This week’s readings included two pieces about the public debate and interpretations surrounding bioethics, while the other looked at a “new” movement in bioethics. The first reading, Reflections on Public Bioethics: A View from the Trenches by Leon Kass, is a review of the major work done by the President’s Council on Bioethics. The President’s council on Bioethics is “a public body, devoted to public questions, whose activities are fully open to public scrutiny” (222). Kass asserts the point that this council has “a duty to promote a greater understanding of these issues for a wider national public,” repeatedly mentioning the importance of discussing bioethics in terms of “ordinary public discourse” (223, 228). I think this is an important point because, before having read any of the articles presented in class, I personally didn’t know very much about human cloning and found it hard to interpret all the issues surrounding it due to the use of bioethics jargon.
The majority of Kass’s essays reviews the five major works of the council, which attempt to address the previously mentioned goals of the council. The first of these works, Human Cloning and Human Dignity: An Ethical Inquiry, was one of our readings from last week and discusses the case for and against cloning-for-biomedical-research and cloning-to-produce-children. As mentioned by Paula in her blog post last week, the majority of the council recommended no human cloning to be allowed.
Monitoring Stem Cell Research is an update that summarizes the significant developments in stem cell research, with the overarching goal “to convey the moral and social importance,” surrounding stem cell research (232). Because stem cell research was a relatively young and constantly developing field at the time, the council intended for this section to improve understanding in order to achieve better public discussion and decision making with regards to stem cell research.
Beyond Therapy: Biotechnology and the Pursuit of Happiness examines the use of biotechnology to serve “human goals beyond healing disease and relieving suffering,” (234). This section deals with questions of human character and humanity, looking into human desires for ageless bodies, happy souls, and “better children.” I found this section to be very interesting. On the one hand, I think the use of technology to potentially treat or prevent mental illness could be beneficial. However, I don’t think we should use these technologies to attempt to create “better children” by selecting for specific genetic traits. In the future, I think this can lead to a blurred line between what is humanity and what is not, while also making regulation of bioethics very difficult to put in place or enforce. As mentioned by Kass, the issues presented in this section force one to look beyond issues of fairness, autonomy, and equality and to consider issues of identity, hubris, and humility to name a few (237).
Being Human: Readings from the President’s Council on Bioethics focuses on aspects of “being human” and how bioethics issues touch on matters “close to the core of humanity,” (238). To address these questions in greater depth, the council published an anthology of readings surrounding the questions of what it means to be human. The final section of the council’s works, “Reproduction and Responsibility: The Regulation of New Biotechnologies,” discusses regulation of biotechnologies, finding that present regulatory institutions are unable to remain up to date with the fast pace of technological advance (242). Instead of recommending a proposal for new regulatory institutions, the council provided a proposal that targets what they believe to be unethical practices in human reproduction, one of which being the prohibited “use of human embryos in research beyond a designated stage in development,” (244).
While this report had the goal of improving public understanding surrounding the debate on bioethics, Kass notes that it is hard to educate people without telling them a direct answer on what they should do. Kass cites “the life question” as one of the “most frustrating aspects of public bioethics,” because it leads most to forget about other important aspects of public bioethics, such as human dignity and human freedom. The life question is “the principle that calls for protecting, preserving, and saving human life,” which as Kass states, although an important consideration, “cannot continue to be the sole consideration in public bioethical discourse,” (249).
- In his essay Kass asks, “When and to what extent should we strive to change and alter nature and especially our own given nature, in an effort to improve or save it?” When do you think the altering of human nature should be stopped or regulated?
Our next reading, Not Just for Experts: The Public Debate about Reprogenetics in Germany by Kathrin Braun examines how policy debates in Germany regarding reproductive and genetic technologies stemmed debates on the definition of ethics and the role ethicists play in public policy. As Braun states, ethics in this context is about “how a nation-state should handle developments in science and technology, specifically in biology and medicine,” (42).
The two sides of the bioethics debate in Germany consist of techno-skeptics and techno-optimists, but the two sides are not strictly split based on ideologies. Techno-optimists “emphasize technologies potential benefits, welcome enhancement of choice, and believe that society is able. . .to calculate and to control potential risks,” (43). For them, ethics is a matter of choice with the task of rationalizing different conflicting values. Understood as a “specific type of professional academic expertise,” techno-optimists think the task of ethics is best performed by professionals.
