A Rich Bioethics: Public Policy, Biotechnology, and the Kass Council

Introduction: An Experiment in Public Bioethics

Introduction An Experiment in Public Bioethics Though his presidency would soon be dominated by the war on terrorism, in the summer of 2001 George W. Bush was focused on the war on disease. The U.S. and other developed countries have long committed national resources to biomedical research to improve the quality and extend the duration of human life.Although justified by an ethical commitment to well-being, federal support of biomedical science and technology raises ethical quandaries about how to distribute scarce resources and how to balance means and ends.By 2001 scientific advances and legislative activity in embryonic stem cell research had pushed such issues to the forefront of national consciousness and onto the president ’s agenda. Does the potential for cures justify the sacri fice of human embryos, the moral status of which is disputed in a pluralist society? Weighing on President Bush’s mind was the more specific question of whether the federal government ought to fund embryonic stem cell research. On August 9, 2001, in his first nationally televised address ,President Bush announced his controversial decision. His policy would allow federal funding only on stem cell lines that existed prior to that day. Subsequent research developments have suggested that new techniques for creating 1 stem cells may mitigate this moral controversy. But stem cells are only one aspect of a much larger constellation of ethical and political questions surrounding biomedical and behavioral science and technology. In recognition of this, President Bush took advantage of his national audience to announce the formation of the President’s Council on Bioethics, which would“consider all of the medical and ethical ramifications of biomedical innovation.”The council would be chaired by Dr. Leon Kass, a long-time contributor to and critic of bioethics. “Bioethics”is a very recent coinage for discourse about very old questions concerning human identity, meaning, and flourishing—questions that are now raised with unprecedented urgency by modern biotechnology. These questions often provoke profoundly divergent answers that may in turn spark animosity. It may be that, in an ideal world, each person would be left alone to give his or her own private answers. But in the real world, substantive issues about being human cannot be banished from the public sphere. This is due in large part to the successes of modern science and technology.By drawing us into an ever more interdependent web and by delving into the very fabric of human nature, science and technology are forcing us to confront together questions about the nature of good lives and good societies. The central thesis of the present work is that since we cannot avoid such substantive matters, it is best to handle them explicitly. I will argue that this is what the Kass Council did and that this is what made it unique and important as an institution of public advice and public philosophy. On November 28, 2001, President Bush signed executive order 13237, officially establishing the President’s Council on Bioethics.The Kass Council finished its term on September 9, 2005, when Kass stepped down as its chairman.1 Bioethics commissions are traditionally heavily influenced by their chairs, and the Kass Council was no exception. In terms of both substance and style, much of the council’s work bears the unmistakable impress of Kass’s thought. Indeed, Kass devoted himself nearly full-time to his council,2 playing an integral role in the production of its seven official reports. The council’s mandate was broad: “to advise the President on bioethical issues that may emerge as a consequence of advances in biomedical science and technology,”“to undertake fundamental inquiry into the human and moral significance of developments in biomedical and behav2 A Rich Bioethics ioral science and technology,”“to provide a forum for a national discussion of bioethical issues,” and “to facilitate a greater understanding of bioethical issues.”As Kass put it at their first meeting in a Washington D.C. hotel on January 17, 2002, the council was to answer the demands for“action ” in public policy and “thought” in public culture.3 The council was thus tasked with fulfilling the needs for both policy-relevant information and philosophic reflection at the dawn of a new age of scientific discoveries and technological powers, from stem cell research and cloning to cognitive and physical enhancements. Naturally the council would hold meetings, listen...