I recently presented an undergraduate class with this quotation: “Some day we will realize that the prime duty, the inescapable duty of the good citizen of the right type is to leave his blood behind him in the world, and that we have no business to perpetuate citizens of the wrong type.” Most of the students attributed the quote to Adolf Hitler, and none guessed its actual author, Theodore Roosevelt. Seen through the prism of the Holocaust, “progressive eugenics” seems more like an unimaginable oxymoron, rather than the mainstream science policy of social progress that it was to so many early-twentieth-century reformers. Although Margaret Sanger did not apply her views to specific groups and abhorred Nazism, “planned parenthood” included the opportunity to reduce the transmission of undesirable traits through sterilization; in some cases, mental institutions sterilized retarded and mentally ill patients. And the deep imprint of these policies lives on: Several states have only recently issued formal apologies for all those thousands of lesser types they sterilized. Eugenic public-health practices rival Prohibition as the greatest success-turned-disaster in the history of American progressivism–all the more so because its history has been largely forgotten.

Liberalism is commonly understood as a willingness to throw off
tradition and consider reforms that work to the end of advancing human
rights. But progressivism connotes a more aggressive commitment to
improvement. This impulse lay behind the enthusiasm for eugenics of
many science-oriented progressives 100 years ago, amid the rush of
excitement about the social implications of Darwinism. Today, there is
similar excitement about the promise of biotechnology, with the
important difference that there is now vastly greater understanding of
underlying mechanisms, a raft of diagnostic capabilities, some capacity
to manipulate genetic endowment, and the prospect of much greater
control ahead. It is not just a question of who should give birth, but
how. Such technologies promise to make great progress against genetic
disease and birth defects. But if ensuring the predominance of the
“best types” is not the goal, then what is? What is the modern
progressive view of biotechnology? Considering their history, this is
not a problem for progressives to take lightly.

Set against the progressive conundrum is a flurry of thinking on the
right, particularly in neoconservative circles, about the ethical
implications of biotechnology. The University of Chicago’s Leon Kass
has been writing about the issue for decades–it was he who, in the
early 1970s, first began serious inquiry into the ethics of human
cloning–and it was little surprise to see him and his compatriots
dominate George W. Bush’s Council on Bioethics in the early
twenty-first century. By and large, however, Kass’s circle has
concerned itself with the dark portents of the modern life sciences, so
much so that it offers little guidance to those who see at least some
progressive potential in biotechnology.

Given the vast gulf between progressive and conservative thinking,
then, the time is ripe for a philosopher to take on the issues of
biotechnology. And in The Case Against Perfection–a short book
that is really one lengthy essay on ethics and genetics followed by a
shorter essay on embryonic stem cell research–Harvard’s Michael Sandel
does just that, attempting to develop a new position on biotechnology,
one that, like Sandel himself, is not easily identified as either left
or right. A former member of the President’s Council on Bioethics,
Sandel is uniquely well suited for this task, and to challenge the left
to gets its bearings on the brave new biology.

Sandel is perhaps best described as a civic communitarian. His early
work received attention as a within-the-liberal-family critique of John
Rawls: As against Rawls’ famous “original position,” Sandel emphasizes
the intractability of actual historical and social ties that mainstream
liberalism often downplays. his political philosophy valorizes a
society built around the virtues associated with production, rather
than the self-centeredness of consumption. What, then, does his notion
of a republican community have to offer a progressive take on
biotechnological innovation, and how does it differ from the
neoconservative position?

Although conservative, or more precisely neoconservative, thinking
is currently held to be in acute disarray, on the issue of bioethics
neoconservative writers are vastly more coherent and comprehensive than
are progressives themselves. In the lead are think tanks, academics,
and, perhaps most visibly, several influential voices on the Council on
Bioethics, including Kass.

As opposed to both traditional conservatives, who have little to say
about values in science, and religiously oriented conservatives, whose
trepidations are familiar to anyone who has seen “Inherit the Wind,”
the neoconservative critics of modern biology have a clear and
straightforward message, one deeply informed by the experience of the
cruelties the previous century wrought as well as by ancient wisdom. In
a word, that message is hubris. They fear that while previous episodes
of Promethean ambition have had dire but reversible consequences,
emerging biotechnologies are so powerful that, by putting the nature of
humanity in fallible and perhaps malicious hands, they threaten the
very foundations of human dignity. The precise consequences are not
always stated–and may not be predictable–but we all know how the road
to hell is paved.

On the left, matters are more muddled. At the extremes, some
activists fear that the vulnerable will either be exploited or left
behind by those who have access to genetic improvement, while
“transhumanists” welcome the opportunity the new technologies presents
to deliberately shape the next stage of human evolution. In general,
though, especially among classically oriented liberals, the tendency
has been to depreciate the uniqueness of genetic interventions, whether
the negative eugenics of genetic screening or the positive eugenics of
selection for desirable traits, in favor of a class-based economic
analysis. The familiar argument is that tennis lessons, math tutoring,
and college-admission tests already seek to improve individuals or
otherwise sort out the superior and lesser types, advantages closely
tied to economic class. Even creepy appeals for the purchase of eggs
from Ivy League undergraduates with certain scholastic and physical
credentials are not, in the standard liberal account, different in kind
from old-fashioned upper-class trawling for a “suitable” mate.

