You know education is always a hot topic. Everybody has a share and interest in education: Parents, educators, government officials, elected public representatives, nonprofit organizations, religious groups, and so on. Besides, there are many aspects of education, such as finance, law, administration, etc. However, do you also think that teachers have long been overlooked regarding their authority in their own classes? Haven’t they been overlooked regarding their professional development, even though they are the backbone of the education system and they need some assistance in their efforts more than ever? It is good if you also think like me. It is even better if you don’t. Thus, you can share your recommendations with me once you see this school where things are done differently than many other contemporary schools. These teachers at this school see themselves as a learning society. They criticized the status quo they were in some time ago, and renewed themselves collectively. I want you to see the product. Let’s start our journey, shall we?

Room 114

We enter through the big doors of the school. Physically, it is not the best school you would ever see, but it can definitely be said that vitality and cleanliness of the halls stand out. The atmosphere is very welcoming; something is different, but it is hard to tell what it is. I point to the very first door on the right hand side. With pride, I ask if you would like to see this classroom. The sound coming from room 114 is not different from the sound that bees make when they work. As we approach the door, I understand that this is Ms. Williams and her eighth-grade students studying math. She welcomes us and tells us, “please come on in; there are some empty chairs over there,” pointing to two empty chairs, and we make our way towards to the back of the class and have our seats. This is a math class, but I don’t see any numbers on the board or equations being discussed. Soon, we understand that they finished the chapter on expressing roots of cubic equations last week, and today they are discussing a person named Omar Khayyam (1044 – 1123 C.E.). Ms. Williams knew that Omar Khayyam was a philosopher, mathematician, astronomer, and poet. She had formed her students into four groups, and assigned each of his professions to a group, so that they could do some research and present their findings to the whole class. I understand what you mean from the way you look at me: you’re sure this is a math class? you seem to be saying. You’re right to ask. Don’t they need to finish a chapter and pass to the next one immediately, and stay focused on the possible topics that are asked at the end-of-year tests?

Let’s hold on to that question; we can ask this after the class is dismissed. The first three groups already talked about his contributions to philosophy, astronomy, and poetry. We feel very fortunate not to miss at least the last group, who talk about him as a mathematician. I can see brightness in students’ eyes, and their excitement to share everything they have learned with their classmates. The first student, Omar who coincidentally happens to share a name with Omar Khayyam, begins. Omar Khayyam was a scholar among many others of his time. He is best known today for his poetry, but his contribution to mathematics was great. He showed how to express roots of cubic equations by line segments obtained by intersecting conic sections… Another student, Margaret continues: his work on algebra was known throughout Europe in the Middle Ages, and he also contributed to calendar reform. The algebra (from Arabic al-jabr) of Khayyam is geometrical, solving linear and quadratic equations by methods appearing in Euclid’s Elements… April inserts that Khayyam also gave important results on ratios giving a new definition and extending Euclid’s work to include the multiplication of ratios.

They continue their discussion, asking how these scholars tried to seek knowledge and an answer to who they were; and the great contributions they made towards peace and understanding among people of different origins. However, I am currently very much impressed and I lose myself in the beauty of these students’ discussion that I have found myself holding my breath and forgot about your presence next to me. It was no different than waking up from a dream when the bell was ringing. Sure, I will introduce you to Ms. Williams. I understand that you want to learn more about the uncommon method she adopted for this class: Ms. Williams, do you have a minute, please?

Of course, she says: “I have some time. It’s break time now.” You ask her about the topic and the way she formed her teaching method: Why would you choose a person from old history to discuss? Why do you want your students to talk about poetry or astronomy or philosophy in a math class? Do you think they know enough math to solve the questions on the end-of-year test? Why did you choose a Muslim scholar? Is this an Islamic or a secular school? Would you… and you realize you have bombarded her with your questions. You halt and smile.

She smiles back and says: “Yes, this is a secular state school. We try to practice secularism in a true sense that we can talk about religion, and bring religious materials to school to study, but we never try to impose these ideas into our students’ minds. They actually study very different kinds of perspectives, and they enjoy it very much. We take each student as a whole. Since our topic was roots of cubic equations, and Omer Khayyam was the father of the idea, you happened to see this example.”

“But why would you touch on different areas of study in a math class?” You say without taking a second breath.

Ms. Williams smiles again. “This is very common in our school. I am sure Mr. Wraga next door will also get into some math in his literature class since he knows my course syllabus. We try to keep our teachings interdisciplinary as much as possible. I receive feedback that kids enjoy it greatly. I understand your concern about the tests. However, testing is the very last thing we think of. Most of our students do well at those tests anyway, and those who cannot do so well are seen to be still successful mostly as artists or musicians…”

There is a long pause and silence now, but hurricanes are happening in our minds. How is it possible? What kind of philosophy is this school following? Is it the principal who leads these teachers like a conductor leading an orchestra? As Ms. Williams answered our questions, more questions kept popping up in our minds. The bell rings again, and the break is over. We thank her for letting us sit in the class. We make our way back to the hall again, and I am already elated with the intelligence of these students. You look at my eyes without saying a word, and smile: Room 115?

We sit for tests of all sorts throughout our lives, tests in varying scopes and levels of difficulty. Tests to enroll a school, to pass a class, to graduate, the test a son happens to endure with his father or the other way around, and many more tests. An exceptionally difficult and humiliating test is being disqualified, pushed aside, and stripped of civil rights due to one’s humanistic thoughts and lofty ideals.

The most unbearable test, however, is the one that comes with the hands of disloyal friends, particularly when one is already suffering from the words and actions of relentless and merciless foes. Although, regardless of however inhumane and short of dignity a foe may be, his or her enmity can still be reconciled by an antagonistic logic. One may rationalize—using the same logic—that the more differences in thought, worldview, and values increase, so does enmity. Nevertheless, it is unreasonable and irrational when those striving on the same line of fate, those who cherish the same feelings and ideas, betray one another because of jealousy and competition. This is no way reconcilable with human dignity.

Indeed, it hurts—as much as it is worrying—when one ends up with betrayal and pain while expecting faithfulness. What else one can do other than enduring it, as tests of this nature are rampant in a world in which deceit is considered equal to being smart, obsession is equal to to loyalty, and bigotry means conservatism. Yes, as individuals, families, and community as a whole, we have no other option than to endure and say:

A reprimand from Your Majesty
or a favor from Your Grace;
Both are a pleasure for my soul;
How pleasant is Your grace
How pleasant is Your wrath

A community or a nation may have suffered from the greatest and most painful of all tribulations and betrayals from foes, some of who were in the disguise of friends. The entire world might have advanced upon them and brought them under siege from all corners, leading some to a vain belief of their complete annihilation. Yet, they were able to survive all these tests of life-or-death, nullifying all the destructive plans. It is highly probable for similar tests to come up along the way through hills of flames and oceans of blood, all of which will in fact help them with renewal and with metaphysical regeneration. Each of these tests will be a means of awareness for them to identify who is who, for self-empowerment through learning how to recollect and get back on their feet after being knocked down by them. A human being is purified through tests and gets hold of his or her inner essence, thus their life is saved from stagnancy and becomes colorful. Our spirit matures in the face of tests and becomes prepared for bigger challenges, as the bigger the tests and harder the questions are, the more entitled the human is to pass the class and to rise higher in the school of human values and perfection.

