Abstract
This article dates from november 2013. It was originally delivered to The Hastings Center (Garrison, NY) on the occasion of an inquiry on how to teach ethics in the fields of biotechnology and related disciplines.
The article is reprinted here because the central argument has proven useful to scholars and students of techno-anthropology. It is mostly referred to as the ethical judgment, the ethical estimate (Danish: det etiske skøn) or simply Birkholms model.
When teaching and learning techno-ethics you have to leave the framework of epistemic sciences, so familiar at academic institutions. The invention and the implementation of new technologies are always situated in specific and very different contexts. Moreover, both scientists, engineers, patients and other users are intermingled in a lot of contingent ways. Therefore no universal rules apply when analysing the ethical implications of a certain technological innovation. Instead, students should learn to apply phronesis, building on experience and a number of very different case-studies.
Since all new technologies seem to be guided by very noble intentions, it’s important for students to learn looking in other directions. Klavs Birkholms approach is to make an ethical judgment through three stages: What are the possible risks to users? What are the eventual potentials for misuse? And what could the long-term consequences be in society and culture?
Ethics as a discipline in techno-anthropology
Techno-anthropology is a quite new academic study, established in September 2011 at Aalborg University in Denmark. The goal is to merge understandings of technology, ethics and anthropology into one and the same academic discipline. This endeavour is based on the assumption that the interface between man and technology is nowadays the locus of a more and more intensive interaction both ways. Homo Sapiens is being engraved and altered by still new technologies, and vice versa: technologies are shaped by scientists and engineers’ idea of what humanity is like. Techno-ethics specifically addresses the ethical questions this situation gives rise to.
In the curriculum of techno-anthropology educational courses in “technology and ethics”, “philosophy of technology”, “anthropology of expert cultures”, “social and responsible innovation” and several others all form parts of both the bachelors and the masters degree.
Having been for eight years (2003-11) a member of the national Council of Ethics – a comparable institution to the Presidential Council in USA – I was asked to assist with the development of the ethics program in techno-anthropology. It was immediately clear to me that basing this program on already existing courses of study in the danish University system was not going to be possible. Anthropological teaching in the tradition of Science and Technology Studies (STS), however important to other parts of our study, seems mostly to be concerned with the “mapping” of scientific cultures, not dealing too much with the importance of specific ethical dilemmas and even less with the questions of how to cope with them in a reasonable way. [1] On the other hand, teaching in “applied philosophy” tends to be all too theoretical and not at all applicable. In Denmark, like elsewhere in the Anglo-Saxon world, teaching in ethics is mostly an exercise in consequentialism, often inspired by the logical investigations of R.M. Hare. Given this, we had to find a new approach – a third way.
Some great inspirations for the founding of such a third way was taken from the writings of Aristotle, John Dewey, Hans-Georg Gadamer and Knud Ejler Løgstrup. This selection of thinkers is not arbitrary. What our students must learn is not insight in a variety of epistemological theories or the ability to compartmentalize ethical reasoning in a metaethical chest of drawers. Rather, students must learn the skills to identify ethical dilemmas in the development and implementation of specific new technologies; to reason and deliberate sensible and balanced about the importance of such dilemmas; and to make well-founded judgments about how to handle these dilemmas in the best possible way.
Applied Phronesis
In the Nicomachean Ethics Aristotle make his famous distinction between the five intellectual virtues epistēmē, technē, phronesis, nous and sofia – episteme being the faculty to demonstrate scientific truths, to prove what is unchanging and universal; techne being the faculty to apply a certain, acquired knowledge in the making of a designed piece of craft (or art); and phronesis being the faculty to choose the right actions, i.e. the actions that in the specific situations are best for the common good. [2] For the purpose of the present argument we can here neglect the virtues of nous and sofia. It seems pretty obvious then that the virtue demanded in the learning goals of our students are closely related to the Aristotelian phronesis. Following the social scientist Bent Flyvbjerg our formula might even be called applied phronesis. [3]
In his book Making Social Science Matter (2001) Flyvbjerg argues that much of the criticism of, and misgivings about, the social science disciplines derives from the enormous prestige nowadays attached to episteme. [4] This prestige is perfectly explicable. The overwhelming triumphs of technological progress during the last quarter of a millennium are mostly to be credited the natural sciences – episteme being the decisive force at play. So, quite understandably, the other Aristotelian virtues have been put in the shadows.
