Leon R. Kass, M.D
Adapted from the Chairmans opening remarks at the first meeting
of the Council, January 17, 2002.
On August 9, 2001, President George W. Bush, in his address to the nation
about federal funding of stem cell research, announced his intention to
create this Presidents Council on Bioethics. Anticipating the broad
charge we would be given, the President said that the Council would serve
"to monitor stem cell research, to recommend appropriate guidelines
and regulations, and to consider all of the medical and ethical ramifications
of biomedical innovation."
Our world has changed drastically since that time and with it, the nations
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 the Council organized.
But if the aftermath of September 11 has hampered our getting started,
paradoxically it may assist us in performing the Councils task.
In numerous if subtle ways, one feels a palpable increase in Americas
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 easy-going relativism, has enabled us to see evil
for what it is and, more important, to celebrate the nobility of heroic
courage, civic 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 for serious moral reflection.
Yet the moral challenges the Council faces are very different from the
ones confronting the President and 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, 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 anti-modern fanaticism and barbaric disregard for human
life, so we must avoid runaway scientism 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 Brave New World on the other.
President Bush has given us the opportunity and obligation of helping
him plot and navigate this 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 28, 2001, states the Councils mission as follows:
SEC 2. (a): 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:
(1) to undertake fundamental inquiry into the human and moral significance
of developments in biomedical and behavioral science and technology;
(2) to explore specific ethical and policy questions related to these
(3) to provide a forum for a national discussion of bioethical issues;
(4) to facilitate a greater understanding of bioethical issues; and
(5) to explore possibilities for useful international collaboration on
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 incarnationthough
the questions it takes up are in fact ancient. When the field was started
in the late 1960s and early 1970s, around The Hastings Center and The
Kennedy Institute at Georgetown, none of the pioneers had training in
bioethics. Indeed, none of us referred to ourselves as "bioethicists."
Actually, the word "bioethics," coined a few years earlier by
biologist Van Potter, in fact referred to something rather different.
It was the name for Potters vision of a new ethic, based not on
inherited philosophical or religious foundations but 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 Potters 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 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,
has a different valence that is in fact close to what I take to be our
mission: bioethics as "the ethics of bios," "the ethics
of life." But the ancient Greek root, bios, means not "life"
as such nor animate or animal lifefor these, the Greeks used zoebut
rather, "a course of life" or "a manner of living,"
"a human life as lived," something describable in a bio-graphy.
Animals have life, zoe; human beings alone have a life, a "bios,"
a 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 developments in biomedical and behavioral science
and technology. We must strive to understand the meanings of the intersection
of biology and biography, where life as lived experientially encounters
the results of life studied scientifically. Even as we tackle specific
issues, we must always attend to the deep character of humankinds
individual and social bioi and how they interact with the findings of
biology and the technical powers they make possible.
It is for this reason that the Council is charged [Sec. 2, (b)] not only
with looking at ethical issues raised by this or that specific technological
activity (such as embryo and stem cell research, assisted-reproduction,
cloning, or the uses of knowledge and techniques derived from human genetics
or the neurosciences), but also broader ethical and social issues not
tied to a specific technology: for example, the protection of human subjects
in research, the appropriate uses of biomedical technology, the consequences
of limiting scientific research, and so forth.
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. 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" [Sec. 2(c)] 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 [Sec. 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 enter our public discourse in
ways that do not appeal to special privilege or 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
Up to this point, my discussion of the Councils 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.
The Presidents Council on Bioethics comes into existence at a time
of heightened public awareness of the importance of the difficult moral
issues raised by biomedical advance. We have just experienced a year of
unprecedented public debate and decision-making about human cloning and
stem cell research in particular and the ethical dilemmas of biological
progress in general. We have every reason to believe that these debates
will continue, and perhaps become something of a permanent fixture in
American public life. Legislators, scientists, and citizens will be called
upon to consider the human and moral meanings of new areas of scientific
research, and how new or potential bio-genetic technologies might transform
various human activities, both for better and for worse. They will also
be called upon to make prudential judgments about the proper role of government
in the regulation of scientific-technological innovation in these areas,
including public funding decisions, the responsibilities of new or existing
regulatory agencies, and the proper scope of state and federal law. 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 Councils intellectual tasks 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 biotechnologyand, 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 and advance,
rather than by reactively considering merely the potential consequences
of this or that particular technological innovation. A rich and proper
bioethics will always keep in view the defining and worthy features of
human life, features that biotechnology may serve or threaten. 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. Bioethical thought
must therefore be ready and able to bring the aforementioned general considerations
to the specific ethical issues at hand. Maintaining this difficult but
all-important balance shall be part of the goal of the Councils
On the practical side, we remind ourselves that this Council came into
being in connection with President Bushs decision regarding federal
funding of embryonic stem cell research. Its work is informed and guided
by the Presidents 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 Presidents decision
established (or re-established) the precedent that scientific research,
being a human activity, is primarily a moral endeavorone 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 Presidents 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 (what sort of)
public oversight or public action. This Council will endeavor to provide
those facts and to offer responsible advice and guidance.
In conclusion, I wish to make two comments about the subject of embryonic
stem cell research and the controversial debate with which the Councils
birth was entangled. In his speech on August 9, 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 Presidents decision. Leading scientists have indicated
that, at least for the research phase (that is, the pre-clinical phase)
of these investigations, the number of ES lines are more than adequate
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 non-embryonic 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.
One little noticed substantive matter about last summers stem cell
debate deserves special mention, 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 of the debate
were arguing largely 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 argued 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 sort 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 the lives of juvenile diabetics or people
with Parkinsons disease" versus "Embryonic stem cell research
will kill hundreds if not thousands of embryos." These are surely
important concerns. But, at the risk of giving offence, I wish to suggest
that concern for "life"for its preciousness and its sanctity,
whether adult or embryonicis 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 humanincluding the virtues we have seen displayed
on and since September 11. 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 itselfas if it were just one more diseasecould 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 lifeof
humanization and dehumanizationare of paramount importance to the
field of bioethics, and I hope they will be central to the work of this
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