Doing Science in 'Ethics Time'
Margaret A. Somerville, 'Science and ethics must march forward together. But when ethics is in the rear and limping a little, science will need to both wait and to help ethics to catch up.'
Gale Professor of Law,
McGill University Centre for Medicine, Ethics and Law
There is in Canada a serious shortage of human organs for transplantation for which a remedy must urgently be found. Some have urged that, among other measures, Canada should seize the initiative of xenotransplantation - the transplant of animal organs into humans - even if future risky consequences have not been resolved. This raises an interesting question about the 'time-lines' that should apply to using new technologies such as xenotransplantation.
'Science time', 'medical time', 'business time', 'political time' and 'ethics time' are on different scales. This can be a source of serious difficulty in doing ethics regarding our new science.
Extraordinary developments are announced almost daily in the fields of genetics and molecular biology, and scientists have an enormous drive and enthusiasm for discovery. They want to get on with what they are doing as fast as they can. The same is true, as it should be, for physicians faced with a seriously ill patient for whom some new development - such as xenotransplantation - offers the only hope. Likewise, business wants to proceed as quickly as possible with 'doing business'.
'Political time' is more complex. There needs to be at least an appearance of considered and wise decision-making. At the same time, however, politicians are subject to the 'do something' pressure of the electorate, especially in relation to threats to health or life, such as the shortage of organs. Moreover, political viability can often depend on short-term answers rather than approaches that would, in the long term, be the most appropriate ones.
In contrast to all of these time-lines, 'doing ethics' in relation to the new science may not be able to be speeded up. There may be an irreducible minimum time needed both to obtain the necessary facts on which to base good ethics, and for a 'sedimentation-of-values' process to take place.
There is, for example, a possibility that viral fragments embedded in the DNA of an animal could recombine with viral fragments embedded in human genes if an organ from the animal were transplanted to a human. This could result in serious risks to the health of the transplant recipient and other humans and/or animals. These risks may take a considerable period of time to become manifest. Should we, therefore, require carefully isolated, long-term studies on xenotransplantation between different species of non-human animals, before involving humans?
Likewise, there is a minimum amount of time needed for the public to become familiar with what a new scientific development means in terms of its benefits, potential benefits, risks and harms, not only at the physical level, but also at the level of its potential impact on values, norms, traditions, customs, cultures, beliefs, attitudes, and so on. There is, as well, a difference between simply delivering information on ethics to the public and engaging the public in 'ethics talk' about a new technology. The latter takes time. Indeed, how to adequately and effectively engage the public in 'ethics talk' is a difficult question.
The relationship between 'science time' and 'ethics time' has also changed in other ways. Not only is the scope and power of our new science unprecedented in terms of what we could do to ourselves and our world in using it, but - especially because of our communications technology and modern travel - this science and technology is also instantly global in its use and impact, in a way that new scientific and technological developments never were before. We do not have the opportunities that we had in the past for limited experiments on the benefits, risks, and harms of new developments, when these were undertaken in only one location and only slowly picked up elsewhere.
The present, instant worldwide access to new scientific developments also raises ethical issues in itself. For example, countries that lack the research infrastructure needed to develop xenotransplantation can use this technology when it has been developed elsewhere. But they might not do so safely for either the research subject/patients involved, or the public, and they may not do so ethically.
A related ethical issue is that some scientists who are prohibited from carrying out certain research in their own countries because of its unacceptably high levels of physical or moral risks threaten to - or do - take their research to countries where there are no restrictions. But while ethical restrictions are geographically limited, the risks that these are meant to protect against are not. In short, many new scientific techniques, such as xenotransplantation, need universal ethical regulation.
We have profound responsibilities to consider not only our own well being, but also that of future generations in using new technologies. The new genetics and all the possibilities that flow from this field constitute a power of unprecedented scope and gravity, with enormous potential for good, but also in some instances harm. This means that in deciding what we will and will not do with this power, we all, as the public, must be involved in the decision-making.
This, in turn, necessarily means that we need adequate time to undertake this decision-making. Science and ethics must march forward together. But when ethics is in the rear and limping a little, science will need to both wait and to help ethics to catch up.
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