> Denis Alexander Case #53 - Humanity 2.0? Future Genetics Humanity New College Lectures 2018

Healing, enhancement and the human future

February 21, 2019

Denis Alexander

Rapid advances in the biomedical sciences, the neurosciences, Artificial Intelligence (AI) and in machine design are leading to some striking improvements in medical therapies. At the same time they are opening up possible new avenues for potential human enhancement in ways that might not only enhance the individual, but also their progeny. For Christians this raises the question as to what kind of mandate God has given us in our care for the world as well as the wider eschatological question as to what kind of transformation is involved in experiencing the new heavens and the new earth (Isaiah 65:17; 66:22).

We will here review some examples of recent techno-scientific advances that make such questions pressing, then discuss whether it is possible to make a clear distinction between healing and enhancement. After that we will consider three rival world-views that come to rather different conclusions concerning the role of techno-science in the human future.

Recent advances in technoscience

Biological examples

Until 2012 the problem for modifying the DNA of a cell was that when you inserted a foreign bit of DNA into the cell, there was no way of knowing where that piece of DNA would end up in the cell’s DNA. That situation changed dramatically with the discovery of CRISPR-Cas[i] and a series of publications illustrating its multiple uses over the period 2012-15. CRISPR-Cas is a molecular complex which has the ability to change the DNA of any organism, including humans, with a high degree of specificity at any particular position in the DNA, in such a way as to potentially alter the properties of that organism. The genie really is out of the bottle.

In terms of healing, the genetic engineering of humans currently has three main types of application. In the first type, immune cells are genetically modified to make them work more efficiently. The second type is aimed at those 7,000 or more genetic diseases, some of them very rare, caused by a defect in a single gene. It is now possible to replace the defective gene with a functioning gene in some cases, to cure the disease. But this heals only the patient, not their progeny, who may still carry the defective gene.

This problem is potentially solved in the third main type of human genetic engineering in which CRISPR-Cas is used to heal very early human embryos of a specific disease-causing genetic mutation. The embryos are generated by in vitro fertilisation (IVF) using the mother’s egg and the father’s sperm. The procedure is at present illegal in most countries (including Australia), but if the healed embryos were implanted in a mother and brought successfully to birth, then all subsequent generations would be healed of that disease.

For example, in 2017 a human embryo editing paper was published by a group from Oregon in the USA.[ii] This involved a gene called MYBPC3 which causes thickening of the heart muscle, a leading cause of sudden death in young athletes. This group fertilised 58 human embryos with sperm from a person with a mutation in their MYBPC3 gene and then used CRISPR-Cas to correct the mutation successfully in 42 of them, a 72% success rate.

To the surprise of the scientific community, in late 2018 He Jiankui, from the Southern University of Science and Technology in Shenzhen, China, announced the birth of twins, one of whom was lacking the gene that encodes CCR5, a protein necessary in many cases for HIV infection to occur. In fact the IVF process involved fertilisation using sperm from HIV positive fathers. This announcement of work as yet unpublished has received widespread criticism.[iii] For example, it broke international ethical norms; there are other well-established and less risky ways of preventing HIV infection in children; and it is possible that CCR5 is required for other functions, as yet unknown. Also, due to technical failure, only one of the twins lacks CCR5. Experimenting with children is wrong.

Yet many other attempts are currently in progress to edit early embryos in this way. Clearly the goal, unlike in the He Jiankui experiments which involved no genetic disease, is ultimately to implant the healed embryo in the mother with the aim of giving birth to a child healed of a particular disease running in a family. But as the reaction to the Jiankui work has highlighted, there is some way to go towards ensuring the safety of the technique before the legal embargo on such germ-line editing may eventually be lifted. In the interim, many wonder why and whether such embryo editing should be allowed when Preimplantation Genetic Diagnosis [PGD] is already available. Here embryos are screened in IVF clinics for a known mutation that causes disease in a family’s history and only the healthy embryos are implanted in the mother.[iv] In the vast majority of genetic diseases, such embryos will be available, so is it really worth developing such a complex, expensive and potentially risky technology as embryo editing for the benefit of such a tiny number of cases where PGD might not be feasible?

And what about the use of embryo editing for enhancement? Is this a slippery slope? Could embryo editing be used to enhance the human genome? To make people more intelligent? To generate better athletes? Stronger soldiers for the army?

