I first encountered the art of Patricia Piccinini in 2003. She had shot to global fame representing Australia at that year’s Venice Biennale. I was in the process of writing a book, Stem Cells: Conflict at the Frontiers of Science.
One of Patricia’s key pieces in the Biennale was We Are Family, a shockingly realistic sculpture of a mother with her babies. Their pink fleshy bodies are pig-like but their faces and expressions are human. Three of the babies are suckling; a fourth gurgles on its back, clutching its foot just like a human baby. I was dismayed by the piece – it seemed to embody even more of the dystopian reaction to stem cell science I was trying to battle with my book. But scientific developments of the past two years have forced me to do a double take. I now view Piccinini’s work as providing a compelling space in which to explore the fast-changing contours of the ethical landscape.
Fifteen years ago Patricia and I were both responding to a scientific revolution. In 1998, researchers in Australia and the United States finally cracked the problem of how to cultivate stem cells from human embryos. Like the embryo, these cells had primordial power – they could multiply and give rise to any organ. But unlike a human embryo, which rapidly relinquishes that power as it morphs into a body, stem cells kept their power forever. The potential was obvious. Like Prometheus stealing fire from the heavens, embryonic stem cells captured the stuff of human life. Any number of human illnesses and injuries might be cured – a new pancreas for a child with juvenile diabetes, new spinal nerves to restore movement in a paralysed person, or new brain tissue to replace the loss caused by Parkinson’s disease.
Dystopian narratives abounded as the Australian government, like others around the world, debated how to capture this biological fire without being burnt. In my view, those narratives were not useful. There were also several ethical arguments mounted against stem cell science. One that seemed to gain the most traction was that it was unethical because it required the destruction of human embryos – strange given these five-day-old embryos did not have a single nerve cell, were ‘surplus’ and, hence, destined to be thrown out. Furthermore, even with fully mature human beings, we harvest their organs when they die to save the lives of others.
Another argument proposed that even if the initial uses of stem cells were acceptable, the ‘slippery slope’ of technology would seduce society into going places it shouldn’t. One of the key dystopian tropes involved chimeras – creatures that are a mix of more than one animal – just the sort of idea Piccinini had given form to with her ‘young family’. Piccinini’s work catches you unprepared – it is the slippery slope in action.
In my book I argued there is no such thing as the slippery slope. Technology is not in the driver’s seat. There are checks and balances. At each point along the road we decide whether or not to continue on our journey. For me, an important example of the robustness of those checks and balances was the genetic modification of human embryos. The technology has existed since the 1970s; it is the same technology that has created goats with spider silk in their milk or fast-growing pigs. Yet decades on people were not being genetically engineered.
We had drawn a moral line in the sand – for good reasons. One was the unforeseen biological consequences; after all, our gene pool is the result of millions of years of natural selection. The diversity and imperfection we see in the human population reflects an optimised set of genes that allow us as a species to survive plagues and changing climates, and to adapt to new food sources. That has led to genetic trade-offs. For instance, to make the haemoglobin that carries oxygen through the bloodstream you need a beta globin gene. If you inherit a ‘sickle cell’ form of the gene you are at risk of anaemia and blocked blood vessels. On the other hand, you are protected against dying from malaria. But what of the other genetic trade-offs we don’t know about? For the sake of future generations and the plagues and cataclysms they must face, it has been considered too risky to tamper with a genetic legacy we don’t entirely understand.
Another argument against the genetic engineering of embryos is the concern about creating a genetic upper caste. As bioethicist Laurie Zoloth has warned, our knowledge of unforeseen consequences is too poor, our capacity for greed and narcissism too strong, and our society already too unjust to begin to design babies to a spec sheet.
According to Zoloth, who served on the US Recombinant DNA Advisory Committee, genetic engineering of human embryos “has been rejected by every political, religious and ethical body that has considered it”.
So in 2015 it was a shock when Chinese scientists announced they had crossed that moral line. They had genetically modified human embryos to correct a defect that causes beta thalassemia, another type of anaemia. The modified embryos were not capable of becoming babies; they were faulty embryos, rejected from an in-vitro fertilisation clinic because they had been fertilised by two sperm. Nevertheless, the experiment heralded the beginning of another revolution.
This modifying of human embryos had been enabled by a new technology. CRISPR is a form of genetic engineering so precise it has been renamed ‘genetic editing’. Traditional genetic engineering was clumsy; to successfully engineer a single embryo required attempts on hundreds or thousands of embryos. This degree of waste was deemed acceptable with animal embryos but not with the 10 or so embryos a woman typically produces during an IVF cycle.
Like many others I was amazed: there was no moral line in the sand after all, and technology was driving us to a place we had not intended to go. While Francis Collins, the director of the US National Institutes of Health (NIH), proclaimed his agency would not fund research viewed “almost universally as a line that should not be crossed”, other organisations like the US National Academy of Sciences took a different view. The academy argued that while the risk of mistakes was too high to allow a genetically modified embryo to develop into a baby, research to refine the embryo editing technique should continue. And it has.
