Southgate, M. Therese

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The Linacre QuarterlyVolume 39 | Number 3 Article 5August 1972Genetic Engineering: RepriseM. Therese SouthgateFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationSouthgate, M. Therese (1972) "Genetic Engineering: Reprise," The Linacre Quarterly: Vol. 39 : No. 3 , Article 5.Available at: http://epublications.marquette.edu/lnq/vol39/iss3/5Another criticism is that the Directives deal too much with the problems of sex, and not suffic ~..nt­ly with t'1e broader a nd mort sig-.nifica nt --t uestions of "who shall live" an : " the quality of life." Yet of the .3 specific directi ves, only 5 deal d irectly with the use of sex, II deal with the protection of life and 16 deal with the qual-ity of li fe . Let us be honest enough to ac-knowledge tha t the problem of the Directives is not so much one of sexuality as of Ecclesiology. The point of contention is not so much what the Church teaches on the question of sex - because that ~~ perfectly clear - the point at i!.~ue is rather: " Should Catholics g ' on believing it?" -and there recisely is the crisis of faith . In summary, then, the basic is-~ue is fa ith in the Church, in its teaching with regard to contracep-tion (and contraceptive sterilization) i11 our predominately contraceptive piuralistic society today- with abortion looming ever larger on the horizon. The authentic, official, recent as well as tradi tional, and repeated teaching of the Catholic Church is that these practices are moral evils. The Second Vatican Council left that teaching undisturbed and made provision for its re-affirma-tion in the E ncyclical Humanae Vitae. T he Encyclical appeared, and the Bishops of the entire Church reinforced it. There are more than a few Cath-olics today who simply do not ac-cept this teaching. That is damaging enough to the Church - to the 146 faithful of Christ. But the worse danger and damage is in priests and theological writers using their authority and prestige to say that this is not really the teaching of the C hurch; or, if it is, that Cath-olics need not accept it ; or that it doesn't really mean what it says; or that the Pope and the Bishops are incompetent and so need not be listened to- because they do not understand the new Ecclesio l-ogy or the new morality - which is to say that they do not know either the nature or the function of the Catholic Church. If we would close with a prayer, that prayer should be the twenti-eth century plea of the Lord Jesus, to His eternal Father, as He re-news His Sacri fice on the altars of our contemporary world: "Strength-en, in fa ith and love, Your pilgrim Church on earth ." This is a prayer that really says it all. T he road ahead - for the Catholic Hospital - partly sup-ported by public funds in a p lural-istic, and to a great extent, contra-ceptive and abortion-oriented society - is fraught with dangers to its corporate endurance, and even con-tinued existence . The pilgrim road ahead will re-quire great reserves of strength, and faith, and love. But if faith fa ils- fa ith in the Church as the authentic on-going Galilean ministry of the Lord Jesus - bringing His redemptive love to today's troubled world - if that faith fails, then our attempts at love will bring to others more harm and hurt - than wholeness and healing and good. (1:£2 Li nacre Q uarterly Genetic Engineering: Reprise M. Therese South gate, M.D. Reprinted with permtsswn from The Journal of the American M edi-cal Association, Chicago, Illinois. We commend to the especial atten-tion of our readers an article by Paul Ramsey, PhD, on some of the ethical considerat ions in art ifi-cia l reproduction of the hu man specie~; , or broadly speak ing, genet-ic engineering. In part I of this article (p 1346) Doctor Ramsey considers the medical ethics of in vitro fertil ization or, as popular parlance has it, the " test tube ba by. " (This latter term is, however, not str ictly correct as will be noted below.) In part 2 of the article, which will appear next week, Doc-tor Ramsey answers objections which might be raised to his state-ments and also develops some of the implications for genetic en-gineering in current embryologic research. Before examin ing some of the issues, it is perhaps important to define some of the terms and pro-cedures which are subsumed under the broad umbrella of "genetic en-gineering," but which are frequent-ly confused , as well as noting the August, 1972 Dr. Southgate is a Sertior Editor of The Journal ofthe American Med-ical Association. She is a gradutAe of the Marquette University School of Medicine (now Medical College of Wisconsin) and during her medi-cal school days was editor-in-chief of the Marquette Medical Review. In her guest editorial (reprinted here f rom the Journal of the Ameri-can Medical Association) Dr. South-gate makes reference to a two part article by Doctor Paul Ramsey. Those interested in reviewing Dr. Ramsey's article "Shall We 'Repro-duce'?" are referred to The Journal of the American Medical Associa-tion Vol. 220, Nos. / 0 & II ; June 5 and June 12, 1972 . 147 ' I' ' I .... ··. · .. . I . • ·, ' ' • • f ', . ·., 1 , ' . "state of the art." The popular term, genetic engineering, might be <on-sidered ;> c; covering anything h. ing to do ' \ ith manipulation o the gametes >r the fetus for wt> lever · purpose, from conception other than by sexual union of two per-sons, to treatment of disease in utero, to the ultimate manufacture of a hum••n being to exact specifica-tions. It has nothing to do with the "creation of li fe" ; it is con-cerned only with the methods for transmitting life. Thus, the earliest procedure in g~.