Genetic Turning Points: The Ethics of Human InterventionWritten by James C. Peterson Reviewed By Brian Brock
James Peterson’s book on the ethics of human genetic intervention may be, to date, the best book written by a Christian on the topic. This is no small praise when judged against the number of books on the topic, yet such praise is warranted only if we understand what the book is not.
First, it is not a theological analysis of the topic, if by theological analysis we mean thought about practical questions that is systematically integrated with doctrinal beliefs. Despite several sections detailing what he considers to be the relevant Christian doctrines, when getting down to discussion of particulars we suddenly find his summary of Christian ‘attitudes’ to have transmuted into the terminology of American secular medical ethics, revolving around the terms autonomy, nonmaleficence, beneficence, and justice. These terms are drawn from the ‘bible’ of secular medical ethics, Tom L. Beauchamp and James F. Childress’ Principles of Biomedical Ethics (New York: Oxford University Press, 1994), under whom Peterson did his PhD at the University of Virginia. Having trained with Beauchamp and Childress, Peterson can be said to be representative of contemporary medical ethics orthodoxy, concerned as it is with addressing its arguments to a liberal pluralist society rather than from and to the Christian church.
By making political liberalism his reference point, Peterson gives up his resources to resist the medical establishment’s essentially uncritical embrace of genetic technology. Thus the second thing this book is not about is indicated in its subtitle. It is a book about how to manipulate the human genome responsibly. Behind that question is a simple acceptance that we will and should so manipulate, based on Peterson’s acceptance of the familiar course of all modern thought: because others suffer, any inactivity becomes culpable (51, passim), and good human action is designed to provide people with more choice (340, passim). It is precisely here that a theological critique could make some serious headway, but Peterson’s delight at the technological possibilities makes any more critical stance superfluous.
Despite these rather sweeping criticisms, this book still has much to offer a broad range of readers, and its merits stem from Peterson’s extensive clinical experience as a research fellow in molecular and clinical genetics. Few of the many writers on this topic have opinions that are based on first hand experience of the practicalities of the technology. Peterson is at his best when accurately and comprehensively surveying the state of the art in clinical practice, and clinic based ethicists’ responses to those challenges. This is a book which gives a very clear picture of the ways in which genetics is radically changing the shape of modern medicine.
The four main foci of the book are genetic research, genetic testing, genetic drugs (adding gene products to the body), and gene surgery (changing genes in the human body). In each area Peterson explains the current technical possibilities, their practical clinical implications, and soberly assesses what may be possible in the coming decades. He sympathetically outlines the challenges which the new technologies bring to patients, doctors, the legal profession, the insurance profession, and national government. We are made privy to the ways the technical choices facing clinical and scientific practitioners have wide reaching implications across all of society. For those who are not familiar with the inner workings of the modern medical complex, such details are highly informative.
It is tempting to think that because the book is so informative, its ethical prescriptions are similarly cogent, but here the lack of theological acumen makes the book badly misleading. In Peterson’s world one of the most important questions is how best to properly direct the inevitable project of human eugenics (ch. 15), while a proper theological ethic would begin to question the use of genetic technologies long before embracing such a wholesale remaking of the human race.
University of Aberdeen
Aberdeen, Scotland, UK