Archive for the ‘Bioethics’ Category

Screen Free

May 2, 2013

It was the last day of class, before finals. We squeezed in a slew of reports in Bioethics: Tim’s on fracking (as a public health issue), Jacob’s on a legislator’s idiotic proposal to eliminate peer review as a criterion of federal funding for science, William’s on justice, fairness, & equality, Joshua’s on the misplaced pursuit (not possession) of happiness, Nick’s on the culture of violence (arguably our greatest public health issue), Mike’s on live organ donation, and Caleb’s on hyperparenting. They were all timed and terrific, occasionally even TED-like in their crisp clock-awareness. (I confess I enjoy ringing the bell.) I think I learned something yesterday.

bellbell

But the big news is from Bell Buckle: Older Daughter smashed a triple over the center fielder’s head (and darn near over the fence) to drive in the tying run late in the game, and then scored the go-ahead. Her team won! They’re in the regionals, playing tomorrow in Donelson. Go Tigers!!

And, coincidentally: it’s “Screen Free Week“… perfect time for me to unplug and get busy grading. Maybe squeeze in a ballgame too, and try to be more like Dan Yaccarino’s free-range robot Doug,”who unplugs himself from his daily download of information to go out and explore the world.” Later.

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A person in full

April 30, 2013

Two of my least favorite (because least conclusive, least agreeable, most acrimonious) topics dominated Bioethics yesterday: euthanasia and abortion.

As usual, more heat than light resulted. Reasonable statements were ignored or dismissed, the “science” of life was invoked by those whose real commitments seem rooted in religion, discussions derailed. Gonna have to start screening topics more assiduously.

Euthanasia means “good death.” Who could be against that, oxymoronic though it sounds? But Vincent may be just a little too eager to slap that label around, on my view. Our focus should be on a good death as the capstone of a good life, not simply the convenient termination of a bad one.

On the perennially-stalemated abortion issue, Austin denies the distinction between (human) life and personhood. What is a person, he challenges, if distinct from its biological vehicle?

Well, I like Robert Solomon’s answer.

To become a person is an achievement. Birth and death do not mark a person’s beginning and end. A newborn baby is not yet a person, while a deceased person who lives in the memory of his or her descendents is a person still, despite physical death. Initiation rites are crucial to achieving full membership in most tribal communities and thus to becoming a full person. A Passion for Wisdom

A person is, or was, a full participant in the complex life of a community. A person has a history and a shared communal identity. A person has a developed personality. Persons do things like take courses in Bioethics. Blastocysts don’t.

In short, as Sandel says, “the distinction between actual persons and potential ones is not without ethical significance.” Personhood grows like an oak, persons grow up. Or don’t.

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Postscript. Those of us with strong opinions on abortion and personhood (and that seems to be most of us in the Bioethics class) should give a listen to this recent Radiolab podcast, 23 Weeks 6 Days… and read the articles it was based on. Beautiful story, happy ending.

Generous to the end, and still smiling

April 29, 2013

We finish with Michael Sandel and Richard Powers today in Bioethics, and get on with final reports. Have they made a good case against the pursuit of biogenetic perfection? I think so. But definitely not against improvement. We can do better. Will we ever be better enough? Will we know which “enhancements” to decline?

We began with Sandel’s discussion of deafness. (He loves to canvass the audience.)

His main parting contention: life is one thing and personhood another, but it’s best not so to obsess over the ethical boundary between them that we relinquish our one living opportunity to improve the human estate.

Genetic engineering to create designer babies is the ultimate expression of the hubris that marks the loss of reverence for life as a gift. But stem cell research to cure debilitating disease, using unim- planted blastocysts, is a noble exercise of our human ingenuity to promote healing and to play our part in repairing the given world.

We end with Generosity, and the character nicknamed “Generosity.” Thassa constantly channels Richard Dawkins sans hubris (one reason why Powers and I love her): “we are the lucky ones,” he said.

And she says

Everyone alive should feel richly content, ridiculously ahead of the game, a million times luckier than the unborn

And

No one should be anything but dead.

And

Everything that is, is ours.

