As a young schoolboy, my brother wrote his first essay on the topic of biology. The essay began this way: "Biology is everywhere. You can't get rid of it." Today we can say something similar about genetics. Discussions about genetics seem to be everywhere, and we likely will continue to find them inescapable.

I chose a random day—a Sunday—to see how many encounters with genetics I would have simply by watching television and reading newspapers and popular magazines already in hand. I did not search for anything on my computer, rent any movies, or read any specialized journals in bioethics. Nonetheless, I found much more than I had expected.

That day, the New York Times ran a large news story on the human genome project. That week, the editorial page of US News and World Report described the "new gene-based medicine" as the first great revolution of the new millennium. Scientific American's special end-of-the-millennium issue predicted that "when historians look back at the turning of the millennium, they will note that the major breakthrough of the era was the characterization in ultimate detail of the genetic instructions that shape a human being."

On that day, genetics also was well represented on television. The evening network news had a segment on the relationship between longevity in certain families and genetics. A cable news program reported new developments in genetically engineered brain cells that might be used in treating Alzheimer's disease. A program on financial investing dealt with the expected rise in the stocks of various biotech companies involved with genetics. The Learning Channel aired an hour-long program called "Genes."

Three movies that dealt with genetics aired that evening on various cable channels. One was The Boys from Brazil about a scheme by Nazi war criminals to clone Hitler in order to reestablish the Third Reich. The second was a remake of Godzilla, the story of a huge reptile that was a mutant because of fallout produced by hydrogen bomb testing in the Pacific Ocean Rim area. The third was Gattaca, a futuristic description of a society in which people can be "genetically enhanced" before birth and an examination of the social, political, and economic implications for those who had not been so "enhanced."

A cursory review of these print articles and television programs that appeared one Sunday in November 1999 lead me to a number of observations about genetics in the present and in the near future.

1. 1. Developments in genetics are happening at an astounding pace, and people are beginning to take notice. Genetics are everywhere. You can't get rid of them. What is already happening in genetics is affecting many aspects of our daily lives, such as the food we eat and the medical care we receive. In the foreseeable future, genetics can be expected to alter the very nature of human life and the way we think about human nature.
2. 2. Increasingly, genetics is being seen as the next area of scientific study in which enormous breakthroughs will be made that are expected to radically transform medicine and human life.
3. 3. The application of new information about genetics will not only change the lives of many people biologically, but it will also enhance and enrich the lives of some economically. Investments in certain biotech companies are expected to surpass the levels of earnings made by investments in computer software companies during the 1980s and early 1990s.
4. 4. Current professional staff in the health care industry are inadequately trained and unprepared to deal with many of the clinical and ethical developments in genetics, much less with the expected, the imagined, and the not-yet-imagined future developments in the field.
5. 5. The scientific vision of human life immeasurably enhanced by developments in genetics conflicts sharply with the views of an increasing number of humanists who see genetics as a clear and present danger to human dignity and freedom and as an invitation to environmental devastation.

In Edward Albee's 1962 play, Who's Afraid of Virginia Woolf?, George (the male protagonist, played in the film version by Richard Burton) describes a future in which "all imbalances will be corrected, sifted out propensity for various disease will be gone, longevity assured. We will have a race of men…test-tube bred…incubato born…superb and sublime." These lines are delivered both as a paean to, as well as an indictment of, expected future developments in science in general and in genetics in particular. It is precisely this ambivalence that hovers over the clinical application of the products of genetic research and that will inevitably be amplified in the near future. I, therefore, anticipate that public policy debates about genetics will both eclipse and influence the currently pervasive discussion of abortion and beginning-of-life issues.

Developments in genetics will become prominent because genetics will become increasingly prevalent in many, if not most, aspects of health care. For example, genetic screening will be applied to an increasing number of diseases and syndromes. Prenatal gene repair promises to eliminate predispositions toward certain diseases even before a person is born. (As treatments of fetuses while still in the womb will increase, the "pro-life" position that claims that human life begins with conception will become increasingly popular.) Gene therapy and genetic repair of cloned organs will change the face of clinical medicine. Genes will be used not only to repair damaged tissue and organs but to generate new ones. Even now there is an emerging procedure whereby new blood vessels can be generated to bypass blockages in other vessels. Here, as in other cases, genetically based therapies will replace invasive surgical and chemical therapies. Gene-based therapies will be used to regenerate new, "young" skin which will not only change the field of plastic surgery, but will also alter the cosmetic industry, making many salves, potions, creams, and cosmetics obsolete.

Yet despite the amazing life-enhancing and life-extending promises of genetics, there is a visceral, intuitive recoil against genetics by many Americans. Surveys consistently show that of all areas of medical research and clinical practice, the one that most Americans find problematic is genetics, especially genetic engineering. (The more recent use of the term "genetic enhancement" does not seem to have altered attitudes as of yet.) Both in Europe and in the United States, escalating opposition to genetically engineered food is emerging. Imagine the growing opposition to the increased application of genetic engineering to people. Why is this so?

