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A Companion to GenethicsA Companion to GenethicsA Cooperative SpeciesA Mind So RareA Natural History of RapeAcquiring GenomesAdapting MindsAgeing, Health and CareAlas, Poor DarwinAn Introduction to Evolutionary EthicsAncient Bodies, Modern LivesAnimal ArchitectsAping MankindAre We Hardwired?Bang!BehavingBeyond EvolutionBeyond GeneticsBlood MattersBody BazaarBoneBrain Evolution and CognitionBrain StormBrave New BrainBrave New WorldsChoosing ChildrenCloneCloningConceptual Issues in Evolutionary BiologyConsciousness EvolvingContemporary Debates in Philosophy of BiologyControlling Our DestiniesCooperation and Its EvolutionCreatures of AccidentDarwin Loves YouDarwin's Brave New WorldDarwin's Gift to Science and ReligionDarwin's UniverseDarwin's WormsDarwinian ConservatismDarwinian PsychiatryDarwinism and its DiscontentsDarwinism as ReligionDebating DesignDecoding DarknessDefenders of the TruthDo We Still Need Doctors?Doubting Darwin?Early WarningEngineering the Human GermlineEnhancing 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SinGenetics of Original SinGenomeGenomeGenome: Updated EditionGenomes and What to Make of ThemGlowing GenesHow Women Got Their Curves and Other Just-So StoriesHuman CloningHuman Evolution, Reproduction, and MoralityImproving Nature?In Our Own ImageIn Pursuit of the GeneIn the Name of GodIngenious GenesInheritanceInside the Human GenomeInside the O'BriensIntegrating Evolution and DevelopmentIntelligence, Race, and GeneticsIs Human Nature Obsolete?Language OriginsLess Than HumanLiberal EugenicsLiving with Our GenesMaking Genes, Making WavesMaking Sense of EvolutionMan As The PrayerMean GenesMenMood GenesMoral OriginsMothers and OthersNature Via NurtureNever Let Me GoNot By Genes AloneOf Flies, Mice, and MenOn the Origin of StoriesOrigin of MindOrigins of Human NatureOrigins of PsychopathologyOur Posthuman FuturePhilosophy of BiologyPlaying God?Playing God?Portraits of Huntington'sPrimates and PhilosophersPromiscuityPsychiatric Genetics and GenomicsPsychologyQuality of Life and Human DifferenceRe-creating MedicineRedesigning HumansResearch Advances in Genetics and GenomicsResponsible GeneticsResponsible GeneticsScience, Seeds and CyborgsSex and WarSociological Perspectives on the New GeneticsStrange BedfellowsStrange BehaviorSubjects of the WorldSubordination and DefeatThe Age of EmpathyThe Agile GeneThe Ape and the Sushi MasterThe Biotech CenturyThe Blank SlateThe Book of LifeThe Boy Who Loved Too MuchThe Bridge to HumanityThe Case Against PerfectionThe Case for PerfectionThe Case of the Female OrgasmThe Century of the GeneThe Common ThreadThe Concept of the Gene in Development and EvolutionThe Debated MindThe Double-Edged HelixThe Epidemiology of SchizophreniaThe Ethics of Choosing ChildrenThe Ethics of Human CloningThe Evolution of CooperationThe Evolution of MindThe Evolution of MindThe Evolved ApprenticeThe Evolving WorldThe Extended Selfish GeneThe Fact of EvolutionThe Folly of FoolsThe Future of Human NatureThe God GeneThe Immortal Life of Henrietta LacksThe Impact of the GeneThe Innate MindThe Innate MindThe Innate Mind: Volume 3The Limits and Lies of Human Genetic ResearchThe Lives of the BrainThe Maladapted MindThe Meme MachineThe Misunderstood GeneThe Moral, Social, and Commercial Imperatives of Genetic Testing and ScreeningThe Most Dangerous AnimalThe New Genetic MedicineThe Nurture AssumptionThe Origin and Evolution of CulturesThe Origins of FairnessThe Paradoxical PrimateThe Perfect BabyThe Robot's RebellionThe Selfish GeneThe Shape of ThoughtThe Shattered SelfThe Stem Cell ControversyThe Story WithinThe Stuff of LifeThe Talking ApeThe Temperamental ThreadThe Terrible GiftThe Theory of OptionsThe Top 10 Myths About EvolutionThe Triple HelixThe Triumph of SociobiologyThe Woman Who Walked into the SeaTwinsUnderstanding CloningUnderstanding the GenomeUnnatural SelectionUnto OthersUp From DragonsVoracious Science and Vulnerable AnimalsWar Against the WeakWhat Genes Can't DoWhat It Means to Be 98 Percent ChimpanzeeWho Owns YouWhose View of Life?Why Evolution Is TrueWhy Think? WondergenesWrestling with Behavioral GeneticsYour Genetic Destiny
Betta offers a collection of essays concerned with the "new genetics," that is, the "convergence of knowledge fields such as biology, computer science, chemistry, physics, and engineering" (4). The first two essays set the stage for the remaining chapters by initiating the reader into the controversies surrounding the new genetics in social and commercial contexts. Chapter 1 asks this important question: given the control that genes have over an individual, does knowledge of the encoded genetic information mitigate the sense that one acts as a self-determining agent? If a genetic test revealed to an otherwise healthy person that she was predisposed to acquiring some debilitating illness, one could feel that the disease was inevitable. Betta is concerned that genetic screening and testing will give rise to a number of persons living as if the testing stripped control of their lives away from them. Besides the case of disease, one can easily imagine a defense attorney claiming that his client had no choice but to commit the crime--his genes made him do it. The concern is that an increased awareness of our own genetic material will lead to overloading our DNA with too much responsibility. The challenge is to strike a balance between making responsible use of information gleaned from genetic screening and testing on the one hand and allowing that information to run our lives on the other.