She’s right, of course; but of course like the rest of us she finally has a hard time holding those thoughts and holding off intermittent existential despair. Maybe none of us has alleles long enough to sustain our most elevated moments of transcendent insight. Alas. But maybe, too, their very transience and instability is what makes those moments so special.

Older Daughter amazed me by participating in NaNoWriMo, ”national novel-writing month,” a public writing project in which participants pounded out 50,000 words in thirty days. I was so impressed with her determination and stamina. I’d have felt more like Russell Stone, or a weak-willed Sisyphus, if you’d made me do that: “I have to go take my own life.”

All writing is re-rewriting. In the past that’s always slowed us down. If we’re re-writing not just words but genetic code, it may speed us up. Hang on.

As a pragmatist I feel somewhat dissed by Powers’ characterization of the ”witty pragmatism” of the positive psychologist who tells “Oona’s” audience– much like Oprah’s– about happiness. He might be right, though, to advise keeping your options open (“stay loose and keep revising the plan”). Is Powers right to predict that pop media culture will be the largest stage upon which our collective future is to be written? Scary thought. But “all the world’s a stage”  is scary, too.

Kurton prefers collaborative fiction to singly-authored texts. He’s with techno-utopian Kevin Kelly, in the Updike-Kelly dispute. I’m still in Updike’s (not Kurton’s or Kelly’s) corner.

More Dawkins-esque rhapsodizing about our evolutionary epic:

Six hundred generations ago, we were scratching on the walls of caves. Now we’re sequencing genomes… If that doesn’t inspire us, we don’t deserve to survive ourselves.

That’s a bit harsh, but I’m inspired. I’m also partial to my old-fashioned founts of happiness. Can’t we have both?

Finally, in this oddly self-referential tale that ends in narrative dissolution, Powers asks “What kind of story would ever end with us?”  For now our story simply continues with us. Where it all ends remains our most vital question. Unlike some reviewers [JWoodJMcInerney] (but like others), I love the postmodern ambiguous ending of Powers’ story.  “She’s still alive, my invented friend, just as I conceived her, still uncrushed by the collective need for happier endings.” Thassa survives, battered by life but still generous and smiling at fate. We may still imagine her happy.

May we all borrow her generosity and cheer, give all we’ve got right now, and meet the future in due course. The Atlas goes dark every night, but so far it’s always turned back again to the light. Cue the symphony.

Everyone’s a little bit speciesist

April 25, 2013

We had our first Bioethics final report presentation yesterday, from Komron, on The Efficacy of Live Tissue Trauma Training for Combat Life Support Applications. He warned the images would be graphic, of live (sedated) pigs and goats in surgical demonstrations. The guy in the 100K “cut suit” was hard to watch too.

Maybe Komron can provide a postscript, updating us on the disposition of this February Congressional order:

…the Pentagon must present lawmakers with a written plan to phase out “live tissue training,” military speak for slaying animals to teach combat medics how to treat severed limbs and gunshot wounds.

Andrew also put up a post on Italian animal rights activists who released animal subjects and allegedly set autism and schizophrenia research “decades” back.

The hard question, perhaps not so hard for confirmed utilitarians: is the prospect of saving even a single human life worth the sacrifice of a goat?

And for those not quite so confirmed: is there a humane and ethically-superior way of going about the sacrifice?

What would Peter Singer say?

“All the arguments to prove man’s superiority cannot shatter this hard fact: in suffering the animals are our equals.”

“The notion that human life is sacred just because it is human life is medieval.”

“If possessing a higher degree of intelligence does not entitle one human to use another for his or her own ends, how can it entitle humans to exploit non-humans?”

“To give preference to the life of a being simply because that being is a member of our species would put us in the same position as racists who give preference to those who are members of their race.”

I suppose I am a little bit speciesist, along with just about every non-self-loathing human. Forced to choose, I’ll almost always choose the human over the goat.

“If it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral importance, we ought, morally, to do it.”

Most of us rightly place a great deal more “moral importance” on saving humans than on leaving goats alone. (Notice I’ve stopped talking about pigs. I’ve read Charlotte’s Web. “Some pig.”)

But if we revere life, we must also insist on preventing gratuitous animal suffering. Further, we must insist on giving those sacrificial animals as much life, of quality, as possible.

