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Acting naturally

14 December 2015
By Tom Shakespeare
Senior Lecturer in Medical Sociology, Norwich Medical School, University of East Anglia
Appeared in BioNews 832

'We're in danger of becoming cool,' said a Nuffield Council on Bioethics staff member to me as we prepared for the launch of a new piece of work about 'naturalness'. For a start, the event was held – not in Bloomsbury – but at RichMix, a vibrant cultural centre in the heart of trendy Shoreditch. On stage were a clutch of poets, a social scientist, a theologian and a public engagement specialist. In recent years, the Nuffield Council have tried to engage with different audiences, with a range of activities and outputs that have a wider reach than the traditional, heavy-duty report. The project on 'naturalness' was an example of this more dynamic public engagement.

But being cool should not be confused with becoming trivial. The concept of 'naturalness' is at the centre of public and media debates about advances in medicine and the life sciences. This project explored how words like 'natural' and 'unnatural' are deployed in policy discussion, in scientific and campaigning contexts, by journalists, and by members of the public. 

At the centre of the work was a review of the professional and public literature, including the Council's own reports, together with dialogue between experts and lay people. Alongside these reviews and associated analysis, poets were engaged to add their voice – after all, it was a debate about language, metaphor and imagery. The Council commissioned Kayo Chingonyi as poet-in-residence, and held an open competition that generated more than 150 entries, from which three winning poems were chosen.

So what did the analyses reveal? First, many people do draw on the terms 'natural' and 'unnatural' together with related words like pure, real, organic, unadulterated, artificial, fake, abnormal and synthetic. These terms are sometimes used to convey moral judgments about science, technology and medicine. In media coverage, it was heartening to notice that such words were more often used in editorial and opinion pieces about science than in news articles. 

Our poets drew on popular concerns for the subject matter of their work. Overall winner Sophie Fenella, for example, wrote 'Aubergines in Acton' about the food industry:

There is no need to bring grapes to the sick
when grapes are pills burst from aluminium foil
but I always smell melons just to know
they are still living, and the earth is not a factory
pushing out hyper-purple plums, one by one.

Jessica Harneyford's poem 'Walking in the Park on a Saturday Afternoon' highlighted the contradiction between the anxieties that the public sometimes feel about the rapid pace of change, together with the benefits accrued through, for example, in vitro fertilisation. 

The nuances came through in Laila Sumpton's moving poem 'Sharing Bodies', about transplantation, which concluded:

We are sharing bodies
trading parts for our conscience
for legacy
to keep the human jigsaw

Underlying the arts strand of this project was the question of whether poets, to adulterate Shelley, could be the 'unacknowledged bioethicists of the world'. Certainly, they brought an alternate sensibility to the questions that the research raised. For example, Kayo Chingonyi's contributions explored different dimensions of 'naturalness': not just scientific research but also hair styles, mobile phones, even the immigrant hoping for naturalisation. This last, probably my favourite, concluded:

To be subjects somewhere
we stood, out of place, so long 
we dreamed of going back
to where our names were 
not some bitter herb added 
to the local cuisine, to where people
did not watch us with suspicion
as if genes could hold a flag.

Readers of BioNews will not need to be reminded that many natural things are not good (viruses and earthquakes) and many unnatural things are not bad (think of vaccines and contraception). As philosophers frequently point out, it is difficult to draw ethical distinctions based on distinguishing between the natural and unnatural. So should we just ignore these misleading usages of contentious terms and resolve to be more rational? Do we need the poetry?

During our discussions at the event we were reminded that the dyad 'nature and nurture', familiar from debates on how genes and environments interplay, derives originally from Shakespeare's description of Caliban in 'The Tempest'. Contributors to the project concluded that there may be wisdom in people's views, even if not expressed in scientific language. Naturalness seems to be a concept we grasp for when we can't really put our finger on what we don't like; it's used as a placeholder or proxy for something else. 

Policymakers need to engage with public concerns about naturalness, in order that we can move forward. Professionals engaged in these debates should first accept that everyone has very different starting points when it comes to naturalness, which can be shaped by ideology, religion, culture or just squeamishness. While the words are unlikely to disappear, public attitudes can and do change over time, as the example of diminishing prejudice about gay, lesbian, bisexual and trans people illustrates. Self-awareness, as well as sensitivity, is needed.

Tom Shakespeare is a member of the steering group for the Naturalness project of the Nuffield Council on Bioethics.

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