On July 26, 2018, the Pew Research Center released the results of a survey conducted among 2,537 adults in the United States to assess their views on the appropriateness of genome editing for babies (Funk and Hefferon 2018). A majority of the individuals surveyed (72%) favored gene editing that would treat a serious disease or condition, but a majority (80%) also thought that using these techniques to enhance a child’s intelligence would take this technology “too far.” One striking finding of the survey was that there is a large difference in acceptance of genome editing between those respondents who self-identify as highly religious and those who are less so, where religious Americans are more likely to view gene editing negatively. Where a significant number of respondents with high religious commitment (87%) thought that testing gene editing on human embryos was taking the technology “too far,” for example, this number was significantly smaller (44%) among those with a low religious commitment. How do we explain these divergent views?

As a Catholic priest who is also a molecular biologist and a bioethicist, I am often asked to comment on the similarities and differences between a faith-based approach to bioethics and its secular counterpart. Though one could compare and contrast these two ethical traditions in many ways, I have come to see that the most fundamental difference involves their rival conceptions of human dignity. Where religious ethicists from the Judeo-Christian tradition – and I will focus here on the Catholic moral tradition – see human dignity, for the most part, as having both intrinsic and extrinsic dimensions, their secular counterparts only acknowledge dignity as an extrinsic value of the human agent. Though this difference may initially appear small and insignificant, it has far-ranging moral consequences. I will propose that this one disagreement can explain not only the divergent responses given by religious and secular Americans to the Pew survey on designer babies but also the other often-conflicting ethical claims made by these two rival groups of citizens about how we are to pursue every scientific and technological research program in our liberal and pluralistic society. My hope is that this chapter will help each of us, whether or not we are individuals of faith, to better understand the complex bioethical debates that accompany modern biological engineering.

Defining Human Dignity in the Catholic Moral Tradition

What is human dignity? Like every other philosophical claim , the principle of human dignity has a long, complex, and controversial history.Footnote 1 It should not be surprising therefore that Deryck Beyleveld and Roger Brownsword concluded a survey of how human dignity is used in international human rights documents in the following way:

In sum, human dignity appears in various guises, sometimes as the source of human rights, at other times as itself a species of human right (particularly concerned with the conditions of self-respect); sometimes defining the subjects of human rights, at other times defining the objects to be protected; and, sometimes reinforcing, at other times limiting, rights of individual autonomy and self-determination. (Beyleveld and Brownsword 1998)

In my view, however, the debates over the meaning and extent of human dignity are inevitably disputes over the value of the human person. They are disagreements over how we are to answer the question: How much is each one of us worth?

For bioethicists working in the Catholic moral tradition and for many who embrace the Judeo-Christian worldview, human dignity has a twofold character. First, it is an intrinsic dignity that affirms that the human being has a worth that cannot be monetized. As Pope Francis has said, “Things have a price and can be sold, but people have a dignity; they are worth more than things and are above price” (Francis 2013). Each one of us is priceless. Each one of us is exceptional.

To say that human dignity is intrinsic is to say four things about human dignity and the human person . First, it is a claim that human dignity is inherent, essential, and proper to the human being. It is a dignity that is constitutive of human identity itself. It is a dignity that affirms that human beings are worthwhile because of the kind of things that we are and not because of what we can or cannot do. As such, it is a dignity that can only be possessed in an absolute sense – one either has it completely or does not have it at all – since one is either a human being or not. Understood as an intrinsic quality , there is no such thing as partial human dignity since there is no such thing as a partial human being.

Next, to say that human dignity is intrinsic is to say that human life is worthy of respect and has to be protected from all unjust attacks. As Pope St. John Paul II explained, “The inviolability of the person, which is a reflection of the absolute inviolability of God, finds its primary and fundamental expression in the inviolability of human life.”Footnote 2 From a theological perspective, human life is inviolable because it is a gift from God. He alone is the Lord of life from its beginning until its end. Thus, no one can, in any circumstance, claim for himself the right directly to destroy an innocent human being.Footnote 3 The Bible expresses this truth in the divine commandment: “You shall not kill” (Ex. 20:13; Deut. 5:17). The Catholic Church’s prohibitions against the destruction of human embryos, physician-assisted suicide, and euthanasia are grounded in her conviction that human beings have an intrinsic dignity that can never be violated.