Singer has also said, of researchers deliberately inducing Parkinsonism in monkeys:

“I do not think you should reproach yourself for doing it, provided there was no other way of discovering this knowledge. I could see this as justifiable research.”

Me too. Still wondering, though, about genetic screening for happiness.

Chance becomes choice

April 24, 2013

We continue tracking the quest for bio-perfection in our “real” and Richard Powers’ alternative “mutant”-fictional universe.

In the “Mastery and Gift” chapter of his Case Against Perfection, Michael Sandel says

A Gattaca-like world, in which parents became accustomed to specifying the sex and genetic traits of their children, would be a world inhospitable to the unbidden, a gated community writ large.

And,

The awareness that our talents and abilities are not wholly our own doing restrains our tendency toward hubris. If bio-engineering made the myth of the “self-made man” come true, it would be difficult to view our talents as gifts for which we are indebted rather than as achievements for which we are responsible.

When “choice, not chance” becomes our way, we’ll slip into an attitude of contempt for others and excessive regard for ourselves. Prometheus Ascendant will harden our hearts, and shrink them to grinch-size. We’ll be left with “nothing to affirm or behold outside our own will.”

That’s the story in Generosity too. Perfection in an enhanced future is a page-turning dream, at least until the alarm sounds . 

…on the insides of her eyelids, hopes rise, taboos fade, miracles get marked down, the impossible goes ordinary, chance becomes choice, and Scheherazade keeps whispering, “What is this tale, compared to the one I will tell you tomorrow night, if you but spare me and let me live?”

In that story, the storyteller saved herself. But who’s writing our story, the tale of our glorious “inevitable” tomorrowland?  And have we figured out that it might just be nonfiction?

Is “Oona” right? Does our “fortune lie not in our stars but in our changing selves,” can we “escape any fate by a daily application of near-religious will”? Tune in…

Eugenics

April 22, 2013

My temporary hot-spot’s shaky (cable guy’s coming later), so to cut promptly to the chase: the Bioethics topic today is eugenics.

It means simply “well born,” and while that sounds aspirationally modest and reasonable we know it’s had a chilling history. “Three generations of imbeciles are enough,” said Justice Holmes in one of the more shocking expressions of judicial imperialism on record. Hitler hadn’t yet given it a bad name in 1935 LA, coerced sterilization was still going on in some U.S. states in the ’70s, incentivized “voluntary” eugenics is going on in places like Singapore today, and “free market” eugenicists call for its revival. James Watson thinks it might cure the “disease” of stupidity, though the market does seem to bear quite a lot of that. (What will cure the arrogant chauvinism of aging Nobelists?)

Michael Sandel brings us back to the central issue as I see it: unconditional parental love, and reciprocal filial gratitude, will both be at severe risk if we turn childbirth into a bazaar. By all means, let’s continue to improve our “stock” if we can. The way to do that is by encouraging our kids to seek their own bliss, not validate ours.

Selling and buying eggs for 50K is not the way.

Happy Earth Day!

The hubris of design

April 17, 2013

We’re on to Michael Sandel’s “Designer Children, Designing Parents,” and to the conclusion of Richard Powers’ “Walk on Air,” in Bioethics today.

It’s pretty much all downhill from here, for Thassa the hyperthymic cloudwalker. Whether it’s downhill for you and me (and the next generations of real humans) too, remains to be decided. Or so we we may hope. Tuesday’s news from Boston does not bode well, for that. But tomorrow’s? We’ll see. [Tips for Resilience in the Face of Horror: http://shar.es/JGgkY] 

“The problem lies in the hubris of the designing parents…” Indeed. I never tire of quoting Mr. Emerson: “You’re trying to create another you, one’s enough.” More than enough, too frequently.

On this note, may I interject: Older Daughter smashed an over-the-fence home run yesterday, for the first time in a stellar High School career. I may have been more thrilled than she, though she did report being “in shock.”

I was happy for us both. I introduced her to the game, while she was still in diapers. But I hope I never created the expectation that my love and favor were contingent on her fulfillment of my  dreams. She swung the bat, she cleared the fence, she gets to decide how big a deal that is. Period. I am not her engineer, and I have no claim on her success. (I do have a lot of vicarious pride, but that’s a different matter.)

