Wrestling with controversial life-and-death issues - C&EN Global

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Wrestling with controversial life-and-death issues Technological achievements that were in the realm of science fiction just a few decades ago are now reality. Science continues to evolve at an unprecedented rate. This should be a time of excitement, optimism, and confidence in our ability to improve our world through application of our discoveries. But it is not. There is a pervading sense of malaise and apprehension, shared by scientists and nonscientists alike. Our feelings of foreboding are based largely on the negative responses to our achievements coming from various groups that see evil or potential evil resulting from the application of scientific advances. Thomas P. Carney's book "Instant Evolution: We'd Better Get Good at It" confronts such problems of today in all of their complexity. He reviews them scientifically, morally, legally, financially, and politically. And he does so with great skill. We have heard it said many times that we scientists cannot afford the luxury of limiting our efforts solely to research but must become skilled interpreters of science to the lay public. We must educate the public to the consequences of technology—to the risks and to the benefits. We are not all able to serve in such roles, as Carney has done, but at the very least we owe it to ourselves to understand, at least for ourselves, the intricacies of the problems. Carney helps us along many lines. In very up-to-date fashion, he discusses, from both technological and ethical viewpoints, such subjects as when life begins and ends, with specific reference to abortion and euthanasia; genetic engineering, with emphasis on genetic screening, amniocentesis, and DNA modification of genetic abnormalities; reproduction developments, including contraception, in-vitro fertilization, embryo transplants, and cloning; human experimentation in new drug development; the control of human behavior; and eugenics and euthenics. Carney's style of presentation is particularly good. He has sifted through large quantities of information in many fields and examines each subject objectively, describing the ethical dilemmas, asking questions, citing historical fact or precedent, and

production. One that he cites is that procreation is a more complete Author explores such human activity than laboratory reproduction precisely because it areas as euthanasia, engages us bodily and spiritually, as well as rationally. Another opinion he DNA modification, cites is that laboratory reproduction is even more "human" compared to cloning, and the conception by sexual intercourse because it is willed, controlled, and done control of human mating for a specific purpose. Surely these characteristics, he says, are among those that distinguish Homo sapiens "Instant Evolution: We'd Better Get from others in the animal world. Of Good at It" by Thomas P. Carney, Uni- course, value judgments on such versity of Notre Dame Press, Notre Dame, matters can lead to very different ethical conclusions. Ind., 1980,180 pages, $13.95 Carney was trained as an organic Reviewed by Irwin J. Pachter, who was chemist and a chemical engineer, trained as an organic chemist, spent performed research as a medicinal many years inventing new drugs (several chemist, and later served as vice of which are now on the market), and for president of research, development, the past 11 years has been vice president and control at Eli Lilly and as execufor R&D at Bristol Laboratories, a divi- tive vice president of G. D. Searle. Currently, he is president of his own sion of Bristol-Myers company, Metatech Corp., which develops and manufactures instruments and devices mainly for the medical field. It is to his credit in writing this ultimately summing up each chapter with a conclusion of his own. The book that he took such pains to give reader does not have a sense of being fair treatment to the subjects disguided to a predetermined polemical cussed. Our society, through the end. Moreover, the book is so packed communications media, through with information that it can be of use government agencies, and through as a reference work long after it is so-called consumer-interest groups, read and will serve as a factual foun- has been taught to distrust people dation for the reformulation of view- who have worked in private industry points when further information is as being hopelessly biased after years accumulated in the fields discussed. of immersion in profit-oriented enRecently, President Reagan was vironments. The balance achieved in asked for his view on when life begins. this book is ample demonstration that He was unable to answer the question such bias is not inevitable. and said that more scientific research The book makes it clear that there on the subject is needed. Carney, are no easy answers to the problems however, is not so reticent. He states we face. In a world of finite resources, his belief that "this occurs at the time we must make difficult decisions. of implantation of the egg in the This was never more apparent than it uterus, from one to two weeks after is today, as we see our government fertilization." His evidence is sub- struggling to perform its functions stantial, but some will find his con- without bankrupting the nation. clusion less than compelling. Technology has made many things Carney notes that it should not be possible that are not economically surprising that scientists disagree on feasible. matters relating to ethics or the benThe subtitle of the book was inefits of an experiment. He further spired by a passage from "The Whole notes, however, that disagreement on Earth Catalog," which states, "We are such issues causes general public un- as gods and might as well get good at easiness. If scientists can't agree on it." Carney observes that gods decide technical matters, who can? who will work and who will be idle, Consider two points of view on re- who will be fed and who will go hunApril 20, 1981 C&EN