According to this storyline, the limits of interventions, genetic or
not, are only reached if they inhibit a child’s autonomy-based right to
an “open future,” a life direction that has not been determined by
others. In effect, this is the left’s response to the misdeeds of its
eugenic past. Some, like the University of Wisconsin’s Alta Charo, also
hold the explicitly libertarian view that scientific inquiry is a form
of speech, and that it is therefore entitled to the usual protections
against censorship. They decry the alarmist science-fiction predictions
used by those they view as anti-science, and they urge more care in
hewing closer to what is reasonable and away from worst-case scenarios.
By and large, this moderate left leans toward toughening the regulatory
regime while wanting to protect scientific freedom. Such classically
liberal positions are widely held, but they seem, to their critics at
least, more a willingness to let whim, professional ambition, and
market forces determine the course of humanity than an earnest attempt
to come to terms with deep moral challenges. And, needless to say, they
tell us little about what to do in the case that, in fact, one of the
worst-case scenarios becomes reality.

Those progressives who believe these liberal views of biotechnology
are inadequate include groups who identify with the “green” movement,
whose philosophical roots are therefore kin to European leftists like
Ulrich Beck. They fear a future dominated by wealthy families who can
afford “designer babies,” whose expensive prenatal alterations give
them an added edge over their poorer fellow humans, further driving a
wedge between the haves and the have-nots. And, despite the different
philosophical presuppositions of these left-wing commentators from the
New Right, their ultimate concern about the biotechnological threat to
humanity is quite similar. Still others, including many on the left and
the right (erstwhile neocon Francis Fukuyama is an interesting case in
point), see no practical alternative to a regulatory regime, in spite
of their misgivings about the prospects that regulation can adequately
cope with what may be barely perceptible long-term trends rather than
short-term risks.

These categories, however, only capture some progressives; by and
large, the movement has yet to grapple with the overall issue. The most
noteworthy attempt, Bill Clinton’s National Bioethics Advisory
Commission, reached a consensus that human reproductive cloning should
not be permitted, due to the risks to the fetus and the mother. On a
philosophical level, this was something of a dodge: Had it not been for
the known problems reproductive cloning presents mammals, it is not
clear that the Clinton commission would have agreed on anything.
Compared with the sometimes apocalyptic but nevertheless stridently
serious language of neoconservative bioethics, such risk-benefit
analysis seems a green-eyeshade approach to deep philosophical
problems.

In the absence of a more philosophically thick progressive
alternative, the President’s Council on Bioethics clearly set the
agenda for such discussions in the first Bush term. Created in the wake
of, and primarily in response to, the controversy over the use of human
embryos in stem cell research, the Council struck many bioethicists–a
largely progressive fraternity–as a gift to right-wing ideologues and a
missed intellectual opportunity. But at the end of the day, while the
Council’s leadership did not accomplish all that the president’s
conservative base may have wished, it did give secular, conservative
bioethical voices far more visibility than they had before, and in
doing so paved the way for a coherent conservative approach to
bioethical questions.

The debate between the left and right over bioethics–or what passes for a debate–provides the background for The Case Against Perfection.
And while specialists may find that Sandel’s account fails to mine the
extensive literature on ethics and genetics, he elegantly retraces much
of that debate of the past several decades in order to derive a new
approach to bioethical dilemmas. Sandel’s sensitivity to the stem-cell
issue has been enriched by his close relationships to both Kass and the
distinguished biologist Douglas Melton, a sober advocate and
practitioner of human embryonic stem-cell research. Indeed, his
position between those two informs much of his writing on the issue.
Where Melton is currently researching replacement pancreatic cells (an
important weapon in the fight against Type 1 diabetes) and has
developed his own embryonic stem-cell lines that are, thanks to Bush,
ineligible for federal research funding, Kass steadfastly takes the
opposite position, warning that such research indulges scientific
arrogance and pushes the moral envelope beyond societal acceptance.

Though Sandel believes that work like Melton’s should go forward, he
is also wary of those who would give Melton free rein–though not
because of a Kassian science-fiction scenario. Much of Sandel’s
approach to bioethics revolves around an Aristotelian appeal to the
ends of human activities as indicators of appropriate limits on their
modification. Thus he distinguishes between sport (for example, Olympic
Greco-Roman wrestling) and spectacle (a WWE smackdown), where the
former refers to excellence through effort and the latter to shock and
awe. However fascinating one might find the home run–hitting capacities
of bodies souped up with steroids, we should not confuse that with the
game played by Babe Ruth. This is not an argument for prohibiting
spectacle but an observation about the way excesses can distort an
activity, and the need to distinguish the two.

