Not Much Help

On the New Frontiers of Genetics and Religion By J. Robert Nelson
Eerdmans. 212 pp. $12.99

We are badly in need of books that will help us engage in moral and religious reflection upon recent mind-boggling advances in genetics. Unfortunately, On the New Frontiers of Genetics and Religion will not meet that need. It provides some useful information in brief compass (indeed, that is probably its most helpful feature), but it does not succeed in its attempt to explore the religious implications of genetic advance.

J. Robert Nelson writes that “the year 1953 is to genetic science what 1492 is to geography.” In that year James Watson and Francis Crick published their now famous article describing the structure of DNA. The decades since then have been marked by an astonishing pace of advance in genetics, funded now in considerable measure by our tax dollars. The Human Genome Initiative, a combination of projects aimed at mapping the human chromosomes and locating the genes on the chromosomes, is to be completed over fifteen years at a cost of some three billion dollars. However strong the motives that drive a purely scientific desire to know, the Congress would not have committed itself to such a project if it did not hold out the hope of genuine advance in our knowledge of hereditary diseases.

A good bit of such advance has already taken place. Nelson writes that at least four thousand single-gene diseases (diseases caused by a single mutant gene rather than by some combination of genes or by a combination of genetic and environmental factors) are now known, and about two hundred of them can be diagnosed prenatally. No doubt the numbers are larger now than when he wrote. Despite this astonishing progress, and despite the fact that we surely stand on the verge of more breakthroughs, we find ourselves in some ways returning to the condition of medicine before the great age of antibiotics dawned: We are able to diagnose far more than we can treat. That condition raises many troubling questions with which we need help.

Nelson is a theologian working in the Institute of Religion at the Texas Medical Center in Houston. That Center sponsored two conferences (in 1990 and 1992) on “Genetics, Religion, and Ethics.” This volume reports on those conferences and summarizes the views of some participants. After the first chapter’s introduction to the topic, chapter two-perhaps the most valuable in the book-describes briefly and clearly advances in genetics and the therapeutic possibilities currently available.

Chapters three and four take up moral questions raised by the Human Genome Initiative and its implications for our understanding of human nature. These chapters are considerably less helpful. Lacking any clear argumentative thread of their own, they mostly summarize views of different participants in the conferences. Such summary tends to lose the complexity of argument. The reader who already knows something about the issues is not likely to advance in understanding, while the reader who knows little will not learn enough to enter deeply into the issues.

Chapter five summarizes-and in some cases reprints extensively-”personal religious positions individually expressed” by conference participants. Chapter six, by contrast, summarizes briefly several “official” statements of religious bodies and includes a helpful analysis of these statements by Audrey Chapman. A reader who has made it this far is likely to conclude-as Chapman does, albeit politely-that the statements don’t help much in bringing religious faith to bear upon genetics. Nelson’s own brief concluding chapter attempts to make some progress toward that end (via a rather puzzling use of Tillich’s notion of “correlation”) but, clearly, much more is needed.

What “more,” in particular? Because we are at present able to diagnose many more hereditary diseases than we can treat, the “treatment” of choice has become prenatal diagnosis (still most commonly by means of amniocentesis) followed by abortion of fetuses with defective genes. This fact, straightforwardly recognized by Nelson, begs for analysis and critique. Evidently, however, the participants in the two conferences upon which this book is based were unable to provide it. Summarizing, I think, views of conference participants, Nelson says of prenatal screening:

In some circumstances the disclosure of true data results only in a satisfactory outcome. Prospective parents can learn that some fears of their infant’s manifesting spina bifida or cystic fibrosis are needless after all. Or they can terminate a pregnancy, however tragic that may be, in order to avoid the birth of a grossly malformed or severely retarded baby. We recognize, however, that the definition of a “satisfactory outcome” to a pregnancy varies widely according to differing evaluations.

Only in instances of prenatal diagnosis used to select the sex of one’s child (by aborting a child of the undesired sex) did many conference participants seem to draw the line, since in these circumstances, Nelson writes, “it is not the will of the prospective parents but the inviolable life of the fetus which prevails.” Given the tenor of the rest of the book, “inviolable” is a strange choice of adjectives.

Prenatal diagnosis accompanied by abortion for genetic defect is a serious issue, and the discussion of its moral significance ought not be simply folded into general discussions of the pros and cons of abortion. As such a procedure gradually becomes routinized, it must raise questions about the depth of our commitment to the norm of equal respect. Some children will always be born with disorders, having slipped through our tests, and others will become physically or mentally disabled after birth because of illness or injury. How will we feel about them when we have gradually raised our standards for what is acceptable and normal in a child? At this moment in time, when we can diagnose more than we can treat, we may teach ourselves to blur the distinction between preventing genetic disease and preventing a genetically abnormal person. It may not be as easy as we think to repeat again our culture’s slow, laborious development of a norm of equal respect for all human beings.

That children can be damaged in countless ways after birth also means that the routinization of prenatal diagnosis accompanied by abortion is poor preparation for motherhood or fatherhood. As Barbara Katz Rothman has written, “Motherhood is, among other things, one more chance for a speeding truck to ruin your life.” Learning to love without condition or qualification the child one has been given is a lifelong task-and certainly the most important task for prospective parents. Yet, as prenatal diagnosis followed by abortion establishes itself as accepted medical practice, we train ourselves to love less heroically and more conditionally. Surely, such a practice calls especially for religious examination and analysis.

Among the “personal religious positions individually expressed” in the book is a brief statement by Gerald McKinney. With his vision shaped by the study of Calvinist theology, McKinney nicely notes that “genetic knowledge gives persons a sense of fate.” And the rapidly expanding scope of such knowledge will, he suggests, “force upon us a much deeper awareness of the sheer givenness of human life and its utter imperviousness to the deep illusions that we are naturally the products of our own making.” Perhaps it will. Or perhaps, rebelling against such “givenness,” we may try still more fervently to take control of our life and shape our destiny.

Christianity first expanded into a Gentile world weighed down by an oppressive sense of fate-the biblical language of “principalities and powers.” In such a world the announcement that these powers could not separate us from the love of God revealed in Jesus, the message that the risen Lord had ascended to the right hand of God with all powers subject to him, was good news indeed. In this respect also we need religious critique of and reflection upon the powers that hold us in their grip. We need to learn again where we ought to look for deliverance. Helpful as it is in providing some basic information, this volume will not, I fear, meet our most pressing needs.

Gilbert Meilaender is the Francis Ward and Lydia Lord Davis Professor of Religion at Oberlin College.