President's Council on Bioethics

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PRESIDENT'S COUNCIL ON BIOETHICS

Since the 1970s, many governmentally sponsored advisory committees have been formed to offer advice about the ethical and political issues arising from biomedical research and biotechnology. In the United States, one of the most prominent of these is the President's Council on Bioethics (Council), which was established by President George W. Bush in November 2001. The work of the Council illustrates how hard it is to deliberate about the ethical issues provoked by modern science and technology in a political arena of partisan conflict and moral diversity. This is particularly difficult when the ethical and political discussion is influenced by the controversy over abortion and the moral status of human embryos. And yet despite these difficulties, the Council stands out as an attempt to promote a Socratic discussion in political debates about the ethical implications of science and technology.

Creation of the Council

On August 9, 2001, Bush gave a nationally televised speech on stem cell research. Stem cells are found in embryos, and have the power to grow into all of the specialized cells of the body (liver cells, muscle cells, brain cells, and so on). Some scientists believe that stem cells could be used to repair or replace the damaged cells that cause human diseases and disabilities such as Alzheimer's disease, Parkinson's disease, diabetes, and spinal cord injuries. But extracting stem cells from human embryos destroys the embryos, and Bush and others believe this is unethical because it means killing potential human life. This creates a conflict between the moral good in relieving suffering through medical research and the moral good in respecting potential human life. The political background for this controversy is the debate over abortion. Bush and many of his conservative supporters regard abortion as murder because they think that as soon as a human egg is fertilized, there exists a human being with a right to life.

The key issue in Bush's stem cell speech was whether federal funding should be provided to support human embryonic stem cell research. His decision was to allow such funding only for those stem cell lines that had been extracted before August 9, 2001. This would allow funding to support the research, but it would not promote future destruction of human embryos. He ended his speech by announcing that he would appoint a presidential council under the chairmanship of Leon Kass to study the ethical and political issues surrounding such biomedical research.

Kass received a bachelor's degree in biology and medical degree from the University of Chicago; he received a Ph.D. in biochemistry from Harvard University. After working at the National Institutes of Health (NIH) and the National Academy of Science (NAS), he taught for four years as a tutor at St. John's College (Annapolis, Maryland). Kass then returned to the University of Chicago as a professor in the Committee on Social Thought. At St. John's and the University of Chicago, he taught seminars on classic texts of philosophy, literature, and theology.

Kass was influenced by Leo Strauss, who was also a teacher at the University of Chicago and St. John's. Strauss and his students sought to revive the ancient philosophic wisdom of Socrates, Plato, and Aristotle and the ancient theological wisdom of the Bible. In promoting these traditions, the Straussians were critical of modern traditions of thought beginning with political philosophers such as Niccolò Machiavelli (1469–1527), Francis Bacon (1561–1626), and René Descartes (1596–1650). They were particularly skeptical about the philosophical project of Bacon and Descartes, which promoted a new science that would allow human beings to conquer nature. The Straussians feared that this scientific conquest of nature would become a willful quest for power unconstrained by moral or religious limits. When Kass expressed similar skepticism about modern science and technology in his published writings, he won the respect of U.S. political and religious conservatives who shared his suspicion that science was subverting moral and religious traditions. His writings warning against the dehumanizing effects of biotechnology attracted the attention of Bush's conservative advisors, which led to Kass's appointment as chair of the Council.

In consultation with Kass, Bush appointed seventeen other people to the Council: Elizabeth Blackburn, a professor of biochemistry at the University of California-San Francisco; Stephen Carter, a professor of law at Yale University Law School; Rebecca Dresser, a professor of law at Washington University School of Law; Daniel Foster, a professor of medicine at the Southwestern Medical School of the University of Texas; Francis Fukuyama, a professor of international studies at Johns Hopkins University; Michael Gazzaniga, a professor of neuroscience at Dartmouth College; Robert George, a professor of politics at Princeton University; Mary Ann Glendon, a professor of law at Harvard University Law School; Alfonso Gomez-Lobo, a professor of philosophy at Georgetown University; William Hurlburt, a physician and a professor in the Program in Human Biology at Stanford University; Charles Krauthammer, a syndicated columnist for the Washington Post; Paul McHugh, a professor of psychiatry at the Johns Hopkins University Hospital; William May, a professor emeritus of theology at Southern Methodist University; Gilbert Meilaender, a professor of theology at Valparaiso University; Janet Rowley, a professor of medicine at the University of Chicago Medical School; Michael Sandel, a professor of government at Harvard University; and James Q. Wilson, a professor emeritus of management at the University of California–Los Angeles and a former professor of government at Harvard University.

Criticism, Conflict, and the Work Begins

Bush's critics thought the Council was biased because it included so many political and religious conservatives (such as Fukuyama, George, Glendon, Krauthammer, Meilaender, and Wilson), who would generally agree with Kass and Bush. But it soon became clear that there was genuine disagreement on the Council, and that some members of the Council (such as Blackburn, Gazzaniga, and Rowley) were strong proponents of biotechnology who rejected Kass's moral criticisms of science.