Refinement of the individual and empowerment of the society cannot take place without tests. Only souls who have been burdened and pressured by tests can coil like a spring, thrust like an arrow, and reach their target with the blink of an eye. Worries that haunt them all day, hunger and thirst, harm and damage, troubles of all kinds that befell their properties or lives, and being trodden under the metal tracks of unexpected events will all make them as strong as steel and prepare them for the future.

Deadened hearts and raw spirits that have not been tested whatsoever cannot rise to their human potential, nor are they of any use to the community. Distinguishing the diamond-like souls from coal-like ones is only possible by way of testing, at the lack of which gold cannot be distinguished from soil, or diamond from coal. If it was not for testing, the most inauspicious ones would be confused with the highest soaring souls, for it is through testing that angel-like ones can be told apart from the evil souls and ascend to their predestined zeniths.

For those who are appreciative of this truth, each test is one added feather to a wing that will enable him or her to take off to the realms beyond the heavens, and each difficulty faced during a test is an elixir of strength and vigor. For these lofty spirits, being cast into fire is the greatest leap into a friendship with the Creator, and being nailed on the cross is an exalted means of ascension to Him.

For a heart directed towards the highest of ideals, a test is a whip lashed on his or her perseverance, a spell that makes their willpower rear up, and a ray of light that shines on the dial of heart. After each test they crystallize even more, tighten like a bow, and soar high up to the Gardens they already built in their hearts.

Let not the muffled hearts with no refinement to welcome both His reprimand and favor fathom even a grain of this phenomenon; the idealist souls that have devoted themselves to this truth will never recognize anything more pleasant than the pains suffered in this cause. They will never lament and complain to others, even though they burn like a furnace inside. Unfaithfulness of friends and ruthlessness of foes will never take them aback from serving people and their country, for they have given oath as in the words of the poet:

Let the world come at me with all possible reasons for trouble
I am a traitor if I give up any conviction in the service of my nation. (Namık Kemal)

Galib’s master work Hüsn ü Ask (“Beauty and Love”) is viewed as one of the most distinguished works of Turkish Literature. It is known for its perfect presentations of symbols and characters with which he tells the story of a dervish who strives to attain a state of perfection after passing difficult tests and obstacles.

Sheikh Galib, who was also known as Galib Dede, is considered to be the last of the great classical Ottoman poets. Born in Istanbul in 1757, when the Ottoman Empire was at its height, he is one of the most important figures in the Sufi tradition. His father was a government official with some connection to the Mevlevi Sufi order, the order of “whirling dervishes” founded by Rumi. He compiled his first divan (book of poetry) at twenty-four years of age, and at twenty-six he finished his master work Hüsn ü Ask (“Beauty and Love”) in less than six months. Hüsn ü Ask is a divan of his poetry and a poetic allegory which is seen as one of the best books of classical Ottoman poetry. Galib went to Rumi’s town of Konya to finish his period of seclusion (çile)¹ so that he would become a sheikh of the Mevlevi order, but he returned to Istanbul at his father’s insistence. Seclusion is an important stage in the Sufi path (tasawwuf), during which a dervish purifies his body from human desires and matures his soul spiritually. Galib completed his seclusion and spiritual education in the Galata house of the Mevlevis in Istanbul in three years, and became a Dede (Master) of the house. He was appointed as Sheikh of the Galata house of the Mevlevis during the time of Sultan Selim III and became a very close friend of the Sultan.

At first, Galib attempted to combine a government career with the interior life of a Sufi, but he eventually turned his focus wholeheartedly to the spiritual life. By this time, he was already famous for his poetry, which was admired even by Sultan Selim III, who was a patron of poets and the sultan at that time. Sheikh Galib deeply affected the sultan spiritually, trained many students and passed away at the age of forty-three in 1799. His tomb is in a place called Hamusan (“Place of silence”) in the Galata house of the Mevlevis in Istanbul.²

The spiritual adventure of a soul: Hüsn ü Ask

Classical Turkish poetry is full of images and symbols which scholars discuss in terms of their function in symbolic meaning, whereas they agree on their lexical meaning. The range of symbols, which are often repeated, has been widened and enriched for centuries. They enrich the content of the poetry by making the words denser and wider in terms of meaning, and they are also seen as an indicator of superiority, originality and privilege while evaluating the poets’ literary skills. The poet aims to say much in few words, a simple but powerful approach that makes the poetry mysterious and something in which readers find their own images and thoughts.³

Galib’s poetry was at a peak in terms of richness of imagination and this has made him a role model for many later poets who emulate his poetic style. His master work Hüsn ü Ask (“Beauty and Love”) is viewed as one of the most distinguished works of Turkish literature. It is known for its perfect presentations of symbols and characters with which he tells the story of a dervish who strives to attain a state of perfection after passing difficult tests and obstacles. Hüsn ü Ask is a quest by a man for his interior life. The man is searching for himself in this quest, and while reflecting his interior life, it also shows the soul of the man. Sheikh Galib says that he took the idea from Rumi’s Mesnevi, claiming that Mesnevi is something that belongs to all humanity, not just Rumi. Hüsn (Beauty) and Ask (Love), who are the main characters of the story, are two people born on the same day in a tribe in the desert. According to the story, Hüsn is very beautiful, she shines like the moon, and she represents all beauty. Ask is very brave, honest, and handsome, and he represents all the love and effort that is directed toward beauty. It is as if Hüsn and Ask are tailored for each other, but Ask has many tests and obstacles to pass in order to prove his capacity to deserve Hüsn.⁴

The obstacles and tests represent the suffering (çile) of the dervish, or our deeds in life that will lead us to the afterlife. Hüsn represents God, all that is most beautiful and most gracious and which represents all beauty in life and the hereafter. Ask stands for the man who desires beauty, who above all seeks it in his soul and in his consciousness. This is true because God created humans for Himself, so that humans always seek eternity and eternal love, whether knowingly or unknowingly. According to Sufism (tasawwuf), a person cannot be satisfied in his or her soul until he or she finds the reason behind his or her creation; thus people always seek this ultimate reason. The Qur’an also expresses this as

Be aware that it is in the remembrance of God, and whole-hearted devotion to God, that hearts find rest and contentment. (Rad 13:28)⁵

During the journey, Hüsn has to face many different tests and is required to pass all of them fully in the given time. Galib describes this: “It is not easy to get Hüsn, you have to pay a great deal. You have to find the required chemical first. This chemical is only found in the realm of the heart and, it is something that transforms anything into gold. You will find dragons with a thousand heads in this realm of the heart. If you pass the dragons, your way will lead you to the sea of fire. On the shore of the sea of fire, you will see a ship made of wax. You have to pass over the sea of fire with that ship made of wax. If you pass over the sea, a witch of many evils will be waiting for you on the other side. Your way will lead you to a desert in which lions, giants and many wild animals are waiting for you. Creatures that sound like thunderstorms will jump on you. There will always be fire in this desert. If you pass through the desert, you can arrive in the homeland of the heart. Find the chemical over there and come back by the same way. What you call life is too short, like the blink of an eye. If you want to get Hüsn, you have to be very quick.”⁶

The obstacles mostly represent the devil and the carnal self (nafs) that are the two main enemies of humans, according to the Islamic faith. If one fails one of the tests, one cannot reach or will be delayed in reaching Hüsn. Hüsn has a teacher named Gayret (Endeavor), and he will be with Hüsn during this adventure. Sheikh Galib says he came to the world to write Hüsn ü Ask and ends his story by giving some advice. Humans, he says, cannot reach anything beautiful without binding it with love and passion. Sometimes, you will face huge problems, and you will feel like you are walking in a desert of fire, and sometimes you will fall into wells of sorrow, but you will be rescued from these wells by grabbing the rope that represents the Qur’an and faith in God (Al Imran 3:103). We should always have endeavor and hope. We might have obstacles, traps and tests in front of us and sometimes we might fail. But we should never give up and we should continue our journey with passion and hope. The chemical that converts anything to gold is affection; once you find it you will see everything differently.

