Try typing the words “President’s Council” or “presidential commission” into the search engine on your computer. When you hit the Enter key, you’ll find yourself confronted with a bewildering array of results — an endless procession of important-sounding entities whose missions touch upon every imaginable problem facing American society. The operations of the postal service, the assessing of Holocaust assets, the health of children and families, the status of women, the physical fitness of Americans, the state of special education, the causes of the space shuttle Challenger accident, the condition of our “critical infrastructure,” tobacco farming, oceans policy, HIV/AIDS, drunk driving, obesity, alternative medicine, and so on — all these issues, and countless others, have attracted the attention of their own presidential councils or commissions. Doesn’t a subject as enormous and pressing as bioethics deserve at least as much attention?
Surely it does, and the fascinating and valuable work of the President’s Council on Bioethics, under the leadership of Dr. Leon Kass, has more than justified that attention. But it is only when one compares the work of this council to that of its many predecessors that one begins to appreciate the full scope of its achievement, particularly as embodied in Beyond Therapy. Generally speaking, the reports of presidential commissions tend to be windy, self-important, dull, and dodgy. But not this one. It is, to begin with, a remarkably lucid and graceful work, seeking to present a sane and sober account of our present condition, in prose that is accessible to any reasonably literate person. The account it offers is meant both as a contribution to broader public knowledge, and as a necessary basis for making wise collective choices about the advance of human biotechnology. Its release is an act of great public significance, though not for the usual reasons.
That last point is especially important to stress. Some readers will be surprised that this book does not conclude, as most such reports do, with a laundry list of specific expert recommendations. It could have done that. But it chooses to do something seemingly more modest — but actually much more ambitious. It aims to begin a process of educating us, both scientifically and morally. It aims to draw us into a discussion that is already underway, in which our informed participation is absolutely essential. It helps us to imagine, in vivid details that touch upon the most personal dimensions of human life — ranging from our physical capacity to our innermost thoughts and feelings — some of the likely consequences of the paths that we are already traveling, or will be traveling soon. And it forces us to see that we cannot walk away from our choices, or leave them for others to make.
In short, Beyond Therapy aims to provide us, as a nation, with the materials we need to engage in acts of serious public deliberation over these crucial matters. It does not ask us to turn the problems over to specialists who know better than we do — the more typical goal of “expert testimony.” Instead, it shows us that we are faced with problems for which there are no expert answers, problems that we as a people must grapple with ourselves, and decide for ourselves. As such, it aims to affirm, and work on behalf of, the very possibility of a democratic future in the biotechnical age that is now upon us.
To appreciate how boldly this Council’s work has broken with the usual pattern, it may be useful to reflect for a moment on the historical process by which presidential councils and commissions came to insinuate themselves so thoroughly into the texture of our political and social lives. Ultimately, the very ideal of the impartial, nonpartisan, expert commission finds its full emergence in the Progressive movement, which arose in the years between the Spanish-American War and American entry into the First World War, and whose momentum continued to shape certain aspects of the New Deal and many other subsequent liberal reform movements in the United States.
Although Progressivism had various aspects, one of its chief features was its optimistic faith in the power of disciplined intellect to reorder society, and free it of the inefficiencies, inequities, and pathologies that beset it. A powerful and active government was the chief means through which the disciplined intellect could act upon the world, and the burgeoning research universities were the places where that expertise was formed and transmitted. Rule by experts was deemed far preferable to conventional democratic politics, which amounted, it seemed, to little more than a messy hurly-burly of colliding interest groups, with no room for a consideration of the public interest and the general good. How much preferable to live under the rule of accredited, competent, wise, rational, and disinterested leaders, university men trained in the natural and social sciences, including the science of governance, free of the taint of corruption, beholden to no party or interest!
Such, at any rate, were the hopes of influential Progressives. Their viewpoint tended to favor the translation of politics into administration, statesmanship into problem-solving, and competing values into manageable facts. The shift of emphasis was evident at all levels of government. It helped give rise to a profusion of nonpartisan regulatory boards and agencies, as well as such quintessentially Progressive innovations as the city-manager system, which turned responsibility for municipal governance over to a nonpartisan administrator chosen precisely for his supposed remoteness from politics, or the growing use of state and municipal research bureaus to provide specialized research in support of progressive legislation.
