by Sean Murphy

Many people, grappling with concerns about freedom of conscience, agree that health care workers should not be forced to participate in procedures or services to which they object for religious, moral, or ethical reasons. However, their agreement is frequently qualified by the condition that a conscientious objector must refer the patient to someone who will provide what is wanted, or otherwise assist the patient to that end.

This is often erroneously explained as "striking a balance" between the interests of the worker and those of the patient. In cases of conscientious objection, however, a patient has an interest in obtaining a particular product or service, and the health care worker has an interest in his ability to live and work according to his conscientious convictions. With sufficient imagination and political will, one may find a way to accommodate the interests of both. But their interests cannot be balanced, because they are not commensurable; they concern fundamentally different goods.

The notion that referral is an acceptable compromise may presume that moral culpability attaches only to direct participation in X, and not to facilitating the provision of X by someone else. This presumption contradicts important religious and moral traditions that hold that we may be morally responsible for the actions of someone else. Such traditions continue to be reflected in law and in everyday life, and show no sign of weakening.

For example: one can be charged for bank robbery if one assists the robber by providing the weapon used, even if one is absent when the robbery occurs. Employers are civilly liable for misconduct by their employees that they could have prevented. Apart from the law, the increasing popularity of "ethical investment" reflects, in many cases, a belief that one is responsible for the good or for the harm that flows indirectly from one's financial participation in this or that company. Note, too, how frequently one hears thanks extended "to all the people who have made X possible" - and how easy it is to offend people by failing to acknowledge their help. Finally, there is the time-honoured practice of mitigating one's own moral failings by asserting that others, too, had a part to play in them.

Thus, law and custom clearly illustrate that the principle of vicarious moral responsibility is widely accepted and deeply entrenched, though manifested in different ways. Health care workers who refuse to refer patients for something they judge to be wrong are not demonstrating excessive scrupulosity, but an adherence to the same principle that guides their fellow citizens in other situations.

Unhappily, people who do not share their moral outlook either find this completely incomprehensible, or misconstrue it as an attempt to control the patient or the practice of their colleagues. The misunderstanding is usually a result of a second presumption, frequently unexamined: that X is morally acceptable, and the objector is mistaken in holding otherwise. This is best illustrated by analogy.

In a school where cheating is endemic, Student A is approached by Student B for the answers to an upcoming test. If Student A declines, for moral reasons, to supply the answers, should he be forced to direct Student B to someone willing to provide them?

A second case: Child C asks Parent D to lie about C's medical condition in order to expedite treatment. Does D's fiduciary relationship to C impose upon him a duty to lie, if that is in C's personal interests?

Most people would not assert that Student A must help a classmate cheat, or that Parent D must lie. In fact, many would maintain that no one should be made to cheat or lie, or to facilitate cheating or lying, arguing that such things are wrong. That is, to the extent that they sense or appreciate the wrongness of an act, they will defend the right to refuse to assist with it. Equally important, they will understand that refusal as an assertion of personal integrity rather than an effort to impose limitations upon someone else.

People extend this respect for freedom of conscience to acts that they recognize to be of grave moral importance to others, even if they do not consider them to be wrong . There is a range of opinion about the morality of capital punishment, for example. It is legal in some countries, and occasionally involves execution by lethal injection. Let us suppose that, in such a country, Pharmacist E is asked to participate in or dispense drugs for an execution, but refuses to do so because he believes that capital punishment is wrong. Is Pharmacist E ethically obliged to find a colleague willing to dispense the drugs, simply because they are to be used for a legal purpose?

Even supporters of capital punishment are unlikely to demand that those who disagree with them should be made to facilitate executions, for they understand that their opponents are seized with sincere and significant moral convictions that warrant respect.

No such respect is shown by employers or regulatory authorities who seek to force health care workers to provide or refer for something to which they object for reasons of conscience. On the contrary: they act as though the conscientious judgment of the objector is not only erroneous, but malign, and must be superseded by their own (correct) moral judgment. They use the threat of discipline or dismissal to force others not just to set aside their own moral convictions, but to act against them.

