Bioethics Gets Political

Sally Satel has a pretty good survey of the field of bioethics over at American Enterprise Institute. While I am no fan of AEI, I have to admit Satel’s piece is actually quite fair. Her section on conservative bioethicists is harsh and clear. Her critique of both liberal and conservative bioethicists came down to how they did their work and the role they played in a patient’s life. Money quote:

Ultimately, the bioethicist presents his analysis to the designated decision-maker–typically a physician or an administrator–who is accountable to his patients and his employer. Bioethicists should not advocate for patients or physicians or hospitals; they should advocate for disinterested moral deliberation. Nor should they mistake consensus, which is required in order to take action, for the discovery of moral truth. The role of the bioethicist, then, should be to illuminate debates, not to settle them. In the parlance of medicine, they do not have prescribing privileges.

Regardless of what one things of Satel or the AEI, this is a true statement. Unlike typical screeds from the AEI, Satel’s piece applies to advocates and opponents of frontier biotech research alike. Whether one is for or against therapeutic cloning and genetic enhancement, Satel lays out reasons why an ethicist’s position in policy should be limited. Of course, her writing isn’t all even handed. She takes a nasty swipe at Arthur Caplan – whose position on organ donation I disagree with, but of whom I am generally a fan – and uses him to typify a liberal bioethicist:

Caplan is a bioethicist; his titles [at UPenn] imply an expertise in ethics. [Douglas] Hanto served as the chair of the Ethics Committee at the American Society of Transplant Surgeons. Yet what are we to make of their willingness to issue life-and-death pronouncements involving other people? Well, we know a few things about them. First, that they share an absolutist approach to egalitarianism: If all cannot benefit, then none should benefit. Second, as ethicists they presume to know how despairing patients should conduct their private affairs. And third, they appear to have few qualms about conveying to desperately ill people a message of hopelessness: Be passive, dying patients–wait your turn and take no initiative to save your own life.

Clearly over the top, but there are kernels of truth in her rhetoric. Neither Caplan or Hanto cheerfully tell someone they are going to die anymore than Leon Kass or Francis Fukuyama does when they say that “death gives life meaning.” Isn’t it funny how Satel managed to not mention that, for Kass and Fukuyama, pain and suffering are the great character builders and all you sick people should just toughen up, grin, and bear it? What an odd omission. But she wins back major points with her general critique of conservative bioethics:

So deft are some conservative bioethicists at conjuring apocalyptic visions of a post-human future that the journalist Will Saletan has characterized them as “standing athwart history, sighing ‘Oy.’” He has a point. To be sure, they sigh with erudition and with eloquence. Should conservative bioethicists–or any bioethicist, for that matter–counsel us on reasons for vigilance? Yes, but too often they warn us not to make any progress at all. There is an irony here. For all the deference that conservative bioethics pays to the implicit wisdom of the ages, it rarely mines the recent past for lessons. Instead of concentrating on the ancients, why not also study the history of in vitro fertilization, paid egg donation, and surrogate motherhood to learn about cultural resistance and adaptation to such practices?

Even better, why not consider earlier practices that were deemed repugnant in their day but are now unexceptionable? The list of these moral apocalypses that never were is a distinguished one: vaccination, anesthesia, blood transfusions, life insurance, artificial insemination. Perhaps the systematic analysis of these practices holds little interest for conservative bioethicists because most of society now regards them as nonissues. Or more likely, they regard an objective assessment as irrelevant given their convictions that certain practices pose such an affront to human dignity that they should not be pursued at all, no matter how much good can come of them.

True that. (H/T Dvorsky)

What To Do With Embryos?

Francesca Minerva (what a cool name) at Practical Ethics gets into the sticky morality of adopting embryos:

[I]f the main concern of couple who adopt embryos is to save as many embryos as possible because they consider them as morally valuable as already born children, why shouldn’t they adopt children who are already born?  In-vitro fertilization involves costs and health risks for women that adoption does not involve. It seems, then, that anything equal, adopting a child instead of an embryo is a more rational choice.

Moreover, if the goal is to save as many human lives as possible, we need a reason why an embryo is more entitled to be “saved” than a five year old child, for example.

The Canon: From Chance to Choice

From Chance to Choice: Genetics and Justice is a landmark text in bioethics. In nearly every work I read on enhancement, genetics, reproductive freedom, or health care, Buchanan et al. are in the bibliography. Written by four top bioethicists in 2000, FCtC is an effort to carefully investigate the questions and debates that had been raised by developments in genetic engineering at the end of the 20th century.

FCtC’s greatest strengths are its authors’ dogged commitment to thoroughness and the beautiful nuance of many of their arguments. No issue is glossed and the authors omissions are either handled in footnotes or recognized as such. In most cases, the attention to detail and effort to eschew bias is superb. For example, the “ethical autopsy” of eugenics at the beginning of the text covers the time span from Galton to post-WWII and investigates the plurality of pro-eugenics positions, methods, and government programs. The autopsy exposes the general scientific ignorance of even the most intelligent supporters as well as their many biases From their historical analysis, Buchanan et al. determine the primary failing of the first eugenics movement was its coercive means and bigoted motivation.

