Transhumanism: Has Fukuyama Made it a Bad Word?

Bio•IT World describes the role of Presidential Bioethics Commission member and recent adventurer in bioethics Francis Fukuyama's pronouncement that human enhancement - in its aggregate, transhumanism - is awful, evil stuff. It has become clear that Fukuyama has done more to bring transhumanism into the public debate than any of its proponents, giving lots of space for public discussion of the ways in which human enhancement might make sense, and of ways in which that process can be understood and managed. No doubt this was not Fukuyama's plan, but the result has been great articles like this one, "More than Human."

President's Council Dignifies Stem Cell "Solutions"

Chris Mooney noticed this careful dissection of the ideas for "getting around" the ethical problems associated with using embryonic stem cells in research. It is a nice, thorough review of these ideas and how problematic they are. We're, frankly, much less impressed with the entire discussion than are either Chris or other critics. But we've already made that argument ad nauseum. It is an open question why the council has pursued the questions it has chosen to pursue.

Praising with Faint Damnation

William Saletan is Slate's chief political correspondent, and he plays chess with someone on the President's Council for Bioethics, he tells us. This is his new Slate editorial about the Council, and its deliberations about enhancement technologies that aim at extending life. Like those deliberations, Saletan wanders a bit. It isn't entirely clear what he is talking about in his "outsider-looking-in" Op Ed about bioethics, but the aim seems to be identifying why it is that - his words - the "council is a ridiculous paradox: an almost completely ignored and powerless body that happens to be debating the most consequential events of our day."

Don't get the idea that this Slate writer is unhappy about the austerity of the council. He loves their academic demeanor, it's clear. He even pauses to list the florid names of the endowed chairs held by several members of the Council. He just wishes his admiration were shared; he is bowled over by the fact that nobody seems to give a darn about the Council's work. Saletan has a real worry about the deliberations getting lost in the arcane methods of the council, such as the long-standing practice of choosing the least public forums imaginable:

[Human life extension is] an intriguing topic, with enormous—and for many people, possibly fatal—economic and political consequences. But you'd hardly know it from the lifelessness of the proceedings, which achieve a status hitherto unknown in Washington: too boring to televise on C-SPAN. The reason for this is simple: The council consists of, and takes testimony from, the sort of people who have spent enough time probing deep questions to cultivate expertise and esteem. These people used to be called monks. Today we call them nerds.

Why is Pres. Bush's erudite bioethics council irrelevant: that is the question Saletan wants Americans to ask. And it is a good question. Saletan's conclusion is that the President's bioethicists are just too professorial to fit in to this imperfect political world. He points to the fact that during their essentially unattended proceedings, these folks just read papers and seem oddly distant. "Papers can't engage in that debate. Only human beings can. And that's what the council must learn not just to say, but to do." Fair point. The public activity of the council to date has really boiled down to publishing a few anthologies that its chairman himself described as ideal texts for an upper-level undergraduate philosophy class. If there were not already dozens of excellent texts for just that purpose, lots of bioethics people would be happy that the council was helping to educate, even if it only really aimed at those who are already fairly well educated.

But there are dozens of those books. So the question is why can't the council do something for the public? Why isn't half its money and time spent on discussion and actual planning for social debates about the issues of the day in biotechnology? Why can the council not put together at least a half-decent website that anybody who can read will be able to utilize?

The answer is that far too many scholars, when finally given the chance to make a difference in public life, find that they don't like the public very much, or at least not enough to abandon more rigorous conversations with their colleagues. The line is something like this: "our job is to think the deep thoughts about complicated issues; others can figure out how to translate those ideas and engage the public -- why can't the public just come listen to us? We put up a website with links to download our papers!"

