On the Importance of Bioethics

by Tom Anderson

Introduction

Bioethics are a new kind of profession for considering ethical questions in new technology for human health. Since Bioethics have become widespread, I have had a critical stance towards them. My first opinion was that Bioethics could be used by government and religious lobbies to suspend research on important forms of technology, and influence the public opinion to support such agendas.

However, I had to admit I knew too little about arguments and facts propagated by bioethicists to judge about their decisions. I've decided to read papers and detailed Bioethics reports that are objecting to forms of new medical and scientifical advances, prepared to seriously consider arguments about real harms and dangers I might find.

What is ethics?

To understand and define Bioethics, we first have to understand the common definition of ethics. The dictionary definition goes as follows:

1a. A set of principles of right conduct.

1b. A theory or a system of moral values.

2. The study of the general nature of morals and of the specific moral choices to be made by a person; moral philosophy.

3. The rules or standards governing the conduct of a person or the members of a profession: medical ethics.

If ethics are the study of morals and the philosophical process of considering what is moral and what not, then what are the concrete ethical convictions underlying the bioethical evaluation process? If these convictions would be reconsidered and questioned on every decision, or if an arbitrary set of ethics, such as religious ones, are used, the decision process can't be effective. After all, bioethics have become a government-supported field, and are intended to determine public policies, and ultimately, laws that affect all individuals in the country. Therefore, ethics would have to be based on convictions that all individuals agree to. Ethics of objectivist moral definitions could be suitable in this situation, i.e. any action that willingly and directly benefits the well-being of a conscious human being is ethical, as long as it doesn't willingly and directly harm any other conscious human being. But, as long as such a definition is not made and used by bioethicists, we cannot be sure what ethical convictions they are referring to. As I mentioned above, I have read several reports on Bioethics in order to analyze and consider the arguments and warnings without bias to make an evaluation of bioethical claims. What I found in such essays is quite interesting. I've decided I could best mediate this to the reader by quoting certain parts of articles, analyzing and commenting on each. All of the following quotes are from professional bioethicists.

Society demands general respect for the human body and its parts: human tissue should not be used at will or abused. Increasing public concern has been expressed over a number of ethical issues raised by the uses of human tissue as they have developed in the 1980s and 1990s.

An authoritarian writing style is used, containing personal judgments about what society should or should not do, without stating concrete reasons. What are the reasons why human tissue should not be used at will, especially if it can help research or benefit people? Does the volitional use of artificial human tissue in experiments harm the rights of any individual? No. Then what is the reason for public concern, perhaps just the lack of knowledge and serious consideration?

There is an important and urgent need to consider, clarify and, where necessary, strengthen the ethical and legal framework within which the clinical and research uses of human tissue take place.

That sounds a bit like justification of the importance of the own job. The writer talks about an urgent need for good old regulation of private sectors of medical science. It is actually questionable if legal guidelines are needed at all, since the rights of the individual and its well-being are already protected by basic constitutional rights. There has been no past incident of a major purposeful violation of these rights through legitimate medicine or science, and there is no generally accepted and proven scenario on how this could happen in the future. Why the urgency to step in, intervent and regulate?

The legal status of human tissue is unclear.

Not true, considering that transplantations of all kinds have been standard medical practice in the past fifty years. At no point, established medical methods like organ donations, have harmed individuals on purpose or acted against their free will. Why should the legal status of human tissue become unclear again, now that simply different methods such as genetics are being used? In any case, operations occur in agreement with the involved individuals.

[...] Second, a children?s future autonomy interests ground the child?s ability to decide for herself to what extent she wishes to obtain knowledge of her genetic profile. Decisions by adults to test children preclude a child?s ?open future? to decide for herself, absent urgent disease conditions, for which treatment exists. E.g. at reproductive age children may decide for themselves whether to be tested for carrier conditions which they may pass on to offspring.

Agreed, but regarding tests that are relevant to a childs' immediate health, the ability of self-decision is irrelevant. For example, it is a medical necessity to make a thorough medical examination, take a blood test of a new born baby to identify health problems at an early stage, and administer certain vaccines, long before the child can make own decisions. It is even a moral necessity because it ensures the childs health and well-being in the future. Preventing or allowing the genetical equivalents of such medical practice would not be different at all.

