corporeal insemination and social-political consequences". This would mean that the modern possibilities of reproductive biology would generally have to be dealt with together with the question of family policies. The Association of Foster and Adoptive Parents would have to be involved in these coordination concepts.

3.
Discussion about the reality of a consumer society in which too many people believe that everything can be done and everything can be achieved. Reflections about a social development in which what is really sometimes the less social and more, very pointed right, for self-realization plays an increasingly greater role.

4.
Interdisciplinary – "scientific-political" – talks which should continue to deal with open questions (in vitro fertilization and abortion legislation) in their extremely paradox coherences. According to W. Brandstetter the legal nature of "nasciturus" does have to be assessed as a person, but legal protection has been dramatically restricted by abortion legislation: "In connection with artificial insemination, abysses are opened up .. which legislators could never even have thought about when introducing the abortion legislation." In this connection, all aspects of gene surgery and the use of embryonic cells for research and treatment purposes would also have to be included. Even here – and not unjustly either – headlines about artificial people and the likes are lurking around, the term "test-tube" is finally becoming real. But this is only one aspect, even if it is an incredibly significant one, and we are still not clear about its ethical and moral consequences. What is clear is only what "can be done", and will probably be most certainly done in the near future. The fact that many people are afraid of these almost unlimited possibilities of genetic manipulation (in the true sense of the word!) is only too understandable. But it is a question of the objectivity of even introducing the second side of the problem sphere; just imagine you go to the babies ward in a childrens hospital and see a child there, tied to a bed, and whose teeth have all been pulled. Its fingers and lips are severely disfigured; the doctor in charge explains these wounds as being the result of an uncontrollable auto-aggression. The child is suffering from a known enzyme deficiency which, amongst other things, leads to auto-aggressive biting.

It is probably only a matter of time until we succeed in correcting the pathological hereditary disposition (deficiency in the production of the enzyme hypocanthine-guanine-phospho-rybosil-transferase). Gene surgery to make a worthy human existence possible!

In this work, Huber also discusses the treatment possibilities of removing organs (cells) from early human embryos. Here, too, it will certainly be possible to cure illnesses and to prevent human suffering.

Of course, our occidental consciousness will per se provoke the question: "Are we allowed to do everything that we can do?" and we will not be spared from answering this. In this respect, the ethical consciousness of the scientist will be more decisive than legislators will ever be. A brief example: pre-natal sex determination has proven to be more than a blessing in the case of some (X-chromosomal mutations) hereditary diseases. Irrespective of ideological values, here, in the individual cases, it has been possible to prevent unimaginable suffering and invalidism and even death (for example X-chromosomal recessive muscular dystrophy of the Duchenne type). It must be said in this connection that attitudes like "man was born to suffer" etc., are borne exclusively from a lack of feeling and egoism. The decision about as to whether the pregnancy should be allowed to continue following positive findings resulting from such a pre-natal examination, lies with the person concerned and must, in each and every case, be respected by society.

It must also be mentioned that these technologies are also used in some countries of the world to literally eradicate unwanted female offspring. It is not the methods that we must be afraid of, but the attitudes of those that make use of these methods. As a result, there must be the demand for the most stringent of controls to be made by ethical commissions which must be established as widely and as efficiently as possible.

5.
Re-conditioning these scientific-historical processes that, for the first time in the history of the science of reproductive biology, have led to state-initiated misuse. From a current point of view, and, in accordance with our current level of knowledge, misuse was only possible as it was not only politicians, but also the afore-mentioned general public which were convinced about the necessity of the compulsory sterilization of "the inferior". Not later than 1907, scientists, psychologists and politicians ate from the tree of knowledge with the consequences of banishing the new science of genetics from paradise. In 1907, in the American State of Indiana a law was issued: "A law to prevent the propagation of inveterate criminals, idiots, imbeciles and rapists"; a number of Federal States followed suit: similarly several European countries also issued such laws in the 1920's. According to the publications of the Human Betterment Foundation, dated 1st January 1939, by 1938 a total of 30,690 sterilizations had been performed in the United States for eugenical reasons. Following the law issued on 14th July 1933 in national-socialist Germany to prevent hereditary ill offspring, in the very first year of coming into power, over 40,000 people were condemned by court orders to be sterilized.