In the decades after World War II, popular culture often portrayed the future as sinister and threatening by pointing to the expected results of developments in genetics, including the often repulsive mutations of animals and human beings. Some feared that eugenics, as practiced by the then recently defeated Third Reich, would make its way to American society. Indeed, as time moved on, it was discovered that not only Nazi Germany but also the American government had conducted and condoned experiments with unsuspecting human subjects, had practiced various forms of eugenics, and had withdrawn medical treatment from certain individuals on a racially motivated basis. The cult status of The X Files shows how deep-seated such apprehensions are and how much people fear being controlled, manipulated, and losing their freedom. In the popular imagination, genetics is a form of fatalism and predeterminism. Indeed, has not so eminent a geneticist as James Watson said, "Our fate is in our genes"?

What does "genetic" mean in this context? With the advent of the Human Genome Project, there have been many claims of links between genes and certain types of human behavior, including criminality. What then is the nature of moral responsibility when genes are presumed to determine behavioral patterns? Does trying to locate a genetic foundation for human moral behavior undermine the basic assumption of ethics—the existence of human moral volition?

What do employers and insurance companies do when an applicant has a genetic predispositions to a certain disease? What do individuals do upon learning that they have strong genetic predispositions to certain diseases for which there is not yet an available genetic therapy for treatment? What does an engaged couple do when genetic testing finds each to be a carrier of a genetic disease, for instance Tay Sachs or sickle-cell anemia? What do prospective parents do when certain genetic traits of their future children are revealed? What kind of antidiscriminatory legislation can be written and enforced to protect individuals from being turned down for jobs or health or life insurance because of their genes? What kind of legal regulations need to be applied to the burgeoning genetics industry where human genes are currently being patented in anticipation of future gene therapies? How will developments in genetics impact the distribution of health care resources, for instance, between genetics and other areas of health care and among members of various ethnic, racial, or age-related groups (with particular reference to testing and treatment of genetically based disorders more prevalent in certain groups, such as Tay Sachs among Jews of Eastern European origins, and Down's syndrome in pregnancies of women over forty)? When "designer babies" become increasingly possible will parents and children be damned if they do and damned if they don't avail themselves of what will be offered them and if what is offered them does not play out the way they had anticipated (as in the film Gattaca)? Should genetic testing remain voluntary or should it become mandatory? Is the very existence of genetic testing and the preference for a life free of disability a form of discrimination against "disabled" and "genetically impaired" individuals? How will people be psychologically counseled to deal with what genetics would tell them about themselves and their children (actual and potential)? And how is all this financed?

As genetics becomes an increasingly pervasive factor in our daily lives, questions such as these will form the agenda of ethicists, legislators, and those concerned with social policy. However, on a more basic level, developments in genetics will stimulate us to rethink ourselves as human beings, and this is an issue that falls squarely within the parameters of theology and philosophy. Ultimately, all of ethics, especially bioethics, rests upon how we understand ourselves as human beings. Future developments in genetics offer both a challenge and an opportunity for us to rethink the presuppositions upon which theological and philosophical anthropology, ethics, and the provision of health care to human beings is based. In other words, genetics—unlike various other areas of contemporary medicine—does not only present new problems and novel case scenarios, but it also challenges us to reconsider fundamental issues such as who are we, what makes us human, what distinguishes us as a species, why do we do what we do, should we do what we can do scientifically and technologically, do we have moral volition? As the "big bang" of genetics rapidly expands, we have a growing inventory of questions to which fewer rather than more answers can yet be given.

Precisely because the future is not what it used to be, we are compelled to call upon the wisdom of the past to confront the moral perplexities of the present and the future. From the perspective of Jewish moral theology, three insights may serve as a rudder as we try to navigate the unknown currents of developing genetic research and clinical practice.

The first is the affirmation of the practice of medicine as a religious endeavor aimed at saving life when it is threatened, preventing illness when health is present, and restoring health when it is absent. For the physician or scientist to withhold any of these aspects of medical care is considered a violation of the scriptural mandate to heal and a form of criminal malpractice. Insofar as genetics furthers these goals of medical practice, it is not only praiseworthy, but is a moral imperative.

A second insight is the observation of Jewish mystics and talmudic rabbis that God's creation is incomplete work in process, that humans can move toward completion. In this view, human beings are God's "partners in the work of creation." From this perspective, being created in the "image and likeness of God" means that, like God, humans have the power to create, because—like God—human beings are essentially creative beings. In working toward the completion of the process of creation begun by God, human beings thereby articulate their nature as beings created in the "image and likeness of God." Thus, bringing about the improvement of that which is found in nature is not "playing God" but is a way in which we can articulate our having been created in the image and likeness of the divine.

The third insight derives from what some medical Jewish biblical commentators consider to be the central moral lesson conveyed by the biblical story of the tower of Babel: technological achievement untempered by humility leads to dehumanization and disaster. In other words, whether genetics serves as a source of blessing or as a curse for humankind ultimately depends upon whether we use wisdom and humility in utilizing the knowledge and the power acquired through decoding the secret language of life encoded into our every cell by the author of life. Or, as the Talmud might put it: from the bee, one can receive either its honey or its sting. Genetics may provide us either with hell or healing—but, the danger of the sting ought not scare us away from the sweetness of the honey.