October 15, 2003
The President
The White House
Washington, D.C.
Dear Mr. President:
I am pleased to present to you Beyond Therapy: Biotechnology
and the Pursuit of Happiness, a report of the President's
Council on Bioethics.
The product of more than sixteen months of research, reflection,
and deliberation, we hope this report will prove a worthy
contribution to public understanding of the important questions
it considers. In it, we have sought to live up to the charge
you gave us when you created this Council, namely, "to undertake
fundamental inquiry into the human and moral significance
of developments in biomedical and behavioral science and
technology" and "to facilitate a greater understanding of
bioethical issues."
Biotechnology offers exciting and promising prospects
for healing the sick and relieving the suffering. But exactly
because of their impressive powers to alter the workings
of body and mind, the "dual uses" of the same technologies
make them attractive also to people who are not sick but
who would use them to look younger, perform better, feel
happier, or become more "perfect." These applications of
biotechnology are already presenting us with some unfamiliar
and very difficult challenges. In this report, we consider
such possible "beyond therapy" uses, and explore both their
scientific basis and the ethical and social issues they
are likely to raise.
We have structured our inquiry around the desires and
goals of human beings, rather than around the technologies
they employ, the better to keep the important ethical questions
before us. In a quartet of four central chapters, we consider
how pursuing the goals of better children, superior performance,
ageless bodies, or happy souls might be aided or hindered,
elevated or degraded, by seeking them through a wide variety
of technological means.
Among the biotechnical powers considered are techniques
for screening genes and testing embryos, choosing sex of
children, modifying the behavior of children, augmenting
muscle size and strength, enhancing athletic performance,
slowing senescence, blunting painful memories, brightening
mood, and altering basic temperaments. In a concluding chapter,
we consider together the several "beyond therapy" uses of
these technologies, in order to ask what kinds of human
beings and what sort of society we might be creating in
the coming age of biotechnology.
On the optimistic view, the emerging picture is one of
unmitigated progress and improvement. It envisions a society
in which more and more people are able to realize the American
dream of liberty, prosperity, and justice for all. It is
a nation whose citizens are longer-lived, more competent,
better accomplished, more productive, and happier than human
beings have ever been before. It is a world in which many
more human beings-biologically better-equipped, aided by
performance-enhancers, liberated from the constraints of
nature and fortune-can live lives of achievement, contentment,
and high self-esteem, come what may.
But there are reasons to wonder whether life will really
be better if we turn to biotechnology to fulfill our deepest
human desires. There is an old expression: to a man armed
with a hammer, everything looks like a nail. To a society
armed with biotechnology, the activities of human life may
seem more amenable to improvement than they really are.
Or we may imagine ourselves wiser than we really are. Or
we may get more easily what we asked for only to realize
it is much less than what we really wanted.
We want better children-but not by turning procreation
into manufacture or by altering their brains to gain them
an edge over their peers. We want to perform better in the
activities of life-but not by becoming mere creatures of
our chemists or by turning ourselves into tools designed
to win or achieve in inhuman ways. We want longer lives-but
not at the cost of living carelessly or shallowly with diminished
aspiration for living well, and not by becoming people so
obsessed with our own longevity that we care little about
the next generations. We want to be happy-but not because
of a drug that gives us happy feelings without the real
loves, attachments, and achievements that are essential
for true human flourishing.
I believe the report breaks new ground in public bioethics,
by dealing with a topic not treated by previous national
bioethics commissions. And it approaches the topics not
on a piecemeal basis, but as elements of one large picture:
life in the age of biotechnology. Beginning to paint that
picture is the aim of this report. We hope, through this
document, to advance the nation's awareness and understanding
of a critical set of bioethical issues and to bring them
beyond the narrow circle of bioethics professionals into
the larger public arena, where matters of such moment rightly
belong.
In enjoying the benefits of biotechnology, we will need
to hold fast to an account of the human being, seen not
in material or mechanistic or medical terms but in psychic
and moral and spiritual ones. As we note in the Conclusion,
we need to see the human person in more than therapeutic
terms:
as a creature "in-between," neither god nor beast, neither
dumb body nor disembodied soul, but as a puzzling, upward-pointing
unity of psyche and soma whose precise limitations are
the source of its-our-loftiest aspirations, whose weaknesses
are the source of its-our-keenest attachments, and whose
natural gifts may be, if we do not squander or destroy
them, exactly what we need to flourish and perfect ourselves-as
human beings.
We close the inquiry with a lingering sense that tremendous
new biotechnical powers may blind us to the larger meaning
of our own American ideals and may narrow our sense of what
it is, after all, to live, to be free, and to pursue happiness.
But we are also hopeful that, by informing and moderating
our desires, and by grasping the limits of our new powers,
we can keep in mind the true meaning of our founding ideals-and
thus find the means to savor the fruits of the age of biotechnology,
without succumbing to its most dangerous temptations.
Mr. President, allow me to join my Council colleagues
and our fine staff in thanking you for this opportunity
to set down on paper, for your consideration and that of
the American public, some (we hope useful) thoughts and
reflections on these important subjects.
Sincerely,
/s/
Leon R. Kass, M.D.
Chairman
