Site Archive Provided by the LSU Medical and Public
Health Site
Other Research Law Materials
 Loews L'Enfant Plaza Hotel Leon
R. Kass, M.D., Ph.D., Chairman Elizabeth
H. Blackburn, Ph.D. Stephen
L. Carter, J.D. Rebecca
S. Dresser, J.D. Daniel
W. Foster, M.D. Francis
Fukuyama, Ph.D. Michael
S. Gazzaniga, Ph.D. Robert
P. George, D.Phil., J.D. Mary
Ann Glendon, J.D.,
L.L.M William
B. Hurlbut, M.D. Charles
Krauthammer, M.D. William
F. May, Ph.D. Paul
McHugh, M.D. Gilbert
C. Meilaender, Ph.D. Janet
D. Rowley, M.D., D.Sc. Michael
J. Sandel, D.Phil. James
Q. Wilson, Ph.D. INDEX
Session 1: Welcome
and Opening Remarks Reactions and Opening Statements Session 2: Science
and the Pursuit of Perfection Session 3: How
to do Bioethics Session 4: Human
Cloning 1: Human Procreation and Biotechnology PROCEEDINGS
SESSION 1: WELCOME AND OPENING
REMARKS LEON R. KASS, M.D., CHAIRMAN CHAIRMAN KASS: First of all, I would like
to welcome members of council and members of the public to the first meeting
of the President's Council on Bioethics.
Dean Clancy, if I might call on you officially to open this meeting
as the designated federal officer.
Mr. CLANCY: Thank you, Dr. Kass. I am Dean
Clancy, the Executive Director of the Council and designated federal officer.
As I understand it, my duties are a combination of justice of the peace,
part-time baby sitter and potential sacrificial victim. And I just want
to say as an editorial note I am very honored and humbled to be able to
serve with Dr. Kass and such a distinguished panel of Americans.
The job of the designated federal officer is to be a proclaimer that
the law has been conformed to in terms of the requirements for holding
public business in this council and, therefore, it is with pleasure and
a bit of enthusiasm, anticipation and humility that I proclaim this meeting
in session.
CHAIRMAN KASS: Thank you very much. We will
shortly go around the room and ask council members to identify themselves.
This time just name and institutional affiliation. You will all have opportunities
later in this session to speak substantively about your own thoughts and
concerns for our group.
I will identify myself as Leon Kass of the University of Chicago on
leave and at the American Enterprise Institute in Washington.
And if I might then just proceed to my right and ask Elizabeth Blackburn
to go next.
By the way, the first housekeeping matter, if you want to speak press
the button on and off and try to speak fairly closely to the microphone
because the session is being recorded and will be transcribed.
Please?
DR. BLACKBURN: Good morning. Elizabeth Blackburn,
University of California, San Francisco.
DR. GAZZANIGA: Mike Gazzaniga, Division of
Cognitive Neuroscience at Dartmouth College.
PROF. MEILAENDER: Gilbert Meilaender, Valparaiso
University.
DR. GEORGE: Robert George, Princeton University.
PROF. DRESSER:: Rebecca Dresser, Washington
University in St. Louis.
DR. FOSTER: Dan Foster at the University of
Texas, Southwestern Medical School in Dallas.
PROF. MAY: William May, Southern Methodist
University, professor emeritus.
DR. HURLBUT: William Hurlbut, Stanford University.
PROF. FUKUYAMA: I am Francis Fukuyama at the
Johns Hopkins School of Advanced International Studies.
DR. MCHUGH: I am Paul McHugh from the Johns
Hopkins School of Medicine.
DR. KRAUTHAMMER: I am Charles Krauthammer.
I represent that small sliver of the American population who are not professors.
I am a syndicated columnist for the Washington Post.
PROF. GLENDON: Mary Ann Glendon, Harvard University.
PROF. CARTER: Stephen Carter, Yale University.
DR. ROWLEY: Janet Rowley, University of Chicago.
DR. WILSON: James Q. Wilson, professor emeritus
at UCLA and currently some time lecturer at Pepperdine University.
PROF. SANDEL: Michael Sandel, Harvard University.
CHAIRMAN KASS: Thank you. I want to thank
all of you for your willingness to serve on this council. We have a daunting
task and I am very much looking forward to working with all of you.
I should mention that one of our number, Professor Alfonso Gomez-Lobo,
who is professor of metaphysics and moral philosophy at Georgetown, is
recuperating nicely but still recuperating after recent surgery and is
not yet able to join us but I have been in touch with him and he will
hear either the tape or read the transcript of this meeting and will join
us on the next occasion.
I would also at this point like to introduce the staff of the council,
people who have been working enormously hard under very stressful conditions
to produce the materials for this book.
Dean Clancy, the Executive Director, you have already met.
To his -- to Dean's right -- and, people, would you please stand.
Next is Lee Zwanziger, who is the research director of the staff.
Then Rachel Wildavsky, who is the senior editor and staff writer.
Yuval Levin, senior research analyst.
Dick Roblin, who is the scientific director.
And Eric Cohen, who is also senior research analyst.
Before proceeding to my own opening remarks there are a few housekeeping
items that I would like to go through.
First of all, there is a change in the agenda for today owing to the
fact that President Bush has invited all members of council to a gathering
at the White House this afternoon. We will accordingly have to stop at
3:00 p.m. sharp to board buses in front of the hotel at 3:15 and we are
due at the White House at 3:30.
If there is logistical assistance required please see Debbie McMahon,
who is the office manager. Debbie is over there where I thought you might
be. Please speak to Debbie if you need help on that.
We will work from the back up agenda that has just been distributed to
you. We had a choice of either dropping the afternoon session today or
by squeezing a little bit here and starting a little earlier to try to
get at least the beginning discussion on all of the topics and we have
chosen to do the latter. We will stop at 3:00 o'clock rather than
2:45. Otherwise the agenda is as you have it before you.
Next I should mention that the council operates under a number of federal
statutes and regulations. Most important of which are FACA, the Federal
Advisory Committee Act; second the Ethics in Government Act; and third
the Freedom of Information Act. Copies of the first two are either in
your briefing book or have been handed to you this morning. Please read
these over and if you have any questions about them please speak to Dean
Clancy. Contact him either at this meeting or subsequently.
Next, something about the papers that are outside at the table. All
of the materials that have been prepared for this meeting are available
for the public but I would like to observe that the four working papers
on human cloning have been prepared by the staff on short notice intended
solely to stimulate the council discussion at these meetings. They are
not part of any preliminary council report. They are marked not for quotation
and attribution and we please ask everyone to honor our requests.
And with respect to media inquiries, they should be directed to Diane
Gianelli, the communications director, who is standing to the left of
the door. We regret that the need to abbreviate the meeting today means
that there will probably not be very much time for council members to
meet with the press today but perhaps we can do some of that tomorrow.
I would like to begin with a semi-coherent statement having -- saying
something about my view of the council's work. After which, that statement
is open to discussion and, even more important, I would like to hear from
whoever is interested in making a statement about their own concerns and
interests for our common work.
It is over five months since President Bush announced his intention
to create this President's Council on Bioethics. Our world has changed
drastically since that time and with it the nation's mood and attention.
The council and its business have not been immune to these changes. For
one thing, the events of September 11 pushed stem cells off the daily
front pages where they had been ensconced for months. More importantly,
the needs of war and homeland security understandably slowed efforts to
get this council organized.
But if the aftermath of September 11 has hampered our getting started,
paradoxically it may assist us in performing the council's task. In numerous,
if subtle, ways one feels a palpable increase in America's moral seriousness
well beyond the expected defense of our values and institutions so viciously
under attack.
We have rallied in support of the respect for life, liberty, the rule
of law and the pursuit of progress but we seem to have acquired in addition
a deepened appreciation of human finitude and vulnerability and, therefore,
of the preciousness of the ties that bind and of the importance of making
good use of our allotted span of years.
A fresh breeze of sensible moral judgment clearing away the fog of unthinking
and easygoing relativism has enabled us to see evil for what it is and,
more important, to celebrate the nobility of heroic courage, civil service
and the outpouring of fellow feeling and beneficence in the wake of tragedy.
It has been a long time since the climate and mood of the country was
this hospitable to serious moral reflection. Yet the moral challenges
the council faces are very different from the ones confronting the President
of the nation as a result of September 11.
In the case of terrorism, as with slavery or despotism, it is easy to
identify evil as evil and the challenge is rather to figure out how best
to combat it but in the realm of bioethics the evils we face, if indeed
they are evils, are intertwined with the goods we so keenly seek, cures
for disease, relief of suffering and preservation of life. Distinguishing
good and bad thus intermixed is often extremely difficult.
As modern Americans we face an additional difficulty. The greatest dangers
we confront in connection with the biological revolution arise not from
principles alien to our way of life but rather from those that are central
to our self-definition and well-being. Devotion to life and its preservation,
freedom to inquire, invent or invest in whatever we want, a commitment
to compassionate humanitarianism and the confident pursuit of progress
through the mastery of nature fueled by unbridled technological advance.
Yet the burgeoning technological powers to intervene in the human body
and mind justly celebrated for their contributions to human welfare are
also available for uses that could slide us down the dehumanizing path
toward a brave new world or what C. S. Lewis called in a powerful little
book by that name "the abolition of man." Thus just as we must do battle
with the antimodern fanaticism and barbaric disregard for human life,
so we must avoid runaway scientist and the utopian project to remake humankind
in our own image.
Safeguarding the human future rests on our ability to steer a prudent
middle course avoiding the inhuman Osama Bin Ladens on the one side and
the post-human Mustafa Amans, Aldas Huxley's (?) spokesman for the brave
new world, on the other.
President Bush has given us the opportunity and obligation of helping
him plot and navigate his course. Duly mindful of the daunting task before
us, we humbly accept this service.
The Executive Order creating this Council on Bioethics signed by the
President on November 28th of last year states the council's mission as
follows: I read from the briefing book, Tab 4B. Section 2A: "The council
shall advise the President on bioethical issues that may emerge as a consequence
of advances in biomedical science and technology. In connection with its
advisory role the mission of the council includes the following functions:
Central to the charge to the council is the idea of bioethical issues.
Permit me a few words on what I think this means and how I suggest we
construe it.
Bioethics is a relatively young area of concern and field of inquiry
no more than 35 years old in its present incarnation though the questions
it takes up are, in fact, ancient. When the field was started in the late
1960s and early 1970s around the Hastings Centers and the Kennedy Institute
at Georgetown none of the pioneers had trained in bioethics. Indeed, none
of us referred to ourselves as bioethicists.
Actually the word "bioethics" coined a few years earlier by a biologist,
Van Potter, in fact, referred to something rather different. It was the
name for Potter's vision of a new ethic based not on inherited philosophical
or religious foundations but built instead on the supposedly more solid
ground of biological knowledge. The bioethics Potter intended was a new
naturalistic ethical teaching founded on the modern science of biology
but Potter's term took on a life of its own. It came to be applied first
to a domain of inquiry regarding the intersections between advances in
biological science and technology and the moral dimensions of human life.
Today it also names a specialized academic discipline granting degrees
in major universities and credentialing its practitioners as professional
experts in the field.
It is my understanding that for this council "bioethics" refers to the
broad domain or subject matter rather than to a specialized methodological
or academic approach. This is a council on bioethics, not a council of
bioethicists. In fact, very few of us are trained bioethicists. We come
to the domain of bioethics not as experts but as thoughtful human beings
who recognize the supreme importance of the issues that may arise at the
many junctions between biology, biotechnology and life as humanly lived.
We are seekers for wisdom and prudence regarding these deep human matters
and we are willing to take help from wherever we can find it. We should
do all in our power to find and develop the best ideas and the richest
approaches in order to do justice to the subject.
As it happens, the term "bioethics" etymologically considered as a different
valence that is, in fact, close to what I take to be our mission. Bioethics
is the ethics of bios, the ethics of life but the ancient Greek root "bios"
means not life as such nor animate nor animal life.
For these the Greeks use "zoa" but rather a course of life or a manner
of living or a human life as lived, something describable in a "bio-graphy,"
biography. Animals have life, zoa. Human beings alone have a life, a bios,
life lived not merely physiologically but also mentally, socially, culturally,
politically and spiritually.
To do bioethics properly, I suggest, means beginning not with judging
whether deed X or Y is moral or immoral but with what the Executive Order
says is our first task, undertaking fundamental inquiry into the full
human and moral significance of the developments in biomedical and behavioral
science and technology." We must strive to understand the meanings of
the intersections of biology with biography where live lived experientially
encounters the results of life studied scientifically.
Even as we tackle specific issues we must always attend to the deep
character of humankind's individual and social "bio" and how they interact
with findings of biology and the technical powers they make possible.
It is for this reason that the council is charged section 2(b) not only
with looking at ethical issues raised by this or that specific technological
activity, embryo or stem cell research, but also broader ethical and social
issues not tied to a specific technology. For example, protection of human
subjects in research, the appropriate uses of biomedical technology, the
consequences of limiting scientific inquiry and the like.
Next to our manner. If our scope is to be broad our manner of inquiry
must be searching and open. We are a diverse and heterogeneous group.
By training, we are scientists and physicians, lawyers and social scientists,
humanists and theologians. By political leaning, we are liberals and conservatives,
republicans, democrats and independents. And by religion, protestants,
catholics, jews and perhaps some who are none of the above. I, frankly,
have no idea in many cases. But I trust that we share a deep concern for
the importance of the issues and the desire to work with people from differing
backgrounds in search for truth and wisdom about these vexing matters,
eager "to develop a comprehensive and deep understanding of the issues."
Because reasonable and morally serious people can differ about fundamental
matters it is fortunate that we have been liberated from an overriding
concern to reach consensus. As the Executive Order indicates in section
2(c) in pursuit of our goal of comprehensive and deep understanding "the
council shall be guided by the need to articulate fully the complex and
often competing moral positions on any given issue and may, therefore,
choose to proceed by offering a variety of views on a particular issue
rather than attempt to reach a single consensus position."
All serious relevant opinions carefully considered are welcome. Any
that may not now be represented on the council we will seek out through
invited testimony. Moral positions rooted in religious faith or in philosophy
or in ordinary personal experience of life are equally relevant provided
that the arguments and insights offered and enter in our public discourse
in ways that do not appeal to special privilege or special authority.
Respect for American pluralism does not mean neutering the deeply held
religious or other views of our fellow citizens. On the contrary, with
the deepest human questions on the table, we should be eager to avail
ourselves of the wisdom contained in the great religious literary and
philosophical traditions.
Up to this point my discussion of the council's mission has emphasized
the philosophical aspect of our task. I have abstracted from the fact
that we are a public body created by and responsible to the President,
charged not just to find wisdom about these matters but to be genuinely
helpful in the practical decisions the President and the nation face.
All our meetings are open to the public and we shall no doubt have numerous
interactions with various governmental agencies and with the media. These
features of our work and the high public visibility of our deliberations
prompt the following additional reflections:
If the council is to offer proper help for meeting these challenges,
two requirements stand out. One for "thought" and one for "action."
Among the most urgent of the council's intellectual tasks as I have
already hinted is the need to provide an adequate moral and ethical lens
through which to view particular developments in their proper scope and
depth. Doing this must involve careful and wisdom seeking reflection about
the various human goods at stake, both those that may be served and those
that may be threatened by 21st Century biotechnology, and in either case
going beyond the obvious concerns of safety and efficacy.
This sort of analysis must begin by prospectively considering what we
wish humanly to defend in advance rather than by reactively considering
merely the potential consequences of this or that particular new innovation.
A rich and proper bioethics will always keep in view the defining and
worthy features of human life. Yet at the same time responsible public
bioethics must not lose sight of its practical duty to shape a responsible
public policy as the demands for policy decisions arise piecemeal and
episodically often without any preparation.
Our bioethical thought must, therefore, be ready and able to bring the
aforementioned general considerations to the specific ethical issues at
hand and maintaining this difficult but all important balance is part
of the goal of our work.
On the practical side we remind ourselves that this council came into
being in connection with President Bush's decision regarding federal funding
of embryonic stem cell research. Its work is informed and guided by the
President's desire for thoughtful consideration of bioethical matters
that bear on his responsibilities and on public policy more generally.
It has been insufficiently observed that the President's decision established
or rather reestablished the precedent that scientific research, being
a human activity, is primarily a moral endeavor. One in which some human
goods, the pursuit of cures for the sick, the inherent value of scientific
freedom and curiosity must be considered in light of other human goods,
the inherent dignity of human life, attention to the unintended consequences
of research and the use of technology, and the need for wisdom and realism
about the meaning of human life, human procreation and human mortality.
In addition, the President's stem cell decision and the surrounding
public debate also demonstrated the capacity of democratic representatives
to make moral distinctions in scientific matters. It is our belief that
armed with the necessary facts and with responsible guidance and advice
the institutions of American democracy can and must take it upon themselves
to consider the meaning of advances in biotechnology and to ask whether
and which of these advances demand and, if so, what sort of public oversight
or public action. This council will endeavor to provide those facts and
to offer responsible advice and guidance.
Our first meeting has been designed with these two fundamental requirements
in mind. The agenda has been developed to initiate work on two different
projects. One long term and one short term. The ongoing project is to
develop the attitudes, ideas and approaches for a richer and deeper public
bioethics, one that does justice to the full human meaning of biomedical
advance and that can also provide guidance to the President and the nation
regarding the concrete policy decisions that inevitably arise.
The wisdom seeking and prudential approach begins by developing the
terms of discourse and modes of inquiry best suited to this task and the
first part of this meeting is all about how we should approach and do
bioethics.
The second part of the meeting seeks to demonstrate that approach with
the specific of human cloning, our first short-term project. Here we must
explore the meaning of cloning human beings and the ethical issues cloning
raises but we must do so in a way that also explicitly addresses directly
the policy and legislative debate in the midst of which this council,
whether it likes it or not, comes into existence and about which we will
be called upon to comment.
We shall accordingly consider both what to think and what to do about
the prospect of cloning human beings. Here we must work not only to analyze
and understand but also to judge and advise as best we can.
Winding up I want to say -- make two comments about the subject of embryonic
stem cell research and the controversial debate with which the council's
birth was entangled. In his speech on August 9th the President stated
that he wanted the council "to monitor stem cell research" and "to recommend
appropriate guidelines and regulations." We take these tasks as a central
part of our responsibility but we shall not be discussing them thematically
in the immediate future.
Firmly articulating his own moral position President Bush has made a
clear decision regarding federal funding of embryonic stem cell research.
Federal funds are now available for research using existing embryonic
stem cell lines and there are many more good cell lines available for
such research than anyone knew existed before the President's decision.
Leading scientists have indicated that at least for the research phase,
that is in the preclinical phase of these investigations, the number of
embryonic lines are more than adequate to begin to explore their therapeutic
potential.
Now is, therefore, the time for research to commence and proceed with
vigor so that we may discover in the next few years whether these cells
perform up to their advanced billing as holding the key to regenerative
medicine.
This council will wait and watch and monitor. We shall ask NIH and any
other relevant agencies to provide us regular reports that describe, assess
and compare the successes achieved with both embryonic and nonembryonic
stem cells. We will take up the subject thematically at some point down
the road once we know more about where the research is going.
Finally, one little noticed substantive matter about last summer's stem
cell debate deserves mention at least in my view for it bears on my view
of the concerns important to this council.
Unlike some ethical debates where each side is defending a different
principle or good, here both sides were arguing solely on what one may
call the "life principle." The principle that calls for protecting, preserving
and saving human life.
The proponents of embryonic stem cell research argue vigorously and
single-mindedly that stem cell research would save countless lives. The
opponents of the research argued with equal vigor and single-mindedness
that it would in the process destroy countless lives.
It was, in short, an argument between two sorts of vitalists who differed
only with respect to whose life mattered most, living sick children and
adults facing risks of decay and premature death or living human embryos
who must be directly destroyed in the process of harvesting their stem
cells for research. Each side acted as if it had the trumping argument.
Embryonic stem cell research will save lives of juvenile diabetics or
people with Parkinson's disease QED versus embryonic stem cell research
will kill thousands of human embryos QED.
These are surely important concerns but at the risk of giving offense
I wish to suggest that concern for life, for its preciousness and its
sanctity, whether adult or embryonic, is not the only important human
good relevant to our deliberations. We are concerned also with human dignity,
human freedom and the vast array of human activities and institutions
that keep human life human, including, by the way, the virtues we have
seen displayed on and since September 11th.
Important, though it is, the life principle cannot become the sole consideration
in bioethical discourse. Some efforts to prolong life may come at the
price of its degradation, the unintended consequences of success at life
saving interventions. Other efforts to save lives might call for dubious
or immoral means while the battle against death itself as if it were just
one more disease could undermine the belief that it matters less how long
one lives than how well and sometimes lives may need to be risked or even
sacrificed that others may survive and flourish.
In my view, such questions of the good life, of humanization and dehumanization,
are of paramount importance to the field of bioethics and I hope that
they would become central to the work of this council.
Thank you for your patience. The floor is now open to discussion. I
remind you if you wish to speak to press the microphone and I would like
people to either make responses to these remarks or even better to weigh
in with some statements if they wish about their own interests and concerns
in this field, what they hope we might accomplish, topics that they would
like to see tackled, and I will simply from now on try to keep order.
If this were my class I would call on you.
(Laughter.)
CHAIRMAN KASS: Mary Ann, may I?
REACTIONS AND OPENING STATEMENTS
PROF. GLENDON: Yes. Well, my own preoccupations
as a legal scholar have been to investigate what other countries of a
type that we often like to compare ourselves with have done with respect
to problems that our legal and political and social systems find puzzling
and difficult, and so the observation and question I would like to raise
is whether there will be some opportunity for our council to be in touch
with or be informed by what other similar councils are doing, either at
the state level as in California or in the international level.
CHAIRMAN KASS: Thank you. I do not think there
is any determined decision on this. We have been encouraged in the Executive
Order to explore opportunities for international cooperation on these
matters. I think it would be highly desirable for us to do so. We have
just had, I think, thanks to Elizabeth Blackburn, been notified of the
existence of the California report that has been -- the web site for that,
I think, has been circulated to all members of council and hard copies
would be made available.
I also can say slightly in advance that the National Academy of Sciences
Report on the Medical and Scientific Aspects of Human Cloning will be
issued shortly. I believe tomorrow.
And we are in touch with -- people from international bodies have been
writing to us and would like to establish contact.
So with the qualification that we should figure out how to do this in
the most effective manner. I think it is terribly important that we learn
what other countries are doing and participate in. If you would like to
help take a lead in that it would be terrific.
Robby?
DR. GEORGE: Thank you, Dr. Kass. Let me begin
by saying what an honor it is for me to serve with such a distinguished
group under your leadership.
I hope it will not be considered trite, I certainly never consider it
trite to begin our reflections with some reflections on the nature of
the political order in which we function and address the important, as
you say, daunting questions of bioethics that are before us as we seek
to assist the President.