Such developments also tended to favor the rise of presidentially or congressionally appointed commissions, which were more often than not tasked with providing disinterested leadership in the investigation and resolution of highly charged and politically fractious problems. The Hoover Commission on the reorganization of the executive branch, created by President Truman in 1947 and led by former President Herbert Hoover, is perhaps the quintessential example of such an initiative. But there have been countless others, ranging from President Eisenhower’s grandiose National Goals Commission, to the Warren Commission on the Kennedy assassination, the Kerner Commission on urban unrest, or more recently, President Bush’s Commission to Strengthen Social Security.
The flourishing of such commissions and councils has been valuable in many respects, but it has not been an unmixed blessing. All too often, such unelected bodies serve to provide politicians with an easy means to punt the hard issues into the arms of “experts,” and thereby subvert the scrutiny, accountability, and public debate that are the essence of a healthy democracy. In so doing, they tend to weaken the capacity for self-government. Indeed, the great paradox of Progressive reform was that a movement enthusiastically dedicated to increasing the public power of ordinary people ended up strengthening the authority of bureaucrats, managers, and specialists instead. That paradox is sadly confirmed in the steady decline of voting and political participation since the reforms of the Progressive era took hold, and by the accelerating readiness of representative institutions to turn political decision-making over to courts, regulatory agencies, and the marketplace.
What does all this have to do with the President’s Council on Bioethics, and the report now before us? This brief glance backward should make it clear how dramatically this Council has broken with precedent, and done something that few, if any, of its predecessors have ever tried to do. It has deployed its own expertise, and the expertise of others, not to propound the “solutions” to the problems before it and thereby remove them from the vagaries of the political process, but to give us an informed glimpse of the complex and far-reaching choices before us. It is not doing so to frighten us, or steer us in some particular direction. There is no hidden agenda. The report’s irenic and tentative tone, and the complete absence of bullet points in its text, should dispel any such misimpressions. Instead, it is doing so to equip the rest of us for the work of genuinely democratic decision-making, for the difficult tasks of self-rule that lie ahead. It reminds us of what we all know, or should know — that the deeper questions raised by the advance of biotechnology are not technical problems to be fixed, at least not in any obvious sense. Instead, they are questions that penetrate to the very heart of our humanity. They are questions that, by their very nature, cannot (and should not) be delegated to others, for they are beyond the competence of any existing expert to judge. It will take all of us, deliberating in good faith, using all our faculties and all our knowledge about the human condition, to decide them wisely.
One of the most formidable barriers to the exercise of democratic self-rule in these matters, though, is a pervasive feeling of powerlessness in the face of biotechnology’s seemingly inevitable march forward. Many Americans have come to believe — some with unalloyed happiness, some with grudging fatalism, and many with fear and trembling — that the momentum of biotechnological innovation is irresistible and unstoppable. Images of genies and bottles, clocks turned back, trains leaving stations, and the like tend to pepper our discourse and justify our passivity in the face of a historical force majeure.
But such an outlook represents a repudiation of the very possibility of self-government, and an abandonment of the very possibility that we have the ability to order our common lives with a view toward the common good. We should not succumb to such fatalism. The march of technology is not an inevitable force, and we owe it to ourselves and our posterity to put up an intelligent resistance to such an assumption. That resistance need not come in the form of a blanket rejection of biotechnology’s amazing therapeutic possibilities, a position that would likely fall short of the standard of intelligent resistance. Instead, we should resist by insisting upon our human fallibility, by never forgetting that all our human actions entail unintended consequences, and by remembering that great evils are likely to come of any enterprise that seeks to ignore or erase the fundamental constraints and normative dimensions of human nature. No theme has been sounded more frequently, and more tellingly, in our Western literary, philosophical, and theological traditions. We would be fools to ignore its ominous testimony.