Researchers are concerned human cells will contribute to the development of a pig brain. Could they inadvertently produce a pig with a human-like consciousness?
In 2016 another Chinese team edited embryos to make them resistant to HIV, by modifying a gene called CCR5; then a third Chinese team corrected faulty genes that cause beta thalassemia and favism – a metabolic disorder that causes red blood cells to self-destruct. Those experiments were all marred by unintended consequences – while one part of the DNA was correctly edited, errors were introduced in other parts. Also, importantly, not every cell in the embryo was fixed. However, in 2017 a US group achieved error-free editing of a human embryo. In this case, the scientists repaired a mistake in a gene (MYBPC3) that causes sudden cardiac arrest in one in every 500 people, without introducing errors elsewhere.
Another moral line in the sand was crossed in 2017, this time concerning chimeras. The name is drawn from Greek mythology, and refers to a fire-breathing beast with the head and body of a lion, a second goat head and a serpent for a tail. This January I was taken aback by a paper reporting something almost as startling: a human-pig chimera.
It was not exactly as Piccinini imagined: the chimera was a foetus that was destroyed four weeks into its development. Most of its tissue was derived from pig cells but about one in 100,000 cells was human. None of the human cells contributed to the foetus’ brain function, as far the researchers could tell.
This was an important point of clarification because of an even stranger paper published in 2013. Researchers had grafted human brain cells (‘glial progenitors’) into mouse embryos; according to those researchers, the mice ended up smarter. (This finding was a surprise given these types of cells don’t actually relay signals; rather, like a maintenance crew, they help neurons stay in tip-top condition.)
Why would anyone want to make these chimeras? To grow spare parts for people. Scientists have already grown a replacement pancreas for a mouse in this way. Mouse stem cells were introduced into a rat embryo whose DNA had been ‘edited’ so it could no longer make a pancreas. The mouse stem cells filled in for the missing organ. The rat-grown pancreas then ‘fixed’ the diabetes of a sick mouse for 370 days.
Though researchers have been trying for years to coax human embryonic stem cells into making organs in culture dishes, these ‘organoids’ are not particularly functional. Imagine a builder trying to construct a freestanding functional bathroom. Without the surrounding walls and plumbing, it won’t work. Biologists seem to be facing a similar problem with freestanding organoids. Building them within the framework of a developing embryo seems to be the answer, for now.
So the potential exists to generate a human organ for someone in a pig using their own stem cells; but there is also an ethical risk. Researchers are concerned human cells will contribute to the development of a pig brain. Could they inadvertently produce a pig with a human-like consciousness? What if human stem cells ended up as eggs or sperm? If chimeras mated, could a human be born?
In August 2016 the NIH announced it would lift its moratorium on the creation of such chimeras for research purposes. In 2018, some 15 years after she created the artwork, Piccinini’s ‘young family’ has even greater resonance. Her human-like pig mother captures an ethicist’s worst nightmares.
I understand now that Piccinini did not intend her ‘young family’ as a dystopian trope, as she told me when we met in her studio. “I take science as a given,” she said. “My art is about opening up a space where things don’t become black and white. They’re not good or bad, they’re related to how we feel about things and that could change. It’s not static, and I think that’s the strength of art; it’s part of the dialogue around how we shape our society.”
I now see her ‘young family’ as a deeply informed work that addresses profound issues: one is the roller-coaster relationship we have with modern medicine. We look to medical expertise with great hope when we, or our loved ones, fall ill; but sometimes we are bitterly disappointed.
Piccinini experienced that roller-coaster as a teenager, watching her mother battle cancer, and she was subsequently drawn to pathology museums to sketch grotesque specimens in formalin bottles. It is easy to see how she forged her idiom – her language of human flesh.
Ultimately Piccinini’s body of work addresses the profound question of what it means to be human. It also explores the boundaries of human-ness – the otherness of animals, of cyber-forms, and of humans who don’t resemble ‘the norm’. As we enter the 21st century, a time where we can engineer flesh to create perfect human babies, or chimeras, and soon enough machines with human intelligence, the question of what it means to be a human being grows more pertinent.
It certainly feels like we are on a slippery slope – and losing our balance. Technology has not just changed what is physically possible; it has also rocked the ethical landscape. Past moral certainties no longer apply. New possibilities may bring new risks, but also new benefits.
We are dizzied by the pace of change. Artists like Patricia Piccinini invite us to pause our frenetic lives, examine what has been captured in the freeze frame and explore our responses as we face these new realities.
An edited version of THIS essay WILL be published in conjunction with ‘Patricia Piccinini: Curious Affection’, a major exhibition at The Queensland Art Gallery | Gallery of Modern Art (QAGOMA) in Brisbane, Australia, running from 24 March to 5 August, 2018.