Sunday, March 26, 2006

From Third World to Brave New World

China's embrace of state-driven eugenics should be of concern to bioconservatives and bioliberals alike

By George Dvorsky, October 27, 2003

China took a great leap forward on October 15 by becoming only the third nation in history to put a man in space. On top of a Long March rocket, China's first manned spacecraft, Shenzhou 5, soared into the heavens along with taikonaut Yang Liwei and a profound sense of inevitability.

While the feat lagged the US and the former USSR by 40 years, anyone who doubted the inexorable nature of technological progress even among the developing nations had their doubts put to rest. The Chinese success story revealed that, given enough time and patience, high-tech makes its way into even the most unlikeliest of places—including former third world countries. While once the exclusive domain of the Cold War superpowers, space is now accessible by such countries as India, Japan and various nations of the European community.

However, one unfortunate reality of the great catch-up game being played by the former have-not countries is that for many of them social modernization has not caught up with technological modernization. Yes, it's a positive sign that China is catching up technologically, but the communist country currently resembles an infant who has stumbled upon his father's toolbox.

Nowhere is this more so than with biotechnology. The authoritarian Chinese government is using advances in the health sciences to further entrench and realize its eugenic agenda. Beyond the "one child, one family" policy, Chinese eugenics is startlingly reminiscent of 20th century social experiments—including the forced sterilization of citizens deemed unsuitable for procreation—conducted not just by the Nazis, but by many nations.

This is exactly the kind of Brave New World scenario that keeps bioconservatives up at night. But it's also the kind of state-driven eugenic imposition that even the techno-utopian and biolibertarian transhumanists worry about. The vision of a centralized, ideological and hyper-bureaucratized politburo hammering out design schematics for its future citizens is abhorrent, representing everything to which ideals of democracy and self-actualization are opposed.

Consequently, liberal democracies should continue to pressure China to embark upon a path of increasing democratization in hopes that its citizens will eventually demand procreative, cognitive and morphological freedoms. At the very least, the Chinese example should act as a continual reminder of where we do not wish to go.

Primed for reproductive restrictions

Historically, the Chinese have operated with the understanding that citizens are obligated with personal duties to the state, and it is partly due to this tendency that Western ideas of individual autonomy are lost. The Confucian tradition, along with its early agnostic and humanist character, placed emphasis on the orderly arrangement of society and stressed appropriate personal relationships.

In conjunction with ancient customs in medicine, Chinese tradition holds that every aspect of an expectant mother's life must be controlled. It was commonly held that maintaining a balance in cosmic forces, in essential bodily fluids and in lifestyle both before and after conception was paramount if you hoped to have a healthy baby.

The Chinese also subscribed to the patrilineal model of descent, in which a person is viewed as the culmination of his or her ancestors and is held responsible for the health of all future generations. Thus, an expectant mother's behavior and attitude is believed to directly influence the well-being of her future baby, and a deformed or developmentally disabled child reflects a moral failing on the part of the parents. As historian Frank Dikötter has noted, "Herein lies the basic eugenic belief that human intervention—in the form of behavior and morality—can shape heredity."

It was not until after World War I that modern science was introduced to China. It was during the Republican Era (1911 to 1948) that elites called for increased intervention of medical professionals and the state into the sexual lives of its citizens. It was also during this time that Western eugenics was imported and combined with existing fears of cultural, racial and biological degeneration in Chinese society, leading to government regulation of sexual reproduction. Compounding these impulses were the Chinese cultural currents that feared anything deviant and the urge to draw clear boundaries between the normal and the abnormal.

Moreover, it is this emphasis on the collective good that has driven modern eugenics in China since the late 19th Century, when, as Dikötter explains, "Chinese intellectuals, the well-to-do gentry, and government officials explored how to improve the Chinese race after the arrival of the stronger Western imperialist nations." Indeed, as Dikötter has aptly observed, nationalism in its many forms remains an important force in eugenics today. And without question, the Confucian ethic, which emphasized the individual's responsibility to the collective, is still felt across China today, and has hybridized itself quite effortlessly with Marxist notions of communalism and self-sacrifice.

