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Bioethcial Challenges

Bioethical Challenges on the Horizon

Panel
The Virtuous Scientist Meets the Human Clone
Robert T. Pennock, Associate Professor, Lyman Briggs School
Michigan State University

Bioethical Challenges on the Horizon in Biomedical Sciences
Lawrence J. Prochaska, Professor, Department of Biochemistry/Molecular Biology
Wright State University School of Medicine

Bioethical Challenges on the Horizon: Environmental Issues
Janice Voltzow, Associate Professor, Department of Biology
University of Scranton

The Virtuous Scientist Meets the Human Clone
by: Robert T. Pennock
Michigan State University

The topic of our session deals with bioethical challenges on the horizon, and we have heard mention of a dozen or more significant ethical issues already. Given that we have just an hour or so remaining, we're only going to have time to solve about six of them, I'm afraid. Well, perhaps that is a bit optimistic, but what I want to do is at least suggest that ethical questions are not something about which we should just throw our hands up in defeat or exasperation. Too often people believe that ethical problems can never be solved. However, while it is not easy, we can make progress. I'm going to discuss one example of something that's on the edge of genetic technological research now that I think most people think of still as an extremely problematic ethical issue but which I think is solvable and that will be solved. I'll argue that it can be done with a little bit of cooperation. But before introducing and discussing the issue, let me make a few preliminary points.

* * *

One common assumption that many people make when they think of moral issues, is that morality just involves telling us what we may not do. Typically, when you begin ethical discussions, people think you are going to be talking in terms of "thou-shalt-nots." If you are thinking of your own research, the reason many of you laughed nervously during the previous talk at questions about animal rights probably is because you all have to worry about what you can't do because of the sorts of regulations that have been imposed because of ethical concerns. But, in fact, ethics as much or more tells you about the things that you should do and also that you may do. Probably the reason people focus on the thou-shalt-nots is, in part, that common cultural biases lead many to think of morality only in narrow religious terms, but also because there are times that we do need to constrain ourselves.

Sometimes we philosophers do take that to be part of our job—to play the tough cop and point out some of these boundaries. However, if you look in the philosophical literature, you will find the whole range of ethical recommendations. The case I want to discuss here is one where the initial reaction from the public has been highly negative. It is a case about which many intellectual leaders have concluded that morality demands that science go no further, but where I think that if you look at how the arguments work out philosophically, one finds that isn't necessarily so. This is but one case from among many, but I offer it as one that shows how progress can be made on ethical problems if scientists and ethicists cooperate. The case I have in mind is human cloning. What is the virtuous scientist to do about this issue?

When Ian Wilmut and his associates announced the cloning of the sheep Dolly in Nature , their dramatic achievement made headlines everywhere. Let's take a look at the way in which the public reacted to the news. It was quick, it was forceful, and it had little to do with sheep. If science could clone a sheep from an adult somatic cell, then what about us?

The initial reaction to this idea came as an almost visceral feeling of repugnance. Even Wilmut himself said of the idea of human cloning, that although there was no reason in principle it couldn't be done, "All of us would find that offensive." Much of the negative reaction involved religious objections. Cloning threatens the "sanctity" of life and "traditional family values," some claimed. Isn't this a case of scientists "playing God," stepping in and usurping powers that don't belong to us? A number of international religious bodies quickly issued statements, saying in the strongest language that there should be no cloning of human beings, that this was an outrage and could never be acceptable. The political reaction was also mostly negative. Just one week after Wilmut's announcement, President Bill Clinton issued an executive order for a moratorium on government-funded research on human cloning, saying "Each human life is unique, born of a miracle that reaches beyond laboratory science," and that "[W]e must respect this profound gift and resist the temptation to replicate ourselves." Such early reactions, and these are typical, expressed the feeling that somehow this would be going to be beyond the pale, that cloning of humans simply could not be countenanced ethically.

There were, however, a few voices that spoke in favor of the idea. They pointed out its possible indirect benefits for medical research and its direct benefit as a new form of assisted reproduction for those who could otherwise not have children genetically related to themselves. Senator Tom Harkin was a lone politician who spoke in favor of human cloning, saying "I think it is right and proper…. It holds untold benefits for humankind in the future." There were even a few religious voices that spoke of the theological tradition that holds that human beings are "co-creators" with God, and pointing out that developing reproductive technology was just another aspect of that creative spark.

