 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.
Robbie?
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, Robbie.
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?
DR. 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: Robbie,
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: Robbie?
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 Robbie 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 Robbie, 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, Robbie, 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 Robbie.
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: Robbie?
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 Robbie 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: Robbie?
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
Robbie 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, Robbie, 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. __________: Robbie
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.
Robbie?
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 Robbie 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 Robbie 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.)
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