So I would simply recall the great proposition on which the nation was
founded, the proposition articulated in the Declaration of Independence
that "we hold these truths to be self-evident that all men are created
equal and endowed by their creator with certain unalienable rights and
among these are life, liberty and the pursuit of happiness."
I do not suppose that reflection or simply averting to those words to
that proposition will solve the problems that we face. However, I hope
that our deliberations will be structured with that principle in mind
and right now just at the beginning I would recall or point out perhaps
a couple of features of that principle that I think are relevant to what
we will be doing.
First, of course, is the principle of equality that all human beings
are created equal. None is a mere means or an instrument to the ends of
others or to the larger collectivity. There is a principle there that
we might articulate today as the principle of the dignity of the person,
that the person is not a mere cog in the social wheel, that it is important
as social life is to the flourishing of individual human beings. Nevertheless
none is reducible to something that has meant some instrument, some mere
means to serve larger collective interests.
In the last century, of course, we fought and prevailed against an ideology
that quite explicitly treated the human being as a mere cog in the social
wheel and we fought that struggle in the name of the principle of human
equalities articulated in the Declaration of Independence. Of course,
it is not a principle that our country has always been able to live up
to faithfully.
It is often remarked that the nation was -- even as it articulated that
principle at its founding -- conceived in the sin of slavery but it was
in the name of that principle that slavery was fought and ultimately defeated
at great cost and blood and treasure that the aftermath of slavery, segregation
and Jim Crow fought, and I would say -- I would argue very largely defeated
in the name of that principle.
And the second thing that I would observe about it, the principle of
the Declaration of Independence, is the idea of life and liberty as gifts.
Not as something that it is within our human power to create. It is certainly
within our human power to destroy them but they are not things that we
make and can, therefore, simply cast aside on the basis of our own judgment.
Perhaps what I am gesturing towards here is the idea that you raised,
Dr. Kass, in your remarks when you observed that it might be something
that we would want to reject that we can remake man in our own image.
That, of course, recalls the biblical proposition that man is made in
the image and likeness of God and in the Declaration, of course, we are
told that our basic rights and liberties, our most fundamental rights
and liberties, come as gifts endowed by the creator. The state did not
give them to us, the government did not give them to us, the king did
not give them to us, nor can these mere human individuals or institutions
rightfully take them away.
And I think the concept particularly of human life as a gift as we enter
into deliberations and debate about bioethics is a very important one
for us to bear in mind. It points to the limits of our own moral authority
over human life.
So with those remarks, Chairman Kass, I will cease and desist.
CHAIRMAN KASS: Thank you very much.
We have a procedural matter of whether we are going to go formal or
informal here in terms of the way we address one another. In my own institution
the students are all Mr. or Ms. I am one of the hold outs on that but
I think to make it -- I think make the conversation flow more easily if
I might take the liberty of suggesting that we do as informal Americans
and call each other by our first names. Is that a problem for anybody
in the room? I would respect it if -- is that all right?
DR. GEORGE: It is not a problem for me, Dr.
Kass -- I mean, Leon.
(Laughter.)
CHAIRMAN KASS: Thanks very much, Robby.
People are free to engage one another or pick up on things that have
just been said. Please, Gil Meilaender?
PROF. MEILAENDER: Yes. I want to more directly
engage your own remarks if I may. Two comments. One specifically responding
to it and then the other that grows out of it but it says something about
my own vision of what we might accomplish.
One I just wanted to -- I cannot resist noting that it would be possible
to dispute your description of the stem cell research debate as between
two sorts of vitalists and it would be possible to describe -- to pick
up on your own language of not using dubious means to describe the position
of those who thought one should not destroy embryos in order to enhance
or preserve life. So I just want to note that that is an arguable and
a disputable description of the way the debate went and I did not want
to just accept it without engaging it a bit.
But then the other matter that relates to sort of where we might go,
there is a kind of tension -- I do not say this at all critically but
a tension in the several things you laid out that on the one hand we have
to concern ourselves with policy, with public policy. On the other hand,
we are specifically not required to seek consensus and the question is
how you shape policy without seeking consensus.
I simply offer my statement about how important it is to me to take
seriously that we do not have to seek consensus but that we rather really
seek to engage one another, look at the arguments, make the arguments,
and we may or may not find that we agree and we, therefore, are not policy
makers. We -- whatever we do, we might hope would inform those who make
policy but other people are elected to various offices to make policy
and it seems to me, therefore, that what we do freed from the necessity
of doing that can, in fact, be something different and accomplish something.
In that sense this council is a little different from some of its predecessor
bodies and I would hope that we take that seriously so that is important
to me in terms of how we proceed.
CHAIRMAN KASS: Thank you. Just a small comment.
I think as I understand it the President would like from this body the
same -- the process that he followed in reaching his decision on the stem
cell research was to consult very widely and to hear from the various
people with different interests and different points of view. What he
would like, I think, from this body is something comparable, only that
these positions such as they are be developed at a very high level and
show the effects of having engaged the other side of the conversation
so that one is not simply talking with preconceived notions but that our
deliberations would, in fact, issue in the best possible statements of
whatever points of view are germane to the issue.
If we have agreement so be it but it seems to me we are not necessarily
driven by that and I would be very surprised if on some of the vexed questions
that we have to deal with that everybody is going to be like minded so
we should not muzzle our best thinking just for the sake of producing
an agreement.
Stephen, is that a hand or a half a hand?
PROF. CARTER: It is certainly a hand. It was
not raised for any particular reason but to scratch my forehead.
(Laughter.)
PROF. CARTER: But I suppose I am happy to
-- as a law professor, I am happy to weigh in on any point on any topic,
whether I am familiar with it or not.
A couple of comments on what has been said so far building, in part,
on Gil Meilaender's point about not seeking consensus. I also think we
have to be very careful in our deliberations in our exchanges not to fall
into the trap of so many policy discussions today of thinking that every
position that is expressed is expressed as a basis for a proposed regulation.
That is to say one of the problems that we often have in discussing difficult
issues, whether in bioethics or any other field, is that a public statement
about the morality or immorality, desirability or undesirability of a
course of action is taken as a public call for requirement or prohibition
of that course of action. I think it is very important in our deliberations
to be able to distinguish between our comments that are intended to go
to morality, desirability, undesirability and our possibly identical but
possibly very different comments that are meant to go to the issue of
what our public policy actually ought to be.
One of the dangers, seductions but also great glories of living in a
free society is the ability to establish an order in which we can often
take up moral propositions without their having to lead to legal propositions.
With that said I also want to register one small point of disagreement,
Leon, with what I thought was overall an excellent and really inspiring
introduction. You mentioned -- I think I got my note correctly -- that
we should not be closing our ears in advance to any particular form of
knowledge. You mentioned religion for example, morality, ordinary experience
but you mentioned religion it seemed to me with a qualifier that it not
be -- except where it rests on special authority, which I took to be perhaps
authority inaccessible to others somehow.
If that was what was what you meant then I think I probably dissent
because my view of public policy, and those of you who know my work this
will be no surprise, and deliberation in a democracy generally is that
we ought to invite to the public square anyone speaking from any perspective
and that is what makes democracy so mighty and strong. And if we do not
happen to be persuaded because of the special authority to which they
appeal or anything else, we are certainly free to ignore what they have
to say.
One last very small comment is that I do think it is possibly to think
of the debate as involving vitalists or involving a fight over great principles
in any case and certainly it may have those aspects.
But in my work I tend to be less interested in rights as such or freedoms
as such than interconnectedness and so perhaps to suggest a bias from
the beginning, and perhaps this comes from my own christianity, many of
my comments, I think, over the course of our meetings and deliberations
will be directed to the notion of thinking less about various ideas in
terms of consequences as such or rights as such but rather how they bear
on the questions of human connectedness and things that make us not so
much a whole integral human being but a whole integral and organic society.
CHAIRMAN KASS: Charles?
DR. KRAUTHAMMER: Yes. Let me start by saying
what an honor it is to serve on this committee. I think the work that
this council is doing is of extraordinary importance. I think the 21st
Century will be known as the century of biology.
CHAIRMAN KASS: Charles, can you get a little
closer to the mic, please.
DR. KRAUTHAMMER: And that the great promises
and the threats to our -- thank you. Maybe I should raise this a bit.
The promises and the threats to our way of life hinge more on biology
than possibly any other human endeavor.
If I could I would like to start by just expanding on what you said,
Dr. Kass, about the vitalist debate. And I think it is an extremely important
point that you expressed rather elegantly and if I may I would like to
express it rather crudely since that is what I do for a living.
(Laughter.)
DR. KRAUTHAMMER: Essentially I think the bioethics
debate has been reduced in the public mind to a debate about life and
as you indicated it is, of course, an extremely important issue but it
is not the only issue and yet there is an impression that these debates
hinge on the questions of when do you believe life begins and that essentially
these debates are subsets of the debate on abortion. I think that is a
misconception and it is a misunderstanding of what these issues are about.
Clearly the issues of the origin of life are important but, as I wrote
in an article earlier last year, in the debate about stem cells in particular
it seems to me that the more important issue is not where the cells come
from but where they are going. It is not so much the origin of the cells
but their destiny, which is another way of saying that the real issue
and the issue I think that we ought to focus on is the problems, the promises
and the threats posed by the prospect of human manufacture.
We are entering an age of human manufacture. That is why this council
has been called into being. That has never happened in human history.
We have now in our hands the technology where we can make and create kinds
of human life, variants of human life never before imagined.
And I think in the briefing, the papers which were issued to us last
week, I think there is a healthy focus on this as the larger coming issue
and I think to the extent that we make the public understand, the policy
makers understand, and ourselves understand that these are the central
issues of bioethics rather than just tired restatements of the abortion
debates. I think to that extent we will have performed a great public
service.
CHAIRMAN KASS: Thank you.
Bill? Rebecca, please?
PROF. DRESSER: Thank you. I, too, am honored
to have an opportunity to serve on the council. I was glad to hear Leon
say that we want to consider bioethics from a wide scope. I think that
matters such as cloning raise important social and symbolic issues but
I also hope that we will spend some time considering what I call ever
day bioethics issues. Issues that have major effects on many people. For
example, many people lack the opportunity to benefit from proven therapies
because they lack insurance or they are under insured. Many chronically
and terminally ill people do not get the kind of humane care that we would
all like to have ourselves.
And I agree with Mary Ann that we ought to consider international issues.
For example, all of the issues raised by the HIV/AIDS epidemic in Africa
and Asia as well.
So I hope we can think about things like the morally defensible allocation
of limited resources for health care and research.
And then just as a last point I think having read the materials generated
by other commissions and councils of this nature, I guess my reaction
is that commissions really make more of a difference when they deliberate
in a balanced way that speaks to people with a lot of different viewpoints
so I hope that we can do that.
And, also, communicate clearly and make our positions accessible to
ordinary people. I hope that we will not become too academic even though
I certainly think we are in danger of doing so. So those are my hopes
for the council.
CHAIRMAN KASS: Thank you very much.
Bill Hurlbut?
DR. HURLBUT: Coming after that remark this
is going to seem a little vague but my hopes for this council certainly
center around the every day and practical realities but I also hope that
unlike so much bioethics which tends to be reactive and remediative that
we can really step in and recognize where we are in the course of the
evolution of life as a species that has radically changed the fundamental
realities leaped out of our environment of evolutionary adaptation and
do a technological culture.
I hope we can have very forward thinking and anticipate where we are
heading in this manufacture or transformation of human life and in that
process my hope is that we can provide a positive platform for human possibilities.
A solid framework for issues of extraordinary urgency or opportunity for
our species and for our place within the larger ecology of life. Here
I think of both negative and positive things.
We have to recognize the changed biological realities of a situation
where there is rapid spread of emerging infectious diseases where chemical
and biological warfare are realities and where we are preparing to perhaps
alter human physiology for manned exploration of space.
What I am trying to say is I hope that in thinking about what it is
that is centrally human we can provide a platform for positive possibilities
that seem at first perhaps unintuitive but also seem to be part of our
extending nature as a species.
CHAIRMAN KASS: Paul McHugh?
DR. MCHUGH: I also want to thank the organizers
for inviting me to join this remarkable council and remarkable both in
its constitution and the aims that you laid out in that wonderful address
that you began us with, Leon.
As well I want to say that my great interests, of course, out of my
professional life are in the realm of neuropsychiatry. Those particular
conditions such as Alzheimer's disease, Parkinson's disease, the dementia
and depression of AIDS and the like are vitally involved in the enterprises
that we are considering and I want to make the -- emphasize your point
that this is a council on bioethics, not of bioethicists. This is very
important because I am afraid that bioethics as you have described it
has a wonderful goal but often in expression in university and hospital
places has turned out to be -- to miss its aim, often becoming more accommodating
to anyone's particular wishes about how to deal with a person in a life
rather than a place that are a group that has raised high issues and put
forward the aims of the claims of life and the claims of patient life
in particular.
In making that point I want to celebrate really the President's address
that formed this council not only because of what he said in it but what
was implicit in what he said and that was to say not only announcing his
plan but announcing that he would encourage the use of stem cells that
are presently available for scientists, and in that way put the burden
of proof back where it belongs.
The burden of proof that experts can help us with will be and should
be carried by people who wish us to change and to produce new ways of
work with people and with the future. I believe that our -- the good ethics
comes from good data but that good data also should be used to prove the
points and the burden of proof should be kept on the individuals that
are encouraging us to do change. Often it is seen that people have concern
are simply trying to hold -- being made to prove why we should hold back.
I think we should ask our experts to tell us why we should go forward
and I look forward to the opportunity to meet those experts in this forum.
Thank you.
CHAIRMAN KASS: Bill May?
PROF. MAY: I take it for granted from what
you have said and Gil emphasized, and others, that we do not meet as a
policy making body and further policies do not automatically convert into
regulations but as one thinks in the past about the development of policies
and research in human subjects it affected basically federal policies
but since almost all research institutions depended upon federal money
at that point there was not much consideration of the further matter,
which is now in a different situation significant.
That is marketplace initiatives are much important today than they were
at the point at which at an earlier time one developed policies and experimentation
on human subjects. There is an increasing and heavy involvement of the
corporations in the university research agenda today which was not the
case decades ago.
I simply wonder even though we are not making policy we are reflecting
upon the whole arena of policies and whether this includes not simply
federal policies bearing on federal research monies but on the larger
investment of funds in scientific research, whether that investment comes
from federal sources or marketplace initiatives.
CHAIRMAN KASS: Janet Rowley?
DR. ROWLEY: I, too, join my colleagues in
expressing my pleasure of being within this group and I look forward to
the challenging discussions we are going to have in the next series of
meetings. I do want to emphasize a point that you made tangentially, Leon,
that in one sense we are discussing a moving target because much of what
we need to know to make -- to both have a thoughtful discussion but also
to try to come to some reasonable decisions really involves issues about
which we do not yet have data.
And following on with what Paul said, it is important that as we try
to evaluate the options and what the consequences are of one course of
action as compared with another, we do not really have the information
that is required to make a thoughtful decision on many of these issues
and this is a challenge to us to try to guess what will happen in the
future but I think also a challenge to us to try to not preclude the possibility
of getting good answers in the future.
CHAIRMAN KASS: Thank you.
Please, Elizabeth?
DR. BLACKBURN: I think I agree with the council
members who have spoken so far. We have very, very weighty issues ahead
of us here and I think I was struck by a couple of points which perhaps
are worth adding to what has already been said in terms of how we make
our decisions and what sort of input we are getting. I think it was Rebecca
who said she hopes we do not become too academic a body but I think what
the corollary of that is we want to educate not only ourselves and be
a way of educating the public, I think we need to have people who can
inform us, as Janet says, come in and talk to us so we really are clear
about some of the issues that, as Charles Krauthammer mentioned, have
become somewhat conflated perhaps in the discussion.
And I think we need to think quite carefully and perhaps even analytically
about some of these issues as we make -- this is to do with the issues
of the biological sides of things I am thinking about -- a we come to
our decisions. We want our decisions, as Janet said, to be made based
on very good information so I think, as you plan to do, we are going to
bring people in who can perhaps clarify some of these biological questions.
CHAIRMAN KASS: Michael?
PROF. SANDEL: That was a great opening statement,
Leon. It really cast our project in very broad terms and invited a generous
expansive conception of public discourse.
One thing that strikes me reading the materials and listening to the
comments around the table is that our -- what we may be involved in here
in thinking about bioethics may not just be a matter of bringing moral
and ethical principles and reflections to bear on practical questions
raised by biotechnology but in the process of doing that we may find ourselves
reconceiving or rethinking what ethics and moral philosophy are about.
The natural sciences and the human sciences were once thought to be
linked. They were the sorts of things that philosophers did back in the
time of Plato and Aristotle but in the last three or four hundred years
they have been driven apart.
There has been a division of labor between the natural scientists on
the one hand and the human sciences on the other and what philosophers
do and what social scientists concern themselves with.
It may be that biotechnology and the ethical dilemmas that arise are
bringing those two domains of science and philosophy closer together but
it may also change the way we think about ethics because so many of our
recent debates about ethics depend on this much discussed and often hard
fought distinction between persons on the one hand and things on the other.
Persons are worthy of dignity and respect, whereas things are open to
use.
So much of the weight of debates, including the debate about abortion,
has been on deciding who counts as a person because unless something --
some natural being gets the status of a full human person, anything goes.
That thing then is open to use and this distinction between persons and
things.
This very sharp dichotomy goes back to have such an influence on us
but it may be that the biotech revolution and the ethical issues that
it raises may suggest that that very sharp dichotomy, all or nothing,
human person worthy of respect or a thing open to use needs to be called
into question.
And we may find ourselves discussing or exploring or groping for ways
of articulating modes of valuation, modes of reverence that are appropriate
to different types of life, forms of life, different beings in nature
such that it may not be all or nothing, on or off, respect or use.
And I think that if this discussion about biotechnology and ethics leads
us to elaborate and articulate a range of different modes of reverence,
respect, regard, valuation for different beings, different types of creatures
in nature then we will have enlarged not only public debate about biotechnology
but also maybe even the way we in the contemporary world reflect about
ethics.
CHAIRMAN KASS: Thank you.
Michael Gazzaniga, please.
DR. GAZZANIGA: Again thank you for including
me. I see my chore as trying to bring to the committee some current understanding
in issues that arise from studying the brain in the area of neuroscience.
One can in the current issue of cloning and stem cells see the issue is
life with a brain versus life without a brain an equivalent status for
us to consider. We will have to look at that.
More importantly, jumping ahead, I think the neuroscience literature
where these new brain imaging technologies are raising a whole set of
new questions that we will have to address as we go on having to do with
such issues as cognitive privacy. We are getting to the point where we
can ask the brain something and forget about the person and find out what
they are really thinking. What sort of issues will that raise for the
legal system? What sort of issues will that raise for us personally? So
I see the nervous system playing a large role in the discussions to come.
CHAIRMAN KASS: Thank you.
Dan Foster?
DR. FOSTER: My microphone is trying to keep
me from speaking. It popped back off.
I only want to make a brief observation. I think it was 1954 C.P. Snow
wrote a book called The New Men in which he posed the angst of the nuclear
physicist about the nuclear powers possibility of achieving good and achieving
harm. The Michigan geneticist Neil said fairly recently that 50 years
later it is the molecular geneticist that is now on the hot seat in place
of the nuclear physicist and I thought he made an interesting remark.
He said, "The power available to us must be used wisely, otherwise it
would be a desecration to humanity." And I believe he is right on with
that statement.
CHAIRMAN KASS: Frank Fukuyama?
PROF. FUKUYAMA: Leon, thank you also for including
me.
As I understand it, the commission has a two year mandate and then it
may either get renewed or goes out of business. My observation as a political
scientist is that you never have any long lasting impact on policy unless
you actually create some institutions and I hope that what -- one of the
things that this commission will consider is the institutional design
of a system for in the long run making decisions on bioethical issues.
As you, yourself, have said previously things like the legislative ban
on cloning -- I mean, we have different opinions about the wisdom of that
but, in general, legislative bans are not a good model to follow for making
this kind of decision in the future, that there are going to be too many
decisions, they will be too nuanced, and really what you need is a regulatory
model.
But I think it is pretty evident that our existing regulatory structure
for biomedicine is really inadequate to deal with the kinds of decisions
that will have to be made in the future. The FDA and NIH have a structure
that really excludes, I think, consideration of a lot of the kinds of
ethical issues that we are going to be dealing with on this commission
and so I think that one of the things that we can positively contribute
is some thought. Since there are a lot of lawyers and political scientists
around the table, you know, one thing that we might consider is whether
-- you know, what -- as a very practical matter what kinds of institutions
might be necessary to create in the future to basically carry on the work
of this commission beyond its two year terminus.
CHAIRMAN KASS: Thank you. Unless I am missing
a queue, it is left to you, Jim, if you want to say something. I think
everybody else has been in once. Am I right?
Further discussion on any of the things raised by one or another people
here? Do people want to come back?
Let me say while you are thinking about things to add, I mean I have
taken some notes and others have, a lot of the -- everything that this
council does is public and documents that we circulate amongst ourselves
between meetings are covered by the Freedom of Information Act. We should
not regard this as a handicap. We should not be saying anything to one
another of importance that we would not take responsibility for but not
everything that can be done on this council can be done only at the times
that we are together.
And that means that everyone is invited -- I will make this remark more
than once but everyone is invited to go home and send in as -- in as short
or as lengthy a way your further reflections on the remarks just made
or after thoughts, both about the issues that you think are most salient,
both about the kinds of projects that you think we should be considering.
Frank Fukuyama makes, I think, a very important point. We have a two
year life span and we have a start. The start was made before the council
was put together. Someone had to make a decision and we made it. The President
has asked us to take up the cloning question and it is a topic of current
interest. I do think that we at least on the intellectual side have an
opportunity to make a more lasting -- a lasting contribution to the extent
to which we can develop the terms and demonstrate the manner of a richer
kind of bioethics. Hence I would like at least in each of the meetings
that we are together to be spending some of our time trying to do that.
The next two sessions this morning are devoted that and Gil Meilaender's
paper in particular has been prepared with that task in mind.
But what else we tackle and certainly what else we tackle after the
cloning question I think is up for discussion and just as we should be
thinking about the modes of analysis and approach that this subject matter
deserves so it does seem to me that the institutional and political questions,
I do not mean partisan political questions but the institutional questions
that Frank has raised, deserve some of our attention.
Anything further? Jim, please?
DR. WILSON: Is there a list of addresses or
e-mail addresses by which we can reach other members of the commission?
CHAIRMAN KASS: Yes. Have these been distributed
at this point? We had trouble distributing things because for a variety
of reasons the announcement of the membership did not come until yesterday
afternoon. Those of you who were discreet left town without telling your
wives why you were going to Washington, and husbands -- husbands, indeed,
or sons or secretaries but we will get this to you even before you leave.
We will get the roster of names, addresses, e-mails.
And if some people have multiple places where they can be reached it
will be helpful to know where you prefer to be reached.
DR. WILSON: A follow-up question.
