DANGERS OF GENETIC MANIPULATION
Pope John Paul II
Address to members of the World Medical Association (October 29, 1983)
At the conclusion of the 35th General Assembly of the World Medical Association at Venice, you have proposed to come to Rome to meet with me. You are cordially welcome in this house, the more so because a particular convergence exists between your concerns and those of the Church. Medicine is an eminent, essential form of service to mankind.
It is necessary first of all to help man to live and to surmount the handicaps which impair the normal functioning of all his organic functions, in their psycho-physical unity.
Man also is at the center of the preoccupations of the Church whose mission it is, by the grace of Christ, to save man, to restore him in his spiritual and moral integrity, to lead him toward his integral development where the body has its part.
This is why the ministry of the Church and the witness of Christians are united in their solicitude for the sick.
With you, then, I express best wishes that the medical science and the art of healing may continue to progress. Already the battle against acquired illnesses, intensive or chronic, has become very effective. That organized action against hereditary diseases is likewise being challenged to further advances.
How could we not hope that you find in contemporary societywhich invests so much in the comfort of healthsufficient concern and support to bring the required care to the illnesses of today and tomorrow?
The theme of your meeting in Venice, "The physician and the rights of man," was an additional reason to arouse the interest of the Holy See. How often have I had occasion to speak of the fundamental and inalienable rights of man, even before the Assembly of the United Nations! The totality of these rights corresponds to the substance of the dignity of the human being. The doctor is, in a special way, involved in the respecting of these rights. The person's right to lifefrom the moment of his conception till his deathis the first and fundamental right, the root and the source, as it were, of all other rights.
In the same sense, one speaks of the "right to health," that is, to the conditions most favorable for good health. One is reminded also of the respect for physical integrity, for professional secrecy, for freedom to be cared for and to choose one's doctor wherever this is possible.
The rights to which one refers are not, in the first place, those which are recognized by the changing legislations of civil society, but they are rooted in fundamental principles, in the moral law which is based on being itself and which is immutable. The domain of deontology may appear, especially today, as the most vulnerable in the field of medicine, but it is essential, and medical morality should always be considered by practitioners as that norm of their professional practice which deserves the most attention and, above all, the greatest efforts in its defense.
It is evident that the extraordinary and rapid advance of medical science entails frequent rethinking of its deontology. You are necessarily confronted with new questions which are stimulating but very delicate. With this the Church is in full sympathy, and it willingly supports your reflection, in its respect for your responsibilities.
The search for a satisfactory position on the ethical level, however, depends fundamentally on one's basic conception of medicine itself. What must be established definitively is whether medicine is, indeed, at the service of the human person, or his dignity, of what he has of the unique and of the transcendent, or whether medicine is considered, first of all, as the agent of the community, at the service of the interests of those in good health, to whom the care of the sick would be subordinated.
Now medical morality has always defined itself, since the days of Hippocrates, as respect and protection of the human person. What is involved here is much more than the preservation of a traditional deontology; it is respect for a concept of medicine which is valid for men of all times, which safeguards the man of tomorrow, thanks to the value it attaches to the human person who is a subject of rights and of duties, and never an object to be used for other ends, not even some self-styled social good.
You will allow me to take up a few points that, in my view, are important. The convictions to which I witness before you are those of the Catholic Church of which I have been appointed Universal Shepherd. For us, man is a being created in the image of God, redeemed by Christ and called to an immortal destiny. These convictions then ring true, I hope, in the case of the believers who accept the Bible as the Word of God. But, since they lead us to the greatest respect for the human being, I am sure that they reach all men of good will who reflect on the condition of man and who are eager at any price to save him from whatever threatens his life, his dignity and his liberty.
First of all, the respect for life. There is no one, believer or unbeliever, who can refuse to respect human life, to make it his duty to defend it, to save it, most especially when as yet it has no voice to proclaim its rights. May all doctors be faithful to the saying of Hippocrates which they swear to uphold when they receive their doctorate!
In the same vein, the General Assembly of the World Medical Association had adopted in 1948 at Geneva a form of the saying which spelled out its content as follows: "I shall maintain absolute respect for human life from the time of its conception, even under threat. I shall never allow my medical knowledge to be used against the law of humanity."
I hope that this solemn commitment will continue, at any rate, to be the line of conduct of doctors. What is at stake is the trust they deserve. What is at stake is their own conscience, whatever be the concessions that the civil law allows one to make in the case, for example, of abortion or of euthanasia. What is expected of you is that you oppose the ailment, whatever is contrary to life, but without sacrificing life itself which is the greatest good and over which we have not dominion. God alone is the master of human life and of its integrity.
A second point that I would like to stress is the unity of the human being. It is important that we do not isolate the technical problem posed by the treatment of a specific illness from the attention paid to the person of the patient in all his aspects. It is well to recall this when medical science tends toward specialization in each discipline. The doctor of yesterday was, above all, a general practitioner. His attention embraced, first of all, the totality of bodily organs and functions.