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Books gry. They decide who will stay sick and who will be cured, who will live and who will die. They even decide who will be born and who will not be born. Recently, the first diabetic person was treated with "human insulin" made by a bacterium genetically en­ gineered to produce the hormone. Evolution is a matter of changing ge­ netic makeup. "Instant evolution" is, therefore, a thing of the present. We are, indeed, becoming as gods. But as gods, we have the possibility of creating calamities. And that brings us to the question of the con­ trol of science. Are there areas of re­ search that should be abandoned al­ together? Carney discusses the recent re­ combinant DNA controversy and concludes that there is practically no chance of a calamity befalling the human race as a result of any research that has been proposed to date. Along the way, he cites the observation of Nobel Laureate René J. Dubos: "A society that does not continue to grow through adventure and willingness to take chances is not likely to survive long in the modern world. With regard to health, as with all other fields, society must be willing to take educated and calculated risks because they are inherent in technological civilization." Carney notes that the great speed with which these changes can occur causes doubts and fears. There is no time to test the consequences or, in some cases, even to know what the consequences will be. With regard to genetic changes, the factor that arouses apprehension is that whatever effect is caused will be irreversible. If an undesirable organism is created, it could reproduce forever. If an unwanted human gene trait is produced, it could be passed from parents to children and to the children's children. An alternative to genetic transformation sometimes is corrective surgery. Congenital heart defects in children now are routinely corrected surgically. We have the knowledge and skills to perform many other corrective procedures. In recent years, 30,000 kidney transplants have been performed. Large numbers of people undergo routine kidney dialysis. In 1979, about $1 billion was spent on such dialysis in the U.S., with the cost per patient per year in hospitals being more than $30,000. Heart transplants can be performed for between $20,000 and $50,000. Carney asks whether there are other ways the money might be spent

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C&EN April 20, 1981

Books with greater justice. He even asks, " Should we try to prevent death by curing cancer, by eliminating heart disease, and other major killers?" What purpose does it serve? It would not eliminate death. The average human life span would be extended no more than a couple of years if cancer and heart disease were both eliminated as causes of death. What are the appropriate uses of the world's all-too-finite resources? In his final chapter, after he dem­ onstrates that we are as gods, Carney stresses our need to act as gods in a sensible way. He concludes that what the world will be like in the future will not be determined mainly by sensa­ tional new scientific advances. Rather, it will depend on how well all of us can organize our efforts and agree on common objectives. More important, it will depend on how much we are willing to pay to reach these objectives. Π

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Manual of Economic Analysis of Chemical Processes. Institut Français du Pétrole, xiv + 462 pages. McGraw-Hill Book Co., 1221 Ave. of the Americas, New York, N.Y. 10020.1980. $37.95. Masters Theses in the Pure and Applied Sciences. Vol. 24. Wade H. Shafer, editor, xv + 293 pages. Plenum Press, 227 West 17th St., New York, N.Y. 10011. 1980. $75. Metal and Inorganic Waste Reclaiming Encyclopedia. Marshall Sittig. xii + 591 pages. Noyes Data Corp., Mill Rd. at Grand Ave., Park Ridge, N.J. 07656. 1980. $54. Metal Carcinogenesis Testing: Principles and In Vitro Methods. Max Costa, xiii + 164 pages. Humana Press, P.O. Box 2148, Clifton, N.J. 07015. 1980. $29.50. Molecular Electronic Structures: An Introduction. Carol J. Ballhausen, Harry B. Gray, viii + 133 pages. Benjamin/Cummings Publishing Co., Reading, Mass. 01867. 1980. $14.50. Molecular Shapes: Theoretical Models of Inorganic Stereochemistry. Jeremy K. Burdett. xi + 287 pages. John Wiley & Sons Inc., 605 Third Ave., New York, N.Y. 10158. 1980. $29.50. Natural Resources and Energy: Theory and Policy. Chennat Gopalakrishnan. xiii + 138 pages. Ann Arbor Science Publishers, P.O. Box 1425, Ann Arbor, Mich. 48106. 1980. $12.50. Nucleic Acids Synthesis: Applications to Molecular Biology and Genetic Engineering. Nucleic Acids Symposium Series No. 7. H. Kôster, editor. 396 pages. Information Retrieval Ltd., Marketing D e p t , Abbey St., Eynsham, Oxford OX8 1JJ, England. 1980. $40. The Oxidation of Organic Compounds by Permanganate Ion and Hexavalent Chromium. Donald G. Lee. 174 pages. Open Court Publishing Co., Box 599, La Salle, 111. 61301. 1980. $25.

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