Third, to say that human dignity is intrinsic is to say that the human being can never be treated as an object. In other words, as a person, the human being can never be treated purely as a means to an end or be used merely as tools to attain a goal. Instead, he has to be respected as a free moral agent capable of self-knowledge and self-determination in all the actions involving himself. Again, as Pope St. John Paul II forcefully declared, “The human individual cannot be subordinated as a pure means or a pure instrument either to the species or to society; he has value per se. He is a person. With his intellect and his will, he is capable of forming a relationship of communion, solidarity and self-giving with his peers.”Footnote 4 We know this truth from our own experience. Individuals who discover that they have been manipulated often feel violated, humiliated, and diminished because they intuit that they are persons who have an intrinsic dignity that is attacked when they are used merely as objects of another’s fancy.

Fourth, to say that human dignity is intrinsic is to say that all human beings are equal. All human beings as persons have an inestimable and thus equal worth. Our intrinsic dignity is the only reason for the fundamental equality among all human beings regardless of the biological, psychological, and spiritual differences that exist in every human population. Thus, as the Second Vatican Council of the Catholic Church taught in 1965, “Every form of social or cultural discrimination in fundamental personal rights on the grounds of sex, race, color, social conditions, language, or religion must be curbed and eradicated as incompatible with God’s design.”Footnote 5 Social discrimination is unjust precisely because it attacks the intrinsic and equal dignity of human persons.

In addition to intrinsic dignity, the Catholic tradition also affirms that every human being has an extrinsic dignity that is a measure of his worth in the eyes of his peers. It is contingent on how others value or do not value the individual. This extrinsic dignity is conferred and can be taken away. It can increase, decrease, and can even be lost through neglect, disease, or sin. This is the dignity to which we refer when we say that someone is “dignified.” In this sense, the judge can be considered to have greater worth than a buffoon, that is, he can have more extrinsic dignity than the buffoon, even though both also have an equal worth because of their intrinsic dignity. Today, in our consumerist society, the human being’s extrinsic dignity is often benchmarked to his salary and accumulated wealth and the social status both usually bring with them.

From the perspective of the Catholic moral tradition and other traditions that emerge from the Judeo-Christian worldview, bioethics is grounded upon the fundamental principle that all human actions need to protect, preserve, and advance the dignity of the human person, especially his intrinsic dignity that is inviolable. Actions that fail to acknowledge the true inestimable worth of the person would be deemed out of bounds for a virtuous and just society.

Considering Human Dignity in the Ethics of Human Genome Editing

Given its foundational commitment to the advancement and protection of human dignity, it should not be surprising that the Catholic moral tradition approaches the ethical question of human genome editing by raising, what I call, dignity concerns. There are at least four dignity concerns applicable here that lead to four ethical guidelines for human genome editing.

First, there is the concern that we protect the human person from harm . To respect the dignity of the human person entails that we act to preserve his or her life and well-being from unjust attack. Therefore, genome editing should be permitted for therapeutic interventions that cure, delay, or prevent disability and disease, as long as there is reasonable assurance that the technology is safe.

Second, there is the concern that we protect the human person from being objectified or commodified. As we noted above, to respect the dignity of the human person entails that we never seek to treat him as mere means to an end. Therefore, genome editing should not be permitted that would allow anyone, parents included, to genetically engineer children according to their own subjective desires. This would reduce children to products designed to fulfill the dreams of their makers rather than treat them as persons who should have the freedom to pursue their own aspirations. Parents who design their son so that he will become a tall basketball player are not taking into account the possibility that he may want to pursue a career where height is a disability and not an advantage! A child should be welcomed and loved. He or she should not be designed and manufactured .

