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Bioethic information and analysis newsletter

Following Letter

N°35 - November 2002

The number of life – Grégory Benichou 

ADN : a programmed language 
Since the sequencing of the human genome, biological scientists have discovered that to understand living things, one cannot simply break down the ADN structures into their most intimate parts, but on the contrary, one must seize the immaterial part of its number to decode it... The genetic programme must now be interpreted as a code which enables chemistry to be converted into syntax. The metaphor of the « Book of life » has therefore never before given rise to so many questions : Where does the code come from ? Is there a Programmer ? Is the information finalised ? Biology, which was the first to use such terms would now like to relegate them into the field of metaphor, and deprive them of any symbolic meaning. The last thing they will admit is the possibility of a programme, a programmer or any meaning, they prefer the idea of chance. The question is vital : is this a metaphor or a much deeper reality ? G.Bénichou has shown that the notions of a programme, a code, a hereditary message designate an objective reality : that a language is written into living matter which embodies a significance. This notion of genetic information establishes a new relationship between material and meaning, between the body and the spirit, which seals the reconciliation between materialism and spiritualism.

Freedom
Then comes the question of freedom : if life programmes us, where does that leave our freedom ? And conversely : does technology enable us to programme life ? In 1892 Charles Richet, holder of the Nobel prize for Medicine offered his vision of the future. Around the year 2000 he wrote : « when the laws of heredity and their applications are well known (...) we shall not be satisfied with merely improving rabbits or pigeons, attempts will be made to improve humans. This will lead to the bases for a sort of artificial selection, through which humans will become stronger, more beautiful, more intelligent.1» The theory of scientific selectionism dates back to Darwin and was developed in his circles, Darwin himself wrote « how this perpetuation of morons must be harmful to the human race.» And in 1896, Vacher de Lapouge, in order to achieve a concrete extension of the selective order in accordance with the social order, suggested the development of « control of artificial insemination » by separating love, voluptuousness and fertility...

Selection of humans
Today, our mastery of genetics, although still in its infancy, is confronting ethics themselves. It is torn between respect for humanism and the temptation of eugenics. This is the logic followed by F. Crick, joint discoverer of ADN, awarded the Nobel prize for Medicine in 1962 : « no newly-born child should be recognised as human before passing a certain number of tests concerning its genetic endowment. If it fails these tests, it loses the right to live ». Pre-natal diagnostics, followed by pre-insemination diagnostics : such practices are drawing medicine into human selection...

The genetic Quotient
By introducing the new concept of genetic Quotient, the last chapter examines the advent of medically 
assisted eugenism. As is the case with IQ, tests could soon be used to measure the performance and quality of the genome The author shows the progress made in materialistic biology, which has also contributed to materialising man himself, to reducing humanity to its genome. This is not the tyrannical and violent eugenism of a state, but private eugenism, legal and based on free consent, included in the context of the parental project. And to hide the truth, medicine is allowing itself to be tempted by the duplicity of an argument which is truncated by the cleansing of words These « apparently innocent linguistic hops are in fact at strategic points in the argument ». Thus the human embryo has become a « potential human being » then a « pre-embryo », « a lump of cells devoid of senses », « almost nothing2 » and more recently « a laboratory artefact3 ». They prefer to talk of diagnostics instead of screening, prevention rather than eradication, in particular regarding trisomic embryos... 

Nevertheless, the author reminds us that « any attitude adopted towards the human embryo leads to the acceptance of analogous attitudes towards human beings. » « The respect for humanity is an indivisible whole. » 
Towards an ethical science
Finally, the author refuses to present the debate dichotomically, as if one had to choose between two exclusive options : between scientific progress or respect for mankind. He presents the true therapeutic opportunities for medicine in the 21st century for treating mankind without demeaning him. These therapeutic hopes are 
numerous, it is up to us to develop them without rejecting our humanity. 