This is an assertion of superior moral judgment, and of the right to compel others to conform to it. Whatever else it might be, it is not a compromise.

Sean Murphy is founder and administrator of the Protection of Conscience Project. For further information on this worthwhile project, visit their web site at: www.consciencelaws.org or contact our office.

By a 5-4 majority, the U.S. Supreme Court declared Nebraska's partial birth abortion ban unconstitutional. If that were all the Court did, it would be deeply regrettable. But the majority opinion shoots quickly past the "regrettable" stage en route to alarming.

One can scarcely envision a ruling more extreme, or one more steeped in the brutal, bloody language of abortion. The majority and three concurring opinions reveal a stony indifference to the lives and deaths of victims of the second and third trimester abortions under discussion. These opinions exhibit a corresponding deafness to the moral sentiments of those who oppose partial birth abortion.

Three strong and articulate dissenting opinions, including one by Justice Anthony Kennedy who voted to preserve abortion in Casey, assail the majority opinion with undisguised and unparalleled contempt. A fourth dissenting opinion, filed by Chief Justice Rehnquist is brief and straightforward as he joined in the dissents filed by Justices Thomas and Kennedy.

With the Constitution silent as to the propriety of killing nearly born children, with no support in abortion case law for such a proposition, with 30 State legislatures agreeing (after thorough study and vigorous debate) to ban this method of near-infanticide, it was no easy thing for the majority of the Supreme Court to fashion a ruling against Nebraska. Their holding in Stenberg required the following:

• twisting the plain meaning of words and phrases in Nebraska's law;

• misrepresenting the Court's own precedents of Roe v. Wade and especially, Planned Parenthood of Southeastern Pa. v. Casey;

• inventing an improbable new scope and direction for the omnifarious "health exception;"

• abandoning customary judicial deference to the State's legislative power;

• repudiating long-established rules of statutory construction;

• rejecting the medical evidence of major medical associations and highly-respected specialists in favor the self-serving testimony of one abortionist who can boast of neither specialty certifications nor even admitting privileges at any hospital;

• disregarding the desire of more than two-thirds of Americans to outlaw partial-birth abortion;

• elaborate dissembling by the majority to portray their holding as anchored in the Constitution and prior cases rather than what it actually amounts to- "a policy-judgment-couched-as-law" (per Justice Scalia's dissent); and

• identifying so closely with the interests of the abortion industry that its interests eclipse those of the child, the mother, the medical profession, the integrity of the Court, the justice system, and society at large.

The majority opinion in Stenberg, written by Justice Breyer, finds the Nebraska partial birth abortion ban unconstitutional per Roe and Casey "for at least two independent reasons. First, the law lacks any exception 'for the preservation of the ... health of the mother. ...' Second, it 'imposes an undue burden on a woman's ability' to choose a D&E abortion, thereby unduly burdening the right to choose abortion itself." This astonishing conclusion is based on a finding that Nebraska's ban might possibly be interpreted by a local prosecutor or a future Attorney General as banning both partial birth abortion and dismemberment abortion (D&E).

Excerpted from Life Insight, A Publication of the NCCB Secretariat for Pro-Life Activities Vol. 11, No. 4 June 2000

"The Court's real fear is that accepting any restriction on abortion will call all of its handiwork into question. It is putting its finger in the dike.