The underlying argument, that diagnosis of genetical diseases can be bad if it reveals the imperfections of a human being, is invalid in the long term. In the near future, genetical therapies or modifications will be possible that can heal such diseases, which means the capability to diagnose genetical diseases results in the ability to heal them. If this can be done, it will be a moral necessity, preventing unnecessary suffering.

Genetics education must be required for every physician, ethics training for every young scientist, and reproductive issues training should be given to every minister and politician. These are issues for today. With our attention focused on the technology of the month (in 1997 these included cloned sheep and monkeys, babies from frozen eggs, headless frog embryos, a 63 year-old mother, sperm from dead men, and septuplets) we seldom take the time to accomplish even these contemporary objectives. [...]

What we see here is not more than the creation of an artificial new market niche for Bioethics through cheap, emotion-driven marketing. Can you imagine what would happen if every scientist, every productive in the medical field, and every politician at the levers of regulatory state power, would be required to deal with the vague questions and considerations of Bioethics? It would be a big setback in scientifical advancements, including important ones like cures for cancer, HIV, cellular aging, and germs resistent to modern antibiotics.

What do things like "cloned sheep and monkeys, babies from frozen eggs, headless frog embryos, a 63 year-old mother, sperm from dead men", all have in common? They all sound very scary and horrible to us. Indeed, much everyday routine in the medical profession, such as todays operations, require a strong personality and self-control for people in these professions who daily save human lives. But despite the naturally negative emotions that normal people bring towards some new and old forms of medical practices, these practices cure diseases and save lives, and develop new, better methods for doing so. This is not different with new technology, and if you take the time to rationally consider the above scenarios, they do not harm humans, nor are forced actions against the will of human beings involved; ultimately, they lead to an improvement of human life and well-being, without going against will or dignity of patients.

[...] Bioethics is growing quickly but it is unlikely to catch up with science.

Yes, let's hope it won't.

It is time, I believe, to use some imagination to think about what might come to be in the world of genetics in the next 100 years. Only by looking at the long-term outcomes of our current genetic research will we see the compelling need to confront the most basic questions posed by genetic medicine. And, in any event, it has not escaped the attention of this author that it is no more dangerous to exercise a little imagination about our future than it is dangerous to fail to be prescient about possible surprises, such as human cloning.

Again, with no concrete facts or considerations, convictions are presented in conjunction with emotionalisms and arbitrary personal concerns. Human cloning, by the way, can be a responsible process, if genetical problems can be predicted at an early stage, and for synthesizing body parts for transplantation, especially when it is done for necessary medical purposes. The most radical example is this: cloning of human bodies with blank or nonfunctional brains and central nerve systems could once lead to body transplantation to cure even the most serious forms of illnesses. This sounds like a very new, unknown field, but it could became a medical practice that helps countless people enormously. Also, cloning is a natural biological process for many organisms such as certain microbes and plants. And, to invalidate another boethical argument against human cloning, cloning live humans is not the replication of the identity of an individual. The unique identity is characterized by much more than the genome of a person, and to prove that, we don't have to look further than at genetically identical twins.

There is more than enough ethical mud in genetics of 1998 to keep physicians, lawyers, scientists and bioethicists on guard. A majority are unaware of the progress made in routine and exotic genetics, and most are caught off guard by each new technology.

Nice polemics. You could also say that innocent technological and scientifical research is caught off guard by the Bioethics movement and its urge for endless regulations and attacks.

Costs of genetic services will fall precipitously just as evidence accumulates about the costs associated with having particular genes. Virtually every culture will have to cope with an unparalleled pressure to conserve social resources by applying pressure to individuals in an attempt to modify their reproductive behavior and other life choices.

That's right, because free, unregulated science moves fast and towards ever decreasing prices. Artifically high prices are mainly a result of regulation and economical intervention by forces like the state. If I interpreted the second awkward sounding sentence right, it looks like the danger of overpopulation is being used as an argument against technologies that result in human longevity. Is prevention of overpopulation through blocking scientifical advancements ethically? Judge for yourself, but take into account that the alternative would be tolerance of evitable deaths of human beings for the sake of political correctness. Independently of resource problems that might or might not occur and need to be solved in the future, this just can't justify "ethical" agendas which tolerate the evitable death of human beings.

Eugenics was taught as scientific fact in the world's finest universities until 1945, sanctioned in global court decisions, and led to the sterilization in the 1920s and 1930s of more that 20,000 in the U.S., 45,000 in the U.K. and 250,000 in Germany.