Techno-skeptics on the other hand, “underscore the limits of technological solutions and the price that individuals and society might have to pay for them,” (43). An important ethos for techno-skeptics incorporates the will to not distinguish between a life worth living and a life not worth living. They conceive ethics as “a matter of paying respect to a set of common legal and moral principles,” fundamentally meant to convey the nature of a good society (43-44). For them, ethics should not be left to the experts, rather ethics requires participation of citizens in a public debate.
Braun conveys the different ways to link politics to ethics through two different discourses: managerial and republican. Managerial discourse is characterized by the belief that problems surrounding genetic and reproductive technologies can be handled through a risk-benefit analysis. Ethics, in this case, is “a set of tools and techniques to solve problems and make decisions,” and emphasizes the competence of experts to handle questions of ethics (44). Republican discourse assumes that problems of technology are a social problem, with genetic and reproductive technologies seen as “affecting fundamental moral principles, questions of identity, and the meaning of life,” (44). Emphasizing citizen engagement and the notion of a good society, problems of ethics cannot be solved, according to republican discourse, without the engagement between citizens and policymakers in a public debate setting (44).
In the rest of Braun’s paper, she applies these differing sides and discourses to portray the development of the bioethics debates in Germany. While the German Embryo Protection Act was highly restrictive, the German abortion law considers abortion to be “illegal but not subject to prosecution,” meaning that abortion is only necessarily considered morally and legally wrong in principle. Something I found interesting about the German abortion laws is that it is based on the idea of “support instead of punishment,” assuming social support is more effective in encouraging women to continue their pregnancy instead of banning abortion entirely, which I tend to agree with. Surrounding the debate on the status of embryos, in 2002 it was decided that the importation and use of embryonic stem cells be prohibited in principle, with the passing of the Stem Cell Act that same year.
- Do you relate more to a managerial or republican discourse surround the meaning of ethics and its place in policy?
- Do you think it’s entirely possible to distinguish between a life worth living and a life not worth living? How would the distinction translate into ethical policy?
Our last reading, The New Conservatives in Bioethics: Who are they and what do they seek? by Ruth Macklin, analyzes the new label of a “conservative” movement in bioethics which they believe challenges ideas and topics in liberal, mainstream bioethics. Throughout the reading, Macklin asserts how these new labels have led to misunderstandings and misinterpretations within bioethics. For example, what used to be deemed conservative bioethics is generally considered to be liberal bioethics now. Macklin cites conservative bioethicists as opponents of biotechnology and its use in “interventions they term ‘artificial’”, new reproductive technologies, stem cell research involving the destruction of embryos, and biomedical efforts to enhance physical or mental capabilities (35).
The mission of conservative bioethics is “to prevent our transformation into a culture without awe filled with people without souls” (37). Conservatives find that mainstream bioethics often disregards the “deeper questions of human dignity and human nature,” (37). Macklin takes issue with the mission of conservative bioethics and find that it leads to confusion about the bioethics field. Through the use of poetic and metaphoric language, appeals to emotion, sentiment, and intuition, mean spirited rhetoric, and discussion of “projects,” Macklin conveys how conservative bioethics has come to misconstrue many concepts and ideals within bioethics. This made me think about our two previous readings for this week, and how both conveyed how important it is to discuss the debate in bioethics in terms the public can understand. Personally, I found many of the examples cited by Macklin to be troubling, especially the opposition to all things “artificial.” The label of being artificial can come with a negative connotation and I think the way the conservatives use this term is inaccurate. As mentioned by Macklin, there is no “artificial sex” that brings “artificial babies.” The babies conceived in this way are quite real, with nothing artificial about them, and they are not conceived through sex because, usually, the female is unable to conceive a child the “natural” way.
- Do you think labels like liberal and conservative can be applied to bioethics? Or do you agree with Macklin that such labels render confusion within the field?
- In her discussion of making children “more biologically equal,” by researching stem cells that could help address child diseases, Macklin asks the question, “Why is it acceptable (or is it?) to alter the physical environment to benefit individuals with disabilities (i.e. accommodations for wheelchairs) but not their biological attributes?” What do you think about this question? Do you think physical environment and biological attributes are comparable in this instance?