.The campaign against partial-birth abortion has revealed that the public's moral sentiments, if not always its moral reasoning, remain healthy. It has revealed something, too, about the abortion lobby - the activists, the politicians, the writers, the judges who support abortion on demand. They have watched a baby, partly out of the womb, have her skull punctured and her brains sucked out. They have been asked, Must even this be tolerated? And they have looked at this grisly scene and answered yes, even this. The logic of abortion is merciless." Editorial, National Review

"I am optimistic enough to believe that, one day, Stenberg v. Carhart will be assigned its rightful place in the history of this Court's jurisprudence beside Korematsu and Dred Scott. This method of killing a human child ... proscribed by this statute is so horrible that the most clinical description of it evokes a shudder of revulsion. ... The notion that the Constitution of the United States, designed among other things, 'to establish Justice, insure domestic Tranquility, ... and secure the Blessings of Liberty to ourselves and our Posterity' prohibits the States from simply banning this visibly brutal means of eliminating our half-born posterity is quite simply absurd." Justice Antonin Scalia, dissenting opinion

"The move to discourage the most flagrant form of abortion was, like the Missouri Compromise, an accommodation. To deny it recognition as such is an exercise in abstraction that accomplishes what? An OK for partial-birth abortions (which are rare) but no thought at all to the thinking, and the sensibilities, of those who, as with the abolitionists, believe they are dealing with human beings. "     William F. Buckley Jr

"A women's right to choose must include the right to choose a medical procedure that will not endanger her life or health. Today's decision recognizes this principle and marks an important victory for a woman's freedom of choice."    President Clinton

There is a worn-out argument that has been used over the years against protecting unborn babies. They say there have always been abortions, and there will always be abortions. If you forbid the legal and "safe" abortions, you will merely return to illegal and "unsafe" abortions. If and when the pro-life movement moves closer to its goals, we will hear this argument voiced louder and longer.

It seems logical enough on the surface. However, there are no documented studies to prove this claim. That doesn't seem to matter to pro-abortion spokespeople nor to a biased media. What is needed is the actual experience in the field. What has happened in a major nation when abortion has been forbidden? Have illegal abortions increased? Have more women died or more women been injured? Well, guess what. We have had a proving ground in a major nation, which is there for all to see. The nation is Poland.

Poland, along with the rest of the Iron Curtain, Eastern Europe countries, was occupied for 44 years by Russia. Russia legalized state-paid abortion in the first three months of pregnancy. What are the official figures of the numbers of abortions performed annually during those years in Poland? In 1960, it was 150,400 - in 1965, 168,600 - in 1970, 148,200 - in 1975, 138,600 - in 1980, 138,000 - in 1985, 135,500. By 1990, with the advent of the Solidarity independence movement and the influence of Pope John Paul II, the number of abortions had declined to 59,417. This was a spontaneous movement.

During 1993, in their freely elected new parliament, legislation was enacted that restricted abortion to life of the mother, rape or incest. Let's look at the number of abortions since that time. In 1993, the total number was 777 - in 1996, it was 559 - by 1998, it was 253.

There had been loud predictions that if the total number of abortions was sharply reduced, the total number of "spontaneous" miscarriages would skyrocket. It was predicted that illegal abortionists would begin an abortion with instruments, and then, when the mother started to bleed, she would go to the hospital to have her "miscarriage" cleaned up and terminated. If this were true, the total number of miscarriages reported in Poland would have sharply risen. Let's look at the numbers. In 1990, when there were still 60,000 induced abortions, there were 59,454 miscarriages. By 1997, with 500 abortions, the total number of miscarriages was 44,185. This is not the increase that pro-abortion people predicted. Rather, it is a 25% decrease.

Another measure of whether or not illegal abortions were being substituted for legal ones would be the total number of women who died from abortion complications. In Poland, this is listed as a single figure due to "pregnancy, childbirth and confinement." Let's look at these numbers. In 1990, when there were still 60,000 abortions, 70 women died. By 1996, with 559 abortions, 21 women died.

Another possible relevant figure would be the number of neonatal deaths, the deaths of infants per 1,000 live births. If there were attempted abortions, then there would be more premature births and more infants dying. Again, let's look at the figures. In 1970, 37 babies died per 1,000 live births. In 1980, it was 25 - in 1990, it was 19 - in 1998, it was 9.6.