This is especially true of phronesis. Just take a look at our spoken language. We can talk about “epistemic”, “epistemology”, “technique” and “technology”, but we find no contemporary terms referring to phronesis. Similarly, we observe the seemingly innate attempt of all social sciences to emulate natural science. The Cartesian concept of rationalism still holds the grip of what is considered genuine science: “genuine science” deals with truths that are invariable, universal, context-independent and predictable.
This perception of science holds a very firm grip on our culture. The Aristotelian distinction of different intellectual virtues is no longer common knowledge. Everyone knows that a person can be skilled to analyze the inverse movements of waves in liquid, or to predict the Higgs boson (episteme). Everyone also knows that yet another person can be skilled to make a sailboat, a diesel engine or a three-parent embryo with replaced mitochondria (techne). But very few people seem to recognize that a person can also be skilled to be a human amongst humans, and that’s an entirely different kind of competence (phronesis).
Nothing, however in the social life of humans is context-independent; it is always contingent and takes unpredictable paths. And since ethics is all about the good – and the not so good – life in human communities, it would an exercise in futility to conduct ethical investigations using the framework of episteme. For this reason, our entire course of study is based on case studies. Whether the cases are copied from reality or constructed on the basis of it, the power of example is the best way to learn phronetic virtues. As Aristotle observes: phronesis is very much about experience. [5]
Identifying the Ethical dilemma
I argue that a genuine ethical dilemma is a conflict between two or more norms that each can be asserted with significant emphasis. A case occurs where you are forced to make a choice – but, mind you, a choice constituted in such a way that it is unavoidable to override one worthy consideration just to promote another.
One of the first cases I present to the students is an incident from the 1990’es at the hospital of Hammerfest, a small Norwegian town north of the artic circle. The nurses, hitherto trained to intubate on plastic dolls, refused to obey orders when the hospital management decided to replace their manikins with cadavers of recently deceased people. The nurses characterised such practice as being a “disrespect of the dead”, and described an “instinctive disgust” that they felt about the proposal. Although the management arranged for an opinion poll in the small community and got themselves an approving majority (albeit a narrow one) among the local population, the staff would not yield, not even following threats of dismissals. The nurses remained firm with their decision. [6]
This story prompted one of my predecessors in the Danish Council of Ethics, Lars-Henrik Schmidt to suggest a sort of “ethical archaeology”, upon which I would like to expand. [7] The set of taboos held by virtually all primitive societies is still working today, Schmidt argues, and it is in fact the deepest layer of our ethical “equipment”. [8] Murder inside the tribe, cannibalism, incest, mutilation or irreverent handling of dead bodies are all examples of such taboos. These normative values however, have been overlayered about 2000 years ago by a new set of ethical claims embodied in the gospel of the good Samaritan: Empathy, care, compassion, mercy and the demand always to help a fellow human in need was established as a new layer in our ethical equipment – accompanied by the demand to forgive instead of blindly obeying the older impetus of revenge. [9] Secularism in politics notwithstanding, this Christian ethics of compassion is still the foundation of the social- and health care systems in modern welfare societies.
But the incident in Hammerfest bear witness to the living conflict between the two layers. The physicians and the hospital management referred to the layer of compassion as justification for their proposed change – the nurses would have a more realistic training situation and hence could be presumed to obtain higher skills in the art of intubation, all to the benefit of future patients. The nurses, however, referred to the layer of taboos, claiming that the proposed training would be a violation of the sacred respect of dead humans. To this conflict there is no simple or final solution. Both possible choices could have both bad and good implications.
An attempt to ‘solve’ this unsolvable conflict complicated matters further as the Enlightenment put a third layer – the layer of self-determination – on top of the two others. A blossoming example of a full-fledged collision between all three layers is the rewriting of proposals to legalize euthanasia as a “Law on compassionate killing on demand”, a formula often seen in the Danish debate. In this one formula appeals are made to both murder, compassion and self-determination in the very same phrase.