The question now is, can science provide the solution to what seem to be insurmountable ethical disagreements? The cover of our program for this conference on New Ethical Challenges in Science and Technology depicts a maze—presumably the ethical maze. In the context of our present discussion, this image brings to mind a recent New Yorker cartoon that deals with the maze that many feel we are in with regard to genetic engineering generally. The cartoon depicts two scientists in their white lab coats who are lost in a maze. One is holding a leash, which is being tugged by a white lab mouse. Looking resolutely at his colleague, the scientist says, "Genetic engineering got us into this mess, and genetic engineering will get us out of it."

This is the question I want to pose. Is science really capable, by itself, of providing the solution? As scientists, our natural reaction when confronted with a problem is to try to gather data, update or redesign our techniques, and so on. But is there going to be a technical solution to these sorts of ethical issues?

* * *

Let us talk briefly about what science can and can't do. This conference is about scientists confronting ethical challenges, but what you first need to ask is the following: Is there something specifically in your expertise as scientists that gives you the ability to answer those sorts of ethical questions? I want to suggest that there is not. The expertise that you have, qua scientist, is rather specific. Science is the knowledge of scientific method. It gives you techniques—extremely powerful techniques—to go out and answer certain types of empirical questions. Here is a question about the world that we want to investigate. Here is a way to do it. Here is a way to do it carefully so we can actually confirm an answer.

But can scientific method tell you when we have crossed beyond the moral pale? Can scientific method tell you what moral rights and responsibilities there are? You can do a study to tell whether something is an invertebrate, but you can't do an experiment to tell whether invertebrates have rights. What you can do is conduct a survey, using scientific methods to find what people think about that issue. You make sure your survey technique is right so you ask focused questions to find out that certain people have certain views, and you check whether the results are statistically significant, and you can draw a histogram to show what those different moral views are. But that is not the same thing as answering the question, "All right, what should we do?" You have now gotten an expression of a set of opinions, but that is not how you answer normative questions.

There is a logical distinction that ethicists take to be basic. It is the difference between descriptive ethics and normative ethics. In descriptive ethics, you simply report what people think about moral questions; you describe people's moral views. But that is not the main content or even a very large part of the standard ethics course. The content of an ethics course and of ethics as a discipline has to be normative ethics. How do you give good arguments, and how do you rule out bad arguments to make progress towards normative conclusions, prescriptive conclusions, that is, that we should do this, or we shouldn't do that.

The distinction is that between is's and oughts. So, if we are talking about these sorts of issues—questions about knowledge of good and evil, and what we should or shouldn't do—this is a basic point that we have to always remember. When one is making moral judgments, there are always going to be two sorts of components to it. What should I do in this particular case? To answer that question, I am going to have to gather a bunch of facts. And once I have the facts, I will have to think how those relate to moral values. Thus, any sort of ethical decision is going to require both of those components. Where does science fit into this schema? Science can't deal directly with the oughts. Science deals with the is's. It investigates the facts of the physical world. For value inquiry, you have to look elsewhere. Some would say you have to look to religion, but, speaking more generally, the answer is that you have to look to philosophical ethics.

* * *

Now we are ready to confront the human cloning case directly. Let us begin by looking at some of the relevant factual issues that one has to take into account to try to figure out whether using cloning techniques is a morally acceptable act or not with respect to human reproduction.

Some of these factual questions involve technical risk assessment. Scientists will be able to say something about that. When Dolly was successfully cloned, it was not a very safe procedure; Wilmut and his colleagues tried 277 fusions before they got one that actually worked. If you have a technique with that rate of failure applied to human beings, obviously, it is not going to in any sense be morally acceptable. Indeed, when the National Bioethics Advisory Commission recommended a ban on human cloning, the primary reason for their conclusion was the safety issue. So, one of the things scientists contribute to the ethical assessment is the empirical assessment of risks. Scientists can also investigate what might be done to minimize such risks. (It is significant that the Bioethics Commission also recommended that any legal ban should expire after a few years, so that the question would have to be reconsidered, given the expectation that techniques might improve and obviate the ethical objection based on safety concerns.) And scientists can actually do the empirical work to improve techniques. In all of these ways, scientific expertise will apply.