It is an interesting editorial and will spark some equally interesting debate about what kind of public commission on bioethics can really be said to make any difference at all. But doubtless the entire debate will be ignored by the council, which is Saletan's point after all. Maybe bioethics doesn't belong on the Presidential seal. Perhaps only things that really do aid and engage the public should be there. - GM

More Debate on Memory Erasing Drugs

Washington Post discusses the use of Propranolol on stress, with the aim of eliminating the trauma of difficult memories. Although there are a number of clear candidates for such therapy, such as victims of domestic and political violence, the luddites and neocons are grumpy: "'All of us can think of traumatic events in our lives that were horrible at the time but made us who we are. I’m not sure we’d want to wipe those memories out,' said Rebecca Dresser, a medical ethicist at Washington University in St. Louis who serves on the President’s Council on Bioethics, which condemned the research last year. 'We don’t have an omniscient view of what’s best for the world.'" Suffer, spake the sage.

w-2: Searching for Good News in a Bush Victory

It is difficult to overstate the damage that George Bush can do to the nation's health care and biomedical science in his second term. Long after the shock of a Bush victory - yes, he did win this time - has faded in the minds of Americans, the world will have to cope with this election. What are the implications for medicine and science? Hint: you won't like any of them ... this term, Bush is empowered, under pressure from conservative protestants, and a lame duck to boot.

Kiss pharmaceutical reform goodbye. There is no way George Bush will do any less for pharmaceutical companies than he has done for oil companies. In fact, if anything, the election will draw a more direct analogy between oil and drugs: Bush now has no reason to fear reprisals from those who oppose the drug industry's extraordinary pricing structure in the United States. Bush's cronies may not yet directly profit from the drug industry in the way that they do from Haliburton, but you can bet plenty of Bush appointees are thinking seriously about their future in biomedical lobbying. Pharma will need the President as its collusion with FDA officians and others comes to the fore. Pharma knew what it was buying with Bush, "make no mistake." Any reform effort that included drugs from Canada, including the one Bush said he was "looking at," and any effort to seriously curtail the price of drugs for seniors, will fall prey to the three million vote margin of victory. Drugs will cost more and fewer people will be able to afford them.

International efforts to, well, do anything that Bush opposes are in real trouble. Unfettered international drug research is part of the bargain. Advocates for research subjects have lobbied the WHO and the UN - and those organizations have lobbied the US - to stop the most lopsided and colonialist drug industry research efforts in developing nations. How many research programs in Africa have really rewarded research subjects with any kind of improvement in healthcare quality, even for the disease being researched? Not many.

Healthcare access and insurance reform? Look, no one wants to be pessimistic. Health insurance reform is long-overdue and we in the U.S. have to find a way to provide affordable healthcare to tens of millions of U.S. uninsured. Here's a great Bush solution that lots of Americans seem to support: tort reform! All we have to do is stop those big lawsuits against physicians, and we can save a whole lot of ... wait ... what? Only 3% of the cost of healthcare is in any way related to lawsuits? Ok, wait, so maybe stopping patients from recovering the damages juries want to award them in cases of malpractice won't have much financial effect ... except on physician and lawyer salaries. But Republican voters aren't weeping about that. What they will cry about is the bills that they, and all of us, will have to pay as we watch emergency rooms continue to be the provider of healthcare for the poor, the sick and the legions of uninsured - hundreds of millions of dollars in unnecessary treatment. Those costs have to come out of somewhere. Just watch your premiums skyrocket, guys. Red states will also bleed red ... ink. Maybe there will be a direct correlation between insurance increases and prices at the gas pump! Who knew anything but college tuition could go up so fast?<[> Enough has been written about Bush's war on science to establish beyond question in the mind of anyone in a blue state that Bush, as a final-term president with uniform control of the U.S. government, will be able to quietly support all sorts of insidious efforts around the nation. Just as gay marriage is quietly being outlawed around the nation, look for Bush to lend support of several kinds to state efforts to roll back protection of women's reproductive healthcare. Bush could care less about evolution, but the "intelligent design" movement can rest easy that Oklahoma's new senator and many other new elected officials around the nation are supporters of creationism in the classroom.

