Ethics

by hilzoy

In a comment on another thread, Phil asked what I thought of this op-ed on stem cell funding, by Sen. Sam Brownback. What follows is the op-ed, with my comments.

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by Charles

Last Saturday, while driving home from my session with the OFMBA*, I heard the most enlightening segment about George Washington on NPR’s Weekend Edition.  It reminded me, yet again, that our country couldn’t have been more fortunate in having an extraordinary man such as Washington as our first president.  The transcript is below the fold, without further comment.

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by hilzoy

I’m trying to get a handle on conservatives’ views about virtue. I’ve been puzzled for a while, but I only entered full bewilderment when Bill Bennett published his annoying book The Death of Outrage, which argued, iirc, that the fact that more people weren’t willing to impeach Bill Clinton just showed that we had completely lost our moral compasses. I said to myself: huh? The mystery deepened when I heard such moral paragons as Rush Limbaugh going on and on about liberals and our lack of concern about morality, and when “moral values” started to be used as though it meant not generosity, decency, kindness, courage, and honor, but a willingness to deprive gays of everything from civil rights to ordinary human kindness.

I mean: I, an ethicist, was baffled. I read and reread Kant and Aristotle and even Edmund Burke, but it still didn’t make any sense.

I was particularly puzzled by conservatives’ views on courage. When Max Cleland lost his limbs in Vietnam, “there was no bravery involved.” Despite having volunteered to serve in Vietnam and receiving a bronze star and three purple hearts, “John Kerry is no war hero.” Apparently, conservatives do not count physical bravery as courage, for conservatives. Nor do they seem all that enthusiastic about moral courage — the willingness to stand up for what you believe in, even when it’s unpopular — to judge by their treatment of apostates in their own ranks.

So what, exactly, do they mean by courage? It’s a puzzlement. Luckily for me, a RedState diary explains all. I will display my own bravery below the fold.

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by hilzoy

Robert George and Eric Cohen have a very disingenuous op-ed on stem cells in today’s Washington Post. They start out by describing the Korean stem cell scandal, in which Hwang Woo Suk, a Korean researcher who had claimed to clone human embryos, turned out to have faked his research. George and Cohen note that “some dismiss the South Korean fraud as the work of a few bad scientific apples”. That “some” includes me. I think that the fact that one researcher seems to have engaged in egregious scientific fraud does not carry any wider implications about stem cell research, any more than the forgery of Hitler’s diaries implies that the study of history is inherently corrupt.

Silly me! As George and Cohen explain:

“In the end, the lesson of the cloning scandal is not simply that specific research guidelines were violated; it is that human cloning, even for research, is so morally problematic that its practitioners will always be covering their tracks, especially as they try to meet the false expectations of miraculous progress that they have helped create.”

Really? I can see arguing something like this about, say, Josef Mengele. Someone who routinely killed his subjects, performed unanaesthetized and unnecessary surgery on them, and in one case sewed a pair of twins together in an effort to create Siamese twins, cannot possibly have straightforwardly believed that what he was doing was morally unproblematic. Mengele had to either believe, explicitly, that what he was doing was wrong, or else be hiding the truth from himself. In either case he would have to have completely ignored his conscience. And someone who can completely ignore his conscience in one part of his life would be more likely than other people to ignore it elsewhere. Or so one might argue.

Whether or not this argument works, though, you can’t make it about people who sincerely believe that what they are doing is right, not because they are hiding from the awful truth, but just because they honestly don’t see anything wrong with it. Stem cell researchers generally do believe that what they’re doing is not morally wrong, and they believe this because, according to them, there really is no problem with killing a five-day-old blastocyst. To say that stem cell research is morally corrupting despite this fact would be like saying that gays who are not tormented by guilt because they do not think that being gay is wrong are nonetheless more likely than other people to rob banks. After all, an anti-gay activist might say, I believe that homosexuality is wrong, and people who do one wrong thing are more likely than other people to do another. That’s just silly.

Oddly enough, though they spend about half of their column on the Korean scandal, George and Cohen’s point isn’t really about that scandal, or even about what they call “research cloning” and the scientific community calls “somatic cell nuclear transfer” (SCNT). It’s about three bills that will shortly come up before the Senate:

“Last week the Senate agreed to consider three bioethics bills: one that would permit federal funding for research on embryos left over in fertility clinics, one that would prohibit fetal farming and one that would fund various alternative methods of producing genetically controlled, pluripotent stem cells — just the kind of stem cells we would get from cloning, but without the embryo destruction.”