CHAIRMAN KASS: Yes.
DR. WILSON: Are direct communications between
myself and one other member of the committee, is that part of the public
record?
CHAIRMAN KASS: Did you hear the question?
MR. CLANCY: I did.
I am still trying to find out the answer.
CHAIRMAN KASS: One of the defects of operating
in the way in which we have been operating, (a) we do not yet have an
attorney. We have been getting legal advice on these various matters.
Members of council -- we have several attorneys here but you have got
more important things to do than advise us on how to solve that problem.
I think -- I do not want to give an answer. My impression is that one
on one conversations are not but as soon as there are two people -- but
I think -- I do not want to -- I think one should give the correct answer
rather than speculate on this.
If there somebody in the room who really knows, now is the time. Good.
DR. GEORGE: Well, I cannot say that I really
know but I served for six years on the United States Commission on Civil
Rights and that is an independent government agency subject to the same
regulations that we are subject to. And it was the understanding at the
commission that private conversations even if they pertained to commission
business were not matters of public record.
CHAIRMAN KASS: We will get an answer on that.
We are speaking to possible candidates for a legal position with the council
and we need somebody quickly.
This last point brings up something else that is also worth mentioning.
There are materials in the Ethics of Government Act that pertain to questions
of speaking, teaching and writing in relation to the work of this council.
You should read it through and we will get clarification on any ambiguities
that exist.
However, there are a number of people in this room who have written
on bioethical topics and people have asked are we now muzzled or what
may we speak and what may we say. It seems to me that public writing about
the business of the council as a council is out. And the sort of activity
-- and no one should be writing or speaking in the name of the council
unless designated to do so, for example, should we be asked to testify
before congressional committee. But all of you -- all of us are thoughtful
and responsible people who, I think, ought not to be muzzled and ought
to simply proceed with discretion in the way in which we conduct ourselves.
Many people in this room serve on other bodies where the same kinds
of questions come up and I think the main thing is to try to do it prudently
and avoid anything that would be -- that you could imagine would be embarrassing
to our collective work but we are who we are and we have contributions
to make in our different voices and I think that if we conduct ourselves
responsibly on this matter that will not be any difficulty.
If people are going to sign petitions, please do not sign as members
of the President's Council on Bioethics, and things along that line.
Is that agreeable? Is there anyone who thinks that that is going to
be a problem?
All right. We have a long day and we have squeezed the schedule. It
is just shortly before 10:00. Why don't we break now and reconvene, let's
say -- let's make this a healthy break. We will convene at 10:15. It is
the only really healthy break before lunch. We have got a short one in
between. We will reconvene to discuss the Hawthorne short story The Birth-mark
at 10:15.
(Whereupon, a break was taken.)
SESSION 2: SCIENCE AND THE PURSUIT OF PERFECTION
DISCUSSION OF NATHANIEL HAWTHORNE'S SHORT
STORY, "THE
BIRTH-MARK"
CHAIRMAN KASS: Might I ask in the back of the room is that light absolutely
necessary for what is being done? It is either on or off. Well, apologies.
Maybe tomorrow we will shift the seats and other people can bear the burden
of the lights other than, I guess, myself. If anybody likes the lights
you can volunteer for duty. The next sessions is, I think, a somewhat unusual session and I hope
a fruitful one. We are going to be discussing Nathaniel Hawthorne's short
story The Birth-Mark and council members know but I would like the public
to know why it is we are undertaking this discussion.
First it does deal with certain important driving forces behind the
growth and appreciation of modern biology and medicine, our human aspiration
to eliminate defects and to pursue some kind of perfection. Goals to which
science and technology more and more have been put into service. But it
also invites us to think about the human meaning of a birth-mark, being
marked at birth. Therefore, it enables us to start talking about bioethics
by locating our current concerns in relation to certain enduring matters
and questions.
Second, I hope, as a matter of process that we can start conversing
at this table not as scientists or humanists but as fellow human beings
thoughtful about these matters and reacting responsively to the story.
Finally, I hope that this will illustrate in case anybody needs persuasion
that there is a wide and wealthy treasury of materials beyond the kind
of literature produced by people like myself that can be fruitfully used
to deepen our understanding of the meaning of biomedical advance.
Now I have asked Bill May if he would be willing just to open up the
discussion of The Birth-Mark with some few remarks and then we can take
it from there.
PROF. MAY:: I do not intend to extract from
the story inferences for any of the policy issues that might come before
the council. The contributions of works of art to public life are largely
indirect rather than direct. Novelists do not bake bread or write legislation.
However, the Hawthorne story may help us recognize the way in which all
major undertakings, those of this council included, sooner or later force
us to reflect on the human condition. A condition which we know first
and foremost not as experts but as participants in daily life so I will
start not with the great public projects associated with biotechnology
but with every day life.
The Birth-Mark exposes as I see it and throws light on two powerful
human experiences. The desire for perfection and the struggle with the
un-elected marks that go with our birth.
We know these experiences chiefly in the setting of the passions and
in daily life particularly the passions of self-love, intimate sexual
love and of parental love. In all three arenas we struggle both with the
yearning for perfection and with the marks of a condition largely given
and received rather than self-created or chosen.
Hawthorne plays out his story in the context of marital love. While
I have untold decades of experience in the complexities of self-love and
marital love, let me spare you comments on these and angle my way back
into the Hawthorne story by reflecting for a moment on parenting.
Parenting entails, as I see it, a double passion in loyalty, both to
the being and to the well-being of the child. Neither loyalty is complete
alone. On the one hand parents need to accept the child as he is. As Frost
said, "Home is where when you go there they have to take you in." Parenting
requires accepting love.
On the other hand parents must also encourage the well-being of the
child. They must promote excellence. If they merely accept the child as
he is they neglect the important business of his full growth and flourishing.
Parenting requires transforming love.
Attachment becomes too quitistic if it slackens into mere acceptance
of the child as he is. Love must wield the well-being and not merely the
being of the other. But attachment lapses into a gnostic revulsion against
the world if in the name of well-being it recoils from the child as it
is.
Ambitious parents, especially in a meritarian society, tend one-sidedly
to emphasize the parental role of transforming love. We fiercely demand
performance, accomplishment and results. Sometimes we behave like the
ancient gnostics who despised the given world, who wrote off the very
birth of the world as a catastrophe. We increasingly define and seize
upon our children as products to be perfected, flaws to be overcome, and
to that degree we implicitly define ourselves as flawed manufacturers.
Implicit in the rejection of the child is self-rejection. We view ourselves
as flawed manufacturers rather than imperfect recipients of a gift.
Parents find it difficult to maintain an equilibrium between the two
sides of love. Accepting love without transforming love slides into indulgence
and finally neglect. Transforming love without accepting love badgers
and, finally, rejects.
E.B. White captured nicely, as I see it, the difficulties of balancing
the two contending passions as they pervade daily life. "Every morning
when I wake up I am torn between the twin desires to reform the world
and to enjoy the world and it makes it hard to plan the day."
It may not be too much of a reach to say that modern science exhibits
the two sides of love suggested here. On the one hand science engages
us in beholding. It lets us study and savor the world as it is. On the
other hand science and the technologies it generates engages us in molding,
in the perfecting, in the project of transforming, amending and perfecting
the given world.
Now why take seriously Hawthorne's story about a scientist caught in
the toils of a one sided passion? He loves his wife but kills her in the
attempt to remove her single imperfection, a birth-mark on her left cheek,
a stain so superficial that "her lovers were wont to say that some fairy
at her birth hour had laid her tiny hand upon the infant's cheek." A superficial
blemish, not a tumor. This husband becomes so obsessed and controlling
that he determines to bring to bear all his learning and resources to
remove this flaw whatever the cost.
Even his plodding earth bound servant recognizes something hysterical,
overwrought, deranged in his project as he mutters, "If she were my wife
I'd never part with that birth-mark."
Aylmer has to take on the challenge of the Crimson Hand because it is
not in his judgment merely a topical blemish. Twice Hawthorne tell us
that the birth-mark is imprinted on her left cheek, a sinister mark as
it were on the left, the mortal side of every living thing, his Georgiana
included. The side on which the heart itself resides, the very fount and
core of life. Life and mortality are sided there together. To remove the
mark of mortality will remove her from life.
In the harrowing dream sequence Aylmer imagines himself "attempting
an operation for the removal of the birth-mark. But the deeper went the
knife the deeper sank the hand until at length its tiny grasp appeared
to have caught hold of Georgiana's heart; whence, however, her husband
was inexorably resolved to cut or wrench it away."
The narrative of the story tells us long before Freud truth often finds
its way to the mind close-muffled in robes of sleep, and then spreads
with uncompromising directness in regard to which we practice an unconscious
self-deception during our waking moments. In his sleep he cries out, "It
is in her heart now. We must have it out." He must do battle with the
birth-mark, "The fatal flaw of humanity which nature in one shape or another
stamps ineffasively on her all productions. The Crimson Hand expressed
the ineludable grip in which mortality clutches the highest and purest
of earthly mold, degrading them into kindred with the lowest, and even
with the very brutes like whom their visible frames return to dust."
Hawthorne carefully locates his story within the central project of
modern Western civilization. He gives us a peak into Aylmer's library.
It includes the work of the alchemists who stood in advance of their centuries
and who imagined themselves to have acquired from the investigation of
nature a power above nature but his library also includes "early volumes
of transactions of the Royal Society in which the members knowing little
of the limits of natural possibility were continually recording wonders
or proposing methods whereby wonders could be wrought."
Aylmer's intellectual forbearers heralded something new in the world.
Whereas the ancient Greeks celebrated the human power for knowledge, the
modern scientist celebrates the powers acquired through knowledge. The
Greeks recognized that reason crashes against limits. The power of fate
and death from without and flaws from within. Reason offers us at best
wisdom in the midst of suffering, not relief from its toils. But modern
science offers the dizzying prospect of the powers which knowledge itself
would generate to alter human life for the good. The ultimate end of which
would be to lift the burden of mortality itself.
I take it that Hawthorne's story is a cautionary tale, not strictly
speaking a tragedy. In tragedy a hero perceives a problem and resolves
to do something about it only when the solution is beyond reach. He eventually
recognizes but cannot undo what he has done. He becomes wise only in the
course of suffering. He cannot eliminate it.
Hawthorne's scientist never achieves such recognition nor do the two
passions of saving and savoring mercifully restrain and qualify one another.
He loves Georgiana but the passion of savoring his bride shifts into the
drive to save her. "I even rejoice in this single imperfection because
it will be such a rapture to remove it."
In a sense his wife alone reaches the moment of truth. Georgiana tells
him after he has given her the toxic cure that would at long last remove
her birth-mark, her mortal life, "My poor, Aylmer, you have rejected the
best that earth could offer. Aylmer, dearest Aylmer, I am dying." But
the story breaks off a few sentences later without Aylmer suffering achieving
this "profounder wisdom."
Hawthorne's story posts a warning about a one-sided passion which his
hero does not decipher.
CHAIRMAN KASS: Thank you.
Discussion?
Bill, thank you very much.
Please, Gil?
PROF. MEILAENDER: I just want to flag something
that Bill did not particularly mention but that relates to what he mentioned
and that interests me, and it is the assistant. What is his name? Aminadab?
Yes.
He is specifically described as representing man's physical nature in
contrast to Aylmer as no less apt a type of the spiritual element. And
I do not quite know what -- you know, what exactly to do with that. There
is a certain sense in which the person who represents the animal nature
here sees more clearly than the person who represents the spiritual nature.
At least he says in the passage Bill mentioned "that if she were my wife..."
you know "...I wouldn't get rid of the birth-mark."
And I do not know whether -- exactly how to take that. Whether the animal
nature is to be more trusted than the spirit or whether the animal nature
divorced from the spirit perhaps. I mean, whether really we need the two
together. I do not know where to go with it exactly but it is -- and I
would welcome clarification, in fact, but it is a very clear contrast
that is made. That is exactly how he described it several places and he
is the one who, in fact, has insight in a way.
CHAIRMAN KASS: Mary Ann?
PROF. GLENDON: It is interesting that in the
first sentence Aylmer is described as a man of science but by the end
of the story he has the reader questioning about how much of a man he
is and also how much of a scientist he is. In the end he seems to even
betray his science by moving into rash experimentation when he has had
indications that a scientist would pay attention to that this is perhaps
not a wise route to pursue.
Gil, I would not have described the dichotomy between the earthly and
spiritual. I think it is more the pure intellect. A good thing. The unrestricted
desire to know a good thing but Aylmer somehow has made himself into a
certain kind of person by neglecting other dimensions. He is presented
to us as somebody who has from early youth insulated himself from the
world. He has taken himself away from ordinary human experiences.
I was interested that Bill brought up the issue of parenting because
it seems to me what would Aylmer have done if there had been reproduction
here. He certainly would have been a person who wanted a perfect child
but before he even got to that he probably would have been upset by the
messiness of child production.
So it is a story -- I think you quite rightly said, Leon, that it is
not a tragedy. He is not a tragic hero. He does not rise to the level
of a tragic hero. He is somebody whose defects actually render him something
less than fully human.
CHAIRMAN KASS: Does everybody agree?
PROF. MEILAENDER: Can I respond just slightly?
CHAIRMAN KASS: Please.
PROF. MEILAENDER: I do agree in large part
but on your reading, Mary Ann, how do we account for Georgiana's high
estimate of him? Is she just mistaken?
PROF. GLENDON: Well, I puzzled about that,
too. He is somebody who is treating her as an instrument and an object
but she is somebody who is allowing herself to be treated that way, cooperating
with it. That is a bit of a puzzle to me.
CHAIRMAN KASS: Stephen, I am sorry.
PROF. CARTER: Well, just on this point, I
think that Aylmer -- if we look at Aylmer as divorced from, in some sense,
ordinary human concerns and the risks of intellect and so on and if you
look at Aminadab as representing the voice of instinct, the voice of ordinary
experience, the voice that a person with common sense as opposed to the
person leading a life of the mind would express, I think that we can look
at Georgiana as she does not have to be pure instrument. From her own
point of view she is perhaps the -- to be the beneficiary of the research.
And the reason I think this is part of Hawthorne's point, if you look
at page 776, when she first enters Aylmer's laboratory his response is
quite striking down near the bottom of the page. "Why do you come hither?
Have you no trust in your husband?" Here is the voice of authority saying
I know what I am doing within my realm. There is no reason for you to
intrude. If you simply let me go on and do my work uninterrupted, trust
me to do what I do best, you will at some point benefit but in the meanwhile
let's have a separation between your effort to find out what I am doing
and the actual benefit you are one day going to receive.
So I think that Georgiana and Aminadab are two types of those outside
of the life of the mind, at least outside of the life of the mind as the
person in the story living life of the mind, Aylmer, conceives it. One
is the voice of every day experience, which he plainly thinks it is not
only irrelevant but somehow brutish, unsophisticated and not really to
take into account. He never even engages with these little asides of Aminadab.
That is error one.
And then the second, the potential beneficiary of the research itself
is treated as an intruder when the beneficiary wants to know what exactly
are you really doing. You ought to simply trust in me.
CHAIRMAN KASS: Does everybody -- Gil raised,
it seems to me, a point about his motives. I think -- I mean, on the face
of the story one recoils, I think, from his activity yet she does in several
places, and I am not sure whether she is speaking ironically, speak in
somewhat praiseworthy terms of this exploration. One on 777 where she
-- after his departure she is musing and she considers his character.
"Does it completer justice than at any previous moment. Her heart exulted,
while it trembled, at his honorable love, so pure and lofty that it would
accept nothing less than perfection, nor miserably make itself contented
with an earthlier nature she had dreamed of."
And then in the last remark just being saying that he has rejected the
best that earth has had to offer, says to him, and I am -- I tried not
to read it, "You have aimed loftily -- you have done nobly! Do not repent,
that.."
And I guess the question is -- and maybe the scientists in the room
especially but anybody -- does one simply want to reject out of hand?
I mean, Bill May did give us, I think, both the distinction between saving
and savoring. I mean, is the impulse to save in this story simply repulsive?
Or does one have -- does anybody have any sympathy with --
PROF. MAY: It is one sided. It is one sided.
CHAIRMAN KASS: Indeed.
PROF. MAY: And, therefore, repelling in its
one-sidedness it seems to me but not repelling in the sense that it is
to be eliminated as part of the poles in which we live. At least that
is my way of reading it.
CHAIRMAN KASS: Stephen, did you want to come
back?
PROF. CARTER: Just a very small point. It
is not entirely repulsive. I think that is part of the point of Georgiana's
response. It is also seductive. That is the confidence that the world
can be changed or that we can be changed, something can be changed for
the better through the life of pure mind, in effect through the life divorced
from other concerns, is seductive. There is a line I remember from years
ago from Spiro Agnew who said, "You do not learn about poverty from people
who are poor but from experts who have studied the problem." And I think
that is what -- that is the very seduction that you see in the story.
CHAIRMAN KASS: Bill?
DR. HURLBUT: It seems to me that what is going
on here is setting up a kind of false persuasion of what circumstances
-- the real circumstances of human life are. Somebody in this room has
said "desire not DNA is the deepest principle of life" and, if so, the
character of our desires is increasingly going to shape the future. Having
been constrained through evolution now new powers are coming forward.
The question is what do we do in this situation where there is a sense
of imperfection? How do we respond to a world where you cannot, metaphorically
speaking, un-bite the apple? In the sense that we have a real reality
of suffering, struggle and sacrifice and expectations and aspirations
towards something greater. Do we use our science now to try to satisfy
that or do we recognize that even within that order of reality there is
something of deep significance going on that may be more perfect than
what we can design as thinking rational beings?
He speaks at the end of his story of the shadowy scope of time, the
perfect future within the present, and living once for all in eternity
already in this earth. The point being that we could easily try to remark
our world and walk ourselves right off the stage of the drama of our deepest
significance.
I had a student once say to me, and here I am thinking in terms of remaking
or setting humanity just the way we think it would be optimal, I had a
student once in a moment of great struggle personally say to me, "My parents
gave me everything except an excuse to fail."
CHAIRMAN KASS: Mary Ann, come back.
PROF. GLENDON: I wonder if anyone else was
struck by the sentence on 774 where Georgiana starts reading Aylmer's
journals and discovers in his records of his own experiments material
which according to Hawthorne "makes her feel less dependent on his judgment
than ever before." She has lost faith in his judgment as she reads his
records but does not lose faith in him. In fact, on the next page she
"worships" him. I think that word is quite significant.
And another sentence that struck me on 774, she says, "He handled physical
details as if there were nothing beyond them, yet spiritualized them all."
So it is as though his one sided development of one aspect of what it
is to be a human being has caused him to worship what one might call a
false god. And she has become aware of the defect in his judgment yet
worships him.
CHAIRMAN KASS: That does not make any sense
to you.
Rebecca, please?
PROF. DRESSER: I noticed that part 2 and also
towards the bottom of 774, "She could not but observe that his most splendid
successes were almost invariably failures..." And I guess --
CHAIRMAN KASS: Finish the sentence.
PROF. DRESSER: "...if compared with the ideal
at which he aimed."
CHAIRMAN KASS: Yes.
PROF. DRESSER: So here she has the awareness
that he has failed in his aims many times and also she begins -- at the
beginning of the story she is not ashamed of the way she looks and she
then comes to hate this birth-mark more than he does. She says, "More
than he does." So I guess I am frustrated with her but also I think it
shows the persuasive power of these kinds of dreams.
And I suppose I am trying to make this more concrete than I ought to
but I am guess I am thinking, well, what would I say if I were going to
try to talk to Georgiana and the scientist as well to communicate, you
know, my disagreement with the way they are looking at this. How could
they even hear a different message?
CHAIRMAN KASS: Paul?
DR. MCHUGH: Well, I had some very personal
reactions to this story primarily because of a different age when I read
it. I read this story years ago when I was a teenager and it made me shudder.
I mean, it was just awful. And I had completely forgotten this story until
I began reading it and then I remember the little hand and that was --
I said, "I bet it is going to be about the hand." And when it came up,
I said, "Oh, yes, I remember this."
And then the interesting thing to me, of course, is then I read this
like a psychiatrist would read it. Not as the teenager who read it and
shuddered about it but then as a psychiatrist would read it and these
issues that Mary Ann and others are bringing up and you are bringing up.
Of course, a psychiatrist, you know, the contemporary era they -- you
know, you just understand it. Not only do we understand it but we have
got words for it, Mary Ann.
(Laughter.)
DR. MCHUGH: Her willingness to throw herself
into this matter is called by the people in the psychoanalytic persuasion
"identifying with the aggressor." You know, that you have just gone along
with the aggressor to the point where you become part and think of it
in the same way with him, that you develop a defensive reaction.
And, you know, I am not sure that -- and by the way the other thing
about the dream, again reading it as a psychiatrist, you see that this
-- Hawthorne, he does not read it like a Freudian. He reads it like a
Jungian. And the difference is that the Freudians think the dream obscures
your real motivation and the Jungian says the dream shows you your real
motivation. It is the true -- and he says that he -- he says that he appreciates
his unconscious self-deception when he is waking and his dream shows him
what he really appreciates he is going to kill her in the process of doing
this.
And then -- so then I had this sort of sense -- here I read this as
an old chap and a psychiatrist, and I think the teenager was better. He
saw --
(Laughter.)
DR. MCHUGH: He saw this story more correctly
and we could lose the shudder aspect of it as we begin to know more about
human -- more that human psychological science brings us -- takes us away
from the ability to really shudder at this awful thing that this man did
and to some extent she was trapped into collaborating with.
CHAIRMAN KASS: That is very interesting. Jim
Wilson?
DR. WILSON: My daughter was born with a birth-mark.
It has not in the slightest degree affected how I or her mother care for
her. It does not affect in the slightest how her husband cares for her
or how her children care for her. I regard Aylmer's behavior as absolutely
outrageous. I am a perpetual teenager on this subject. I do not know whether
she identified with the aggressor or not. I am somewhat at a loss to explain
her behavior but I find Hawthorne's story unsettling and in a degree appalling.
CHAIRMAN KASS: Michael?
PROF. SANDEL: I do, too, but the question
is what is it that is appalling. And one answer which maybe is the obvious
answer is that this is a parable of the folly of perfectionism, the aspire
to perfect what nature has given us. It is a parable of the folly of despising
the given. That is one description of why we find this appalling but I
wonder if that is the best account of what is repulsive about the story.
I am not sure that it is, in part, because it is not so clear in this
story whether this birth-mark really is a defect we should take seriously
or not. It seems trivial, like a trivial defect, so, of course, a scientist
who tries -- who goes to mad lengths to remedy it is crazy and repulsive.
So that -- but if it is trivial then it is not a test of perfectionism
or of the given at all. That test could only come if this was really a
serious defect. Suppose the birth-mark were one leg significantly shorter
than the other but that would raise a question about what it means to
respect or to despise the given because the given can take two forms.
There is what appears to be given and there is the telos that is given
in the sense that what is given implicit or is a gift to be realized,
a potential to be realized, and in struggling with what counts as the
given the second is always a possibility that we have to take seriously.
