He Jian-Kui vs. Christiaan Barnard: A Tale of Two Ethical Transgressions

As I write this post, He Jian-Kui, the Chinese scientist who claimed to have brought about the first gene edited babies in history is reported “missing,” having been seen last at an international meeting of scientists where his experiment was widely criticized on ethical grounds.

It is too soon to know if he is being detained (or worse) by the Chinese authorities, but the case brings to mind another “first” with important ethical consequences.

In his outstanding book, Thieves of Virtue: How Bioethics Stole Medicine, Tom Koch (our guest on our latest podcast episode) mentions the story of the legendary South African surgeon Christiaan Barnard.

Barnard was an extremely ambitious man who was racing to be the first doctor to complete a heart transplantation. He achieved his goal in 1967 by taking the heart of a woman who had sustained a severe traumatic brain injury but was still alive.  So Barnard killed the woman by injecting potassium chloride into her heart at the urging of his brother Marius, who kept the action a secret for 40 years. (This fact is not mentioned by Koch, but is related by Donald McRae in his book Every Seconds Counts).

The Barnard brothers kept their action secret because killing a patient to take her organs would rightly have been viewed as abhorrent.  Within a month of the operation, however, Harvard ethicists began working on how to make such an action no longer fraught with ethical difficulties.  As we learned from Dr. Alan Shewmon, equating absence of neurological activity with death was a step deliberately taken with a view toward making organ transplantation widely available.

I don’t know what fate awaits Dr. He Jian-Kui, and I hope for him that—if he is in custody of the Chinese government—he be treated justly and ethically.  Unlike Barnard, who understood the limits of what was acceptable and what could be revealed, Jian-Kui seems to have been over-confident that his prowess would receive the same acclaim as Barnard’s did in 1967.

What remains to be seen is how the bioethical community will react to the ever-changing technological powers once the dust of this affair settles.  Will it adopt a principled approach to the question or will it, as Tom Koch’s book shows admirably, continue to provide ethical cover and philosophical rationalization to defend the interests of the technologically-oriented and utility-guided state and corporate apparatus?

Ironically, the Chinese government which is claiming that He Jian-Kui’s gene editing work is “extremely abominable” has no compunction harvesting organs from political prisoners.  (You may want to hear the gut wrenching account of that practice in Eric Larson’s excellent podcast episode here.)

In the consequentialist culture we live under, what is ethical and what is not is frequently a matter for the powers-that-be to decide.

Related podcast episodes:

Ep. 50 Thieves of Virtue: How Bioethics Stole Medicine

Ep. 35 Why Brain Dead Isn’t Dead: An Introduction to “Shewmon’s Challenge”

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