Julian Savulescu - Medical ethicist HARDtalk

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been stranded after the cancellation of more than 2,000 flights.

Now on BBC News, HARDtalk. Welcome to HARDtalk. From genetic

engineering to bioscience, humans are close to acquiring the ability

not just to combat disease but to enhance and perfect our species.

But should we seek to do it? Or should we shy away from the path

that led to Nazi eugenics? My guest is Australian-born,

Oxford-based medical ethicist Julian Savulescu. Can we trust ourselves to

be wise masters of our own biology? Julian Savulescu, welcome to

HARDtalk. It seems we humans have acquired

extraordinary knowledge of how to re-engineer the genetic building

blocks of life. Do you regard that as a profoundly positive thing? I

think it is. Because we are, all, products of evolution. We aren't

products of design. We aren't designed to live happily or live

long-term or be peaceful. We are just the blind results of nature. Is

that natural evolution? What we are going to talk about today is about

human intervention. Human meddling. You can call it meddling or you can

call it modification, what you like. The important thing to ask is, is

the natural state of affairs the best state of affairs? There is huge

variation in levels of aggression, intelligence. At the extreme ends we

call them diseases. We call the bottom 2% diseased or disordered in

some way. Why should we draw the line at 2%? Why not 50% or 30%? We

now have the possibility of deciding what kind of beings we should be and

what sorts of lives we should lead. To believe that's a good thing, one

has to believe in the wisdom of human beings, to use the ability in

a way that is both individually and collectively beneficial. It's

certainly correct that with any powerful technology or intervention

is the possibility of great good and great harm. We haven't been

judicious masters of our technology, that's true. We have developed

nuclear weapons. But can we, at this point, use it and will it be

developed anyway and should we try to control its direction?

Let's start with repairing disease. Few people these days have found

ethical issues with the notion of genetic intervention used to prevent

or fix some of the most difficult inherited diseases, like cystic

fibrosis. That's a reality today, isn't it?

It's certainly a reality that you can select to have children who will

be free of that genetic mutation that causes cystic fibrosis. But for

many characteristics to do with our mental lives, like psychiatric

disorders, the line that's drawn is arbitrary. 10% of children now have

this new disease called attention deficit disorder. That's called a

disease but suddenly 10% of children have this disease warranting

treatment. I believe that, in many of these cases, these are normal

human variations that are just disadvantageous. Science now gives

us the ability of improving those. You go further than just discussing

the possibilities that science offers. You seem to believe there is

some sort of philosophical or moral obligation upon parents, who live in

a context where this technology is available, to use it, enhance and

maximise the potential of their progeny? Am I right?

As parents, most people want to have... Want their children to have

the best lives they can have. But it's a moral obligation? As we

look forward and technology becomes more pervasive, would you, as a

philosopher and ethicist, say to a parent who is offered the chance to

take advantage of this technology and to turn maybe just a kid, who

genetically looks like he might be under average, is there a

responsibility to intervene and make that kid above average? To make it

enhanced? If it makes his or her life the

better, yes. By moral obligation I mean that there is a reason to do

it. We should do lots of things, provide a good education to

children, provide diet and treat diseases. Where there are things

like vitamins or nutritional supplements that improve their

intelligence or reduce unwarranted aggression, then we should use those

in the same way. It sounds like strong language. I'm not saying

people should be required by law to do these things but we should

encourage people and using terms like moral obligation is not to say

that's what they must do. There's a good reason to do it. The reason is,

the child is expected to have a better life.