A life devoted to the faith

Since according to tasawwuf, true love is love for the sake of God, Who is the source of all beauty and to Whom is due all worship and love, Sheikh Galib’s works display rich examples and meanings that reflect his love of God. The phrases are usually not directed to the creator directly, but the true meaning is hidden in the symbols. For example, he writes,

Love is a lamp of God, I am its moth;
love is a shackle, my heart is its crazy captive.
…
The Beloved’s candle has such a wonderful light,
its light does not fit into the lamp glass of Heaven.

According to the poet, “having God’s everlasting pleasure for a person is an everlasting treasure that is more valuable than anything else.” It is this understanding which forms the basis for a dervish’s deeds, and it is what makes a dervish’s life understandable. The dervish only wants God’s pleasure and love, and he conducts himself in such a way as to earn it. It is not important for him to be rich, powerful, or handsome, or so on, because these are not the tools that take him to divine love.

Sheikh Galib’s poem in praise of the Prophet is accepted as one of the best ever written and shows his devotion and dedication to him. It was indeed a tradition for the poets of classical Ottoman literature to write poems called “naat” dedicated to the Prophet Muhammad, peace be upon him. In his poem, Galib begins by describing the Prophet’s features and by praising his personality, and at the end asks for his intercession for the afterlife.

O Master, you are the sultan of all prophets, king of all the honored.
O Master, you are the eternal cure for the desperate and helpless.
O Master, you are the most valuable person in the abode of God.
Master, you are the most praised and most beloved.
O Master , you are given as a mercy to us by God.⁷

In this noble eulogy of the Prophet, there are also some descriptions of the Prophet’s great friends, the places whose names the Prophet often mentioned and the Day of Judgment, on which everybody will seek help and mercy. The poet humbly asks for the Prophet’s help, not just for himself but everybody who has faith. This reflects the hope that as much as you remember, praise Prophet Muhammad and send greetings to him, the more likely he will pray for God’s mercy upon you on the Day of Judgment.

Conclusion

Tasawwuf and its effects constitute very important elements of Classical Ottoman Poetry. Drawing on the rich vocabulary and symbolism tasawwuf enables poets to convey a great many additional layers of meaning, as well as the visible lexical meanings in the lines they compose. Sheikh Galib claims that a human being is born with a given love that is from past eternity and that is divine love. Love is something that already exists in the soul and heart; it does not merely appear at a late phase. Therefore, love is not an ending but it is a beginning. Galib does not follow a path where the story goes from love of the human to divine love; in fact, he talks directly about divine love. If a person frees himself or herself from the shackles and chains of human love and finds divine love, he or she will be able to pass over the sea of fire in a ship made of wax, able to defeat giants, witches, demons and exceed all his or her limitations.

Ahmet D. Bahadir is a post-doctoral researcher with a special interest in Ottoman literature.

Notes

1. Denoting abandonment of all worldly pleasures and delights, çile is used to express an initiate’s spending at least forty days in strict austerity and self-discipline in the name of spiritual training. During this period initiates keep to the absolute bare minimum in meeting such bodily needs as eating, drinking, sleeping, and speaking, and spend most of their time in worshiping, mentioning God, thinking and self-supervision. They spend the period of çile either in a silent corner of a dervish lodge or in a quiet room in their homes.
2. Ayvazoglu, B., Kugunun Son Sarkisi, Kapi Press, Istanbul: 2006.
3. Capan, P., “On Seyh Galib’s Image of Fire,” University of Muðla, Faculty of Arts and Sciences, Department of Turkish Language and Literature, Muðla: 2005.
4. Holbrook, V. R., Beauty and Love (“Hüsn ü Ask”), Mla Texts and Translations, 2006.
5. Unal, Ali, The Qur’an: An Annotated Interpretation in Modern English, The Light, Inc, NJ: 2008, p. 505.
6. Holbrook, 2006.
7. Pala, I., Divan of Sheikh Galib, Kapi Press, Istanbul: 2005.

With the full extent of its use not being understood at the time of its establishment, the project emerged mainly with the pharmaceutical mission to predict, detect, treat, and cure diseases that were caused by genetic anomalies by identifying the genetic information in the human organism.

The desire for such a project was something akin to, or even beyond, the desire to climb Mount Everest, for it aimed to find out something that was unknown at the time. In such fields of biology as cell biology, immunology, and neurology the specialists need genetic information from human organism. The genetic information that an individual organism inherits from its parents can open a door to answer the questions of how an individual develops, how long an individual will live, or how the various species on Earth have lived over many generations.

New developments followed one upon another with the emergence of the Human Genome Project. When the famous Scottish sheep, Dolly, was cloned in 1997, it still seemed to be theoretically impossible to clone a human being. American scientists cloned an ape named Tetra which shared 98 per cent of the same genetic information as human beings. Soon after this, the scientists began to suggest that that all that remained to be cloned was humans.

Dr. Richard Nicholson, the editor of the Bulletin of Medical Ethics, noted that there is no danger in cloning humans, as long as the techniques of doing so are kept under control. If a dictator, however, were to get hold of this information, they would be able to produce an army of genotypically identical soldiers.

The most exciting scientific study of recent years of the Genome Project is that it is trying to develop a complete gene map of an individual organism. According to scientists, a human body has between thirty thousand and fifty thousand genes. All genetic features identifying an individual are found in the gene sequences of the DNA molecules. Eye color, character traits, IQ, and all the illnesses a person may possibly develop are all hidden in the genes. The genome carries all the hereditary features that determine all of life’s diversity, determining whether an organism is human or another species, or ape; all living things have their own genomes. The human genome, which is the full complement of genetic material, and which resembles large tablets recording the history of ancient civilizations, is distributed among 23 sets of chromosomes. It is comprised of approximately three billion letters and is the biological record of our destiny.

Ethical, Legal, and Social Issues

In H. G. Wells’ classic novel The Island of Dr. Moreau (1896), Dr. Moreau conducts hybrid experiments on animals that result in twisted masses of flesh, half-man, half-animal. When the European Patent Office allowed the Australian company Amrad to obtain new embryos by combining human and animal cells, this led to a revival of genetic fears, more than a hundred years after the story of Dr Moreau was published. Not surprisingly, this event alarmed several civilian organizations, including Greenpeace. In a press statement made in Hamburg, Greenpeace drew attention to the fact that we might face “dangerous creatures” in the future that would be created from such techniques. Probably one of the most disturbing facts was that the patent did not disclose how these creatures were to be used. Greenpeace voiced opposition to this for the following reason: “A patent grants its owner the exclusive control over his/her invention. Therefore, patents on life fundamentally change our perception and understanding of living nature and our relationship towards it. Living organisms, which have been ‘created’ by industry and which can be patented cannot have a value of their own, since they are only considered an invention of human beings. Thus they can be exploited without any ethical concerns.”