Some discussants might argue that the layer of taboos is too old or too irrational to claim current impact. I just remind my readers how meticulously most people arrange mourning’s and funeral ceremonies for the deceased – we do not dump the dead bodies at landfills or incineration mills. We count it as one of the many crimes against mankind committed by the Nazis that they used the dead bodies of exterminated Jews for the production of soap and used their skin for the production of lamp shades. Not only did the Nazis execute the Jews, they also handled their dead bodies with the uttermost irreverence, we say.
A more recent example emerged in November of 2012, when a Danish professor of law suggested abolishing the ban on incestuous relations between parents and (adult) children and between siblings. This ban has no rational basis, professor Vagn Greve declared in several newspapers. [10] Since having children is no longer illegal for people carrying genetic diseases, the risk of inheriting the genetic defects being often as high as 50%, there is absolutely no logic in maintaining a law against in-family breeding where the risk is substantially lower, he argued. I am confident that I don’t need to explain to foreign readers how this proposal was met in the Danish public, because intuitively we all know that the abovementioned layer of taboos is very much alive and kicking.
In sum, a genuine ethical dilemma demands a conflict of worthy norms. Of course, such a conflict need not be between the “archaeological layers” presented here. It could also be a conflict of two norms both belonging to the layer of compassion or the layer of modernity. For instance, when a number of American companies ask applicants for new jobs to hand over their Facebook username and password [11], this seems to be a case of conflict between the regard for autonomy (of employers) and the regard for citizens right to privacy. Likewise, when a group of American and British scientists, referring to the widespread use of brain stimulant drugs amongst students and in other “intellectual environments”, proposed that methylphenidates should be free of prescription (“legalized” for the market) [12], this promoted a conflict between the need for recognition (a value reinvigorated by modernity, not least expressed in the philosophy of G.W.F. Hegel) and the need for social justice, very much a foundation for the modern societies.
Although there is great diversity in the kinds of norms that can come into conflict in genuine ethical dilemmas, in the case of bioethical dilemmas in particular, the layer of compassion is almost always involved. This is entirely to be expected, since most research in this area is conducted under the aegis of care for suffering humans.
The unforeseen consequences
But identifying ethical dilemmas is the easiest job that trained techno-anthropologists have. The really hard work comes in when a techno-anthropologist is tasked with tracing the effects of emerging technologies on communities and society today—and perhaps especially—tomorrow. K.E. Løgstrup writes:
“The side effects [of a new invention, a new technology] are the important effects, much more important than the goal [the purpose]. “The goal – as it is born in the laboratories – does not change the world. The side effects to the pursuit of the goal do that, however”. That is because the goal “is always targeting a rather partial development, whereas the side effects change the totality”. [13]
Løgstrup has a lot of very interestering supporting arguments, especially concerning the factors changing the goal–side effect relationship during the past 200-300 years. I will not deal with these arguments for now. I just want to establish here that whenever a new technology, a new research project or some medical innovation effort is presented to bodies like the Danish Council of Ethics, the usual procedure is to ask for an approval of the purpose. The Ministry of Health, the Health and Medicines Authority, the various Boards of Technology Assessment, the civil servants – everybody are mostly asking only about the purpose of this or that particular technology.
I must admit, however, that I do not remember having seen one single project presented with a nefarious purpose. R&D-engineers, biotech researchers, pharmaceutical research teams – all have noble aims; they all want to help and do good deeds. Therefore, I often remind our students of the proverb ascribed to Samuel Johnson: “The road to Hell is paved with good intentions”. You should never look too much for the intended goal of a certain new or emerging technology, I teach them. Look instead for (1) the possible risks for users, (2) the eventual potentials for misuse, and most of all (3) the long-term consequences in society and culture. I prescribe this as the three successive steps to a properly weighed ethical judgment.
Let me elucidate this by a rather clear example: Fertilization by micro-insemination is a technique that has been in a steep rise over the last decade in many western countries. The backdrop of course, is the rather sudden decline of sperm quality in our part of the world. As such, the noble purpose of introducing treatments with micro-insemination (ICSI) is rather obvious: to help young couples suffering from this particular kind of infertility.
