اصلاح ژنتیک انسان از منظر عقل‌گرایی کانت

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری حقوق خصوصی، گروه حقوق، دانشکدة علوم اداری و اقتصاد دانشگاه اصفهان، اصفهان، ایران.

2 دانشیار، گروه حقوق، دانشکدۀ علوم اداری و اقتصاد دانشگاه اصفهان، اصفهان، ایران.

3 دانشیار، گروه حقوق، دانشکدة علوم اداری و اقتصاد دانشگاه اصفهان، اصفهان، ایران.

چکیده

حقوق طبیعی مدرن با تکیه بر جایگاه عقل به‌عنوان منبع قواعد حقوقی و اخلاقی، بر انجام تکالیف عقلانی بر اساس ارادة خیر تأکید می‌ورزد و نیل به کمال را در گرو آن می‌داند. قوای جسمانی و روحی ابزار و مقدمۀ عمل به این تکالیف هستند. انجام اصلاحات بر ساختار ژنتیک، یکی از طرق مطرح برای رفع موانع عمل به تکلیف، یا تسهیل‌کنندۀ آن است؛ اما، چالش حقوقی و اخلاقی رضایت آگاهانه، که ناشی از تکلیف لزوم احترام به استقلال فردی دیگران است، مانعی جدی در این مسیر به‌نظر می‌رسد. با این‌ حال، تکالیف دیگری از جمله تکلیف فرد نسبت به دیگران، می‌تواند موافق با اصلاح ژنتیک انسان باشد. در این پژوهش، با روش تحلیلی-توصیفی، این مانع و نظرهای طرح‌شده در این خصوص بررسی شده است. به‌نظر می‌رسد در نهایت، می‌توان با توجه به دیدگاه کانت در خصوص وظیفه، اصلاحات ژنتیکی بر روی جنین انسان را پذیرفت.

کلیدواژه‌ها


عنوان مقاله [English]

Human Genetics Modification from the Perspective of Kant's Rationalism

نویسندگان [English]

  • Mojtaba Shafizadeh Khoulenjani 1
  • Mahdi Shahabi 2
  • Seyyed Mohammad Sadegh Tabatabaei 3
1 phD student of private law, Department of Law, Faculty of Administrative Sciences and Economics, Isfahan University, Isfahan, Iran.
2 Associate Professor, Department of Law, Faculty of Administrative Sciences and Economics, University of Isfahan, Isfahan, Iran.
3 Associate Professor, Department of Law, Faculty of Administrative Sciences and Economics, University of Isfahan, Isfahan, Iran.
چکیده [English]