Scholars of bioethics complained that the Council had no members who were professional bioethicists. This was a deliberate move by Kass. At the first meeting of the Council, Kass indicated that he would lead the Council away from the methods and topics that dominate bioethics as a professional field of academic expertise. "This is a council on bioethics, not a council of bioethicists," he explained at the January 17, 2002, meeting. "We come to the domain of bioethics not as experts but as thoughtful human beings who recognize the supreme importance of the issues that arise at the many junctions between biology, biotechnology and life as humanly lived." He stated that the Council was not required to reach complete agreement, and he quoted from the president's executive order creating the Council: "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." Kass doubted that complete agreement was likely in any event, because if the Council engaged in serious discussions of the competing human goods at stake in biomedical research and technology, disagreement would surely arise as different people would weigh those various human goods in different ways. For example, some might give more weight to the human good of respect for potential human life and less weight to the human good of relieving human suffering, while others might do the opposite. What was important, Kass insisted, was that every serious point of view be considered as part of a deliberative debate that would probably not reach consensus.

Kass was guiding the Council towards a tradition of ethical and political inquiry that goes back to Socrates, Plato, and Aristotle in ancient Greece. In it, thoughtful people work through the great questions of human life by debating the meaning of the human good—often using classic texts that illuminate fundamental alternatives—without expecting to reach final agreement on the answers to those questions. Kass had been initiated into that Socratic tradition during his years as a student and a teacher at the University of Chicago and St. John's College.

In the first meeting of the Council, Kass led the members in a discussion of a short story by Nathaniel Hawthorne—"The Birth-Mark" (1844)—about a scientist who unintentionally kills his beautiful wife while trying to surgically remove a slight birthmark on her cheek. The clear lesson of the story was that the scientific quest for perfection and power could be destructive in its lack of respect for human beings with all the imperfections of mortal creatures. Reporters and others at this first meeting remarked on the serious—even philosophic—tone of the Council's discussions. It was clear that Kass would turn the discussions of the Council into something like a college seminar on science, technology, and the meaning of human nature. Transcripts of the Council's meetings were posted on its Internet site along with copies of its formal reports. All of this material was designed by Kass to stimulate interested citizens across the nation into serious reflection on the moral character of modern science and technology.

And yet, as must be the case for any committee appointed by the president, the intellectual discussion of the Council could not be separated from partisan political debate. This became clear when the Council released its first formal report, which was on human cloning. The Council debated both reproductive cloning (or cloning to produce children) and therapeutic cloning (or cloning for biomedical research). Bush had argued vigorously for a legal ban on all forms of human cloning. The Council was unanimous in recommending a total ban on reproductive cloning, but it was divided on therapeutic cloning. Cloning human embryos could have therapeutic value in producing human stem cells that would be genetically identical to those of patients who need such cells for restoring damaged tissue, thus avoiding the problem of immune rejection. Some Council members thought this sufficient reason to approve therapeutic cloning. But others who believed that human life begins at the moment at conception considered the destruction of embryos to be murder, and so rejected therapeutic cloning. Still other members who thought that embryos were less than fully human but still deserved deep respect also rejected therapeutic cloning. Kass feared that a lack of consensus for a complete ban on therapeutic cloning would embarrass the president. To avoid this, he convinced a majority of Council members to recommend a four-year moratorium on the process.

When the Council's report was released, some members who opposed Kass's position complained that he had put pressure on three swing voters—Dresser, Fukuyama, and McHugh—to agree to the moratorium recommendation. Four of the members who voted to recommend federal funding for embryonic stem cell research—Blackburn, Gazzaniga, Foster, and Rowley—published a statement criticizing the Council's recommendations.

Early in 2004, the two-year terms for the Council members expired. Bush reappointed fifteen of the eighteen members for another two-year term. Carter and May resigned voluntarily. But Blackburn was dismissed. Bush and Kass filled the three vacancies with people who were like-minded to them—Benjamin Carson, a neurosurgeon at Johns Hopkins University; Peter Lawler, a professor of political science at Berry College in Georgia; and Diana Schaub, a professor of political science at Loyola College in Maryland. Prior to their appointments, Lawler and Schaub publicly stated their agreement with Kass's intellectual stance on biotechnology; Schaub had been a student of Kass's at the University of Chicago. Blackburn wrote articles protesting that her dismissal was politically motivated because she had opposed the positions taken by Kass and Bush. Kass responded that politics was not involved at all. The controversy was widely reported in newspapers and science journals as an indication of Bush's effort to promote his political goals among his science advisers.