According to the patent, the embryonic stem cells derived from humans, mice, birds, sheep, pigs, cattle, goats, or fish could be used. The patent covers a “method of producing a non-human chimeric animal” by mixing human and animal embryonic cells: human stem cells are integrated into animal embryos. As a result, the created chimeras are non-human, but they may contain human organs, body parts, nerve cells, and even human genetic codes.

Experts state that the system of producing chimeras is completely different from that of cloning and they drew attention to the risks involved. For example, a virus like the one that caused mad-cow disease could easily pass from one species to another.

The Media Joins the Issue

Thanks to the great interest people have shown in the future of genetic studies, we frequently come across news reports that deal with the topic. However, we would like to note that titles like “the homosexuality gene has been found” or “genetic solution to talkativeness discovered” infuriate genetic scientists. Dr Arnold Munnich says that media aims to raise interest by misinforming the public with subjects like “obesity gene” or “laziness gene”; they merely oversimplify the issue. Dr Munnich emphasizes that a gene means nothing by itself.

The Danger of Abuse

The researches who have worked toward improving gene technology have performed some good for humanity; this is without a doubt. However, there is the risk of abuse. The discoveries in this field may be worth a great deal financially; when we add the rivalry between companies and countries, it seems highly likely that legal bans and ethical rules will be ignored. Some people even object to all kinds of genetic research, not only their abuse. They say that the abuse of seemingly useful genetic technology practices in the future is possible, as has happened in other fields of technology; nuclear researches and laser technology also used to be innocent studies at the very beginning. But we cannot object to the use of electricity just because it is also used for executing people with electric chairs.

Governments and international organizations are quite sensitive to ensure that gene technology will only be used for the good of humanity. There are several international organizations interested in the ethical dimension of the issue. There are certain rules and regulations that establish the fundamental principles that will prevent the abuse of genetic studies, and protect the biodiversity and ecological balance. It is forbidden to carry out research on human cloning and altering human embryos. In the past, dictators like Adolf Hitler attempted to abuse gene technology in this respect. The ruthless Dr Joseph Mengele tried to clone his Fuhrer from the epitel cells he took from him.

Will Confidentiality be Respected?

Another concern brought about by new diagnosis methods and tests is that the principle of patient confidentiality, which has existed for centuries like a secret agreement between doctors and their patients, has begun to be debated, even violated. We usually talk about such “confidentiality” when the information is likely to be harmful for the patient if publicized. From this perspective, the results obtained by genetic tests can be evaluated as such. It is one of the duties of doctors to maintain patient confidentiality. On the other hand, if the relevant data is also likely to harm society, the hospital staff, and those around the patient, then the doctor can face a dilemma.

Some of the possible problems that may be faced due to the mapping of human genome will be that employers could be provided with forehand knowledge about the potential genetic diseases of applicants; they may know whether the person to be employed will be a future financial burden to the company if they carry such genetic risks as cancer or Parkinson’s. In this way new standards of employment will be developed. Even though systematical public surveys do not indicate any significant dangers at hand, it would be nearly impossible to stop rumors. Several people may be denied insurance if they have the genes for a fatal disease. Another may be dismissed from their job for the same reason. In the USA, it is illegal in 39 states to issue insurance policies according to genetic test results, and it is also illegal in 15 states to expel employees according to these. However, employers and insurance agents take advantage of the gaps in relevant laws and they secretly make use of genetic tests. According to research carried out in 1999, 30% of medium-sized or small businesses use such tests to promote and dismiss their employees.

Psychologically, it does not seem likely that people would consent to their status being determined by genetic tests. Would you really like to face your genetic disadvantages? A survey made with cooperation of Time magazine and CNN revealed that half of the participants did not want to know.

The Fate of an Unborn Baby

Deciphering the book of life unfortunately brings along ethical problems. The discovery of our genetic codes can also lead to other humans controlling the future of the human race. The critical question is “Can scientists produce human beings with the desired physical and mental qualities?” If so, genomic science may enable biologists to prepare a list of spare parts, parents may “order” a baby, and as altering our children or ourselves gets easier, we may be less tolerant against those who have not been altered. Lori Andrews of Kent University wonders if we were to be informed of mental defects, obesity, shortness or other undesired characteristics beforehand, whether the parents of those babies would still allow them to be born into a society that scorns such qualities. Even now, it is not uncommon to see some doctors and nurses criticize the parents of babies who are born with pre-detectable defects. If we assume that all parents have “ordered” babies, God knows what kind of a world we will have.

What Should the Aim of Such Practices Be?

Genetic studies should aim to prevent or treat illnesses, not to “enhance” genes. The opportunities offered by genetics should not be a mass elimination medium used by employers or a mechanism of spotting potential criminals in the hands of oppressive regimes. The Almighty One Who has been running the order of our universe so perfectly has granted us some keys to its mysteries. Why should we not do our best and use them for the good of humanity?

References

• Sasson, A., Biotechnologies in Developing Countries: Present end Future, UNESCO Publishing, Paris: 1993.
• McKusick, V.A., “First South-North Human Genome Conference”, Genomics 14, 1121-1123 (1992).
• Barnhart, B. J., “The department of energy (DOE) human genome initiative,” Genomics 5: 657-60,(1989).
• Ferguson-Smith, M. A., “European Approach to the Gene Project,” The Taseb J. 5:61-5 (1991).
• Malakoff, D., Service, R.F., Science, 16 Feb. 2001.
• Dulbecco, R., “The Italian genome project,” Genomics 9:404-5, (1991).
• McKusick, V. A., “Mapping and Sequencing the Human Genome,” J. Med. 320:910-15, New England: 1989.
• Murray, R.K. et al, Harper’s Biochemistry, Appleton & Lange, 1993.
• Neyzi, O., Ertugrul, T., Pediatri, Nobel T›p Kitabevi, Vol. II, Istanbul: 1993.
• Harrison’s Principles of Internal Medicine, International Edition.
• Nature Medicine, Vol. 7, No.4, Apr. 2001.
• Science, No.290, 1 Dec. 2000.
• Nature Reviews, Genetics, Jan. 2001.

The specific neurobiological processes, brain structures, genes, and other factors involved in human intelligence are still largely unknown. Current research on brain anatomy and physiology suggests that various levels of intelligence may be associated with such things as the number of connections between neurons or the degree of branching in cortical neurons. Important factors may include brain metabolism and how fast nerves conduct signals.

Types of intelligence

Measuring intelligence depends on which of the three intelligences one relies on and uses the most. For example:

Static Intelligence: The accumulated knowledge measured by IQ (Intelligence Quotient) tests. Psychologists call it cognitive content. Standard IQ tests have changed very little since their first appearance over 100 years ago, while cognitive psychology’s understanding of how the brain and mind function has made great progress over that same time period.

Fluid Intelligence: How quickly the mind learns and adapts to new problems and conditions. Also known as practical or dynamic intelligence, this important aspect is hardly ever measured.

Brain Intelligence: Also known as BrainQ or cognitive capacity, this is the speed and efficiency at which the brain processes information. In electronics, Q is how efficient and well-tuned the circuit or system is. So BrainQ is how tuned the brain is, which is reflected in mental quickness, memory, and concentration powers. It is fluid and variable, as it is e very sensitive to environmental and lifestyle conditions.

Both static and fluid intelligence depend on BrainQ. Academic, professional, and even personal success depends mostly on BrainQ. In fact, studies have shown very little correlation between one’s IQ score and monetary success. Most importantly, BrainQ (also known as brainpower) is highly trainable (improvable) with the appropriate type of exercise.