In this case if it really was a serious, not a trivial defect as a birth-mark,
then to realize the telos, in this case the beauty or the full human functioning
or the highest human possibilities of this particular woman, then some
cosmetic surgery or in the case of the short leg it would not be merely
cosmetic surgery, would not seem quite so mad.
Or suppose another way of trying really to get at whether this is a
parable about perfectionism and the given or just about misidentifying
in this case the defect or the beauty, suppose she just needed orthodontia
and suppose the means of orthodontia in the time were not to go to get
braces but to consume some potion that a sorcerer would devise. Would
it be as repulsive as this story is?
CHAIRMAN KASS: Jim, do you want to respond?
DR. WILSON: Could I?
CHAIRMAN KASS: Yes, please.
DR. WILSON: I would say the answer to that
is yes.
CHAIRMAN KASS: Yes, I was about to say yes.
DR. WILSON: I mean we are talking not only
about what is repulsive and what is merely a disfigurement and what does
not count, we are also talking about science. And the notion here is that
this lone scientist, loony by my standards, has concocted potions that
have not passed any test. The Food and Drug Administration has not been
heard from. There are not ten other cases beginning with animals going
up to humans in which it has worked. He in his zeal and his madness persuades
her to drink something that kills her. That to me is among the many reasons
I find his behavior so deplorable.
Now you could say, well, in his time we do not have science and there
was not a Food and Drug Administration, and there was not a Journal of
the American Medical Association. It seems to me the lesson you take from
those times is that we do not know how to change these things very well
and when we do not know in some meaningful sense of the word "no" we ought
not to try.
DR. KRAUTHAMMER: If I could just say -- Leon,
over here, it is Charles.
CHAIRMAN KASS: Sorry.
DR. KRAUTHAMMER: It is appalling because he
is not a scientist, he is a narcissist and he kills her for the most superficial
of reasons. I mean, literature is replete with examples of people who
kill the object of their love and the reason that we shudder and we do
not have sympathy and a sense of tragedy as we do, for example, in Othello
is because his reasons are absurd.
And what is striking to me, also, is Hawthorne's notion of what science
is, this man is not a scientist as we understand it, he is a magician.
He is a tinkerer, if you like, at best. This is not science. This is magic.
And that is why I think it -- I am not sure how closely or how it translates
into modern times. Today we think of a scientist as a person who is far
more analytic, who does stuff because he wants to understand how things
work, and then later he will manipulate.
What Hawthorne calls science here really is not what we would call science
so I feel rather distant from this story and although I do share Jim's
repulsion. I think that is the -- there is a coldness here that I think
is what makes it repulsive.
CHAIRMAN KASS: Well, let me try and see if
I can bring it a little closer without getting rid of the repulsion. And
it goes to the question of whether this birth -- whether the birth-mark
is superficial and why don't we spend a couple of minutes on the question?
I mean, this could have been any other imperfection that could have led
to the same thing. Hawthorne has chosen to treat the birth-mark, a mark
that was somehow connected with birth. And I guess the question is what
is a birth-mark? It seems to me you cannot decide whether this is madness
fully until you have sort of thought through what kind of a defect is
a birth-mark really in addition to being the mark of this little hand.
DR. KRAUTHAMMER: But as Hawthorne himself
implies, it is a superficial defect of appearance that is trivial enough
that all her other lovers had either overlooked it or found it almost
charming.
CHAIRMAN KASS: Mary Ann?
PROF. GLENDON: I wonder -- in the beginning
he says, "Deeply interwoven with the texture and substance of her face."
That is in the first part.
CHAIRMAN KASS: Right.
PROF. GLENDON: And then it goes on that it
maybe goes deeper. It is not even just the texture and substance of her
face but the texture and substance of her being.
CHAIRMAN KASS: "A spectral hand that wrought
mortality." I mean that does not sound superficial to me and in some way
connected to the heart paradoxically.
DR. KRAUTHAMMER: But there is no evidence
that there is anything in her character, her being, her soul, her spirit
that is defective. In fact, she is presented as a rather angelic being
so how else do you interpret her defect if not superficial?
CHAIRMAN KASS: Robby, on this, please?
DR. GEORGE: I do not think that it matters
in the end whether it is superficial or not. Hawthorne knew and we know
that different people and different cultures have different conceptions
of what human perfection would be. It is not as though there is some common
conception of perfection and it will be against that ideal that any particular
individual will assess imperfection. In the literature of bioethics one
encounters frequently discussions of defective human beings. Most often
in relation to infants where you will see references to defective infants.
What will we do about defect infants? What is legitimate to do about defective
infants?
I must say that I recoil when I hear such language used but at the same
time I recognize that there are human defects. Whether the birth-mark
counts as a defect, and we can debate Hawthorne's meaning there -- I think
Mary Ann made a good point in calling our attention to the passage she
just quoted -- but whether or not we treat that as a defect, plain Michael's
example of a child born with one leg shorter than another, that we can
call a defect. And, of course, there are much more serious defects even
than that. A child born with severe retardation. A child born with a massive
deformity say of the face. Things that will profoundly affect people's
lives as they move forward.
Yes, it is not unreasonable to speak of these as defects but I think
it is just profoundly important that we not make or move as a culture
towards identifying the worth and dignity of the human being with the
absence of such defects. A child is no less equal to the rest of us by
virtue of being born even with a severe deformity, whether that deformity
is mental as in retardation or physical as in being born with one leg
shorter than another. So that whatever attention we give to trying to
remedy that defect it should be given with an understanding of the child
or the individual, the person himself, being the end to which the administration
of any therapy or remediation is merely the means.
I think that Aylmer has simply lost sight, if he ever had in grip, an
understanding of Georgiana, perhaps people in general, as worthy intrinsically
-- as having an intrinsic dignity that was not dependent, that was not
conditional upon their specific attributes which may or may not, according
to any particular standard, be rightly judged to be defective.
So the message I take away from the story is you will really go off
the rails, whether it is in the name of science or any other ideal, you
really go off the rails when you miss -- when you fail to understand human
worth and dignity as an inherent and intrinsic thing and understand it
in some other terms such that human beings become mere means to other
ends.
DR. ROWLEY: I just wanted to come back and
echo the statements of both James and Charles that in no way should we
equate Aylmer with -- and what he does with science because he is just
not a scientist in the way he approached the problem intellectually or
then experimentally in terms of trying to evaluate the treatment and its
potential outcome in terms of a whole series of experiments. So I think
it is absolutely essential that we recognize that if one wants to use
the term "science" in regard to this that bad science is likely to have
bad outcomes.
CHAIRMAN KASS: Go ahead, Stephen, and then
Dan.
PROF. CARTER: Just a small point. I think
I would disagree with two aspects of the sense around the table, respectfully
disagree. I do not think that it matters much whether we think that Aylmer
is a good scientist or a bad scientist because I do not think it is a
story that is about science, whatever else it may be about.
When we ask what repulses us about it, it cannot -- I assume it is not
the case that we are repulsed because he is trying to work a change in
the physiognomy somehow of his wife. We do that all the time. Some of
us are repulsed by it in many other cases as well but that is something
on which certainly reasonable minds may differ.
It also cannot be the case that we are repulsed because the treatment
does not work. That is you can imagine the same story and at the end she
leaps up, she is happy, she dances a jig, her face is now the way that
they both wanted it to be, and they live happily ever after.
It strikes me that Aylmer -- that the problem Aylmer poses to us as
a character is the same whether the treatment works or not. If he is working
in accord with all of the understood norms of his profession of that day
or of this day it is still, I suggest, his very obsessiveness, his --
the obsessiveness and the arrogance with which he goes about it, the very
single mindedness that sometimes is necessary to solve a problem in the
end can also be terribly repulsive when we see it in the context of a
single kind of disconnected human being as Georgiana is here presented
to us because we have no -- neither one of them is presented as part of
a larger community, family thriving in any way.
The obsessive control of one individual over another, the obsessiveness
about this characteristic is a problem for us or ought to be equally repulsive
whether the treatment succeeds or not.
CHAIRMAN KASS: Dan, and then Jim.
DR. FOSTER: Well, I do not want to digress
too far from the story but I also do not want us to -- I do not want to
sit as sort of a judgment committee about what this means and it certainly
should not translate, I think, into an attack on science.
I hang around with a lot of scientists. I sort of want to be a physician-scientist
myself. And I do not hear many of them talking about, you know, some sort
of salvation from all illness and so forth. The rules of the physician
are pretty simple, pretty pragmatic, after competence what we say is we
are trying to prevent premature death when that is possible. We are trying
to alleviate symptoms when cure is not possible. And we try to comfort
always.
I do not think most of the scientists that I know have some grandiose
scheme of doing away with all imperfection. Maybe somebody wants to end
mortality but mostly they are just talking about advances that might be
helpful to the community at large.
I think by and large they tend to be good people. They are like all
humans. They have got flaws and we make terrible mistakes. We kill young
people with adenoviruses when a disease is not serious enough to warrant
a gene therapy but most of them do not have grandiose schemes. I am not
really too worried about the scientific community being without common
sense.
We have got four active Nobel Laureates at our place and we have talked
about this quite a bit.
I actually am more worried, and Bill may have mentioned it earlier,
not about the scientific community but about the changes that the market
contamination has made on science because I have been around long enough
to remember when basic scientists would not do anything that had clinical
implications. Janet will remember this. I mean, it was pretty nerve racking
if you worked on a slime mold. You know, that was too advanced. Now every
basic scientist is talking about the cure of disease. Why is that? It
is because the market has contaminated it to make money.
I am much more worried about the technology driven by the market system
to do all these things in the hopes of making money than I am about the
scientific community trying to change the nature of humans.
So I would just ask that as we consider all these things we do not make
phantoms of some community that is designed to end the world as we have
always known it but I am very worried about the contamination of science
and scientific medicine by the market. That is where I think we have to
be worried about people who might want to manufacture humans if one wants
to use that term that has been tossed around.
So I guess what I am trying to say, and not very well, is that I do
not think we ought to use a scientist who has abandoned science and become
an evangelist as a model of modern biomedicine, which is dignified and
has goals that are achievable that want to help human beings but not take
over the world.
I want to say again I am very worried about the market. It is not just
Enron, you know, that is driven by greed and this market is driven by
greed. And scientists that I truly admire spend more time on their companies
and do not do that. So it is just a minor point. I do not know whether
I made it well but I just want to avoid judgmental attacks on -- I do
not mean this as an attack but I mean I think we ought to avoid the assumption
that scientists are like the protagonists in this story.
CHAIRMAN KASS: Gil?
PROF. MEILAENDER: While I hate to be either
judgmental or attacking but there are a lot of motives in the psyche besides
greed and I want to come back to the terms Bill set -- Bill May set at
the start, the savoring versus saving, transforming, and a few of you
know, of course, that I am actually generally on the savoring rather than
the saving side of this.
But it seems to me that -- and Stephen Carter raised the question of
would it make any difference how the story ended sort of. The really interesting
question is whether there are clues that we can tell in advance in the
story, whether you read the story and you can really find things. I mean,
he mentioned obsessiveness. Charles mentioned narcissism, for instance.
How do we know in advance -- that is the really interesting question --
whether it would be useful to undertake something like this or not?
And the truth is that there are a enormous number of promises being
made in the public realm about what science can do. And when we take them
one at a time we have a hard time getting to the deeper question that
the Hawthorn story is intended to raise. How do you know in advance of
any single attempt that something is going to go wrong, that she will
not get up and dance a jig at the end but, indeed, will die?
It seems to me that is a question the story raises that we ought to
take seriously.
CHAIRMAN KASS: Jim Wilson?
DR. WILSON: Suppose we update Mr. Aylmer and
bring him into the 21st Century and he now has a Ph.D. and teaches at
a leading university as a scientist and biologist. He is a consultant
to a major gene technology company and on the basis of prior animal and
some human researches he believes there is a reasonable chance, though
no guaranteed certainty, that by in vitro -- by intrauterine action or
by gene transplants he can done one of more of three things. First he
can reduce significantly the problem that the child will have a birth-mark.
Secondly, he can reduce significantly the chance that the child will have
one leg shorter than the other. And, thirdly, he can increase the probability
that the person can dunk the basketball from outside the free throw line.
Now this is where it seems to me this committee eventually is going
to be. Do we think that interfering with unborn life to achieve any or
all of these objectives is legitimate? It seems to me that that is not
a easy question to answer. If there is a therapy that has presumably little
down risk and much up side benefit that will prevent the birth-mark from
appearing, I think the public desire to do this will be overwhelming.
If it has to do with making one leg the same length as the other, I
think the public will be remarkably supportive.
What happens, however, if what we want to do is not remove defects but
enhance abilities by increasing IQ or being able to get them to be the
next Michael Jordan, or if you prefer the next Pamela Anderson? That raises
a very entirely different sort of question.
So when we talk about this as being a story about science, we should
update the science but then we should not lose track of the issue of what
are people's responsibilities toward life. Is enhancement, the elimination
of defects acceptable or not? Is improvement, the increase in ability
beyond what you would normally predict acceptable? Because I am convinced
that by the end of this century all of these things will be possible.
CHAIRMAN KASS: Bill Hurlbut, and we will move
toward -- I am going to break this off so we can leave time for the next
paper. I want to comment, too, after this.
Bill, please.
DR. HURLBUT: I want to follow up on your comment
in support of science for sure but with a cautionary note. I, too, believe
that market forces will drive all this and commercial interests but market
forces ultimately respond to human desires or they do not have much traction
in human life. It seems to me that increasingly we are moving into a social
reality where people have expectations of satisfying their desires through
technology, through medical intervention.
I think at the heart of this story at least from my reading of it is
the question of the meaning of suffering and imperfection in life and
the role of science in relationship to that. If you look at life from
different perspectives you see it very differently. If you look at it
from a particular evolutionary perspective as though it is generated by
certain types of forces you see it one way. If you see it as initiated
and produced by a benevolent force you see it differently.
But either way we are caught in this strange middle space between desperation
and aspiration. We are caught between what the author speaks of as the
fatality of the earth versus the immortalescence (?) of a higher state.
The question is how do we attain that higher state and what does it
mean that it beckons forward? Yes, there are scientists who are aiming
for immortality. I will quote you William Hazelton, head of genome sciences,
marking the creation of the Society for Regenerative Medicine, said, "The
real goal is to keep people alive forever."
And so to me the real question is how do we see perfection in this strange
order of suffering that we live in? Is this a meaningful reality? Is there
an essential eternal issue being played out here in the shadowy scope
of time or is this somehow just a random collocation of chemicals? Kind
of a coincidence within a chaos. As the cosmetic surgery becomes the paradigm
of the new medicine the question is how do we seek perfection? It has
been written "be ye perfect" but to my mind that means not perfect in
physical form but perfect in love.
DR. FOSTER: I know you want to finish this
up. I just want to quickly respond in just one sense. I agree wholeheartedly
with what you say. I also agree with what Jim said over there. And I know
what Bill said about immortality. I know those things are true and I know
the problems about enhancement and I am sure we will talk about suffering
and all of that.
But I just want to try to keep this at a -- you know, that we have a
practical level about that. And one of the things that I wanted to say
in response is that if you -- everybody around here is talking in theological
terms and, you know, if there is one palpable sin of the scientific community
and the media that reports it is the hype with which these techniques
have been sold to the public where they think that there will be gene
therapy available in a year or two or all of these things, and that is
a terrible sin that the scientific community often times in hopes -- when
they work for a company -- to sell things up is -- we have to avoid.
And the fact that newspapers every Thursday or something bring the latest
reports of what I call "not the importantly new but the trivially new"
and a lay person reads it and cannot understand it, that is a terrible
fault. I jokingly use the term "sin" but it is a terrible fault and we
need to avoid that. I mean, we the scientific community need to avoid
that and have realistic voices there.
CHAIRMAN KASS: Thank you. I think what we
probably should -- Paul, briefly?
DR. MCHUGH: It is hard to brief on this important
subject. I just want to come back to the shuddering business that I think
we are all talking about. What was it that still makes you shudder in
this case? And I think that the issue really for me anyway was from the
beginning this idea of the arrogance of authority and essentially the
momentum of its presumptions that overwhelms the moral sense to the point
where even an awful result does not register. And in that sense this is
a tragedy not about these figures here but for our assumptive world where
the arrogance of authority can be such that even when death and destruction
arises we eventually come to say, well, gee, that is just what happens.
I thought with Gil at the beginning, right from the beginnings this
story led you to shudder because you saw the inevitability of what was
going to happen. Not only though the death but that these people were
not going to get it even when they had it, and that was my reaction.
CHAIRMAN KASS: Indulge me for just a brief
comment and then we should break because we want to spend the time for
Gil's paper.
On the matter of the birth-mark, the birth-mark is something which arrives
with the fact of being born in the world, a contingent event, and it is,
therefore, a sign of our finitude and limitation. The birth-mark, though
it comes with our birth, is, as the story repeatedly points out, a mark
of our mortality and our finitude.
And he says, "The bond and the spirit in the mortal form." It really
is something that indicates our limitations. And a question, I suppose,
is whether one could really, in fact, love something wholeheartedly in
an idealized sense if it were not perfect and is mortality for at least
some people a sufficient blemish, which you start by saying, "We will
remove the tumor or we will prevent premature death," but when we get
very good at that the question is what kinds of deaths are not premature
when the desire to live knows no bounds.
And it does seem to me that the desire to remove this birthright (sic)
means the desire for a mortal being not to be and, therefore, to go after
the birthright really means he must kill this woman. It is not that there
is another alternative at the outset. The desire to make her not mortal
is a desire to wish her out of existence which he, in effect, does by
this effort.
I do not think the sign of the birth-mark -- the sign is superficial.
What it means is deep and the attempt to go after the human condition
to save it completely and to save it even from its mortality -- which
was by the way, Janet, part of the aspiration of Bacon and Descartes in
the founding of the Royal Society. It is not just Hazeltine but it has
a long pedigree -- means that while they do not follow the scientific
method here, there is something in the culture at large and something
in medicine today, however modestly practiced, that almost says, "Look,
we will never stop until we can deal with mortality as such." The question
is, is that a worthy aspiration or is there something that necessarily
gives rise to shuddering as a result of our efforts to do that? I think
to that extent without impugning any particular group of people, I think
that remains a deep question for us as we look at various kinds of efforts
to improve this or to fix that. What are the limits and to what extent
do we have to accept the given both as given and the given both as perhaps
perfectible and what that means?
Look, at this time a short break. Five minutes to stretch because we
want to really have the time for Gil's paper.
(Whereupon, a brief break was taken.)
SESSION 3: HOW TO DO BIOETHICS
DISCUSSION OF GILBERT MEILAENDER PAPER, CHAIRMAN KASS: This session which will run until shortly before 1:00 o'clock
is entitled "How to do Bioethics," and it will be a discussion of a paper
written especially for this meeting by Gil Meilaender, a paper entitled:
"In Search of Wisdom: Bioethics and the Character of Human Life." I remind you that one of our goals has been to start trying to develop
the terms and the approaches and the questions that belong in a richer
and fuller form of bioethical discourse, and I am especially grateful
to Gil, under very short notice and under some additional duress, for
producing what I think is a wonderful paper to start us off down this
road.
I might say, by the way, that it has been suggested in staff that in
the course of our time together that there would be opportunities to invite
all members of council to attempt some kind of a paper that would be a
contribution to this question "how ought we to do bioethics to do it well"
and those papers by themselves might make an interesting contribution
to this discussion but not everyone has Gil's gifts and that is not yet
an assignment.
But let me turn it over to Gil who is going to get the ball rolling
on this wonderful paper.
PROF. MEILAENDER: Thank you, Leon.
My understanding of my assignment from Leon was that I try to write
something that would invite discussion among us about some of the most
important human goods that are at stake in bioethics. I am not quite certain
how one decides, you know, on the list precisely what that is but what
I tried to do was focus attention briefly on four that I think are significant
and that are in some ways interrelated.
All I am going to do is just say a brief word about each and then raise
two questions that grow out of it and that seems to me it might be useful
for us to discuss, though you will not doubt go in whatever directions
you are moved to go.
So, briefly, the four issues that I focused on are these:
First, the advances in science in medicine, though also different ways
of thinking morally, have raised for us puzzling questions about the unity
of the human being as an organism.
I note several ways in which this happens. Two of the most significant
are thinking of human beings as what we might call collections of genes
and what that makes possible. And then, second, distinguishing in ways
that come close sometimes to separating the human person from the body.
And we are forced, therefore, to ask whether any sense of the unity and
integrity of the embodied person is one of those human goods that is worth
preserving or not. So that is the first issue that arises.
And, second, part of the reason we can think in ways that seem to undermine
the unity of the human being is that there really is a kind of duality
in our nature. You can try out various languages to describe it. I use
here the language of "finitude and freedom." We are on the one hand limited
and located beings.
On the other hand we seem to have the capacity indefinitely to transcend
those limits and so we are forced to ask whether it is only the exercise
of our freedom that is among the goods of human life or whether acknowledgement
of some limits may also be humanly important. And that is my way of putting
something that in a way Bill May got at with his savoring and saving language
before.
Third, one of the most fundamental of those given limits, which we might
nevertheless seek to transcend and are to some degree able to transcend,
involves the relation, which is a bodily relation, between the generations.
This is, in part, a matter of the relation between parents and children
in large part but it is also perhaps increasingly a matter of the relation
between present and future generations more generally as we expand our
capacity to shape decisively the character of future generations. So we
are forced to ask whether there is some human good to be found in the
giveness of human relationships between the generations, whether that
is one of the human goods we ought to be concerned with.
And then, fourth, when we think about the relation between the generations
we realize that one of the things that parents try to do for their children
is keep them from suffering. It is a natural thing for parents to do and
yet we also know that two single-minded an attempt to do that may crush
the developing child. So we may not be able to give our children everything
they need and we may have to accept their vulnerability in order to let
some other important goods come to fruition in their lives. That points
us to the more general question whether relief of suffering, undoubtedly
a very important human good, is always an imperative or even always desirable.
An issue that arises time and again in bioethics.
So those -- you know, that very brief form, those are the four issues
that I tried to unfold briefly.
Again that summary of the paper's contents I would pose two questions
for us. At least a place where we might start. The first arises very directly
out of the substance of the big questions explored in the paper because
they are questions which will often bring us back to the meaning of human
freedom. So we might ask ourselves does the meaning of our humanity lie
finally simply in the freedom to make and remake ourselves? Is that what
it means to be human or are there other characteristics equally integral
to humanity and equally in need of respect and protection and, if so,
can we talk about them?
And then the second question is not as directly raised by the paper
but a little thought about the questions the paper does raise, I think,
might lead us to it and it concerns something about how one does bioethics.
If there should -- if human beings are not just the freedom to make
and remake themselves if there should be any limits to our freedom. They
are not likely to just sort of collapse all at once or be attacked all
at once. Those limits are gradually eroded. And any given erosion may
seem like a good idea because it will surely appeal to some other undoubted
human good. Seeming to offer considerable benefit perhaps without undue
harm.