Chapter 2 specifically treats the commercial relationship between biotech corporations and the medical science community. Betta argues that a tendency exists to regard scientists and medical practitioners as wholly removed from the world of commercialism. Joint ventures between corporations and scientists leads a community to be skeptical of the genuine objectivity of the scientists involved. One interesting issue that Betta engages is the influence of market driven economies on patient care. Betta sees a profit motive influencing contemporary healthcare coming from a "fundamental transformation of healthcare into a commodity that introduces market practices into the medical profession and its establishments" (34). Betta cites the U. S.'s putative healthcare crisis as the paradigmatic case of market driven medicine. The supposed problem is that through private health insurance patients become consumers.
However, such a claim is misguided. Insurance companies are the primary consumers of healthcare goods, deciding what kinds of patient services are worth the financial risk. In this context, the patient has relatively little say about the services that she will procure. Of course, the patient may decide to purchase a medical service independently, but insurance companies have skewed the market such that healthcare costs have moved beyond the financial resources of the average middle class patient.
Medical savings accounts may provide a solution to the problem by giving patients the means to make their own healthcare decisions with their physicians. Nevertheless, Betta sees these savings accounts as the primary factor responsible for turning healthcare into a commodity (35). Her problem with such a move is that consumers are much more interested in new cars and vacations than medical care. This seems patently false. Despite my own lack of faith in the rationality of human beings, most of us seem to be interested in not dying. Even if I am wrong on this point, if one decides to purchase a new sports car as opposed to electing to have heart surgery, it ought to be the person's decision. The responsibility for making a bad decision rests on the one refusing care, and no one else (including the government). In several places, Betta seems to imply that government ought to be the distributor healthcare. Our intuitions part on this point. I have no space to argue against this claim.
Moving on, chapters 3 through 12 discuss the way in which Australia has met the challenges of the new genetics, specifically considering the Australia Law Reform Commission's (ALRC) and the Australian Health Ethics Committee's (AHEC) joint study Essentially Yours: The Protection of Human Genetic Information in Australia. Three main issues are discussed: (1) the need to protect the of privacy an individual's genetic material, (2) the need to protect individuals from discrimination (by insurance providers and in the workplace), and (3) the protection of persons vulnerable to harm such as children caught in paternity battles and innocents coerced to provide genetic material by police agencies. Unfortunately, these chapters all take the same form: the Study discovered the need for policies addressing the concerns mentioned above, and the Study recommended the development of policies addressing the concerns mentioned above. The authors take no position and offer no arguments. Chapters 5 and 6 provide the most in-depth reporting of the facts of the Study. Read these two chapters together as one long paper. Once one has read them, there seems to be very little reason to read the rest of the second part. Each of the other chapters either rehashes the results of the Study in total or picks one of the three on which to focus.
Chapter 13 closes the book with a discussion of "self-knowledge and self-care in the age of genetic manipulation" as the base for an ethical life (249). Ending in a place not too far from where she started, Betta reminds us that who we are as humans and the kinds of persons we take ourselves to be will be challenged by the new genetics. The information our genes give us threatens to destroy our sense of moral agency. Yet, we can care for ourselves and make the best with what we have. Such self-care reflects a moral life "that not only has its own rewards, but relieves others of any obligation to care" (255).
The opening and closing chapters of the book present the most interesting material for those interested in applied ethics. Despite the fact that the remaining chapters fail to cover much philosophical ground, if one is looking for a list of the imperative looming on the genetic horizon, then this book makes an important contribution.
© 2007 Jeremy Green
Jeremy Green, Department of Philosophy, Western Michigan University
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