Bioethics and The Public Interest

A Journal’s Lasting Legacy
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For forty years, some of the best commentary on American public policy could be found in the pages of The Public Interest. To the dismay of its many grateful readers, the journal was shuttered in 2005. Though most famous for its role as a measured critic of the modern welfare state and the early home of neoconservative thought, one of the magazine’s most lasting contributions was its publication of some of the most important thinking on the moral challenges of modern science, especially those posed by man’s growing biotechnological mastery over body and mind. A recent conference at Princeton University provided the occasion to reconsider the journal’s legacy and influence. Diana Schaub, a professor and chairman of the department of political science at Loyola College in Maryland, and a member of the President’s Council on Bioethics, spoke about bioethics and The Public Interest. Her comments are excerpted below.

While “bioethics” is a relatively new coinage, serious thought about what technological advance might mean for human life is not a new activity. Aristotle, for instance, in the first book of his Politics, mentions the possibility of automation. “If each of the instruments were able to perform its work on command or by anticipation,… so that shuttles would weave themselves … [then] master craftsmen would no longer have a need for subordinates, or masters for slaves.” Aristotle can imagine mechanization and robots making underlings obsolete, but for him the possibility is so remote that he associates it with the god Hephaestus and the legendary craftsman Daedalus. What for Aristotle was largely a thought experiment eventually became a perceived social crisis. The first issue of The Public Interest in 1965 had two articles on “The Great Automation Question,” examining the displacement of human labor first on the farm, then in the factory, and eventually in the office.

In some sense, every technology is biotechnology, since every technology will have implications for our manner of life. In its origins, the Greek word bios referred not to animal life or mere aliveness (the word for that would be zo-on as in zoology), but rather to a course of life or a manner of living. One is alive, but then that life must be lived. As young people so trenchantly express it: “Get a life!” Their sarcasm conveys a moral judgment. Human beings don’t just live in the zoo. They seek to lead lives (and have bios) worthy of biography, as in Plutarch’s Lives of the Noble Greeks and Romans. “Bioethics” and “biotechnology” may be neologisms, but bios has always been intrinsically connected with ethos and with techne.

Many of the best articles in The Public Interest on the problems of technology — on topics like pollution, global warming, and the environmental movement — may fall outside the charge of, say, the President’s Council on Bioethics, but they still have some claim to consideration under the rubric of “bioethics.” These are all questions concerning technology and its import not only for the human future, but the future of the biosphere. The planet as a whole has a biography which is being written, and perhaps rewritten, by our species. One of the first articles along these lines, entitled “On Making the Future Safe for Mankind” (published in the summer of 1971), took a decidedly anti-growth, anti-technology stance, describing the automobile as “the greatest disaster to have befallen mankind” and calling for “a wholesale reversal of the powerful trends — technological, philosophical, economic — that began in the eighteenth century.”

The magazine did not regularly present such doomsday views. More common over the years were articles like “The Environmentalist Assault on Agriculture,” “A Sensible Environmentalism,” “How Much Does Global Warming Matter?,” and even “Why Global Warming Would Be Good For You.” Articles like these by and large looked to further technological advance to solve the potential problems of technology. The authors argued that it is, in fact, the affluent society that will do away with noxious effluents; and they denounced the technophobes in the strongest terms.

The judiciously balanced position was articulated by Irving Kristol, the journal’s founder and co-editor, in a 1975 lecture to the Polytechnic Institute, reprinted in The Public Interest in 2001 under the searching title: “Is Technology a Threat to Liberal Society?” There, after revealing that he started out as a physics major, Kristol describes his own Socratic turn: “after one year of studying physics, I discovered that physics was very hard. So I decided to be an intellectual instead.” We are all the beneficiaries of that shift in life course from natural philosophy to political philosophy. He then diagnoses the nature of the technological threat:

Scientists and engineers … have the inclination to think that the world is full of “problems” to which they should seek “solutions.” But the world isn’t full of problems; the world is full of other people. That’s not a problem, that’s a condition. Politics exist precisely because the world is full of other people. These other people have ideas, different ways of life, different preferences, and in the end, there is no “solution” to the existence of other people. All you can do is figure out a civilized accommodation with them.

