AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. July 2000, Volume 2, Number 7.

Images of Healing and Learning

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The Biology of Ethics: Genetics, Evolution and Moral Behavior

The journal invites students to share their medical training observations captured in photographs by highlighting a drawing of a DNA double helix as a symbol for the role of ethics in genetic research.

Since the publication of Charles Darwin's Origin of Species in 1859, considerable attention has been devoted to the question of whether our moral behavior can be related to our biological nature. Darwin's thesis - that traits arise over time for the benefit of survival — has raised questions pertaining to the nature of human action, the origin of moral behavior and personal responsibility. Can moral behavior — as a trait of human action — be explained as an adaptive strategy for human survival in terms of the evolutionary process? If so, what are the implications of a biological model for moral (or immoral) behavior?

In the century and a half since Darwin's seminal work, the search to find the mechanism for biological trait expression has led to the discovery of the DNA double helix and, more recently, to the Human Genome Project. On June 26, 2000, Dr. J. Craig Venter, president of Celera Genomics, and Dr. Francis S. Collins, director of the National Human Genome Research Institute, announced the completion of a working draft of the human genome which identifies the more than 100 000 genes in human DNA and will determine the sequences of the 3 billion chemical bases that make up human DNA. As the variations of these sequences are collected and analyzed, this information will lead to a more explicit understanding of trait expression in organisms. DNA model
This model of DNA appears courtesy of the Image Library of Biological Macromolecules, based in Jena, Germany.

Conceptual and philosophical questions abound regarding the implications of genetics for human behavior, and have given rise to concerns about notions of genetic determinism and human responsibility. Knowledge about the genome is becoming an increasingly significant element in the relation between individuals, institutions, and political bodies. Not suprisingly, then, fears of discrimination based on genetic profiling have lead to scientific discussions previously assigned to the realm of human rights issues.

To protect against the discrimination based on genetic profiling, the International Bio-Ethics Committee of the United Nations Educational, Scientific and Cultural Organization (UNESCO) has put forward a Universal Declaration on the Human Genome and Human Rights which was adopted by member nations (the United States withdrew from UNESCO in 1984) on November 11, 1997. The UNESCO Declaration attempts to set up guidelines to protect freedom, autonomy, privacy, and confidentiality for all investigations related to one's genome sequence. It also specifically warns against notions of genetic determinism:

Article 2: "a) Everyone has a right to respect for their dignity and for their rights regardless of their genetic characteristics, b) That dignity makes it imperative not to reduce individuals to their genetic characteristics and to respect their uniqueness and diversity."

The answer to the question posed by Darwin's work of the 19th century, as to whether human behavior and morality is the result of evolutionary modification, may well remain unanswered until well into the next century. As of yet, the results of the human genome project do not address the unique — and potentially problematic — evolutionary interactions between genes and environmental influences, and those between genomic inheritance and social influences.

To protect individuals against policies that may discriminate on the basis of genetic information and unproven conceptions regarding behavior and genetic determinism, the ethics of genetic research may do well to draw on principles of human rights such as those outlined in the UNESCO Declaration.

Healing and learning seem to be paired processes, occurring together throughout human activity. But nowhere are these processes as prominently seen as they are during medical training.

For most students, the medium that most readily lends itself to retaining some visual memory of a succession of fleeting moments is the camera. Through photographs, the highlights of yesterday's happenings remain vivid and communicable to others. The subtle interplay of light and shadow that renders a photograph unique may even be likened to the delicate shifts that characterize interactions between patient and physician or between student and teacher.

We invite students to send photographs portraying aspects of healing and learning. Accompany your photos with a description of what is captured in the image and the special significance the picture has for you. Through these images, students can communicate their personal perspectives on medical training and share their observations and reflections with others.

Each month, a selection of photos and descriptions will be posted on this page.

Include 1-6 large, glossy photos with:

1. Title and description of photograph(s)
2. Student's name, address, phone, e-mail, and medical school

Send your images of healing and learning to: Audiey Kao, MD, PhD, Institute for Ethics, AMA, 515 North State, Chicago, IL 60610

The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.