A dubious leap forward

The introduction of communism in China did not do much to change these historical notions or tendencies. In fact, Marxist notions of the blank slate and the creation of the "new man" have inspired Chinese thinkers to mesh Marxist ideals into their already eugenic-primed view of population management.

While scientific and technological advancements were stunted during the Maoist era, recent decades have witnessed the revitalization of health-based issues. Deng Xiaoping's reforms of the late 1970s emphasized the rapid development of scientific knowledge and technological innovation, along with the acknowledgement that Western-style capitalism was necessary to both increase economic efficiency and state power.

While these reforms have led many to conclude that China has finally embarked on the path towards democracy, the truth of the matter is that the totalitarian infrastructure has remained intact; the Chinese political regime has shown no willingness to abandon Marxism anytime soon. This has been made painfully apparent by China's ongoing poor human rights track record, including 1989's Tiananmen massacre, its suppression of religious and cultural freedoms, its stringent control of information (including its own internal Internet) and, of course, its devotion to eugenics.

As a result of Xiaoping's reforms, the standard of living has steadily improved, as has Chinese proficiency with technology, causing a number of thinkers to push for a renewed commitment for eugenic measures. In 1995, the Law of the People's Republic of China on Maternal and Infant Health Care went into effect. The move was greeted with near unanimous international uproar.

The law primarily seeks to ensure the "health of mothers and infants and [to improve] the quality of the newborn population" while reducing the burden of disabilities. Among the many provisions of the legislation was the requirement that all couples seeking to marry submit to a physical examination by a physician to "see whether they suffer from any disease that may have an adverse effect on marriage and child-bearing." The diseases include "genetic diseases of a serious nature.that may totally or partially deprive the victim of the ability to live independently, that are highly possible to recur in generations to come." Also covered by the law are infectious diseases, such as AIDS, gonorrhea, syphilis and leprosy, and relevant mental diseases, including "schizophrenia, manic-depressive psychosis and other mental diseases of a serious nature."

Physicians who perform these premarital checkups "explain and give medical advice to both the male and the female who have been diagnosed with certain genetic disease[s] of a serious nature which [are] considered to be inappropriate for child-bearing from a medical point of view." The couple can marry "only if both sides agree to take long-term contraceptive measures" or to undergo permanent sterilization.

Couples not satisfied with the results of the check-up may apply for an appeal mechanism. When applying for marriage registration couples "shall produce their pre-marital physical check-up certificates or medical technical appraisement certificates." Diagnosis will be verified prenatally if an abnormality is "detected or suspected," such as by ultrasound or because of family history, after an antenatal examination. If a serious disease or defect is found, physicians will offer the couple "medical advice for a termination of pregnancy."

Applications to terminate a pregnancy or to undergo sterilization must "be agreed [to] and signed by the person concerned." Couples that are identified by this process "shall take measures in accordance with the physician's medical advice." In other words, they will be compelled to do what their doctor tells them to do.

Even though this law came into effect in 1995, it is estimated that hundreds of thousands of Chinese citizens have been sterilized against their will since 1986. Clinic-based and mobile birth control teams, dubiously known as the "womb police," have been known to travel across the countryside enforcing both the number of births and the "quality" of the newborn population, assessing such things as feeble-mindedness and mental illness.

There is little doubt that the Maternal and Infant Health Care law is a throwback to 20th century style eugenics. During the first half of the previous century, it was fashionable for the politicians of many countries to implement sterilization schemes that targeted questionable deficiencies while greatly diminishing the reproductive freedoms of their citizens. Two primary factors that led to these policies—two factors that still exist in the Chinese worldview today—are nationally and racially fed conceptions of social Darwinism and an immature understanding of medicine, genetics and science—not to mention unenlightened and socially primitive stances on democracy and the moral and practical efficacy of individual autonomy.

