Health & Medicine / Health Policy

As a former chairman of George W. Bush’s President’s Council on Bioethics, Leon Kass is well acquainted with controversy, and with the treacherous terrain at the nexus of science and politics. The council, tasked with advising the president on such hot-button issues as stem cell research and cloning, has sometimes been dismissed as a vehicle for the right wing of the Republican Party. But although some of his views comport with those of hard-liners, Kass, a physician with a Ph.D. in biochemistry, is hard to pigeonhole. “I do not come from a school of thought, nor do I have an ideology,” he says.

An old-fashioned moralist, he holds some views that are remarkably unfashionable—even premodern. He still employs the term bastard to describe the children of unwed parents, and he has written despairingly about the loss of “female modesty” in our culture. At the same time, he has misgivings about the effects of global capitalism and believes in integration, tolerance, and inclusiveness. In the end, what really rankles many scientists is Kass’s belief that society has a duty to regulate research, and his frequent warnings about the dehumanizing effects of some technologies.

The recommendations of the Council on Bioethics, though substantive and scholarly, have by and large not been put into practice by policymakers, and the group’s prominence has faded as the debate about stem cell research has ground to a standoff. Kass left the council in September and currently is a fellow at the conservative American Enterprise Institute for Public Policy Research, where his office is a few paces from Lynne Cheney’s. He sat down with DISCOVER to reflect on his tenure and discuss his beliefs, his influences, and his concerns for the future.

You were chairman of the Council on Bioethics, yet you don’t regard yourself as an ethicist. Why?
I do not present myself as having professional ethics expertise, the existence of which, in fact, I have doubts about. The term ethicist is of recent vintage. I prefer to say that I engage in moral reflection on various matters of human experience but look at them not through the lens of any ethical theory or system. I’m an old-fashioned humanist. A humanist is concerned broadly with all aspects of human life, not just the ethical.

How did you develop this perspective?
My parents were one of my major influences. Both were immigrants from Eastern Europe with no formal schooling. My father had a clothing business on the South Side of Chicago. My mother read novels late into the night. It was a Yiddish-speaking, secular, socialist-leaning home, like lots of others around that time, but with a very strong emphasis on doing the right thing and being a mensch. Moral questions were discussed around the dinner table.

I was an early protester against the Vietnam War. I was probably something of a peacenik. My wife and I did civil rights work in Mississippi when I was still in graduate school at Harvard. And I came back with this question: Why was there more honor among these poor black farmers in Mississippi than among my fellow graduate students at Harvard? The answer seemed to me to have something to do with their religious faith.

A question you’re currently taking on is how we should deal with progress and technology.
I think lots of things conspire against dealing in a sensible way with technological advance. There’s a large cultural bias toward progress, a belief that innovation is good innovation. We love the freedom of scientists to inquire, of technologists to invent, of entrepreneurs to develop, and of customers to buy what they want. The country runs on this principle. I’m inclined to a more classically tragic view in the sense that all the good comes with some bad. We pay a price for everything. And you pay a higher price if you don’t know that you pay a price. In the biomedical area, the people who are bringing you all the novelties occupy the moral high ground. They are human­itarians. They are interested in curing disease, ending suffering, extending life. If anybody says, “Let’s go slow here,” it looks like the imposition of a narrow religious view on what is a pluralistic society, and the response is “Get your morals off my science.”

What about the commercial pressures of innovation?
Some of my old friends in the sciences are very worried about the biotech companies and how their intrusion into academic science skews the agenda. The commercial interests that are in favor of pushing the envelope are very, very well established. And there are no economic interests in favor of going slow. In Europe in the aftermath of the Holocaust, the concern for human dignity became embodied in the law. Americans, by and large, fly the banner of liberty and equality. We don’t have the public language—other than religiously formulated language—for dealing with some of these things.

Are there any innovations you think should be prohibited?
I’m in favor of legislative bans on only a couple of things. Because the evils are so intimately connected with the goods, you don’t want to kill the goose that lays the golden egg. But I would ban human cloning. And I would keep physician-assisted suicide and euthanasia illegal.

What else troubles you about contemporary medical research?
For my money, the area where we should be most concerned is psychopharmacology and the uses that go beyond treatment for clear psychiatric disorders—the whole family of mood-altering, euphoriant drugs that separate satisfaction from the human activities generally responsible for our achieving satisfaction. This is not puritanism on my part. I’m concerned about a society in which people refuse to take responsibility for themselves, about a society in which human aspirations are short-circuited because achieving them is too difficult and too painful. We’re treating grief as a problem to be solved.

What about people who have endured horrible traumas? Shouldn’t they be allowed to suppress their bad memories with drugs?
I have absolute sympathy for people who were in the World Trade Center or people who have experienced rape who want to have some way of blunting these memories to minimize the trauma. I’m all for doing this. But this is also going to foster the possibility of eliminating memories of acts that are shameful, acts in which we behave disgracefully, acts for which we should feel guilt and remorse and seek forgiveness. To sit as editor of our memories is to acquire a life other than the one we have truly lived, to fabricate an identity that is false to our lived experience.

You’ve raised concerns about the “medicalization” of society. But isn’t it too late?
I taught my first bioethics course last spring. In several areas, the class did better than my council in seeing the dangers in the use of psychotropic drugs in children. There were several students who had been on Ritalin. And they spoke with subtlety about what it meant to be on this medication and how they differed from some of their friends who had toughed it out. I think most young people would like to be really happy rather than appear to be happy. Do they want the pleasure of hitting the baseball to come out of a bottle, without ever learning to hit the ball? No. They know the difference between excellence and mediocrity, and they want to feel the sense of their own accomplishment.

But you’re not categorically opposed to the use of such drugs.
I’m not some sort of ogre who wants people to suffer for their own good. We learn sometimes when we suffer, but I don’t approve of somehow increasing the amount of suffering in the world.

One of your most noted accomplishments as council chairman was the report “Reproduction and Responsibility.” What were the council’s goals in publishing that report?
There were certain boundaries we wanted to erect: no pregnancy except to give birth to a child; no human embryos placed in animals for any reason; no fertilization of a human egg by animal sperm or the reverse; no buying or selling or patenting of human life at any stage; no child conceived except by the union of one egg and one sperm, both taken from adults. The point is that no child conceived with the aid of assisted reproductive technologies should be denied the lineage and biological ties to two parents that all children born “naturally” have. No child should have to say, “An embryo was my father.”