Third, there is the concern that we protect the human person from being marginalized. To respect the dignity of the human person entails that we never seek to treat him as less valuable or less worthwhile than his neighbors. Therefore, genome editing should not be permitted if it will exacerbate the divisions and inequalities already present in our societies, reinforce social stigmas, or encourage the eugenic temptations that our societies face to eradicate undesirable traits and tendencies. As such, genetic interventions for nontherapeutic reasons, reasons usually associated with enhancing the individual’s personal or social opportunities, would be ruled out.

Finally, there is the concern that we protect the poor and vulnerable. To respect the dignity of the human person entails that we seek to respect the dignity of all persons regardless of their wealth or social status. Therefore, genome editing should not be permitted unless a genuine effort is made to ensure that there will be just access to this technology for everyone.

Debating Human Dignity in a Secular Society

For Catholic bioethicists, the claim for the intrinsic dignity of the human being can be justified in two ways. Philosophically, it is grounded in the nonreligious claim that the human person’s capacity for thinking is determinate in a way no physical process can be (Feser 2013). As such, she must be a spiritual being whose ontological worth radically transcends the limited value of purely material things. Theologically, it is grounded in the faith-based claim that the human person is made in the image and likeness of God. In the words of Pope St. John Paul II,

The dignity of the person is manifested in all its radiance when the person’s origin and destiny are considered: created by God in his image and likeness as well as redeemed by the most precious blood of Christ, the person is called to be a “child in the Son” and a living temple of the Spirit, destined for eternal life of blessed communion with God. (John Paul II 1988)

This transcendent and eternal destiny, justified by both faith and reason, is the fundamental reason for the human being’s intrinsic dignity, a personal dignity that is not dependent either upon his own or upon human society’s recognition (Catechism of the Catholic Church 1997).

Given how the intrinsic dignity of the human person is justified by Catholic and other faith-based bioethicists, it should not be surprising that its existence has been rejected by many secular bioethicists. In a much-discussed essay, Ruth Macklin dismisses dignity as a useless concept that means nothing more than respect for persons or their autonomy (Macklin 2003). Macklin writes that “dignity seems to have no meaning beyond what is implied by the principle of medical ethics , respect for persons: the need to obtain voluntary, informed consent; the requirement to protect confidentiality; and the need to avoid discrimination and abusive practices.” In addition, Macklin proposes that dignity “is nothing more than a capacity for rational thought and action, the central features conveyed in the principle of respect for autonomy” (Macklin 2003). She is not alone among secular thinkers who hold this view. In an essay where Steven Pinker condemns the “theocon” bioethicists who advocate a thick sense of human dignity, he writes, “The problem is that ‘dignity’ is a squishy, subjective notion, hardly up to the heavyweight moral demands assigned to it” (Pinker 2008). However, what is clear from his analysis is that Pinker, as do many other secular bioethicists, does not understand appeals to dignity among faith-based bioethicists because he fails to acknowledge the distinction between intrinsic and extrinsic dignity. For Pinker, dignity is only an extrinsic dimension of the human person that can be easily diminished or lost. It is a “phenomenon of human perception,” he writes, “just as the smell of baking bread triggers a desire to eat it, and the sight of a baby’s face triggers a desire to protect it, the appearance of dignity triggers a desire to esteem and respect the dignified person.” In my view, no one who grasped the intrinsic nature of dignity of the human person would ever compare it with the smell of baking bread.

In fact, every one of us voluntarily and repeatedly relinquishes extrinsic dignity for other goods in life. Getting out of a small car is undignified. Having sex is undignified. Doffing your belt and spread-eagling to allow a security guard to slide a wand up your crotch is undignified. Most pointedly, modern medicine is a gantlet of indignities. Most readers of this article have undergone a pelvic or rectal examination, and many have had the pleasure of a colonoscopy as well (Pinker 2008).

Therefore, in Pinker’s view, dignity is almost a useless concept. Once again, on his account, bioethics in a post-Christian and liberal society should be grounded not on respect for dignity but on respect for autonomy. It is autonomy that is inviolable, and not dignity.