Throughout FCtC, Rawls’ theory of justice provides a foundation, with each chapter moving slowly and deliberately through the mine fields of reproductive rights, health care and equality, primary goods, and other basic facets of society that genetic engineering threatens to put into flux. Most interesting, however, is the investigation into the “Morality of Inclusion.” This principle, drawn from arguments by disabilities rights advocates, advances the case that an effort to eliminate disabilities before birth using genetic engineering is tantamount to both negative genocide and positive dehumanizaton of the disabled. Buchanan (the primary author of the chapter) proceeds to address the issue of the “Morality of Inclusion” with some of the best and most nuanced argumentation I have ever read. His deft handling of their accusations, the highly pertinent counter-examples, argument deconstruction, and ability to draw upon the deep work of previous chapters is astounding. It’s really marvelous to read.

If you are interested in the bioethics of human enhancement, this is where you must start. If you’re pressed for time, skim chapters 1 and 3, read 2 and 7 in depth.

Great Paper Title

“‘NOBODY TOSSES A DWARF!’ THE RELATION BETWEEN THE EMPIRICAL AND THE NORMATIVE REEXAMINED” CARLO LEGET, PASCAL BORRY, RAYMOND DE VRIES (Bioethics, vol. 23 issue 4)

Transparency

See-through tech makes our lives…easier?

The above image is of a transparent goldfish engineered to allow the little guy to serve as a living anatomy showcase, saving millions of his (or her? does anyone here know how to sex a goldfish?) brethren from going under the knife. [Gizmodo]

Alternatively, William Saletan argues for the use of full-body scanners at airports. Originally, this idea made me angry because it didn’t involve “fire everyone in the TSA” as part of the argument. Then I realized that I wouldn’t have to disrobe (including shoes, jackets, my watch, belt, etc.) because the TSA could just see through all of it. So, tentatively, I support the use of scanners if and only if other restrictions, such as taking away my liters of Code Red Mountain Dew, are lifted.

As a side note – I know the privacy thing is worrying and that people get especially squeemish around the naked human body. Folks, the human body is gross. Not bad or sinful, mind you, nor does the body’s grossness take away from how impressive a natural machine it is. But for every Adonis and Aphrodite that walks through that scanner, the poor TSA agents are going to have to look at hundreds of people naked that they’d really rather not. It’s like the Clockwork Orange effect for peeping toms.

New Bioethics Council

After kicking Kass to the curb Obama has selected Amy Gutmann, the president of the University of Pennsylvania, to head a new bioethics council. The whole set up looks extremely promising:

Bioethical, social and legal questions relating to genomics and behavioural research are all on the commission’s agenda. So are issues of intellectual property, scientific integrity and conflicts of interest in research.

The contrast with the previous bioethics council established by President George W. Bush is stark. Bioethicist George Annas of Boston University, Massachusetts, has described that council, which existed in two incarnations, as having a “narrow, embryo-centric agenda”, focusing largely on the research implications of questions such as the moral status of the embryo and when life begins (see Nature 431, 19–20; 2004).

In another break with the past, Obama has chosen not to appoint bioethicists to lead the commission. Instead, it will be chaired by political theorist Amy Gutmann, president of the University of Pennsylvania in Philadelphia, and its vice-chair will be materials scientist James Wagner, president of Emory University in Atlanta, Georgia.

Gutmann’s work deals with deliberative democracy, and using reasoned argument to depolarize politics.

Imagine that, Obama appointed someone who made her name trying to depolarize politics. It gives me hope.

["US Bioethics council promises policy action"  Nature]

The Bioethics of Human Enhancement

Transhumanism is a weird area of study and a complicated field to try to get your head around. Pop Transhumanism is shifting it’s focus a bit and I’m looking more intensely at specific issues of ethics within the modification of human beings. Don’t worry, now that I’m back from my international travels there will be regular postings and my obsession with pop-culture won’t go away. In fact, it’ll probably be heightened, because now it’ll feel more like a break from the rigor than a distraction.

This will be the third time this blog has undergone revision and not the last, I suspect. Every part of what this blog tries to cover is fledgling and difficult to categorize. It is also a very public way for me to figure out what it is I’m trying to study. For now, I’ve settled on a new line of focus: The Bioethics of Human Enhancement. And I’ve given up on trying to report/break/immediately discuss stories. That’s not what I’m good at doing. I’m no reporter and awful at neutral prose (as R.U. Sirius can confirm). I’m an analyzer and synthesizer. I’m also a debater, so hopefully I can nettle a few of my fellow technophiles and a lot of technophobes and bioconservatives into some rousing discussions.

Right now I have a few big gun targets lined up for critique. Among them, Jurgan Habermas, Francis Fukuyama, and the critics of Oscar Pistorius and Aimee Mullins. Additionally, I’m working on an analysis of Julian Savulescu and Nick Bostrom’s core ethical theories. Oh, and an essay on Lady Gaga.

For those of you harassing me to get writing again, thank you.