When (in 2003) I entered the Danish Council of Ethics, a report on ICSI and pre-implantation diagnostics (PGD) was at the final stages. The Council had been working on this particular report for more than 12 months and it was now almost ready for publication. [14] The text as I found it was advocating the acceptance of the ICSI-technology as an offer for all infertile Danes, since “the risk of a pressure on the woman to undergo an unpleasant treatment because of a flaw in her male partner … cannot outweigh the consideration for the infertile couples desiring a baby of their own genetic imprint”. This conclusion is a very clear illustration of what is happening when you are asking for the purposes only.
1) Possible risks: What risks do we evoke by implementing this technology? In the traditional intercourse the man happily ejaculates around a quarter of a billion sperm cells, all of them immediately starting a race to reach the female egg and be the first to enter it. Is this an example of the Darwinian survival of the fittest? In fact, we do not really know. What we do know is that this “race of the spermatozoon’s” has been taking place over the course of millions of years and in many different species preceding our own. So we have every reason to be careful here and suspect that the wisdom of nature exceeds what a couple of thousand researchers working for ten-fifteen years are able to oversee. What will happen if we suspend this “fight for genetic continuity” by forcing an arbitrary and handicapped sperm cell to deliver the paternal part of a new human embryo?
“Nothing, as far as we know”, answered a leading fertility physician, Søren Ziebe, back in 2003 at a parliamentary hearing. [15]
“As far as we know” – Is this answer good enough, considering the weight of the problem? Today we know that there is a four times increased risk of chromosome abnormalities in ICSI embryos [16]. And we are still in the investigating phase concerning the (unfortunately) growing suspicion that male children produced by ICSI bears a significantly increased risk of being infertile like their fathers. In brief, ICSI is today an ongoing human experiment – with no formal ethical protocols attached.
2) Potentials for misuse: One can look in several directions for misuse possibilities. One, immediately apparent consideration may occur when you realise that in vitro fertilization (IVF) is an expanding business in many parts of the world. So when physicians and researchers rebuff, often blatantly, the warnings about increased risks of infertility in the male ICSI-offspring, they are in a conflict of interest. In fact, I have heard the argument: “That is not important, since now we have the ICSI-technology”. Should this count as an experts verdict or as a stakeholders argument in a public deliberation?
3) Long-term consequences in society and culture: Today, close to 10% of all newborns in Denmark are conceived by IVF, and the ICSI-part of this figure is increasing. [17] Treatment is free for all, including singles and homosexual couples; this count also for an eventual child number two. Some reports suggest that a number of couples even “chooses” IVF, although they have no medical indication of infertility – only because they feel “safer” by the extra involvement of controlling health personnel. The extent of this latter category is highly insecure, however.
For the sake of an argument, let us suppose that in 30-40 years the majority of all newborns are conceived artificially. The present trend might stop at a certain point, but it might also continue. One obvious consequence of this future scenario would be that humankind stands out as a species no longer able to reproduce itself. (I know very well the transhumanist’s reply: that since man has also invented IVF and ICSI, the opposite statement seems to be proven. I take this argument as a non-phronetic diversion, and I won’t deal with it here. [18])
More important however, might be the consequences to our perception of sex, love and genetic variations. If children are no longer considered to be the outcome of a love history – people searching for the preferred mate, everyone following his or her individual priorities – but rather something you decide to order from a laboratory, this will dramatically change our whole concept of what it means to be a man, to be a woman and to be in love.
Some people might consider such development a progress to be preferred. I will not question that. I will, however, question the present tendency to embrace all technologically advanced inventions without any kind of deliberations on their future benefits and drawbacks. This is the main reason for my own and my colleagues’ commitment to educate techno-anthropologists equipped with such skills: the ability to put some of today’s most important issues on the agenda. What are the long-term consequences in society and culture? Do we like these consequences? Do we want to embrace them? Or would we like to adjust what’s in the cards?