·netic engineering might be con-~ ide red to be artificial insemination, <)r the laboratory introduction of l>perm (usually, but not necessarily, tl-te husband's) into the woman's b •dy with the intention that fertili-z ttion of an ovum will occur. This . ractice is relatively widespread to-•ay and utilizes not only freshly acquired sperm, but sperm which may have been stored for indefinite periods oftime (frozen-sperm banks). The next procedure in point of logical development is artificial, or in vitro, fertilization , ie, union of sperm and ovum outside of the human body, "in the test tube." This has been accomplished in the laboratory with human sperm and ovum and the resulting zygote has developed in the test tube through several divisions, at least to the em-bryo stage of blastocyst. The next step logically is, of course, artificial implantation into a uterus, since the blastocyst stage is when the embryo normally needs a uterine environment for contin-ued development. This has been accomplished in laboratory animals 148 with the birth of some apparently normal offspring, but not yet in humans (the latter "failure" owing largely, we suspect, more to the fact that as yet we understand lit-tle about the process of implanta-tion than to the fact that no one has been willing to try it without at least some chance of "success"). It is with these latter two proce-dures that Doctor Ramsey is chiefly concerned in the first part of his article. Yet in the future, but following the same stepwise logic, are pro-cedures which are commonly iden-tified more sensationally with the term genetic engineering: ectogene-sis, or total extracorporeal gestation of a fetus to term and "deli very" by reproducing the uterine environ-ment in a test tube (this is prop-erly called a "test-tube baby," al-though in the popular media artifi-cial fertil ization is often referred to as such), cloning (already accom-plished in frogs), in wh ich the nu-cleus of an ovum is removed and replaced by the nucleus of an asex-ual cell, eg, a skin cell, with the production, of course, of a being genetically identical to the donor of the nucleus (two observations can be made here : one is that whereas sex without procreation has always been possible, cloning makes possible procreation, or more accurately reproduction, with-out sex- a totally different and most serious human consequent; the other is that the only persons essential to preservation of the hu-man species will be carriers of mature ova); production of chim-eras, or the grafting of cells from Li nacre Quarterly one or more blastocysts to another blastocyst, perhaps to correct de-fects in the original blastocyst, the "parents" of the several blastocysts being the same or different in each case ; and finally, and what is popu-la rly meant by genetic engineering, the production - or better, the biological manufacture- of a hu-man being to desired specifications. Doctor Ramsey considers some of the implications for the future in the concluding portion of his arti-cle next week. And why our concern about these matters? Why be concerned about genetic manipulation when at least some of its results will be good for the individual fetus, eg, detection and treatment of disease in utero? Why be concerned about procedures which have provided inferti le couples with children, or which have made it possible for male sterilization to be "reversible"? Why be concerned about futuristic procedures which may seem so pre-posterous as to be impossible of accomplishment? Doctor Ramsey discusses well the reasons for concern from the standpoint of what he terms " re-ceived medical ethics." Others1 have been equally thoughtful and have raised additional issues. Pop-ula r concern, in contrast, usually voices more obvious and sensation-al pros and cons, for example, the raising of the so-called intelligence quotient or the fear that politicians will preempt contro l of the species to nefarious ends. These are hardly serious concerns at this moment, however, nor will they perhaps ever August , 1972 become so, precisely because they are so obvious. In other words such practices as clonin~ or tht biological manufacture o l a human being are as yet several ) ant steps away and as such are Il'adily re-jected as being unethical, immoral, or impossible precise!~ because they are as yet in conftil with our culture. The change fron he pres-ent is too drastic to adn into our perceptions of reality. Rather, of graver cc cern today should be the ready acceptance by many of the first steps we are taking in divorcing procreation from hu-man sexual union, ie, artificial in-semination and in vitro fertilization, and the cultural conditioning we thereby undergo to accept the next small logical step as even better. Our concern thus is with this much more subtle danger- that of con-ditioning. It is the graver danger precisely because it is not easily evident. For example, we accept artificial insemination as a good because its immediate, seen result, relieving childlessness, is "good." We are thus conditioned, at least culturally if not ethically or moral-ly in all cases, to accept the next logical step, artifici al fertilization, without too much questioning be-yond our establishing the fact that ultimately research will bring it to the same "good" end. Not asked are two corollary questions: ( l) Have we a right to satisfy by any means whatsoever our legitimate desires, even our needs? and (2) What are we doing to the act in which human procreation takes place? Human procreation ought to be 149 ' I ' .' I ,'' J! t .... ' · .. . ··. I .. ' . ·.