The Case against PerfectionMichael J. SandelHarvard University Press, $18.95, 176 pp.
In his 1987 novel Bonfire of the Vanities, Tom Wolfe explores the hubris, greed, and recklessness of the 1980s Wall Street boom. One of the central characters, Sherman McCoy, a Wall Street bond trader, styles himself a “master of the universe” because he controls vast amounts of money and is therefore treated deferentially by almost everyone around him. It is a book about the folly of human arrogance. I thought of Bonfire when I read The Case against Perfection, Michael Sandel’s marvelous little book about the moral issues raised by genetic engineering and other forms of biotechnology, for Sandel’s central thesis concerns the drive to mastery that appears inseparable from our society’s enthusiastic embrace of biotechnology. Indeed, a passage at the end of Sandel’s book is strongly reminiscent of Wolfe’s indictment of unbridled arrogance, and it is a nice summary of Sandel’s whole argument. “It is possible to view genetic engineering,” Sandel writes,
as the ultimate expression of our resolve to see ourselves astride the world, the masters of our nature. But that vision of freedom is flawed. It threatens to banish our appreciation of life as a gift, and to leave us with nothing to affirm or behold outside our own will.
The book is an elaboration of themes first sounded in an article of the same title published in the Atlantic Monthly (April 2004). Although Sandel, who teaches government at Harvard, is not a trained bioethicist, he served on the President’s Council on Bioethics and this book grows out of his work on the council. Among the issues that the council has taken up in recent years are enhancement technologies, including bioengineering stronger muscles, better memory, and taller people; preimplantation genetic diagnosis; and sex selection. All these issues are discussed here with exceptional clarity and conciseness.
There are many things to admire about this book. For example, the care with which Sandel examines arguments for and against various forms of biotechnology makes this an excellent primer on how to formulate and assess moral arguments. His discussion of the problems with cloning is typical. He notes that many argue that cloning and other forms of bioengineering that allow parents to choose their children’s genetic characteristics are wrong because they violate a child’s right to autonomy. Sandel notes that there is a certain appeal to this argument, because we do wish to preserve a child’s prospects for an open future. Still, he says, the appeal to autonomy is not persuasive for two reasons. First, the logic of the argument presupposes that “absent a designing parent, children are free to choose their physical characteristics for themselves.” But, of course, none of us chooses our genetic inheritance and so cloning does not rob a child of some bit of autonomy that he would otherwise have. Second, the worries we have about “made-to-order children” are not just about designing and controlling children; they are about designing and controlling ourselves.
Concern about autonomy, though, does not really explain our apprehension at the prospect of, say, the genetically engineered baseball player who hits a hundred home runs before the All Star break. If we have reservations about breast implants or Botox injections, imagine the concern about shifting standards of human excellence when our self-engineering is not just skin deep. The potential loss of autonomy is a concern, Sandel says, but it is not the primary concern.
Although providing a model of thoughtful, balanced moral argumentation is a real virtue, the greatest strength of this book is Sandel’s understanding of how the Promethean aspiration to mastery erodes a sense of what he calls the “giftedness of life,” and how the eclipse of this sense diminishes our humanity. A passage from the section of the book on how the use of enhancement technology by athletes corrupts athletic competition captures this point well.
“To acknowledge the giftedness of life,” Sandel writes,
is to recognize that our talents and powers are not wholly our own doing, nor even fully ours, despite the efforts we expend to develop and exercise them. It is also to recognize that not everything in the world is open to any use we may desire or devise.
Interestingly, Sandel insists that acknowledging that life is a gift does not require belief in a gift giver. Although a sense of giftedness is characteristically a religious sensibility, it is not exclusively so. Even strident secularists speak about an athlete’s or a musician’s gifts, and doing so is perfectly sensible even when one does not believe that athletic ability or musical talent is a gift from God. When we talk in this way about gifts, we may mean simply that there are talents or abilities that exceed our control. Yet whether a sense of giftedness is religiously rooted or not, acknowledging that human powers and achievements are not entirely under our control has implications for three important moral traits: humility, responsibility, and solidarity.
Sandel’s explication of how the failure to appreciate the giftedness of life erodes both humility and solidarity and fosters a debilitating sense of hyperresponsibility is compelling. Consider, says Sandel, how the ability to engineer ourselves comes with burdens that are absent when human life is viewed as a gift. As we abandon the humility that comes from seeing ourselves as creatures of God (or nature or fortune), we suddenly find ourselves weighed down by enormous responsibility. Where once there was chance, now there is choice. Parents can choose the traits of their children, scholars the capacity of their memories, athletes the talents needed by their teams. And, of course, all will be accountable for making (or failing to make) those choices.
Sandel is perceptive about other matters as well. His discussion of how the familiar moral language of autonomy, fairness, and individual rights fails us in the face of the difficult issues of contemporary biotechnology is important and helpful for those who are trying to articulate another moral vocabulary for bioethics. Sandel does not explicitly invoke Catholic common-good theorists, but his work dovetails nicely with those writers who do.
Having said that, I should note that the positions set out in the epilogue, “Embryo Ethics: The Stem-Cell Debate,” may come as a surprise to many readers. Sandel believes that an ethic of giftedness supports embryonic stem-cell research because such research does not—or at least need not—aim at transforming human nature. Ideally, stem-cell research aims to develop therapies that will restore normal functioning in patients who are ill. To be sure, there is an apparent tension between Sandel’s stated commitment to resisting the Promethean impulse to reduce everything in the world to an object we may bend to our will and his willingness to destroy embryos in the service of our medical desires. But even if this tension is troubling, there is much in this final chapter that is valuable.
For example, Sandel tackles as directly and forcefully as anyone what he describes as the “equal-moral-status position” regarding embryonic life. According to this view, unless we can find “some definitive moment in the passage from conception to birth that marks the emergence of the human person,” we must treat the earliest embryo as no less inviolable than a fully developed human being. Sandel presses two serious objections to this view of the embryo.
First, the fact that we cannot specify a definitive cutoff point for personhood does not mean that there is no moral difference between an embryo and a child. We cannot say just how many hairs must be lost before a person becomes bald, but this does not mean that there is no difference between being bald and having a full head of hair. We may simply have to admit that, like baldness, human life develops by degrees.
Second, if the equal-moral-status view is fully embraced, it commits one to positions that few would accept. For example, if embryos must be treated as indistinguishable from persons, we should be working to ban IVF programs and we should not hesitate to condemn the couples who use them. Indeed, writes Sandel, “if the embryo loss that accompanies natural procreation were the moral equivalent of infant death, then pregnancy would have to be regarded as a public-health crisis of epidemic proportions.” Yet many of the most strident advocates of the equal-moral-status view do not treat natural embryo loss as tragic; that they do not is revealing.
In short, Michael Sandel has given us a valuable gift—a sustained and carefully crafted meditation on the ethics of biotechnology. Let us hope that this is not his last foray into the world of bioethics.