1 - Charles Richet, In a hundred years, La Revue scientifique, March 1892
2 - René Frydman, God, medicine and the embryo, Paris, Odile Jacob, 1997
3- Henri Atlan, Is science inhuman ? Paris, Bayard 2002 
Ref : The number of life, Grégory Benichou, Seuil, 2002. G. Benichou is a doctor of philosophy and doctor of pharmacy, graduate of ESSEC, he lectures there in the Health chair.

Belgium authorises euthanasia, an isolated case facing Europe ?  

A Belgian doctor practising euthanasia does not commit any offence if he fulfils the request of an adult patient, expressed "voluntarily, deliberately and repeatedly". 
Such is in substance, the main measure of the legal text adopted last May by the Belgian Parliament, which came into effect in September. The philosophy of the Belgian law, despite its amendments and adjustments is clear : it sanctions individual autonomy and partially depenalises euthanasia.

What is the European position ? First of all remember what was said at the Nuremberg trials at the end of World War 2, the Court adopted the Nuremberg Code, which supplements the Hippocratic Oath. It defines the fundamental code of practice governing experimentation on humans. No doubt it was the memory of this recent history which prompted the Parliamentary Assembly of the Council of Europe to adopt in June 1999, Recommendation 1418 : « Protection of Human Rights and the dignity of incurably ill and dying patients ». The European organisations involved in this thinking were particularly keen to preserve the balance between abiding by the Hippocratic Oath and remaining open to modern questions, a balance which covers most of the positions adopted on this question by the medical profession. The conclusion is a categorical rejection of euthanasia, for reasons which are made obvious by end of life care, with its despair, its fears, its false requests.

The European Court for Human Rights and Euthanasia

The adoption of the law depenalising euthanasia in Belgium, coincided with the all-important decree by the European Court for Human Rights in the Pretty case versus the United Kingdom (29th April 2002). The 43-year old applicant, suffering from the terminal phase of amyotrophic lateral sclerosis, wished to put an end to her days. Being completely paralysed, she obtained a promise from her husband to help her to commit suicide. However, such help contravenes English law. Mrs Pretty asked for a waiver, which was rejected. She therefore turned to the European Court for Human Rights, considering that the English law contravenes in particular (and essentially) articles 2 (rights to live) and 3 (prohibition of inhuman and degrading treatments), 8 (right to respect for private and family life), 9 (freedom of thought, conscience and religion), and 14 (non-discrimination). The crux of her claim concerned articles 2 and 3, which are part of the hard core of Human Rights (which cannot be subject to any waiver). We shall discuss here only the response by the Court concerning the alleged violation of article 2. 

Mrs Pretty claims that this measure « guarantees not only the right to live, but also the right to choose to continue or to cease to live ». In other words, article 2 covers not only a positive right (the right to live), but also includes a negative right (that of refusing to live). The Court replied by stating that « among the measures in the Convention which it judges essential, {it}, in its precedent, grants precedence to article 2. » Indeed, « article 2 protects the right to live, without which the possession of any of the other rights and liberties guaranteed by the Convention would be illusory ». In all its precedence, the Court has always stressed the obligation of the State to protect life. The absolute nature of this article was then recalled : « It has no relationship with questions concerning the quality of life or what a person may choose to do with their life ». Very interestingly, the Court referred to Resolution 1418 of the European Parliamentary Council Assembly, which follows the logic and fundamental objectives of the Convention for Safeguarding of Rights and fundamental Liberties : « The Assembly recommends (…) the Committee of Ministers to encourage the European Council member States to respect and protect the dignity of incurable and terminally sick patients in all circumstances (…) by maintaining the absolute prohibition to intentionally end the lives of the incurably and terminally sick : 
- in view of the right to live, in particular concerning incurable and terminally sick patients, is guaranteed by the member States, in accordance with article 2 of the European Convention for Human Rights which states that « death cannot be inflicted on anyone intentionally» ;
- in view of the will to die expressed by an incurable or terminally sick person can never constitute a legal basis for their death at the hand of a third party ; 
- in view of the fact that the desire to die expressed by an incurably sick person cannot as such be accepted as legal justification for executing actions intended to cause death. 

Resolution 1418 has thus made its entry into European precedent.