The President's Council on Bioethics, Take Two
Can Obama do better than Bush when it comes to biotech freedom?
In June, President Barack Obama disbanded Bush's controversial President's Council on Bioethics. He is expected to appoint a replacement panel sometime this fall. This is no small matter. Before terrorism became the all-consuming interest of his presidency, it looked like bioethics policy might be Bush's lasting legacy—his first televised speech to the nation was about restricting stem cell research. Now it's Obama's turn. What should the next bioethics council do?
The future bioethics commission should be data-driven rather than ideology-driven, writes Michael Peroski, of the Progressive Bioethics Initiative at the Center for American Progress—a left-leaning think tank from which President Obama has plucked numerous members of his administration. I quite agree. A national bioethics council should seek out data on the risks and benefits of new biotechnologies and figure out how to adequately inform citizens about them. A bioethics commission could also make valuable recommendations on how best to make sure that patients and research subjects are fully informed and protected against undue safety risks.
However, Peroski's essay goes off the rails with his rather odd example of what he means by ideology-driven bioethics. "Proceeding from ideology-driven inquiry entails starting from an answer: 'Research on human embryonic stem cell should be forbidden because embryos are equivalent to human lives' and working backwards to a question: 'Is research on human embryonic stem cells ethical?,'" suggests Peroski. "Proceeding with data-driven inquiry means starting with the question: 'Is embryonic stem cell research ethical?' and then taking the time to educate the public, gather information about public sentiment on the topic, carefully analyze the costs and benefits of proceeding with or prohibiting the research, and offering a pragmatic recommendation that takes all of these considerations into account."
I am pretty sure that people who think that embryos are people would respond that Peroski's data-driven formulation is basically begging the most important question rather than answering it. But other progressives see no problem with ideology-driven bioethical inquiries. For instance, the nation's progressive-in-chief: In March, when President Obama issued a new executive order setting up a review that would allow for the expansion of federal funding for human embryonic stem cell research, he also declared: "We will ensure that our government never opens the door to the use of cloning for human reproduction. It is dangerous, profoundly wrong, and has no place in our society, or any society."
Hold on a minute! Where is the supposedly non-ideological data-driven question: Is human reproductive cloning research ethical? It turns out that President Obama's proposed ban on reproductive cloning is motivated by exactly the kind of ideology-driven inquiry decried by Peroski. What if a data-driven inquiry found that cloning could be done safely so that cloned babies would have as much of a chance to be healthy as those produced conventionally? Would it still be "profoundly wrong"? No answer.
In a companion essay to Peroski's, Marcy Darnovsky, associate executive director of the radical Center for Genetics and Society, takes up some conservative concerns about bioethics from a progressive perspective. She worries about how cloning and other biotech developments might change the way we "uphold social justice, human rights, and even our shared humanity." Her way of resolving conflict isn't ideology, she says, but finding "ways to extend the purview of democratic oversight to these questions and challenges." Darnovsky claims that the advent of designer babies, the development of markets for human eggs and gestational surrogacy services, and the possibility of human genetic enhancement "call for substantive deliberation about [their] meaning and consequences, among the widest range of stakeholders." But then, in a seeming about face, she praises President Obama for singling out "human reproductive cloning as an instance of intolerable misuse." Intolerable? Who's an ideologue now?
Darnovsky's vision of how to establish and empower a new bioethics council is shot through with an ideology, one which amounts to democratic authoritarianism. Polls show most Americans currently oppose human reproductive cloning, a fact Darnovsky may be relying on to secure the outcomes she prefers. But are poll results sufficient moral justification for banning any new technology? Hardly. Recall that in 1969, a Harris poll found that a majority of Americans believed that producing test-tube babies was "against God's will." In 1970s, the federal government imposed a moratorium on federal funding of in vitro fertilization (IVF) research. In 1995, a Tarrance poll found that 74 percent of Americans opposed government funding of research that would involve destroying or discarding live human embryos in the first two weeks of development. In 2001, 60 percent of Americans in an ABC News poll and 56 percent in a CNN-USA Today-Gallup approved President Bush's restrictions on the funding of human embryonic stem cell research.
That was then, and this is now. In 2009, solid majorities of Americans enthusiastically back both in vitro fertilization and human embryonic stem cell research. If Darnovsky had had her way, an inclusive bioethics panels in the bad old days would likely have banned both IVF and stem cell research as an exercise of their "democratic oversight."
Darnovsky's democratic inclusiveness extends offshore. Darnovsky urges that "a national bioethics council should take advantage of the important work that has already been done throughout the world toward development of responsible policies for genetic, reproductive, and biomedical technologies. The United States is in many ways an outlier, with few meaningful regulatory and oversight policies in place." Well, yes. And a good thing too, since lack of government intrusion allows for the expression of moral pluralism. So far, at least, with regard to many biotechnical advances, the majority in the U.S. doesn't get to impose its values on the minority, as has happened in many other countries.
Germany democratically bans using pre-implantation genetic diagnosis, for example, which involves taking a single cell from an eight-celled embryo produced by means of IVF to check it for genetic diseases. Would-be parents can choose embryos that do not have the deleterious gene. In addition, Germany bans the derivation of human embryonic stem cells. Producing human-animal chimeras by combining human and animal genetic material with the goal of producing stem cells or animals that better model human diseases is outlawed by Australia, France, Germany, and Italy. Canada democratically bans the sale of human eggs and sperm, punishing violators with a maximum penalty of a $500,000 fine and 10 years in prison.
As a result of these overseas restrictions on various assisted reproduction treatments, the United States has become a haven for people seeking reproductive freedom. For example, fertility treatment centers in Illinois reported in June that overseas patients seeking to use donor eggs or surrogacy to have babies had jumped 50 percent this year. As IVF specialist Brian Kaplan noted, "Unfortunately, these couples are often restricted by harsh regulations and limited options in their own country."
There is a difference between progressives like Darnovsky and true liberals. Liberals believe that human rights enjoy priority over democracy. Liberals accept as true that there is a protected sphere of private activity and belief into which even well-meaning democratic majorities may not intrude. Biotechnology is one of a suite of new intimate technologies which are well on the way to empowering people to enhance themselves and their progeny by giving them stronger bodies, longer and healthier lives, and smarter brains. Certainly technologies dealing with birth, death, and the meaning and purpose of life need protection from meddling by others who, however democratically, would force their visions of the good on the rest of us.
A national bioethics panel can serve a very valuable function in communicating to the public the ethical risks and benefits of new biomedical treatments and research endeavors. But when people of good will deeply disagree on moral issues that don't involve the prevention of force or fraud, it is a fraught exercise to submit their disagreement to a panel of political appointees or a democratic vote. That way leads to intolerance, repression, and social conflict. Whatever else President Obama's new national bioethics council does, it must make sure that Americans have wide scope to pursue their own visions of the good without excessive hindrance by their fellow citizens.
Ronald Bailey is Reason magazine's science correspondent. His book Liberation Biology: The Scientific and Moral Case for the Biotech Revolution is now available from Prometheus Books.
Disclosure: I had the pleasure and privilege of participating in the Center for American Progress's Progressive Bioethics Summit two years ago.