The supposed relevance of the Korean scandal to these bills is as follows. Researchers have said that SCNT would be helpful to them. This is true, for reasons I explained here (scroll down to ‘The Main Issue’.) George and Cohen draw this conclusion: “If cloning is really so important for research, then overturning the Bush administration policy to fund research on “spare” IVF embryos is not very useful.”

Let’s consider a few analogies to this alleged argument.

(1) “If microscopes are really so important for research, then buying Petri dishes and cell culture medium is not very useful.”

(2) “If having working brakes is so important for a car, then having an engine that actually runs, or a steering wheel that can steer, must not be very useful.”

(3) “If having a cool haircut is so important to teenagers, then they must not care very much about wearing cool clothes.”

Newsflash: it is possible for two things to be important for one purpose at the same time! It’s amazing, I know, but trust me on this one: the fact that I would be very happy if the air conditioning guys called me back does not mean that literally nothing else would “be very useful” to me. Maybe I, and stem cell researchers, are just very demanding people, and that’s why we are capable of finding not just one but several things useful, all at the very same time. Or maybe that’s how human life works, and George and Cohen are just being disingenuous.

***

About “fetal farming”: I’ve been reading scary references to “fetal farming” for several years now, all of them in pro-life publications. Every now and again, I ask some of the stem cell researchers I know whether they have any idea what, exactly, “fetal farming” might be, and they just look bewildered. As far as I can tell, what people who use the term seem to have in mind is this: we create a cloned embryo with some genetic profile that we want. We then implant it in a woman’s uterus, and let it grow for a while, until it has reached the specific stage we need it to get to. Then we abort the fetus and harvest its tissue.

Right.

I have no problem whatsoever with banning the implantation of any cloned embryo, ever. That’s fine by me*. Moreover, it’s also fine with the research community, which has consistently supported a ban on implanting cloned embryos, and on keeping them alive for more than fourteen days. (This is partly because you can’t get embryonic stem cells from an embryo that’s more than five or six days old.) George and Cohen seem to think that this is just a temporary ruse — that once researchers gain the ability to engage in somatic cell nuclear transfer, they will turn their attention to legalizing “fetal farming”. To which I can only say: well, let’s finally enact a ban on implanting cloned embryos, and then we can see whether or not George and Cohen’s dark imaginings actually materialize. While we’re at it, we could also ban harvesting fetuses to make cunning little fetus-skin coats, just to be on the safe side. After all, you never know what those scientists might be up to next.

George and Cohen’s final point is to recommend work on so-called “alternative methods” of deriving embryonic stem cells.

“Instead of engaging in fraud and coverup, or conducting experiments that violate the moral principles of many citizens, we should look to scientific creativity for an answer. Since the cloning fraud, many scientists — such as Markus Grompe at Oregon Health & Science University and Rudolf Jaenisch at MIT — have been doing just that. And others, such as Kevin Eggan at Harvard, may have found a technique, called “cell fusion,” that would create new, versatile, genetically controlled stem cell lines by fusing existing stem cells and ordinary DNA. Scientists in Japan just announced that they may have found a way to do this without even needing an existing stem cell line.

In other words: all the benefits of research cloning without the ethical problems.”

I have nothing against funding research into these methods provided that this is not seen as an alternative to funding embryonic stem cell research. Some of the techniques seem unlikely to work, and some represent no moral advance over SCNT, since they require the destruction of a being that could develop into a human child. (See here (subscription wall, alas) and my slightly out of date explanation here.) Kevin Eggan’s technique requires the use of embryonic stem cells, and moreover yields cells with twice the normal complement of genes, which makes them unusable in therapy. From the NEJM (sorry, subscription):

“There is some risk that people who are seeking to place restrictions on research into the biology of human embryonic stem cells may misinterpret these findings, arguing that the new technique represents an alternative approach to the generation of “chromosomally tailored” human embryonic stem cells that have therapeutic potential. Kevin Eggan, one of the investigators in this study, says he is “very disappointed” by this prospect and emphasizes that the study “does not deliver a methodology that can replace human embryonic stem cells.” Although this finding will inspire further studies to identify and determine the mechanism of action of the critical factors that reprogram chromosomes, the hybrid cells cannot generate embryonic stem cells and, because they are tetraploid, their therapeutic potential is nil.”

Oh well.

The last technique mentioned by George and Cohen was announced (sorry; subscription again) just a week ago, and the experiments behind the announcement have not yet been published. It sounds very interesting, but it’s hard to evaluate without more information. According to scientists who were at the meeting where this result was announced,

“But scientists caution that Yamanaka’s report has not eliminated the need for work on embryonic stem cells. Researchers must test the same four factors in human cells. And it is not entirely clear whether the reprogrammed cells can do everything that embryonic cells can. Although many of the genes they express are the same, many are not.

