OFF CENTRE: Qualified opinions on a matter of Life: MILLENNIUM JURY: There are always moral dimensions to scientific discoveries, Carl Djerassi, inventor of The Pill, tells Christian Tyler in the fourth of an occasional series of interviews on topical issues at the turn of the century
Financial Times ; 14-Aug-1999 09:09:03 am ; 1730 words
Technology moves faster than our capacity to handle it. Perhaps that was always the case, right back to the invention of the wheel.
But it seems to be moving particularly quickly at the moment, and throwing up some of the toughest questions mankind has ever had to answer. From cluster bombs to hydrogen bombs, from genetically modified crops to genetically modified humans, our ability to alter the state of nature has never been so formidable.
We are constantly being forced to ask ourselves where the limits of human intervention should be set: Is nature sacrosanct? How natural is "natural", anyway? How safe is "safe"?
Carl Djerassi is called the father of The Pill, although he thinks it more accurate to describe him as the mother. In 1951 he led the small team of Syntex research chemists in Mexico City, which was the first to synthesise a steroid oral contraceptive.
Controversial from the start because of its physical side-effects, the birth of the Pill is seen today as a major sociological event. Hailed as an agent of women's liberation (though a few feminists hated it) it is now condemned by some moral conservatives as an agent of male irresponsibility, sexual licence and the breakdown of the family in the west.
The infant Djerassi was a spoiled and curly-haired child who grew into a ladies' man. He is dapper, dress-conscious and immoderately youthful-looking for someone of 75. He never lost his Viennese accent. He has his own website, where he advertises his books and his lecturing schedule. But personal vanity has been tempered by misfortune - above all the suicide of an adored daughter - and his autobiography, though introspective, is generous to other scientists and modest about his own achievements.
Few people can be held accountable for everything that flows from their work. Djerassi has had 50 years in which to ponder the meaning of that youthful discovery (which in scientific terms, he says, was not his biggest). If his conclusions are somewhat contradictory, that is hardly surprising.
For this chemist straddles cultures. He is not only a laboratory scientist and teacher, but a business entrepreneur who held board meetings during lunchbreaks at Stanford university.
He is a multimillionaire who collects Paul Klee's art and owns a ranch in the Santa Cruz mountains of California called SMIP, ("Syntex Made It Possible").
Yet he gives away, he says, most of his income. He lives in a country where plagiarism and cheating are becoming frequent even in the laboratory, and where the simplest moral issues - sex and guns, for example - are seen as problematic. "The United States is both the most prurient and the most puritanical country in the world," he said.
Like many successful immigrants - his father was Bulgarian, his mother Viennese - Djerassi believes the rich should help pay for the poor. He drives an old Volvo and his third wife, Diane Middlebrook, a professor of literature at Stanford, owns a 10-year-old Mazda. He flies business class though he can afford to travel first class.
We met in the London flat where he spends the summer. I asked him: If you knew then what you know now about the effects of the Pill, would you have said 'I think we'll give this one a miss'?
"Absolutely not. I would do exactly the same again." As for the side-effects, he said, it was a case of Catch 22: the only way to test its long-term safety was to let women take it for years. His regret is that research into contraception has dried up, denying women a wider choice of methods.
And its effect on the sexual revolution?
"I would say it's a grey issue. It's simplistic to say the Pill caused it. There was rock and roll culture, and the rest of it.
"What they say about family bothers me very much, however. Are they saying that only the fear of pregnancy was maintaining high ethical standards, maintaining the family? That moral conduct was enforced by threat? Are they saying people only refrain from killing, outside of war, because they are afraid of being caught?
"I say no moral conduct is worth maintaining if one can only enforce it by threat."
As for young men refusing to accept the responsibility for getting a girl pregnant, the answer was to do something about the "abysmal quality of sex education" in the US and elsewhere.
Ten years ago, the chemistry professor turned to writing novels and plays - not science fiction, he emphasises, but sciencein fiction. He gets his students to discuss ethical puzzles. By these means he hopes to broadcast the moral dilemmas that scientists feel but too often suppress because of their own tribal culture, and the much bigger dilemmas their discoveries pose for the rest of society.