This is a quote from you. "Technology allows us to avoid the

lottery of life, to choose our destiny". Such a strong statement

and it brings to my mind the word hubris. If humans start talking

about choosing and deciding their destinies, that is hubris, is it

not? It can be but it's also important to

realise that there is enormous inequality and disadvantage. We are

two of the lucky ones. We are sitting here having a comfortable

conversation. There are many people who have a life of extraordinary

disease, disability, disadvantage and really being born behind the

eight ball, not only socially but in terms of biological obstacles to

them being able to just do the basic things in life, like work. If we

have a chance to overcome that, why shouldn't we ask ourselves whether

we should? Maybe because it's going down a

dangerous path. It's a mindset which the philosopher and ethicist Michael

Sandel says is undermining one of the most basic and important

qualities we, as humans beings, have. That's humility and openness

to be unbidden. I have been open to the unbidden.

Why shouldn't we remain open to being unbidden? Why should we try to

determine our destiny by meddling with genes?

When you provide education to children, it changed their brains.

You modify them. You do that according to certain values.

What is the moral or any other equivalent between genetic

engineering of the human embryo and sending your kid to school?

There's no morally relevant difference. Both change the way the

brain works. One acts directly, one acts through social mechanisms. The

final common pathway is what's going on in people's brains. If you can

use knowledge of science, in this case genetics, to augment the

effects of education, why would you draw an arbitrary line, just because

you think it's an internal modification rather than external?

Why would that make a difference? Maybe we can tease that out with

some examples. Starting with one of the most basic uses of genetics that

people may be aware of. That is, gender selection. For a long time

now people have been able to look at the fertilised embryo and see what

gender it is. You have taken a strong position on this, saying it's

a basic human right. That everybody should be allowed to choose the sex

of their baby. We have the right to choose when to

have children, how many children to have, now we have the possibility of

choosing between possible children. If you are going to restrict liberty

in a liberal democratic society, you need to have a reason based on a

risk of harm to people. You can't go around willy-nilly, stopping people

doing what they want, unless they are really harming somebody. When it

comes to sex selection, who are they harming? There are several possible

candidates but the usual one is society or women by creating sex

ratio imbalances. Which we see all over the world.

Not reducing genetic technologies but basically by prenatal testing

and abortion or infanticide. But when it comes to the use of these

technologies, if you could demonstrate a harm to women or

society, that would be a good reason to ban it, but you could easily

prevent this. You simply allow for what you call family balancing,

allowing it for the second or third child of a family who want a mix of

sexes. You can monitor the sex ratio, there are many ways in which

you can ensure that these sorts of harms don't occur.

You talk about this in the context of a liberal, free, rich world

society. Are you accepting that if you were to apply the logic of

freedom to choose, for individual parents on this gender question, in

many societies you would end up with a terribly unbalanced gender

situation inside the country and it would also entrench the second class

status and the disempowerment of so many women and so many societies?

If it had those effects... It would.

Then it would be a good reason to ban it in those societies.

Having a basic human right in respecting freedom is always limited

by the harm that you present to other people. In this case, there is

a clear harm to women. But if we don't have a grave social problem,

we shouldn't be infringing people's liberty.

Imagine a world where the science of genetics has gone even further than

it has today and one can look at the fertilised embryo and draw all sorts

of conclusions about things you have already mentioned. Intelligence,

likelihood of an inclination to violent or criminal behaviour.

Coming back to moral obligation, do you believe in those circumstances

there is a moral obligation to intervene? End those pregnancies

which involve embryos with those signatures or to somehow repair

them? Again, this is the reason amongst

others. I have never suggested that people have a moral obligation to

have termination of pregnancy. That's a very serious intervention.

What I have been discussing is when you have ten embryos and you have

tested them all for diseases... Like IVF?

This is the simplest case. You will soon be able to sequence the embryos

and you have found they are healthy. Why wouldn't you go on to look for

their dispositions towards intelligence or towards psychopathy?

1% of the population are psychopaths. We might identify the

genetic contributions to psychopathy, not to say it's

genetic, but those things that make it more likely and why wouldn't you

take that information into account when deciding... You will implant

one of those ten embryos. Why not choose the one that has a lower

chance... That sounds dangerously like

eugenics, when you take away all the traits, all of the huge numbers of

different traits that make up human beings, and you try to develop a

successful stereotype. We are in a completely different

world to the world of the past. It's true, this is eugenics. It is

eugenics when you test for cystic fibrosis or Down's syndrome, that's

trying to have a child who is healthier or has less intellectual

disability. That's healing a real impairment.

