Friday, January 16, 2004
Session 5: Toward a "Richer Bioethics"
Council's Report to the President
Release of Being
Human: Readings from the President's Council on Bioethics
Panel Discussion: The Role of the Humanities in Bioethics
Bruce Cole, Ph.D., Chairman, National Endowment for
the Humanities
Paul Cantor, Ph.D., Professor., Department of English,
University of Virginia
Edmund Pellegrino, M.D., Emeritus Professor of Medicine
and Medical Ethics, Center for Clinical Bioethics, Georgetown
University
CHAIRMAN KASS: Good morning. We should get started.
This is the fifth session of the meeting devoted toward our
project, "Toward a Richer Bioethics," celebrating
the release of our — let's call it a report — fourth book,
Being Human: Readings from the President's Council on
Bioethics.
This has been a relatively invisible project of the Council
in the sense that it has been the subject of no formal Council
discussions, though Council members have been consulted at
all stages of the process to make suggestions of readings.
And, in fact, some of the readings in this volume have been
explicitly discussed. And probably 10 of the 95 have appeared
either in comments made in the meetings or in previous publications.
This is a most unusual document for any government body to
produce. And I think it probably deserves some justification,
but I don't want to steal time from the discussion that we
are going to have here this morning. The justification for
it is given in the Chairman's introduction to the volume.
And although we are not anything like a congressional committee,
if members won't mind, I would like to just insert some of
those remarks into the record so they will be part of the
official record of this meeting. The people in the audience
have a copy of the text; they can read it for themselves.
I think the Council members know why we care about this subject.
Questions of bioethics very often come to touch the deepest
issues of our humanity. And the readings from the humanities
are among the best resources we have for thinking about those
things and addressing those questions.
Before turning to the panel, I simply want to acknowledge
the extraordinary work of our director of education, Rachel
Wildavsky, who collected these essays, who served as the general
editor of this volume. Rachel, we're in your debt for a really,
really beautiful project.
(Applause.)
(Chairman Kass asked and received unanimous consent to insert
into the record the following prepared remarks, taken from
his introduction to Being Human.)
BEING HUMAN:
AN INTRODUCTION
by Leon R. Kass, M.D.
Chairman, President’s Council on Bioethics
Why another thick book about bioethics? Why a bioethics reader?
Why a reader on Being Human? And why a reader on being human
from the President’s Council on Bioethics? The short
answer is this: The Council believes that readings of the
sort offered here can contribute to a richer understanding
and deeper appreciation of our humanity, necessary for facing
the challenges confronting us in a biotechnological age. The
longer answer constitutes our introduction to this volume.
We begin at the beginning: What is “bioethics,”
and why do we need it? Bioethics is a relatively young area
of concern and field of inquiry, less than forty years old
in its present incarnation—though many of the questions
it leads to are in fact ancient. In the mid-1960s, following
the disclosure of several abuses here and abroad, ethical
attention first focused on the use of human subjects in medical
experimentation. Intense public discussion established the
importance of voluntary and informed consent, and institutional
arrangements were subsequently developed to protect vulnerable
patients against the potentially excessive zeal of otherwise
worthy experimenters. Around the same time, it also became
clear that advances in biomedical science and technology were
raising—and would increasingly raise—more far-reaching
and profound challenges to familiar human practices and ways
of thinking, feeling, and acting.
By 1970, the effects of the so-called biological revolution
were beginning to be felt. Oral contraceptives, tranquilizers,
and psychedelic drugs were in use, as were cardiac pacemakers,
respirators, and kidney dialysis machines. In vitro fertilization
of human egg by human sperm had just been achieved and the
first heart transplant had just been performed. People were
developing a new “definition of death” that looked
to brain activity rather than heartbeat or spontaneous breathing
as the definitive sign of existing life. Scientists had discovered
a “pleasure center” in the brain, and were exploring
possible uses of implanted electrodes in this area for purposes
of behavior therapy and control. Genetic screening and pre-natal
diagnosis had just arrived, and scientific conferences were
being held about coming prospects for gene therapy and even
about genetically engineered improvements in the human race.
