Letters

To the Editor:

Paul Lauritzen (HCR, Mar-Apr 2005) is certainly right in urging us to move toward an "expansive view of technology" in order to escape the "narrowly focused . . . repetitive and rigid" quality of much existing debate over stem cell research. Yet Lauritzen's otherwise insightful essay still betrays some narrowness, both in its assertion that the broader perspective on such biomedical technologies is merely "beginning to emerge," and in its assumption that our ethical commitments—grounded as they are in the notion of "natural human life"—are not subject to productive critique and reformulation.

Had he followed his own advice and moved beyond what he calls the typical frame of bioethics to consider the "cultural space that art provides for moral reflection on social issues posed by definitions of nature," he would have discovered that the history of popular debate over the social and moral impact of biogenetic research and therapy is a long and rich one. As Squier has explored in Babies in Bottles (1994) and Liminal Lives (2004), the question of the implications of a wide variety of biomedical interventions into the human lifespan has engaged novelists, playwrights, journalists, and embryologist-poets, as well as zoologists, geneticists, crystallographers, philosophers, and physicians, since the early twentieth century.

Why does Lauritzen believe the debate has just begun? Perhaps because he writes in an era when the popular forum referred to has been replaced by conversations among experts whose disciplinary positions (as scientists, doctors, theologians, and bioethicists) give them the authority to be heard. Relying on experts to gauge the impact of new biomedical technologies keeps us from considering their full consequences. Instead, since we have declared the testimony of those who are not experts off-limits, we are limited to gauging the level of acceptable risk posed.

Lauritzen's article argues that biotechnological innovation represents a threat to human rights—biotechnology will change the species-typical characteristics shared by all humans, and thus the biological basis for human nature. The problem with stem cell research to Lauritzen is it may significantly extend the life span and change the natural trajectory of human life "that moves through youth and adulthood toward old age and finally, decline and death." This, he fears, would alter the kinds of social relations and mutual obligations associated with aging, illness, reproduction, and death.

We regard the grounding of human rights in a natural trajectory of human biology as highly problematic. The trajectory he posits is not natural, if by natural we mean uncontaminated by technology. The life trajectory in which a person lives for seventy or so years, is healthy in childhood and adulthood, and declines only in old age is utterly dependant on a vast biomedical research and clinical infrastructure: dental care, antibiotic medication, diagnostic and screening technology, vaccination, regulatory standards—the list is endless. These technological interventions protect those who live in the developed world from the infectious epidemics, parasitic invasions, malnutrition, and sheer risk that threatens the viability of life at any point among the poor in the developing world. The life trajectory Lauritzen assumes is natural and species-typical is in fact a product of social wealth, biotechnical intervention, and the sheer flexibility and mutability of biology, its responsiveness to change, and instrumentalization.

Furthermore, while Lauritzen associates biotechnical intervention with dehumanization and loss of moral foundations, we argue that medicine's tendency to treat the body as matter to be manipulated does not have straightforward ethical implications. This tendency is the basis of all great humanist achievements of biomedicine, as well all its ignominious moments. It forms the basis, for example, for both organ donation and eugenic sterilization of the disabled in the 1930s. Certainly we should scrutinize stem cell research for the ethics and politics of its possible applications, but to argue it should not proceed on the basis that human rights depend on an immutable biology is to engage in a logic of infinite regress.

Although we indicate the limitations of Lauritzen's argument, we also affirm the important contribution it makes. By drawing attention to the broader cultural...