There are other areas, as well, where scientific knowledge is relevant. For instance, the initial negative reaction people had and many of the arguments that they gave against cloning were based upon misconceptions about how the process works. Let me mention one representative example.

In 1996, I was part of a group of scientists and philosophers in a summer institute jointly sponsored by National Science Foundation and National Endowment for the Humanities on the social and ethical implications of the human genome project. During the institute, the movie Multiplicity was to be released, and we were all invited to an advance screening because the film-makers thought we would be interested, since it dealt with cloning.

The promotional tag-line for the movie was "Better Living through Cloning" and the setup involves a fellow who is overworked and thinks that it would be great if he could clone himself so he would have more free time. The premise of the scenario is that cloning works rather like photocopying, and it spins this out into a clever plot. Now the protagonist can send his clone to the job site and take off sailing, but then his cloned self tries the same trick. Of course, as with photocopying, with each subsequent cloning, the copy quality decreases, which leads to many humorous problems.

It's a great concept for a movie, but the premise is based upon a complete misunderstanding. When you clone an organism, whether it be a sheep or a person, you do not get another adult version of it. Cloning is not like photocopying. Neither is it resurrection. It would not bring back Hitler or Jesus if one could find a cell from them to clone. Obviously, one should not expect scientific accuracy from Hollywood, but, unfortunately, the movies do often provide the public with their ideas about science. What scientists can do from their expertise to help resolve these issues is explain such facts. How does cloning really work?in fact, not in fiction? Getting rid of some of these factual misconceptions is a critical prerequisite to our moral deliberation.

Science can also explain cloning in familiar terms, such as by pointing out that clones are rather like twins. When you can explain a new technology to people in terms of something else that they already know, that will allay many of the fears they have associated with it. Once the connection between cloning and twining is made clear, people can see that idea that a clone would be a "soulless zombie"—a religious worry that was regularly expressed—is just silly. Once they understand that clones are like twins, most of these irrational fears will disappear.

Science can do more. In the previous talk we heard how when you do cloning and insert nuclear DNA, this does not affect the mitochondrial DNA. There are also other causal factors involved, such as intrauterine factors, and all of these things play a role in embryonic development. So, even setting aside the significant subsequent effects of environment and nurture, it is not even the case that cloning result in an exact genetic replica. Investigating and explaining what actually takes places biologically is one of the things you can do from the point of view of your expertise as scientists.

* * *

Those are examples of what science can contribute to intelligent discourse on the subject at hand. How about contributions from ethics?

Ethicists looked at many of the early arguments made against human cloning and immediately saw they were fallacious. Many kinds of arguments have been discussed and dismissed in other contexts decades ago, and even millennia ago in some cases. For instance, arguments against "playing God" or purportedly "slippery slopes" are still very common, but the vast majority of those can be shown to be ill-conceived, irrational or irrelevant. One of the things you can do on the ethics side is to say, "Wait a minute. Your reasoning about this is poor." Ethicists can help us get rid of some bad ethical arguments.

On the positive side, ethicists can offer a variety of general ethical principles that are relevant to the case at hand. For instance, there is a very well worked out ethical framework for what it is to be an autonomous agent and about the respect we owe to autonomous agents. This goes all the way back to Immanuel Kant's work. One version of his categorical imperative deals with the basic principle of treating others never as means only but as ends in themselves. The fact that someone was born with the help of cloning doesn't mean he or she can be used as just a means. It will be another person. It will have its own autonomy. Thus, the suggestion that people may clone a "spare" copy of themselves to use as a histo-compatible organ bank, should they need a transplant, is absurd.

Also relevant to this argument is the large literature in philosophy on personal identity—what it is to be a person. If you look at this, it is quite obvious that the idea people have that somehow clones would have no individuality or that they could just be used as one wished and wouldn't have rights doesn't make sense. The notion of what it is to be a person and the individual rights that go along with that apples equally to people conceived with the help of cloning technology as it does to twins and to anyone else.