(And, sticking to the example of ICSI: You have to make the public debate now, because soon it might become politically incorrect. Visiting a class room at elementary school you can be sure today that more than one of the children are “IVF-offspring” – and they are of course no less worthy humans than everyone else.)
So the all important deliberation is missing. In the present debate on ICSI the main protagonists are the ‘experts’ from the fertilization business and a number of interest groups, all of them arguing for the natural right to have children. Counterposing the present industry and consumer interests with ethical concerns about possible landslides in our cultural and societal norms seems to be an uphill struggle at the moment. This might be different in North America, but in Denmark and the whole Europe just now the public consensus seems to be: “I have the right to have beautiful and intelligent children”, just like “I have the right to stay healthy, live happily and get very old” – and the state health industry has the obligation to deliver.
Different cases
I have characterized the ICSI example as a “clear” one. That’s because it is rather easy to see the ethical dilemmas and their serious implications in this case. This does not mean that it is easy to make a phronetic ethical judgment. It seldom is. The deliberations on possible risks, potentials for misuse, and long-term consequences are usually complex and intricate to sort out.
Furthermore, it is crucial for the student to understand that once you have handled an ethical judgment of a particular technology, you have done just that – nothing more. You have not solved all of the ethical dilemmas attached to the many different biotechnologies.
I was once called by the Danish National Television (DR) who wanted me to take part in a news debate on sperm banks: Should it be allowed for sperm banks to post catalogues of information on the parental phenotypes on their internet-pages? Information like: “This donor is 6’3” tall, he has brown hair and blue eyes, he likes running marathons, he is a professor of mathematics and he plays the piano.”
– “I see no problem in that”, I answered.
– “But why, you are on the record opposing a prolongation of the allowed number of years for a fertilized egg to stay in the freezer?”
– “Yes, but that is something quite different. The arguments bare no resemblance in these two cases.”
A tendency towards binaries is very common in most public debates nowadays: black or white, pro or contra, technophile or technophobe, etc. This makes it extra important for students to be aware that they are not educated to form a firm, unwavering opinion, which can be used in all cases and across different contexts. Rather, the ethical judgment is always context-dependent, pragmatic and temporary – it is not universal and not irreversible. Hence it is very important for students to learn openness (in the Dewey sense of the word) and to practice their judgement in a lot of different cases. Like the following five, all picked from my present course:
Case A: Two hospitals in Denmark (Rigshospitalet and Horsens Sygehus) now offer to evaluate women’s baby-deadline, i.e. “how many years of fertility the woman in question eventually has left”. According to several newspapers this new service is very popular. Please, give an ethical judgment of the service and also state your hypothetical position on this, assuming you were a member of a hospital’s management in Denmark.
In this case, which I handle the students at a very early stage, the ethical dilemma might not be very heavy. I believe it’s not – although of course, the risk of a false evaluation might have a bad impact for the patient, and this is not a minor concern. But the case illustrates very well the importance of context. Such as the fact that the Danish government has put a hellacious pressure on students to finish their studies earlier on (known as the “momentum-reform”). Further important context to consider is the well-known propensity of company-managements to elude female jobseekers of the childbearing age. Against this background, might it be a possibility for instance, that the new hospital service results in bringing more middle aged customers to the fertilization business?
Case B: Botulinum toxin has since the 1950s been used in medical treatment against muscle spasms, and since 1989 under the trade name of Botox ®. In recent years this neurotoxin has also been used for cosmetic treatments, notably facial lifts. Now research implicates that facial treatments with Botox do not only weaken a person’s ability to express his or her emotions through mimicry, they also weakens the person’s ability for empathy. [19] This goes well with other types of research linking both empathy and learning to the human ability to mimetically ‘mirror’ other humans. According to the discovery of the mirror neurons by Luciano Fadiga, Giacomo Rizzolati et. al. we ‘feel’ the pain, the sorrow, the anger of our fellow humans as if it was our own pain, our own sorrow, our own anger – and this occurs because our brains ‘imitate’ the expressions we see in others. [20] Now, if further research support the findings of Neal and Chartrand, could this in your opinion have ethical implications? And are you able to point to steps that should follow such an insight?
