Bioethics Forum Essay

Why Is Ethics Too Often Playing Catch Up?

The question is as old as the field of bioethics: why does ethics too often not see problems coming and is then forced to play catch-up? Note that I use the phrase “ethics too often,” implying that the difficulty lies with the discipline of ethics itself, not with those who try to understand and use it. But that’s the way I have usually heard the question asked and, if so, one might speculate that ethical issues usually capture public attention only when times are changing and in flux. Ethics is then called upon for social rehabilitation and restoring some stabilizing morality. And something like that happened with the advent of bioethics itself, invented and called upon to confront the staggering, often confusing  array of new ethical issues posed by medical and biological advances.

Yet one might ask whether in fact the charge that we are always too late is true? Sometimes no, and sometimes yes. Many problems of the “new biology,” as it was often called in the 1960s and 1970s, were foreseen well in advance of their technical achievements. The possibility of genetic engineering and prenatal genetic testing, for instance, was much discussed, long before they became clinical reality. The charge was often leveled, in fact, that alarmist speculation about some imaginable downside of the new biology–and anxious talk about a coming Brave New World– would endanger valuable research and should stop. My colleague Willard Gaylin was chastised by his dean at the Columbia University College of Physicians and Surgeons for an article he wrote for The New York Times Magazine about the possibility of reproductive cloning.Such talk would hurt the school’s ability to raise grant money, he was told.

Then there was the case of recombinant DNA research in the mid-1970’s. Some bioethicists and scientists saw potential dangers, broadcast their possibility, and helped establish a short (and voluntary) moratorium on the research. No hazards ever emerged and some scientists, later led by James D. Watson, argued that it was a fatal mistake for scientists to make their worries public. What they will get is an uninformed, irrational public.

Yet there are other examples of public worries about biological developments that led scientists to carry out their research in secret to avoid public and legislative scrutiny. The death last year of Lesley Brown, mother of the first IVF child, born on July 25, 1978, was a reminder of that tactic. The researchers, Patrick Steptoe and Robert Edwards, had begun their research in the 1960s and immediately came under attack on scientific and ethical grounds. They decided simply to avoid that fuss by going underground, neither talking about nor publishing on their work. The world learned nothing about the failures they may have encountered along the way, nor did it care about them in the wake of the success of the procedure, now commonplace.

In that vein, I am reminded of a comment by Robert Oppenheimer in the aftermath of the development of the atom bomb: “When you see something that is technically sweet, you go ahead and do it, and you argue about it only after you had your technical success. That is the way it was with the atom bomb.” Of course there have been ethical arguments ever after about whether the development of the bomb was ethical and now, interestingly, there have recently been some relatively low-key contentions that second thoughts may be in order on IVF, with clear harms to some mothers and their children from the procedure. But just as arguments against nuclear weapons have not much changed the course of human history, it is equally unlikely that faith in the value of IVF will soon be diminished.

Ethical catch up, it turns out, does not do much good when some research meets with public approval, ethical warts and all. And anxious ethical foresight is not necessarily any more effective when it leads savvy researchers to keep to themselves, even when worried, their own failures and misgivings, hoping to be saved in the end by the kind of home-run success of the nuclear scientists working on the Manhattan project and Edwards and Steptoe making IVF possible.

If correct, that perception may not be altogether helpful for us in ethics. We can do some clean- up work, but we are at the mercy of the consciences of the researchers. We can only hope that, if real dangers turn up–for instance, with synthetic biology research–the scientists will be the first to tell us, and maybe invoke just the kinds of public worries their colleagues will not want. That will take some courage as well as some willingness to entertain the possibility–despite the “sweetness” of the research—that all might not turn out well. As with most other spheres of life, it is positive, upbeat thinking that is welcomed and gets the grants. The Grinch who steals science is no more favored than the one that tried to steal Christmas.

Daniel Callahan, cofounder and President Emeritus of The Hastings Center, is the author most recently of a memoir, In Search of the Good: A Life in Bioethics, and The Roots of Bioethics: Health, Progress, Technology, Death.

Posted by Michael Turton at 01/02/2013 03:14:14 PM |

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