Principles of proportionality also come into play when you are considering innovations that will have costs as well as benefits, which our last speaker mentioned. Again, there is a well developed theoretical framework for thinking about those sorts of issues.

A lot of these questions, in fact, are not really new. They are old questions that have taken on a new form, so one can often readily apply ethical principles and considerations to these sorts of cases that have been discussed and have been very well worked out. When you do that for the case of human cloning, given the sorts of things I've just pointed to, the kinds of arguments that people brought up against human cloning may be seen not to hold. In the end there doesn't seem to be any good moral objection to human cloning once one gets the technical problem solved.

From a moral point of view, the debate over human cloning has much in common with the earlier debate about in vitro fertilization. When it first was introduced, IVF was also thought to be immoral, for mostly the same sorts of reasons we have been considering, and very quickly philosophers showed that those arguments were not very good, either. Even the social fears were similar; in both cases, for instance, the argument was made that children born with the help of genetic technology would suffer some social stigma. Today this is put in terms of how "clones" might be regarded, whereas before it was "test tube babies." Such fears faded as IVF became more common. There is no stigma attached to being conceived with the help of IVF; if anything, it demonstrates the loving determination of parents to bear a child. Family values were not undermined by IVF; if anything, they were strengthened. And now we accept and use this technology very broadly. There are some holdouts who still reject IVF, of course, but they do so for the most part because of specific religious beliefs. In general, the moral permissibility of IVF is no longer seriously in question.

I predict that the same shift in attitude will happen, and is now happening, for cloning. If you take a room full of people who have not thought through the question, you will find a large majority who will say that human cloning is morally illegitimate. However, after you take them through the arguments, explaining to them the facts of the matter scientifically, as well as the philosophical arguments and ethical principles, most will very quickly realize that the ethical objections they had are really not sound.

* * *

Let us review what we have learned. We have seen that finding our way out of the ethical maze of new genetic technologies will necessarily require the expertise of both scientists and ethicists. Answering these kinds of questions involves both factual and value considerations, and there will have to be collaboration. It is notoriously difficult for those in the humanities and those in the sciences to talk to one another, but collaborating on these issues is just the place to work to bridge the two cultures. Untangling the ethics of human cloning is a perfect case where you need to have the expertise of both, and as we have seen, by bringing to bear the expertise of each, we have already made considerable progress, finding that there is no compelling ethical reason why cloning should be banned.

We do need to be clear about the scope of our conclusion here, of course. We have seen that, provided the safety problems are solved, ethics does not rule out using cloning as a method of assisted reproduction for human beings. However, this does not imply that scientists should now make this a priority and divert significant financial and intellectual resources to it. One member of the Bioethics Commission, Retaugh Graves Dumas, who was vice provost for health affairs at the University of Michigan, did argue that "It is immoral not to have access to the best technology we could muster" , but this is too broad a principle. Given limited resources, we may not be able to have the best of everything. It is by no means clear that achieving the ability to clone human beings is an important goal relative to other research pursuits. With the problems already caused by over-population, should we pour scarce research funds into a new method of assisted human reproduction before we pursue projects that will help those human beings already living have their basic needs met? And if we do go ahead with cloning, how can we do so in a way that does not exacerbate social injustices? These and other ethical questions will have to be addressed elsewhere.

In conclusion, we may simply affirm that the virtuous scientist takes such ethical issues seriously. The virtuous scientist respects the limits of scientific expertise and collaborates with those who have other relevant sorts of expertise. And it is by virtue of this that we may continue to make small but steady steps towards the resolution of whatever bioethical challenges are yet to come over the horizon.

References
Kolata, G. (1997). After sheep clone, ethical concerns have new urgency. New York Times. New York: 2.

Kolata, G. (1997). Panel Backs human-Clone Moratorium. New York Times. New York: 14.

Recer, P. (1997). Senator, scientists dispute cloning. Austin American-Statesmen. Austin: 17.

Weiss, R. (1997). Clinton: No money for human cloning. Austin American-Statesmen. Austin: 2.

