Conclusion

History, even very recent history, can be held to up to the prognostic ability of bioethicists who reflect on the future and predict its course. How has bioethics as a field done, in this way, against the unfolding of the knowledge only speculated about in the 1990s? To be sure, few if any of the predicted catastrophic or euphoric scenarios have occurred in any empirical way.

Is it prudent to have concerns about the potential consequences of genetic knowledge? To be sure. It has been fears and not faith that have driven the thoughtful design of many of bioethical regulations. Fearsome events may well await us, but the trends have not been in that direction, as a review of the world since the 1990s teaches. To the contrary, the importance of families has not waned, nor have kindred and kind been neglected. Children, as families have chosen to have fewer children overall, remain highly valued, and the bond between generations seems entirely unaffected at least by genetic testing, although there has been increased vigilance in all matters genetic. A deeper sense of faith in the ethical and moral integrity of research and in the core duties of medical science may well be in order.

By 2003, there were new laws, and far more robust ones, that protect privacy and insurance misuse; there also existed national oversight bodies in most industrialized countries, and bodies at the international, national, state, and non-governmental organization (NGO) levels, to regulate or at least publicly examine genetic policies and techniques. Bioethics centers and ethics debate in general flourished at the beginning of the twenty-first century, despite new and pivotal research in genetics taking center stage in many science policy debates. The President of the United States, George W. Bush, made human embryonic stem cells the subject of his first public address, and the U.S. Congress debated the science and ethics of genetic policies, especially cloning and genetic modification. The ethical discourse about meaning and agency moved from the academic margins to the center of the debate. Decades after James Watson, Francis Crick, Rosalind Franklin, and Linus Pauling moved the chemistry that enabled the basic theory of genetics towards the modern intellectual project of genetic sequencing, and decades after computational and structural biology coalesced this sequence into a credible account of how human persons develop, few would claim a victory for an unreflective position in the debates about the influence of nature versus nurture.

The human genome, our nature, is clearly understood as responsive and interactive with the environment, adaptive yet constrained. Few can credibly deny the reality of the genetic-protein explanation of the physical world. It is, for now, the best account of the phenomenological terrain, and it is the text and tool that facilitates the exploration of the details and the variable of our human selves. Will we reach unbreachable ethical boundaries in this terrain? Will the "moral harm" that might exist become too dangerous to contemplate, and will the existence of moral harms outweigh moral duties to simply know and name as much about the world as we can? Are there horizons beyond which we cannot venture, and entities we ought not to know, mysteries that allow humanity to exist? Or have we a human duty to our human curiosity? Can one argue for a duty to heal and in the pursuit of the goal of healing, allow for all knowledge, and all pursuit, no matter where it might lead? Such worrisome questions remain, despite both increased regulatory efforts and a series of gravely sobering and stochastic human events. An article such as this can only hope to highlight competing moral appeals as they emerge in the literature of bioethics and in the literature of science—it cannot hope to solve the quandaries, and humility in prognostication about our genetic future, for good or for ill, would be a wise and prudent path. Genetic knowledge places us in a position of unprecedented choices—not yet about our final telos, but in a very real way, in a position to understand both the gravity and the temptations of the road we travel there.

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