The Politics of Bioethics

...indeed, it would have been almost impossible for anyone to predict in January 2002 (when its membership was announced and when it began its work) what the council would say about an issue such as research that destroys embryos in order to procure stem cells...

...Anyone who followed the resulting controversy might be forgiven for supposing that the last smidgen of diversity of opinion in the Bush administration had been crushed beneath a desire for ideological conformity...

...To be sure, he was a cautious supporter of embryonic stem-cell research, but hardly one with whom those with other views would have thought of themselves as "clashing...

...In order to accomplish this—in order to marginalize participation by those eager to discuss larger questions, and in order to keep elected officials from concerning themselves with these questions—scientists were willing to give an advisory, though clearly secondary, role to some bioethicists...

...There were clinicians and lawyers, and even a journalist (though Charles Krauthammer, trained first as a psychiatrist, is no ordinary journalist...

...The academy dis-cusses—and disapproves because of risk of harm—what it calls "reproductive cloning," that is, producing a cloned embryo, implanting and gestat-ing it, and bringing to live birth that cloned human being...

...they are questions about who we are, where we are going, and what sort of people we want to be...

...The last observation, at least, was accurate...

...When it turned out that the council was, in fact, a highly diverse—even contentious—group, few of these critics took the occasion to offer a public mea culpa...

...Such unnuanced and careless comments, which are not unlike other things she has said in print about the council's work, suggest that the White House acted unwisely...

...The aim was to make bioethics the province of a small cadre of experts—however limited their insight might be beyond their range of expertise...

...The views expressed here are his own and do not represent the council...

...Indeed, years from now, when the full story of the council's work can be adequately told, I suspect it will be clear that ideological conformity has been sought at least as fervently by scientists as by any other group in our society...

...So here is the irony of it all: Those who charge that the White House has "politicized" bioethics are right, though hardly in the way they suppose...

...In a recent study, Playing God...

...The larger and more important point that should concern us, however, goes well beyond particular individuals, reports, or committees...

...tinguished a bioethicist as there has been over the last 40 years, has written that Evans's argument "needs to be taken seriously by all those who believe that a basic consideration of human ends and biomedical goals has been neglected...

...A petition circulated among bioethicists piously advised the president: "On controversial issues your council must consist of members with a wide range of opinions in order to provide wise, prudent and effective advice...

...Arthur Caplan, a bioethicist, seemed assured that the council would "steer nearly exclusively to the right" and took care—unsurprisingly for readers of Evans—to note that there were few bioethicists on the council...

...Before we consider this recent brouhaha, it will be useful to provide some historical context...

...Having argued that such reproductive cloning is for now unsafe, however, the academy's report asserts that "there is a very different procedure, here termed nuclear transplantation to produce stem cells . . . whose aim is the creation of embryonic stem cells (ES cells) for clinical and research purposes...

...The academy's verbal gymnastics have the effect of redescribing this act entirely in terms of the motives or goals of the agents, and it is, I think, a redescrip-tion carried out much more for political purposes than for rigorous pursuit of clarity and truth...

...BY GILBERT MEILAENDER AT THE END OF FEBRUARY, the White House announced changes in the membership of the President's Council on Bioethics...

...We can all hope that is generally the case, but anyone who has read Evans's account must also know that some demytholo-gizing is in order...

...It broke the stranglehold that had been established by researchers and bioethicists in the 1980s—and, unsurprisingly, it brought swift criticism from some of those whose professional status had been undercut...

...This is, I fear, more sleight of hand than quest for truth...

...Given that fact, it hardly seems necessary for the White House to justify its decision to turn elsewhere...

...This impossibility did not, of course, prevent some from making such predictions...

...And those bioethicists, in exchange for their place at the table (their place in clinical and research centers, on institutional review boards, and on national bioethics commissions) were on the whole happy to support the cause of advancing science...

...For the first time, a national bioethics panel had been established on which there was a wide range of opinion on controverted questions...

...In that public discussion, experts do, of course, have a role to play...

...But they should take care to see that their role informs the public discussion and illumines its contours (as, for example, the council's report on Human Cloning and Human Dignity did, when it set out in detail opposing arguments on the issue of cloning embryos for research...

...Thus, for example, Daniel Callahan, as disGilbert Meilaender is a member of the President's Council on Bioethics...

...It is about bioethics and politics...

...Bioethical issues are matters that ought to involve our elected representatives...

...But though there are others who share such a concern, many bioethicists did shift the focus of their work, and in Playing God...