Wilmut, I. A. E. Schnieke, et al. (1997). "Viable offspring derived from fetal and adult mammalian cells." Nature 810-813.

Bioethical Challenges on the Horizon in Biomedical Sciences
by: Lawrence J. Prochaska
Wright State University School of Medicine, Dayton, Ohio

Introduction
In today's presentation, I will discuss recent advances in molecular genetics and the effect of these new discoveries on bioethical issues that will present us with new moral challenges both as scientists and laypersons in the near future. I will focus on three topics of research, first giving some scientific background in each area, and then discussing ethical issues that will be created by these new avenues of research.

I have identified three different areas as state-of-the-art technologies that are currently being developed in biomedical sciences and have assessed what ethical issues might be raised in each area. [Slide 1, Topics for Discussion]. The first area is DNA chip/array technology, which when used on a person's DNA will raise the issue of the individual's right to privacy. The second technology is human and animal cloning, which will create ethical problems of individuality and immortality in humans, and in animals, the morality of harvesting organs for transplantation into humans. And finally, I will discuss the modification of the genome of gametes, which could change the human genome and cause serious bioethical concerns.

DNA Array and Gene Chip Technology
The Human Genome Project, at least in my opinion, has really focused using the large array of genetic information to investigate the states of genes in human diseases. In an overview of how DNA chip technology works [Slide 2, DNA Array Chip Technology], cells from a tissue of interest are grown and the RNA is isolated. The RNA content in the cells at the time of isolation reflects the expression levels of different proteins in these cells. The enzyme, reverse transcriptase, then transcribes the isolated RNA into copy DNA (cDNA). The reaction is carried out so that the cDNA is labeled with a specific marker molecule. The cDNA is then hybridized to known gene sequences on a microchip, and the information from the hybridization is collected by a DNA array machine. You may have read about this process in a recent issue of American Scientist (1), where this technology was fully discussed.

Essentially, the labeled cDNA fragments are hybridized onto a chip in the DNA array [Slide 3, Expression Assay Format] which contains DNA sequences from 10,000 or 20,000 different genes. The fact that the cDNA transcripts made from the original cellular RNA were labeled with a marker molecule allows their detection in the DNA array, so that proteins expressed in the cell can be quantified by the ability of the labeled cDNA to hybridize to the chip. For example, the intensity of the signals from specific, expressed genes can be monitored in a normal patient versus a patient that has a malignant breast cancer in epithelial cells [Slide 4, Expression Profile of Normal and Malignant Breast Epithelium]. The data show a dramatic difference in the types of genes that are being expressed in the two patients. In the normal patient, there are uniquely expressed genes and an entirely different set of genes that are up-regulated. But focusing on the malignant cell line, there are many new genes that are being induced by the malignancy. These data show the tremendous impact that the DNA array technology will have on disease diagnosis and treatment.

The human genome is now known and there is intensive, ongoing work that will describe molecular events in the cancer/heart disease process. So one can imagine that an individual might have this kind of scan done on different tissues or, in fact, on any tissue for diagnosis of disease.

One use for the DNA array technology is to identify where specific mutations are occurring within each individual person. And if one thinks about that, the type of information that this technology is going to provide scientists and clinicians is immense. This technique of knowing the exact position of a mutation is called genotyping. [Slide 5, Uses for DNA Array Technology] Genotyping will allow physicians to diagnose and design treatment of disease. It will also allow gene therapy and facilitate additional discovery and research on disease processes.

Thus, we will have information about the kind of disease processes that will occur in each individual. One ethical concern that I can easily identify is who will have access to the knowledge of the genotype of each individual. This will become a major individual privacy issue. If I go into a clinic and I have a gene array scan on my genome, I'm going to be concerned about who gets that information. [Slide 6, Ethical Concerns from DNA Chip Technology]. Who has access to that gene array data on my genome, and what can be done with that information? As one can imagine, individual privacy is a very important civil rights issue.