Emotional Intelligence (E-IQ) and BrainQ are correlated. According to Mayer, Caruso, and Salovey, emotional intelligence is composed of being able to identify, perceive, express, and understand emotions in different contexts; emotional understanding; and emotional management.

Measuring intelligence

Abundant research proves that thinking about and testing for human intelligence is no small matter. Yet, Robert J. Sternberg, professor of psychology at Yale University, says that, in many ways, we have it all wrong: There are major problems with conventional thinking about intelligence at best, our notions are incomplete, and at worst, simply wrong.

The dominant psychometric approach to studying intelligence claims to measure intelligence through IQ tests. One’s IQ is the result of dividing a person’s mental age by his/her actual age. This procedure has been dropped, but IQ is still used to refer to the scores obtained on intelligence tests and to the tests themselves. Such scores are normally scaled so that the mean is 100 and standard deviation is 15. Ninety-five percent of the population scores within two standard deviations around the mean (between 70-130).

Many IQ tests exist to measure verbal, spatial, mathematical, and analytical skills, while others depend on reaction or recognition time to a visual stimulus. Several IQ tests combine multiple subtests, each testing a specific skill. Regardless of the test’s nature, many researchers believe that factor analysis can extract a general statistical factor (g) from thes results of to obtain a general measurement of intelligence. There is evidence suggesting that g correlates with academic success and, to some extent, with measuring non-school accomplishments.

Despite its wide acceptance, not all researchers agree with the concept of a general, measurable intelligence factor. Some experts believe that g measures some types of intelligence (e.g., analytical problem solving) but not others (e.g., creativity and practical intelligence). Other theorists have abandoned the idea of accurately measuring intelligence, saying that there are multiple kinds of intelligence that cannot be measured with pen-and-paper tests.

Sternberg has proposed a new definition of intelligence that includes analytical skills (the ability to analyze and judge, compare and contrast) and creative and practical abilities. He adds the second and third factors to make the definition of intelligence more meaningful, although he acknowledges that analytical intelligence is an important component of intelligence. Creative intelligence is measured by problems assessing how well an individual copes with relative novelty and can create or invent new products, while practical intelligence measures the ability to handle daily problems.

Increasing IQ?

Some studies have shown that young children exposed to stimulation-rich environments in kindergarten had higher IQ scores than their non-exposed classmates. However, such increases were mostly gone upon graduating from elementary school. Despite this temporary improvement, evidence suggests that the exposed children tended to perform better in school, were less likely to need special education, and were more likely to finish school. Thus, some cognitive functions as well as one’s quality of life were enhanced.

The results of such test suggest that stimulation is a key factor in increasing cognitive performance. Could this positive effect be prolonged by continued exposure to enriched environments? Recent studies in neuroscience show that neuronal synapses in a highly stimulated environment tend to grow and expand, at least in the visual system, compared to those that receive only background static (white noise) input. Also, synapses tend to grow stronger with regular stimulation, which suggests that cognitive function may be improved by a variety-rich environment, stimulation, and activity.

Another suggestive study is the Mozart effect. Researchers picked his Sonata for Two Pianos in D Major for its complexity, and showed that college students who listened to it before taking a spatial-temporal reasoning test performed better than control subjects. However, the effect only lasted 15 minutes and seems to be specific to the piece of music and to experimental conditions.

Although these results are limited to specific circumstances, they still have promise. The results are temporary, but one can make an analogy between these effects and those of physical exercise, which are also usually temporary. The key in maintaining and potentially improving cognitive function may be the forms of mental exercise. Solving puzzles, reading, learning new language or a musical instrument may have positive effects. Again, the important point may be in optimizing overall cognitive function rather than in increasing measured IQ scores, which research shows to be relatively stable after childhood.

Physical exercise clearly provides optimal results when combined with a proper diet. The same is likely to hold for mental exercises. Severe malnutrition while a child can have negative effects on intelligence, and the brain requires nutrients to function properly on a daily basis. Also, physical exercise seems to have a positive effect on mental performance. For example, aerobic exercise appears to increase memory retention, improve some types of creative problem solving, and has positive effects on general well-being. Also, exercise can help relieve stress, which has a negative impact on learning and memory. Various relaxation techniques are also beneficial.

Overall, it does not seem likely that measured IQ can be increased permanently. But other supporting factors of cognitive function might be enhanced, thereby optimizing overall mental performance. The best ways to do this seem to be combining physical and mental activities to create a stimulating environment, and to get enough nourishment.

Sternberg’s theory of intelligence

Sternberg has made some interesting points that have been borne out by research results. For example, he has demonstrated that people can handle cognitive challenges in real-life situations. For example, housewives and Brazilian street children have difficulty calculating in a classroom, but not in a supermarket or while making a deal on the street, respectively.

Another consideration is the importance of family expectations on children’s learning. For example, Kenyan families typically do not value formal Western, but do value knowledge of the indigenous environment. He found that when Kenyan children were tested on their knowledge of the indigenous environment, those who scored high on the indigenous tests scored low on conventional IQ tests.

Sternberg also has shown, in a study of Yale students, that students in the high-analytical group were much less diverse in terms of racial, ethnic, socioeconomic and educational backgrounds than those in the high-creative and high-practical groups.

Sternberg’s research has critical impacts on teaching. He asserts: First of all, it is important to note that all three abilities analytical, creative, and practical can be taught. When students are taught in a way that best fits how they think, they do better in school. Children with high levels of creative and practical abilities, who are almost never taught or assessed in a way that matches their pattern of abilities, may be at a disadvantage in course after course, year after year.

Abusing IQ test scores

However, Sternberg is aware that resistance to change in measuring intelligence is great and widespread. He adds: The U.S. has developed a multi-million dollar testing industry whose tests are based on conventional notions of intelligence. The modern version of the Stanford-Binet Intelligence tests or the Wechsler Adult Intelligence Scales have not evolved much over the years. Whereas old computers and old VCRs and old telephones rapidly go out of date, old tests never seem to die, except for updating of norms and cosmetic changes.

Sternberg is confident that conventional notions of intelligence can be surpassed, despite the reluctance and opposition to change, and that doing so will benefit everyone. He concludes: In fact, the most important abilities for science are creative abilities, and if we continue to measure students with conventional tests and do not value creative abilities in training, the result may be that we are picking the wrong people. People who are highly creative may be denied the opportunity to go into science, and science may lose its best potential to advance.

The current misuse of IQ or similar tests is not as problematic as the ones in past. Murray and Herrnstein’s controversial The Bell Curve summarizes research allegedly purporting that blacks are innately less intelligent than whites. This conclusion depends on culturally biased IQ tests or content-oriented SAT tests. However, these conclusions neglect the social limitations, unequal conditions, underprivileged situations, low-quality education, malnutrition, and poverty. The famous Milwaukee Project of the 1970s showed that nurturing plays a vital role in a child’s intelligence. And Goddard’s results, obtained in the early 1900s and based tests given to newly arriving immigrants who had spent months on a boat, who were mainly laypeople, and often had little if any grasp of English, has been disproven by those very people and their descendants, many of whom went on to build quite successful careers in America.

IQ tests are culturally biased. However as Reynolds points out: The argument is whether the brain’s processing speed determines how well one can do in an IQ test. The IQ tests and SATs are very content-oriented. If you weren’t taught some important element, you’d be at a disadvantage (Report From Biomedical). Rather than this, an IQ test should check how quickly one’s brain can process information.

