The alleged blindness of nature
can certainly not be guided by the ethical blindness of a mankind that is still under the illusion
of being the measure of all things.

The guidelines for the genetic diagnosis of sterile couples, presented by Foresta in this issue, lend themselves to various considerations of a philosophical nature, not only from an ethical point of view, that is in connection with what is right to do under certain circumstances, but above all from an epistemological point of view, that is at a stage of knowledge which methodologically precedes the actual ethical issues.
The Document produced by Foresta clearly provides an empirical datum: medically assisted procreation (and in special way extracorporeal fertilisation) may actually become a powerful ally in the transmission of both sterility and various genetic diseases, some of which are today diagnosable but not as yet curable. First of all, it is worthwhile emphasising a paradox: a fact which has so far been evidently impossible, that is the inheritability of sterility, has now become, thanks to technology, a fact which may actually undergo an uncontrollable growth.
This impossibility, which was quite obvious in ordinary terms, indeed corresponds to the evolution principles typical of nature which organises (so to speak) mechanisms that brake the propagation of any factor preventing either its preservation or evolution. What we are facing here is not a philosophical theory or a scientific hypothesis, but an empirical datum, which of course needs to be interpreted but certainly cannot be ignored. In many cases, male or female sterility tends to be related to the existence of genetic pathologies that in actual fact remain restricted to the individual patient, whereas the species is, so to speak, safeguarded from them. Now, the value of so-called assisted procreation has often been related to its therapeutic potential, which is in actual fact denied. Indeed, not only do these techniques not cure the patient suffering from certain pathologies, but they are very likely to contribute to their diffusion.
This involves new and unusual responsibilities towards future generations, as well as new matter for thought with regards to the path unwinding before medicine. As we know, the advances of western medicine have enabled mankind to coexist with several pathologies, transforming them into chronic diseases when it was not possible to cure them. But fertility and sterility represent special conditions, in that they do not directly affect the well being of the individual, but the coming into existence of another being, a child. Now, man has for a long time theorised, especially in the field of biology, some sort of axiological and teleological neutrality of biology. Especially thanks to a famous and successful work by Monod, biological evolution has been represented in terms of casualness and necessity.
But the denial of nature’s teleologicity did not simply correspond to a scientific hypothesis, but to a philosophical interpretation of nature and to an anthropological notion based on certain epistemological assumptions. Professing ‘blind’ evolutionism meant viewing man as the only party capable of directing nature, that is the only teleological element in nature, so to speak. The concept of blindness (similar to that of destiny) successfully lends itself to the description of a process that is necessary but aimless, similar to the moving to and fro and to the disorientation of a blind person groping in the dark. Of course, as Hans Jonas has often pointed out, this theory continues to be overhung by the aporia of a blind nature that, at a certain point, produced a being (man), capable of aims and projects.
Therefore teleological nothingness (that is nature proceeding out of necessity but without internal logic) would give birth to the only element capable of ruling nature itself. The extent of the scientific and of the philosophical contribution to this interpretation of evolution has for a long time been a subject for discussion. But a similar interpretation of life and of its dynamics corresponds, in any case, to a cultural process which has changed from the conviction of nature’s sacredness (which is still typical of certain immanentistic notions of reality and of certain eastern religions) to that of its inherent purpose (of which man was the outstanding example) up to the profession of nature’s “neutrality”, both from an axiological and teleological point of view. This last thesis owes a lot to Kant’s crucial gnoseological acknowledgement of man’s position as the source of reality’s significance and purpose. But the statement that a telos exists in nature involves the acknowledgement that the intelligibility of the empiric world does not depend on human intelligence (which grants a meaning to things) but on empirical reality itself. Those who, more or less explicitly, state that the intelligibility of the real does not depend on man, who is capable of interpreting, directing, and even altering and distorting intelligibility at will, have identified in the normal and pathologic pair a useful criterion to approach life. In actual fact, medicine has displayed a naïve (but not groundless) trust in the intrinsic dynamics of vital processes, and has been capable of developing by intelligently imitating what nature suggested in its spontaneous dynamics when questioned through the tools of technique.