From the perspective of the secular tradition of bioethics , therefore, it should not be surprising that for many ethicists, the guiding principle governing the ethics of human gene editing has inevitably emphasized protecting and preserving not the dignity of the human person but his autonomy, whether this is the parent’s reproductive autonomy or the child’s personal autonomy.Footnote 6 According to many who hold this view, human gene editing should be pursued to maximize the autonomy of the persons involved, again as long as it is safe and does not harm the health and well-being of another.

But in response, I have to challenge my secular colleagues: Why is autonomy inviolable? Why should it be respected and maximized? Why is it intrinsically valuable such that it trumps all other concerns, including many of the dignity concerns that Catholic bioethicists have proposed?Footnote 7 Some have argued that autonomy is intrinsically valuable because every reasonable person will always choose autonomy over heteronomy.Footnote 8 A person would always choose to make his or her own decisions rather than delegate those choices to others.

However, from the perspective of evolutionary theory , the capacities to think and to choose are mere evolutionary adaptations that are no more valuable than any other evolutionary adaptations in nature. In fact, expanding John Rawl’s proposal of a veil of ignorance to encompass all the species of the planet, it is not clear that it would always be reasonable to choose the human capacities of thought and choice over one of the other evolved adaptations, if one did not know the ecological niche one would find oneself once the veil is lifted (Rawls 1971). For instance, if I found myself in the Siberian tundra, I think that it would be more reasonable to want to be a polar bear with the capacity of hunting and fishing among the ice floes rather than to be a human being with the capacity of thinking and choosing yet naked and utterly helpless. And yet if I found myself in Boston, it would be more reasonable to want to be a human being rather than a bear. This thought experiment suggests that from the perspective of a post-Christian and materialist worldview, the capacity to be an autonomous agent – indeed, the capacity to be a person too – is not intrinsically more valuable than any other evolved capacity in nature. Its worth is relative because its value is dependent upon the environmental niche of the organism that may or may not have it. But if this is the case, why then should autonomy be respected and preserved? Why should it be inviolable?

I have not yet found a secular response to these questions that adequately explains why autonomy should be defended as an intrinsically valuable good. I do not think that one is forthcoming. In my view, Immanuel Kant and the other Enlightenment philosophers who invented autonomy (Schneewind 1997) simply presupposed a Christian worldview that proclaimed the exceptionalism of the human person made in the image and likeness of God.Footnote 9 Autonomy is inviolable because the human person who, in his very nature, thinks and chooses is inviolable. Autonomy is worthwhile only because it is an emergent capacity of the human person who is inherently worthwhile. Thus, pace Macklin and Pinker, respecting the intrinsic dignity of the human person is not the same as respecting their autonomy. The former justifies the latter, and the latter cannot stand without the former. In at least this one way, the tradition of secular bioethics is reliant for its own internal coherence and intelligibility, upon the rival tradition of Christian bioethics that it dismisses and rejects.

In conclusion, this chapter began with a discussion of the recent Pew Research Center study that revealed the striking differences between religious and secular attitudes toward the genetic engineering of the genomes of babies where religious Americans are more likely to view gene editing of babies as taking medical technology too far. Some of these disagreements, in my view, can be traced to the divergent accounts of dignity presupposed by the respondents. Accordingly, religious Americans, most of whom belong to the Judeo-Christian tradition, would be wary of any technology that could undermine the dignity of the human person, especially his or her intrinsic dignity that is inviolable. In contrast, the secular American tradition may be more permissive of technological advancement in the name of preserving individual liberty and reproductive autonomy. Though there are those who think that these two perspectives are incommensurable and therefore irreconcilable, I have proposed that the secular tradition actually needs an account of intrinsic dignity to justify its autonomy claims. As such, to remain coherent and intelligible, both sides should be able to acknowledge that in cases where dignity concerns apparently come into conflict with autonomy concerns, dignity should trump autonomy because the former in the end grounds the latter. Dignity makes autonomy valuable.