Conclusion

In conclusion, intelligence depends on many things: daily diet, physical and mental exercise, emotional state, stress, and so on. It is not fixed or static, so one can improve it by a combination of techniques that suit the individual. In spite of the developments in cognitive science and medicine, measuring intelligence is still in its crawling stage and open for research. One can be filled only with awe before such a vital yet mostly unknown organ, whose functions have tantalized humanity for centuries. Thus, each person should appreciate having such a distinguishing feature and thank the Creator.

References

• Herrnstein, Richard J. and Charles Murray. The Bell Curve: Intelligence and Class Structure in American Life. Free Press: 1996.
• Mayer, J. D., D. Caruso, and P. Salovey. Selecting a Measure of Emotional Intelligence: The Case for Ability Scales. (Second submission version), 11 January 2000. Chapter in: R. Bar-On and J. D. A. Parker (eds.), The Handbook of Emotional Intelligence. Jossey Bass: 2000.
• NIH Behavioral and Social Sciences, NIH Behavioral and Social Sciences Research Seminar Series, 1999.

If you find something hard to grasp, do you immediately conclude that you have reached the limit of your cognitive ability and give up? Do you usually associate successful outcomes with smartness and failures with lack of intelligence? Do you consider intellectual ability an indispensable component of every accomplishment, or it is the effort-plain, sweaty hard work-that brings about the desired outcome?

The above questions tackle the dilemma of effort versus ability. Although it can be relevant to more than one topic and domain, this article will elaborate on the dimension of intelligence. Is intelligence a fixed, innate talent bestowed by heredity? Is it an accumulated, cognitive reservoir constructed through such personal factors as effort and motivation, and such environmental factors as held in common by family and community members?

A Historical View

The effort/ability dilemma has been very controversial in the West. It has not been a mere academic debate, but one with political and social implications and a very eager public interest. The publication of Darwin’s The Origin of Species (1859) had a major impact on biology and other fields.

Francis Galton, a cousin of Darwin, advocated applying Darwinian principles to human society and coined the term eugenics, from the Greek words of “good in birth.” In his Hereditary Genius (1869),(1) he argued that mental features are as hereditary as physical features, and that a selective breeding of human beings (similar to horse breeding) could raise the proportion of people with a better-than-average genetic endowment. This new approach helped Darwin extend his evolution theory in The Descent of Man (1871).(2)

Galton believed that intelligence and ability are fixed, innate, and determined by heredity. This idea is proven by accomplishments in competitive careers.(3) He proposed the encouragement of good marriages as a way to create a superior human race, not so much as a way of “unwanted” ones. Gregor Mendel’s work on genetically transmitted dominant and recessive traits increased interest in eugenics.

The first half of the twentieth century witnessed an overwhelming belief in eugenics in academia and among intellectuals, politicians, and businessmen.(4) It became “an established fact” that single-unit genes determined such traits as alcoholism and mental incompetence.

Such conclusions naturally had political and social implications. For example, beginning in 1911, the United States tested arriving immigrants to assess their “worthiness.” Since many of those tested did not speak English and had just endured a long and difficult sea voyage, scores were low, and particularly lower for certain ethnic groups.(5) As a result, the US Congress passed the Immigration Restriction Act of 1924, which enforced quotas for unfit ethnic groups. Many American states also passed laws mandating sterilization of inmates judged to be genetically inferior.(6)

The fiercest implementation of eugenics happened in Nazi Germany. The 1933 Eugenic Sterilization Law required compulsory sterilization of all German citizens deemed to be suffering from presumably hereditary defects, including offensive physical deformities. Sterilization of the unfit was later transformed into many of the war crimes committed during World War II.

Eugenics’ association with World War II era war crimes and genocide ruined its popularity and reputation. However, some parts of its principles are still considered valid by some scientists in various fields. Two examples are the nature and causes of difference in human intelligence, and whether intelligence is hereditary or not. In other words, people are not identical to each other in the areas of comprehending complicated material, reasoning, learning, and solving problems. Researchers do not agree on the sources of these differences, and hence ask: “Is there a general mental ability called ‘intelligence’ that causes these differences, or is the underlying cause something else?”

Theories about Intelligence

Presented below are some contemporary theories about intelligence and its determinants.

The Psychometric View: This view claims that individual differences in human cognition or mental ability can be measured adequately by intelligence tests.(7) Many widely used tests seek to measure some closely related criteria, such as scholastic aptitude and academic success-not intelligence itself. Examples of such tests in the Unites States are the SAT or ACT (college admission), GRE (graduate school), and GMAT (graduate business school) exams. Although test administrators try to distance themselves from testing one’s actual intelligence (namely, one’s I.Q.), it is generally accepted by the research community that one’s IQ and the above tests are closely related.(8)

IQ tests are offered in many verbal and non-verbal forms. The general practice for IQ scores is to scale them around 100 in such a way that 95 percent of the population falls between 70 and 130.

Psychometricians assert that people are born with unequal intellectual potentials, just as they are born with different physical potentials, such as height and eye color. They also state that no amount of social engineering can make individuals with different mental competences into intellectual equals.(9)

One American social engineering program is Affirmative Action. This program encourages underrepresented minority groups in society to pursue education and business through required quotas. For example, state universities are required to accept a certain percentage of minority freshmen. If the psychometric view is true, these programs will fail and amount to discrimination against the capable. In their controversial book, Hernstein and Murray maintained this view together with the heredity of intelligence and genetic IQ differences between races.(10)

In short, this view states that a single factor known as “intelligence” can be measured with IQ tests and predict success in life.

The Cognitive-Psychology View: Adherents of this theory view intelligence as a process, not an innate ability. The process consists of creating a mental representation of problems encountered, retrieving apparently related information, and devising a solution. In short, it emphasizes experience for success in life, but does not completely eliminate the relation between general intelligence and experience.

Gardner’s Multiple Intelligence Theory: In his Frames of Mind, Gardner argues that psychometric tests ignore several aspects of intelligence. He also claims that the tests’ paper-and-pencil format rule out many kinds of intelligence performances that are important for success in life.

Sternberg’s Triarchic Theory: This view asserts three dimensions of intelligence: Analytic intelligence (similar to the psychometric, IQ-based view); creative intelligence (involves insight, synthesis, and intuition); and practical intelligence (the ability to grasp, understand, and solve real-life problems).(11) Although Sternberg does not reject some heredity in intelligence, he strongly believes that all three aspects of intelligence can be developed.

Problems with the Psychometric View

The psychometric view claims that intelligence is the single best predictor for individual performance at school and on the job, as well as for chances of divorce, dropping out of school, unemployment, or having illegitimate children.(12) However, the interactions and correlations of various factors in social studies make it very difficult to draw such conclusions. One cannot know for sure if intelligence is the cause or the result of the above-mentioned factors. It may very well be the case that some other criteria contribute to both the outcomes outlined above, and to the high scores as measured by IQ tests. Here are some remarks on the psychometric view of intelligence and its relation to success in life:

• Many people with high IQ scores fail to become successful due to a lack of motivation, personality, laziness, or short attention span. In contrast, some people with low IQ results succeed due to personal dedication, vision, systematic effort, and motivation. A low IQ score can be changed through conscious choice and effort. As an analogy, consider a gifted athlete. Some athletes have special talents for a particular sport. However, they fail to perform as well as those without those talents, for the latter depend on systematic effort. Readers familiar with sports can name several specific examples of this phenomenon. • An IQ test may be a speed issue. That is, it may measure only how quickly people learn or solve complex problems. It is a well-known fact that once something is learned, the performance of a person with a lower IQ is not significantly different from that of a person with a higher IQ.