Sandel speaks of parental love in two “aspects,” accepting and transforming.

Accepting love affirms the being of the child, whereas transforming love seeks the well-
being of the child… “Attachment becomes too quietistic if it slackens into mere acceptance… Parents have a duty to promote their child’s excellence.

But where to draw the line  between promotion and demand? Somewhere short of hyperparenting, surely. “Parents of college students are out of control.” Tell me about it. Then, stop me from joining them.

I texted my daughter last night that she needs to hit another dinger, for me, when I’m present. The season’s nearly through. Have I already crossed that line?

Another well-intentioned but problematic line crossed by too many: the ritalin solution to ADHD. (Or Adderall and the other designer drugs supposed to enhance attention and focus, “for buckling down” and “fitting in” and “complying” with the performance demands of a society that values productivity and efficiency over peace of mind and the traditional pace of childhood.)

The pace of childhood: does that phrase still signify? Do we still acknowledge a child’s right to self-discovery at her own direction and speed?

Bill McKibben has written sensibly about all this. In Enough: Staying Human in an Engineered Agehe wonders if his marathon achievement is still his, “if my mind has been engineered to make me want to push through the pain of running, or not notice it at all.” He quotes Gregory Stock (Redesigning Humans: Our Inevitable Genetic Future):

“Enhancements of this sort by parents [will] engender mindsets disinclined to attenuate the traits in their own children,” and so “such traits may reinforce themselves from generation to generation and push the limits of genetic possibility and technical know-how.”

McKibben: Because, that is, one late-twentieth-century woman found solace and meaning in playing the piano, her descendants yea unto the generations are condemned to an ever-deepening spiral of musicality, one that they did not choose and that may haunt them, depending on how much consciousness remains…

How much consciousness, and how much conscious pleasure in living?

We left Generosity with a gift-question:  imagine you’re in a deserted parking lot and $20 blows right in front of you.  There’s no one in sight to return it to. “How do you feel?”

“Good.”

Right. Now, imagine you fish in your pocket for that gift later and it’s not there.

You feel very bad. “The bad is crazily out of proportion to the good.”

Exactly. Nature selects for pessimists. We’ve got an uphill climb to our happiness.

Tell us something we didn’t know.

Well, did we all know that Richard Powers’ Make Your Writing Come Alive trope mirrors the writing and re-writing (“all writing is re-writing”) of genetic code? He and his narrative/authorial voice are so insistently present in this tale precisely because people like Gregory Stock have insisted that “our genetic future” is “inevitable.” Powers insists to the contrary that we don’t have to write the story just that way. Not yet.

Our atlas is still alight, though the flame gutters. Let’s not curse the darkness. Let’s light some more candles, dispatch the demons, and make our writing come alive.

Walk on air

April 15, 2013

Dawn’s nowhere in sight but the birds are humming and Younger Daughter’s waiting at the door, to join her 8th grade friends on a flight to D.C. Ah, the gift of youthful adventure. Must go fire up our airport taxi, there’s truly no time like the present. Seems like only yesterday we were doing this with Older Daughter, years ago now. Time’s the fastest flyer.

Kung Fu Panda says today’s always a gift, and that’s why we call it the present. Dare we open it? (No peeking? How about peak experiencing?)

Gift is Michael Sandel’s keyword in today’s Bioethics chapter, too, as his Case Against Perfection continues in chapter two. He’s an anti-doping anti-perfectionist (with the world’s most popular course on justice), worried that we’ll design ourselves right out of the possibility of accomplishing our own goals and, ultimately, achieving meaningful lives.

“Bionic Athletes,” enhanced by various means (not restricted to pharmaceuticals), have looked the gifthorse of natural (some will say “god-given”) athleticism in the mouth (he says). They’ve corrupted their respective sports and compromised our capacity to appreciate their gifts and their games.

So what? Games are only, well, games. Arbitrary, unimportant, meaningless. Right?

Maybe. Maybe not. But that’s not the central argument here. Let me just say, though, that I’ve experienced at least a few glorious afternoons in the bleachers that felt anything but “meaningless” – they felt like what James Carse calls “infinte games,” played for their own sake and experienced as ends in themselves. Never mind, though, for now.