In the end, Kristol recommends liberal education for scientists in order to harmonize science with liberal society. He writes:

And this may well turn out to be the biggest single challenge facing the scientific community — its own moral education, its own assumption of moral responsibility for the use and abuse of scientific knowledge. For this, you need an education not in science but in the humanities, because you don’t get moral education by studying science. You may acquire good moral habits by studying science, but you don’t get a moral education. You don’t learn to think about problems of good and evil by studying science. That’s what the humanities are for. And scientists, I believe, in the decades ahead, are going to have to become much more attentive than they have been to the humanities, in their own self-defense.

The need for a humanistically-grounded science is more than ever apparent in light of new developments in the sciences of biology and medicine. Since the second half of the twentieth century, there has been a revolution in biological knowledge. In 1953, the structure of DNA was discovered. By 2003, the mapping of the human genome was essentially completed. With newfound knowledge has come a remarkable ability to manipulate and transform life: we have organ transplantation, gene-splicing and genetic engineering, in vitro fertilization and the manufacture of embryonic stem cells lines, the cloning of animals and the creation of human/nonhuman chimeras.

Knowledge advances and power expands, but what of wisdom? How will bioethics keep pace with biotechnology? The Public Interest had the answer. The contribution of The Public Interest to bioethical reflection can be summed up in one name: Leon Kass. Of course, Kass was not the only author to address these matters in the pages of The Public Interest, but he is the most significant. Moreover, I suspect that many of the others would be willing to acknowledge Kass’s teacherly influence on their own thinking. All told, The Public Interest ran eight articles by Leon Kass and published reviews of three of his books. In addition, after Kass became chairman of the President’s Council on Bioethics, the magazine published a symposium on the Council’s report on Human Cloning and Human Dignity (with a reply by Kass) and a review of the Council’s report, entitled Beyond Therapy, on the moral meaning of using biotechnology to satisfy certain fundamental human desires. The Public Interest was, of course, not the only place Kass published important articles — Commentary, The American Scholar, and various professional journals have received their share — but it was a regular venue in which he pursued his quest for a “richer” bioethics.

What would a richer bioethics look like? For starters, it would go beyond the liberal shibboleths of safety, choice, equal access, consent, and autonomy. Mainstream bioethics operates within the constricted horizon of liberalism. The object of its ethical reasoning is the autonomous self — that dangerously abstract and almost disembodied entity.

It isn’t just ethical impoverishment that Kass complains of, however. He is a critic of modern biology as much as of modern bioethics. Modern biology, like modern science altogether, is reductive. It flattens life to body. It de-animates. It sucks out the breath, the soul, the spirit. Or, if that sounds a little too ghoulish, perhaps one could just say that modern science ignores the higher aspects of our animation and concentrates on the body understood as matter in motion. Apparently, if life is to be mastered by the science of life, then life must be understood as the sort of thing that can be mastered. It must be defined as something fundamentally slavish — something fully manipulable and controllable. As Kass explains it:

In order effectively to serve the needs of human life, modern biology reconceived the nature of the organic body, representing it not as something animated, purposive and striving, but as dead matter-in-motion.

In one sense, the strategy of abstraction and simplification clearly worked. Modern science has posted significant achievements and acquired tremendous power. The lingering question, though, is whether we have purchased those achievements and that power at the price of our full humanity. Modern man has become both tyrant and slave. From neither position can he achieve much in the way of self-knowledge or happiness.

Kass wants to restore the scientist’s range of vision. He calls for a “more natural” biology and anthropology that would examine the phenomenon of life in its entirety, without the reductionistic blinders on. Jonathan Rauch, in a very fine Public Interest book review, described Kass’s project as “the philosophic reconstruction of natural science.” This new biology would in turn provide the foundation for a new bioethics. The result, according to Kass, would be

a richer ethic of bios tied to a richer logos of bios, an ethical account of human flourishing based on a biological account of human life as lived, not just physically, but psychically, socially and spiritually.

