BACKGROUND

The editors (Erik Parens and Josephine Johnston) are explicit in mentioning the volume’s conceptual and financial roots. It is just one of the outcomes from a three-year John Templeton Foundation international project that aimed to address social and ethical implications of gene-editing technologies on human ‘germline’ cells, eggs, sperm, and embryos. The major concern of the project was that these technological advances could (inadvertently) instigate changes to our human genetic inheritance that might be irreversible. The aims of the volume then are to stimulate a ‘public conversation’ about some of the central ethical questions raised by the development of gene editing technologies. This is more than merely an academic exercise, but has practical import because as the editors suggest, ‘it is through this public conversation that citizens can influence laws and the distribution of funding for science and medicine’. The editors see this volume as being a catalyst for social change, empowering stakeholders, leaders and citizens in communities to make informed decisions over matters that shape their lives. Some of the key concerns raised by the editors include:

• What might gene editing—and related technologies—mean for human flourishing? 
• What does it mean to flourish, and how might gene editing help or thwart flourishing?
• Could gene editing redefine what it means to be healthy, normal, or loved?
• How might it change relationships between parents and children?
• Could gene editing exacerbate the gap between the haves and the have-nots – and how can we avoid this risk?

The issues raised in the volume are, then, multidisciplinary in orientation because these centre on tensions between the sciences as well as normative studies, in particular, recent and emerging issues in bioethics (especially prescient in a post-COVID world). Nonetheless, they are crucially related to other fields of interest as well such as philosophy of science, philosophy of technology, philosophy of health & medicine, political philosophy and ethics. 

STRUCTURE & APPROACH

The volume is divided into five parts, each part containing between three and four chapters on a particular theme. For example, Part I (What is human flourishing?) there are insightful contributions from authors such as Rosemarie Garland-Thomson, Daniel M. Haybron and John H. Evans. It’s worth mentioning that an accepted conception of flourishing is outlined upfront by the editors in the introduction. Their conception centres on valuing human diversity, human ‘lived’ experience and an awareness for the importance of social justice in any discussions of flourishing. As an aside, readers might also benefit from seeing Carel (2014, 2016) for further discussion on the phenomenology of illness where she adopts a first-person approach to human nature and psychology that is critical of various forms of naturalism which she sees as excessively dominant in the modern sciences. As argued elsewhere (e.g. by Hughes [2016]), there is a view that at times science and technological change can exclude or marginalize vulnerable communities that have little voice and say in the echelons of governmental or corporate power; hence, the initial chapters address various issues on the topic of human flourishing from a perspective of emancipatory social justice, including: what this might mean for different kinds of human communities (such as those with disabilities); the value of ‘authenticity’; and an analysis of the sociological aspects of human flourishing, including the power dynamics in current socio-political debates. 

In Part II (The value of acceptance), there are chapter contributions from Hauskeller, Kim and Kaebnick. These authors here concern themselves with the conceptual and ethical issues of ‘control’, asking questions such as: ‘Is it always better to have more control?’ Implicit from all the authors in this section is a sceptical attitude towards progressivist notions of human nature, and some truly insightful remarks can be seen by, for example, Hauskeller (Chapter 4). Building on the value of diversity as advocated beautifully by Garland-Thomson in Chapter 1, Hauskeller avers that there are ‘different ways of living the good life’. The trouble with too much of a focus on technological advance at all costs is that it reduces human diversity of expression to specific ‘standards of correctness’. Whilst remaining open to technological advance, he argues that we can (and should) cherish ourselves as we are. The new challenge that presents itself then might rest on effectively navigating both conservative and progressive trajectories side by side. Whilst this will no doubt be extremely difficult in a globalized world, it is a challenge we must face if we are to truly flourish in our diverse ways as a species. 

In Part III (Is control the key to flourishing?) the contributing authors – Iyengar, Kuman, Johnston, Vincent and Jane – build on some of the issues of control raised in the former chapters by addressing tensions that gene editing raises for parents and parenting. For example, in Chapter 9, Vincent & Jane discuss emergent pressures to ‘screen and intervene’.  Screening for gene ‘abnormalities’ may become as accepted as screening for Down’s syndrome (though this remains highly controversial and arguably morally dubious). The point being that the normative dimensions of parenting are shifting. The authors also raise pragmatic concerns such as reduction in healthcare costs with the real prospect of premiums for those who do not edit illness out of their children. These are unprecedented times that require renewed ways of engagement and thinking if we are to address the challenges ahead. As the authors suggest, you may decide to get a flu shot to avoid illness, but your employer may pay for it (or even mandate it) because it makes ‘business sense’ to do so – at least according to their frameworks that assumes they might get more productivity from you if they do. (In the current post-COVID climate, this kind of thinking is certainly part of the current political and ethical battle being fought in the media, society and in some cases, even the courts (see Kaminer [2021] for a recent exploration of the issues of mandation by employers in a US context).

