Healthy and Normal: Contrasting Metaphysics of Contemporary Genomic Medicine and Islamic Tradition
Shahram Ahmadi Nasab Emran, MD, MA, PhD (c), St. Louis University
Human Genome Project and the consequent advances in genomics have greatly shaped contemporary understanding of the mechanisms of diseases and the available medical treatments. As a result, various genetic tests have become part of the routine medical practice. In addition, a wide range of concepts such as “genetic information”, “genetic code”, “genetic map”, and “gene editing”, are currently used in both scientific and popular literature. The underlying metaphysical assumption in all the various manifestations of genomics in scientific, medical, and common cultural domains seems to be the notion of a “normal human genome”.
Without that assumed “normal” point of reference, “mapping” human genome would be a meaningless undertaking. The main goal of the Project was to discover and define that normalcy. In addition, scientific terms used in genomics are “universal” and apply to human beings in general, regardless of their race, gender, or any other particularity. Having established that universal, normal human genome, modern genomic medicine seeks to “edit” individual human genomes based on that perfect and ideal map. Such an approach fits well with the “interventionist” nature of modern medicine. If human health and disease has to be understood in terms of genes and their level of concordance with a universal yardstick of normalcy, then medical treatment should be directed at “deleting” responsible genes. The whole point of genetic testing is that since we have that yardstick, we should find and manage “abnormal” genes. However, the metaphysical problem is that nobody is “normal”. Compared to that “normal” human genome, all actual human beings have at least one “abnormal” gene.
Human body is no longer considered the way in which Muslim physicians and patients assumed it to be naturally and originally perfect and healthy. Diseases, in Muslims’ view, were understood as imbalances in certain natural forces. Consequently, Muslims’ medicine was basically the science of restoring the original state of balance, harmony, and health. Health was not a state “made” or “constructed” by the physician. It was a matter of bringing back to a former, original, or “normal” condition.
However, in modern genomic medicine the metaphysical assumption is that health and normalcy is not a state that can be found in human nature: it should be constructed and made possible through human scientific intervention. The state of health is something “under construction” based on science. Achievement of health, correspondingly, is a matter of scientific intervention on human nature in order to make it more similar to the ideal, perfect picture of human being “constructed” in science. In other words, normal is no longer the status quo. Normal is a normative and designed state that is in need of scientific intervention for its fulfillment.
In conclusion, there is an unfillable gap between the metaphysical underpinnings of modern genomic medicine and the core metaphysical assumption of Muslim physicians and patients. In contrast to the assumption of normal and healthy as something already existing in nature, which is the metaphysics of traditional Muslims, contemporary genomic medicine assumes the “abnormality” of basically all human beings. As a result, current genomic medicine, regarding its metaphysical basis, cannot be integrated into the practice of Muslim physicians.
Human Genome Project and the consequent advances in genomics have greatly shaped contemporary understanding of the mechanisms of diseases and the available medical treatments. As a result, various genetic tests have become part of the routine medical practice. In addition, a wide range of concepts such as “genetic information”, “genetic code”, “genetic map”, and “gene editing”, are currently used in both scientific and popular literature. The underlying metaphysical assumption in all the various manifestations of genomics in scientific, medical, and common cultural domains seems to be the notion of a “normal human genome”.
Without that assumed “normal” point of reference, “mapping” human genome would be a meaningless undertaking. The main goal of the Project was to discover and define that normalcy. In addition, scientific terms used in genomics are “universal” and apply to human beings in general, regardless of their race, gender, or any other particularity. Having established that universal, normal human genome, modern genomic medicine seeks to “edit” individual human genomes based on that perfect and ideal map. Such an approach fits well with the “interventionist” nature of modern medicine. If human health and disease has to be understood in terms of genes and their level of concordance with a universal yardstick of normalcy, then medical treatment should be directed at “deleting” responsible genes. The whole point of genetic testing is that since we have that yardstick, we should find and manage “abnormal” genes. However, the metaphysical problem is that nobody is “normal”. Compared to that “normal” human genome, all actual human beings have at least one “abnormal” gene.
Human body is no longer considered the way in which Muslim physicians and patients assumed it to be naturally and originally perfect and healthy. Diseases, in Muslims’ view, were understood as imbalances in certain natural forces. Consequently, Muslims’ medicine was basically the science of restoring the original state of balance, harmony, and health. Health was not a state “made” or “constructed” by the physician. It was a matter of bringing back to a former, original, or “normal” condition.
However, in modern genomic medicine the metaphysical assumption is that health and normalcy is not a state that can be found in human nature: it should be constructed and made possible through human scientific intervention. The state of health is something “under construction” based on science. Achievement of health, correspondingly, is a matter of scientific intervention on human nature in order to make it more similar to the ideal, perfect picture of human being “constructed” in science. In other words, normal is no longer the status quo. Normal is a normative and designed state that is in need of scientific intervention for its fulfillment.
In conclusion, there is an unfillable gap between the metaphysical underpinnings of modern genomic medicine and the core metaphysical assumption of Muslim physicians and patients. In contrast to the assumption of normal and healthy as something already existing in nature, which is the metaphysics of traditional Muslims, contemporary genomic medicine assumes the “abnormality” of basically all human beings. As a result, current genomic medicine, regarding its metaphysical basis, cannot be integrated into the practice of Muslim physicians.