Historical errors in eugenics, that unarguably took place, seem to be the bioethicists' favorite tool against genetical research and similar technologies, but the example of eugenics is irrationally taken out of context if one considers that the only harm caused by eugenics could be caused through forcing and misinforming individuals to use this technology. Forcefully using any technology is as bad as forcefully banning it. Only with political and legal pressure, conceptually flawed eugenics could cause harm by forcing individuals to be sterilized. I'd make any bet that if genetics or other forms of future medical science should ever cause any harm to society, then governmental or other forms of institutional force will have played a main role in causing that harm.

How much should parents be able to use such technologies to design their offspring? What are the moral objections to design of offspring that are most useful in initiating public conversation? The present US and European policies allowing infertile and fertile couples to do as much as they like with genetic testing are rooted in reproductive rights.

How much? To any extend they deem appropriate. How much authority do governments and the public have to tell parents what to do for their child and what not? None. The only moral restrictions that do apply are that parents are responsible for their decisions regarding the well-being of their children. Obviously, parents alone always had and will always have this responsibility for their own children.

And regarding human embryos: at any time the human embryo is a potential human being. But potentiality is not actuality. The embryo in its early stages is not much more or less a human being than human sperm/egg cells before meiosis. The identity of a human being is its way of intelligent, conscious, introspective thinking. For cloned human embryos, sufficient methods already exist to diagnose genetical diseases or problems at an early stage where the human brain, and even the vegetative neural system, a prerequirement for feelings of any kind, has not developed. At this stage, no human consciousness, self-introspectiveness, and similar thinking can exist. Any other claims are rooted in emotionalisms or religious beliefs, which may be tolerated, but which simply cannot be used as a public ethical standards for governing the populace.

Before we can answer such questions there must be a comprehensive global public health effort to regulate the spread of genetic testing, and in particular an effort to establish global cooperation in assessing the efficacy of genetic tests and the relationship between particular genes and environments. There must also be a new emphasis on retraining journalists, politicians, and ministers about genetics so that genetic testing will not always result in hysteria about eugenics.

Bioethics asks a lot of questions about future dangers and implications of science, but today, has given very little answers, especially not in a concrete and rational manner. Ironically, to answer such questions, the only possible route for bioethics would be to advocate unlimited scientifical research. Only then one can observe the factual implications instead of imagining the possiblities. How else could it ever be possible to either validate or contradict what today are not more than speculations?

Should prospective adopters or adoption agencies be able to order genetic tests for children awaiting adoption? Should biological parents be able to order genetic tests for their biological children? Should the same standard prevail for each?

But, more important, should any governmental or religious institution, or any person, for that matter, have the right to answer such questions, make these decisions, and enforce them in the place of parents, sick and disabled people, and generally, other individuals?

The third issue for the future is perhaps the most difficult one. It is clear that the maldistribution of public resources in health care cannot continue in the U.S. or other countries. The U.S. spends billions on genetic research and biotechnology, yet still is unable to spend pennies on public health prenatal services for all pregnant women. Americans spend millions on genetic research concerning intelligence, but find their institutions unable to spend pennies to educate the world's children to the point where comprehensive understanding of, and informed consent for, genetic services is possible.

This is an interesting, valid point that I can agree to. Let's see how it continues:

This is dangerous because it suggests that we hope for a future in which nutrition, education and environmental issues are sublimated to genetics or genomics or gene therapy.

The conclusion is dead wrong, however. The institution in control of the future of these issues in America right now is the US government, since they simply decided to take control of all these issues, which they were never supposed to, or authorized by their own constitution, for that matter. The educational and social systems are not failing because they are doomed to fail, but because the government has no real motivation for doing the best they can. A future privatization of education and healthcare would be best, so private persons, institutions and competitive economy would be in charge of solving these problems, instead of governmental force-backed, slow bureaucratic systems. Therefore, stopping funding of scientifical research, and at the same time stopping and removing any regulatory bureaucracy in these areas, would be a great first step of stopping government interventions into public areas it should never have taken over.

Valid "Bioethics"

The necessary ethical rules for medicine and human sciences were found and established over two thousand years ago, by the first bioethicist, if you want, known as Hippocrates. He claimed that nobody should willingly cause any preventable human suffering or harm. This is the most fundamental rule of medical ethics and the only necessary one. Considered rationally, this does not include the potentiality of harmfulness of any future research, without concrete evidence that can be pinned down by means of science, reason and common sense.