And typically, the law went into effect in China without any real discussion by bioethicists proper. In fact, it is arguable as to whether China even has a bioethics discipline by Western standards. China doesn't even have the same conception of eugenics; in Mandarin, "yousheng" is the closest word that corresponds to "eugenics," and it simply means "healthy birth." (This is interesting, because "eugenics" is a Greek term meaning "good origin," but has gone on to mean a centralized, preconceived and imposed vision of heredity.)

Moreover, legislators in China don't have to face the political hurdles, scrutiny and heated discourse that tend to greet new biolegislation in other countries. Simply put, the communist Chinese government is not held to the same ethical standards as are governments in the more developed and socially mature nations of the world.

Marching into the 21st century

Of course, in my condemnation of Chinese eugenics I could be accused of both cultural and social relativism. As medical doctor Patrick MacLeod has observed, China is struggling with issues of population health beyond our comprehension in the West.

For example, the UK has five percent of the population of China but 20 times the number of medical geneticists and counselors to serve that population. Compounding the problem, China is largely rural, with health insurance programs that do not cover medical genetic assessments. Some estimates place the disabled population of China at more than 50 million. "It is from this perspective," says McLeod, "that one can understand why social planners might adopt eugenic solutions without any knowledge or understanding of the long-term consequences for the gene pool."

And while the work of many health scientists in the West is stunted by debates about whether or not a microscopic clump of embryonic cells is a person or not, China marches on in terms of important medical research and development. Eric Brown, in his provocative but ultimately technophobic article "Brave New China," notes, "China has made some brave leaps beyond the rest of the scientifically advanced nations in crucial areas of biogenetic research."

Chinese researchers, for example, recently created 30 cloned human embryos and allowed them to develop to unprecedented stages. This work could eventually allow people to grow their own organs to replace failing ones. In Tianjin, a stem cell engineering institute is being constructed that will have its labs filled with half a million cloned embryonic cells. As Brown observes, "In the near future, China may well emerge as a major global dealer in human genomic expertise. Recognizing the opportunity China has to leap ahead of a comparatively reluctant West in the world biotechnology market, investors from both China and abroad may provide the capital necessary to drive China's genetic revolution to a much larger scale."

Thus, over the next few decades, as the Chinese continue to develop innovative biotechnologies, and as they continue to impose their eugenic policies, they will have greater and greater control over how they actively re-engineer their citizens.

A democratic transhumanist's nightmare

From a democratic transhumanist perspective, these prospects are both exciting and troublesome. Transhumanists agree that stronger, smarter and healthier people are a good thing, as are reductions in suffering and various psychological and physical disabilities. But while progress in health sciences is a value unto itself, it shouldn't come without proper public debate or the proper bioethical infrastructure to gauge the impact of technologies on individuals, societies and the human condition as a whole.

Worst of all, in China these technologies are being used as tools by the communist government to impose its idea of a healthy and evolving populace onto its "subjects." This idea, that of totalitarian transhumanism, is anathema to democratic transhumanism, which insists that choices about whether and how to use these biotechnologies must be left to individuals. While some of the goals of transhumanists and Chinese politicians run in parallel, the manner and spirit in which they are applied makes all the difference, both from ethical and sociopolitical standpoints.

It is understood by most transhumanists that parents, when empowered to make informed procreative decisions for themselves and their families, will make responsible choices that will result in the improved health of their offspring. How the human family evolves and develops as a result of these individual choices is anyone's guess, but it must be the role of future governments to help their citizens prosper along chosen paths, not to dictate preconceived and group-think notions of what it means to be normal or healthy, and certainly not to do so from a rigid ideological agenda.

I can only hope that as China modernizes itself technologically, social and cultural modernization will quickly follow. The impact of the information revolution has only recently been felt in China, and has been greeted with great caution, resulting in the Great Firewall of China.

Fortunately, technology often acts as the great equalizer, and as mobile phones, computers and other information technologies make their way into China, the Chinese will surely start to take advantage of these tools as they begin to democratize themselves at the grassroots level. The push for better science and technology, I can only hope, will be the ultimate undoing of the current communist regime, rather than further its state-driven eugenic goals.

Copyright © 2003 George Dvorsky

This column originally appeared on Betterhumans, October 27, 2003.

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