...They are not, in the most fundamental sense, technical questions on which only experts may comment...

...Many of the most significant issues in bioethics force us to contemplate what it means to be human— which is something that concerns us all...

...Newspapers, magazines, and bloggers on the web used the news as an occasion to criticize the council...

...Evans tells a story that accounts for it...

...And those charged with "politicizing" bioethics do indeed want just that, but hardly in the sense their critics intend...

...Whatever is said by those who would like to reestablish the alliance between bioethicists and scientists—an alliance designed to contain these questions within a narrow frame-work—bioethics should be a political matter...

...And so the researchers joined hands with the newly emerging profession of bioethics in order to prevent a wide-ranging public examination of where biotechnology might be taking us...

...Thus, for example, writing in the Washington Post on January 17, 2002, in an article replete with factual errors, Rick Weiss managed to imply that the newly appointed council was not unlike the Taliban against which the United States was fighting in Afghanistan and cited "experts" who surmised that the council might well "legitimize an effort to codify fundamentalist views into law...

...Moreover, since these developments broke, Blackburn has been quoted as suggesting that several council reports carry the "strong implication . . . that medical research is not what God intended...

...In one of the many angry pieces Blackburn has written since her non-reappointment, she opined that scientific research "is defined by the quest for truth...

...Leon Kass...

...The other member who was not renewed, Elizabeth Blackburn, a distinguished researcher in cell biology, had been absent from roughly half the council's meetings...

...Charges of the "politicization" of science emanating from such quarters ought to be met with considerable skepticism...

...At a time in the early 1980s—just as bioethics was emerging as a profession recognized by universities, hospitals, and even the courts—the scientific research community was worried about the establishment of regulatory commissions, which might have placed limits on developing possibilities for human genetic engineering...

...It was very peculiar to read in news reports (such as that by Peter Gorner in the Chicago Tribune of March 4, 2004) that May and fellow council member Elizabeth Blackburn "had clashed frequently with more conservative panel members, including chairman Dr...

...Consider, for example, the report entitled Scientific and Medical Aspects of Human Reproductive Cloning, issued by the National Academy of Sciences in 2002, just months before the release of the council's report, Human Cloning and Human Dignity...

...One of the two council members not renewed for its second term, William F. May, whom I consider a mentor and whose presence on the council I will miss, had himself spoken of serving for only two years, but he will continue to serve the council as a senior consultant...

...The birth of public bioethics was inextricably intertwined with an attempt to narrow the range of public debate and to keep bioethical questions out of the hands of elected representatives...

...They view these questions as the concern of all of us—as the very stuff of democratic discourse...

...The two purportedly very different procedures begin, in fact, with precisely the same act— the cloning of a human embryo...

...That attempt succeeded in large part—until the appointment by President Bush of the President's Council on Bioethics...

...Indeed, some of those who circulated among bioethicists the petition criticizing personnel changes made for the council's second term, had been among those predicting in January 2002 that the council would be ruled by ideological conformity...

...After all, our ultimate bioethics commissions should be the bodies we call legislatures...

...Human Genetic Engineering and the Rationalization of Public Bioethical Debate, the sociologist John H. Evans analyzed the forces that altered public bioethics in this country during the 1980s—a transition from a bioethics that focused intensively on the meaning of our common humanity, on the goals that we should pursue in any transformation of human nature, to a bioethics that largely assumed certain goals and focused simply on the best means to reach those ends...

...Thus, for example, among council members were distinguished political scientists such as Francis Fukuyama and Michael Sandel, who had written relatively little about bioethical matters and were certainly not considered bioethicists, but who were prepared to think about the larger human questions raised by advancing biotechnology...

...Thus, the formation of the President's Council was an attempt to expand the range of public bioethical debate...

...Many researchers and some bioethicists protested the "politicization" of bioethics...

...The last thing they want is for the public to begin to have a say in these questions...

...Scientists are no less drawn to power, and have no fewer agendas, than others...

...This shift was not universal...

...One wonders whether Gorner actually read transcripts of council meetings, and, in any case, it is almost bizarre for anyone who knows May to picture him as "clashing frequently" with others...

...Thus, Evans tells a story of professions competing for jurisdiction and political clout...

...for it is there that the people themselves, through their representatives, should strive to think about these questions in rich and varied ways that do justice to the full meaning of our humanity...

...These critics want to keep bioethics out of public debate, to keep it the private domain of a small group of experts...