One other statistic is possibly of some interest. I have noted that in 1998 the total number of induced abortions in Poland was 253. What were the reasons given for these? To save the "life and health" of the woman - 199; for "fetal impairment" - 45; for rape or incest - 9.

In summary, then, here we have a large nation that, for 4 1/2 decades, had abortion-on-request, paid for by the state. Certainly, the practice of abortion in Poland had become deeply ingrained. Then came independence and a law that took the total number of abortions down to 0.004% of what they had been, and this contrary to all predictions by government agencies, the media, the UN and Planned Parenthood. To perhaps everyone's surprise, there have been 25% fewer miscarriages and 30% fewer women dying compared with what it had been while abortion was legal. In the latest annual report, 21 women died from pregnancy- related problems, with none listed as dying from illegal abortions.

These are firm statistics. The facts above have been annually reported and heatedly discussed by the Polish parliament, its ministries of health, labor, social welfare and education, as well as by mass media, non-governmental organizations and anyone else interested in the problem.

If abortions are again forbidden, will illegal abortions, with all of their alleged tragic consequences, take their place? Certainly in Poland the answer is in - it is a resounding no. In fact, the women in Poland are clearly healthier now, from a gynecologic and obstetric standpoint, than they were when abortions were legal.

Is the Polish experience one that would be mimicked in other countries? Of all the former Iron Curtain countries, it has become the most rapidly westernized. Its only difference from many other Western nations is that it is more Catholic. But it has the same biased media and radical feminism as the West. In balance, it would seem to be a good prototype of what can and will happen if and when other western nations once again protect their pre-born children from abortion by law.

Dr. J. C. Willke is President of International Right to Life Federation and the author of the well-known abortion primer "Abortion Questions and Answers". He has recently completed a two-week lecture tour in Poland.

This article originally appeared in "Life Issues Connector" and is reprinted with permission.

Jewish ethicist sees clear contradiction of principles.

For the second time in less than four years, a debate is taking place in our nation over the issue of physician-assisted suicide. This week PBS aired a Bill Moyers report on the subject of death and dying today in America with an extensive discussion of assisted suicide. Next week the U.S. Senate is expected to debate the Pain Relief Promotion Act - a bipartisan measure that will address this critical issue in a meaningful way. It is a debate that has serious moral and public policy implications and one on which Jewish tradition is quite clear, for Judaism values life.

The "pop" image of physician-assisted suicide is that of Jack Kevorkian administering a lethal injection to an ailing individual on "60 Minutes." The image offered by advocates of its legalization is certainly more sympathetic; it imagines a terminally ill person suffering horrible pain due to the inadequacy of legal, pain relief medications and that allowing someone to "die with dignity" is the truest act of love in such circumstances. Unfortunately, this sympathetic image is as detached from reality and the kind of society we should champion as is the first.

Last year, the Portland Oregonian newspaper featured a detailed account of one person's assisted suicide odyssey from the only state where this practice has been legalized.

The account highlighted the real-world dangers inherent in the legalization of this practice, especially as relates to those least capable of protecting themselves from harm. Eighty-five-year-old Kate Cheney, suffering from inoperable cancer, petitioned to be assisted in committing suicide.

As a result of her illness, she suffered bouts of dementia and was, therefore, referred by her doctor to a psychiatrist for evaluation as required by Oregon's "Death With Dignity" law. The psychiatrist found Cheney to be suffering from short-term memory loss and, more worrisome, wrote that the Cheney's daughter was the proponent of the suicide much more than Kate herself. Cheney was thus refused assistance in killing herself.

But the story does not end there. Cheney's daughter took her suffering mother to a second doctor who referred her to a psychologist, who determined that the mother was competent to kill herself with assistance. The final decision on the matter fell to the "ethicist administrator" for Kate Cheney's HMO; he approved the lethal prescription, she took it, and died.