• A certain amount of intelligence seems to be needed to gain entry into an intellectually demanding field. However, beyond that point, success is determined by the effort put into the job, social support, and experience.

• Average IQ test scores have been increasing in the West for several decades. However, school performance has remained almost constant, if they did not actually decrease. This clearly indicates that success in life is not directly related to IQ scores.

• People can improve their test scores by becoming familiar with the test. This implies that expending the necessary effort can affect the outcome.

• Cultural and family environments (e.g., beliefs, oppression, poverty, fear, and lack of health care) together with such biological factors as nutrition and exposure to toxic substances (e.g., alcohol), affect IQ scores. Flynn analyzed Asian Americans’ IQ test scores and found that they were always around 97 or 98. However, their academic and professional achievements were remarkable; equivalent in achievement to people with IQ scores of over 120! This can be attributed to a cultural belief in learning, as summarized in Gorner.(13) According to Claxton, Western cultures focus on ability as the major determinant of success. If you fail, it is probably because you were not smart enough. Asian cultures, however, emphasize effort and generally consider failure the result of a lack of effort.

• A common error is to assume that something heritable is unchangeable. Infants adopted into advantaged families tend to have higher IQs in childhood than would have been expected, had they been raised by their birth parents.(14) This is further proof that how a child is raised and what he or she is exposed to have very long-lasting effects. Further, and individual’s personal choice has considerably more impact on one’s life than usually thought. A recent initiative at the University of Chicago, the RealAge Program led by Michael F. Roizen, stresses the importance of an individual’s choice on how long and how well they will live. He claims that 70 percent of this is determined by one’s personal choice.(15) So even if heritability is high, intervention is possible.

• Some claim that IQ tests measure nothing more than cultural conditioning, education, and language fluency. As these are not inherited in the same way as eye color and other physical factors, they can be modified.

Conclusion

Considering the above remarks, it is very difficult to conclude that intelligence can in any way be a fixed, innate ability that determines success in life. If the very few exceptionally gifted and mentally retarded people are left out, most people have an almost equal potential for success in life. Men and women were created for the purpose of learning. This lifelong learning process and its outcome are closely tied with the effort expended. Anybody can become better at anything, provided that they strive for it with the means available to them. Encountering difficulties should not prevent people from trying harder. Learning to learn is possible, and depends upon the willingness to stay engaged when faced with uncertainty. Without rejecting the effect of genetic factors, we can have a significant effect on our own well-being and success in life through conscious choice and effort.

Footnotes

1. Francis Galton, Hereditary Genius, reprint (Peter Smith Pub., 1990).
2. Encyclopedia Britannica, “Sir Galton Francis.”
3. Leslie Jones, “Social Darwinism Revisited,” History Today (August 1998).
4. Paul Gray, “Cursed by Eugenics,” Time, 11 January 1999.
5. Rawat Rajiv, “The Return of Determinism,” Cornell Science and Technology Magazine (summer 1995).
6. Sterilization is defined by American Heritage dictionary as follows: “To deprive (a person or an animal) of the ability to produce offspring, as by removing the reproductive organs.”
7. Earl Hunt “The Role of Intelligence in Modern Society,”American Scientist (July-August 1995); Report of a Task Force established by the Board of Scientific Affairs of the American Psychological Association (APA), 7 August 1995.
8. For historical reasons, intelligence tests are termed IQ, which stands for “Intelligence Quotient.”
9. Linda S Gottfredson, “The General Intelligence Factor,” Scientific American, (November 1998).
10. Richard Hernstein, and Charles Murray, The Bell Curve: Intelligence and Class Structure in American Life (Simon & Schuster, 1995).
11. Frank Miele, “Interview with Robert Sternberg on The-Bell Curve book”, Skeptic Magazine, 3, no. 3 (1995).
12. Guy Claxton, “Wise Up,” Bloomsbury (September 1999), 26.
13. Peter Gorner, “Interview with Dr. Richard F. Roizen,” Chicago Tribune (Perspective section), 28 November 1999.
14. Report of a Task Force established by the Board of Scientific Affairs of the American Psychological Association (APA), 7 August 1995.
15. Gorner, “Interview.”

There are many reasons why a developing baby may have congenital problems (Moore, 1989, p.lO8). Exposure to infections and certain drugs (most commonly, alcohol), chromosomal abnormalities and inherited congenital conditions have all been shown to disrupt normal fetal development. In this article we will concentrate on the diagnosis of chromosomal and genetic disorders during pregnancy.

PNT procedures and their interpretation can be extremely intimidating for parents. It is therefore important that tests are done only after a full explanation of the procedures involved and their possible consequences. The aim of PNT is to inform and prepare parents for the birth of an affected infant, so that they can choose between the possible courses of action (Aksoy, 1996). The possibilities will include: (1) in utero treatment; (2) delivery at a special centre for immediate postnatal treatment; and 3) termination of an affected fetus, i.e. abortion.

Over the years, professional standards and laws have evolved which influence the clinical application of PNT and help to tackle many of the complex ethical issues involved. There is little doubt that relatively non-invasive techniques whose primary purpose is to diagnose treatable disorders and then treat them, before or after birth, would be warmly welcomed by all, especially the parents. The fact is, however, that in practice PNT is generally being used to diagnose abnormality and then terminate the life of the unborn babies. The reality is that prenatal diagnosis rarely leads to fetal therapy

In what follows, we will try to explain the range of prenatal tests available and indications for their appropriate use. We will consider some of the technological advances on the horizon in this field of medicine, as well as some of the ethical dilemmas that arise.

Prenatal Diagnostic Tests

Prenatal diagnostic tests can be divided into two types, invasive and non-invasive. Non-invasive tests simply involve a blood sample taken from the pregnant woman or an ultrasound scan. Invasive tests on the other hand are more complicated and involve obtaining a sample of cells or tissue from the developing foetus, either by amniocentesis or chorionic villus biopsy. The samples obtained by invasive tests can be used, specifically to assess the fetal chromosome pattern, to determine if the fetus has a particular genetic mutation, or for a whole range of biochemical assays.

Maternal Blood Sampling. Between 15 and 19 weeks of pregnancy, the pregnant woman attending ante-natal clinic will be offered a blood test. The blood sample will be analysed to assess the level of three proteins, b human chorionic gonadotropin (b HCG), oestriol and a -fetoprotein (a FR). The three levels in combination with the mother’s age can be used to estimate the risk of the baby being affected by a chromosomal problem, especially Down’s syndrome (Wald and Cuckle, 1992, pS63). If the test result indicates a high level of risk, the mother will be offered further tests to assess the status of her baby.

Ultrasound Scan. Ultrasound uses high frequency waves to form a picture as the waves are reflected back by tissues of different density. The developing fetus grows in a liquid filled sac (amnion). As fluid shows black on the scan, this provides a good contrast with the fetal parts allowing high resolution images. Early in the first trimester an ultrasound scan can be used assess the viability of a fetus and to estimate its stage of development. Most women will be offered a formal high resolution scan at between 16 and 19 weeks (Sutton, 1990, pp.20- 1). The images from the scan will be the first time the expectant mothers see the baby. For many, this is a happy event; for the others it could be a very sad event if the scan indicates an abnormality.

