Ethics through time
To understand the fundamentals of ethics and the evolution of law over time, it is important to discuss prior civilisations where legal systems and moral codes naturally differed.
Early descriptors of ethics
The birth of ethics comes from an era where humans began to reflect on what behaviours were in the best interest of life. According to the World History Encyclopaedia, the oldest known code of law was written by King Ur-Nammu in 2100- 2050 BCE a Sumerian king who presented 57 laws to his people 5 . King Ur-Nammu presented the idea that this code was written by the gods sharing ideas that all subjects are equal disregarding social status. Another early surviving document from the Egyptians supported ideas of ideal conduct and societal behaviour for boys 9 . Arguably, this document only focused on how to achieve social favour and did not delve into ethics but conveyed ideas about not passing judgement and how others should be treated.
Later on, around 350 BCE, Aristotle wrote describing the theory of Nicomachean Ethics as the nature of human actions derived from the concept of happiness 3 . The preface of the discussion highlights the difference in opinion surrounding the best interest for mankind and how disagreement may be resolved. Ideally all of humankind would have the same ideals whereby the same morals and values are shared, in this way there would never be a difference in opinions and conflict would consistently be avoided. This however, is impossible, the difference in culture, religious belief and social etiquette paired with the ability of man to have free will ensures there will always be differences in values. For instance, female genital mutilation (FGM) is considered the social norm in some regions of Africa, the Middle east and Asia 11 . Most contemporary Western societies consider this practice highly unethical practice, as this is a clear violation of human rights for girls and women. It goes without saying that societies have their reasons for such practices, traditional patriarchal societies have associated the practice with coming of age in preparation for marriage to prevent fornication and foster fidelity 11 . There are no religious scripts that advocate for the practice, but it is believed that there is religious support.
The 13 th century philosopher, Thomas Aquinas discussed that there exists two forms of law: an eternal law, which is an omnipotent God's law governing the universe and a natural law which humans acknowledge through reason 6 . The idea that God ordains humans to ultimate happiness may, for certain groups of people, result in the addition of practices that are thought to please the God in which they follow 1 . One can argue, FGM is an example of this.
Many other ethically questionable practices learnt about in history result in the addition of new laws to prevent such disasters from recurring.
Past unethical disasters and their implications
It is apparent that rules are added to prevent the recurrence of historical mishaps and ethical disasters, mishaps that question the idea that decisions are made in the best interest of humankind- eugenics was the prime example. In the year 1883 Sir Francis Galton invented the term "eugenics", which was defined as the selection of desirable characteristics to better equip latter generations 10 . This term, which was initially accepted by scientists and political leaders, rapidly degenerated as a fundamental science after the Nazis used eugenics in an attempt to eradicate many groups of people (Jews, Roma, the disabled, homosexuals) who they viewed as undesirable for the human gene-pool 2 . The publication by Kevles highlights the practice of eugenics from the 1930s - 1970s in Sweden, where 60,000 people were sterilised in an attempt to prevent the number of infants born with genetic disorders. In many societies these practices were driven by a superiority complex of particular races over others. This gave life to negative eugenics, the belief that the quality of the human-race may be improved by eliminating ‘inferior’ people. That poses the question, who is allowed to decide which group of people are inferior?
In recent times there has been the abolishment of deep-rooted societal ideas, this is all to say that we as humans acknowledge our belief is altered by the development and discoveries of new theories and ideas.
The Impact of ethical theories on novel science
Variations of regulations and laws exist to protect patients in multiple ways with new regulations being implemented the moment a practice goes wrong – to prevent recurrence. The Centres for Disease Control and Prevention (CDC) alongside the Federation of State medical boards (US), The Health and Care Professions council (UK) and even the United Nations are examples of organisations that work in the best interest to protect human rights and regulate the use of certain technology in scientific practice. Even with these heavy regulations what is currently deemed as unethical practices still occur unnoticed until it is uncovered. A 2018 report of the first gene-edited infants shocked the world of science and bioethics as we know it. Scientist He Jiankui was responsible for using clustered regularly interspaced short palindromic repeats (CRISPR) to alter the lives of twin girls. By disabling the C-C Motif Chemokine Receptor 5 (CCR5) which is a HIV co-receptor enabling the entry of HIV into host cells, Jiankui was able to make these children immune to HIV 4 . In the UK, The Human Fertilisation and Embryology (HFE) Act prohibits the insertion of an embryonic cell with an altered germline DNA into a woman. Similarly, the Chinese Ethics Guiding Principles for Research on Embryonic Stem Cells banned research of embryos in vitro 14 days after conception, and its implantation into a uterus 8 . This research faced much global backlash with many scientists in agreement that this action was not morally or ethically sound; from birth, the lives of these children are the result of a science experiment; however, their lives are a testament to the functional ability of scientific technology. Finally, one could argue that not intervening when it is known that quality of life could be greatly improved is not ethically correct.
The new generation of scientists alongside established governing bodies are now responsible for deciding how novel technologies should be implemented in modern medical treatments. As a scientist or someone who can understand the gravity of some of these new advancements there are a few things to consider: Is it ethical to prevent the use of new technologies when it is certain they could considerably alter patient diagnosis and treatment for the better? Is it ethical to prevent the use of gene editing in cases like the one above, removing the need for treatment by preventing the disease? Or has science gone too far, and should this practice be prevented?
A quote from Edward Osborne Wilson, American sociobiologist, stated “We have palaeolithic emotions, medieval institutions and godlike technology. It is terrifically dangerous and now it is approaching a point of crisis overall” 7 . How can we utilise new technology in a way that is not harmful to prevent unethical mishaps?
References
1. Floyd, S. (n.d.). Thomas Aquinas: Moral Philosophy. Retrieved 30/10/2024, from https://iep.utm.edu/thomasaquinas-moral-philosophy/#H4
2. Kevles, D. J. (1999). Eugenics and human rights. BMJ , 319 (7207), 435. https://doi.org/10.1136/bmj.319.7207.435
3. Kraut, R. (2022). Aristotle's Ethics. https://plato.stanford.edu/archives/fall2022/entries/aristotle-ethics
4. Lopalco, L. (2010). CCR5: From Natural Resistance to a New Anti-HIV Strategy. Viruses , 2 (2), 574-600.
5. Mark, J. J. (2021). Code of Ur-Nammu . Retrieved 30/10/2024 from https://www.worldhistory.org/Code_of_Ur-Nammu/
6. New Advent. (1920, 2017). Question 94. The natural law . New Advent LLC. https://www.newadvent.org/summa/2094.htm
7. Oxford Reference. (2016). Edward O. Wilson 1929 - American sociobiologist. In S. Ratcliffe (Ed.), Oxford Essential Quotations (Vol. 4). Oxford University Press. https://www.oxfordreference.com/display/10.1093/acref/9780191826719.001.0001/q-oro-ed4-00016553
8. Raposo, V. L. (2019). The First Chinese Edited Babies: A Leap of Faith in Science. JBRA Assist Reprod , 23 (3), 197-199. https://doi.org/10.5935/1518-0557.20190042
9. Singer, P. (2024). The history of Western ethics . Britannica. Retrieved 30/10/2024 from https://www.britannica.com/topic/ethics-philosophy/The-history-of-Western-ethics
10. Wilson, P. K. (2024). Eugenics . Britannica. Retrieved 30/10/2024 from https://www.britannica.com/science/eugenics-genetics
11. World Health Organization. (2024). Female genital mutilation . Retrieved 30/10/2024 from https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation