The Kass Agenda: "Bioethics for the Second Term"

Well, finally we got our hands on the heretofore unpublished document, "Bioethics for the Second Term: Legislative Recommendations," written by Chair of the President's Council for Bioethics Leon Kass and distributed to Congress this week in a lobbying push led by Kass himself. It contains the grand plan for all sorts of bans and restrictions of science to be enacted by the U.S. Congress, and has been unabashedly promoted by Kass - who says that he is not acting as Presidential Council Chair during his lobbying efforts.

The agenda is sweeping, conservative, and odd enough that it has angered Republicans in Congress more than Democrats; the latter are beside themselves with joy at watching the right wing rip the Kass document to shreds for being too liberal. Democrats should not be too giddy - much of what is here could be pushed through the executive branch and left to the courts and states to reject.

Behold, the Plan:

Bioethics for the Second Term: Legislative Recommendations

Track One: Defense of Human Life
• Prohibit the creation (by whatever means) of any human embryo solely for research, in which the embryo will be harmed or destroyed.
Track Two: Defense of Human Dignity
• Prohibit the transfer, for any purpose, of any human embryo (produced ex vivo, by whatever means) into the body of any member of a non-human species.
• Prohibit the production of a hybrid human-animal embryo by fertilization of human egg by animal sperm or of animal egg by human sperm.
• Prohibit the transfer of a human embryo (produced ex vivo) to a woman’s uterus for any purpose other than to attempt to produce a live-born child.
• Prohibit attempts to conceive a child by: (1) Any means other than the union of egg and sperm. (2) Using gametes obtained from a human fetus or derived from human embryonic stem cells. (3) Fusing blastomeres from two or more embryos (a) Operationally, in each case the prohibited act comprises the creation ex vivo of any such human embryo with the intent to transfer it to a woman’s body to initiate a pregnancy. (b) Nothing in this law shall be construed to prohibit or interfere with efforts, on the part of someone not violating provision (a), to adopt or rescue such an embryo by transferring it to a woman’s uterus in an attempt to bring it to birth. (c) Any child conceived by these prohibited means shall, at whatever stage of its development, be regarded and treated under the federal law no differently than a child conceived naturally, enjoying equally all rights and protections accorded to a child conceived naturally at the same stage of development
• Prohibit the buying, selling, and patenting of human organisms at any stage of development.

In this and the subsequent provisions, it will be necessary to offer a definition of “human embryo.”

In this provision, it will be necessary to define “fertilization” in such a way as to exclude from this statutory prohibition the current practice, in assisted reproduction clinics, of testing the capacity of human sperm by seeing if they can penetrate oocytes taken from hamsters. No union of sperm and egg nuclei occurs; thus no embryo is formed.

It will be important here to define who will be seen as violating this prohibition: suggest that this include at least those (1) who plan or do the act, (2) who advertise themselves as offering this service for this purpose, and (3) who own a company whose employees engage in such a practice or that profits from it.

A Bioethics Agenda for the President’s Second Term

This purpose of this memo is to outline a bold and plausible “offensive” bioethics agenda for the second term.

What we seek to achieve

New biotechnologies challenging human freedom, equality, and dignity are arriving at an accelerating pace, especially in the domains of assisted reproduction and genetic manipulation. And yet there are currently no boundaries or protections in federal law to help us confront the challenges they pose. Three aims, above all, guide the effort to establish boundaries:
1. To defend the dignity of human procreation, of parents, children, and families, from certain dehumanizing practices now becoming possible through new biotechnologies.
2. To defend nascent human life from exploitative and destructive practices, and to prevent the treatment of the unborn as a mere resource for research.
3. To advance responsible scientific research within these clear ethical bounds.