 
Genes are implicated in the manifestation of not only physical traits but also behaviours, moods and mental illnesses. Genetic modification enables the alteration of an individual's characteristics. In addition, some diseases have a genetic origin that can be treated using this method.
Genetic engineering is classified into four principal categories: somatic gene therapy, somatic genetic enhancement, germline gene therapy, and germline genetic enhancement. The genetic alterations achieved through somatic gene therapy are confined to the individual undergoing the procedure and are not inherited by subsequent generations. In contrast, the consequences of germline gene therapy persist across multiple generations.
The ethical and legal challenges associated with human genetic modification are manifold, with informed consent being a particularly salient issue, particularly in the context of genetic modification of germ cells.
Genes are implicated in the manifestation of not only physical traits but also behaviours, moods and mental illnesses. Genetic modification enables the alteration of an individual's characteristics. In addition, some diseases have a genetic origin that can be treated using this method.
In this study, we employed an analytical-descriptive methodology to examine this challenge and the perspectives that have been put forth in relation to it.
Modern natural law posits reason as the foundation for legal and moral norms, leading to the term "rationalism." The objective of modern natural law or rationalism is to safeguard individual rights. The individual is regarded as the ultimate end, and the principles of individual freedom and the sovereignty of the will are considered to be of paramount importance. This perspective emphasises the importance of undertaking rational tasks in a manner that is guided by benevolent intentions, and posits that the realisation of perfection is contingent upon this approach. The physical and mental faculties serve as the instruments and preliminary steps in the accomplishment of these tasks. From the perspective of rationalism and Kant's thought, people have a moral obligation to pursue their own perfection and that of others. One proposed method for fulfilling this obligation is through genetic modification. However, several principles have been proposed in this thought which are considered to be the most important rational reasons for opposing human genetic modification. Genes are implicated in the manifestation of not only physical traits but also behaviours, moods and mental illnesses. Genetic modification enables the alteration of an individual's characteristics. In addition, some diseases have a genetic origin that can be treated using this method.
In this study, we employed an analytical-descriptive methodology to examine this challenge and the perspectives that have been put forth in relation to it.
The ethical and legal challenges associated with human genetic modification are particularly pertinent in the context of informed consent, particularly in relation to genetic modifications on germ cells.
The question thus arises as to whether an individual is entitled to make a decision to undergo genetic modification with a view to influencing the traits and characteristics of subsequent generations and thereby determining their future and life prospects in a positive or negative manner. This raises the question of whether the principle of informed consent presents an obstacle to human genetic modification. Alternatively, can it be accepted by reference to other rational principles of Kant's moral philosophy, including deontology and the concept of the human being as an end in themselves? What are the human duty and role in perfecting themselves and others on this basis? Is proxy consent accepted by Kant's rational view and can it replace the consent of the patient or a person who is created in the future or not? Given that the majority of objections to human genetic modification have a Kantian basis, is such an approach correct and complete? If this view is not correct, can a view in favour of genetic modification be inferred from Kant's thought?
The initial stage of the discussion centred on an examination of the fundamental principles, concepts and categories of informed consent. This was followed by an investigation into the constituent elements of the process of informed consent and the circumstances under which the principle of informed consent can be applied. In addition, the potential implications of this principle for the field of genetic modification were considered. Finally, this study analyses the effect of Kantian dutyism and the concept of the human being as an end in itself on genetic modification.
It seems that genetic modification does not necessarily mean violating the rights of individuals, and on the other hand, embryos or even germ cells do not have free will, which can be seen as an obstacle to genetic modification. Moreover, human beings have a duty to the happiness of others, and parents have a duty to their children. Although this duty is in conflict with the duty to respect individual autonomy and informed consent, the way out of the conflict is to emphasise the results orientation and to pay attention to the end of the human being, because there is no basis for preferring one of these two tasks over the other, and therefore Kant's thought is blocked in this respect. In this way, the treatment of diseases of genetic origin and the provision of a better life through the development of the individual's traits is the cause and introduction to other rational tasks, in other words, the positive results of genetic modification are preferable to the obstacle of lack of conscious consent. Acceptance of genetic modification and exit will result from this blockage and conflict, and therefore the duty to fulfil the duties of the parents is superior to the duty to respect the individual autonomy of the foetus, and in the meantime there is a difference in the therapeutic goal or the strengthening goal in germline methods or somatic in children will not be incompetent. Finally, according to Kant's view of duty, genetic modification of human embryos can be accepted.

کلیدواژه‌ها [English]

  • Genetics
  • Duty
  • Informed consent
  • Child
  • Fetus
  1. منابع

    الف) فارسی

    1. کین، برایان (1385). جنبه‌های حقوقی فناوری ژن. ترجمۀ رضا نخجوانی، محمدعلی نوری، تهران: گنج دانش.
    2. بزمی، شبنم و علی متولی‌زاده اردکانی (1387). «ژن‌درمانی و اخلاق پزشکی». اخلاق پزشکی، ش 4، ص 189-199.

            https://doi.org/10.22037/mej.v2i4.12167

    1. دین، هامر و پیتر کوپلند (1382). نقش ژن‌ها در شکل‌گیری شخصیت. ترجمۀ علی متولی‌زاده اردکانی، چ اول، تهران: انتشارات چهر.
    2. کاتوزیان، ناصر (1352). فلسفۀ حقوق. تهران: انتشارات دانشگاه تهران.

     

    ب) خارجی

    5. ACOG Committee opinion (2021). Informed consent and shared decision making in Obstetrics and Gynecology, Vol. 137, pp. 34-41.

    6. Berg, Jessica W., & Appelbaum, P. S. (2001). Informed consent: legal theory and clinical practice. Oxford, Oxford University Press.

    7. Bonnicksen, A.L. (1998). “Transplanting nuclei between human eggs: implications for germ-line genetics”. Politics and the Life Sciences 17, pp. 3-10. DOI: 10.1017/S073093840002520X

    8. Booth, S. (2002). “A philosophical analysis of informed consent, nursing standard”. Nursing Standard, Vol.16, Issue 39, pp. 43-46. DOI: 10.7748/ns2002.06.16.39.43.c3211  

    9. Carmen, M. G del, Steven J.. (2005). “Informed Consent for Medical Treatment and Research: A Review”. The Oncologist, pp. 636-641. DOI: 10.1634/theoncologist.10-8-636

    10. Committee on Human Gene Editing: Scientific, Medical, and Ethical Considerations; National Academy of Sciences; National Academy of Medicine; National Academies of Sciences, Engineering, and Medicine, Human Genome Editing: Science, Ethics, and Governance, The National.

