Bioethics and Culture Wars
Callahan, Daniel, The Nation
Not long ago two stories appeared in the paper on the same day, both greeted with enormous media fanfare and instant argument. One of them was on the successful cloning of a sheep, Dolly. The other story was about the confession of Ron Fitzsimmons, executive director of the National Coalition of Abortion Providers, that he had lied about the frequency of late-term abortions. Those abortions are, he said performed far more frequently than he and his colleagues had earlier admitted and performed as well on healthy fetuses, not only those that are malformed or whose mothers are dying.
Both stories raise complex and troubling ethical issues. As a worker in the field of bioethics, I had an uneasy sense that, once again, these questions would quickly get overlaid with ideology and swept up in the culture wars. Indeed the argument about Dolly saw two camps instantly formed one was alarmed by the development and opposed to any further movement toward cloning humans; the other (seemingly much smaller) touted a potential gain in health and more reproductive choice if cloning went forward. The Fitzsimmons case elicited a we-told-you-so response from antiabortion groups and an embarrassed effort among pro-choice groups to distance themselves from Fitzsimmons.
Good ethical analysis in my trade is supposed to be tightly logical, utterly consistent, dispassionate, evenhanded and universal in its application. Whether the ethics is Kantian in its orientation--looking for tight rules and unyielding rights or utilitarian--looking at consequences and a maximization of benefit over burden (so called consequentialism)--the ultimate goal is the same: to provide a rational and compelling way of telling good from bad, right from wrong. While feminism, contextualism and a resurgent pragmatism a la Richard Rorty have sought to open some new doors, the old models still hold general sway.
They just don't work well with the Dolly and Fitzsimmons cases, though cloning seems to invite a consequentialist analysis. In asking whether human cloning would be a good thing, we should surely try to envision the likely results, using as a test, for instance, those utilitarian warhorses "the greatest good of the greatest number" or the balance of potential pleasure over pain. But that's not much help--we have cultural disagreement, as we should, over what "good," much less "greatest good," means, and what would count as an appropriate calculus for balancing pleasure and pain.
If one tried to use a Kantian standard in the Fitzsimmons case, his lying would have to be condemned. Kant admitted few, if any, exceptions to the duty to tell the truth. But in our society, lying in the name of a supposedly higher good is widely winked at if the cause is noble enough. Spin-doctoring only adds to the confusion. I would be astonished to learn that Fitzsimmons's co-advocates had been privately condemning him for lying.
All of this poses some puzzles not widely acknowledged in contemporary philosophical ethics or bioethics. If one tries to hold on to a universalist, coolly rational mode of analysis, floating above culture and class, no room is left for the play of passion, context and ideology. Lofty abstractions win the day. If, in contrast, one tries to recognize situation and circumstance, the result may be subservience to the interests of class and tribe, to our crowd and the passions of the moment.
Can bioethics find a better way? So far it hasn't, even if we have done reasonably well in remaining civilized with one another. As a field, it was born in the late sixties and early seventies, a response to a number of terrible abuses in medical research (the Tuskegee experiments, for instance) as well as a reaction to a suffocating medical paternalism (doctors, not patients, making all decisions). It answered the need for some strategies to evaluate the meaning of the new medical knowledge and technology, especially genetic engineering. …