Efforts to achieve these aims in the first term, and results
• Cloning: Sought to combine the first two aims by prohibiting a practice that both deforms human procreation and creates human embryos for research:
human cloning. Backed a total ban of all human cloning, which passed the House but failed to reach a vote in the Senate for two consecutive Congresses. Appears unlikely to succeed in the next Congress as well. o Meanwhile, South Koreans successfully cloned human embryos; British HFEA
authorizes human cloning-for-research; Harvard scientists get permission to do human cloning-for-research; a right to do such research is constitutionalized in California and endorsed in several other states. We did not get the preferred convention passed at the United Nations. We have lost much ground.
• Stem cell research: Allowed federal funding for ESC research on lines existing as of August 9, 2001. Got no credit from scientists, physicians, and patient groups for doing so. Got nothing in exchange for this permission (e.g. limits on other noxious practices). No control over embryo research in the private sector. Have successfully defended the policy to this point, but are purely playing defense for a policy that gives no permanent benefit: the next Democratic administration will overturn the policy, and the field will be left with no moral limitations anywhere.
• Other Biotechnical Areas: No activity whatsoever. Radical techniques of human reproduction and genetic manipulation proceed unscrutinized and unregulated.

Summary: We have played defense to support a funding policy that touches but a tiny fraction of the brave-new-world issues we must address. If it is clear that the cloning ban does not have the votes, we must pursue another strategy to address our concerns. It is time to broaden our approach and to go on offense.

Diagnosis
One key reason the effort to ban cloning has not succeeded is that it is too narrowly focused and insufficiently ambitious; it limits our political coalition and deforms our arguments. It sought to prevent only the cloning of children, and not other troubling new methods of baby-making, and to prohibit the exploitative creation and destruction for research only of cloned embryos, rather than all human embryos. It was thought that the combination of these two partial steps around the technique of cloning might strengthen our position, but it has turned out only to confuse the underlying issues, and to detract from the force of either concern seen in full. The debate degenerated into an argument about terminology, rather than placing cloning in the larger and more disconcerting contexts of threats to the dignity of procreation and threats to nascent life. Our response to the failure of the cloning ban, therefore, must not be to pull back, but to move more aggressively on these two fronts, properly and individually understood.

The second term agenda To make progress, we must return to our principles and think fresh about how best to protect the dignity of procreation and family, how best to defend nascent life, and how best to advance scientific research within moral bounds. We propose a three-track approach that takes these three aims as its starting point, and seeks to pursue them each aggressively.

1. On the Dignity of Human Procreation: Seek legislative protections of the dignity of human procreation, banning the following degrading and dehumanizing practices (more than just cloning):
• Transfer of a human embryo into the body of an animal, for research (or other) purposes
• Production of hybrid human-animal embryo (human egg with animal sperm, or vice versa)
• Transfer of a human embryo to a woman’s uterus for any purpose other than
to produce a child (no pregnancies for research or organ farming) • Attempts to conceive a child by means other than the union of egg and sperm, derived only from adults (no cloning, no using eggs and sperm derived from fetuses or embryos, etc.)
• Buying, selling, and patenting of human organisms at any stage of development

2. On the Protection of Human Life: Seek a legislative ban on creation of any human embryo solely for research and destruction (not just by cloning, but also by IVF)

3. On Advancing Stem Cell Research within Moral Bounds: Continue to defend the current stem cell funding policy, but offer encouragement and support through the NIH for efforts to find new ways to derive human pluripotent stem cells without destroying or harming human embryos. These might include deriving stem cells from (a) dead embryos, (b) artificial non-embryo-but-embryo-like artifacts, (c) non-destructive embryo biopsy, (d) reprogrammed adult somatic cells.

Summary: Taken together, these offer a strong and coherent bioethics agenda for the second Bush term. They target squarely the three key moral aims, with each track designed to be pursued independently and to be difficult to oppose in its own terms. They allow us to respond to the inability to pass the cloning ban not by yielding ground, but by seizing the initiative and raising our ambitions while still defending the existing funding policy.

We have today an administration and a Congress as friendly to human life and human dignity as we are likely to have for many years to come. It would be tragic if we failed to take advantage of this rare opportunity to enact significant bans on some of the most egregious biotechnical practices.