Then, too, on another plane, it was easier for him to be acquainted with the patient's family, his milieu, his whole medical history. Evolution is inevitable; it depends on the specialization of studies, and on the complication of life in society. At least you should unceasingly make the effort to keep in mind the profound unity of the human being, in the evident interaction of all his bodily functions, but also in the unity of his bodily, affective, intellectual and spiritual dimensions.
Last year, on October 30, I urged the Catholic physicians who were meeting in Rome to take their stand perseveringly in the perspective of the human person and of the demands that derive from his dignity.
This perspective of the whole, in which it is important always to situate the particular medical problem, may also be understood, not only of each individual but, in an analogical sense, of society where complementarity allows us to find a certain solution to problems that cannot be solved on the individual plane. Suffice it to recall the handicap of definitive physical sterility which some families manage to compensate for by adoption or by their devotedness to the children of others.
The third point was suggested to me by a very important theme taken up during the course of your General Assembly at Venice: the rights of the human being, when confronted with certain new possibilities in medicine, particularly in the matter of "genetic manipulation" which poses a serious question to every individual's moral conscience. How, in fact, can such manipulation be reconciled with a concept that credits man with an innate dignity and an untouchable autonomy?
A strictly therapeutic intervention whose explicit objective is the healing of various maladies such as those stemming from deficiencies of chromosomes will, in principle, be considered desirable, provided it is directed to the true promotion of the personal well-being of man and does not infringe on his integrity or worsen his conditions of life. Such an intervention, indeed, would fall within the logic of the Christian moral tradition, as I said when speaking to the Pontifical Academy of Sciences Oct. 23, 1982.
But here the question returns. Indeed, it is of great interest to know if an intervention on genetic inheritance that goes beyond the limits of the therapeutic in the strict sense should be regarded likewise as morally acceptable. For this to be verified, several conditions must be respected and certain premises accepted. Allow me to recall some of these.
The biological nature of each person is untouchable in the sense that it is constitutive of the personal identity of the individual throughout the whole course of his history. Each human person, in his absolutely unique singularity, is constituted not only by his spirit, but by his body as well. Thus, in the body and through the body, one touches the person himself in his concrete reality. To respect the dignity of man, consequently, amounts to safeguarding this identity of the man "corpore et anima unus," as Vatican Council II says.
It is on the basis of this anthropological vision that one should find the fundamental criteria for decision-making in the case of not strictly therapeutic interventions, for example, those aimed at the amelioration of the human biological condition.
In particular, this kind of intervention must not infringe on the origin of human life, that is, procreation linked to the union, not only biological but also spiritual, of the parents, united by the bond of marriage. It must, consequently, respect the fundamental dignity of men and the common biological nature which is at the base of liberty, avoiding manipulations that tend to modify genetic inheritance and to create groups of different men at the risk of causing new cases of marginalization in society.
Moreover, the fundamental attitudes that inspire the interventions of which we are speaking should not flow from a racist and materialist mentality aimed at a human well-being that is, in reality, reductionist. The dignity of man transcends his biological condition.
Genetic manipulation becomes arbitrary and unjust when it reduces life to an object, when it forgets that it is dealing with a human subject, capable of intelligence and freedom, worthy of respect whatever may be their limitations; or when it treats this person in terms of criteria not founded on the integral reality of the human person, at the risk of infringing upon his dignity. In this case, it exposes the individual to the caprice of others, thus depriving him of his autonomy.
Scientific and technical progress, whatever it be, must then maintain the greatest respect for the moral values that constitute a safeguard for the dignity of the human person. And because, in the order of medical values, life is the supreme and the most radical good of man, there must be a fundamental principle: first oppose everything harmful, then seek out and pursue the good. To tell the truth, the expression "genetic manipulation" remains ambiguous and should constitute an object of true moral discernment, for it covers, on the one hand, adventuresome endeavors aimed at promoting I know not what kind of superman and, on the other hand, desirable and salutary interventions aimed at the correction of anomalies such as certain hereditary illnesses, not to mention the beneficent applications in the domains of animal and vegetable biology that favor food production. For these last cases, some are beginning to speak, of "genetic surgery," so as to show more clearly that medicine intervenes not in order to modify nature but to favor its development in its own life, that of the creation, as intended by God.
While working in this obviously delicate domain, the researcher adheres to the design of God. God willed that man be the king of creation. To you surgeons, specialists in laboratory work, and to you, general practitioners, belongs the task of cooperating with all the forces of your intelligence in the work of creation begun on the first day of the world. One cannot but render homage to the immense progress achieved in this sense by the medicine of the 19th and 20th centuries.
But, as you are aware, it is more than ever necessary to overcome the separation between science and morality, to rediscover their profound unity. It is man whom you are dealing with, man whose dignity precisely it is the province of morality to safeguard.
Thanking you for your visit and for your trust, and aware of the grave responsibilities that weigh upon you, I express my best wishes for your activity and your witness within the World Medical Association and among all your medical confreres, and I invoke the blessing of God, the author of life, upon each one of you, upon your labor, upon your families and friends.
1. Oct. 2, 1979, n. 13.
2. See AAS 75 , Part I, pp. 37-38.
3. Constitution "Gaudium et Spes", n. 14, par. 1.
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