AI and robotics

It is perhaps helpful to distinguish between ‘Narrow AI’—involving the more mundane applications of machine learning involved in on-line banking, Google maps, chat boxes and the like—with ‘Creepy AI’, which aims at much higher levels of social control. As billionaire Elon Musk has recently commented with regard to the latter, based on his very extensive access to the world of AI, ‘AI is a fundamental risk to the existence of human civilization’.[v]

Some of that blunt assessment of existential risk comes from the extensive use of AI by the military. But of more immediate relevance to most people’s lives is the rather more subtle shaping of human desires and expectations brought about by our machines. The process is two-way—we create machines made in our image, and in AI we try and make them smarter than we are, imposing our own particular sets of values on the machines, and then in our very interactions with the machines, they are changing us and shaping us in their image.

Up the really creepy end of AI applications is the surveillance software already in use in China. Based on surveillance data, the Chinese government is introducing a ‘social credit system’,[vi] The idea is that people will be scored based on past behaviour, taking into account misdemeanours such as traffic offences and court records. A poor social credit score could jeopardise a university place, rule out certain jobs and even limit travel. Big brother is watching. The ultimate goal is clearly complete social and political control by the State.

What about the robot as servant? Robots have the run of Tokyo’s Shin-tomi nursing home, which uses 20 different robotic models to care for its residents.[vii] The Japanese government hopes it will be a prototype for harnessing the country’s robotics expertise to help cope with a swelling elderly population and dwindling workforce. Certainly that may be very helpful for the elderly who have already had a life full of human, relational interactions, but what about children growing up with robotic servants? What do we call a servant who has no free will and cannot say ‘no’ to our wishes? I think the word is ‘slave’. What will it do to early child development if the child is increasingly exposed to slave machines that obey their every command? What about relational deprivation if child rearing is increasingly put into the hands of robots, with life then seen as a series of mechanical operations?

The point is that our many attempts to enhance human life and experience via AI and robotics can certainly be successful if carefully organized, but the potential is also quite high to create machines that reflect and amplify some of humanity’s least desirable aspects.

Brain research

What about brain control? The image of the cyborg is a familiar one from science fiction movies—organic beings with mechanical parts. But one of the main drivers of developing brain-machine interactions is medical. This well illustrates the way things normally go in technoscience. A new medical technique is developed with the best of motives, to cure some medical condition, but this same technique then opens up new doors for use in enhancement or for more sinister applications in social control.

One of the earliest and most successful examples of direct machine-brain interaction was the cochlear implant developed in Australia by Prof. Graeme Clark, in which a multi-channel electrode implant is connected directly to the auditory nerves so that deaf people can now hear.[viii] Around 500,000 people around the world have now benefitted from cochlear implants.[ix] As of 2017, it became possible to stream sound straight from your iPhone into your brain via a wireless cochlear sound processor.

Recently the US company Second Sight announced a brain implant designed to restore vision to blind people.[x] Called Orion, this device involves implanting an array of electrodes on the visual cortex, so bypassing the eyes altogether. The electrodes receive wireless signals from a camera mounted together with special glasses on the person’s head. There are many heart-warming stories of people who have been blind for years once again seeing at least something of their loved ones using such devices. There is still a long way to go, but most forms of blindness should eventually be curable using such cyborgian techniques.

What about controlling the cyborgian computer interface simply by thinking about what to do? Take the case of Bill Kochevar, who was paralysed in a bicycle accident 9 years ago.[xi] Using a brain-computer interface, Bill is now able to move his arm to do useful things simply by thinking about it. The built in computer transmits his thoughts straight from his brain to a so-called ‘functional electrical stimulation system’ that then moves his paralysed arm.

But let us also notice that very similar cyborgian technologies could readily lend themselves to quite different applications. Imagine a situation where it was possible to place an electrode in the brain of a persistent paedophile. As soon as paedophilic intentions are detected, these are flashed to a computer in a local police station that immediately sends a suppressing signal that blocks the thought before it can turn to action. At the moment such a scenario belongs to science fiction. But would this represent human enhancement? And where do we draw the line?

