Bioethical Consensus and the Force of Good Ideas

Public bioethics has many disagreements, some vociferous. When we step back and reflect on these debates, we often say that the two sides are "talking past each other." This suggests that they share common ground on which they could forge consensus, or at least that recognition of their shared intellectual or moral heritage could help them be more civil to each other. It is useful, then, to analyze the two sides to try to uncover this common ground and show that, at some level, the combatants are on the same team.

Erik Parens' essay has this purpose. He examines the debate over enhancements—over using medical science to make people taller, happier, more immune to disease, and so on. Certainly this debate has become vociferous and polarized. Parens uses the time-honored method I call a "counter-slicing" argument, in which one looks at a polarized debate as two pillars and then cuts through these pillars on the horizontal plane to show the old debate in new relief. I find that these "counter-slicing" arguments are powerful tools, although something more is needed to actually build consensus.

First let me say something about the tool that Parens offers us. He contends that if we take a slice across the pro and con positions on enhancement—the two pillars—we see a common foundation: namely, they both share the "moral ideal of authenticity," according to which there is an "authentic self " that needs to be protected. To take one example, proponents of enhancement argue that Prozac allows patients to fulfill their authentic selves. Opponents would say that it destroys authenticity by numbing one to authentic experience of the world. But both pillars share the ideal of authenticity.

Parens then says that these different perspectives on the underlying shared norm of authenticity are the result of different moral frameworks. He proposes that the proponents have a deep orientation toward "creativity" and the opponents a deep orientation toward "gratitude." His analysis is helpful, but for present purposes, what is important is that, in Parens' view, neither opponents nor proponents adhere solely to only one orientation. Both sides of the debate are drawn to some degree to both of these orientations, but each emphasizes only one for the sake of argument. To continue my metaphor—at the risk of mangling it beyond all usefulness—the pillars are actually closer together than we thought, or perhaps we could say that they become one near the bottom. Parens' essay is an especially useful instance of the counter-slicing argument because he shows that the parts of the pillars he is describing are not minor pieces of each, but the actual foundation.

Parens' analysis reminds us that in the modern era of pluralism and rapid communication, it is inconceivable that we do not adhere to some of the values of our supposed opponents. To take a more institutionalized debate: it is inconceivable that pro-life advocates do not actually value freedom of choice and that pro-choice advocates do not recognize at least some value in embryonic life. But they cannot say that, I think largely because social pressures stop them from doing so. Similar pressures are at work in the enhancement debate, and they will make it difficult for people to use Parens' tool.

Sadly, the general social pressures against using any cross-slicing tool are at an all-time high. This is a tough time for projects of common ground, especially when they touch on anything that might influence policy. Interestingly, studies have shown that the public has not become increasingly polarized over social and moral issues; only the elites have—politicians, professional activists, and "knowledge workers." These groups have decided that discussion and compromise are pointless; they have gone in for power politics instead. Opponents are to be given no quarter. One side will say that no mistakes were made in the Iraq war, and the other will say that there was no good in the Iraq war whatsoever. Gay marriage is either the decline of civilization as we know it—and its proponents the barbarians at the gates—or it is...