The development of technological power, which largely depends on man’s inherent existential tension, enables today to direct evolutionary processes in a manner which may directly oppose what so-called blind nature has created over millions of years, enabling man to live and progress. When Potter invented the term bioethics, thus attempting to place a bridge between scientific practice and human values, he after all invited people to think about these new and unusual responsibilities that man has towards both nature and environment on one side, and his own human condition on the other. With extracorporeal procreation, which imitates the fertilisation processes of other species, such as fish for instance, two types of problems have in fact been generated, which are strictly related to each other but may be theoretically distinguished. The first one relates to man viewed as a pure biological structure, as a mammal affected by a disease; the other one relates to man as an ethical individual, in his anthropological specificity. The fact that medicine, and in special way certain areas of reproductive medicine, may have thought that the ethical issues related to human generation could be solved by simply complying with the desire for generation has led to the conviction that the chief issue involved was the result (the “child” in one’s arms), whereas the means resorted to for the purpose represented a minor issue. It appears obvious today that the means is not neutral, neither from an anthropological nor from a biological point of view: solving the problem of sterility without going through the treatment and restoration of reproductive functionality leads in fact to an expansion of the pathologic conditions to future generations. The internal logic of biological processes, if studied carefully, makes it possible to understand the need to review the concept of casualness and neutrality in biological terms.
Human desire cannot, on its own, rule the ethical and biological value of reproductive processes. Also in the recent discussions relating to the feasibility of human cloning, a major role has been plaid by the problem relating to this connection, which no reductive notion of man is in a position to solve. It is not necessary to go back to an inadequate and false notion of nature’s sacredness to understand that the biological dynamics are not casual and that human intelligence is only capable of obtaining good results when it rediscovers the inherent intelligibility of nature, and refers to it as a standard for human behaviour. Indeed, it is not by “chance” that many objections against human cloning today result from the awareness of the genetic and biologic “risks” the generated being would be subject to. Relying on fear as a criterion for action (even if it is only fear of giving birth to children affected by pathologies or malformations) is not certainly sufficient. Indeed, the ethical positive value of a human action cannot simply be based on the fear of its consequences. But this “fear” may actually play a significant role if it encourages us to reconsider the human condition. It is not a matter of opposing a fear-principle to a hope-principle (which would lead us to an inconsiderate experimentalism), but of resuming a coherent perspective towards life and its phenomena. Without lapsing into biologism, that is in some sort of re-sacralization of nature, which would lead to fatalism and resignation in facing diseases, we can reconsider the biological aspect of man as a significant factor, capable of suggesting what is the right thing to do whilst fully respecting man and the complex and articulate human condition. The classic idea (so to speak) of the cure and of the rediscovery of the ethical and not simply practical limits of human action may once again act as a guideline with respect to man’s pathologic conditions. Overcoming a disease is, after all, a moral duty (even though it is not an absolute duty when other human values, such as life dignity, are at stake).
Doctors, who are involved in the complex task of searching for the means to overcome sterility, are directly called not only to take upon themselves the responsibilities deriving from their actions towards actual and future generations, but also to exercise such responsibilities with the clear awareness of the theoretical and practical premises conditioning their work. The progress of science (which nobody abstractly wishes to oppose) is strictly related to the discovery of guidelines that do not relate only to practise but also directly relate to the ethic and philosophic aspect of research. As it often happens in the history of man, it is once again reality, with its internal logic, to awaken us from our Promethean dreams and to ensure that we do not rely on the comforting myth of a power capable of proceeding based on the criterion of human desire and projects. It is unlikely that man will be able to rule and direct nature’s processes if he does not first get some practice in ruling himself, by rediscovering the sense (meaning and direction) of his own existence and work.
The alleged blindness of nature can certainly not be guided by the ethical blindness of a mankind that is still under the illusion of being the measure of all things.

Adriano Pessina

Docente di Bioetica
Università Cattolicxa - Milano