"Science in my opinion has no ethical dimension," he said. "Ethics starts with individual scientists. Not only is science neutral, you don't even know what you are going to discover. Yet the moment a scientist starts getting some answers, ethical questions enter."
The story of the Pill, the first medical treatment for healthy people, shows that the chain of responsibility is a long one. Basic science is one thing, technology another, even if the division between them is not always clear. At what stage along the line from theoretical idea, to experimental research, to clinical application, does the moral buck stop?
Djerassi and his team at Syntex did not set out to invent the Pill. Like so many breakthroughs, it was a spin-off from another project, just as the non-stick frying pan was a spin-off from the space programme.
"So it's unrealistic to demand of the scientists who pioneered in vitro fertilisation or single-sperm fertilisation that they should know the ethics," he said, "even if human reproduction without sex raises enormous ethical questions.
"These are social questions which society must answer - I mean the individual citizen, leading eventually to legal action."
The trouble with this prescription is that it assumes a lot of public understanding, at a time when science is getting more specialist, scientific education more unpopular, scientists themselves more defensive in their dealings with the outside world.
"We are talking really in a strange language and we need interpreters," Djerassi agreed. "The reason I write is that I want society to understand the culture, behaviour and motivation of scientists, not to glamorise or revere them."
If the public - which includes the politicians - cannot keep up, if religious leaders no longer have the power to pronounce, how will decisions be made?
"This is where the scientist comes in. He has to be detached from his own baby, his invention. He must communicate, and ideally this should be done continuously, at all stages."
Djerassi does not believe in moral absolutes, apart from injunctions such as Thou Shalt Not Kill. Culture was what determined attitudes, and cultures vary across the world. In most cases the right response to medical innovation was "Yes, but . . ", in others "No, but. . ."
Does it bother you that there is no common framework?
"I think you ask an impossible question," he answered. "Yet at the same time you give me, a non-religious person, the only justification for religion. Perhaps that is its real function. It isn't just a crutch. Perhaps it is the only way in which we can establish moral frameworks. But I still think it is difficult to talk about universals."
Scientists were often on the defensive these days, he agreed. "They spend so much of their working life on socially beneficial things, not bombs and poison gases, and they feel they are getting pretty well maligned."
Djerassi had been angered by ill-educated attacks on the products of scientific discovery, but felt calmer now that he was trying to set the record straight by writing. "We are accused of playing God," he added. "But if there is a God, he has made it possible for us to do these things. People talk about things being 'unnatural'. What is natural? Is it natural that we have doubled our life span in the last century?"
The example was not picked at random. For Djerassi identifies a bigger and broader issue behind the ethical application of medical science: the division of the world into a "geriatric" northern hemisphere and a "paediatric" southern one.
"Why? Because we are practising death control more effectively than they are practising birth control."
It was a world in which one fifth of the population consumed 90 per cent of the resources, where, according to a recent UN report, a 1 per cent annual deduction from the richest 200 individuals would buy primary education for every child.
"Tithing on an international scale would be reasonable. I would say make that compulsory: 1 per cent from every billionaire."
Fertility treatment in the US cost between Dollars 20,000 and Dollars 100,000 a couple. "The money it costs to produce one child for someone who was not meant to be a parent could maintain the lives of thousands of children in a poor country, children already born naturally. This is where one can ask: is it, or is it not, indecent?
"I do not want to give the answer because I could take either side of the argument. It is a perfect case of 'Yes, but . . .'or 'No, but . . ."
Djerassi says "Yes, but" to genetic engineering. He says Yes to screening the human embryo for serious handicaps such as Down's Syndrome and cystic fibrosis, before reimplanting it in the uterus. (The problem here was that only the rich can afford it.) He says "No, but" to cosmetic engineering. "Suppose you could specify - 6ft tall, blue eyes, straight nose - I would say that's bullshit. But, there might be a few cases
"We're almost there with sex predetermination. That would be terrible in a place like China where they only want males. But, if a family has four daughters and wants a boy, why not?"
The only way to settle the issues was by "continuous dialogue", he said finally. "It's the rights of individuals against national - or world - standards. But I don't think scientists are in the best position to make such statements.
"I don't know more than anyone else."