Healing and enhancement

In July, 2018, the respected UK Nuffield Council on Bioethics produced a report entitled ‘Genome editing and human reproduction’.[xii] Somewhat to people’s surprise, they rather blurred the distinction between healing and enhancement in their report. Enhancement refers to the aim of improving human abilities by techno-scientific means in a way that exceeds the abilities of an averge population. It is true that the boundary between healing and enhancement is somewhat fuzzy. We have been vaccinated and therefore have enhanced immune systems. Some take daily statins to reduce their blood cholesterol to prevent heart disease and strokes, so are medically enhanced. Some athletes have prosthetic devices to overcome disability that enable them to run faster than average athletes. A research group in Sydney is using kangaroo tendons, six times stronger than the human equivalent, for the treatment of ruptured human ligaments, thereby presumably leading to a form of enhancement.

But none of this means that the distinction between healing and enhancement is not useful. One may argue whether the speed limit for cars should be 50 km/hour in urban areas, or maybe 48 km/hr or 52 km/hour, but everyone is agreed that 110 km/hr is inappropriate, and that on the open highway a limit of 10km/hr is not much good either. In other words, binary distinctions remain helpful, even if they are demarcated by a fuzzy boundary.

Three rival worldviews

It is ultimately different metaphysical world-views that make the biggest difference to the ways in which people think about enhancement. On healing most are agreed, but on enhancement there is divergence.

Transhumanism

Transhumanists share a common commitment to a materialistic, ontologically reductionist, non-relational view of human personhood—a mechanistic view of human life in which the body is a mere device.[xiii] In the present Machine Age in which we are living, any technical input that increases our happiness is to be valued, but such inputs are assumed to involve physical, mechanical or chemical manipulations. The vision is, on the whole, hyper-individualistic, though some transhumanists express a broader democratic concern for the whole of society.

Transhumanists tend to denigrate our present human nature in order to contrast this with the wonderful human future promised by technology. Ultimately there will be the extinction of biological humanity in order to abolish death altogether. Homo sapiens will be replaced by Homo cyberneticus. In the transhumanist vision, only Transcendent Mind will finally exist—a cosmic eternal intelligence. In many ways transhumanism maps out a secularized version of Christian ideas.

MOR-WSH

Middle-of-the-Road Western Secular Humanism (MOR-WSH) is a common position amongst the 30% of people in Australia who self-identify as having no religion, particularly within the scientific community. MOR-WSH adherents are often suspicious of transhumanism because it sounds too ideological, too enthusiastic, even a bit crack-pot in its more extreme forms, and not sufficiently informed by scientific reality. Like all forms of western humanism, MOR-WSH has a value system with roots in centuries of Christian teaching, but the theological justifications are excluded with the aim of maintaining the moral values without any religious support. MOR-WSH is often associated with a strong sense of human value, frequently coupled to a high level of moral concern and interest in the social implications of scientific advances. The problem, of course, is whether such values can be maintained in the absence of any metaphysical underpinning. There are plenty of MOR-WSH people who sit on ethics committees in universities and in science research institutes. MOR-WSH adherents are certainly committed to healing, but are generally more cautious concerning the use of techno-science for enhancement.

Judeo-Christian

The ancient Judaeo-Christian concept of Adam made in the image of God is first introduced in Genesis 1: 26-27, where it is clear that Adam refers to the whole of humankind. The term ‘image of God’ was used only of kings and priests in ancient Egyptian and Mesopotamian literature. But in Genesis 1 we find that the whole of humankind is made in the image of God. Here is a totally new idea about the value and status of humankind—humankind created with dignity and worth, called to play a delegated kingly role, male and female alike, in caring for the created order. The kingly and priestly roles the Egyptians and Mesopotamians allocated to the privileged few by a pantheon of gods are instead delegated by the one creator God to the whole of humanity.[xiv]

Being made in the image of God guarantees the value and status of each human individual irrespective of their physical status. Humankind’s value lies not in some list of intrinsic qualities, important as they may be, but in God’s grace, in his bestowal of a kingly-priestly status that we certainly do not deserve. And that status is bestowed upon the whole of humankind as a community. Those whose genetic endowment entails that they suffer some handicap in life, be it physical or mental or both, are as much sharers of the image of God as anyone else. Where the individual is unable to express or fully practise their status as being made in God’s image, then human solidarity insists that we care for and protect those less fortunate than ourselves. The care-receiver is as much reflecting their status of being made in the image of God as the care-giver.