There is still one winable battle, although I fear it is not in Ohio or Iowa. The battle is to reform or reject the President's Council on Bioethics. Leon Kass is no doubt gearing up to lead all the President's ethicists for another term of 'moral seriousness'. He must be put on notice that bioethics cannot afford four more years of feckless, xenophobic neocon posturing, even if it is delivered with austerity. Kass should have apologized to the nation for selling the proceedings of his Council through a for-profit, conservative commercial press. He should not have abused the reputation of one of the world's most prestigious biomedical scientists, Elizabeth Blackburn, named by Bush to the PCB and then shown the door under the pretense that she did not attend enough meetings. Blackburn was by all accounts one of the most active participants in the dialog about stem cell research, emailing Kass and others constantly. Kass could not find another way to defend the PCB against the charge that it sat idly by while the Bush administration (or he) fired one of two moderate scholars, and "retired" the other one, replacing both with ultraconservatives. So Kass resorted to distortion and blame in broad public view. To this day he has neither apologized nor attempted any kind of rapprochement with Blackburn or for that matter with anyone more moderate than William Kristol.

The new generation of conservative bioethicists seems dedicated to the proposition that debate is the enemy, or more accurately that opponents are best left ignored. The PCB virtually ignores the bioethics literature in its writing and anthologies. There are passing references to those who agree with them on matters at hand, most noticeably Carl Elliott, but it has become a hallmark of Bush Bioethics that no position is argued by the PCB while there are people 'in the room' with whom one must argue, unless absolutely necessary. This Council must go, or at least be made to play a peripheral role in the bioethics scene, unless it is radically remade with voices from both sides of the aisle. Supposedly even Wesley Smith agrees that there should be such voices. Now it is time for the American Enterprise Institute's Hertog Fellow Leon Kass to act with courage so that we really can have a "richer" bioethics.

It is a pretty terrible day for those of us in bioethics who supported the right to choose, hES research, and dozens of other areas I have not taken the space to discuss. But the real tragedy would be if bioethics did not take from this mess the lesson that not all battles must be fought nationally. State-by-state we will see the new changes made in bioethics-relevant law. California's Proposition 71 is just the beginning of some very important new shifts that deserve some real pragmatic consideration. Bioethics may not be as prestigious when it is fought out in the states, but that is where the battles now lie, at least for four more years. - Glenn McGee (UPDATED 11/3;11/20 )

Embryonic Stem Cell Research Legal Now in Spain

Incredibly, even Spain is allowing some forms of ESR. This shows just how hollow and illogical the ban that the President has imposed on federal funding and the anti-ESR arguments of the President's Council truly are. - Art Caplan

Kass Will Now Officially Say Anything

The Independent UK reports on Leon Kass' latest extraordinary statements. Kass is on the stump, although this time not so much for the President as against every nation that wants to do hES research using nuclear transfer. He is speaking on behalf of all the, um, yet to be created. "Britain is wrong. A woman's body should not be a laboratory for research or a factory for spare body parts. No child should be forced to say, 'My father or mother is an embryonic stem cell'." For what it is worth, there is no evidence that producing 5 day-old blastocyst-like organisms through nuclear transfer would make reproductive cloning any more likely to work. But the metaphor is great: little people alone and alienated, crying out "my mommy is a cell! my mommy is a cell!" The other members of the Presidential Bioethics Council must be so proud of this heroic effort.

Another Op Ed Asks Why the Bioethics Council Head is Stumping for Bush

From Mass High Tech.

Updated: Leon Kass on Playing Politics?

Playing Politics With the Sick is the title of Leon Kass' editorial concerning politics and stem cells. Given the title of his Op Ed, it is particularly interesting that he does not distance himself or recuse himself from his official political role or from the opinions of other members of the Presidential Bioethics Council. In fact his affiliation in the piece is listed as chairman of the President's Council of Bioethics. Kass is speaking at ASBH this month; it will be interesting to see if that is raised. Is it a problem?? UPDATE: Chris Mooney argues that Kass' use of science in the editorial is ironic and incredibly misleading.