Reflecting upon this report, the Oregonian editorialized that "tales of some Oregon assisted suicides betray more troubling issues than anything assisted suicide foes could call up," and underscored the substantial financial interest health insurance companies have in terminal patients committing suicide rather than insisting upon receiving costly palliative care.

We well know that Jewish tradition holds the preservation of human life as one of its supreme moral values. It takes precedence over virtually all other moral values to the degree that only the violation of three cardinal sins (idolatry, adultery and murder) in limited circumstances can claim precedence over the imperative to preserve life.

Nevertheless, Judaism - acutely linked to the reality of the human condition - realizes there are circumstances in which a person might long for death. The Talmud reports of Rabbi Judah the Prince suffering great pain from an illness and his righteous maidservant praying for his death as an end to his suffering. At least one commentator cites this passage as an approbation of praying for the merciful death for one suffering pain from illness.

Even with this appreciation of our human reality, Jewish law does not reduce the mandate that we preserve life, even under the most challenging conditions. While rabbinic authorities, ancient and modern, debate whether under limited circumstances medical treatments may be withheld from a suffering person (thus, no longer delaying an inevitable death), it is abundantly clear that one may not proactively hasten death. At the same time, Jewish law would endorse the aggressive palliation of pain to a degree not currently practiced in the medical profession. Rabbinic authorities place such treatment under the rubric of loving one's neighbor as one's self (Leviticus 19:18) and condone even the use of narcotics to ameliorate a person's pain.

In 1997, the U.S. Supreme Court was asked to invalidate state laws in New York and Washington that criminalized physician-assisted suicide and recognize a constitutionally protected right to obtain such assistance.

The Orthodox Union, along with many other concerned constituencies, argued before the high court that the Constitution clearly did not speak to this issue, let alone resolve it in favor of a right to die. The court prudently ruled as such and recognized that this policy debate should be resolved in a legislative body, not a court.

America's national legislature has now acted upon the court's holding. Last year, the House of Representatives took up this critical issue and voted 271 to 156 in favor of the Pain Relief Promotion Act. This measure does two important things thoroughly consistent with the Jewish values outlined above. First, it promotes the aggressive treatment of pain by offering doctors a "safe harbor" for prescribing controlled substances to reduce pain, even if the use of these otherwise illegal drugs results - unintentionally - in the patient's death. Second, the bill largely overrules an Oregon law legalizing physician-assisted suicide in that state.

The bill has been endorsed by many groups including the Orthodox Union, American Medical Association, and National Conference of Catholic Bishops, as well as former Surgeon General C. Everett Koop. It will bring comfort to the ill and ensure that the medical profession remains faithful to its call as healer, not agent of death. It deserves the strong support of the Jewish community and should be passed to the benefit of us all.

Nathan Diament is director of the Institute for Public Affairs of the Union of Jewish Congregations of America.

This column originally appeared in the September 15, 2000 edition of The Jewish Week of New York and is reprinted with permission.

The use of fetal tissue for medical transplants raises disturbing questions about the moral limits of research
by Paul Ranalli, MD

Renewal is a driving force in medical research, particularly in the fields of tissue rejuvenation, regrowth and transplantation. Yet, can renewal as a medical therapy be a bad thing?

On the subject of the biomedical use of human fetal tissue, this is an important question to ponder. For alongside the promise of fetal-tissue research there are uncomfortable realities. As recent ghoulish news reports have revealed, medical researchers do not simply order "fetal tissue" from providers- they order leg bones, livers, spleens, whole eyes and other organs. And despite admonishment from the Canadian Royal Commission on New Reproductive Technologies and a U.S. congressional prohibition against a money-making marketplace for fetal tissue, there are clear indications that just such a marketplace has developed; human fetal parts are being sold for a profit. "In a civilized society there are things that should not be for sale," Andrew Kimbrell, author of The Human Body Shop, said recently. "But right now we are in an ethical free fall."

