AFTER MORE THAN TWO YEARS of complaining that President Bush’s Council on Bioethics has been a reactionary, jaundiced, and unscientific influence upon American science policy, its critics have changed tack. The sneer du jour is that it has had no effective influence upon the administration.
The council was conceived in a blaze of publicity at the president’s first primetime national address in August 2001. Its chairman is Leon Kass, a prominent professor of social thought from the University of Chicago. Seventeen other high-profile scientists, doctors, ethicists, social scientists, lawyers, and theologians were appointed in January 2002. Since then, the council has produced several weighty reports on human cloning, biotechnology and the pursuit of happiness, stem cell research and assisted reproduction, as well as an anthology of literature illustrating bioethical dilemmas.
And what has been the result? According to a report in the Boston Globe last month, very little.
The Globe obtained White House correspondence with the council under the Freedom of Information Act. This showed that it had been a mere “afterthought” that “served primarily to give an ideologically rigid president the veneer of open-mindedness.”
Bioethicist Arthur Caplan of the University of Pennsylvania, whose two cents’ worth is sought almost daily by the media on issues ranging from embryo storage to feline kidney transplants, was equally dismissive of the council’s fascination with “esoterica.” “They haven’t had anything to say about Americans lacking health insurance, research in the Third World, drug pricing,” he told the Globe.
Only two days after the Globe‘s report, a withering blast from the same point of the compass appeared in Nature, the world’s leading science journal. Boston University bioethicist George J. Annas and a colleague from Northwestern University claimed that the council had been responsible for making “public bioethics” so narrow that it had become “virtually irrelevant.” In a post-9/11 world, bioethicists ought to be debating the war on terror–but instead the council had been shilly-shallying with its “embryo-centric, anti-abortion and anti-regulation political agenda.”
While these accusations of toothlessness are relatively new, the council has been at the center of controversy since it was set up. From the beginning many bioethicists felt that it had been stacked in favor of the president’s pro-life leanings. Last year, for instance, Glenn McGee, editor of the American Journal of Bioethics, penned a vitriolic editorial comparing Leon Kass to a professional assassin with the same name in a 1994 film and describing him as the “messenger of a new antiscience elite.”
And when scientist Elizabeth Blackburn was dropped from the council at the beginning of 2003, the grumbling became a howl of outrage. Employing a rather tasteless hyperbole for a 9/11 world, the American Society for Cell Biology denounced the firing of its former president as a “Friday afternoon massacre.” Since then, and no less hyperbolically, the work of the council has been used as evidence by the Kerry campaign that the Bush administration has consistently distorted and censored its scientific advice.
It seems paradoxical that the council should be damned for corrupting national science policy and also disparaged for sitting on its hands. What merit do the charges of ineffectiveness and embryo-centrism have?
Not much.
First of all, the council was never intended to be a legislative think tank. In fact, its brief from the president was not “the review and approval of specific projects,” but a “fundamental inquiry into the human and moral significance of developments in biomedical and behavioral science and technology.” For the pragmatic wing of the bioethics profession, this may look like thumb-sucking. For those who worry about the dehumanizing potential of biotechnology, it looks like a much-needed policy handbrake.
Second, President Bush sought a variety of views and not “a single consensus position.” In an apparent effort to be genuinely inclusive, he appointed 18 members whose views on the moral status of the embryo–and nearly everything else–differed. As a result, it soon became obvious that the council was deeply divided between technology enthusiasts and technology skeptics. It did become “a forum for a national discussion of bioethical issues”–but at the cost of limiting the range of substantive agreement. In short, the president himself had hard-wired the council for hemming and hawing.
Despite this handicap, under Kass’s guidance it still managed to slash its way through thickets of scientific fact, semantic distinctions, and bioethical principles and emerge with a clutch of proposals for interim legislative measures, especially in the areas of cloning and assisted reproductive technology.
Finally, the charge of embryo-centrism assumes that microscopic embryos are too narrow and trivial a topic for a national debate on bioethics. On a practical level, this is quickly refuted. One of the facts uncovered by the council is that the in vitro fertilization business in the United States has swollen from nothing into a $4 billion industry in 25 years. The financial potential for embryonic stem cells is largely speculative, but it could be far greater. The future of embryos touches every home in America.
According to another council member, William B. Hurlbut, a medical doctor and instructor at Stanford, belittling the importance of the embryo ignores the commercial potential of human body parts at all stages of development. “Anyone who denigrates our council work as ’embryo-centric’ and therefore an overfocus on obscure concerns is not seeing clearly where science is heading,” he says. “Sometimes the smallest things carry the largest meaning. This is not ‘microethics’ but a crucial hinge in the history of our understanding of human embodiment and human dignity.”
On a political level, the word “embryo-centrism” is a potent weapon in an often spiteful civil war among bioethicists over the very nature of what they do with their time. The word “bioethics” was coined only three decades ago, in 1970, by an American oncologist, Van Rensselaer Potter. The new field of study metastasized quickly, invading medicine, ecology, and sociology as well as traditional philosophy. But unlike sharp-edged disciplines such as physics or mathematics, bioethics has goals, methods, and boundaries that are as murky as the lower depths of the Potomac River.
What has emerged from the quarrel over the council is evidence of the fracture between the “bio” substance and the “ethics” process. Critics like Annas and Caplan focus on the ethics–the codes, protocols, and declarations created by their new discipline. In their eyes, the destiny of bioethicists is to sit on bioethics committees and set public policy. As council member Gilbert Meilaender pointed out in an email, “It’s exactly that view that has been responsible for a loss of much of the depth of reflection in bioethics in recent years.”
Kass’s fundamental concern, however, and one that is reflected in the unusually thoughtful tone of the council’s reports, is to examine the “bio”–the nature of life and what it means to be a human person. As the 2002 report, Human Cloning and Human Dignity, says, “On the surface, discussion has focused on the safety of cloning techniques, the hoped-for medical benefits of cloning research, and the morality of experimenting on human embryos. But driving the conversations are deeper concerns about where biotechnology may be taking us and what it might mean for human freedom, equality, and dignity.”
A variety of public policy issues merit careful study by bioethicists, but few affect a fraction of the people whose lives are touched by the rapidly changing context of human reproduction. On that score alone, the council’s deliberations deserve praise, not censure, for placing far-reaching technologies at the center of national debate–not closeted away in company boardrooms.
There could be a lesson for the White House in this most recent spat over the President’s Council on Bioethics: the folly of bioethical open-mindedness. Had the president really stacked the council with clones of Leon Kass back in 2002, the amount of noise made by its critics would have been about the same, but the council’s achievements might have been even more substantial. If the election swings Bush’s way in November, he might want to try again.
Michael Cook is the editor of BioEdge, an Australia-based international email newsletter on bioethics.
