Life, Liberty and the Defense of Dignity: The Challenge for Bioethics [Englisch] [Taschenbuch]

One person who has done so is biologist and philosopher Leon Kass of the University of Chicago. He has spend a lifetime thinking about, and writing on, the new reproductive technologies and the challenges they present. And he has done so always with a view to the implications for human dignity and freedom. This volume, which includes articles which have appeared elsewhere, contains of wealth of information and ethical reflection on the new technologies.

All the major issues are covered here: cloning and stem cell research, IVF and assisted reproductive technologies, the new genetics, euthanasia and end of life decisions, and other recent developments in biotechnology.

Also carefully discussed are the hard questions: What is the moral status of the human embryo? Should there be limits to where we are heading in biology and technology? Are there areas of mystery in life that science should simply leave alone? Should autonomy, and the modern concept of human rights, trump other social and community concerns? What is the nature of medicine and what are its goals? These and other important ethical concerns are all given wise and careful consideration.

Kass examines the relationship between liberal democracies and the new technologies, for example, offering incisive and cautious reflection. He notes how democracies help create a climate which makes possible the growth of science and technology. But he also warns that without a moral vision of how that technology should proceed, there is the danger of commercial interests and utopian schemes derailing the science into undemocratic ends.

Indeed, since the time of the Enlightenment, an overly rationalist and utopian dream of the perfectibility of man has been pursued, often with disastrous consequences. Only by continually affirming the mystery and sacredness of life, and the dignity and wonder of man, can we prevent such coercive utopianism.

However, as Kass so clearly points out, the real threat is not coercive utopianism, but well-intentioned utopianism. That is, the real dangers come from those who speak of compassion, the relief of suffering and the battle for immortality. Says Kass, "the benevolent uses of humanitarian technologies often have serious unintended and undesired consequences." The promises of the relief of all suffering and the extension of life may sound pleasing to the ears, but can in fact bring bitterness to the soul.

Lost in the discussions of overcoming all problems and eradicating all unhealthiness, is the concept of the human person, of human dignity. To what end should we strive for immortality? What benefit will it be if we can live longer but not better lives? It is living well, not just living longer, that should preoccupy our minds and dreams. Yet the modern quest for perfection rarely addresses those more important concerns. Indeed, the modern rationalistic and secular march of science and technology often deliberately eschews any moral or religious considerations.

The whole problem of designer babies is another outcome of the new technologies. We now have the power to determine in advance how a baby can and should live. We not only have the power to change an individual's life through the new genetics, but generations to come. And with the new genetic medicine comes the power to decide who will live and who will die.

As we redefine a human being in terms of his or her genes, we run the risk of "justifying death solely for genetic sins". Genetic reductionism makes it easier, not harder, to allow experts and scientists to make the difficult choices of who is allowed to live. Eugenics, even if done with the best of intentions, is still eugenics. And the new eugenics is not so easily discerned, when it comes hidden behind a white lab coat or in an attractive fertility clinic.

The pressure of science and Big Biotech to simply do whatever can be done, without asking whether it should be done, will only continue. Especially when sold in the guise of relieving suffering, or offering more lifestyle choices. We have, as Kass says, the "biomedical equivalent of a spiraling arms race" where research and technology seem to know no limits. The consequences are frightening.

Kass concludes by acknowledging that he is not a Luddite, that there has been much good to come from the new technologies. But there is much to fear as well, especially if our scientific advances are not coupled with moral and spiritual growth. A perfect body, with a hole in the soul, may not be progress, but an unspeakable regress.

Which way the future unfolds is an open question at this point. The future in many ways is up to us. Do we allow a future with dignity and freedom, or do we passively accept the dehumanisation and depersonalisation that comes with unbridled scientific advance? The important warnings offered here need to be read and heeded, if we are to advance on the right course.

Dr. Kass is an MD by training. He then went on to become a Professor at the U of Chicago with the Department of Social Thought (not a lecturer). While at the U of C, I never once saw him "prancing around," though he did once have a book signing - which seems normal for people who do things like, say, write books. His views would be considered by most to be conservative and thus "right-wing" since to people such as Durfee, the two are exactly the same. His views are thoughtful, though, and should be considered by anyone with an open mind. I imagine Dr. Kass has had to discuss his views with patients who suffer from neurologic diseases and doubt that he has any difficulty doing so. As a pathologist who sees all the horrible cases a hospital has while interacting with many scientists, I don't find it difficult to tell people certain treatments are morally wrong, and I have no where near the intellectual fortitude of Dr. Kass. Finally, I doubt if Dr. Kass works any less hard than Mr. Durfee's scientists who are "working overtime" and "toiling hours away." Mr. Durfee is either a scientist with an over-inflated idea of himself or an idealogue who has no idea how hard or why most scientists work. Mr. Durfee's biggest complaint is that the book has somehow insulted him. He has obviously not read it and instead insults anyone who might question the use of the sick and dying to justify all methods of scientific research.

Like his previous books, this book is timely and well-written. It is accessible to most people (who actually take the time to read it). It provides cogent arguments against some methods that many have come to agree with for the sake of the sick. It should be read by anyone who believes that the means are not always justified by the end and who is open to intellectual argument.

About half of this book deals with abstract, and half, concrete, issues. His abstract sections I was almost in total agreement with. Ethical philosophy, he writes, long ago lost track of how to deal with issues rather than theories, and real peoople rather than 'rational man' constructs. Minutia is argued on a quest to develop a consistent theory of the human right and good. BUT NO SUCH THEORY NEED TO BE CREATED! We are dealing with people who make most decisions on a hearty combination of feeling (not amenable to intellectualization) and rational thought. This is where Kass comes from.

Add to this that biology has gone on so well with the reductionist program that even it has started to lose track of how to deal with the whole person. Like wantling to understand a person-in-full by studying the small minutia of their lives seperately, event-by-event; you won't get the feel of the whole person that way; she must be studied as a whole person. Biology, by breaking us down to the smallest constituent parts, don't explain us, so much as break us down to the type of bite-sized chunks they find helpful in THEIR studies.

So Kass starts from the philosophy of the whole person. It is here that I feel he uses this more as an excuse to be inarticulate than a tool to REALLY examine the issue. Whether it is cloning, euthenasia, the selling of organs; he keeps taling about how our human dignity is threatened but never even attempts to explain what in the world he means.

He argues that our instinctual revulsion to such processes may reflect a deeper wisdom that intellect can't articulate. But didn't we also feel revulsion to the idea of heart transplants too? Many of us feel revulsed by the very idea of surgery (going under the knife and all). Does that mean that we are expressing a 'deeper wisdom' and should not have surgury at all? I think our revulsion to biotech comes more from the thought of the unknown and our desire to hold on to the "natural order of things".

Life, he tells us, is precious. Thus, we must be very careful with how we treat it. I agree. But why does it follow that we have to, then, leave birth up to the chance process that causes miscarriages, deformities, premature deaths, and...let's be honest...unwanted babies that may well grow up to abuse? And why does it follow that an old woman who is nearing a painful end to her life (with only a glimpse of hope for recovery) be made to live out her last days when she wants to end it?

To be sure, there are quite a few philosophers who are just as sensitive to human dignity as Kass is who take the opposite conclusions. John Lachs ("Community of Individuals", "Relevance of Philosophy to Life") and Sidney Hook ("Convictions") are two notable examples.

To close, though I agree with Kass's theoretical goals, I disagree on virually everything else. This book, though, is professionally writte, gives some (some, that is) strong points and never comes off as zeolous, abrasive, or mean-spirited toward critics. Read this - even if you don't agree with Kass.