    11.Cummiskey, D. ( 2000). “Kantian Consequentialism”. Canadian Journal of Philosophy, Vol. 30, No. 2, pp. 315-339.DOI:10.1080/00455091.2000.10717535

    12. Cureton, A., Hill, Jr., & Thomas E. (2017). “Kant on Virtue: Seeking the Ideal in Human Conditions”. The Oxford Handbook of Virtue, pp. 1-23. DOI:10.1093/oxfordhb/9780199385195.013.13

    13. Delk, E. (2013). “A Kantian Ethical Analysis of Preimplantation Genetic Diagnosis”. CedarEthic, pp 1-10. DOI: 10.15385/jce.2013.12.2.1

    14. Dumisic, S. (2016). “The Choice of Pre-Birth Genetic Modification Through Kant’s Ethics in the 21st Century”. University of Umeå, pp. 1-22. https://www.diva-portal.org/smash/get/diva2:943528/FULLTEXT01.pdf (Accessed 4 janury 2023)

    15. Ebbesen, M., Sundby, A., Pedersen FS Andersen S. (2015). “A Philosophical Analysis of Informed Consent for Whole Genome Sequencing in Biobank Research by use of Beauchamp and Childress’ Four Principles of Biomedical Ethics”. Journal of Clinical Research & Bioethics. DOI: 10.4172/2155-9627.1000244

    16. Evitt, N., Shamik, M., & Russ B A. (2015). Human Germline CRISPR-Cas Modification: Toward a Regulatory Framework, 15 AM. J. BIOETHICS 25, pp.25-29. DOI: 10.1080/15265161.2016.1214308.

    17. Fletcher, G. P. (1987). “Law and Morality: A Kantian Perspective”. Columbia Law School. https://scholarship.law.columbia.edu/faculty_scholarship/1071 (Accessed 4 janury 2023)

    18. Mazur, Grzegorz, O.P., (2012). Informed Consent, Proxy Consent, and Catholic Bioethics. Springer.

    19. Gunderson, M. (2007). “Seeking Perfection: A Kantian Look at Human Genetic Engineering”. Theoretical Medicine and Bioethics, pp. 87-102. DOI: 10.1007/s11017-007-9030-4

    20. Gunderson, M. (2008). “Genetic Engineering and the Consent of Future Persons”. 18 J. EVOLUTION & TECH, pp. 86-93. https://jetpress.org/v18/gunderson2.htm (Accessed 4 janury 2023)

    21. Habermas, J. (2003). The Future of Human Nature. trans., Cambridge: Polity Press.

    22. Hill, Gerald N. and Hill Kathleen Thompson, (2009). Nolo’s Plain-English Law Dictionary, 1st edition.

    23. Hoehner, Paul J., MD; FAHA MA, (2003). “Ethical Aspects of Informed Consent in Obstetric Anesthesia—New Challenges and Solutions”. Journal of Clinical Anesthesia, pp. 587-600. 6. DOI: 10.1016/s0952-8180(02)00505-6

    24. Hopton, terry, (1982). “Kant's two theories of law” History of Political Thought”. Imprint Academic Ltd, pp. 51-76. https://www.jstor.org/stable/26212252 (Accessed 4 janury 2023)

    25. Ishii, T, (2014). “Potential impact of human mitochondrial replacement on global policy regarding germline gene modification”. Reprod Biomed Online, pp. 150-155.

    DOI: 10.1016/j.rbmo.2014.04.001

    26. Kant, Immanuel, (1887). The Philosophy of Law: An Exposition of the Fundamental Principles of Jurisprudence As the Science of Right.

    27. Kant, I. (1991). the Metaphysics of Morals.cambrige university press.

    28. Kant, I. (2002). Groundwork for the Metaphysic of Morals. Yale University Press.

    29. Kant, I. (2006). Anthropology from a Pragmatic Point of View. trans. and ed. Robert B. Louden, Cambridge: Cambridge University Press.

