On April 16 on Capitol Hill, the New America Foundation sponsored a panel discussion on "Cloning, Stem Cells, and What Comes Next?" The speakers included me, Shannon Brownlee from the New America Foundation, Eric Cohen from the Ethics and Public Policy Center, and William Kristol, editor of The Weekly Standard. Cohen and Kristol are co-editors of a new book, The Future is Now: America Confronts the New Genetics, filled mostly with neoluddite musings. But the book does reprint my Reason article, "Petri Dish Politics," which discusses the new biopolitics emerging in the 21st century in a less frightened manner than most of the book's contributions. Kristol and Cohen's dystopic view of the new genetics is made clearly evident by the dark and distorted image featured on their book's cover.
The one thing that the panel members (besides me) could absolutely agree on was the need for stronger federal regulation of what Princeton biologist Lee Silver calls "reprogenetics." Panelist Shannon Brownlee, it turns out, is a standard-issue liberal whose knee jerks in favor of more federal regulations whenever she encounters any activity that she thinks might possibly go awry. Brownlee, who has cast her gimlet eye on America's very successful fertility industry, finds a few instances of misconduct, panics, and calls in the feds.
During the panel discussion, she justified stricter regulation by citing two examples of wrongdoing in fertility clinics. Curiously, they did not prove her case. In fact, they proved the opposite.
In the first case, fertility doctors in California swapped embryos without their patients' consent. In the second, a fertility specialist in Virginia was artificially inseminating patients with his own sperm. Do these aberrations prove we need new regulations? In the California case the doctors were indicted and convicted of fraud. In the Virginia case, the fertility specialist was convicted on 52 counts of fraud and perjury and sent to prison for five years. Clearly our legal system can already punish such criminals without new federal rules or new regulatory bodies.
William Kristol offered a more serious challenge to the future of reprogenetics. He insisted that my expectations for a modern medicine catering increasingly to patient choice, including genetic enhancements chosen by parents, are hopelessly utopian. Kristol insisted, and the audience of Hill denizens and the other panelists all nodded in agreement, that the federal government is only going to become ever more deeply involved with health care, especially in financing it.
As a consequence of this growing federal role, the government would necessarily be involved with setting standards and protocols for any new genetic technologies, including most especially interventions aimed at genetic enhancements. According to Kristol, cloning, even just therapeutic cloning to create perfect transplants, is further down the slippery slope where, when we reach the bottom, we will find that the Brave New World of government-mandated eugenics is inevitable.
In this scenario, future government health care decision makers will succumb to the egalitarian temptation. They will eventually mandate that parents use genetic technologies to insure that their children have stronger immune systems, more athletic bodies, and cleverer brains. Of course, the flip side of the egalitarian temptation, which Kristol clearly prefers, is to forbid parents from using genetic technologies to benefit their children. If everyone can't have access to the new technology, then no one should have access to it.
No one else appeared to notice the irony of Kristol's analysis. Here was the man who is often credited with single-handedly stopping Clinton from nationalizing health care now declaring that free market medicine is doomed. Of course, Kristol might declare it doomed because such a declaration conveniently suits his political needs of the moment -- that is, bolstering his campaign to ban both therapeutic and reproductive cloning. In any case, instead of trying to stop potentially beneficial biomedical research because he fears what the government may do with it one day, Kristol should instead be redoubling his already successful efforts to make the government less powerful and less intrusive in the private choices of citizens.
However, there are good grounds to believe that Kristol's dystopia of government-mandated eugenics is unlikely. First, we already have the example of America's thriving fertility industry. Much to Shannon Brownlee's dismay, it is largely unregulated and, as a consequence, it is highly innovative. Since 1978, when the first test-tube baby, Joy Louise Brown, was born, hundreds of thousands of healthy babies have been born using in vitro fertilization and related techniques.
You can't get much more free market than the fertility clinics, since almost all fertility treatments are paid out-of-pocket by patients. Insurers and government health care systems have not entered this area. Why? Largely because they are strapped for cash and therefore loath to expand into new areas of medical care.
As new, more-personalized therapies designed for specific patients are developed using knowledge gained from genetic science, more and more health care sectors will come to resemble the fertility industry rather than mass medicine offered by HMOs and Medicare. Indeed, as Americans become wealthier and older they will turn increasingly to personalized medicine. It is even possible that as biomedical researchers increase their knowledge of the interactions between environmental factors and underlying genetic predispositions, targeted treatments may become not only more effective but cheaper as well.
Finally, banning biomedical research like therapeutic cloning on the grounds that the government may one day abuse it is somewhat like saying we should ban telephones because the FBI can listen in on our private conversations. If we ultimately cannot limit the government's intrusions into our lives, then it little matters whether cloning and other genetic technologies are banned now or not, since whenever the oppressive government Kristol is envisioning comes to pass, it will simply mandate genetic technologies when it wants to anyway. The problem is government power, not biomedical research.