I have used this case (among many others) for end term examinations, and I observed an unusual difficulty for the young students, may be because of the cultural images of beauty nowadays exposed through the media etc. I remember one student showing me and my co-examiner a picture of two different women, the one clearly a model, the other slightly overweight.
– “Who of these two would you prefer to employ?” she vehemently asked.
– “Imagine you are the leader of a hospice or a caring center for elderly people – would you then invite only one or both of these women to a job seekers interview?”, I asked back.
At that point the ethical deliberation could finally begin. But I think there is a point in creating a number of cases that are both referring to very recent research and also close to the daily life of today’s students.
Case C: Several research teams around the world are working on projects for the resurrection of extinct species. Mostly, this research is about sequencing the genomes. The resurrection technology is a kind of cell nucleus transplantation similar to cloning. One research team for instance, isolated genetic information from the Tasmanian Tiger, which became extinct seventy years ago. They inserted this information “into mouse embryos, where it contributed to the development of cartilage and eventually, bone.” [21] In Nature 492/9, 2012 you can also read the contribution of Dr. Subrat Kumar (biotechnologist), “Extinction need not be forever”.
One of the larger efforts is sponsored by The Long Now Foundation (see: Longnow.org/revive) – the pilot project being a revival of the American Passenger Pigeon, which became extinct around 1900. Other Longnow “candidates for revival” are The Carolina Parakeet, Steller’s Seecow (hydrodamalis gigas) and the Dodo.
One question often raised is: how far back can we go? and how far should we go? In the case of the Woolly Mammoth (extinct 4600 years ago) valuable material found in the Siberian permafrost raises hopes amongst scientists to be able to reconstruct the complete DNA from this animal. Very old DNA-material has also been found in egg shells from the enormous Elephant Bird (Aepyornis) and the Moa Bird (Dinornis novaezelandiae, made extinct by the maori people presumably around one thousand years ago).
Your task is to make an ethical estimate of this whole research. In your judgment, are there reasons to question the advantages of getting back extinct species? Should limits be set? If yes, how should that be done?
The students are having one week to prepare their answers which are then presented and discussed in class. We do not of course, ask them to evaluate all the scientific and technological evidence for and against the possibilities to complete such “resurrection” – this kind of skills is the prerogative of other courses in our study. We ask them only to make ethical judgments along the line described in this article. That is because our job is to educate students in ethical skills needed in today’s businesses and institutions.
Case D: AudiCon™ is a minor and very innovative HiTech-business in Copenhagen, dealing with cochlear implants and other sorts of hearing aid. The firm has recently obtained patent on a new hearing device, that can optimize the human hearing so that you are able for instance to discern speech and other sounds through normal walls. The device has been tested for several years and the company is now able to issue a warrant that it’s free of side effects. The plan is to put the product on the market in November and the following sales slogan is on the table: “Be better informed than you neighbour!” Now imagine you are employed in a small consultancy firm working as an ethical task force on ad hoc jobs. Your office is contacted by AudiCon, who wants to see your estimate on eventual ethical issues in the business plan. What is your answer?
This case on the ethics of human enhancement can serve to illustrate two techniques I often use when creating new cases: Firstly, it is fictitious (and the students are informed about that, of course). As long as “fictitious” does not mean completely “unrealistic”, it is my experience that these cases are no less fruitful in the learning process than cases copied from reality. In fact, we do have advanced hearing aid companies in Copenhagen. And we do have devices today, whose performance exceeds that of the normal human ear. So the case is only fictitious in the sense that it has not happened exactly like this. Secondly, it places the students in medias res, thereby preparing them for the life as employed techno-anthropologists. I find this exercise important and implement it in many study cases because these students, while preparing themselves for jobs in many businesses, find themselves in a university institution engraved by the belief that a scientist only studies the reality with tweezers or through a microscope.
CASE E: In a tv-documentary on BBC News (April 3rd 2013) [22] it is demonstrated how the Kent Police Constabulary (south east of London) tries to exploit Big Data technologies to predict crimes before they even happen. The purpose, of course, is to prevent crime. Filed information on crimes 20-25 years back as well as all new records and selected psychological knowledge are merged in a common database, also linked to the UK National Criminal Intelligence DNA Database. The predictions are used to allocate larger police forces in specific quarters expected to be at increased risk, but also for taking other preventing actions.