·. : t 't I 1 , ~· I, .. ·, # I ,., 0' ' · ?.~ ·~· . .. \ . .. .. ,'( ,• . ' I ·! '· : · · ,.. ,. •' .. ' ,, I . ' ' an act involving the total hu man person. It is a human act, as Kass1 has noter , precisely because it ~n­gages t' '. ' people physically and spirituall : and not merely ration-a lly, as :. , a laboratory procedure. With w :ificial insemination we have a l ady de-humanized the act invoi i in conceiving a human being b. 11aking it a merely ra-tional ac. recreation thus becomes reproductt a word borrowed from the l H)ratory, but now es-tablished in our daily usage. Perhaps, too, medicine, and es-pecially the area of research, ought to reexamine itself in terms of its public relations. Perhaps we bear no small share of the blame in causing a demand for the realization of even legitimate desires by over-sell ing our wares or distorting our true task. For example, the unfor-tunate word "cure," and by implica-tion "satisfaction" and "happiness" as well, has crept into the language when we real! y mean " treat." In truth, we have no rose gardens to promise. Obviously, we must examine more than the end result of our 150 actions. Otherwise we will be conditioned gradually so as to eventually forget what is human. Obviously, too, this is a complex and ongoing process of examina-tion and decision. We must not lose the benefits of research out of fear. Mistakes will be made in our decisions. But we will retain and grow in our humanity if we look beyond the immediate "good" to what will allow us to reach our full measure of dignity as phys-ical, rational, and spiritual persons, not reproduced or manufactured, but "called into being." As such, human procreation is a mystery, and not a problem. Whereas given enough money and time, one may solve virtually any proble m, mys-teries can only be contemplated. Given the intricacies of the hu-man mind, we doubtless possess the potential for reproducing some-day, to exact specifications, a human person. But should we? Should we have even taken the first step? REFERENCES I. Kass LR: Making babies: The new biology and the "old" morality. Public In-terest No. 26, pp. 18-56, 1972. Linacre Quarterly HISTORY OF PSYCHOTHERAPY John R. Cavanagh, M.D. Dr. Cavanagh sets the stage with a preliminary discussion of various schools of psychotherapy in the first of a two part " History of Psy-chotherapy" to be published in the Linacre. The second part of the history, an in-Jepth look at the his-tory of hypnosis will appear in the November issue. That issue will also include Dr. Cavanagh's exten-sive bibliography for the two parts of his article. This issue of the Linacre Quarter-ly deals wi th the morality of psy-chotherapy. As a preliminary to this discussion, it is important to know something about the various schools of psychotherapy. The most popu-lar of these schools was that of Freud. As a consequence, more time will be spent on Freud and less on the other schools. Until Freud developed free as-sociation and dream interpretation, his main therapeutic instrument was hypnosis. Not only did Freud use hypnosis, but many of his contem-poraries did also. Although hypnosis cannot be considered a school of psychiatry, it was so important to a ll schoo ls that I believe it should be described. For this reason, hyp-nosis will be briefly described in this first section of this history and considered in length in part II in the next issue of the Unacre. Although the history of psychia-try is full of well-known names such as Benjamin Rush, Tuke, Pinel, Esquirol, Falret, Mesmer, Charcot, and others, 1 no notable August, 1972 cc tributions to the ps~ 1odynam-ics of mental disease re mad·· before the time of Freud ~ Breuer. Prior to that time, the t .ment of the mentally ill was Jar· v a mat-ter of custodial care a ugh nu-merous studies had be ' lade of hysteria. Breuer Modern psychopath >gy may be said to have had its .r igin in the work on hyste ria of Joseph Breuer. Breuer, as a result of his studies with hypnotism, was led to believe that neurosis had its origin in a fai lure to express the effect of past mental trauma. He taught that the affect had been suppressed but came forth in the form of symp-toms, and tha t the condition could only be relieved by hypnotizing the patient, bringing about a recall of the initial trauma and a t the same time helping him to abreact (work oft) the associated emotion. Breu-er 's work would have received lit-tle attention except for his associa-tion with Freud, whom he had met in Bruche's laboratory where Freud was studying prior to the comple-tion of his medical degree. Before Freud had gone to Paris in 1885, Breuer had discussed with him the case of hysteria in a young girl whom he had studied by means of hypnotism and which had re-vealed to him new concepts as to the causation and significance of hysterical mani festations. This dis-cussion marked the beginning of the development of Freud's sys-tem of psychoanalysis.2 151 .•• .. ' • ~ .. : • • 'i'' • I .· ·· ' ·, . .. t .. ·, . ... .. ' • • 1, ··: . .. : ' ~ .. .. .. ,. \ 

Genetic Engineering: Reprise

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