On top of that, there's a chance that there could be discrimination against a person who carries the gene for a disease that was identified in the gene array. For the individual, there may also be personal psychosocial concerns upon learning the results of the DNA array test. If a patient finds out that his/her genome dictates that they will be hypercholesterolemic, how will they react? A patient that has a genetic defect may develop some self-stigma. For example, perhaps it is in the patient's genome that he/she might develop Alzheimer's Disease in the future. Does the physician tell the patient that he/she will probably develop Alzheimer's disease? What does that do to his or her self-image?

There are other bioethical concerns that need to be addressed when it comes to the information gathered by the DNA array technique. What type of legal protection against the misuse of test results will be enacted? Can insurance companies or employers use that information against the individual? So, for DNA chip technology, these are some significant examples of future ethical concerns.

Human and Animal Cloning
The second research area that will impact future bioethical concerns is human and animal cloning [Slide 7, Human/Animal Cloning]. The experimental approach for cloning from somatic cells is to isolate the nucleus from a cell of the donor DNA and remove the nucleus from a recipient egg germ cell. This technique was used for Dolly, the sheep. [Slide 8, Dolly slide]. The donor nucleus can be injected into an enucleated recipient egg to restore the DNA in the cell and form a clone of the donor. The clone can pass the transferred gene and other accumulated mutations or alterations of the donor genome to its progeny. Only one organism can be a nuclear donor. For example, a desirable trait in sheep is a heavy coat. The animal that expresses this trait would be a candidate to donate a nucleus from a somatic cell. The donor nucleus could then be injected into a recipient egg from another animal where the nucleus has been removed. Any animal that develops will be a clone of the sheep that produced a heavy coat and can pass that trait onto its progeny. The same approach can be used for organs for future transplantation into humans.

The scientific problem with cloning is that it retains the mitochondrial genome of the recipient individual and, thus, an exact duplicate cannot be made using this experimental approach. The mitochondria of the cell regulate energy metabolism and the health of the individual. Therefore, the clone is not an extract copy of the donor due to the difference in mitochondrial genomes and, thus, different efficiencies of cellular energy metabolism.

So one ethical concern for cloning in humans includes how will this affect individuality of the human species? [Slide 9, Ethical Concerns for Human/Animal Cloning]. We should be concerned about the maintenance of individuality when we discuss cloning. What is the morality of the whole issue of whether humans should be cloned? I think our session chair, Robert Pennock, will address this later. What is the ramification of creation of genetically engineered life on our society? These unresolved issues must be addressed both in the scientific and lay communities.

With animal cloning, one can envision a future where we will harvest organs from animals for human transplantation. Genetic modification of animals will be necessary, so that their organs will be compatible with humans. Will these genetically modified organisms be patented by individuals or corporations? Are patents going to be issued for modified animal genomes and any new genomes that are created? These bioethical issues are just now beginning to be addressed by laws and will need significant legal scrutiny.

Inheritable Genetic (Gamete) Modification
The last new technology that will raise bioethical issues is the use of gamete genetic modification to change the human genome. [Slide 10, Inheritable Genetic (Gamete) Modification] Chapman and Frankel have recently chaired a group of bioethicists for the American Society for the Advancement of Science discussing this major issue (2). By changing the DNA within a sperm or an egg, an individual's unique genetic characteristics could be modified in any progeny. As it stands now, there is no real mechanism for gene transfer in gametes, but there are laboratories intensively investigating experimental approaches to this problem. Most are using traditional gene transfer techniques; that is, trying to use DNA targeting vectors that recognize certain sequences of DNA and then using the vectors to incorporate a trait into the genome of that individual's gametes. An additional approach to gamete modification is using DNA repair enzymes to correct mutations within the gamete. The goal of both approaches is to treat the genetic basis for diseases such as sickle cell hemoglobin, so that an individual can pass on to its progeny a disease-free genome. The limitation of both approaches is that the mutant nuclear genomic DNA sequences will be corrected, but the mitochondrial genome is unaffected by the techniques, so that any disease induced by changes in the mitochondrial genome cannot be repaired.

The bioethical implications of gamete modification are profound. [Slide 11, Ethical Concerns in Inheritable Genetic (Gamete) Modification] Are we, as a human race, going to end up commercializing designer traits for our children? Do we want our children to have blue eyes or straight hair or specific physical features? Will anyone who discovers gamete modification be able to commercialize it and profit from it? Once this treatment is implemented, how will this affect the human gene pool?