It may not look like the place where you would want to draw a line in
the sand and say no but if that is the case then the question is how we
can do justice to the larger questions of human good if we just take up
bioethical problems piecemeal moment by moment, issue by issue, and whether
we lose the deeper underlying issues that are at stake. That would be
my way anyway into the discussion of the paper.
CHAIRMAN KASS: Clear enough? So that we do
not talk about both questions at once let's start with the first one.
If I misstate it you will correct me. The emphasis on human freedom with
its opportunities to constantly make and remake ourselves, is that somehow
the heart of who and what we are or are there some other goods that we
treasure that properly ought to set limits to that free exercise of creativity
and, if so, what are they?
Bill?
PROF. MAY: What I found helpful about this
paper is that so much reflection on what we do in the future moves into
the mode of this could happen, this may happen, we might face and so forth,
and measured against the right to do this or that.
It always seems to be fear mongering about some kind of slide into this
or that which -- and since we have not had experience with it, therefore,
is written off as speculative, as speculations.
And this paper it seemed to me instead of engaging in that kind of speculation,
which is often times readily dismissed, asks us to think about the admittedly
complex features of our nature and ask is this not an important feature
of our nature which we ought not to dismiss? And it seems to me forcing
us to think back into the whole question of human nature is what this
paper accomplishes instead of simply a paper -- papers which I read, the
grammar of which is always "this could happen, this might happen, this
may be what we face." And which always seems to lack force when measured
against a declared right.
CHAIRMAN KASS: I think -- I mean, while you
are working yourself up with enough nerve to speak, it seems to me that
Gil has done exactly what I hoped he would do, which was to abstract from
this or that particular development but to try to lay out and to do so
by the way not by asserting this is important or that is important but
to lay out certain kinds of polarities which are intrinsic to our existence
and to make us realize that you cannot really -- whether you know it or
not when you are thinking about bioethics, these are the questions that
are implicit if not explicit in the conversation.
And what he has done, I think, is to try to make these considerations
explicit and invite us, hard though it is, to speak somewhat at this more
abstract level to ask, you know, are there any kinds of limits that should
be placed on the human freedom to remake or to recreate and, if so, in
the name of what goods would want to assert those limits.
Charles, is that half a hand?
DR. KRAUTHAMMER: Yes, it was half a hand so
here is half a thought. It is interesting that on the one hand you have
the sense in environmentalism that we ought to put great restrictions
on human freedom to shape, to mold, to remake what Michael referred to
earlier as sort of the inanimate world, which you would think ought to
be a world of use, and yet we have a sense that, you know, when you strip
mine you have to put it back together again after you have been there
to restore nature to its wholeness and this here we are dealing with nonhuman
things, sometimes nonliving things like a hill. And yet we have that strong
sense that there ought to be a restriction on human freedom in that kind
of manipulation of the natural inanimate world but it is not, I think,
matched in passion by that same sense that we ought to have the same reverence
and sense of restraint in reshaping the human world. For example, strip
mining embryos to produce stem cells. You would think that a civilization
that has put great restrictions on strip mining hills ought to put the
same on living organisms but the passion for the second in many people,
particularly those who tend to want to protect the environment, is rather
limited and rather wont.
CHAIRMAN KASS: Rebecca?
PROF. DRESSER: I think a lot of this goes
back to something we were talking about in the earlier session. Line drawing,
what factors should be considered in terms of justifying an intervention?
And just I think basically we or most people can agree that limits such
as risk -- physical harm to others, perhaps psychological harm to others
would justify restrictions on freedom. What kinds of harm? What chance
of harm? How certain must we be about potential harm and potential benefit?
And how much agreement must there be on all of these things before we
go forward? And I think the difficulties are in the details there.
CHAIRMAN KASS: Paul?
DR. MCHUGH: I want to first of all just agree
very much with Charles on the idea that we should be thinking of what
we are asking in our environmental challenges and compare what we are
asking in these biological challenges but I also want to thank Gil for
this wonderful article that he has written here and also his ability to
condense it down to a couple of little important -- these important questions
at the end.
What does it mean "our freedom"? Is the meaning of our humanity the
freedom to remake ourselves? Well, I think there is also an aspect of
our humanity that he mentions in his article that is the freedom to contemplate
ourselves and contemplation -- after all, the great contemplative here
he mentions is St. Augustine. And Augustine talking about the issues of
what it means to suffer allows us to appreciate how often that suffering
is going on for many and that appreciating that suffering and contemplating
it can give us better aims for the future.
Remember in Augustine's time one of the big arguments he was having
was with Donatists, the people who felt that the only worthy transmitters
of the tradition were those people that did not give in to Diocletian
and were martyrs but kind of tried to get around the necessity for martyrdom
in order to live and bring life further along. Augustine was on the side
of those people that, you know, said, "Well, you know, it was very important
for the tradition as well that we live."
And a contemplative idea here is what is going to be important for us
so that we can live in the face of the challenges that are being asked
to do as for progress.
CHAIRMAN KASS: Robby?
DR. GEORGE: I think this is a point at which
it is well to be reminded of a comment that Stephen Carter made in this
opening remarks about having in mind the distinction, although also the
relationship between the question of legal regulation or regulation as
such, and the question of moral evaluation. I think as important as the
question of regulation, including legal regulation is to this issue that
Gil has put on the table, as important is the question of what sort of
ethos we ought to try to nurture or if it is already in place to the extent
that it is in place maintain both in the community as a whole and also
in the scientific world.
Very often what keeps us on track, keeps us from going off the rails,
is not just formal regulation, be they legal or otherwise, but the ethos
that is in place in our community or in a particular subcommunity that
is dealing with issues of moral substance and import.
So whatever the substantive answers are to the question Gil has put
on the table they go beyond questions just of regulation and into the
broader question of the maintenance of an ethos, a moral understanding
of the goods that have to be protected and cannot be compromised even
for the sake of other important goods.
CHAIRMAN KASS: Stephen, did you want to join
in on this?
PROF. CARTER: Just a small point, I suppose,
going back to Gil's paper and also something that Bill May said, I think,
earlier that when we think about parenting, mother and father, and we
think about children, one of the questions that it seems to me is very
directly raised about human freedom that we encompass, those who are parents
and even those who are not confront every day, is the freedom to make
a variety of different kinds of decisions regarding children. This has
very important moral implications that are directly related to a lot of
the conversations we have had and will be having over the next few months.
In particular, the distinction -- I suppose we could think of it are
children production or consumption. When we think of children as having
to perfect them, we are going to live our lives through them, we are going
to push them to do -- you have got to excel in this sport or you have
got to play the flute or at least you have to bring home straight As,
we have got to do one of those things because you have got to. It strikes
me that one aspect which one might think about a moral limitation on human
freedom that I suggest would not have any regulatory implications at all
is precisely on this question of how we view our own children and interventions
in their lives, whether we are speaking of interventions after they are
born or before they are born. We can well imagine a great spectrum of
things, of ways that we might think of parents raising and nurturing children
for the good of the parents, for the satisfaction of the parents, for
the dreams and desires and needs of the parents, or of other members of
the family versus thinking of the children as ends in themselves.
DR. GEORGE: Precisely on the point that Stephen
now raises, whatever one thinks about, and down the line we may get into
issues about IVF and other assisted reproductive techniques, I certainly
always find myself even though I have now seen these ads many times just
arrested by ads in the student newspaper where I teach and I am sure at
your universities you will find the same thing advertising for egg donors
and stipulating a certain SAT score range of the student from whom the
eggs are desired. The idea really is here to have a child who is going
to be, as they say and I am as disgusted by this as I hope the rest of
you will be, of "ivy league quality."
We have run into a problem here. What kind of an ethos produces a situation
where ads like that can freely appear? We are not talking about legal
regulation or stopping people from putting them in. The ethos is one in
which people have no problem about advertising in these kinds of terms
that strike me at least as quite dehumanizing.
DR. BLACKBURN: Not only dehumanizing but I
just want to briefly interpolate that that is probably even not well founded
that there will be an inheritable aspect of it. So, you know, I am repelled
by the -- you know, the lousy science aspect of it as much as the other
aspect.
DR. HURLBUT: It says, "Egg donor needed, large
financial incentive, intelligent, athletic egg donor need for loving family.
You must have at least..." this is from the Stanford Daily. "...intelligent,
athletic egg donor needed for loving family. You must be at least 5'10",
have a 1400 plus SAT, possess no major medical issues," and they are offering
$50,000.
One of my students followed up on this and she got to be second in line
for possible egg donation. Filled out a 30 page questionnaire that included
such questions as "Did your grandfather freckle when he tanned?" And was
finally introduced to the parents.
And I was on a CNN program just after this came out and the broker,
the lawyer for the brokerage firm that was brokering the deal was asked
by one of the people in the audience, "Well, why do you want such a tall,
intelligent, athletic donor?" And he said, "Well, it is a tall, athletic,
intelligent family." But when my student finally got to meet the prospective
mother she turned out to be about 5'1".
So I wondered if maybe --
CHAIRMAN KASS: It is just enhancement.
DR. HURLBUT: Huh?
CHAIRMAN KASS: It is just enhancement.
DR. HURLBUT: Just a what?
CHAIRMAN KASS: Enhancement.
DR. HURLBUT: Enhancement. I do mean to say
like I know what is really going on but I wondered if maybe the prospective
father, he would be the biological father too, was not satisfied with
his wife like in our birth-mark story and wanted to be sure he would not
have a child who was -- maybe he wanted a boy and wanted to be sure he
would not have a short boy.
CHAIRMAN KASS: Yes.
DR. HURLBUT: Bad genetics too but beyond that
bad social attitude, bad expectations of children.
CHAIRMAN KASS: Gil, do you want to come back?
PROF. MEILAENDER: Yes. Just to play a sort
of devil's advocate role. I mean, I am more or less sympathetic to these
comments but if you assume at all that using these technological means
to go about producing a child is worthwhile or at least a legitimate thing
to do then you might say, "Well, why not the best?" I used to have students
watch a program that Barbara Walters had done on TV and she interviewed
some parents who had gone to Mensa Sperm Bank, you know, and the husband
said, "Well, it is not that we are looking for the perfect child but why
not the best?"
And presumably to the degree that it is within your control, and I am
sure that Elizabeth is right that there are many aspects of it that are
not, but presumably you would not set out to create something distinctly
inferior. So if you once set off on this path then why exactly shouldn't
you seek the best? I mean, I think that is a question that needs to be
addressed.
CHAIRMAN KASS: In the name of what other words
would one say to these people this is a misuse of your freedom?
Rebecca?
PROF. DRESSER: I was going to make that comment
that is, all right, so we are on CNN or one hopes we are in a situation
where we could actually deliberate with people who are convinced or at
least very interested in these kinds of things and think they are positive,
and we want to have a dialogue that is not just about regulations but
about morality and a more rich discussion. How do we communicate? How
do we speak without sounding, you know, parentalistic? You know, we know
what is best for you and so forth. I think that is a major challenge for
us.
CHAIRMAN KASS: Could I invite you, Rebeccas
or anyone else, how would you put -- if invited to make the argument about
what is wrong with this loosely speaking? I mean, why this is a use of
freedom that is -- this is a use of freedom that threatens other things?
What is being threatened here?
I mean, Gil says, 'Look, a couple wants to have a child of their own.
They are prevented by oviduct obstruction or something and they are going
to use egg donation.' Surely one would want to say one wants to give the
child the best shot in life and you certainly would not take eggs from
someone with severe genetic disease, right, presumably. So, I mean, how
can one -- in the name of what sorts of things must one raise some questions
about this?
PROF. DRESSER: I do not have the answer. I
think one major issue is this line between enhancement and good health.
What kind of -- and this goes on with donor sperm as well. What kinds
of characteristics are perhaps cosmetic, frivolous, versus getting someone
who is going to give a child a healthy start in life.
CHAIRMAN KASS: Paul?
DR. MCHUGH: Well, my answer to you, Leon,
would be that again we are seeing the slippery slope here. I agree with
Rebecca that you are moving away from health to some kind of higher quality
but you are giving up on the giftedness of life as it arrives and you
are moving steadily towards manufacturing and manufacturing is partly
seen here.
By the way, it is important as well to give the data that Elizabeth
mentioned, and that is that as the generations go on there is a reversion
towards the mean. You could be asking for 1,400 SAT scores in this egg
and the offspring will move back towards the mean in the next generation.
And, by the way, in my practice with VIPs the biggest issue that I have
with families is bringing in what seem to be very attractive offspring
and being told by the father or mother that "he is not the valedictorian
and I was, and isn't this a terrible tragedy?" And I try to say, "Isn't
he a wonderful person?"
DR. BLACKBURN: There are many aspects of intelligence.
The SAT is but one very narrow culturally defined aspect. I think that
was the objection I was primarily raising that we are defining something
poorly --
PROF. SANDEL:: Including grade point average
and a wider range of attributes that would have been all right.
(Laughter.)
DR. KRAUTHAMMER: Leon, if I could --
CHAIRMAN KASS: Charles, and then Stephen.
DR. KRAUTHAMMER: I think the approach to the
answer to your question is the word "eugenics." The word "eugenics." This
is a form of eugenics. I think as Gil noted in his piece it is privatized
eugenics so that sanitizes it to some extent. But what is interesting
about the history of eugenics is that earlier in the 20th Century it was,
as you all know, a progressive course and then it fell into the wrong
hands and was discredited obviously in mid Century by the Nazi experience
but its recovery now is under the guise of privatization.
It is not easy to answer your question why shouldn't you if you could
choose a child who would have all of these enhanced attributes. I think
what scares us and maybe beginning even an understanding of the problem
here, the repulsion that we feel is if everybody did it or if the state
ordered it, we enter a brave new world.
And I think it is again the question of the slope. Once you grant the
principle that you can do this then perhaps you get to a point where you
are going to have to do this and then where are we and who are we?
CHAIRMAN KASS: So your answer is that it is
finally in the name of freedom that one accepts some limitations of freedom
because if you start this way you are going to have coercers rather than
that there is something wrong with the thing itself?
DR. KRAUTHAMMER: No, I am not sure that the
only good that is threatened here is freedom. I think there are other
goods which are threatened. Diversity, creativity, spontaneity, contingency.
There are other things that will be threatened. Freedom is one of them
but I think that it opens us to a completely new world. We have never
been able to manufacture humans and we are now able -- almost able to
do it and certainly by the end of this Century we will be. We have to
prepare ourselves for what that can mean and begin to make restrictions
and limitations to keep it from becoming a horror.
CHAIRMAN KASS: Stephen?
PROF. CARTER: Well, I want to -- in an effort
to answer the question and you are right to raise it and to challenge
us because it is one in which all of us have instincts and they are hard
to articulate but first to go back to something that Paul said a moment
ago about the sense of the giftedness of life. And the more that we try
to adjust people from the beginning, I think the less we tend to view
them as a gift.
This has implications that someone mentioned earlier, a couple people
mentioned about equality as well. There is a lovely and very depressing
essay by Stanley Howass (?) in which he talks about a commercial, a television
commercial that he saw that was intended as part of a crusade against
what was described, a particular kind of -- as he was describing the commercial
-- birth defect and he is concerned about the term "defect."
And he said that the theme of the commercial seemed to be wouldn't we
better off if no one was born with this and he said in the one sense from
the point of view of the individual or the agonized parents it is easy
to understand that theme but from the sense of human equality it is suggesting
that there are people who really ought not be among us, that we as a society
are a better and richer society if certain types of people are not around
us.
And it is not so much that that is anybody's intention. It is not that
is a theme that is chosen or even a hidden but intended subtext. It is
rather a risk of our rhetoric and our way of talking about these problems
and a risk of when we ask what human goods at stake, the very good that
has been articulated around the table that we have an obligation of equality
-- the obligation -- the word "love" was used by Bill a little earlier
-- to all human beings is at stake it seems to me when we suggest that
somehow there are some that are less lovable than others and let's make
sure we build a society of the more lovable ones.
CHAIRMAN KASS: Michael?
PROF. SANDEL: I am going to push Charles a
little bit. Let's grant that it is eugenics, this ad. Doesn't that beg
the question about what is it that is objectionable about eugenics? Apart
from the coercion which many actual forms took. And if we -- and one way
of making that question harder is to take not the enhancement cases, which
seem more readily objectionable, but the -- but remedial eugenics, if
we could somehow through genetic engineering assure that babies would
not be born with Down Syndrome or would not develop diabetes.
And I do not mean this as a rhetorical question to say -- to defend
the genetic engineering even in the remediation case but to see whether
that -- whether articulating what is objectionable in eugenics apart from
coercion does not push us to this somewhat inchoate but intuitively powerful
idea that has been part of the discussion all day about according some
respect or reverence or consideration or moral weight to the given or
the natural which is not, strictly speaking, human nature only. It may
extend to sequoias as well as to babies and embryos.
DR. KRAUTHAMMER: Let me respond by trying
to push you and say that -- let's speak about a completely uncoerced eugenics,
privatized eugenics that would produce a class of people who are super
human. I am asking what will life be like? What will society be like?
What would it be like to live in a world where you have a class of super
humans among us?
This is not as weird and science fiction as we are thinking. If this
stuff could work we can manufacture extremely intelligent, extremely powerful,
extremely resistant people. Presumably that would be done. Some people
would do it.
Do you have -- I mean, does that arouse in you any trepidation? I am
saying I think that is the reason some of us are resistant and hesitant.
Are you saying that it is not a problem?
PROF. SANDEL: No, I think it is a --
DR. KRAUTHAMMER: I am speaking of a super
race, which is what we are talking about here.
PROF. SANDEL: Right. No, I think that is a
problem but what I am trying to -- but I would say the reason that is
a problem is -- requires us to give us some account of what modes of reverence,
let's say, or respect are appropriate to what forms of life and I would
not restrict it to human life given by nature. And to answer that question
we have to ask what does it mean to act and to value goods in ways that
are fitting with their nature? What are appropriate modes of valuation
for not only human beings but goods generally? And beings, creatures and
nature generally?
But that pushes -- so -- and if that is -- what seems to me wrong with
the nightmare scenario of the super human enhanced creatures is that it
is a kind of hubris. The objection is not that it violates somebody's
rights or that it causes harm to anyone even but that it is a mark of
-- a deep mark of bad character having to do with a kind of hubris, a
human hubris that assumes that nature is merely open to use for our purposes.
So the offense is in the hubris, not in the harm or in the violation
of rights that might be done to any particular person.
DR. KRAUTHAMMER: I grant you that and I think
that is -- I would agree with you entirely on that. I would simply add
that in addition to the sin of hubris involved here there is also the
consequentialist question of what kind of society would that look like.
Apart from the morality of the act of creating it, I am asking what it
would be like to have created it? What would it be like to live in it
and what would happen to the values that we now share in such a world?
So I am adding a layer of concern. I am not questioning your's.
CHAIRMAN KASS: Jim?
DR. WILSON: Did you want to respond?
PROF. SANDEL: No.
DR. WILSON: We are getting very close to the
core issues here in this exchange between Charles and Michael and I am
trying to draw some lessons from the three births with which I have been
distantly, not so distantly in one case, connected. My wife and my daughter
and my daughter-in-law, and why they valued the experience so much. Did
they value it because they knew the kind of child that would emerge? No.
They valued it for a different reason, that it was a mysterious gift,
that it was a union governed to be sure at the margins by genetic laws
which produce imperfect or unpredictable results. And they spent a great
deal of time talking about who the child most resembled. To me, of course,
it most resembled a worm, a worm that I loved, but women have a better
eye for this than I do.
They speculated about its developmental unknowns. When it would walk,
what it would do, would it be tall, would it be short, would it fair,
would it be dark? They talked about all of the unknowns of these things
and in my experience this is an unrepresentative sample and everyone in
this room may have very different and quite critical judgment but these
unknowns, this mysterious gift was to them a great gift.
And I take if I am correct in my assessment some comfort in this that
the outcome of a human birth is a delight to its parents in part because
they are being given something new, something whose identity they cannot
predict about which they have anticipations but no firm convictions.
Now since I live on the west side of Los Angeles I am all too aware
there are many people who do not have this view. The magazines that circulate
on the west side of Los Angeles are primarily supported by advertisements
for cosmetic surgery. And I have noticed now of late in my trips to Boston
the Boston magazines are supported by ads for cosmetic surgery. There
are a lot of people there who get engaged on a weekly basis and a legion
of men who practice something that could only be called serial monogamy
so that I know that I am not generalizing about all people.
But it seems to me that the emotional context of birth, the idea that
it is a mysterious gift is important to understanding where people on
the average would draw the line. I think on the average they would draw
the line if they could do so with confidence at removing defects but not
producing enhancements because removing a defect is removing a specific
thing. Cerebral palsy, down syndrome, spina bifida, et cetera, which although
countless parents do a splendid job in raising such children, most would
have been happier had they not had the obligation to do this. But adding
enhancements, that eliminates the mystery. That eliminates this gift that
they have been given.
CHAIRMAN KASS: Janet, then Frank.
DR. ROWLEY: Well, I would like to say from
the standpoint of a scientist I feel quite lucky if I can figure out what
are the reasonable questions to be asking in the next year or two and
I am concerned that if we focus on things that might possibly happen 100
years from now we are not necessarily going to be providing the kind of
guidance that is needed in the near term. And I think that it is important
to separate what is potentially possible some very long time from now
with what is -- clearly are possibilities now and what are the unknowns
that would be helpful if they were resolved so that we could make wiser
decisions.
And just to come back to the specific issue in the ad, fortunately it
is not a concern of mine because I was able -- my husband and I were able
to have our own children but I have to say if I were in the position of
not being able to have a child, I would think very carefully about what
kind of qualities I would like in an egg donor to then have the child
that would be born have the best possibility of a successful and rewarding
life.
So I guess I am not quite as offended as some people are. 5'10" is not
one of those qualities I would choose to have but I think that a potential
parent given the apparent impossibility of having a child completely of
both parents, then trying to think of what qualities are important to
that parent.
Now this is an individual family making this kind of individual decision
based on their assessment and it does not really speak to manufacture,
which is not necessarily directly a consequence of a single family making
this kind of choice.
DR. KRAUTHAMMER: Could I just make one comment
about the time horizon for our thinking here?
CHAIRMAN KASS: Please.
DR. KRAUTHAMMER: I would defend the 100 year
time horizon for the following reason: We are at a unique time. We just
-- the cloning of the first mammal occurred only a few years ago. That
never happened before and it opens a whole new possibility of what can
be done.
I think we have -- I have a sense that we are at a time where the decisions
that we make because these questions are so new are going to have a remarkable
effect on the future. I do not think that these technologies are that
speculative or science fiction. I think the moral decisions, the legal
decisions, the regulatory decisions taken now are going to have reverberating
effects for decades because they are new and because they had not been
dealt with before.
