May 9, 2008


The Stupidity of Dignity: Conservative bioethics' latest, most dangerous ploy. (Steven Pinker, 5/28/08, The New Republic)

This spring, the President's Council on Bioethics released a 555-page report, titled Human Dignity and Bioethics. The Council, created in 2001 by George W. Bush, is a panel of scholars charged with advising the president and exploring policy issues related to the ethics of biomedical innovation, including drugs that would enhance cognition, genetic manipulation of animals or humans, therapies that could extend the lifespan, and embryonic stem cells and so-called "therapeutic cloning" that could furnish replacements for diseased tissue and organs. Advances like these, if translated into freely undertaken treatments, could make millions of people better off and no one worse off. So what's not to like? The advances do not raise the traditional concerns of bioethics, which focuses on potential harm and coercion of patients or research subjects. What, then, are the ethical concerns that call for a presidential council?

Many people are vaguely disquieted by developments (real or imagined) that could alter minds and bodies in novel ways. Romantics and Greens tend to idealize the natural and demonize technology. Traditionalists and conservatives by temperament distrust radical change. Egalitarians worry about an arms race in enhancement techniques. And anyone is likely to have a "yuck" response when contemplating unprecedented manipulations of our biology. The President's Council has become a forum for the airing of this disquiet, and the concept of "dignity" a rubric for expounding on it. This collection of essays is the culmination of a long effort by the Council to place dignity at the center of bioethics. The general feeling is that, even if a new technology would improve life and health and decrease suffering and waste, it might have to be rejected, or even outlawed, if it affronted human dignity.

Whatever that is. The problem is that "dignity" is a squishy, subjective notion, hardly up to the heavyweight moral demands assigned to it. The bioethicist Ruth Macklin, who had been fed up with loose talk about dignity intended to squelch research and therapy, threw down the gauntlet in a 2003 editorial, "Dignity Is a Useless Concept." Macklin argued that bioethics has done just fine with the principle of personal autonomy--the idea that, because all humans have the same minimum capacity to suffer, prosper, reason, and choose, no human has the right to impinge on the life, body, or freedom of another. This is why informed consent serves as the bedrock of ethical research and practice, and it clearly rules out the kinds of abuses that led to the birth of bioethics in the first place, such as Mengele's sadistic pseudoexperiments in Nazi Germany and the withholding of treatment to indigent black patients in the infamous Tuskegee syphilis study. Once you recognize the principle of autonomy, Macklin argued, "dignity" adds nothing.

Goaded by Macklin's essay, the Council acknowledged the need to put dignity on a firmer conceptual foundation. This volume of 28 essays and commentaries by Council members and invited contributors is their deliverable, addressed directly to President Bush. The report does not, the editors admit, settle the question of what dignity is or how it should guide our policies. It does, however, reveal a great deal about the approach to bioethics represented by the Council. And what it reveals should alarm anyone concerned with American biomedicine and its promise to improve human welfare. For this government-sponsored bioethics does not want medical practice to maximize health and flourishing; it considers that quest to be a bad thing, not a good thing.

To understand the source of this topsy-turvy value system, one has to look more deeply at the currents that underlie the Council. Although the Dignity report presents itself as a scholarly deliberation of universal moral concerns, it springs from a movement to impose a radical political agenda, fed by fervent religious impulses, onto American biomedicine.

The report's oddness begins with its list of contributors. Two (Adam Schulman and Daniel Davis) are Council staffers, and wrote superb introductory pieces. Of the remaining 21, four (Leon R. Kass, David Gelernter, Robert George, and Robert Kraynak) are vociferous advocates of a central role for religion in morality and public life, and another eleven work for Christian institutions (all but two of the institutions Catholic). Of course, institutional affiliation does not entail partiality, but, with three-quarters of the invited contributors having religious entanglements, one gets a sense that the fix is in. A deeper look confirms it.

Conspicuous by their absence are several fields of expertise that one might have thought would have something to offer any discussion of dignity and biomedicine. None of the contributors is a life scientist--or a psychologist, an anthropologist, a sociologist, or a historian. According to one of the introductory chapters, the Council takes a "critical view of contemporary academic bioethics and of the way bioethical questions are debated in the public square"--so critical, it seems, that Macklin (the villain of almost every piece) was not invited to expand on her argument, nor were mainstream bioethicists (who tend to be sympathetic to Macklin's viewpoint) given an opportunity to defend it.

Despite these exclusions, the volume finds room for seven essays that align their arguments with Judeo-Christian doctrine. We read passages that assume the divine authorship of the Bible, that accept the literal truth of the miracles narrated in Genesis (such as the notion that the biblical patriarchs lived up to 900 years), that claim that divine revelation is a source of truth, that argue for the existence of an immaterial soul separate from the physiology of the brain, and that assert that the Old Testament is the only grounds for morality (for example, the article by Kass claims that respect for human life is rooted in Genesis 9:6, in which God instructs the survivors of his Flood in the code of vendetta: "Whoso sheddeth man's blood, by man shall his blood be shed, for in the image of God was man made").

The Judeo-Christian--in some cases, explicitly biblical--arguments found in essay after essay in this volume are quite extraordinary. Yet, aside from two paragraphs in a commentary by Daniel Dennett, the volume contains no critical examination of any of its religious claims.

How did the United States, the world's scientific powerhouse, reach a point at which it grapples with the ethical challenges of twenty-first-century biomedicine using Bible stories, Catholic doctrine, and woolly rabbinical allegory?

At least his title is exactly right: Dignity is Stupid in the most profound sense of the word. It is also the basis on which the United States is Founded, so it would be downright bizarre if it did not inform debates over mere scientific experimentation. Of course, it's unsurprising to find a Darwinist so hostile to human dignity--that, after all, is the point of the ism.

Posted by Orrin Judd at May 9, 2008 7:15 PM

Hitler's Germany was a scientific powerhouse with no ethics and a thorough contempt for "Bible stories, Catholic doctrine, and woolly rabbinical allegory."

Maybe that's why the author doesn't like the idea of a "life for a life" in Genesis 9:6.

Posted by: Randall Voth at May 10, 2008 5:42 AM

Wow! ". . .[B]ible stories, Catholic doctrine and wooly rabbinical allegories." They're trying to get us all with one round.

Of course the dumb-*ss Darwinist just doesn't get it. Those stories, doctrines and allegories will guide us when our star-ships trek forth away from the dying sun.

Posted by: Lou Gots at May 10, 2008 6:22 AM

I'm dubious about dignity in a bioethics context since it can be easily used as an excuse for euthanasia, i.e., "death with dignity."

Posted by: Joseph Hertzlinger at May 11, 2008 2:24 AM

No, it can't. That's not what dignity means.

Posted by: oj at May 11, 2008 6:37 AM