So healing is at the heart of Christian faith, Jesus of course giving us the supreme example, often linked to the coming of the Kingdom—God’s reign over all things (Luke 9:11; Matthew 14:14). In the future fulfilled Kingdom, all those who have identified with the risen Christ will be recreated perfectly in the image of God in their resurrection bodies. So healing people now is a sign of the coming of the kingdom. As we follow Christ in the ministry of healing in the present age, so we are pointing towards that time when God’s rule over our physical bodies is finally complete. It will never be complete in the present age, but it certainly will be in the age to come, the future fulfilled Kingdom.

Rival worldviews and enhancement

For the transhumanist, utilitarianism is clearly the key principle at stake, and they tend to have a rather low view of our present biological status. So if embryo editing eliminates disease-causing genes from a particular family lineage in a safe way, or if we can make people more intelligent or stronger or less aggressive, then of course we should do it.

From a biological perspective there does seem to be a considerable amount of naiveté in the transhumanist literature concerning the potential of genetic engineering to generate humans with greatly advanced complex human traits, such as intelligence. We know from behavioural genetics that around 50% of the differences in biometrically measured forms of intelligence such as IQ can be attributed to genetic variation within a given population. But such differences are explained by thousands of genetic variants that contribute to such heritability, each one contributing 0.1% or less to the overall variance in the population.[xv] So the human genome is a very complex system, and improving complex systems is very complex. The complexity of the genome is its best defense against meddlers.

And if you’re going to use the utilitarian argument, why would you want to do that anyway? Out of great intelligence can come great evil. And how would it be fair at school if the genetically engineered enhanced pupils did so much better than the ‘normals’? All that would happen is greater social inequality.

Genetic or mechanical attempts to reduce aggression in the human population are likewise fraught with difficulty. The transhumanist and philosopher Mark Walker, who has theological interests, thinks that we can improve morality and virtues via genetic engineering. Prof. Walker writes that ‘The implications ….of the genetic virtue program are clear: if we can locate the genes associated with agreeableness and increase their frequency, then we may increase the virtue of caring in a population and reduce the vice of uncaring’.[xvi] But again there seems to be a yawning gap here between transhumanist aspiration and scientific reality. Hundreds of genetic variants contribute to the variation in a population of a complex trait like agreeableness. And in any case, would you really want to engineer super-agreeable people, those who don’t stand up to injustice, who are super-passive in the face of adversity? The problem with many suggested genetic enhancements, for example to reduce aggression in the human population, is that the likely outcome would be ‘passives’, super-boring people.

For MOR-WSHers, enhancement is not generally such a priority, though certainly some are open to the possibility, albeit without the ideological passion displayed by transhumanists. One of the striking aspects of the Nuffield Report already mentioned is the consequentialist tone of its conclusions. Pragmatic sociological arguments are prominent. To the question ‘why bother with embryo editing’, its Foreword states ‘The answer offered in this report centres on the reproductive choices of prospective parents and the preferences they may express for their future child’.[xvii] So the bioethics of the Nuffield Report really comes down to a regulatory question—how should we regulate this new technology in such a way that people’s wishes are satisfied without harm to the genetically modified child and without harm to others? The question of the value and status of the early embryo is simply ironed out of the narrative. Similarly neglected is the question as to whether the perfection of embryo editing technology for healing embryos will lead to increased pressure to seek ways of enhancing humans genetically in the future.

Christian theists are passionate about human enhancement, but an enhancement which centres on growth in virtues such as kindness, humility, love and generosity, the kinds of virtues that flourish in community and that help relationships to flourish. And this flourishing takes place in human communities that are diverse, and with limitations and weaknesses that entail that its members have to rely on one another. This is in striking contrast to the transhumanist vision in which the reliance is to be on machines and genetic modification to achieve the perfect future for the individual, with little interest in the relational community.

The point about Christian virtues is that they develop through the actions of God the Holy Spirit working in people’s lives via their own free will to produce the fruits of the Spirit. And establishing good habits is what leads to good virtues. So it is a category mistake to look for the genetic causes of virtues, because the whole point of a virtue is that it develops as a process that involves human effort and free will, for the Christian coupled to the work of the Spirit in bringing about a transformation of life. It is persons who are virtuous, and there are no short-cuts to virtue.