If we choose wrongly, I think we will open futures which will be very
unhappy and that we will regret and that is why I think that we have to
have a horizon that is rather long thinking about how our decisions are
going to have reverberating effects.
DR. ROWLEY: Well, I just want to respond that
Dolly, being the first cloned mammal, now apparently has arthritis at
age five years, which is far earlier than expected. So I think at least
in the scientific community it is recognized that at least some of these
experiments are fraught with great dangers or untoward consequences and
I think that people are less likely to -- at least some people are less
likely to rush into this than we may imagine.
CHAIRMAN KASS: It seems to me this -- not
to adjudicate away the tension in the discussion, it seems to me the question
of how long a time horizon is appropriate for this body is a question
that we all wrestle with continually. We are trying to not duck what is
right in front of our face but we are also trying to see this in the context
of things to come and I would advert to Gil's second question in which
he pointed out that other values that might be threatened by the untraveled
use of freedom are rarely assaulted head on.
In fact, if they are assaulted at all it is as a kind of indirect consequence
of a certain use of this development, say the treatment of infertility
that we all embrace, but ten years from now that becomes a kind of precedent
not just in technique but also in the logic and justification. And, therefore,
it seems to me we need this kind of double vision. The things for the
long range future are admittedly speculative and what the facts will be
we do not know.
On the other hand, one sees to some extent the continuity of the powers
here gathering and the decisions we make about the present ones are not
without consequence for how we will be thinking about the future ones.
So I would want to say I think you are right and I think he is right
and how we deal alternatively with the need to look both close at hand
and down the road, I think, is -- we are just going to have to struggle
with it.
There was a hand. I think, Frank, you have been wanting to get in for
some time.
PROF. FUKUYAMA: As in a lot of cases if you
wait long enough most of your points get made by other people. On this
question of long term versus short term I do think that some of the questions
that have already been raised about enhancement versus therapy are ones
that we are going to confront in the short term and they do not depend
on the development, for example, of germ line engineering or things that
are, you know, I think fairly far down the road.
For example, you are going to have preimplantation, diagnosis and screening,
you know, fairly shortly for a lot of conditions where you are going to
be basically forced to make therapy versus enhancement types of choices.
In drug -- in neuropharmacology you can have enhancement versus therapeutic
uses of a lot of, you know, neuropharmacological agents.
In fact, we already make implicit, you know, distinctions between those
so I do not think it is at all inappropriate to -- you know, to be aware
of, you know, the fact that there could be extremely large technological
developments way down the road but to begin the discussion about just
a couple of short points.
Just in response to something that Michael said earlier, I really do
not think the only problem with the -- you know, the super enhanced people
is the matter of hubris.
I mean, I think that the principle of liberal equality really, in fact,
is based in our modern democratic world on the empirical equality of people
when you strip away all nonessential characteristics like -- you know,
like social status and race and the like. So when you start monkeying
around with essences I think a lot of people are much too casual about
what the implications of that for human rights are. The only one that
was not -- did not have these kind of blinkers on was Nitze (?), he said,
"Yes, let's do this and then we can go back to natural aristocracy and
the domination of, you know, one set of human beings by another." I think
that a lot of people are not going into this with their eyes open.
The other thing that struck me, even if you do not want to get into
these kinds of issues, is just simple things like family law. This is
something that Mary Ann Glendon knows much better than I do but one thing
that has always struck -- you know, you are asking in the name of what
would you accept restrictions on human freedom.
I have always thought that there is something strange about family law
in that it tends to take the interest of parents much more seriously than
the interest of the children that they produce or tends to regard, you
know, the choices that people make as preeminent. You can see this already
in the cloning debate that it is almost exclusively debated as, well,
can you think of a parent that would like to clone himself or herself
and if you can find that interest then, you know, that is sufficient to
justify the practice and then you can kind of presume the consent of the
cloned child, you know, to go along with whatever the parents have decided.
It seems to me that that in itself is not an appropriate way to think
about these kinds of decisions because, in fact, I do not know how you
could ever presume the consent of someone to be born as a clone. I mean,
you could say after the fact, of course, anyone that is born will be grateful.
I mean, they are not going to contest the choices that their parents made
but, you know, there is a deeper problem embedded. And I think a lot of
current family law that it actually does not take, you know, account of
the interests of children and simply sees the children as a result of
the personal, you know, autonomous decisions and preferences of the parents.
CHAIRMAN KASS: Stephen?
PROF. CARTER: I want -- oh, I am sorry.
CHAIRMAN KASS: I missed Rebecca.
PROF. DRESSER: I was just going to say that
one way to bring together the far off developments and the ones at hand
is to think about -- with many of these technologies there tends to be
an assumption that enhancement will work, germ line will work, cloning
will work. And I guess for us a question now is, is it -- how much risk
are we justified in exposing people to in order to develop these technologies
so the research phase issues. And then the other would be given that we
have limited resources to spend on research, is this an area that ought
to receive priority or are there other areas of research that would be
more worth developing to get away from enhancement and health issues?
CHAIRMAN KASS: Let's see. I am in danger of
really losing control of the whole order. I think it was Bill May, Bill
Hurlbut, Stephen and Robby unless I have missed somebody.
PROF. MAY: To return to your earlier question
what would allow one to say that this is an abuse of freedom. It seems
to me that is very -- a crucial question. I recall reading one paper on
reproductive rights where the word "right" is used without quotation marks
with respect to the freedom but then what is right, use of freedom, "right"
there was used with quotation marks. So the suggestion is that the fundamental
feature and characteristic of human beings even in parenting is freedom
and what I think Gil's paper has asked us is to think whether that is
the sole feature of human beings that trumps all other considerations.
Whether other considerations are merely frothy or dependent upon the
particular views of particular groups and so forth and, therefore, cannot
enter into public discourse.
So it seems to me what is very crucial is that this paper forces us
to think back about human nature and what are the enduring features of
human beings that would allow the word "right" to be used with regard
to the question of right and wrong and not simply dismissed in quotation
marks whenever it used in that way and simply to be honored as right when
it refers to rights.
Now how that works out with regard to our political decisions as a nation
that is another question but our moral discourse it seems to me is shrunk
if we do not face that question.
CHAIRMAN KASS: Let's see. Bill Hurlbut and
I will add Mary Ann to the list.
Bill?
DR. HURLBUT: To pick up on a couple of themes
and if I may ask a question of Professor Gazzaniga. We were speaking about
enhancement and what we should be practically considering and so forth.
To pick up on what Francis was saying, there is a story about the labor
leader when asked what his ultimate goal was he pounded the table and
said, "We will not be satisfied until every worker in America is making
above average wages." It seems to me that there is something in the human
psyche that is not satisfied with being average and yet what danger are
we under?
I think we need -- one of the things we need to do in this council is
to realistically assess the science. I mean, I hear an awful lot of things
about where they we are heading futuristically that I think are at least,
from what I know of genetics, unrealistic. So we need to assess what the
dangers really are. It is not going to be easy to manufacture human beings.
That is for sure.
But the larger question is if we can what will we do. And I -- the question
I would like to put to Professor Gazzaniga is if you say that there is
not certainly -- maybe biologically grounded impulse to self-assertion
in human nature and we have the tools of our technology, like Nitze said,
"To be naturalist, to dare to be as immoral as nature," and the evolutionary
psychologists tell us that we are like Gil Bailey said not -- or Gil Meilaender
said, "We are not cobbled together collections of --" what was your term?
A loose leaf folder of genes? We are, in fact, a coherent creature.
The question is what kind of a mind do we have? What actually? When
we speak of freedom what do we really mean? Increasingly neuroscientists
are saying that we have modular minds, that we have various neurologic
programs for various purposes that do not necessarily form a capability
to find a coherent cosmology, the ultimate kind of split brain.
And so what I would like to ask you is what is nature's mind? In that
sense what -- are we capable of coherent use of freedom in a moral way?
Is freedom biologically capacity to do the good, in fact?
CHAIRMAN KASS: Do you want that?
(Laughter.)
CHAIRMAN KASS: Do you want to say something
or do you want to pass?
DR. GAZZANIGA: I will answer that in great
detail at the bar tonight.
(Laughter.)
DR. GAZZANIGA: I do not mean to be facetious.
It is a tough question and it is the notion that there is a structured
human nature that reflects a series of adaptations that have been built
into the human brain over evolutionary time. It is a very active current
belief which rides up against the more common social science model of
the blank slate, which we start with a clean slate and interacting with
culture we build who we are.
I think the formed view is that there is a lot of us that come with
mini mental structures that are sort of built at the factory and that
we -- as we interact in our environment we structure ourselves differently
as a function of how those built in systems interact with the environment
that we grow up in.
So that then leads to the question of where do you structure freedom?
Freedom of action and what does it mean. That is a really tough one. I
think everybody in this room probably is a 20th Century informed scientist
and we believe in the forces of the physical world and how they guide
biologic processes and so forth. I think everybody in this room probably
believes that the brain enables mind. I do not think anybody thinks that
it is floating somewhere around our skull, that somehow the brain constructs
our cognition.
And that leads one to the kind of obvious statement that by the time
you and I know something consciously our brain has probably done hard
work on it and that gives rise to this threat, this sense of, well, then
who is in charge here and are we out of the loop and so forth. That is
a deep question that we could all talk about at great length with great
intensity but it is an example of how neuroscience, I think, and cognitive
science and the philosophically interested natural sciences are going
to have to come together and talk about these issues that once we get
beyond the stem cell thing all those issues are very relevant to how we
think about science and how it interacts with our culture.
CHAIRMAN KASS: Stephen, then Robby, then
Mary Ann.
PROF. CARTER: I want to go back a little bit,
although this will tie in to some recent comments, to a very interesting
point that Janet made a few minutes ago. Not the point about the -- which
century we should be concerned about but rather that when you think about
something like the ad in the Stanford Daily or in the Yale Daily News
or the other ads that these are in effect private decisions of families
who are often in a situation which they find painful and challenging and
trying to make the best of it and so they are making choices. Let's assume
for the moment that certain kinds of enhancements are reliably possible,
that is to say that if you did get the right ad you could get some good
traits. Assume that were true. It seems to me that this is -- even though
it is not exactly the problem -- that is that this exercise of freedom
may be a private exercise but it is a public act and these collective
exercises of freedom drive the market, which we talked about then driving
science. That is if a lot of families decide this is the way to go that
pushes research in a particular direction but it also does something else.
It drives our sense of what is valuably human.
So that is so if we find that a lot of families given the choice would
say I would like somehow to enhance something measurable about some aspect
of my child's intelligence that conveys a sense of what we as a culture
find valuable in the human and, of course, by negative implication conveys
a sense of what we find not so valuable. We get -- it interferes in an
interesting way with this vision of empirical equality and it interferes
with the vision of equality in the abstract because then the announcement
that is made through an ad like that, even if the ad does not work, even
if what they are doing is impossible, the ads say we will pay you this
much money if your SAT is over 1500, that conveys a message about the
value we place on people whose SATs are below 1500 and the value that
-- not just places as a university admission committee but as something
in this society in a larger sense.
Finally, the last part, to bring something that Rebecca has mentioned
twice and we have not talked about very much but I assume we will as the
time goes on, there are distributional concerns as well. You say, well,
suppose that you do possess these various attributes and you could contribute
an egg and one family says, "We will give you $100,000 for it," and the
other family says, "We do not have any money to give you but, gee, we
want it for our kid, too." Well, the market is going to operate and most
of these eggs will be sold to the highest bidder if, indeed, we decide
that private market decisions are the right way to conduct such transactions.
CHAIRMAN KASS: Could I just ask for clarification?
Surely the question of whether the society values and values properly
or over values the intelligence of our children, which are -- there are
as many individual variations probably as there are households on this
as to where it fits into the scheme of the household's evaluation so if
someone were to say, "Look, what difference does it make if we are doing
this with biological means since those values are either properly formed
or deformed culturally speaking already?"
What does the fact that we might be doing this genetically or pharmacologically
do to our concern? Is there something there? Is it just that we have got
other scientists in there whom we are nervous about or is there something
different about doing this biologically rather than doing it culturally?
PROF. CARTER: Are you asking me or the group?
CHAIRMAN KASS: Yes, because you -- I just
wanted to draw you out to see if you had an intuition on that.
PROF. CARTER: I am sure I will bore people
at length on my views on this as the months go by but let me just say
something brief about it now.
The problem is what it says about human possibility and the values of
different kinds of human possibility. The cultural trend that we have
already is enormously dangerous and does enormous damage to the fabric
of society, to children, to families who seem bent on insuring that for
reasons they, themselves, can scarcely articulate their kid gets to the
top of the heap because there is some deep failure, familial failure,
genetic failure, the school failed, somebody failed if somehow the child
fails to rise to the top of the heap.
Already, and all of us are familiar with this in various aspects in
our own lives already, in the society the culture is deeply distorted
by the emphasis on intellect as -- and especially the measurable aspects
of intelligence as a vitally important divider and a vitally important
tool for assigning cultural worth.
At least if one is battling against that trend one is able to point
out that we are given a great deal of diversity, all equally beloved we
hope. If it turns out that, well, no, actually we have the capacity to
manipulate this it strikes me that the message is actually reinforced,
the cultural trend in some sense becomes worse in the sense that equality
becomes weaker.
CHAIRMAN KASS: I have got others down here
but some people, I think, want to follow this line if I might. So, Robby,
if you would hold off and let Janet and then Gil, I think.
DR. ROWLEY: I just want to point out that
it depends on what measure you use to say that society values intelligence
and intellectual success over all others. If you look at the monetary
rewards, one would raise serious concerns that that is not what society
values. It is beauty and how well you can sing and how well you can play
basketball, and intellectual pursuits are highly under valued in our society
if you look at the monetary rewards. People with Ph.D.s having gone to
college and up to six years of graduate school or more can then get a
position of $30,000 a year as a post-doctoral fellow. So I do not look
on this as society values it very much.
CHAIRMAN KASS: A question not to be settled
at this moment.
Gil, and then Robby.
PROF. MEILAENDER: Yes. I thought that the
question Stephen raised could be generalized. It would not have to deal
with valuing intellect. It could value various things and, you know, is
an important question but it seems to me it really drives to a deeper
issue about how one thinks about the child in language that has come up
at various places along the way and that I use the Galway Kinnell poem
to get at, which I take this opportunity to mention again since it is
such a wonderful poem.
But it seems to me that there is a deeper question, Stephen, that your
position would have to face even though I agree with your position. If
the child really is in some sense our product then it seems to me you
ought to take responsibility for it. You see it is irresponsible not to
exercise a kind of control over something that is our product.
So the really fundamental question is how we think about the child,
how we go about developing attitudes that teach us to think about the
child in different sorts of ways because I think, you know, things that
are our products you are supposed to exercise quality control over.
CHAIRMAN KASS: Robby?
DR. GEORGE: Leon, I think that in the discussion
in response to your question about what values, what considerations, what
goods can be placed in jeopardy by the exercise of freedom, three hypotheses
have emerged and it might be more than three and these are not incompatible
with each other.
Freedom itself could be jeopardized by the unrestricted use of freedom.
History is replete with examples of that happening in other areas so there
is absolutely no reason to suppose that it will not happen or cannot happen
here.
The second would be dignity.
And the third equality.
It seems to me that in our discussions going into the future will probably
be exploring and testing these hypotheses with a view in every case to
seeing if they stand up or in what senses they stand up but I would like
to just kind of put on the table early on that while I suspect all will
be borne out as representing values that can be seriously jeopardized
in the area of biotechnology by the unrestricted use of freedom, I suspect
that the concept, the value, the good of human dignity is going to be
playing a special foundational and perhaps in a certain sense even architectonic
role because it undergirds our conception of why freedom and equality
are valuable.
And by dignity here, which I admit is something of an obscure concept,
I mean what it is we have in mind. What we are gesturing toward when we
attempt to distinguish -- let's just take the case of the child since
it has been on the table -- the child as a gift and the child as a product.
When we recoil, at least those of us who do recoil, from the idea of manufacturing
human beings or the idea of ivy league quality human beings, it is what
we have in mind when we intuitively, as if we are groping in darkness,
move towards the distinction between therapy and enhancement. Not quite
sure what to make of it but perceiving that there is something there,
that people have a kind of special thing that just makes it wrong to use
them or treat them or merely use them and treat them as instruments, treat
them as means rather than as ends in themselves.
Just a quick final point because we are bound to continue to work with
these concepts, and Bill May helpfully introduced this question of the
difference between the -- what Mary Ann Glendon has, a very important
book called The Language of Rights as opposed to the concept of right
and wrong.
I would put on the table as a hypothesis, and I am sure Michael Sandel
can speak to this very intelligently, I would put on the table the hypothesis
that the concept of rights, whatever else is to be said, that modern work
in moral and political theory makes clear that the concept of rights,
whatever else is to be said about it, is parasitic, which is not to denigrate
it but is parasitic on the concepts of right and wrong and the possibility
of distinguishing between right and wrong such that we can say, for example,
that there is something wrong with violating the rights of other people.
That it is not just an interesting fact about the world that people have
rights that can be violated and sometimes they are violated sometimes
by genocidal maniacs. That is just not an interesting fact about the world.
There is something wrong with violating people's rights.
CHAIRMAN KASS: We, I think, are close to lunch.
The question that has been talked about sometimes head on and sometimes
around about way will, you will not be surprised, be back after lunch
when we come to our first session on human cloning, which we are not going
to take up in the first instance by asking for discussion today of the
arguments for and against reproductive cloning. But in keeping with our
sense that we want to think about the human context into which this technology
fits, we begin rather with human procreation and biotechnology.
One of Gil's themes that we did not talk about explicitly, though it
was in a way when we talked so much about children, was really the question
of the relation between the generations. That comes back in that session
again.
And as a person who is as guilty as anybody in the room of repairing
to the notion of human dignity, and who would have a very hard time, if
pressed, articulating it in terms that would be satisfactory even to me,
I would be -- I would want to underscore my agreement with Robby that
that is at least one of the notions very important to our discussion and
yet incumbent upon us to do more than use it as a slogan and a banner
and to try to give it some kind of weight.
Just with a view to the next discussion -- well, let it sit there. We
will get into the procreative questions when they come up.
Council members have lunch next door. Who knows where? Is it -- it is
through one of these doors. We will tell you when we break.
The public members and visitors are, unfortunately, given not too long
a time for lunch because of the truncation of our schedule. We would like
to reconvene at 1:30, which is 40 minutes from now.
(Whereupon, at 12:52 p.m., a luncheon recess was taken.)
DISCUSSION OF CLONING WORKING PAPER #1 CHAIRMAN KASS: All right. This is the fourth session
of a very crowded day and I want to express my gratitude to council members
for living with this rather ferocious and compressed scheduled with insufficient
time for breaks and easy conversation. We will be breaking sharply at 3:00 o'clock to meet the buses outside
the front of the hotel, which will take members of council to the White
House. I will be accompanying you with some various logistical questions
so we can sort out as we travel.
This is the first of three sessions on human cloning. One this afternoon,
two tomorrow morning before we have the session for public comment at
noon tomorrow, our seventh session.
We have prepared four staff working papers to support these discussions.
In the first session Cloning Working Paper #1 entitled: Biotechnology,
Procreation and the Meaning of Human Cloning. That is the paper primarily
meant for discussion. And it is supported by a Cloning Working Paper #2,
which is on the Scientific Aspects of Human and Animal Cloning.
I might mention again that I have learned through courteous information
that the National Academy of Sciences report on the scientific and medical
aspects of human cloning will be released tomorrow. That deals with the
scientific and medical aspects. We look forward to having that report.
It will help us a great deal on the scientific side learning where we
stand.
The Academy has indicated that it has left -- and I copied this down
-- I trust I copied this down -- that the ethical, social and religious
questions they hope will be the subject of vigorous public discussion
and debate and we hope to help out in that respect.
We do not regard this as a competition but as complementary activities
and we will welcome the opportunity to read that report, and I hope at
one of our meetings soon to invite the members of that panel to our meeting
so that we can discuss the science and its implications with us.
The subject of human cloning is the first specialized topic that we
are investigating and the President has authorized us to look at the scientific,
medical and ethical issues related to human cloning and to place it in
the larger context of other growing capacities to influence the genetic
endowment of future generations.
In keeping with the spirit that we have been following to this point
rather than begin really with the question of arguments pro and con of
human reproductive cloning, which is the subject of the Working Paper
#3, which we will start with tomorrow morning, we thought we would begin
really by trying to locate human cloning in its larger context, both technological
and in terms of human procreation. The Working Paper that you have first
discusses biotechnology and human procreation and shows how this has come
to be a matter of growing moral and political concern placing human cloning
in the context of previous innovations, technological innovations in human
reproduction and genetics.
Second, and I will not rehearse this here, there is some discussion
as to why it might be important for the council to take this question
up not only because there is a public debate swirling and it would seem
to be irresponsible for us not to be talking about it when we are going
to be asked to, and where this is the -- one of the major topics of pubic
bioethics at the moment. But also a suggestion that the subject of cloning
is not only timely but, as Charles indicated earlier, clonal reproduction
may represent if it is successful -- we should keep that proviso in mind
-- might represent -- would represent an early first instance of assisted
human reproduction in which the genetic endowment of the resulting child
would be the subject of choice. Not just whether there is a child but
precisely what genetic constitution that child is to have, whether that
is going to play out the way the parents hope or not is beside the point.
That certainly would be the intent. And that, therefore, this is -- this
represents an innovation worth thinking about, both in itself and what
it might represent in principle for developments that might lie ahead.
And it also gives us an opportunity to think about -- on the policy
side -- whether public control of biotechnology is possible, desirable,
by what means and what cost. Vexing questions but something on which if
we are going to be responsible to the policy side and not just the ethical/philosophical
side we should pay some attention.
In the working paper the staff suggests that the proper point of departure
for discussion of clonal baby making is to locate it in connection with
some of the basic values that are, in fact, stressed in the discussion.
On the one hand things having to do with the character of human procreation.
On the other hand questions having to do with freedom of scientists, innovators,
entrepreneurs, individual parents facing reproductive decisions. And also
since the question of research cloning tags on to the question of reproductive
cloning, the desire of scientists to use science and technology to cure
disease and relieve suffering.
So on page 6 of the Working Paper the Working Paper sort of concludes
with a series of questions on the two sides of this discussion. On the
one hand cloning seems to fit in to the nexus of human procreation and
all of its entailments, family relations, personal identity, questions
of genetic make up to who one is.
What does it mean if reproductive activities become increasingly technological
and commercialized, touching in part on a comment that Dan Foster raised
this morning but in this particular area.
And questions of what does it actually mean to take responsible for
or have the power to select, is it design, redesign in advance the genetic
characteristics of the next generation and, if so, on the basis of what
goals and standards on the one side.
But on the other side there are these pursuits of human freedom in all
of its forms and the particular medical benefits touted not by reproductive
cloning so much but by the experimental cloning and the research on cloned
embryos where in a way the ethical questions fit more in the general category
of research on embryos in general rather than research on cloned embryos
but here it is and we will take it up because it is our's.
