Tuesday, June 13, 2006

Engineering the Perfect Baby

Most engineering societies publish codes of ethics, and most of these codes say something about the health and welfare of the public. My own professional society, the IEEE, has over 300,000 members involved in electrotechnology of all kinds, including the ultrasound machines that produce images of unborn babies. The IEEE code of ethics says among other things that its members agree "to accept responsibility in making decisions consistent with the safety, health and welfare of the public" and "to treat fairly all persons regardless of such factors as race, religion, gender, disability, age, or national origin." Many people—and several U. S. states—include unborn babies in the category of "persons," even if they are found to have disabilities.

Before the advent of ultrasonic medical imaging, amniocentesis testing, and other prenatal diagnostic techniques, the mother's womb was a mysterious and inviolable sanctum. But now, due largely to the efforts of biomedical engineers and scientists, we can monitor heart rates, blood chemistry, and even perform surgery on babies who have several months to go before their regularly scheduled arrival. We can also discern defects such as clubfeet, extra digits, webbed fingers, and cleft palates. None of these defects are life-threatening, but they mar the ideal image that all parents want of a "perfect baby."

In her June 7 Orlando Sentinel column, Kathleen Parker deplored the cases of several British parents who had aborted their babies precisely because they had one of the defects I just mentioned. The numbers were not large—twenty or so with clubfeet, four with hand problems, one with a cleft palate—but numbers are not always the most important thing. While we have no comparable data for the U. S., our larger population and access to largely unrestricted abortion probably means that even more abortions in this country are performed for comparable reasons. In India, it is well known that many abortions take place simply because the unborn baby is female. And this fact is usually disclosed by an ultrasound imaging machine.

I am not about to issue a blanket condemnation of prenatal diagnostic technology. It is a classic case of the two-edged sword. Some anti-abortion groups have found that one of the most effective ways they can persuade a potential mother to carry her baby to term is to show her an ultrasound image of the live, kicking infant inside. And until recently, the universal unstated purpose of medical technology was to save lives and preserve health, abortion and euthanasia notwithstanding.

But if you consider unborn babies persons and members of the public, in these cases technology is a hazard to their health, safety, and welfare. And even more obviously, technology is being used to discriminate against (e. g. kill) those with disabilities or those who happen to be the wrong gender, at an early age when they are most defenseless. Such use of technology clearly violates the IEEE Code of Ethics.

Well, you say, technology is neutral, and the person who designs equipment can't always predict how people will use or misuse it. As I have mentioned elsewhere, the "technology is neutral" argument is a shaky one, especially in the case of technologies designed explicitly to harm people. As for predicting how technology will be used, engineers are responsible for making sure that when a new technology is introduced, they have taken reasonable safety precautions in terms of warning labels, training in safe procedures, and so on. But when an unsafe condition arises in use, it seems to me that turning a blind eye to the situation is irresponsible.

I don't like to talk philosophy in this blog ordinarily, but in this case it's unavoidable. There are scientists and engineers today who take the view that the human being is essentially no different than a computer, and an early-stage primitive computer at that. I'm thinking of such "posthumanists" as Ray Kurzweil and Hans Moravec, who see humanity as just a crude sketch of what we are now obliged to improve upon using genetic engineering, robotics, and artificial intelligence. One way to approach this improvement process is to throw away defective units, which is the approach the British parents of defective infants used. This reminds me of the early days of transistor manufacturing when the chemistry and physics of semiconductors was poorly understood. The factory would do their best to make a batch of a hundred transistors, and then they would sort through them one by one to find the ten or twenty that worked acceptably, and throw the rest away. But people aren't transistors, or computers, or machines. They're people.

Kathleen Parker began her column with a poetic quotation from the famous—and clubfooted—Lord Byron, who wouldn't have made it out of the womb if he had been conceived by a British couple equipped with an ultrasound machine and a false ideal of bodily perfection. People with minor or major bodily defects, and yes, even mental defects, who went on to achieve incredible feats of human endeavor are among the most encouraging examples of what it means to be human. Paradoxically, you will find in many of the biographies of the great, from Homer the blind poet down to Lance Armstrong the cancer survivor, some great physical challenge which forced them to develop the kind of character that can overcome great challenges.

It is time to divide the medical wheat from the chaff. Given a human life, the job medical science and technology should tackle is how to help that human life overcome problems and difficulties with a reasonable use of limited resources. That is the wheat. But any technology or procedure that is used to end a defenseless human life because others decide that for whatever reason—status, economics, politics—it is not worth living, is chaff. And the sooner the chaff is gone with the wind, the better.

Sources: The IEEE Code of Ethics is at http://www.ieee.org/portal/pages/about/whatis/code.html. Kathleen Parker's article "Abortion's dead poets society" is at http://www.orlandosentinel.com/news/opinion/columnists/orl-parker07_106jun07,0,2091692.column. The Alan Guttmacher Institute study she mentions, "Reasons U. S. Women Have Abortions: Quantitative and Qualitative Perspectives," is at http://www.guttmacher.org/sections/abortion.php.

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