Rival eschatologies make a big difference to what we do now in and with our bodies. The New Testament envisages the human future as being located in the resurrection of the body, not the immortality of a platonic soul. For the MOR-WSH person, death is the end of the story, so that’s that. For the transhumanist, the immortal human future lies in a disembodied digital existence with our failing biology left behind. As Simon Young writes in his book Designer Evolution: A Transhumanist Manifesto, ‘the belief in the Fall of Man will be replaced by the belief in his inevitable transcendence—through Superbiology’.[xviii] But when you look to see what Superbiology means in transhumanism, it always seems to end up in a pure digital mind without a body in sight, a truly boring existence. And in any case, an eternal future for fallen humanity would just ‘give corruption an everlasting license’, to use the potent phrase of theologian Ted Peters. So what you believe about the future, what Christians call eschatology, really does make a difference to the present. For in the Christian vision it is not only humanity who are to be redeemed, but also the whole created order.

As Ted Peters puts it, ‘God calls each of us individually and the human race as a whole toward a divinely appointed end or goal, namely, our true humanity in participation with a redeemed and healed creation’.[xix] This entails not the cartoon image of angels playing harps on clouds, but a new heavens and a new earth, with resurrected persons enjoying completely fulfilled lives with God and each other, not as a result of their technoscientific striving, but as a result of God’s grace. For the Christian, this is the enhancement that really counts, and all others fade in comparison.

Dr Denis Alexander delivered the 2018 New College Lectures on 'Genetics, God and the Future of Humanity'. He is the Founding Director (Emeritus) of the Faraday Institute for Science and Religion, St Edmund's College, University of Cambridge, where he is Emeritus Fellow. Denis is a past chair of the Molecular Immunology Programme and Head of the Laboratory of Lymphocyte Signalling and Development at The Babraham Institute, Cambridge.

[i] Clustered Regularly Interspaced Short Palindromic Repeat; Cas = CRISPR-associated proteins.

[ii] H. Ma, N. Marti-Gutierrez, S.W. Park, et al., ‘Correction of a Pathogenic Gene Mutation in Human Embryos’. Nature Vol.548, 2017, pp413-419.

[iii] D. Cyranoski, ‘CRISPR-baby scientist fails to satisfy his critics’. Nature Vol.564, 2018, pp13-14

[iv] M. Heijligers, A. Van Montfoort, M. Meijer-Hoogeveen, et al., ‘Perinatal Follow-up of Children Born after Preimplantation Genetic Diagnosis between 1995 and 2014’. J Assist Reprod Genet., 2018.

[v] https://theconversation.com/the-future-of-artificial-intelligence-two-experts-disagree-79904.

[vi] https://www.ft.com/content/2182eebe-8a17-11e8-bf9e-8771d5404543.

[vii] https://www.independent.co.uk/arts-entertainment/photography/japan-robot-elderly-care-ageing-population-exercises-movement-a8295706.html.

[viii] M. Worthing, Graeme Clark - the man who invented the bionic ear (Allen & Unwin, 2016).

[ix] Graeme Clarke, Personal Communication.

[x] https://www.technologyreview.com/s/608844/blind-patients-to-test-bionic-eye-brain-implants/

[xi] https://www.bbc.co.uk/news/health-39416974.

[xii] http://nuffieldbioethics.org/project/genome-editing-human-reproduction.

[xiii] M. O'Connell, To Be a Machine (Granta, 2017).

[xiv] J. R. Middleton, The Liberating Image : The Imago Dei in Genesis 1 (Brazos Press, 2005).

[xv] J. J. Lee, R. Wedow, A. Okbay, et al., ‘Gene Discovery and Polygenic Prediction from a Genome-Wide Association Study of Educational Attainment in 1.1 Million Individuals’. Nat. Genet. Vol.50, 2018, pp1112-1121.

[xvi] M. Walker, ‘Genetic Engineering, Virtue-First Enhancement, and Deification in Non-Irenaean Theodicy’. Theology and Science Vol.16, 2018, p265.

[xvii] http://nuffieldbioethics.org/project/genome-editing-human-reproduction.

[xviii] S. Young, Designer Evolution : A Transhumanist Manifesto (Prometheus, 2005).

[xix] T. Peters, ‘Imago Dei, DNA, and the Transhuman Way’. Theology and Science Vol.16, 2018, p360.