Another way of formulating this would be to say that biology and bioethics should begin not from body, but from embodiment. Given Kass’s interest in the meaning of human embodiment, it is fitting that both his first article in The Public Interest in 1972 and his last one in 2002 dealt with the making of babies. Kass begins where we all once began, with the fact that we are begotten and born. He explores the meaning of procreation and the human significance of sexual reproduction. He articulates the links between sexual reproduction and the ground and purpose of the human family, the continuity of the generations, the formation of individual identity, and the meaning of our freedom and our mortality. He shows how the low and the high, the animal and the rational, are inextricably linked together. For compound beings like us there is a continuum from the elemental to the transcendent.

Kass explores how that continuum might be altered by a shift from the begetting and bearing of new life to the manufacture of new life in the laboratory. He sketches what is at stake in the advent of in vitro fertilization, egg and sperm donation, surrogate pregnancy, and perhaps eventually human cloning and artificial wombs. What would it do to the ethos — the beliefs, customs, and habits of a political community — if the substratum of human existence, the family, were to be profoundly altered? What does filial piety mean when one’s father is a sperm donor? Towards whom should a cloned human being feel filial piety?

Think for a moment of the bizarre and baffling situation to which the practice of in vitro fertilization (IVF) has led us. Along with the 170,000 miracle babies born through IVF, the embryos who are their genetic siblings are stacked up in petri dishes in deep freezes around the country. There are said to be some 400,000 of them and we call them “surplus” or “excess” or “spare” embryos. We have started to regard some embryos not as members of the next generation, but instead as “spares” who might as well be put to use as spare parts. We can now manufacture new life not to succeed old life but to serve and sustain old life; new life becomes the research material that will allow us to live longer and more comfortably.

What becomes of America’s constitutional commitment to “secure the Blessings of Liberty to ourselves and our Posterity” when we start to view our posterity as our property either to engineer to our specifications or to destroy for our benefit? Finally, what becomes of wonderment and awe in the face of Nature and Nature’s God when there don’t seem to be any limits upon our assumption of godlike powers?

Along with these inquiries into the meaning of embodiment, The Public Interest published a number of articles dealing with the art of medicine. The seminal work was again by Leon Kass. His 1975 article entitled “Regarding the End of Medicine and the Pursuit of Health” was an exploration of the proper purpose and limits of the medical profession. Arguing that the natural standard of health is what ought to guide care for the body, Kass questioned whether medicine should be in the business of biomedical enhancement or neuropharmocologic happiness or attempting to conquer death. Other boundaries of the medical enterprise were marked out in later articles dealing with doctor-assisted suicide and organ transplantation. (It should be noted that the magazine also published a piece on organ transplantation that took an economistic approach and endorsed at least an indirect commodification of body parts.) The transformation of the medical ethic was also explored in a number of fine contributions on the state of doctoring and nursing by Ronald Dworkin, as well as a series of pieces by various authors that traced the increasing medicalization of many facets of life. We read about “Medicalizing Character,” “Medicalizing Temptation,” and “The Medicalization of Unhappiness.”

The ancient Greeks were well aware of medicine’s tendency to usurp territory. According to an old legend, the great physician Asclepius was struck dead by Zeus for daring to pursue immortality by bringing a dead man back to life. In the absence of Zeus’ thunderbolts, we today rely primarily on self-regulation. We need scientists and physicians to think more profoundly about the use and abuse of their art, and we need a bioethics that can articulate why human dignity sometimes requires setting limits on our biological experiments and biotechnical powers. Inviting such reflection and seeking such wisdom is the achievement of The Public Interest. It may not be remembered first and foremost for its contributions to bioethics, but much of what is best in bioethics first took root in its measured, searching, and yet always lively pages.

Diana Schaub, "Bioethics and The Public Interest," The New Atlantis, Number 15, Winter 2007, pp. 135-140.

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