“So then you get into how far do we let people go?” he asked. “We don’t go tell people if they can or can’t create children and how or with whom … but once babies are born you’d think we have some ability to control what some people will do, but we really don’t, parents get to decide what they want to do with their children.”
Presently, Kahn anticipates addressing issues that could be raised about use of reproductive technology regarding a three-person in-vitro fertilization, used to avoid mitochondrial diseases.
Some women carry risk of passing on severely debilitating or fatal mitochondrial diseases (that only affect boys), which occur in the mitochondria, not in the nucleus of an egg, explained Kahn. Previously the only way to combat that situation has been to adopt a child or secure an egg donor. But now there is a process that combines the nuclear DNA of Woman No. 1 — who carries mitochondrial risk — with the healthy mitochondrial DNA of Woman No. 2. The newly
created egg is then fertilized and the developing embryo is implanted in Woman No. 1, resulting in an egg that contains DNA from two women and one man to create a baby.
Though the vast majority of the DNA comes from the nucleus of Woman No. 1 (with mitochondrial risk), Kahn explained, an ethical question still arises because “we don’t know the implications of having two women’s DNA” in the creation of a baby.
“We know how to think about the ethics of research on human subjects,” Kahn continued, “but we don’t know how to think about the ethics that creates human beings. It’s like what they should have been talking about when the first test-tube baby, so called, was born.”
Kahn explained that it may be easy for the parents in a three-person IVF situation to say they’re willing to accept the risk on behalf of the future person for whatever issues might arise, “but in this case it’s hard to even articulate what it is you’d be speaking for, it’s a not-yet-born person.”
This is just a small example of the grey areas in health and medicine Kahn and his colleagues grapple with on a daily basis. He anticipates committees forming and wrestling with questions on cases like this because these IVF tests have been successful on primates, and there is the desire and willingness by clinics and patients to employ the technique.
Kahn admits his Jewish upbringing has influenced his career, but he does not consider himself a “Jewish ethicist” nor does he want to conjecture that coming from a background of Judaism has an advantage in the ethics field.
“But I can’t say that the way I think about the world isn’t informed by the fact that I’m a Jewish person,” he said, “and care about my Jewish identity and learned about Judaism over the course of my entire life.”
Kahn attended Hebrew school and confirmation class, and he also attended the Brandeis-Bardin Institute, where, at the time, Dennis Prager was director and Rabbi Joseph Telushkin was also on staff. Kahn and his wife, Orlee, are members of Beth El Congregation.
“[Bioethics] appeals to a person who is brought up in an environment of questioning, where uncertainty is not something to be feared or avoided,” said Kahn. “There’s a lot of ‘on the one hand, on the other hand,’ which feels very Talmudic.”
The Berman Institute is also working to define what is required as the core of the study of bioethics. Now, all degrees in the field are interdisciplinary, combining the study of ethics and other fields such as philosophy, medicine, law, nursing, psychology, anthropology or history.
Kahn said the main goal of bioethics is to help the people who work in the fields of medicine, biomedical research, food policy and the basic sciences succeed in what they are working to achieve “without crossing lines or falling prey to unethical aspects.”
“We try to make the world better by helping people make ethically acceptable or better decisions from an ethics perspective,” he added, “and help make policy to navigate those difficult decisions, as new things arrive and evolve and confront us.”