Sandel’s clear insinuation is  that we’re in danger of killing the biggest game of all, the game of life. If we make winning by all means the only thing, we’ll be robbing life of intrinsic interest, meaning, joy. Joie de vivre is the greatest gift; the dopers and cheaters and transhumanist dreamers may yet prove to be our greatest killjoys.

The deeper danger of enhancement and genetic engineering is that they represent a kind of hyper-agency, a Promethean aspiration to remake nature, including human nature, to serve our purposes and satisfy our desires.

At stake, Sandel says, is “an appreciation of the gifted character of human powers and achievements.” Such appreciation reflects a “religious sensibility” that is grateful but humble, and not so presumptuous as to try and replicate those powers. Hmmm.

Do nature’s gifts require and reward such self-abnegating gratitude? Does the “religion of humanity”?

There follows an interesting comparison, interesting at least to baseball fans, of Pete Rose and Joe DiMaggio.

Then, a surprising and at least overstated (probably false) claim: “striving is not the point of sports; excellence is.” I think Sandel really does not want to say that, does not mean what his words may convey. He wants to block the kind of ambitious striving that lusts after (say) seven medals at the Tour de France, or 73 suspiciously -amped Home Runs, or a shortcut to the marathon finish line. But surely he does not oppose striving against one’s own previous limitations to overcome internal resistance and achieve more than we knew we could.

Don’t some admirable athletes (and humans in general) possess a gift for striving?

I do think Sandel’s right to point out that “success” in baseball must continue to mean a 70% (or so) failure rate, in order to sustain our interest. I also agree that Judge Scalia is full of peanuts when he calls all rules “arbitrary.”

Sandel did an interesting Philosophy Bites interview worth hearing. His Harvard lectures on justice are wildly popular. He was also described in a recent profile as a “rock star.”

Richard Powers’ Generosity: An Enhancement (Part Two: “Walk on Air”) also raises crucial questions about the genetic gift of a sweet and happy disposition, and how well- or ill-advised we and our heirs might be to experiment with re-gifting happiness via biogenetic interventions and therapies. There are “big winners in genetics’ happiness roulette” (the biggest are hyperthymic, “every day bathed in renewable elation”) and relative losers. It’s not fair. Can we level the playing field? Can “peak experience” be packaged and sold?

A few highlights from today’s Generosity:

People want to live longer and better. When they can do both, they will. Ethics is just going to have to catch up.

…we might still become the authors of our own lives.

One glance at the only available planetary future made having children at best
benighted and at worst depraved. Nulliparity— human build-down— was a moral imperative… she was already a member of the Voluntary Human Extinction Movement.

Resolved: the human race would have been better off if the agricultural revolution had never happened. Resolved: the government should cap the salaries of professional athletes… Resolved: the human race will not survive its own ingenuity. Resolved: the cure for our chronic despair is just around the corner… Tonia Schiff can make the most cataclysmic debate almost as entertaining as reality itself.

Candace helps students understand that feeling good about themselves is more important than being “perfect…”

It took the species millions of years to climb down out of the trees, and only ten years more to jump into the fishbowl.

“If I knew a drug that produced sustainedintense, level, loving well-being without any trace of stupor or edge, I’d take it myself.” She cocked her head and twisted her lips. “You’d have to. Everyone else would already be on it.”
You have cause — so have we all — of joy.
Does generous [heart, joie, expansion, big feeling] include all those who are by nature genuine, generative, anyone pregnant with connections, keen to make more kin?
     Or is generosity a question of having the right blood, the innate germ of the genteel gentry?
Enough philosophy; she has sworn off it. Philosophy never consoled anyone.
I’d spent my whole life coming here, and now I was home. Everyone alive deserves to feel that way once.
Only once?
And so we’re off to BNA. Happy flight, kids. Walk on air.

Enhanced, but… improved?

April 10, 2013

We’re on in Bioethics to Michael Sandel’s The Case Against Perfection: Ethics in the Age of Genetic Engineering (“The Ethics of Enhancement”) and Richard Powers’ Generosity: An Enhancement.

“Enhancement” is the inescapable issue here. Enhanced for what, to what end, with what rationale?

In Enough: Staying Human in an Engineered Age, Bill McKibben imagines several responses. Perhaps the road to enhancement will take us to Enchantment too, and answers (at last!) to the philosophers’ perennial questions.