Even if we consider and feel these "eugenical measures" today as being frightful and alarming, we should not forget that – not only in the NS State – many people, probably the vast majority (!), were convinced of the social-political necessity of such legal rulings. The cultural pessimism based, amongst other things, on Spengler, coupled with an irrational anxiety about the biological survival of the peoples, provided the ideal hot bed for "scientific quarter truths" and elitist mental attitudes uniting to bring about a fatal consequence. It is certainly not wrong to maintain that the legislator at that time was "only" realizing the voice of the people – and is not the voice of the people the voice of God? In order to prevent any misunderstandings here: representatives of both Churches fought vehemently and at the risk of their own lives against sterilization in national-socialist Germany.

It is worth mentioning in this connection, that since 1900 there have been, of course, scientists and politicians who did speak out, with all the means they had available, against compulsory sterilization-but who were not listened to. The history of sterilization and consequently reproductive biology is a story of idea reception depending on economic, political and an infinite number of other factors, in which injustice became justice. This justice was based on the simplifying power to convince by means of nonfactual, unscientific and consciously one-sided information. In order to avoid repeated undesired developments, the uppermost goal today must be to inform objectively and fundamentally so as not to have ideological polemics enter into the discussion. The critical discussion about modern bio-technology on the basis of the fundamental biological knowledge necessary for this, could probably be effected for the first time to this extent by the Federal Ministry for Family, Youth Affairs and Consumer Protection's investigation commission for "Family Policy and Artificial Propagation".

But what is the situation today? We can meet the convictions of the moral theologist, A. LAUN, with awe and respect, when he writes, "If we do not consider the social situation and ask, merely, what is to be said about the moral truth of in-vitro fertilization from the point of view of Catholic moral theology, the answer is: Without mistaking the great ethical differences which result from the respective different objectives, on the basis of which in-vitro fertilization is used, then Catholic moral theology must dismiss in-vitro fertilization." But: we will have to respect people who have been informed via the media that various techniques in artificial fertilization have become almost routine methods in gynacological out-patient clinics, thanks to scientific progress, and who have now put all their hopes in those doctors who could fulfill their innermost wish.

Janisch and his important work can be quoted, a work which explicitly specifies a passage from the Declaration of the United Nations, that "every man and every woman has the right to establish a family". To establish a family means not merely to get married, but also to have children. But who shall be the supreme moral authority to pronounce himself or herself as being for or against making it possible to have children in event of male or female infertility? Who can now actually claim to pronounce or decree that, despite the existence of the new and generally successful technologies, children should be foregone, while appealing to higher values? Of course, here it should also be stated that the term "forego" is never taught in our society after childhood days and for this reason can neither be understood nor accepted by many.

It is always very easy, as it were, to determine what is good, less good and bad from the conference table; and in many cases one may even be right. What about the psychological situation of people who cannot have any children and whose heart's desire it is to have children; people who have waited in vain, for years, to get a child for adoption! In this connection, we must be reminded that in the relevant counselling offices in the city of Vienna, the repeated attempt was made to convince women who had decided to terminate a pregnancy to have their child, and then to put it up for adoption. The almost immeasurable expenditure in terms of personal and financial means brought no success at all: despite intensive therapeutic talks they didn't once succeed in preventing the death of an embryo.

Therefore, at the present, despite all objections, so-called "artificial insemination" is probably the only way to help childless couples get children. Scientific progress cannot be checked; LAUN also concedes with this: "There is in-vitro fertilization, and no appeal whatsoever will make it disappear. None of the laboratories which practise in-vitro fertilization today will stop their work. On the contrary, state money is being increasingly put into this research and we have new success reports from science which are immanent about getting life more and more under control". This realism must be opposed by a realistic attitude in society. Ethics Commissions which are constantly active and permanently voicing their opinions, must become effective over and above the university sphere in order to prevent every conceivable misuse. Pedagogical strategies must be drawn up and must be passed on, in the sense of a new form of "life and partnership-hygiene teaching", to the schools, commencing in Primary Schools and continuing on to compulsory and higher level schools. The solution to the problem: "artificial insemination" will, in the short-term, be more or less solved efficiently in a legal-political way. But: short-term solutions and the resulting short-term political satisfaction will only be able to produce suspensive action, as is becoming particularly noticeable with the abortion legislation. As important as it may be today for those concerned to replace the largely vacant space with adequate legal security via suitable government measures – the demand to develop long-term social structures with provisions is just as necessary; provisions which no longer regard everything as being able to be done, achievable and consumable.

LITERATURE:

W. Brandstetter, J. Huber, H. Janisch, A, Laun: Künstliche Befruchtung – Versuch einer Standortbestimmung in medizinischer, strafrechtlicher und moralischer Sicht. Facultas Universitätsverlag, Vienna 1985.