    30. Kant, I. (1965). Metaphysical elements of justice: part I of The metaphysics of morals. Indianapolis: Bobbs-Merrill.

    31. Koller, P. (2020). On the Connection between Law and Morality: “Some Doubts about Robert Alexy’s View”, Ratio juris, Vol. 33, pp.24-34. DOI:10.1111/raju.12272

    32. Leo, R. J. (1999). “Competency and the Capacity to Make Treatment Decisions: A Primer for Primary Care Physicians”. Primary care companion to the Journal of clinical psychiatry, pp 131–141. DOI:10.4088/PCC.V01N0501

    33. Manninen, B. A., (2008). “Are human embryos Kantian persons?: Kantian considerations in favor of embryonic stem cell research”. Philosophy, Ethics, and Humanities in Medicine. DOI: 10.1186/1747-5341-3-4

    34. Marshall, T., & Neumann, C. (2000). “The Ambiguity of Kant’s Concept of Happiness”. Reason Papers, Vol. 26, pp. 21-28. https://reasonpapers.com/pdf/26/rp_26_2.pdf (Accessed 4 janury 2023)

    35. Mc Cormick S.J & Richard, A. (1974). “Proxy Consent in the Experimentation Situation”.Perspectives in Biology and Medicine, Vol. 18, No. 1, pp. 2-20. DOI: 10.1353/pbm.1974.0001

    36. McCarty, R. (1991). “Moral Conflicts in Kantian Ethics”. History of Philosophy Quarterly, Vol. 8, No. 1, pp. 65-79. https://www.jstor.org/stable/27743963 (Accessed 4 janury 2023)

    37. Mintz, Rachel L., John D Loike., & Fischbach Ruth L., (2018). “Will CRISPR Close the Door to an Open Future?”. Science and Engineering Ethics, pp. 1409-1423. DOI: 10.1007/s11948-018-0069-6.

    38. National Bioethics Advisory Committee (1998). “National Bioethics Advisory Commission: Guidelines for Research Involving Cognitively Impaired Subjects” Washington.

    39. Norman, G. V. (2012). “Informed Consent: Respecting Patient Autonomy”. CSA Bulletin, pp.213-221. DOI: 10.1017/CBO9780511841361.003

    40. Pavlova, T., Zarutska, E.; Roman, P.; Kolomoichenko, O (2019). “Ethics and law in Kant’s views: the principle of complementarity”. International Journal of Ethics and Systems, Vol. 35 No. 4, pp. 651-664. DOI: 10.1108/IJOES-04-2019-0080

    41. Prainsack, B. (2017). Personalized Medicine Empowered Patients in the 21st Century?. New York University.

    42. Prainsack, B. (2019). “The “We” in the “Me”: Solidarity and health care in the era of personalized medicine”. Science, Technology, & Human Values, Vol. 43, pp. 21–44. DOI:10.1177/0162243917736139

    43. Ramsey, P. (2002). The Patient as Person: Explorations in Medical Ethics (2nd ed.). New Haven, CT: Yale University Press.

    44. Research, T. (2010). “Understanding Consent in Research Involving Children: The ethical Issues”. A Handbook for Human Research Ethics Committees and Researchers.

    45. Ross, D. W. (2007). The Right and the Good, Clarendon press, OXFORD.

    46. Savulescu, J. (2001). “Procreative Beneficence: Why We Should Select the Best Children”, Bioethics, Volume 15.

    47. Schmidt, Elke Elisabeth,(2022). “Kant on Trolleys and Autonomous Driving”, Kant and Artificial Intelligence, Walter de Gruyter GmbH, Berlin/Boston.

    48. Shah, P., Imani Thornton, I.;Turrin, D.;Hipskind, J. E.(2021). Informed Consent, Treasure IslandStatPearls.

    49. Sotrup, M. (2011). “Viewpoint, how to avoid a dichotomy between autonomy and beneficence: from liberalism to communitarianism and beyond”. Journal of Internal Medicine, Vol. 269, pp. 375-379. DOI: 10.1111/j.1365-2796.2011.02349_2.x

    50. Stoljar, Mackenzie, C, N., (2000). Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. Oxford: Oxford University Press.

    51. Turner, R. C. (2008). Design and Destiny. Massachusetts Institute of Technology.

    52. U.S. Department of Health and Human Services Food and Drug Administration, (2014). Informed Consent Information Sheet Guidance for IRBs, Clinical Investigators, and Sponsors, DRAFT GUIDANCE.

    53. Waldron, J. (1996). “Kant's Legal Positivism”. Harvard Law Review, Vol. 109, No. 7 pp. 1535-1566. http://www.jstor.org/stable/1342024 .

    54. Wert, Guido De, (2018). “Responsible innovation in human germline gene editing: Background document to the recommendations of ESHG and ESHRE”. European Journal of Human Genetics, pp. 450-470. DOI: 10.1038/s41431-017-0077-z

    55. WOOD, ALLEN W., (2008). Kantian Ethics. Stanford University.