Yamanaka’s report came just a day after the US Senate said it would vote on relaxing rules on embryonic research later this year. Some have argued that progress in reprogramming has made work on embryonic stem cells unnecessary, and they may seize on Yamanaka’s work to bolster this position. But scientists at the Toronto meeting said that would be a mistake.”

I don’t know Eric Cohen’s work very well, but I normally respect Robert George. I don’t think that this column, with its lack of decent arguments and lurid fantasies, is worthy of him. There are serious debates to be had on this topic, but this column doesn’t contain any of them.

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by hilzoy

In a comment on an earlier thread, DaveC asked me to comment on the case of Andrea Clark, a Texas woman whose hospital had planned to discontinue life-support treatment. Yesterday, the hospital decided to continue treating her. But that doesn’t make the underlying issues go away, and since this is neither the first nor (in all likelihood) the last such case, I’ll discuss them below the fold. But it’s important to recognize one crucial point about cases like Andrea Clark’s: They are not about whether or not a hospital can decide to kill people. In this country, no hospital can do that legally. They are about whether a hospital should be required to go on providing care that it believes is futile.

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by hilzoy

When I ask myself what exactly is it that makes killing a person such a terrible thing, the answers I come up with generally involve the possession of consciousness or sentience. It’s a terrible thing to cause someone pain, as killing her often does. It’s worse to kill a being who can feel not only pain but emotions, and who can participate in social relationships. And it’s worst of all to kill someone who is capable of autonomy: to cut short the story that someone is trying to tell with her life, or to pull the curtain down on all her hopes and plans and dreams. She has the right to decide what to do with her life, I think; and for someone else to barge in and end it without consulting her — to tear apart the web of relationships, aspirations, idiosyncrasies, and so forth that is her life, and to ignore completely her right to decide for herself what to make of it — is unconscionable.

I could go on and list more reasons for objecting to killing people. All the items I could list, however, require the possession of some sort of sentience or consciousness, or on the fact that the person in question has developed sentience or consciousness, but has temporarily lost it. (Thus, it is wrong to kill someone who is in a coma, since this person retains the right to determine what to do with her life, just as she retains, for instance, her property rights, or her marriage. It does not follow from the fact that someone can remain married while in a coma that someone who had been in a coma all her life could get married. Likewise, I think, for the right to autonomy: it is retained when all consciousness has been temporarily lost, but is not possessed by those who have never been conscious to start with.)

For this reason, I think that there is no reason to object to think that abortions that take place before the earliest point at which these sorts of considerations kick in are morally wrong*. The first to appear is the capacity to feel pain, and it probably does not occur before the third trimester. The third trimester begins at 27 weeks; according to the CDC (PDF: Table 16, p. 166), 98.6% of abortions in this country are performed before the 21st week, and 94% before the end of the first trimester. So even if, to be on the safe side, I were to conclude that abortions after, say, the 22nd week were immoral, the vast majority of abortions in this country would still be OK by my lights.

Not everyone agrees, of course. But it’s harder than you’d think to be consistently pro-life.

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by hilzoy

Once upon a time, I went to a gathering of liberals and conservatives that was intended to promote dialogue and understanding between the two groups; and I was struck by the fact that whenever someone learned that I was an ethicist, they immediately assumed that I was a conservative. This seemed odd to me: it was several decades over a decade* ago, before ‘moral values’ had emerged as a political term, and at that point I couldn’t imagine why anyone would suppose that conservatives had a lock on moral values.

(This was not just partisanship, or a reflection of the fact that my moral beliefs underwrite my political views. It was also due to my having spent several decades being lectured by conservatives about my “excessively idealistic” views — e.g., about how it was silly to think that we shouldn’t support, say, Guatemala in the early ’80s “just” because it was murderous and repressive. It was genuinely surprising to discover that the very people who had made these arguments were regarded as champions of morality.)

These days it’s more obvious why someone might think that. But it’s deeply regrettable. There is a straightforward moral case to be made not just against the current crop of Republican politicians, but also, I think, for liberal values. But as long as we cede moral language to conservatives, we will not be able to make this case effectively. Nor will we be able to speak to the legitimate fears of people who (correctly) think that morality is extremely important, who are worried that it’s under seige, and who (mistakenly) suppose that only conservatives are willing to speak up for them, or that defending morality involves an obsession with preventing gay marriage, or something like that.

If we want to reclaim moral language, however, we need to get comfortable with the idea of making moral judgments. Some of you already are, of course, but some of the reactions to my Evil post made me think that some of you are not. Therefore, I have written a short primer. It’s meant for those who are not fully comfortable making moral judgments, or using the language of morality. Many of you probably don’t need it. It also contains only the issues that happened to occur to me. I’ll write about others on request.