What you are now talking about is trying to perfect, trying to

maximise, the benefit to any newborn individual. For example, you might

say in a deeply prejudiced society, where it's difficult being an ethnic

minority, being black or being gay, then you should meddle with the

genetic material before birth in IVF, for example, to lighten the

scheme or to avoid having the genetic disposition to

homosexuality, because that would create such problems for the future

child. Is that what you would contemplate?

You also have the obvious strategy of reducing... Good memory

institutions. That's politics. But in the short

term, as a scientist, you are faced with the issue, do I get rid of the

embryo that is physically disabled or predisposed to being homosexual,

because the individual, if born, would have a much more difficult

life than the perfect stereotype that I'm seeking? As I said, there

are a number of ways to address this kind of problem and one of them is

through social intervention. That does not answer my question. Imagine

the society is not fixed, it has not worked the way you would like it to

work. But you still have to decide. Do you think it's legitimate to

decide on the basis that I just outlined to get rid of the embryo

that is predisposed to be homosexual or might have a physical impairment?

Because, to use your logic, why wouldn't you? Why not take the

embryo and maximise its own advantage? From the perspective of

the child that is born, in considering whether their life goes

well, you have to consider these unjust institutions and choose the

child that will have the better future. But there are other reasons

not to bend to these forces. Perhaps they want to change these unjust

practices by resisting this kind of choice. But you have to remember

that you are not doing that for the benefit of the child, you're doing

that to change society. And the reasons why people choose to have

boys in India... There are two reasons. First, if you have a girl,

you have to have a very large dowry. For poor people, it's very expensive

to have a girl. The problem there is the institution of the dowry. If you

are a poor person and you cannot afford a dowry, there is a very good

reason for you to select to have a boy. The problem in these cases is

not just to say that you are perpetuating this problem. You have

to address the causes not the symptoms of the disease. The causes

are homophobic attitudes, racism, and outdated social institutions.

Those are the causes. Of course, if you cannot treat the disease, you

have to consider symptomatic treatment. Thereby entrenching those

very institutions. And that might be a reason not to administer

symptomatic treatment. But you are picking a case where... You are

clearly an ethicist and you have to deal with it. Ethics is about not

considering one reason but to consider all relevant factors. You

cannot make a decision in theory about the rightness or wrongness of

selection that applies in every single circumstance. I don't want to

suggest this is simple. It's complex.

Human cloning. Do you believe that the ultimate logic of what you

suggest about perfecting - enhancing and perfecting human genetic

material - does lead to cloning? Taking the very best and replicating

it? Well, again, if that were your only goal, to have the most gifted

possible child, then... Sometimes it sounds like that is your goal. No,

it's not. Sometimes we have a reason. But sometimes people want to

have their own child, not Albert Einstein's child or Michael Jordan's

child. You would need to have a good reason to clone. Here is one.