The most direct clinical application of human fetal tissue has been the decade-long experience in transplanting fetal brain tissue into the brains of patients with Parkinson's disease. Herein lies a tale of desperate hope, moral anguish, initial scientific and public enthusiasm and ultimate- though still strongly denied- failure.

The exact cause of Parkinson's disease is unknown, but we do know it is associated with a decline in the production of the brain chemical dopamine. In the early to moderate stages of the disease, neurologists have a fair degree of success treating patients with a variety of medications that either boost dopamine synthesis, or directly stimulate dopamine receptors in key deep brain structures. After a number of years, however, the effectiveness of these drugs wears off, or is accompanied by troubling side effects.

A search for novel therapies has led to a variety of experimental brain surgery procedures. The theory behind fetal transplantation is that dopamine-producing cells extracted from the brains of several aborted fetuses can be injected deep into critical brain regions of the recipient Parkinson's disease patient, hopefully to take root and begin to produce the needed dopamine. However, a series of limited, uncontrolled case reports provided little evidence of real success, despite tremendous hype that continued to capture the public imagination. Finally, a well-designed study funded by the U.S. National Institutes of Health revealed that the use of fetal tissue was essentially worthless. This was an immense disappointment to workers in the field but the public was shielded from the full force of this result, with headlines such as Parkinson's progress and Hints of success in fetal transplants.

From an ethical perspective, even for those who do not recognize an individual human life as beginning at conception, the fetal transplant issue draws attention to certain scientific facts about early fetal development that should be more than a little unsettling. Most abortions take place in the latter part of the first trimester of pregnancy, from eight to 12 weeks. This is exactly the stage at which fetal brains are removed for potential transplant. Far from being an undifferentiated "blob" of tissue, the first trimester fetus not only has a brain but has also developed a fantastic level of specialization.

Defenders of the use of fetal tissue often advance two lines of argument. One, that fetal tissue transplantation is merely an extension of organ donation, a long and honoured form of medical altruism. Opponents of the use of fetal tissue, however, would counter that organ donation arises from tragedies we try to prevent: fatal accidents, or murder. Abortion, on the other hand, is an elective choice in our society and many affirm it as an absolute right.

A second point to be made in support of the use of fetal tissue is the "let's not let it go to waste" sentiment, in which even those who profess to be troubled by elective abortion see the benefit of salvage in making a contribution to science with material that would otherwise be discarded. It is probably not unfair to characterize this position as Pontius Pilate-like in its handwashing of any concern about the troubling source of this tissue.

Since the 1988 Supreme Court of Canada Morgentaler decision struck down the old hospital abortion-committee law, there has been a legal vacuum on the subject of fetal rights. Moreover, the current unrestrained practice of abortion supersedes a number of recommendations contained in the 1989 report from the Law Reform Commission of Canada, Crimes Against the Foetus. Another Law Reform Commission report, on human biomedical experimentation, goes to the heart of the matter: "At what moment in the development of the product of conception are we dealing with a human being or a human person?"

There is a troublesome aspect to the unwarranted aura of success that surrounds the practice of fetal tissue transplantation. A 1995 survey by the Joint Centre for Bioethics at the University of Toronto found that, among women who would consider having an abortion, 17 per cent would be more likely to undergo an abortion if fetal tissue could be donated for medical use. When one considers the current abortion rate of over 100,000 per year in Canada, and 1.4 million per year in the U.S., the extra number of abortions that may occur, based on a false premise, becomes a real public health issue.

The world of medical research may be passing by fetal tissue transplantation. It is now over a decade since the experiments began and precious few advances have occurred. On the other hand, new medications continue to be added to the armementarium in treating Parkinson's disease and there are now two brain surgery procedures, which do not require fetal tissue, that have been proven effective at extending the functional longevity of patients with advanced Parkinson's disease.