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by hilzoy

(Warning: not everyone will find the topic of this post at all interesting. Nor should they: there’s no reason that I can see why anyone has to know or care what philosophy is or how it’s done. Unless, of course, they want to publish something about it…)

I have this peculiar idea that when I write about something, I should either know what I’m talking about or say up front that I’m just speculating. It is, I have always thought, a part of being responsible: I should not present my guesses as if they were facts, especially when someone might read what I say and think I know what I’m talking about. Evidently, however, this is just one more bit of evidence that bloggers don’t hold themselves to the same standards as journalists. At any rate, that’s what I’d have to conclude if I were uncharitable enough to take this article in Slate as representative of journalism.

It’s about something called “experimental philosophy” (or “X-phi”) that, according to Jon Lackman, the article’s author, poses a deep challenge to philosophy. Why?

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by hilzoy

I have a lot of respect for Mark Kleiman, and one of the reasons is that he generally stops, thinks, and considers the evidence before forming an opinion. Not in this post, though. He posts an article by a woman who is looking for a kidney donor over the internet. The article itself is thoughtful and moving. Above it, Kleiman writes:

“I missed the essay below when it first appeared in the New York Times, even though the author, Sally Satel, is an old friend. It’s a story about the power of the Internet to facilitate good deeds.

Naturally, the “bioethicists” are against it. This reinforces my basic belief that “bioethics” should be punishable by prison time.

Note that the current organ donation system, of which the bioethics crowd is inordinately proud because it’s so impersonally “fair,” eliminates any incentive for families or communities to mobilize themselves to get their members registered as organ donors, because there’s no relationship between who donates organs and who receives them. It would be wonderful, of course, if everyone in the world regarded everyone else in the world as infinitely valuable. But since that’s not the case, I don’t see either the moral or the practical case against trying to mobilize particularist emotions in the service of altruistic actions. To focus on the relatively trivial question of who gets the inadequate number of cadaveric organs donated, rather than the vital question of how many people sign up as donors, strikes me as reflecting an astonishing degree of moral blindness.

But of course I shouldn’t be astonished. This is the sort of reasoning that dominates the pseudo-field of bioethics, and has, by infiltrating the Institutional Review Board process, put a serious crimp in both medical and social-scientific research.”

Some problems with this:

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by hilzoy

Via Atrios:

“Encouraging responsibility is not a search for scapegoats, it is a call to conscience. And though it requires sacrifice, it brings a deeper fulfillment. We find the fullness of life not only in options, but in commitments. And we find that children and community are the commitments that set us free.

Our public interest depends on private character, on civic duty and family bonds and basic fairness, on uncounted, unhonored acts of decency which give direction to our freedom.

Sometimes in life we are called to do great things. But as a saint of our times has said, every day we are called to do small things with great love. The most important tasks of a democracy are done by everyone.

I will live and lead by these principles: to advance my convictions with civility, to pursue the public interest with courage, to speak for greater justice and compassion, to call for responsibility and try to live it as well.”
— George W. Bush
***

Matt Yglesias has a very good post:

“The Blame Game: A brief comment on the subject of this game, which, apparently, it’s a bad idea to play. First off — it’s not a game. Assigning blame is a deadly serious matter. It’s also integral to any sort of viable social practice. The criminal justice system relies on assigning blame to various people and punishing them. So does the civil tort system, and so does the non-criminal regulatory system. So, for that matter, does any kind of coherent business or non-profit enterprise — when mistakes are made, you need to decide who’s to blame for them, and ensure that the culpable are sanctioned. If you don’t identify and punish the blameworthy, then people will have no reason to try to do their jobs correctly.

Politics is the same way. There’s a very serious principle-agent problem associated with public policy — the interests of government officials tend to diverge quite sharply from those of the citizens they’re supposed to be serving. This is why dictatorships tend, in practice, to ill-serve their citizens and be beset by corruption, malgovernment, and all kinds of other problems. In democracies we try, through elections and the ability of elected officials to fire their subordinates, to align those incentives. The way that works is that when bad things happen, people are supposed to blame someone, and then elect someone else to replace him. For that to do any good, you need to “play the blame game,” which is to say find out who’s actually responsible.”

Matt is absolutely right. And since thinking about blame, responsibility and guilt is part of my day job (a fact which, oddly enough, has never gotten me eliminated from a jury pool during voir dire), I thought I’d add a few things. And to try to eliminate any confusion arising from the mixed motives people might have in blaming others, I want to start with what we are doing when we blame ourselves.

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