Imagine if you were infertile and could only produce one or two

embryos. You cannot produce anymore eggs. And you have a pregnancy and

it looks like the pregnancy will be lost. But you can clone that foetus

in utero in case the pregnancy miscarries. That seems an entirely

legitimate use of cloning technology if you could do it, to enable that

couple to have a child. Yes, it would be a clone, but so what? One

line you appear to be happy to cross is cross-species genetic mixing. You

talk about a future in which the human being might have, to quote

you, sonar ability like a bat, or indeed, the ability to convert

sunlight into energy for growth like a plant. I know that this is

blue-sky thinking, but you don't have an ethical problem with this

cross-fertilisation of genetic material? Again, it's important to

start with the science and the facts. We are the result of

integration of viral DNA into our genome. A lot of our genetic

material is viral. We are already integrating stuff from the

environment. Now, if I had a gene sequence that could confer

resistance to HIV that came from some other animal, that was

constructed in a laboratory and put into people to prevent the spread of

HIV, you have to ask why is the fact that it comes from an animal

different from the fact that you just invented it in a laboratory? In

fact, you could just copy the sequence and construct it in a

laboratory. The question is, what are the risks and benefits of the

particular case under consideration? If we ran out of food and we could

then use sunlight to produce energy, why would that be... Certainly

unnatural, but why would it be wrong? Risks and benefits. It's

always a difficult calculation. You have been talking about futurology

to some extent but let's bring it back to something real, which is

your stance on performance-enhancing drugs in sport. You have made a big

noise around the world, saying that you believe it is right to allow

athletes, cyclists, to use performance-enhancing drugs, even

though many of those same athletes say that it is absolutely not the

way they want their sport to go. Why is that? The rules of sport are

entirely arbitrary. There is no inherent rightness or wrongness in

the set of rules. You choose them according to various values. Some of

those values include their ability to be enforced, the ability to

protect the health of participants, the ability to create a fair playing

field that is enforceable. The current regime involves, today, what

athletes are actually doing today is not what the East Germans did in the

1970s, taking massive doses of drugs to turn women into men. They are

moving within the natural range for all of these parameters. Blood,

testosterone, growth hormone. And it's virtually impossible to detect

whether someone is moving within this normal range and it's safe

because it's within this normal range. But if you persist in this,

you turn sport into a contest between scientists rather than a

contest between physical athletes. Because the best drugs will win. Of

course, you could if you again moved into supra-normal doses of these

things. You seem to miss the human element. To quote you from Bradley

Wiggins. He says he has never used drugs, in a sport which has been

tainted by drugs. He says, "I do what I do because I love it. I don't

do it for a power trip. What I love is doing my best and working my

hardest. If I felt I had to take drugs in my sport, I would quit

tomorrow". Well, they do take substances. Caffeine used to be

banned. It's not a naturally-occurring substance. It's

now permitted. It increases the tolerance of the body. Other

examples include analgesics. Local anaesthetics. Non-steroidal ones. It

enables them to deal with the pain and damage of competition. Nearly

100% of footballers are on these sorts of drugs to enable them to

perform better. They are very unnatural and they are dangerous but

nobody perceives them to be performance-enhancing drugs, but of

course they are. That's why they give them. You put an enormous

amount of faith and trust in humanity to use ever expanding

scientific, biological knowledge to the best effect, for the best good

of us as a species. There is one area where you seem to fall down in

that approach and that's bioscience, where you have admitted you're

terrified by the capacity of human beings to create a new pathogen,

which could actually wipe us all out. Are you terrified because of

what bioscience can do or are you actually terrified because you have

come to realise that human beings, we ourselves, are actually pretty

dangerous? I don't have great faith in human beings and their ability to

make decisions about this technology at all. We are the most dangerous

species on the planet. We may extinguish all life on the planet.

Don't get me wrong. And yet you want to give us all these freedoms to

meddle with nature. When it comes to meddling on the level of allowing

people to choose their family, yes, they should have freedom, but what I

would say is that once science gives us the knowledge and power, we have

to make a decision and we have to make it on the basis of values and

ethics. What I have argued in terms of sport and genetic selection is

that once you can make a difference, you have to ask if you should stay

with the status quo or if you should not. And if you choose to stay with

the status quo, you are then responsible for it. In all these

areas, we have to start thinking because unavoidably, science is

giving us the power to make these sorts of changes. My point is that

we need to have a set of values. What I have argued with sport is

that you can have a set of values that allows a level of safe

performance enhancement that would be not threatening to the human

contribution and would be much more enforceable and would make the whole

thing better. That is just a proposal. We know it's up for

debate. But that's what ethics is about - making proposals. And plenty

of debate. Thank you for joining us. There will be spells of wet and

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