Much will depend, then, on the wisdom of our choices, and their harmony with our natural endowment. The very fact that we are faced with such choices is a novel challenge. We may soon be unable to rely on necessity to carry the weight for us, and impose the limits that we have struggled against for all the millennia of human existence — the very struggle out of which human life acquires its highest dignity and deepest meaning. Instead, we will have to learn to carry that responsibility ourselves, through our own choices. This is a great liberation, but it is also an enormous, and perhaps crushing, burden. More than any previous technology has ever done, biotechnology challenges us to articulate what it means to be human, to think seriously and deeply about what is entailed in human flourishing, and to structure our lives in a way that permits such flourishing to occur.
That may be an even more difficult task than it seems at first glance, as the text of Beyond Therapy shows us at every turn. Biotechnology may enable us to fulfill many of our liberatory dreams, but in a way that undercuts the very preconditions that made those dreams precious in the first place. Is it I that my lover admires, or is it the collective skills of my cosmetic surgeon, orthodontist, and psychopharmacologist? What are we to make of athletic achievements that are largely the product of re-engineered bodies? What happens to a man when he comes to regard himself as a mere plastic consequence of anterior actions, including conscious acts of self-engineering? How will the possibilities of genetic control over our offspring change the feelings and aspirations of parents toward their children — and children toward their parents?
Compared to these prospects, the hard edge of the old biological determinism may eventually come to seem downright inviting, assuming it leaves some space for at least the illusion of freedom. But all the testimony of human history tells us that human flourishing requires limits, and that we do not really know what happiness would mean in a world without them. “To live without let or hindrance would be life indeed,” wrote George Santayana in his Dominations and Powers. “Yet there is a snare in this vital anarchy. It is like the liberty to sign checks without possessing a bank account. You may write them for any amount; but it is only when a precise deposit limits your liberty that you may write them to any purpose.” So it may be in an increasingly bioengineered world.
So long as the force of biological necessity was relentless and inexorable, most of life’s inherent limits were not limits that we needed to embrace consciously or willingly. That will likely change, as necessity’s empire shrinks. But human kind cannot bear too much plasticity. We may come, as Wendell Berry has predicted, to look with renewed respect upon the Amish, and appreciate them as the pioneering avant-garde in the art of choosing limits. We may find deeper and more comprehensive meaning in our religious traditions of voluntary poverty. And we may gain a deeper appreciation of Edmund Burke’s luminous phrase, “the unbought grace of life,” though we may want to add the modifier “unengineered” to bring it fully up to date.
But all these questions of moral sensibility are dealt with in the pages of Beyond Therapy far more compellingly than they can be treated here. The fundamental point I wish to make about this remarkable report, and the work of the Kass Council, is instead a broadly political one. The challenge of the biotechnological revolution manifests itself in countless ways in our nation and our communities. But it is, perhaps above all else, a test of our democracy, of our capacity to be a self-governed, self-ruled people, with the mind and the will to harness these innovations for the common good, rather than their helpless pawns or paralyzed spectators. By choosing the path it did, rather than taking the more conventional path of offering authoritative expertise, the Council has also cast a vote for the possibility of self-government. It remains to be seen whether we are equal to the challenge.
If it is any consolation, however, there is a sense — and not an entirely fanciful one — in which it can be said that we have been here before. In an utterly uncanny way, Alexander Hamilton’s words at the beginning of The Federalist Papers, advocating the ratification of the new U.S. Constitution and written at a time when none of today’s problems was even conceivable, express very beautifully the essential features of the dilemmas that confront us now:
It has been frequently remarked that it seems to have been reserved to the people of this country, by their conduct and example, to decide the important question, whether societies of men are really capable or not of establishing good government from reflection and choice…. If there be any truth in the remark, the crisis at which we are arrived may with propriety be regarded as the era in which that decision is to be made; and a wrong election of the part we shall act may, in this view, deserve to be considered as the general misfortune of mankind.
Beyond Therapy is a response to what is, in a sense, only the latest version of that same crisis, the ongoing challenge of being a self-governing people. We have an opportunity to see if we can make the best use of our growing mastery of nature — or whether we will, paradoxically, become its slaves. To avoid the latter fate, we would be well advised to remember the wise advice of Francis Bacon, that for nature to be commanded, it must first be obeyed. These words may have been even truer than he realized.
Science and Self-Government