Now imagine that the Danish police intelligence considers implementing the same concepts and technology in Denmark, and that you as a techno-anthropologist are asked to join this effort. What would be your ethical judgment?
A lot of university students – in my experience most of them – are fascinated by the brave new possibilities opened by the rapid development of advanced technologies. This fascination is not only understandable, it is also perfectly legitimate. Who would not agree that a reduction of theft, robbery, violent assaults etc. obtained by smart use of data technologies offer a major progress to the people of the districts in question? On the other hand, future techno-anthropologists must also be trained in taking a sceptical approach and be able to discern the eventual backdrops of wonder-technologies. In this case the ethical norms at stake are not only the protection of privacy, but even more notable the openness of the future. The openness disappears if the future is staged and organized following predictions based on the past, and this in my view represents a huge ethical challenge.
Case F: A 2004-amendment to the Danish law on pre-implantation diagnostics (PGD) allows the use of PGD in search for positive characteristics in an embryo “in very special cases” (tissue compatibility), meaning in cases where an urgent transplant can only be made possible by creating a “donor sibling”. There have been a few attempts to do this, in one reported case [in fact a case of whistleblowing] more than a hundred embryos were dumped until finally the clinic found one with the necessary genetic imprint. This embryo was then implanted, until a chorionic villus sampling (CVS) proved the child to be suffering from Downs Syndrome, after which the parents chose an abortion. We want you to give an ethical judgment of the law and the eventual dilemmas of the clinic staff.
This case gives the students an opportunity to excel in demonstrating the depths of some conflicts of norms – as the reader may remember, such conflicts are seen by us as the core of genuine ethical dilemmas. Dignity, human rights, autonomy, compassion, taboos – almost all of the most important ethical norms are at stake here.
Difficulties
In other parts of the techno-anthropology study program our students receive teachings in e.g. molecular biology, healthcare electronics, robot engineering and similar disciplines within the natural sciences and attached technologies. Also, when writing interdisciplinary study projects they receive supervision from teachers within those domains, in addition to supervision in ethics.
In my experience the teachers in natural sciences – as well as the teachers in anthropology – have very little idea about the ethical challenges of today. Most professors seem to think that ethical dilemmas are something you personally have to avoid. All new technologies are seen as unnegotiable facts-of-life, period. If accidentally, you stumble upon some ethical “knot” related to a technology, the traditional academic decorum forbids you to take part and engage yourself in the dilemma by making judgments about it. Eventually you can set up an investigation of the problem – in the form of inquiries or an anthropological mapping. But stay away from any kind of participation, stay distant, so they reason – stay “objective”, stay epistemic! Being an academic, the main “ethical danger” should be located in your research design; e.g. if your research involves patients, test persons, interviews or sensitive information and some of these are not treated in a proper way. This is the prevailing attitude.
Although ethics of professional conduct is as important as ever, and the need for protective arrangements of whistleblowing as demanding as ever – the challenges stemming from emerging technologies and from the accelerating speed of innovation should be the central focus of our attention today, not least in the field of biotechnologies. The rapidly growing ethical aspects of these challenges can not, however, be treated in the epistemic ways of natural sciences. The demand is for deliberations about values with reference to praxis and experience. The demand is for phronesis.
That is why we have founded this new academic study.
*
© 2013, Forfatteren.
Alle rettigheder forbeholdes. Mekanisk, fotografisk eller anden gengivelse af eller kopiering fra denne publikation eller dele heraf er kun tilladt i overensstemmelse med overenskomst mellem Undervisningsministeriet og Copy-Dan. Enhver anden udnyttelse er, uden forfatterens skriftlige samtykke,
forbudt ifølge gældende dansk lov om ophavsret. Undtaget herfra er korte uddrag til brug for anmeldelse.