I thought, and this continues in part, Gil Meilaender's -- grows out
of the discussion this morning both about the question of freedom, which
we touched on from one side and asked what of its -- what possible things
in the name of which might one conceive of limiting it. And also the section
in his paper that we did not discuss exactly, though it was there much
of the time, the question of the relations between the generations.
I mean, maybe the way into this would be to -- picking up on any one
of these smaller questions in the top paragraph of Part 6 to ask -- speaking
anthropologically in terms of what we value about human life. What is
this thing, human procreation? And what of its humanity matters to us?
I mean, Jim Wilson spoke a bit about it earlier today when he talked about
the encounter with the mystery of new life, which is to replace us. You
speak better than I but it seems to me before we take up cloning and whether
it is threatening to human procreation one should try to talk positively
about what those goods are, hard though it might be to do, to -- in order
to be able to see what it is that is at stake here and what we care about.
Because if there is not anything at stake and some people want to do it,
it seems to be perfectly reasonable to say why not.
So that was a rather long winded way to what should have been a short
question.
What do you -- when we talk about the humanness of human procreation
in ways that we value, what is it that we care about here? What are the
things that matter to us so that we would be in a better position to think
about human cloning in relation to it?
(Pause.)
CHAIRMAN KASS: I know that is a good question.
DR. KRAUTHAMMER: (Not at microphone.)
CHAIRMAN KASS: I am sorry. Look, this is partly
what it means to fumble with our intuitions and our thoughts not as experts
but as people. When the public worries about these things, this is --
they do not have the terms very often for expressing it but it is these
kinds of things and we do people a service if we struggle to articulate
what it is that we care about in these matters so that at least the debate
can be conducted properly to say on the one hand there is this but on
the other hand there is that. If you simply say, "Ugh," you are not really
being terribly helpful.
Michael?
PROF. SANDEL: Well, I really just have a question
that might help raise at least one of the issues. There seemed -- as I
understand what I have read here and I also had the benefit of reading
this fine volume by Leon Kass and James Q. Wilson on the ethics of cloning,
and a question that I came away with was this one: There seemed to be
two different objections to human cloning at work in the discussions and
I am wondering insofar as we are troubled by human cloning, are both of
these objections really at play or is it one of them rather than the other?
The first objection -- and, Leon, you emphasized this in your argument
in the book about cloning -- is cloning's character is an asexual mode
of reproduction and a different objection, which also arises, has to do
with where you were just mentioning that cloning involves a genetic copy.
It makes the genetic characteristics the subject of choice.
And as a way of testing which of these features of cloning seems most
closely or deeply related to our instinctive worries about cloning, would
this thought experiment help just to isolate these two elements? Let's
take a case of traditional sexual reproduction but where somehow there
is a pill that people could take. Let's say a pill that the mother could
take after conceiving a child that could select for the genetic -- same
genetic characteristics that the cloning could so you could do sex selection,
you could -- I do not know -- program in all of the other characteristics
we were discussing earlier today about IQ, about height, physical appearance
and so on. Would that pill be objectionable in just the way that cloning
is objectionable? Would our objections to that pill exhaust the objections
we have to cloning? If so, then it is the selecting of genetic characteristics
that would be the decisive objection and the asexual character would not
be or would there still be some remaining worries?
CHAIRMAN KASS: Can I take the liberty of twisting
your question this way? I would rather not start the discussion, if you
do not mind, with objections to cloning. I would rather to try to start
-- we can use the exact materials that you have dealt with but try to
put it in the positive terms of what is it in the relation -- in procreation
and the relationships that follow upon it and of the self-understanding
that follows on it that matter to us?
And I would rather -- I mean, I think tomorrow maybe, if it cannot be
held back later in this particular session, we could take up the question
of whether cloning is or is not an assault on these particular things
but I would rather us not simply be reactive to it at first but to try
to stake out the ground on which this innovation comes.
Cloning enters an already existing stream of human affairs and in order
to understand its influence on that stream we should try to characterize
that stream and why we -- you know, why we like the water in it or if
we like it.
So let me without -- let me take the substance of your question and
turn it not in terms -- not raise it in terms of the objections to the
cloning but in a way ask the question is it -- does the fact that a child
has two biological parents rather than being the product of one matter,
which is a way of raising the question. What is the difference? What is
the meaning of the fact that each of us at least to this point is the
fruit of two lines coming together? Does that have human significance
of worth or is that just an accident? Accident would be wrong.
I mean, it has got powerful deep natural selective roots if you read
that book or biblical roots if you read the other. But it has been around
for a long time and the question is does that natural fact also have some
value for us? Is it of worth? Or would anything important be lost if,
in fact, we came into being not by this path? That would be a way of taking
up the question of sexual versus asexual.
The other question is, is it somehow compatible with the understanding
of ourselves as parents of our children for whose existence we bear responsibility
and for some of whose well-being, both for their being and for their well-being
we bear some responsibility to also take on the responsibilities that
would come from the power to choose in advance some of their genetic characteristics?
I think I split that -- I think the sentence is parsed so I have got
both of your points but if you do not mind could we take it up in a positive
term before raising the objections? Is that all right?
PROF. SANDEL: Sure.
CHAIRMAN KASS: Does someone want to weigh
in on either of those?
Jim?
DR. WILSON: Well, let me speak to the first
question. What you are asking is a question that could be also asked about
adoption. Is it important that the mother and father jointly produce the
child or is it equally acceptable that the mother -- that the child is
borne by somebody else and taken over by two parents who did not create
it?
All of the evidence I know of says that it does not make any difference.
That is to say if both husband and wife jointly and enthusiastically seek
out a child, whether it by sexual reproduction or, failing that, by an
adoption, the devotion they give to the child and the pleasure they take
in the child is equivalent.
Now I am sure there are a few exceptions. This is different from the
case of stepfathers and stepmothers, which is a much more troublesome
question. But it seems to me that if you agree with my argument then it
is the family unit that is the central issue and not the sexual activity
that produced the child.
CHAIRMAN KASS: Frank, please?
PROF. FUKUYAMA: Well, it seems to me that
adoption is not a good analogy because adoption is natural parenting in
the sense that there is an equal degree of relatedness on the part of
both parents. It is either 50 percent in the case of a natural child or
zero percent but it is shared equally for, you know, both parents.
What seems to me problematic about life in a family in which one child
is a clone is that the child is a 100 percent related to one parent and
zero percent related to the other and that is the kind of asymmetry which
simply -- I mean, there really is no precedent for it. If you want to
think about this in just practical terms let's say that you have a family
where the wife clones herself and then the daughter is brought up. The
daughter is a physical copy of the mother except 30-35 years younger and
this girl grows up and then it seems to me, you know, what is really problematic
there that does not exist in the case of the adoptive family is that,
you know, here is the father, the mother is getting older and this copy
of this beautiful young woman that he married, you know, several decades
ago is suddenly growing up but it happens to be his daughter. And it seems
to me that what is very unnatural about this situation is the confusion
of these roles of parent and child because the cloned child is both --
you know, plays both of those roles simultaneously and the asymmetry in
the degree of relatedness.
I mean, if you believe, you know, the conclusions in, you know, evolutionary
biology of inclusive fitness, I mean you are, you know, instinctively
your altruism is proportional to, you know, share genes and I think that
is also one of the problems in step families is that the step parent does
not share any of the genes compared to the 50 percent that is shared by
the natural parent. So I think you will get some very problematic relations
in that kind of a family.
DR. WILSON: I am sorry. I was not answering
the question to which you provided the rebuttal, effective as your rebuttal
was. I thought I was answering Leon's question which I thought was a different
question. But you should restate the question because I obviously said
something that only confused people.
CHAIRMAN KASS: Does it matter? You actually
-- you answered -- I do not think you answered the question I asked but
you answered one that was close. You answered that the effects in terms
of child rearing if you study adoption indicate that it does not matter
to the eventual well-being of children provided the children are adopted
into good families. Therefore, whether they grow up with their biological
parents or not is not decisive. The question was does it matter in any
way that in the ordinary case, let's say, that what it means to be a human
child is to come from a father and mother. Does that biological fact --
by the way, whether done with in vitro fertilization, which is still sexual
reproduction biological speaking, does that have some kind of meaning
in terms of the identity of the child? And it seems to me -- let me just
add a small thing. What you say might be very true, Jim, but there are
two things in the biology of this that are also -- have to be part of
the discussion. It is not accidental that lots of the adopted children
insist on trying to find their biological parents as if those relations
somehow mattered to who they were.
And on the other side, part of the engine for some of these new technologies,
is people faced with the possibility of adoption or in vitro will be moved
by what they say is the desire to have a biologically related child as
if that kind of biological connectedness has human meaning quite apart
from what social science tell us in the outcome as to whether we have
done just as well otherwise.
DR. WILSON: Then I do not understand your
question.
CHAIRMAN KASS: The question -- well, Bill
May, maybe he can -- he may understand my question.
PROF. MAY: Trying to take a stab at it. I
think at one point it does not matter that they biologically come from
a mother and a father. In one of the papers, I am not sure whose, there
is the observation that there is the element of surprise. Another way
of putting that a little bit more traumatically, there is the element
of the strange. I mean, there are exceptions. My older son is so much
-- seems a biological copy that an Irish playwright friend of our's, Dennis
Johnson, laughed when he met Ted at ten and he said, "I am sorry, Bill,
I apologize for laughing but in Ireland we would call him painfully legitimate
because he looks so much like his old man." But still there is the element
of the strange in birth. In advance of birth we expect a Gerber baby and
then we get this prune and there is the jarring of the strange in the
experience.
I would like to explore for a moment the element of the strange. I think
it is a powerful continuing abiding problem in American life, all over
the world I am sure but especially in American life the constant, chronic
assault of the stranger. People came over sometimes in shipboard covenants
and then they got over here and discovered there are already people here
who were not there on shipboard with them and so you had the jarring experience
of the strange.
And then you had the arrival of people who were not on your shipboard
entering into your covenant and that is the second jarring experience.
There goes the neighborhood, these latter immigrants.
And then the third jarring experience of the strange was the birth of
your own children who were not on shipboard either. That is the ultimate
stranger in a sense, the immigrant from the future and a future that is
not simply a perfect biological copy of what was already there.
And so the problem of how to be open to the strange, it seems to me,
is a long-term and abiding moral problem in American life.
Now at the same time parenting is not simply the birth of that which
in various ways is strange but also the attempt to bring it into the orbit
of one's own life. They carry a name. We subject them to education and
so forth.
But we also discover, it was not just discovered, the generation gap,
in the late '60s, that part of that bringing them into the orbit of our
own life and making a part of bonded and connected community still requires
ways of being open to the strange. And it seems to me that is very much
involved in the moral challenge of generating that bears on -- ultimately
bears on the question of cloning.
CHAIRMAN KASS: Gil?
PROF. MEILAENDER: Yes. That was so good I
almost hate to say anything after it but another way -- a related way
of getting at your question about the character of procreation is to think
about the difference between making and doing. I mean, there are already
and may be more -- there are lots of ways to make a child. It is not clear
that they amount to doing the same thing, that their human significance
is the same, and what Bill just unpacked is, in fact, part of -- one way
of thinking about that significance that the making of a child through
the sexual relation of a man and woman means that the child springs from
their embrace is -- grows from their giving of themselves to each other.
That is a certain kind of doing that -- and we think it important and
one of the reasons we do not think of a child just as our's or just as
our product is precisely because it springs from that. So that it is possible
at least to think that cloning, which eliminates that relationship, though
making something that is the same is still not doing precisely the same
thing and that is something human is lost there.
DR. WILSON: Is making -- does your preference
for doing a child or for making a child rule out in vitro fertilization
in your mind?
PROF. MEILAENDER: Not necessarily but we would
have to think about it.
DR. WILSON: Well, let's think about it. I
mean, it is not the result of a normal male-female sexual embrace. It
is the result of a surgical procedure. My experience is that children
born in this way do very well and do not suffer from a lack of an emotional
attachment to mother and father.
PROF. MEILAENDER: Are we talking about donor
egg and sperm or not?
DR. WILSON: Well, either way. Yes.
PROF. MEILAENDER: Okay. Well, if we are then
I think it may not be doing the same thing, that is right.
DR. WILSON: You do not think so. We will have
to look into that. I have a different view.
PROF. MEILAENDER: The way we decide it would
not simply be by looking at how the children do in your terms. We have
to think about what it is -- what the human significance of what we are
doing is and how it teaches us to think.
DR. KRAUTHAMMER: But, Gil, another counter
example is artificial insemination and a third counter example where a
child can be loved even if there is no sexual embrace if you like is a
child born of rape can be raised by say the woman and loved as any other
child. So I am a little skeptical that the essential problem here is the
lack of this sexual embrace that created the child. There are enough counter
examples that I think the real issue is what kind of child is created
and I think the essential characteristics here that we are -- we ought
to value is the uniqueness, the genetic uniqueness of the child.
And the other -- it is a little bit harder to classify the second but
the second has to do with the randomness and contingency of that uniqueness,
that it is not planned manufactured. I mean what distinguishes a crafted
good from a mass produced one is its uniqueness and in some ways its unplannedness.
And I think that is what we value as distinguishing individuals and
that is what lost in cloning.
PROF. MEILAENDER: Leon, one comment?
CHAIRMAN KASS: Please.
PROF. MEILAENDER: The issue is not whether
the child can be loved. I mean, the human capacity to love children of
all sorts is enormous. The issue is what -- how it teaches us to think
about the relation between the generations. That is the issue I am trying
to raise.
CHAIRMAN KASS: Rather than move on to complicate
this with other questions and I know that Stephen and a few other people
have indicated that they would like to speak, let's stay on this point
for a little longer and see if we can make some progress on it, at least
clarify it a little bit more.
Gil makes -- offers us a distinction between making and doing about
which he needs to say more to bring everybody along with him so there
is an invitation to you to try to formulate that but there is also --
why should I ruin this by trying to remember it -- a poem that appeared
in Gil's paper.
"In the half darkness we look at each other and smile and touch arms
across his little, startlingly muscled body -- this one whom habit of
memory propels to the ground of his making..." it is poetry, it is not
argument. But there is -- there seems to be some suggestion, not that
children who would be adopted could not come to the parent's bed and somehow
be loved. I think Gil's point is that. But that there is something of
great human significance in that symbol of the child going to the source
and that the relations are somehow founded there and that that is known
both to the child instinctively and especially known to the parents in
the way they view that child.
I take it that that is part of what is under the discussion here about
the difference between making or doing and the place of the embrace or
sexuality in this discussion but I may have only muddled the water.
Stephen?
PROF. CARTER: Leon, I am glad you brought
us back to the poem in a way because I think that one of the reasons that
maybe we have had just in the last few minutes differences around the
table not so much about the answer but about the question, the question
is actually a very hard one to put, and it is a hard one to put because
we are running up against a kind of central mystery, almost a totem. There
is a sense in which so much of our reaction on this point is a matter
that goes deeply to instinct, whether it is an instinct that is natural
or trained into us is for the moment beside the point.
What makes that poem appealing is precisely its mysterious aspect that
we cannot really give a proper name or a proper account of the relationship
that is being described and yet for the most part we recognize it and
many of us would value it and see its significance in a larger vision
of the human story.
This leads me back to Bill May's point which I think is absolutely essential,
whether in the end we endorse it or not, although I think I do, the strangerhood
of the child, the encounter of the child as something, someone who is
in important ways beyond our control, beyond our prediction, makes statements
not only about love and our capacity to love, makes a statement not only
about family, it makes a larger statement about what is truly important
to the human, the importance of our diversity, the importance of the encounter
with the stranger.
And I guess that is why for me at least, to confess a bias, at the instinctive
level I would not claim this as a well reasoned position at all, when
I think about the possibility of the child as the creation of human ingenuity
and the loss of -- I was thinking of the part of the strange -- what comes
to my mind is school segregation. What I really want to be around is people
more and more like me or more and more like the people I want to be around.
That is who I want my kids to go to school with, that is who I want to
be around as opposed to people whose differences are surprising and often
threatening to me and that which I hold dear.
But I say that I do not consider that a well reasoned position. That
is simply an instinct. It is an instinct, I think, born of the respect
for -- indeed, I might even say an affection for the very mystery that
this poem aptly describes without beginning to unlock (sic).
CHAIRMAN KASS: That is very lovely. Thank
you.
Rebecca?
PROF. DRESSER: I would like to ask a question.
If we are saying that creating a biological copy, making a child a copy,
a biologic copy of someone else reduces the possibility of the child being
a stranger and is that for that reason, are we then invest -- are we saying
biology is determined -- determines the child's identity? That is I could
imagine someone being a genetic copy and -- I mean, with cloning they
are not a complete genetic copy but nearly a genetic copy and turning
out quite different -- differently from the origin person.
So I guess I -- it seems to me by worrying about these things to some
extent we are saying, well, biology and genes makes us who we are and
I know -- I am not crazy about saying that completely.
PROF. CARTER: Can I answer that just very
briefly since I take it was responding to what I just said? I want to
make clear, of course, I do not believe that about genes. I am speaking
again here of the rhetoric we use, the things we attempt to do, send messages
without regard to whether the attempt is successful or even rational.
So that even if you know and I know and it is commonly known around the
table that biology is not a determinate of certain things, yet our desire
to manipulate it suggests that we -- that in some aspects of ourselves
we believe what we wish otherwise.
CHAIRMAN KASS: Robby?
DR. GEORGE: I want to say a word on behalf
of sex as something more than one among other possible equally valid means
of bringing new human beings into being.
There is a kind of pragmatism or utilitarianism or some combination
thereof that tries to deal with moral problems simply by way of evaluating
the palpable consequences, how the world external to us is changed by
this choice or that, and there are notorious problems with that as there
are with competing ethical views let me admit, including my own. But I
want to suggest that there is at least an alternative way of proceeding.
It is not one that would dismiss a discussion of consequences like the
question whether the child born of processes -- brought into being processes
other than sexual reproduction can be loved.
There is another way of approaching these things that does not focus
on consequences in that kind of direct and exclusive way but rather proceeds
dialectically by looking at principles that we believe securely to hold
and to be true and then to examine possible choices with regard to their
-- that we just do not know the answer to yet -- we are thinking about
with regard to their conformity or lack of conformity to those other principles.
In relation to the precise topic at hand we might begin by asking why
is it that parents do not own their children? They brought them into being.
It was their choices and actions. Ordinarily if it is by virtue of our
choices and actions that something is brought into being, it was our deliberate
will, our resource was used, we consider that we own them but we do not
consider that we own children. Now other -- at other places and times
there has been something like the view that children are property of their
parents but we reject that. I would propose that is one of these principles
we do hold securely so let's work from there dialectically.
Why don't we? Well, it is because we consider that children are not
just objects, not just products, that they do have something special about
them that makes them ends rather than means. Let's call it dignity just
as a placeholder for now as we try to put more rigor in that notion in
the months ahead.
Now I think we can ask what posture then is to be adopted towards such
beings and does that posture -- does the question of what posture -- posture
we should adopt apply to the case of the transmission of new life, to
the transmission of life to those beings or can we simply with regard
to the question of transmission consider the matter of bringing efficient
-- just consider the matter being simply one of bringing efficient means
to bear to produce ends that we desire.
My own -- to use a word I dislike and is misleading in philosophy but
there just seems to be no way around it these days, my own intuitions
say that we ougthen to dismiss the question of what is the proper posture
toward new -- human life when it is a question of how shall that new human
life come into being.
I think we have to ask the question and we should ask the question is
it possible -- are we -- and this applies, I agree with Jim Wilson, I
think we cannot avoid the question, this applies to the question of IVF.
It applies to the question of artificial insemination. With respect to
all of these I think we should pause to ask the question is there in the
posture we adopt, the posture we adopt implicit in choices to produce
new life by these means, a treating of the new human being who is to be
brought into existence as an object, as an product and, therefore, in
principle as a means to parental satisfaction or what have you rather
than as an end in itself.
It is not a question -- here I agree with Gil. It is not a question
about will we down the line be able to adopt in any individual case or
even in a large number of cases, adopt an attitude of love towards them
and treat them as an end in themselves and not a mere means down then
-- down the line then.
No, I think we have to ask how are we treating them, what posture are
we adopting towards them now.
CHAIRMAN KASS: Let me try to reformulate and
make sure that I have got it because it seems to me it is a rich suggestion
if I understand it.
First, just in passing I observed that the question the way Robby put
it is not in terms of is this good or bad, right or wrong, but talking
about dispositions, attitudes and postures, right, which I think is a
neglected -- a sadly neglected notion and moral discourse. Some things
you cannot simply settle by rules but dispositions and attitudes count
decisively.
And if we are to adopt a certain attitude toward our children compatible
with the view that whatever -- that would explain -- that would somehow
reflect the fact that we cannot regard them as our property, is that posture
-- is that desirable posture toward our children influenced by the means
that are used to bring them into being?
Jim, did I hear you answer soto voce?
DR. WILSON: I think no. No child born of a
woman will be regarded as an object except in deviant and happily rare
and largely deplorable circumstances. A child born of a woman will be
regarded as a human being and will be cared for, ideally by two parents,
at a minimum by the mother, however, the child happened to be planted
in her uterus.
CHAIRMAN KASS: Let me sharpen this up if I
can. I do not think the question -- I do not think the implication was
that it would be regarded -- I was not happy, Robby, with giving us either
person or object but let's say Jim is right that the child is regarded
as a human being, you know, born of a woman. I would even be prepared
to say should -- forgive me, Janet -- 100 years from now it become necessary
that certain kinds of infertility be treated by extra-corporeal gestation
en toto. I would say a child that came off that machine that looked like
you and me, we would receive into the human community and it would --
I mean, insofar as it functioned. We would be capable of loving such a
child even if it was not born of woman. So that is to complicate the
question further.
Granted that one looks at such a child as a human being, the question
is are there any kinds of subtle differences in the disposition when to
some extent -- to speak sort of loosely -- one has surrendered one's self
to the possibility of there being a child and when one has chosen not
only to have a child but to arrange for its coming into being by these
means. That is not whether it is a human being or not but whether there
are not subtle differences that might affect how we regard our relation
to it.
I think I am walking in between the question --
DR. WILSON: Suggest what the differences are.
We are getting a long way from the subject. Why don't you just tell us
what you have in mind?
CHAIRMAN KASS: I do not really have something
in mind -- something clearly in mind.
DR. __________: Robby does.
CHAIRMAN KASS: I defer.
DR. KRAUTHAMMER: Jim, could we try this as
a way to sharpen that question, make it hypothetical. You have got a society
in which all children are produced from the genes of two parents in factories.
CHAIRMAN KASS: In?
DR. KRAUTHAMMER: In factories. Not through
human gestation as we have it but they all come out of factories and are
assigned to the original parents. The question is it is a brave new world
but without the control of the state, without the alteration of the genes,
and the question is -- I guess it is the way to operationalize your question
-- will children -- are children then seen, treated, understood differently
in that society than in one in which they have the children naturally?