Relatedly, in Part IV (Balancing acceptance and control) the contributions from Scully, Sparrow, Burdett and Deane-Drummond focus on the problem of the ‘bias toward the goodness of intervention’. This is not to justify scepticism in excess or indeed a modern form of Ludditism but it is to argue for a ‘better balance between control and acceptance’. These chapters use various perspectives and approaches to these values through, for example, drawing on ethnographic inspired interviews taken from various cross-sections of society, including lay people as well as professionals. The assumption is that we all have important contributions to the debates and perhaps what is needed is not merely engagement for engagement’s sake, but an affirmation of the ancient need for practical wisdom of the everyman/ woman. Finally, in Part V (Flourishing Together), the contributory authors – Roberts, Scherner, Bennet and Jennings – orient their concerns around the ‘bigger picture’. The focus here is on the prospects for creating and supporting new ‘social environments’ of flourishing which includes supporting an axiological centre for our cultural and social norms founding them solidly on the values of justice, dignity and sustainability.

SUMMARY

Overall, the volume is hugely accessible, easy to understand and written in everyday English. This helps not only the layman but also the policy specialist and the academic to engage with the issues unblinded and undazzled by the technicalized language often used in academia. It is also coherent, integrated, and well-designed with every contributor relating their insights to the work of others in the volume. At times this feels tokenistic, but this is rare; for the most part it is executed in meaningful and useful ways providing a successful weaving ‘global’ narrative across the volume. Crucially, it is engaging and dialogical, not aiming to answer profound and contested questions on topics as broad as human nature, flourishing and the common good. At times this might for some readers feel frustrating e.g. for readers not accustomed to philosophical inquiry, or for those seeking easy answers. However, there are no easy answers to such complex topics. Whilst this background assumption can mean that the volume at times reads as ambiguous or challenging on political, philosophical and personal grounds, as a philosopher and teacher, this is an assumption I am perfectly happy with. It is vital to remember that facilitating cross-community conversation on these complex topics is ‘the’ central aim for the volume. The dialogical style is then in my view, a clever pedagogical strategy adopted by the editors. This is useful not merely on the specific topics addressed in the volume, but equally or even more so, in the unprecedented post-COVID world where our discussions of the potential benefits and problems for the global implementation of novel vaccine MRNA technology are often so polarized. This outstanding and timely volume could, and should, be a catalyst for academics, policy-makers, and ordinary citizens alike, to begin to engage in these important topics of substance, and to work towards building more democratic fora where this cross-community dialogue can meaningfully occur. 

WORKS CITED

• CAREL, H. 2014. Illness: the cry of the flesh. Oxford: Routledge.
• CAREL, H. 2016. Phenomenology of Illness. Oxford: OUP.
• HUGHES, B. 2016. The Bleeding Edge: why technology turns toxic in an unequal world. Oxford: New Internationalist Publications.
• MOUNTBATTEN-O’MALLEY, E. 2021 (forthcoming). Human flourishing: a conceptual analysis (PhD thesis). Edge Hill University. 
• KAMINER, D. 2021. ‘Can an employee object to mandatory COVID-19 vaccines on religious grounds?’. The Conversation. URL available @ https://theconversation.com/can-an-employee-object-to-mandatory-covid-19-vaccines-on-religious-grounds-153058 [last accessed 14/03/2021]. 

Eri Mountbatten-O’Malley is a Fellow of the Higher Education Academy and a Fellow of the Centre for Welfare Reform. He has worked in education and social welfare policy for many years (for which he won an award in 2016). He is now an incoming senior lecturer in education policy at the School of Education, Bath Spa University. His philosophical interests include highlighting the importance of normativity and context in tackling issues relating to scientistic, reductionist or essentialist notions of human nature and flourishing. He is in the final stages of his PhD, which is entitled: ‘Human flourishing: a conceptual analysis’, due for completion imminently.

Categories: Ethics

Keywords: Ethics, flourishing, genetics