—————————————–
References
[1] E.g.: Cecilie Glerup, Maja Horst, “Mapping ‘Social Responsibility’ in Science,” Journal of responsible Innovation, Vol 1 (2014, Taylor & Francis).
[2] Aristotle, Nicomachaen Ethics. With an English Translation by H. Rackham, M.A. (London: William Heinemann Ltd., 1982/1926) 324-373. – Vol XIX in: Aristotle in Twenty-Three Volumes (Same Publisher, Loeb Classical Library).
[3] Bent Flyvbjerg, Todd Landman, Sanford Schram (ed.), Real Social Science: Applied Phronesis (Cambridge, UK: Cambridge University Press, 2012).
[4] Bent Flyvbjerg, Making Social Science Matter: Why social inquiry fails and how it can succeed again (Cambridge, UK: Cambridge University Press, 2001) , passim.
[5] There might be an interesting affinity between our case-based approach and the Narrative Ethics discussed by Martha Montello and others in The Hastings Report, Volume 44, Issue s1, january-february 2014. I have just seen this report and I’m not yet prepared to discuss it.
[6] Aspects of the case are discussed in
– G. Brattebø et al, “Etiske dilemmaer ved undervisning i intuberingsteknik – hvad mener befolkningen,” Tidsskrift for Norsk Lægeforening 114 (1994):1534-37.
Confer
– M. Ardagh, ”May we pratice endotracheal intubation on the newly dead?” Journal of Medical Ethics, 23 (1997): 289-94.
[7] Lars-Henrik Schmidt, “Den sorte gryde – spørgsmål forud for kannibalernes indtogsmarch” in Giv mig dit hjerte. Organdonationens etiske dilemma, ed. Det Etiske Råd (København, 1998).
[8] Meaning: our inveterate preparedness.
[9] Cf Hannah Arendt, The Human Condition (Chicago: The University of Chicago Press, 1958), 236-243.
[10] ”Sex mellem børn og forældre bør være lovligt”, Interview with Vagn Greve, Ekstra Bladet, november 5’th 2012.
[11] See for instance Manuel Valdes and Shannon McFarland, “Job Seekers’ Facebook Passwords Asked For During U.S. Interviews”, The Huffington Post (March 20, 2012).
[12] H. Greely et al, ”Towards reponsible use of cognitive-enhancing drugs by the healthy,” Nature 456 (2008): 702-705.
[13] K.E. Løgstrup, System og Symbol (Viborg: Gyldendal, 1983), 22 [translation from danish by KB].
[14] Revised version published later the same year: Etiske Problemer vedrørende Kunstig Befrugtning, 3.del: Mikroinsemination og Præimplantationsdiagnostik (København: Det Etiske Råd, 2003).
[15] Hearing at the Folketing (Danish parliament), October 8’th 2003, 9:00 am. Transcript from tape.
[16] J.P. Alukal and D.J. Lamb, ”Intracytoplasmic Sperm Injections (ICSI) – What are the risks?” Urologic Clinics of North America, Volume 35, Issue 2 (2008): 277-288.
[17] According to the Danish Health and Medicines Authority the number of started treatments has surpassed 10.000 pro year – but far from all of them end with a delivery of course. This is in a country where the number of births in the year 2013 was 55.873 (Statistics of Denmark).
[18] See instead Klavs Birkholm, ”Human Enhancement as Techno-Anthropology par excellence” in What is Techno-Anthropology? ed. L. Botin and T. Børsen (Aalborg: Aalborg Universitetsforlag, 2013), 89-114.
[19] D.T. Neal and T.L. Chartrand, “Embodied Emotion Perception Amplifying and Dampening Facial Feedback Modulates Emotion Perception Accuracy,” Social Psychological and Personality Science 2 (2011):673.
[20] Klavs Birkholm in conversation with Luciano Fadiga (audio) on http://www.etiskraad.dk/da-dk/Temauniverser/Homo-Artefakt/Forskerinterviews/Luciano%20Fadiga.aspx
[21] Ian Murnaghan, “Resurrecting the DNA of Extinct Animals”, explore.dna.co.uk (February 21, 2013).
[22] You can watch it here: http://www.bbc.com/news/technology-22008497