Politics and Religion

Many contend that the Council's work is distorted by political pressure. In response, Kass argues that critics have not read the Council's reports carefully enough to see how fair it is in surveying arguments on all sides of every debate. Kass notes that journalists concentrate all their attention on the political implications of the Council's recommendations rather than the intricate reasoning supporting those recommendations. To avoid this criticism, which started with the first report, Kass designed the subsequent reports as surveys of opposing positions on moral issues in biotechnology that offer few specific recommendations. The Council has issued reports on using biotechnology to enhance human life, stem cell research, and regulation of reproductive technologies. These reports clearly favor Kass's position that biotechnology might endanger moral values. Yet the reports always include arguments on the other side of the debate. This is Kass's way of promoting serious and fair-minded discussion of the deep moral questions raised by modern science and technology.

Nevertheless bioethicists such as George Annas criticize Kass for leading a "neoconservative bioethics council" that pursues "a narrow, embryo-centric agenda" (Annas and Elias 2004, p. 19). Although Annas concedes that the moral status of human embryos is an important issue, he cites many other important topics in bioethics such as access to healthcare, dangerous commercialization of science and medicine, pricing of drugs, and bioterrorism. Annas also charges that neoconservatives such as Kass have failed to embrace a global bioethics based on human rights because embryos do not have the same status as human beings in international codes of human rights, such as the "Universal Declaration of Human Rights."

In the presidential campaign of 2004, John Kerry criticized Bush for not funding embryonic stem cell research because of religious beliefs not shared by most people. Bush used this issue to win votes from conservative Christians identified with the "religious right." Although religion is rarely mentioned in the council's meetings and reports, some of the members of the council are motivated by religious objections to biotechnology. Kass has written a book on the Bible in which he interprets the Book of Genesis as condemning science and technology as part of the "humanist dream" of "the city of man," particularly as depicted in the biblical story of the Tower of Babel (Kass 2003, pp. 219, 242–243). For Kass, this is part of the Bible's general warning that all civilization expresses the impious pride of human beings.

Council reports show extraordinary intellectual and moral rigor in probing the political and ethical issues arising in modern biotechnology. This reflects Kass's deep understanding of how science and technology arose in the seventeenth century as a project of modern political philosophers to give human beings power over nature. And yet the reports also show how intractable the ethical debate becomes when it is entangled in abortion politics, and in the controversy over whether embryos should be treated as fully human with the same moral standing as children or adults.

LARRY ARNHART

BIBLIOGRAPHY

Annas, George J., and Sherman Elias. (2004). "Politics, Morals, and Embryos." Nature 431: 19–20.

Blackburn, Elizabeth H. (2004). "A 'Full Range' of Bioethical Views Just Got Narrower." Washington Post, March 7, p. B02.

Blackburn, Elizabeth H., and Janet Rowley. (2004). "Reason as Our Guide." PloS Biology 2(4): 1–3. Criticisms of two reports of the Council from two members.

Hall, Stephen S. (2002). "President's Bioethics Council Delivers." Science 297(5580): 322–324. Report on the controversy surrounding the cloning report of the Council.

Kass, Leon. (1985). Towards a More Natural Science. New York: Free Press.

Kass, Leon. (2002). Life, Liberty, and the Defense of Dignity: The Challenge of Bioethics. San Francisco: Encounter Books.

Kass, Leon. (2003). The Beginning of Wisdom: Reading Genesis. New York: Free Press.

Kass, Leon. (2004). "We Don't Play Politics With Science." Washinton Post, March 3, p. A27.

Kass, Leon, and James Q. Wilson. (1998). The Ethics of Human Cloning. Washington, DC: AEI Press.

Kristol, William, and Eric Cohen, eds. (2002). The Future Is Now: America Confronts the New Genetics. Lanham, MD: Rowman and Littlefield. Collection of writings showing the conservative fear of biotechnology.

Lawler, Peter. (2004). "Restless Souls." New Atlantis 4(Winter): 42–46.

President's Council on Bioethics. (2002). Human Cloning and Human Dignity: The Report of the President's Council on Bioethics. New York: PublicAffairs.

President's Council on Bioethics. (2003). Beyond Therapy: Biotechnology and the Pursuit of Happiness. Washington, DC: Dana Press.

President's Council on Bioethics. (2004a). Monitoring Stem Cell Research. Washington, DC: Government Printing Office.

President's Council on Bioethics. (2004b). Reproduction and Responsibility: The Regulation of New Biotechnologies. Washington, DC: Author.

Rowley, Janet D.; Elizabeth Blackburn; Michael Gazzaniga; and Daniel Foster. (2002). "Harmful Moratorium on Stem Cell Research." Science 297 (5589): 1957. Criticisms of the cloning report from four members of the Council.

Schaub, Diana. (2003). "Slavery Plus Abortion." Public Interest 150(Winter): 41–46.

Weiss, Rick. (2004). "Bush Ejects Two From Bioethics Council." Washington Post, February 28, p. A06.