Recently, new hope and controversy has arisen with the potential use of implanted stem cells. These primitive "pluripotent" cells, normally present in the human embryo, are capable of being coaxed into developing along one of several cell lines, including brain cells. The controversy has been over the need to use aborted human embryos to retrieve these versatile cells. Yet even this ethical dilemma may be averted, following the stunning recent reports that such stem cells can be found, albeit in small numbers, within the tissues of adult humans; scientists now suspect that each person may harbour all the cells he or she will ever need to regrow or rejuvenate ailing body parts.

Which goes to show that, given time, science will often find a way to advance, without the need to compromise human dignity in the interim.

Adapted from "An Ethical Free-Fall", originally published in University of Toronto Magazine, May 15, 2000. Dr. Paul Ranalli is a neurologist in the University of Toronto Faculty of Medicine.  Contact our office to order original paper.

By Gregor Wolbring

Bio/gene technology research is developing at breathtaking speed. The sequencing of the human genome is more or less completed and the race is on to identify the gene products encoded by the genes. But what now? What is to be done with this knowledge? The claim is that this knowledge will be used for the good of humankind. But who decides what is good for humankind? It is claimed that the new knowledge will help eradicate disease and suffering. But who decides which genes are 'defects' in need of fixing, and who decides what suffering is? Who will cover the expenses associated with "fixing" genes and how will people afford to use the technology? How will we determine who should be allowed access to the technology? These are just a few questions we must ask ourselves. How will we answer these questions? If our current uses of existing information about genetics and technology are any indication, a few conclusions can already be drawn.

1) People in marginalized groups and people with characteristics targeted by the new technologies, will not be the people answering these important questions. Already, poor countries and individuals, disabled people, and others with targeted characteristics are excluded from mainstream discussions about the introduction of genetic technologies.

2) So-called positive and negative eugenics practices will be viewed as good for humankind. Characteristics viewed as defects are already targeted for eugenic practices. Through eugenic practices women lose their right to autonomy and reproductive freedom, becoming instead the quality control gatekeepers of human perfection. In a 1995 Ms. Magazine article, Laura Hershey asserts that, although prenatal testing appears to empower women because it allows for reproductive choices, it is actually asking women to ratify social prejudices.

Robert Edwards, the world-renowned embryologist, the creator of the first test tube baby, has predicted that the increasing availability of prenatal screening for genetic diseases gives parents a moral responsibility not to give birth to disabled children. According to Edwards, "Soon it will be a sin of parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children." It follows that parents will be under similar pressure to use these technologies to attempt to improve the quality of their children by adding genes thought to be advantageous.

3) Many abilities, attached to the new knowledge and the new technologies, will only be available to the people who can pay for it. This will not only broaden the gap between rich and poor parents within any given society but also broaden the gap between rich and poor countries.

4) Our propensity to judge each other, based on attributed characteristics will increase our potential for intolerance and the appearance of an Animal Farm philosophy in which some are more equal than others. Different characteristics will be targeted, depending on the cultural political, philosophical, economical and spiritual background of any given society.

5) Elimination of unwanted characteristics might take place before and after birth. Many characteristics labeled as disease and disability are already so targeted. Euthanasia and infanticide might become after-birth eugenic tools, especially in cases where the individual does not have access to the pre-birth technologies (due to individual or country poverty).

6) If society has the right to attempt to create "perfect" members of society wouldn't a company have the right to demand perfect workers? Wouldn't an insurance company have the right to cover only perfect clients?

These are just a few consequences of applications of the new genetic knowledge that I foresee. Many more will surely follow. But it all boils down to the fact that humans become a commodity for society and the powers that be will decide which humans will be allowed to be part of society and which will not

Dr. Gregor Wolbring is a Biochemist at the University of Calgary. He is founder and coordinator of the International Network on Bioethics and Disability which looks at how bioethical issues such as biotechnology affect marginalized groups. Citations to references in this article are available on his webpage: www.bioethicsanddisability.org