Other ethical questions arise from the use of gamete modification. What is the impact of being able to change DNA sequences on our long-term survivability as a species? Furthermore, two or three generations down the line after a genetic modification has occurred, how are our grandchildren or great grandchildren going to feel about their family members who actually modified their genome? Future generations lacked consent in the decision-making process of genome modification.

Another ethical question raised is that there may be inequities of access to the therapy, and as such, not everyone is going to be able to receive it. The therapy may not be available to all individuals across the board. Only a limited number of people may have access to this therapy. Is that something we should be worried about? Also, will gene gamete modification reinforce or increase existing discrimination within our society? And then, finally, by doing this kind of modification, what kind of challenges to equality in our society will result?

Concluding Remarks
The new molecular biology techniques discussed today are going to dramatically affect society and medicine in the next five to 10 years. [Slide 12, Summary] New molecular biological methods will challenge our current bioethical values. Sequencing the human genome will lead to dramatic changes in the treatment of disease, which will include gene therapy. DNA array chip technology, cloning of humans and animals and modification of gametes will raise serious ethical issues. Society will need to address these ethical questions (morally and legally) in depth in the short term future. Dr. Pennock will provide us with a better view about what the status of the ethical and legal debate is at this point.

Acknowledgement
I'd like to acknowledge my colleagues at Wright State University School of Medicine, Drs. S. Berberich, M. Leffak, J. Turchi, and M. White, for their valuable discussions in helping me prepare this presentation.

References

  1. Hamadeh, H., and Afshari, C.A. (2000) Gene Chips and Functional Genomics. American Scientist 88, 508-516.
  2. Frankel, M.S., and Chapman, A.R. (2000) Human Inheritable Genetic Modifications: Assessing Scientific, Ethical, Religious, and Policy Issues. (http://www.aaas.org/spp/sfrl/germline/main.htm.) pp 1-89.

Bioethical Challenges on the Horizon: Environmental Issues
by: Janice Voltzow
University of Scranton

The organizational hierarchy of nature gives biologists a framework for their research. Beginning at the lowest levels of atoms, molecules and organelles, the hierarchy extends through cells, tissues, organs, organ systems, individual organisms, populations, communities, ecosystems and the biosphere. Many researchers focus on a particular level or levels of organization. But it is the interactions between levels, including positive and negative feedback, that are especially important in environmental issues. For example, there are top-down effects. Spraying a pesticide that kills insects by interfering with molting may also kill shrimp, crabs and other crustaceans because the biochemistry for building the exoskeleton is similar throughout arthropods. Similarly, there are also bottom-up effects. A gene introduced for pest resistance may affect other insects that are not the target pest.

As technology becomes more sophisticated, the interactions between levels will become more complex, and so will the ethical issues arising from that technology. So complex, in fact, that their long-term consequences may well be, as William Wulf pointed out in his plenary address to this forum, impossible to measure. Because we will be capable of (almost) anything, the things we do will potentially have even greater, far-reaching implications. Thus it will be increasingly important to have scientists that are trained across disciplines so that they can integrate across levels of the organizational hierarchy.

One of the most significant issues on the horizon (both figuratively and literally) is global climate change. According to some calculations, we have just had the warmest year on record (Spotts 2000). Hansen et al (1998) estimate that the global temperature is rising by 0.11 Celsius per decade. Other estimates predict an increase of 6 to 11C over the next 100 years. This warming is due especially to greenhouse gases, produced primarily by burning fossil fuels. The Intergovernmental Panel on Climate Change (IPCC) has produced a strong statement calling for action. At the meeting at The Hague in November 1999 they tried to negotiate the details of the Kyoto Protocol, a treaty to reduce CO2 and other greenhouse gases. As Hansen et al (1998) state "The issue should no longer be whether global warming is occurring, but what is the rate of warming, what is its practical significance, and what should be done about it."