Biotechnology is a growing industry and might soon become equivalent to the IT revolution in numbers of growth. Therefore, perhaps Bioethics does have its place as a profession in the future, but in a different form, being an interesting side-branch profession related to biotechnology in the private sector. Investigation of new trends in Biotechnology to determine the most promising ones, and to consider future prospects and benefits for humanity could be an important task. Also, if left alone by governments, Biotechnology will surely develop forms and systems of responsible self-regulation, much like the existing ones in today's Information Technology.

An example of genuinely responsible and constructive Bioethics can be found at the website http://www.humancloning.org.

The institutions behind Bioethics

The problem with todays growing Bioethics "community" is that it is a rather closed society of mainly government, academia and church representatives, which urges to "promote a public dialogue on bioethics" but doesn't really encourage open discussion - most bioethics sites are known primarily to bioethic lobbyists and government workers.

The United States government was a primary driving force behind the efforts to establish a Bioethics movement. By an executive order of Bill Clinton in 1995, an investigatory "National Bioethics Advisory Commitee" was first founded, originally only for a term of two years. Since 1995, the term had been extended by Mr. Clinton every two years, and the commitee kept growing without much public attention. Today, the commision consists of 6 different subcommitees, for legal issues, theological issues, philosophical and ethical issues, medical issues, scientific issues, and one on social issues. You can imagine how big this bureaucracy is and how much it is going to cost american taxpayers. Also, efforts are being made to drive Bioethics aspects into universities and public education, and everywhere you can imagine.

Further institutions behind the Bioethics movement and regulatory attacks against science and Biotech enterprises are the roman catholic church, academical institutions, religious philosophers and theologists, and the self-proclaimed global guardian of human rights, the UN, which uses UNESCO initiatives to propagate Bioethics and related regulations internationally through their legal and political agendas.

Here is a quote from the disturbing and alarming article, The betrayal of Hippocrates, which I strongly advise you to read in order to find out much more facts about the Bioethics movement than I was able treat under the scope of this paper.

Q: These bioethicists -- is there an actual, for-real academic track for that? Or are they kind of self-anointed?

A: Mainly what it is, is philosophy. There is no licensing to become a bioethicist. A hairdresser has to be licensed; a bioethicist doesn't. There are about 30 university postgraduate courses where people can get masters in bioethics, and the movement is only 30 years old.

Q: So it is not unlike being a reporter. You get to be one by calling yourself one?

A: That's right. It's not like being a lawyer or a doctor. You are one because you call yourself one, and I guess if people pay attention and listen to what you have to say, you're right. And if people don't pay attention to what you say, I guess you're wrong.

Call to public action

Considering the trends I could observe, as well as the future importance of Biotechnology for human life and well-being, I encourage concerned individuals to take action, by voting and speaking out against questionable government practices considering the regulation of medical advancements, and participate in open discussions to bring Bioethics down to the facts and work against the influencing of public opinion, hysteria, and towards the demystification of important technology like genetics, stem cell research, and cloning.

Especially if you are an concerned doctor, medical worker, investor, biotech entrepreneur, or a sick or disabled person in need of new technologies, you should engage in the discussion about new Biotechnology. However, anyone is encouraged to contribute to this effort, as new medical therapies would eventually help anyone, including you, to achieve a better and longer life, or help you against serious disease you might get in the future.

Some of the articles which were quoted as examples in this paper, can be found at http://www.med.upenn.edu/bioethics/02/GeneticsEthicsArticle03.shtml, http://www.nuffield.org/bioethics/publication/humantissue/rep0000000186.html, and http://www.nuffield.org/bioethics/publication/transplants/rep0000000030.html.

Some of the few existing forums on Bioethics in which you may contribute, can be found at: http://www.med.upenn.edu/bioethic/cgi/Ultimate.cgi?action=intro (The forum of the biggest Bioethics site on the web, bioethics.net), and perhaps some forums at http://community.cnn.com/.

You are also encouraged to give your critical comments to sites such as bioethics.gov, UNESCO, and private anti-biotechnology sites like gene-watch.org.

Finally, please help contributing to the effort of urging representatives in the areas of politics, education and public healthcare to de-regulate medical sciences and limit the powers of the Bioethics movement to create and influence legal policies, by signing the online petition at http://www.petitiononline.com/biofree.

References:

U.S. Congress Bill S1595: To provide for the establishment of a Commission to Promote a National Dialogue on Bioethics. List of some FDA raids in the past