Questions our fathers never asked: The national debate on bioethics

The President delivered his annual State of the Union address Tuesday night to a packed house at the Capitol and a television audience of nearly 42 million. Naturally enough, the commentary the next morning zeroed in on the speech’s big points: progress in the fight against tyranny and terrorism, the economy, the future of Social Security, America’s dependence on oil. Headline grabbers, all.

But one paragraph of the text didn’t get as much attention as it deserved.

“A hopeful society has institutions of science and medicine that do not cut ethical corners,” the President said, “and that recognize the matchless value of every life. Tonight I ask you to pass legislation to prohibit the most egregious abuses of medical research: human cloning in all its forms, creating or implanting embryos for experiments, creating human-animal hybrids, and buying, selling, or patenting human embryos. Human life is a gift from our Creator — and that gift should never be discarded, devalued or put up for sale.”

He didn’t use the word, but what the President was talking about is called bioethics. In the broadest possible terms, bioethics is study of the ethical questions that arise from medicine, medical research and the biological sciences. Put another way, bioethics is where science and philosophy meet.

Bioethics is not a new discipline. Ever since the practice of modern medicine began in the 19th century, physicians have debated the ethics of providing care. When scientists first learned that our bodies, and in many ways our minds, are determined by the structure of our genes in the mid-20th century, the implications of that discovery escaped no one. Even modern bioethics has been around for more than three decades; the authoritative work on the subject, Van Rensselaer Potter’s Bioethics: Bridge to the Future, was published in 1971.

But in recent years, advances in science have thrown bioethics into the spotlight as never before. Stem-cell research, cloning and prenatal screening all bring with them serious ethical questions that have yet to be debated extensively, much less settled.

Is it ethical to create a fetus solely for the purpose of harvesting its stem cells? Is it ethical to terminate the pregnancy of a mother whose baby is at high risk for a birth or developmental defect? Is it ethical to choose the sex of your child? What about the hair color? Is it okay to select for height, attractiveness or intelligence? Should prospective employers be able to screen candidates for susceptibility to drug addiction or alcoholism? Should insurance companies be able to set a customer’s premiums — or even deny care altogether — based on your family history or DNA?

This isn’t science fiction. These are all questions that are already being discussed in the hallowed halls of our nation’s most respected institutions. And the pace of scientific advancement will only continue to accelerate.

Human beings have 23 pairs of chromosomes in our cells. Sometimes, due to an error in cell replication, a person can be born with an extra 21st chromosome. This condition is called trisomy 21. One of the effects of having an extra 21st chromosome is the family of birth and developmental defects known as Down syndrome.

In the June 2005 issue of the American Journal of Obstetrics and Gynecology, five doctors from King’s College Hospital in London published the results of a study in which they found that a particular test was 90 percent accurate in identifying instances of trisomy 21 in the first trimester of pregnancy.

In other words, we now have a test that can accurately predict whether a child will be born with Down syndrome early enough that, in the event of a positive result, the parents may opt to have an abortion.

This President’s interest in bioethics is nothing new. In November 2001, less than a year into his first term, President Bush issued Executive Order 13237 creating the President’s Council on Bioethics. The Council, made up currently of fifteen doctors, scientists, lawyers and philosophers from around the nation, advises the President on issues of medical and scientific ethics. Since its formation, the Council has released seven reports on such hot-button subjects such as cloning, assisted reproduction and stem-cell research.

But the concerns of the Council on Bioethics go far beyond such relatively narrow topics and delve into basic questions of political and social philosophy. As we learn more about the mechanisms of life, bioethics wiggles its fingers into every aspect of our society.

Even criminal procedure must take its cue from bioethics. How do we define the crime of murder when the legal definition of “person” is thrown into doubt? In 2004 the Unborn Victims of Violence Act defined a violent attack against a pregnant woman as two separate and distinct crimes: one against the woman and one against her unborn child. Our law has always held that an insane person cannot be held criminally responsible for his actions, but as we understand more about how the chemistry of our brains affects our behavior, the definition of “insane” is changing.

Ironically, the more we learn about ourselves and our bodies, the less clear the distinctions become: born and unborn, alive and dead, sane and insane.

In the 1992 New York murder case People v. Weinstein, the defendant was accused of strangling his wife and throwing her body from the window of their twelfth-floor apartment. Though Weinstein had never been treated for any mental disease and had no history of diagnosed mental illness, his defense entered a plea of not guilty by reason of insanity. During the trial, the defense introduced medical evidence that showed a defect on Weinstein’s brain called an arachnoid cyst, and argued that the defendant’s brain had not been functioning normally when he committed the crime.

In the face of such persuasive evidence, the prosecution stopped the trial and let Weinstein plead guilty to manslaughter.

There is no evidence whatsoever, either clinical or correlative, that links arachnoid cysts to violent or criminal behavior.

The Bush administration has taken intense criticism over the past five years for what has been widely described as a negative or dismissive attitude toward science. Last February, the Associated Press characterized statements made at the American Association for the Advancement of Science thusly: “The voice of science is being stifled in the Bush administration, with fewer scientists heard in policy discussions and money for research and advanced training being cut.” In particular, the President has been widely rebuked for his refusal to allow federal funding of embyronic stem-cell research, despite being the first President in history to provide federal funding for other forms of stem-cell research.

In fact, the Bush administration, through its support of adult stem-cell research funding and the establishment of the Council on Bioethics, has been remarkably forward-thinking in its attitude toward science and research. But the administration’s focus on the ethical advancement of science angers those who think advancement should be unhindered by concerns of conscience. University of California lecturer Dale Carrico wrote last September about what he called “the devastating debasement of consensus science under the Bush administration.” Carrico and other self-described “techno-progressivists” show no reluctance in expressing their disapproval of the current trend toward ethical advancement rather than advancement for its own sake.

Sometimes that disapproval is sincere and honest; this week it was scornful mockery. Jonathan S. Reiling, a designer from Arlington, Va., framed his comment on the President’s position on bioethics in that uniquely American form: the tee shirt. “I have little doubt that the use of [the phrase ‘human-animal hybrids’], so carefully wedged between two long standing public issues, was a scare tactic,” Reiling wrote on his Web site this week. “Three choice words and Bush does what it is he does so well: distills complex issues into overly simplified statements that appeal to the base emotions.”

Reiling’s mockery is of course understandable. Human-animal hybrids are the stuff of bad B-movie science fiction, just another telling of the Dr. Moreau cautionary tale. Nobody would actually create such chimeras, right?


Ian Wilmut, head of the Center for Regenerative Medicine at the University of Edinburgh, has filed a request with the UK’s Human Fertilization and Embryology Authority for permission to create cloned human-rabbit hybrids. The professor intends to use the hybrid embryos in the study of motor neurone diseases. “It gives a way to study the development of the disease which you could not do in any other way,” Wilmut wrote.

Wilmut, while hardly a household name, was featured prominently in the news ten years ago. In 1996, he led the team that cloned the first mammal, a sheep named Dolly.

The advances made by medical and biological science in the past fifty years have been awe-inspiring. The human genome, the blueprint of everything we are, has been identified, understood and sequenced. We are now capable of manipulating ourselves on the molecular level, creating and destroying life with significantly less work than goes into baking a loaf of bread. We stand on the threshold of a new era, an age of medical technology beyond even our most ambitious dreams.

But it’s that breakneck pace of advancement that should give us pause right now. We should take a minute, catch our collective breath, and ask ourselves some hard questions about life, about individual rights and about ethics before it’s too late. This President deserves credit for using his bully pulpit to advance the national debate on bioethics.

Jeff Harrell blogs at The Shape of Days.

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