  • Where did the universe come from?
  • Why is there something rather than nothing?
  • What is the meaning of conscious existence?

“Not to be impolite, but for this we trade our humanity? Sure, these questions are important, especially the last one. But they’re not all-important.” Are we happy? might just be a better one.

What’s ultimately problematic about enhancing ourselves and our progeny, aside from legitimate worries about equity, democratic opportunity, and enhancement for all? Sandel is concerned for our freedom and dignity, for the “moral status of nature” and the “given world.” He’s worried about the prospective sacrifice of our humanity for something  less intrinsically meaningful and more divisive.

Powers is concerned for the fragility of happiness, and seems eager to impress upon us all a consciousness of ourselves, at this specific moment of natural history, as the collaborative authors of a future to whose inhabitants we owe the greatest generosity (which we can pay only in the coin of responsibility in the present).

Sandel begins with the case of the deaf lesbian couple who wanted a child “like themselves” (i.e., hearing impaired) and so arranged it, with a strategy “not very different from what straight couples do when they have children.”

Well, that could be the problem. Emerson long ago scolded parents who insist on reproducing “another you,” when “one’s enough” already. The problem’s in the will to design, rather than accept the genetic lottery’s default. “None of us chooses our own genetic inheritance,” nor should any of us have to accept the choices of parental engineers

And yet, “Viagra for the brain” sounds irresistibly alluring to some of us. “Memory suppression” too.

But as a parent who’s already spent a small fortune to educate the next generation, I’m definitely not interested in “hormonal arms’ races,” height extension, gender selection, or anything else in any Gattaca scenario. “They used to say that a child conceived in love…has a greater chance of happiness. They don’t say that anymore.” Well call me old-fashioned, I still do. [MoreIt’s Time to Question Bio-engineeringPowers@dawn/DS]

As for our playfully self-conscious novel, with its Camus epigraph, Sisyphean theme, and protagonist called “Stone”: the early stage-setting of Generosity comes with a foreboding warning (but also a reminder that we’re involved here with a story, a work of the imagination still subject to human choice and will): “Here… is one plot no one will ever bother writing down: A happy girl passes through the world’s wretchedness and stays happy.” Happy, generous, and present.

But do remember: this is fictionSo far.

Slow down, we move too fast

April 8, 2013

Time already (at last?) for our final quartet of bioethical cases and cautions from Glenn McGee. (I look forward to the revised and expanded edition.)

Case 57 prudently cautions against the “Kevorkianization” and “reality TV”-ization of cloning. Glenn says Ian Willmut should not have used that term to designate the procedure of  cellular nuclear transfer (“the most revolutionary and complex exercise of human procreative control in history”), should not have named his mammary cell-based sheep “Dolly,” and should not have embraced human reproductive cloning just when he did, amidst swirling debates on abortion and stem cells. Evidently he should have consulted a Bioethicist first.

Is it just me, or do the (mostly) stem cell-centered discussions here at the end feel more dated than their precursors? Like an uninvited blast from the Bush-era past, and Professor William Hurlbut gets way more than his eponymous fifteen minutes. He was the (Bush-era) Council on Bioethics member who proposed Altered nuclear transfer (ANT), aka “semantic nuclear transfer” (and “stupid nonsense,” and “snake oil,” and “voodoo”). It’s a “bogus” and “political” proposal. (Cue Tom DeLay, Jeb Bush, and former-Senator Frist…) There’s not much recent public discussion of ANT, that I could find. [Stem cells at TEDGina Kolata nytNIH on stem cellsWhat’s Next for Stem Cells & Regenerative Medicine? Sciam]

Just one last question, from the last case: “the biggest program in the nation in bioethics… would serve the public interest,” wouldn’t it?

And then Glenn’s conclusion cautions smartly, in the perfect set-up to our next and last texts this semester: let’s try to “slow the speed at which science advances.”  We must give bioethical discussion time to catch up to the pace of biomedical and biotechnological innovation. Let’s listen to Michael Sandel and read Richard Powers.

Next: The Case Against Perfection: Ethics in the Age of Genetic Engineering and Generosity: An Enhancement.