Postmodernism, Autonomy and Bioethical Boundaries

A funny thing happened when President Obama announced the dissolution of the President's Council on Bioethics. For much of its existence the council had been (mis)characterized as little more than the bioethics appendage of a vast right wing conspiracy, a place where reason confronted religion and reason lost. At the end, it transformed into something much closer to what it really was. The New York Times story by Nicholas Wade formed the basis for much subsequent commentary about the President's action. Wade quoted Reid Cherlin, a White House press officer, to the effect that the Council was "a philosophically leaning advisory group" and Dr. Alta Charo, an ethicist at the University of Wisconsin, saying that the Bush council's work "seemed more like a public debating society."¹ But this transformation was not enough to save the Council; indeed, that was why it needed to be abolished. A new commission, Charo opined, "should focus on helping the government form ethically defensible policy." Cherlin suggested an Obama panel would involve less discussion, and more effort to develop "a shared consensus."

In what follows, I will suggest that if Cherlin/Charo present an accurate picture of an Obama bioethics panel, it is very likely to be a politicized body characterized by some of the most problematic intellectual currents that presently dominate the academy generally and the academic sub-discipline of bioethics specifically. Academic "postmodernism" and the bioethical principle of autonomy will work together to make it difficult if not impossible for an Obama bioethics panel to call into question disturbing developments that biotechnology, nanotechnology and artificial intelligence may have in store for us.

In the realm of bioethics, it is certainly not immediately obvious why discussion, debate, and whatever assistance a philosophical leaning could provide are inappropriate to an advisory group dealing with questions that are notoriously difficult and contentious. But the alternative being suggested by Cherlin and Charo is tolerably clear. To some, their practical, policy-by-consensus charge for a bioethics council may seem little more than common sense. Is not the point of presidential panels to bring experts together to solve the nation's problems?

Yet there are problems visible when we look at what Cherlin and Charo are suggesting more closely. On the one hand, experts are not, qua experts, necessarily at all interested in consensus; they are interested in being right, or perhaps in knowing something true. Consensus in and of itself is no measure of truth. On the other hand, building consensus from which to make policy is one way of understanding what politics and regulation are all about. If that is true, why do we need a bioethics council at all, so long as there are legislative and regulatory processes in place? The Cherlin/Charo model seems to ask of experts what they may not be interested in doing, and duplicate what in any case others might be able to do better.

The obvious answer to this objection is that legislators are not bioethics experts and bioethics experts are unlikely as such to win elective office. Still, this answer fails to note that legislators and regulators already have ample access to expertise. Indeed, when we see that expertise is at work in the context of legislative and regulatory politics we see experts free to follow their natural inclination to disagree; it is the rare issue where well-credentialed people do not have a variety of points of view. The give and take of their disagreement is, we hope, part of what helps craft better regulation or law. In any case, the subject-matter experts are not expected to reach a policy-relevant consensus themselves; that is left to the experts at reaching consensus to the extent that there are such, i.e., politicians or politically-minded regulators. Clearly, expecting experts to mold a consensus upon which to base policy is asking them to act like politicians. That is to say, by using a political model of consensus seeking, the Cherlin/ Charo approach promises to politicize a presidential bioethics panel in a way that, by their own testimony, the Bush council was not politicized...