Amniocentesis. In this test, done between 15 and 20 weeks of pregnancy (Cohen, 1990, pp.19- 20), a very fine needle is passed through the abdomen under ultrasound guidance, avoiding the fetus, and a sample of amniotic fluid containing fetal cells is withdrawn. The sample is cultured to grow more cells so that the chromosome pattern of the cells can be examined or DNA extracted for genetic analysis. This process can take three weeks, a period of considerable anxiety for the parents. There is also a small risk of miscarriage occurring after an amniocentesis.

Chorionic Villus Sampling. In this test, done in the same way as than amniocentesis but five weeks earlier, a sample of tissue is taken from the developing placental tissue. Both chromosomal and genetic analysis can be performed on this tissue, and the results are available quicker and at an earlier stage of the pregnancy than with amniocentesis. However, there is a higher miscarriage rate following chorionic villus sampling than amniocentesis (Boss, 1994).

Fetal Blood Sampling. Occasionally, when there is concern that a pregnant woman has been exposed to an infection early in her pregnancy, a sample of blood will be taken from the umbilical cord with a very fine needle under ultrasound guidance. This sample is used to assess if the fetus has become infected and at high risk of development problems following the maternal exposure.

New Advances

Advances in prenatal diagnosis have followed rapidly from technological improvements in ultrasound equipment, refinement and experience of current techniques, and the development of new tests. The aim of research in this area is to provide the earliest possible accurate information about the health of the developing baby, and to do so in the way safest for the expectant mothers and their babies. If the information is reassuring, the couple can enjoy the remainder of the pregnancy in the knowledge that everything will progress normally. However, if the result are unfavourable and an abnormality is diagnosed, earlier decisions about potential treatment or termination are possible and so may be less traumatic for those involved.

Fluorescent in situ Hybridisation (FISH). FISH is a technique which uses a specific DNA sequence as a probe to recognise its complementary sequence on a chromosome. The probe has a fluorescent tag attached which lights up when it is attached to the recognised chromosome segment. Recently FISH has been applied to analysis of amniocentesis samples to assess if an extra chromosome 21 is present or not in the cells. Because the amniocentesis cells do not require culturing for this technique the test results can potentially be available sooner than following standard amniocentesis.

Fetal Blood Cells in the Maternal Circulation. At about 6 weeks fetal blood cells can be found in a blood sample taken from a pregnant woman. These cells exists in very small numbers. Recent work has extracted and purified these cells to allow assessment of the fetal chromosome pattern and to determine if the fetus has a specific genetic mutation. Although this technique is very new it has the potential to make the currently used invasive techniques obsolete and will allow very early diagnosis.

Preimplantation Diagnosis. This procedure involves the use of technology developed with in vitro fertilisation (IVF). An oocyte is removed from the woman and brought into contact with spermatozoa from her partner under controlled conditions. One of the spermatozoa effects fertilisation to form a zygote. Following three stages of cell division (this eight-cell stage is termed, the blastocyst), one cell can be removed and used for analysis (Aksoy, 1997a). The DNA sequence of this cell can be determined to identify the presence or absence of a gene mutation that has caused illness in one of the parents. If the cell does not contain the mutation, the blastocyst can be implanted in the womans uterus (womb) to develop into a fetus which is unaffected by the condition that has affected other family members.

Human Genome Project. The aim of the Human Genome Project is to have identified the entire human DNA sequence (genome) by 2005. The extra information generated about specific genes and their association with specific disorders has the potential to expand dramatically the number of genetic tests available to couples with a family history of a genetic condition.

Ethical Issues

It is important to understand the purpose of prenatal diagnosis. It is done to provide parents with information about the health and development of their baby, not to provide them with a reason to have a termination of pregnancy. There are 180,000 terminations performed each year in the United Kingdom, of these 5000 are because of fetal abnormalities diagnosed by prenatal tests. Abortion is a serious problem itself in all regions of the world, developed and developing, and we discussed it in an earlier issue of this magazine (Aksoy 1997b). When prenatal tests reveal that a baby has health problems, parents face a number of difficult questions. Is any treatment available? What are the baby’s chances of survival? What would be the baby’s quality of life if he or she did survive? Some illnesses can be treated during pregnancy and after delivery. One of the main aims of fetal medicine is to develop therapies to treat fetuses and improve the survival. However, some conditions are fatal despite all treatment. In these circumstances couples sometimes take the extremely difficult decision to have a termination of pregnancy

For religious, moral or other reasons many couples opt not to have any tests performed during pregnancy. They feel that even if the results of any test indicated that their baby was affected by a serious condition they should and would continue with the pregnancy. It is important in each situation that the parents’ decisions are respected and supported. The parents need to be given appropriate guidance and counselling rather than be met with disapproval.

In some countries prenatal testing has been extensively used to determine the sex of the baby at an early stage, with the intention of ensuring that only male babies are born (Kusum, 1993). In the United Kingdom, as in many other places, prenatal diagnosis to determine fetal sex is deemed morally unacceptable. It is important that new advances in medicine are paralleled by an informed ethical debate. Prenatal tests should reflect what is appropriate within a society rather than just allowing what is technically feasible. A number of regulatory groups have been formed, including the Human Fertilisation and Embryology Authority (HFEA), to monitor and regulate new advances in this area.

In sum: prenatal diagnosis is a rapidly expanding area of medicine. New techniques are constantly being developed which are aimed at allowing earlier diagnosis, less invasive methods and, ultimately, treatment. It is important that developments are monitored and regulated to ensure that the techniques available are applied within an ethical framework.

REFERENCES

Aksoy, S. (1996) ‘Prenatal Testing: An Ethical Perspective’, The New Journal of Medicine, 13:2, pp.12-14.

Aksoy, S. (1997) ‘Moral Controversies on Preimplantation Genetic Testing’, paper presented at UNESCO Asian Bioetlncs Conference, Kobc-Japan, November 1997.

Aksoy, S. (1997), ‘Abortion: Mercy or Murder?’, The Fountain, 2:17 pp.32-5.

Atkins, A.F.J. and Hey, EN. (1991) ‘The Northern Regional Fetal Abnormality Survey’, in Drife, jO. and Donnai, D.(cds) Antenatal Diagnosis of Fetal Abnormalities, Springer-Verlag Ltd., London.

Boss, J.A. (1994) ‘First Trimester Prenatal Diagnosis: Earlier is not Necessarily Better’, JME, 20 pp.l46-5l. )

Cohen, L.G. (1990 Before Theýr Týme at Risk, American Association on Mental Retardation, Washington DC.

Kusum (1993) ‘The Use of Pre-natal Diagnostic Techniques for Sex Selection: The Indian Scene’, Bioethics, 7: 2/3 pp,149-65.

Moore, K.L. (1989) Before We Are Born: Basic Embryology and Birth Defects, WB. Saunders Comp., Philadelphia.

Sutton, A. (1990) Prenatal Diagnosis: Confronting the Ethical Issues, The Linacre Centre, London.

Wald, NJ. and Cuckle, H.S. (1992) ‘Biochemical Screening’, in Brock, D.J.H., Rodeck, C.H. and Ferguson-Smith, MA.(eds) Prenatal Diagnosis and Screening, Churchill Livingstone, Edinburgh.