That is, I think, the starkest way to put that question.
CHAIRMAN KASS: That is a way of putting it.
Robby?
DR. GEORGE: Again that is to put the focus
on the consequences. I suspect, I mean this -- I am guessing, anybody
would guess here and our guesses may be made very sharply but my own guess
would be we would be doing pretty bad things pretty quickly but that would
be connected to the collapse of a view of the person that is anything
like the one that I think today most of us would want to affirm.
But I think always down the line -- always down the line the compromising
of fundamental moral principles has bad consequence. Very frequently we
do not see those when it is about to happen. They only become clear down
the line.
But even more fundamentally I think that a sound ethics, and it is a
perennially debated question I grant you, is not one that makes the consideration
of the consequences just by themselves decisive. Rather it is one that
looks at the principles that we hold securely and then asks with respect
to any new choice whether there is a compromising of those principles
or whether there is a compatibility with those principles.
DR. KRAUTHAMMER: So what is compromised in
this case? I mean that is my question.
(Simultaneous discussion.)
DR. KRAUTHAMMER:: The general point Jim and
Charles want to know --
(Simultaneous discussion.)
DR. WILSON: If it is not a consequence what
principle is it? That is my question.
DR. GEORGE: Yes, I think it is the principle
that the child as an end in himself and not a means to other ends should
not be a product of manufacture. Now we may debate. Even if I am right
about that and I grant that I understand you are not going to grant me
that but even if I am right about that, I realize we could then have a
debate about what does and does not constitute manufacture. But I know
that there is an archetype. There is a central case if we can just use
that old Aristelian idea of a central case and then the cases that fall
away from it. There is a central case of what is not manufactured and
that is the child begotten not made. That is the child where the sexual
union of the parents is such that an accurate description of it could
be put in terms of doing rather than making.
And Gil is just here appealing to a very ancient and, I think, defensible
distinction and it is the distinction between techne and praxis, between
doing something and making.
Now from there I am happy to have the debate but I wonder if even prior
to that you guys get off the train and say, no, it really is just a matter
of bringing efficient means to bear to ends that we have in mind. The
end being let's have a child.
CHAIRMAN KASS: Michael Gazzaniga?
DR. GAZZANIGA: I think there is such a natural
revulsion to the notion of reproductive cloning that what we are doing
is fishing around for reasons why we have that revulsion. The -- can you
imagine the evening where you take your wife out and you say, you know,
'Honey, I think it is time to have a child, I pretty much decided to go
with me.'
(Laughter.)
DR. GAZZANIGA: I cannot imagine the expense
of that French dinner.
CHAIRMAN KASS: I hope to adjourn...
DR. GAZZANIGA: So since none of us really
are carrying around our favorite person who wants to be cloned, and the
pressure on us to do this and all the reasons that Janet spoke to earlier,
this is so far off in the future and there is even maybe serious biologic
reasons why it would not even work, forgetting all that, let's get back
to this magnificent poetry of the nights of sexual embrace and your child
was born story.
Now we know that the left brain, the left hemisphere has this great
capacity to weave a story, tell a story. It tries to explain your own
behavior. And no sooner does a behavior come out of us then we have a
narrative about it.
I would venture to say that -- as a matter of fact, I know somebody
who -- a couple of deer friends who -- he is Italian, she is Irish, and
they just adopted a Chinese baby, which went through an enormous process
as you know. And they talk fondly in the same fond way you talk of the
embrace of the evening they decided to do that and that will go down in
their family history just as the personal evening that we -- that other
people enjoy.
So I think what we are faced with is a revulsion of the whole idea of
reproductive cloning and then we are trying to find another reason for
why that is when it is just kind of a revolting idea as opposed to therapeutic
cloning.
CHAIRMAN KASS: Frank, and then Gil?
PROF. FUKUYAMA: Well, on that question of
the great revulsion, I am actually surprised at the amount of legislative
support there was for the reproductive cloning ban because if you had
listened to the conversations certainly among professional bioethicists,
you know, prior to that -- I would say actually a majority of them said,
"Well, why not? I mean, we can think of a lot of good reasons why you
would want to do this and not that many reasons other than safety why
we should not."
But I think it is very interesting that as far as I can tell not a single
member of Congress has been willing to get up and, you know, argue against
the reproductive cloning ban but I am curious to know why that is. And
it is relevant to the discussion we have been having.
I mean, do people think that this violates some inherent, you know,
principle, you know, of nature and that is why they feel a revulsion or
do they just, you know, take the consequentialist argument or is it simply
out of ignorance. I mean, people think that we are going to clone Hitler
and, you know, have a very dangerous world if we allow this to happen.
But in a way I guess this is an empirical question that the staff can,
you know, perhaps supply us with some more data on by the time we meet
the next time.
CHAIRMAN KASS: Gil, and then Elizabeth?
PROF. MEILAENDER: You started us down this
road, Leon, asking us to articulate what it is about procreation that
is significant. And I want to -- I may just repeat myself but I want to
try to come back to that specific question. I certainly think it is true.
I grant what Charles said and Jim said and so forth that we have the capacity
and I think we will continue for some time to have the capacity to love
children who come into the world in all sorts of ways.
It may be, though, that that variability is parasitic upon our normal
understanding of the significance of children, that two people, themselves
different, look out of themselves toward each other. That from their union
arises a child, a third being, who is also other, who incarnates the union
but does not sort of repeat either of them in the flesh and that, therefore,
they cannot simply regard that third being as their own in any possessive
kind of sense.
And that is part of the significance of human procreation. That is how
we learn to think about children and it is from that central paradigm
then that we are enabled to think about children and to love children
whose presence perhaps does not quite fit the paradigm.
So the question is not whether we are or would be able to love other
children but whether some other paradigm gradually teaches us to think
in different ways, whether we can imagine ourselves having that kind of
love for children in a world where sexual reproduction was not the norm
if want those sorts of beings. That seems to me to be the question that
you were pushing towards.
CHAIRMAN KASS: Very nice.
Elizabeth? Paul?
DR. MCHUGH: I just wanted to make a couple
of brief points in relationship to what is at stake and what is our experience
now. The issue of duality is so crucial, I think, to ordinary family life
and ordinary experiences but that does not take away from the fact that
as we have seen that adoption is possible and not only is adoption possible,
it is also very rich.
I want to pick up what Mike Gazzaniga said about his friends. All of
us now, it seems, have friends who have decided to adopt a Chinese baby.
Almost all of us know such -- and we love them. We love the -- we think
it is a very wonderful thing that they have done and they speak not only
of the decision, as Mike said, but also they speak of the trip. The trip
to sometimes the furthest reaches of China.
The babies are all girls. They are all girls because in China they are
not accepting their girl babies. We accept them and love them and in my
friend's case -- I mean it is like a princess from a faraway land taken
from the mouth of the dragon, you know, and you just feel love for her.
All of us do. But what is going to happen -- what are the consequences
going to be when these thousands of girls grow up in America and think
back on China and what will it be for us in our relationships to China
that has had that view of women?
And I think that is a crucial matter to think about in relationship
to the processes of adoption that need to be taken up if you want to have
children but would, you know, have many, many very interesting, often
unintended consequences.
CHAIRMAN KASS: Stephen, and then I think I
want to shift back to the part of the discussion that was bracketed earlier.
We have been on this business of doing and making and begetting and making,
the question of sex for a while.
PROF. CARTER: Very briefly just to interject
the "R" word, that is the religion word. Frank asked how come no member
of Congress is willing to get up and say, 'Well, I personally think reproductive
cloning is fine if people want to do that.' I think that there are probably
millions and millions of Americans who for good reasons or bad find something
deeply threatening their religious sensibility in the idea. Threatening
somehow to some notion of creativeness, threatening to their notion of
the relation between God and God's work.
There is a variety of different ways in which people are running up
against that and not the sort of thing you can articulate so much in a
discussion of why we ought to have this policy or that policy from the
point of view of government but when members of Congress are thinking
about their actual constituents and actual concerns they have they must
take account of particular fears that -- because after all they are driven
by the incentive for reelection.
I do not mean that facetiously when I say they are driven by the incentive
for reelection, that is democracy.
DR. BLACKBURN: I was going to leave it till
later but I think it does fit in answering what Frank was saying and just
extending what are the fears. You know, I think one of the other kinds
of fears, not to negate the kind of fear you are talking about at all
but another kind, is the fear of the terrible risks involved and people
visage at the moment that this is currently seen as a very risky, risky
procedure based on what is known in the animal studies.
And I would not be surprised, and I do not know the numbers but I would
not be surprised if that was not for at least some people, you know, another
aspect of it. They have seen and heard about this as risky and it would
be, you know, very dangerous for the child to be affected if this were
to happen now.
CHAIRMAN KASS: Let me return -- we have got
a little over 20 minutes. Let me return to the second of the issues raised
by Michael Sandel when I sort of reformulated and shifted the gears. It
is very hard to shift the gears because people want to talk about cloning
and its threat to something rather than talking about the something, and
that is instructive. I mean, that is very instructive because it is very
hard as I think Stephen really beautifully said. You asked to talk about
something sort of mysterious that we have access to it but it is very
hard to articulate.
And the repugnance if I might say, Michael, especially when one is called
upon -- when someone says, "Well, what is really wrong with it?", and
you say, "Yuck," at least in the Academy and in the professionalized academies
that is regarded as the ignorance of the man on the street.
You need at least to come to the table with some arguments to back this
intuition and the intuition is a cue that something might be wrong but
we have had similar intuitions about other things which we have come to
accept and, therefore, it is incumbent upon us to try fumblingly to say
something because there are going to be people saying, "Well, look, I
want to do it. It does not repel me. Is there any reason why I should
not?" And, you know, some like chocolate and some like vanilla and there
you go.
But Michael Sandel began by calling our attention to two things. One
was the difference between sexual and asexual reproduction. We have been
talking about whether the fact the child stems from one man and one woman
biologically, how much that counts. The other was the question about whether
or not there is a choice over the genetic inheritance of the child to
be and what difference that might make and whether that is somehow compatible
with the understanding of human procreation as we value it.
There will be people who will say in this discussion, Michael, that
actually we practice eugenic choices all the time. We -- there is mate
selection and we do not do it on the basis of seeing the genotype but
there is -- you know, people who go to the ivy's marry people who go to
the ivy's, et cetera, et cetera, and that people will say that is -- how
is that different from deliberate genetic intervention? The same analogous
question, how is the genetic intervention different from the kinds of
cultural emphases on the same things that we talked about in the last
session?
So let's talk about this a bit and ask the question does the fact that
parents might have, whether it be in preimplantation genetic screening
negatively or more positively with respect to cloning the opportunity
to determine and hence be responsible for some aspect of the genetic endowment
of their children, never mind whether they are going to get exactly what
they hope for? The responsibility will be there whether it turns out the
way they intended or not.
Am I faithful to the question? Does someone want to open it up and maybe
you would like to yourself?
PROF. SANDEL: Just to add one -- in some ways
we have already embarked on this discussion which is why I do not really
think these were two separate questions. It is possible to a certain extent
to ask in general what is the human meaning or worth of human procreation
or loving children without asking about a practice that would challenge
standard modes of human procreation.
But I am not even sure it is possible to articulate the human worth
or meaning of human procreation, to pick it out except by considering
the alternative cases because the different types of alternative cases
will direct our attention to different features of what it is we prize
maybe without even having been aware of it.
And I think that the evidence of the link between these two questions
or even the dependence of the first affirmative question on the second
imagined negative was brought out by what I thought was to my mind the
most compelling answer to the first round of questions which was William
May who talked about the jarring experience of the strange and the important
human experience of being forced to confront the strange, to be jarred
by it.
I thought that that was a very suggestive answer and it is an answer
that I think reinforces the -- well, if we go back to the two distinctions
about objections to cloning, one that it involves asexual reproduction;
two that it involves selecting genetic characteristics, what is so powerful
to me about the account of the strange as constitutive of humanity, it
explains exactly why the fact that we are exercising the mastery or a
sovereignty in choosing gets at the kernel of the objection.
And that objection alone can fully capture and link up with this account,
this beautifully articulated account about the constitutive human character,
the strange, and we do not need anything to do -- this will be maybe the
controversial part of my claim -- we do not need to draw at all on the
first objection to cloning, that it is asexual, in order to do justice
to the elaboration that, Bill, you may offer. They fit beautifully.
And the negative side of the affirmative vision that William described
is that what we really -- what bothers us about cloning, whether in the
brave new world scenario that Charles raised or in more modest versions
is that it is a kind of assertion of mastery or sovereignty that would
destroy or fail to honor the constitutive human dimension of the strange,
the encounter with the strange that William has described.
CHAIRMAN KASS: Bill, do you want a quick response?
PROF. MAY: Yes. As I see it, as it relates
to the question of sovereignty, one way of seeing the strange is the one
who constantly tests out the safeties that I build into my life. The stranger
is the one who is the hemorrhage in my universe. We all know how we close
in and talk with somebody and then the stranger comes up and suddenly
it has to open up. The rhythms are no longer the same in conversation
that used to be there with intimates. Or the husband and wife dealing
with this, the birth of that child, and suddenly how you handled sleep
and all sorts of other safeties need to go through some kind of accommodation.
So it is not simply the original event of male-female but what happens
in gestation, what happens after birth, and this immediately broadens
out into a larger social problem.
The constant testing of a society's community is its resources and sustaining
itself but it has to sustain itself in relationship to the strange, the
unelected, that which cannot be totally subjected to control.
CHAIRMAN KASS: Jim?
DR. WILSON: I very much agree with what Michael
just said and let me -- since he was kind enough to mention the book that
Leon and I wrote, and he was very kind, indeed, since it sold seven copies.
(Laughter.)
DR. WILSON: There is now eight in circulation.
I have changed my mind since I wrote that book. In part in consultation
with Leon and in part in brooding about this, and what I have changed
my mind about is the issue of genetic selection. I am not concerned about
how a child is produced in a female womb in order to be born, whether
it is by a male embrace or artificial insemination or by projecting gamma
rays. I think the essence of morality and the essence of society is that
children come from mothers and out of that moral sentiments are formed
that govern the whole life.
What concerned me about the issue of genetic selection were two things.
First, instead of -- to refer to my earlier phrase -- the couple contemplating
the mysterious gift, they would be contemplated a predictable certainty.
They will not be wondering who it most looks like. They will be wondering
why it does not look precisely like the person that was copied.
They will begin to worry that the mitochondrial DNA did not get there
in the right amount so there is now some slight deviation from what the
nuclear DNA would have predicted.
They will -- the whole relationship of parents to children will be governed
now by their anticipation that this is going to be a duplicative something
they know. I think this radically alters the child rearing experience.
And then, secondly, duplicative of what? And I began to think about
this after Leon and I put our essays together. Duplicative of relatives?
Well, that creates the problem that if it is a male relative the father
will grow up with somebody who is both his son and his brother. If it
is a female daughter the mother will grow up with somebody who is both
her daughter and her sister. If it is another relative, the combination
of relationships between cousins and aunts and nephews becomes profoundly
confused in a world that is -- in a cultural world that is utterly governed
by kinship relationships.
Now suppose they step out and find a stranger? Well, I suppose they
could get a stranger from some egg bank somewhere. I think it is much
more likely they will get a stranger that measures up to some evolutionary
standard and now they are suddenly trying to recreate a smart Pamela Anderson.
(Laughter.)
DR. WILSON: If such is biologically possible.
(Laughter.)
DR. WILSON: A Michael Jordan, a Cal Ripkin.
You can see the arena from which my heroes are drawn. Okay. I will change.
Emmanuel Kant, David Hume.
And this it seems to me is deeply offensive that people are going to
try to manufacture copies of people.
And then finally, though this is no cause of concern for the couple
but it is a cause of concern for society, if we do try to duplicate successful
people, we will reduce the evolutionary fitness of the human race. We
will be less diverse and less able to accommodate ourselves to environmental
changes. Now no one person has to pay a price for this but society will
pay a very large price for it.
So I feel that the genetic identity question is the heart of the problem.
CHAIRMAN KASS: Bill?
DR. HURLBUT: It seems to me you are just backing
the question up a little. I mean, you said as long as it comes from a
mother. Well, why does it have to come from a mother? There have been
studies with mice that show that if you -- well, I do not want to exaggerate
this but there were some hints that if you placed an embryo in the abdominal
cavity of a male mouse and gave it the proper induction you could induce
a pregnancy. And the head of OB/GYN at Stanford told me that she believes
that eventually we will have exogenesis.
The question it seems to me is a deeper one. The question is what are
the norms? What are the natural norms of our morality? To what extent
do we derive our meaning from the way we have come forward into life?
I think that -- whether you are a religious person and you believe God
created the world or you are strict evolutionist and believe that we have
evolved in a complex mix of biology, still it is possible that the question
I asked of Professor Gazzaniga early in the day is a crucial question.
Where do we get our minds? What does constitute the meaningful reality
of our lives?
You know, when I was a medical student I realized that the introduction
of contraception, which by the way was by Carl Geracci (?) in a program
I teach in, invented the pill anyway, I realized that contraception was
a strange new milestone in the history of medicine. Well, I did not know
what to think of it but I wondered why the Catholic church is willing
to abandon so many billions of dollars by offending their congregations
by not allowing this.
So I went up and I listened to a discussion of this by a collection
of Catholic people in San Francisco and I started to think more deeply.
My gosh, this is the first time in medical history that medicine is being
used to cure something that is not a disease. This represented -- without
regards to what you think about it, it was a change of natural reality.
So then a few years ago I read an interesting book by Ann Taylor Fleming
called Motherhood Deferred and I started thinking about how many people
have deferred pregnancy by contraception without kind of knowing the deeper
wisdom of what desire was. In fact, even though the desire was sexuality,
nature had in mind something deeper and perhaps richer for the individual.
So she speaks of the unused magic of her body when she was unable to conceive.
And there are many tragedies. Many of the IVF patients today are people
who deferred pregnancy until the slope of the curve of fertility.
Now we have a post -- what is called -- so-called the post-menstrual
era on our map. There is a three month pill under development, including
an intention that maybe we can create a no pill -- no menstruation at
all. Now look I do not want to say contraception -- anything about contraception
or menstruation in this. I do not have any personal experience with the
latter and relatively little with the former.
But the real question here is what is the normative significance of
the natural order? Where do we get our minds and where do we find a full
satisfaction of our lives? And is it possible that in pursuing one desired
end we might lose more fundamental, less conscious but more essential
ones? And what is the prerogative of medicine anyway? What is the good
use of human freedom?
In one of the papers, I cannot remember where it is, maybe it is this
one, it talks about humility. Well, it is an interesting thing. Human
and humility both share the Latin root of "earth" or "soil" and it is
an interesting thing to think that we came forth from the earth. In that
sense whether we were created by God that way or by evolution, the question
is are the deepest significance of our lives somehow wrapped up in the
natural order of things far more than just whether it comes from the mother
or not but the whole meaningful construction of life.
DR. WILSON: Just one brief response. I believe
that our fundamental moral sentiments are acquired from the early family
experience and I think there is a lot of data to support that.
DR. HURLBUT: That is not good biology in my
opinion.
DR. WILSON: It is good social science, though.
DR. HURLBUT: No, it is not good science. The
mind is partly shaped --
DR. __________: Can anything good from social
science.
DR. HURLBUT: -- normative impressions. I do
not think it is just coincidence that we do not respond to -- that we
respond more favorably to clear skin and, if it is true, the waist-hip
ratio of a certain notion. I think we do have an evolved psychology to
some extent without endorsing evolutionary psychology as a whole. I do
not think it is all just social.
Simone de Beauvoir said, "Human nature is that species which by nature
has no nature," but I think that is not proving to be true by more modern
biological inquiry on that.
We -- you know, disgusting -- it is very interesting, perhaps Professor
Gazzaniga can either affirm or correct me on this but I believe there
are some studies now that show that the center for moral discernment or
one of the related centers is located right near the center for taste
and that we get this interesting connection, disgusting and gustation.
The interesting question is whether or not some kind of moral realities
are built into our brains. I agree with most everything you are saying.
It is just that there is this one little thing. Is it possible that we
are going to walk ourselves right off the stage of the drama of our deepest
significance as I said earlier?
CHAIRMAN KASS: Mary Ann, Gil, and then we
will call all for the day because we have to --
PROF. GLENDON: I just want to mention another
great human watershed that we have passed in the last century that seems
relevant here. We went in the United States from a time when children
were economic assets, absolutely necessary for the family farm and shop,
to economic liabilities as many of us have learned in putting children
through college.
Along with that shift has come, I think, a shift in attitudes. I do
not know how widespread it is but it has caused me to scratch my head
a bit as Gil and Leon and Robby were speaking about sexual reproduction.
I think maybe at a certain point a considerable proportion of the population
that participates in ordinary sexual reproduction does so with a way of
thinking about children that is rather distinctively modern. That is they
are sort of like consumer goods. I will have one for my gratification.
Not so much this openness to the strange and the mysterious but rather
just a different way of thinking about and valuing children.
And I might say, also, as the parent of an adopted Asian girl and two
daughters born the old-fashioned way, I am with the folks who say that
it is all very mysterious.
CHAIRMAN KASS: Gil.
PROF. MEILAENDER: I just wanted to come back
to the two questions Michael Sandel distinguished. It would take more
conversation but I still think they are connected in a way and that it
does not all turn on the one because it seems to me that the asexual reproduction
also involves something about openness to stranger or lack thereof. So
that it is not just the question of the control over the identity of the
child that involves openness to the stranger but it may also be the nature
of the reproductive act. It would take more but I think the two are connected
in ways and we should not too quickly conclude that we can say everything
we want to say with reference to just one of the two questions.
CHAIRMAN KASS: This has been a day of experiment,
not only in the sense that this has not been tried on these particular
guinea pigs before, though you have given your tacit consent, no forms
were signed, but that we have tried to come at the bioethical questions
not beginning with the technological but beginning with some reflections
on crucial aspects and goods of our humanity.
The test will be, I think if not worked out quickly, the test in the
long term will be whether our work when we get down to cases will, in
fact, be as I hope richer for having moved so far away from what is common
discourse even amongst -- with the exception of people like Gil and Bill
May and Robby who do this for a living, and Stephen Carter -- whether
this foray into the hard to talk about will bear fruit when we actually
take up the cases and that discussion I hope would be richer for it.
Tomorrow morning we will resume at 8:30 here and the Working Paper,
and I suspect it is the one for which the public members might -- public
-- people from the public present might be especially interested -- is
where we actually take up the arguments for and against human reproductive
cloning. We had staff members prepare what look like briefs and I put
it to anybody who thinks there is bias in the house to show where it is
because the briefs have been prepared, I think, in as strong a way as
possible to make the best case on each side. We will try that out tomorrow
morning.
The bus is waiting at the front door. That is a hope, not a fact. The
bus should be waiting at the front door by 3:15 at the very latest and
thank you all, and we will meet again in the morning.
(Whereupon, at 3:00 p.m., the proceedings were adjourned.)
|
