The Morality of Genetics
Moral Maze
BBC
4.5 • 609 Ratings
🗓️ 21 November 2019
⏱️ 43 minutes
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Summary
Doctors of medicine swear the Hippocratic Oath, written some 2,500 years ago, declaring that they will protect the confidentiality of their patients. Sometimes they break that promise and are criticised; sometimes they keep it and are criticised. This week a woman is suing an NHS trust for not telling her about her father’s Huntington’s disease, which doctors had already diagnosed when she had her own child. Only after the child was born did she find out that she also carried the faulty gene for the degenerative, incurable brain disorder – with a 50% chance of passing it on. Her father had told doctors he didn’t want her to know because he feared she might kill herself or have an abortion. This tragic case is at the centre of a moral tussle between the duty of confidentiality and the duty of care. If our right to medical privacy is intrinsic to our freedom, security and sense of self, when – if ever – should it be overridden to prevent harm to others? That’s a problem doctors have faced for a long time, but now inherited conditions are setting us another moral conundrum: science is giving us the power to eradicate many of them entirely, through gene-manipulation. So, should we press on with stem cell therapy and selective IVF? Or should we slam on the brakes, conscious of the perils of playing God and of creating a world in which prospective parents can order the characteristics of their designer babies from a tick-box à la carte menu? Featuring Dr Michael Fay, Sir Jonathan Montgomery, Sandy Starr and Dr Helen Watt.
Producer: Dan Tierney
Transcript
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| 0:00.0 | You're listening to a program from BBC Radio 4. |
| 0:04.3 | Good evening. Confidentiality has been a central tenet of the doctor-patient relationship for two and a half thousand years. |
| 0:10.3 | Since Hippocrates, the physician of Koss, made it part of the eponymous oath, the medical profession, abide by to this day. |
| 0:17.4 | No matter, the oath is sworn to Apollo and a whole pantheon of Greek gods long out of favour. |
| 0:22.2 | No matter it was originally as much to protect the physician's tricks of the trade as the patient's interests. |
| 0:28.1 | The Stritcher still stands. |
| 0:30.2 | But now a case in the High Court could challenge the ethical primacy of medical confidentiality. |
| 0:35.4 | A woman known only as ABC, for reasons of, well, confidentiality, is suing an NHS trust |
| 0:42.1 | for not telling her that her father was suffering from Huntington's disease, an incurable |
| 0:47.1 | degenerative condition with a 50-50 chance of being passed on to the next generation. |
| 0:52.6 | Not knowing, she became pregnant. Her father said |
| 0:55.9 | she shouldn't be told because he feared she might have an abortion or even kill herself. |
| 1:01.0 | In the end, she found out by accident. It turns out she has inherited the condition. Her child |
| 1:06.6 | now has the same even chance of having it too. Her case is that the doctor's duty of care to her |
| 1:13.4 | should have outweighed their duty of confidentiality to her father. It's a painful moral calculation |
| 1:19.7 | as well as a difficult legal judgment and it opens the way to a wider question. We may have it |
| 1:25.5 | in our power with a combination of selective IVF and abortion, |
| 1:29.8 | gene manipulation, stem cell therapy perhaps, to eradicate all sorts of heritable conditions, |
| 1:36.0 | but at what, if any, moral cost? That's our moral maize tonight. The panel, the libertarian author |
| 1:41.4 | Ella Wheelan, the historian Tim Stanley, the chief executive of the RSA, Matthew Taylor, and the priest and polemicist, Charles Fraser. |
| 1:48.4 | Ella, Ella Weillan, if you had been one of these doctors, would you have told her? |
| 1:53.3 | I think that, yes, possibly, but I would also argue for the baseline to always be erring on the side of trust in doctors to keep confidentiality |
... |
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