What kind of impact did that report have?
A few of our recommendations were enacted into law last year. The language was carefully worked out so as to satisfy both the pro-life and scientist members. We have shown a way to come together in defense of commonly held values, even while continuing to disagree on the moral status of human embryos. Our example, and the specific proposals, should be of interest to anyone wishing to overcome the current stalemate in Congress.
Why did stem cells become the dominant bioethical issue?
Stem cell research was everybody’s Public Issue Number One—God knows, really, why. Partly as a legacy of the way the abortion decisions came about in this country and the degree to which abortion is important in American politics, killing and destruction-of-life questions have come to be regarded as the bioethical questions, whether it’s euthanasia at the end of life or abortion and embryo destruction at the beginning.
Scientists recently announced that they have found a way to turn human skin into cells that have all the therapeutic potential of embryonic stem cells. How does that change the debate?
This is what everybody has been waiting for. They’ve hit a home run. One of the most popular things the council did was to suggest science could come to the rescue and find a way around an ethical impasse to produce a mode of obtaining stem cells that everybody would regard as ethical, and that this vexed period of our politics could be put behind us. This is just really quite thrilling.
The Bush administration has been accused repeatedly of injecting politics into science. Did you experience that?
We were not interfered with at any time. The president got a copy of the “Reproduction and Responsibility” report only the day before it went public, as a courtesy.
Another of the council’s far-reaching reports is titled “Beyond Therapy.” What’s the difference between medical therapy and medical enhancement?
There is no bright line. But therapy, classically understood, is the removal of disease or disability and the restoration of health and normality. Enhancement would seem to go beyond the natural given powers, whether to increase IQ and memory or to boost athletic performance by steroids or by genetic modification of muscles. A number of questions are raised by this. First among them is, how do you know that the change is in fact a betterment? Nobody would question the correction of a cleft palate. On the other hand, there is the case of the surgeon who removed part of a woman’s breast because it interfered with her golf swing. There is a distinction between serving the patient’s health and serving the patient’s desires. And there’s a lot of gray area in between.
So are you opposed to plastic surgery?
I’d feel much better if they had some kind of body technicians who were not trained physicians to do this. It is a kind of corruption of the art to put it in service of satisfying people’s desires—even when some of those desires are reasonable. I’m somewhat old-fashioned on that subject. If medicine is not guided by some kind of commitment to wholeness or healing, it’s reduced to being a simple body shop where technicians for hire perform.
Are we too focused on personal happiness?
I think some of that is true. Families are more atomized. On the other hand, there is at least the recognition that we’re in trouble. There’s an enormous amount of work being done on what’s come to be called civic engagement.
Religious institutions are part of that. Are you a believer?
I’m a member of a synagogue in Chicago. I don’t really know the answer to this question.
That usually means no.
Well, take a simple aspect of it. Do I think there’s an afterlife? I don’t think I’ve spent five minutes of my life with that expectation. I’m agnostic on the question. However, I like the idea of living as if I’m going to have to answer for what I’ve done. I feel grateful. Do I know to whom or to what I feel grateful? I’m not sure. Am I aware that there are powers that move me in ways that are not at my disposal and under my control? Yes. Do I think there is an old man upstairs with a long beard who takes calls from room service? No.
What are the most significant bioethical issues of the future?
One of them is the large question of the health-care system. It’s partly a bioethical topic. Some people put it in terms of justice. Some people put it in terms of rights to health care. My preference would be to say something along these lines: What does a decent and prosperous society owe to the health of its citizens? The crisis of ethical long-term care for the elderly might be the most important issue we took up in terms of how it affects the lives of pretty much all the families in the United States. Scientists hope for a magical cure of Alzheimer’s. I have it in my family. It’s depressing. Forty percent of us right now die after a period of enfeeblement, debility, and dementia lasting up to a decade. That’s the most common trajectory toward death. In the more biotechnical areas, I think the possible hazards have to do with genetics. And pharmacology: Drug-induced pleasure or feelings of self-esteem are shadows divorced from the underlying human activities that are the essence of human flourishing. We want to feel good about ourselves, but only as a result of doing and being good.
Are you hopeful that people will voluntarily take that hard road to happiness rather than the easy way out?
I don’t have any illusions about how easy it is to turn the culture around, but I’ve never had any dealing with any person who didn’t have some aspiration to the good.