Moreover, Sandel finds the standard autonomy-based, liberal
view–which contents itself with assurances of an open future and the
advancement of human equality through genetic interventions–lacking the
depth the subject requires. After all, Jürgen Habermas argues that
direct genetic manipulation fails the liberal test precisely because it
violates the principles of autonomy and equality: Parents can shape
their children’s futures to an unacceptable degree. Sandel agrees, but
thinks more is needed to understand the transgression of
hyper-parenting. Drawing on the theologian (and fellow Council member)
William May’s notion of the “unbidden” as a special lesson of
parenthood, he contends that if parents are in a position to choose
more traits for their children, they will be excessively responsible
for their children’s fate. If children fall short, then, it is because
their parents failed to make the right investment in some constituent
of their design. No one would be self-made or expected to be. My
limitations would be due to someone else’s failure to outfit me
completely or correctly. Sandel would therefore seem to draw a bright
line between research with a therapeutic aim and cosmetic (if that’s
the correct word) procedures meant to enhance a perfectly normal child.

Sandel does, however, betray some bias toward Kassian pessimism by
arguing that a society in which the contingency of talents is lost
would also be one in which we will lose sympathy for those who are not
so favorably endowed: “Perfect genetic control would erode the actual
solidarity that arises when men and women reflect on the contingency of
their talents and fortunes.” This perhaps goes too far; human
solidarity has long been in short supply, in spite of the pervasively
accidental nature of our abilities. Would matters be markedly worse in
a world rife with genetic remedies? Why wouldn’t we be more, rather
than less, inclined to human solidarity when it is so clear that one’s
inadequacies are not necessary or permanent, that our flaws are
biologically based rather than the result of weakness of will or the
evil eye? If all of us could, in principle, be genetically “improved,”
those less fortunately placed might elicit our sympathy as having been
failed by those (their parents, their genetic engineers, or whomever)
responsible for their design.

Of course, this whole way of thinking smacks of science fiction more
than science, and it is fair to ask if public policy should be
developed in light of anxieties that follow from only one of many
possible distant futures. When I was growing up we were all supposed to
be zipping around in flying cars by now. The technical capacity is
there, but Jetson-mobiles just don’t pay off. The same might turn out
to be true of much genetic manipulation. Who can tell?

One experiences a sort of whiplash when one reaches the last part of
this slim volume, an essay on the embryonic stem cell research debate.
The grave consequences of mucking around with human reproductive
capacities are often closely associated with the concerns Sandel
expresses earlier in the book about the eugenic road we might be
traveling. However, it is hard to see how his approach to this
particular issue has been informed by the cautionary position he
presents in his first essay. Sandel rejects the view that embryos are
persons, though he allows that they are special and therefore that the
research should only proceed according to a strict regulatory regime.
Using leftover embryos to produce pluripotent stem cells is consistent
with this position, he concludes, and he insists that such a policy
would not “necessarily” lead to “embryo farms” and other abuses. Yet
what concerns the critics is not the inevitability of embryo farms but
their empirical possibility. What exactly is meant by the term “embryo
farm” is not clear, but those who object even to the use of excess
embryos after donation by their progenitors surely fear the prospect
that fertility clinics would themselves come to be seen as acres of
convenient embryos. And they worry that somatic cell nuclear transfer
(SCNT) or “cloning for research” would be made more likely if any
permissive policies at all are installed concerning embryos, regardless
of their location or destiny. In this they may well be correct, but it
is not clear whether Sandel would find SCNT abusive or not.

One may not be persuaded that Sandel’s complex position is coherent.
But his may ultimately be the least-worst position currently available.
While neoconservatives find the entire drift of the new biology
disquieting, preferring to put matters in the hands of wise counselors
rather than ambitious scientists and voracious biocapitalists, Sandel
is more disposed to seek a natural balance in the context of particular
cases. He plays Aristotle to Kass’s Plato. Nevertheless, at the end of
the day the implications of Sandel’s traditionalism are not so far from
that of Kass and other neoconservatives. Neither would leave science or
the industrial interests behind them to their own devices. Both are
deeply suspicious of the rise of consumer genetics.

Though Sandel is more permissive than the neoconservatives with
regard to the domains that science may legitimately enter, presumably
he would admit some intractable ambiguity in the appropriate moral
response to the biotechnological questions that face us. As Aristotle
warns the reader in his Ethics, one should not expect more
precision in the analysis than the subject matter permits. Nonetheless,
by integrating May’s ideas of the “unbidden” and “giftedness” into a
novel anti-liberal framework, Sandel poses an important challenge to
contemporary progressives who have failed to grasp the importance of
the emerging biopolitics. He helps us appreciate the central point that
neoconservatives have championed: that if the new biology is indeed our
destiny, we need to take it seriously, anticipate the consequences, and
learn from the prior life-denying eugenic embrace.