Some of the effects of global warming are easy to predict, at least qualitatively—rising sea level, changes in distributions of organisms that will greatly affect the natural landscape, effects on crop production due to increasing levels of CO2, the spread of "tropical" diseases such as malaria and dengue associated today with developing regions to temperate, developed regions.

One example of the complexity of understanding these effects involves coral bleaching. Over the past 10 to 15 years, researchers have recorded an increasing frequency of patches of white, dead coral on reefs. Most coral polyps contain unicellular dinoflagellates, called zooxanthellae, that live symbiotically in the coral tissue. The bleached corals have lost their zooxanthellae by discharging them, and usually die shortly thereafter. Initially, global warming was blamed as a cause of coral bleaching. It was believed that the bleaching was a response to increased levels of ultra-violet radiation and/or elevated water temperatures. But the situation is not that simple. Bleached polyps of one species of coral that has been studied extensively, Oculina patagonica, contain large numbers of a rod-shaped bacterium, Vibrio shiloi AK1 (Kushmaro et al. 1996). These bacteria are commonly present in the host coral tissue, but in low numbers. Bleached corals have high numbers, and inoculating healthy coral with the bacterium can cause them to become bleached. Normally, cool winter temperatures, which inhibit adhesion of the bacterium to the coral tissue (Kushmaro et al. 1997), hold the bacterial population in check. Thus, global warming is contributing to bleaching, but not simply because of increasingly higher temperatures; rather, because of lack of cool weather.

A second issue that is rapidly moving to the forefront is the problem of invasive species. Approximately 50,000 introduced and invasive non-native species have entered the United States to date, including purple loosestrife, zebra mussels, Formosan termites, Asian swamp eels and an unknown number of microorganisms in ballast water (Robichaux 2000, Ruiz et al. 2000). Invasive species are expensive for the environment and for the economy. Non-native species are blamed for almost half of the species listed as endangered or threatened. Documenting and controlling these invaders cost the U.S. an estimated $138 billion annually (Robichaux 2000). A new National Invasive Species Council was charged with developing a National Invasive Species Plan to deal with these organisms. A major question on the horizon will be: Which is worse, the spread of the invader or the cost of eliminating it?

A third bioethical challenge on the horizon is space. With the arrival of Russian and American astronauts on the International Space Station, we have entered an era of permanent human occupancy of space. NASA official Jim Van Laak hopes this marks the beginning of "at least 15 years of continuous human presence in space" (Leary 2000). Issues such as mining other planets, waste disposal and international jurisdiction have barely been addressed, much less resolved. As evidence rises that microbes might survive interplanetary travel (McFarling 2000), we run the risk of ballast-borne interplanetary invasive species. The consequences may lead to Silent Spring meets Silent Running. What will happen when (and if) we discover other life forms or they discover us?

What's on the horizon? A new level in the organizational hierarchy of nature—space.

References

Hansen, J. E., S. Makiko, R. Ruedy, A. Lacis, and J. Glascoe. 1998. Global warming: Global climate data and models: A reconciliation. Science 281: 930-932.

Kushmaro, A., M. Fine, A. Toren, L. Landau, Y. Ben Haim, E. Rosenberg, and Y. Loya. 1997. The role of temperature in bacterial bleaching of corals. American Zoologist 37: 13A.

Kushmaro, A., Y. Loya, M. Fine, and E. Rosenberg. 1996. Bacterial infection and coral bleaching. Nature 380: 396.

Leary, W. E. 2000. A new, and ambitious, home away from home. http://www.nytimes.com/2000/11/03/science/03STAT.

McFarling, U. L. 2000. Microbe travel aboard meteorites, possible, study says.

Robichaux, M. 2000. A plague of Asian eels highlights the damage from foreign species.
http://interactive.wsj.com/archive/retrieve.cgi?id=SB970017741134463943.djm.

Ruiz, G. M., T. K. Rawlings, F. C. Dobbs, L. A. Drake, T. Mullady, A. Huq, and R. R. Colwell. 2000. Global spread of microorganisms by ships. Nature 408: 49-50.

Spotts, P. N. 2000. The defining issue of 21st century: Global climate. http://my.csmonitor.com/Subscription/archive.html?page=656aafc69060f52
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