It is precisely because “brain death” is not a universal criterion that “pulling the plug” is considered a form of euthanasia. It is probable that future legal decisions, increased medical sophistication on the part of the lay community, and the simple passage of time will serve to ease the transition to a new criterion of death. However, the new medical technologies can also extend an individual’s life long past the point that he or she might wish to live. At this point in time, the old question of euthanasia is increasingly coupled with the rather fuzzy concept of “quality of life;” one can request that no heroic measures be taken to preserve life under certain conditions, but the person most concerned with whether or not such measures are taken is often the one least in control of events. Such “passive” euthanasia often leaves medical personnel open to malpractice suits by relatives unless the relatives also agree to this course of treatment (or non-treatment) and, in the case of Baby Doe, even this may not be sufficient. And “active” euthanasia – helping a person to terminate his or her life -is still legally considered murder in many parts of the United States and the world.
There is yet another issue to be kept in mind for the future, the possibility that medical technology will advance to the point where even the brain can be “restarted”. At this point in time, degeneration of the nerve tissues of the brain or severe damage to critical portions of it cannot be reversed and, in fact, part of the aging process is due to natural degeneration. But intensive research in this area is in progress, and it is probable that methods of neural tissue regeneration will soon be developed. What, then, will be the definition of death? And, perhaps even more important, will the person with the new neurological tissue be the same individual as the one before brain damage? If (e.g.) motor function has been impaired by a stroke, then repair of this portion of the brain would not affect personality. But there are other portions of the brain which appear to be associated with memory, emotions, and different kinds of thought. If THESE regions are damaged and then repaired, who is the person that will emerge after these procedures? What is their legal (and philosophical) relationship with their own pre-damage selves? With their spouses and relatives? In essence, then, such a technology could raise new questions about the old mind body/problem, as well as necessitating a new definition of the personality and of death.
Recombinant DNA Technology: Promises, promises … (and threats)
The questions raised by current medical technologies are thorny and complex, but most are essentially new versions of much older questions. The same can be said for the animal rights movement, an outgrowth of anti-vivisection groups, and for other special interest groups who take a moral stance on biological or medical issues. However, in addition to what could be termed “classical” ethical and moral questions concerned with aspects of the biological world, there will soon be a whole new class of ethical problems with which we will have to deal, outgrowths of the new subdiscipline of recombinant DNA research (also called molecular biology, molecular genetics, or simply gene splicing). In effect, the logical applications of this young field are the repair and/ or modification of genes of all species including human beings, the addition of genes from one species to the gene set of another, and the creation of entirely new genes. It will be both a philosophical and a biological problem to determine how much and what types of genetic change can be made without altering the fundamental nature of a given species.
Recombinant DNA techniques have emerged from intensive studies of the genetic and biochemical mechanisms by which genes and their products are expressed (made) and regulated. After the determination of the structure of DNA in 1953 and the subsequent decryption of the genetic code, progress in this area was extremely rapid. At this point in time, most biologists have a clear idea of the general mechanisms governing the relationship between the genome (the set of all genetic information) and the expression of the genome in the form of gene products (proteins of various sorts), although the particular aspects of a given part of the total picture are still unknown.
At the same time that these mechanisms were being elucidated, a number of new enzymes involved in the processes were found and characterized. One type of enzyme, called a gyrase, is concerned solely with unwinding the double helix of DNA so that copies of the code (messenger RNA) can be made. There are repair enzymes of various sorts, which mend breaks in the DNA and, where necessary, fill in missing bits of the helix. And there is a third class of enzymes, called the restriction enzymes, which recognizes certain base sequences on the DNA and cuts the helix at those points. Finally, there are reverse transcriptases, enzymes which read RNA messages and synthesize the DNA code from them. In essence, then, the tools necessary to make a copy of a particular DNA or RNA sequence and insert that sequence into an already existing genome can be found naturally. Combined with advances in understanding how viruses work, it is theoretically (and practically) possible to transport a gene into a given set of target cells using a virus packaging mechanism, and insert it into the cell’s genome.
Thus, copies of genes can be switched around from one organism of a given species to another, or between species, or even between phyla. This is the kind of work being done in the new genetic engineering companies, where the human genetic sequence for (e.g.) insulin is inserted in multiple copies into the genome of a microorganism such as E. coli, turning the microorganism into an insulin-producing factory. It is also possible to “design” new genes or modify already existing genetic sequences (i.e., write one’s own code) and get them inserted into an already existing genome. Many protein scientists are using this technique to study the process by which proteins fold up into their active structure, to test which amino acids in a given sequence are “essential” for activity or folding, and even to test predictions of which types of amino acids are involved in different types of internal protein substructure (e.g., alpha helices vs. beta-sheets). Finally, there are continuing attempts to “tailor” new organisms with unique metabolic activities. One example of this is the work on microorganisms that might use toxic waste or spilled oil as “food,” breaking these materials down into forms that can be incorporated into the natural food chain.