There was great excitement about using the new knowledge and
techniques to cure disease, overcome infertility, treat mental
illness, and relieve much human suffering. Yet at the same
time, people sensed that the new possibilities for intervening
into the human body and mind would likely raise large questions,
not only about safety and efficacy but also about human freedom
and dignity, human self-understanding, and the kind of society
we were bringing into being. No one had yet heard of bioethics
or bioethicists. But their time had arrived.
Actually, the word “bioethics” was coined in 1970
by the biologist Van Rensselaer Potter—to designate
a “new ethics” to be built not on philosophical
or religious foundations but on the supposedly more solid
ground of modern biology. But the term soon came rather to
denote a domain of inquiry that examines the ethical implications
of advances in biomedical science and technology for everyday
life, as well as for law, social institutions, and public
policy. Today, “bioethics” also names a specialized
academic discipline, granting degrees in major universities
and credentialing its practitioners as professional experts
in the field.
Over the past thirty years, the field of bioethics has mushroomed.
It has entertained discussions and debates on moral and policy
issues connected with abortion, fetal tissue implantation,
genetic screening (and privacy and discrimination), assisted
reproductive technologies, surrogate motherhood, embryo and
stem cell research, cloning, gene therapy and genetic “enhancement,”
the use of mechanical hearts or animal organs in transplantation,
the use of performance-enhancing drugs in athletics or psychotropic
drugs for modifying and controlling behavior, living wills
and “Do Not Resuscitate” orders, assisted suicide
and euthanasia, and the merits of hospice care—among
many, many others. Ongoing attention to research with human
subjects has further refined the principles and procedures
needed to safeguard subjects’ rights and well-being.
Hospital-based ethics committees have been established to
deal with difficult end-of-life issues regarding termination
of treatment. Professional societies and biotechnology companies
employ ethics committees to address specific issues as they
arise—say, about whether to practice sex-selection,
or how to insure fair access to the fruits of biotechnical
innovation. Federal legislation has been enacted both to facilitate
organ transplantation and to ban the buying and selling of
the organs themselves. Debates continue regarding remedies
for the inequities of heath care in the United States or the
virtual absence of health care and public health measures
in underdeveloped countries abroad. Today, bioethicists teach
at most medical schools and universities, advise governments
and corporations, and appear frequently in the media. Hardly
a day passes without some topic of bioethical significance
appearing on the front pages of the newspapers. And the President’s
Council on Bioethics is but the latest in a series of national
bioethics commissions charged with offering advice about this
entire set of developments. Bioethics business is booming,
and deservedly so, for there is much of importance at stake.
In creating this Council, President George W. Bush gave us
a broad mandate and, among other charges, a somewhat unusual
responsibility: “to conduct fundamental inquiry into
the human and moral significance of developments in biomedical
and behavioral science and technology.” We are also
charged “to facilitate a greater understanding of bioethical
issues.” Yet, as the Council noted when we first convened
in January 2002, many of the deep and broad human implications
of the coming age of biotechnology are not today receiving
adequate attention. Perhaps it is because the field is so
busy attending to the novel problems that emerge almost daily.
Perhaps it is because attention to devising guidelines and
regulations leaves little time to reflect on the full range
of human goods that we should be trying to promote or protect.
But it may also be that the concerns and concepts that have
come to dominate the discussions of academic and public bioethics,
for all their strengths, do not by themselves get to the deepest
reaches of our subject.
The major principles of professionalized bioethics, according
to the leading textbook in the field, are these: (1) beneficence
(or at least “non-maleficence”—in plain
English: “do no harm”), (2) respect for persons,
and (3) justice. As applied to particular cases, these principles
translate mainly into concerns to avoid bodily harm and to
do bodily good, to respect patient autonomy and to secure
informed consent, and to promote equal access to health care
and to provide equal protection against biohazards. So long
as no one is hurt, no one’s will is violated, and no
one is excluded or discriminated against, there may be little
to worry about. Fitting well with our society’s devotion
to health, freedom, and equality, this outlook governs much
of today’s public bioethical discourse.
Thus, we worry much that human cloning may be unsafe, but
little about what it might mean for the relations between
the generations should children arise not from the coupling
of two but from the replication of one or should procreation
come to be seen as manufacture. We worry much about genetic
privacy and genetic discrimination, but little about acquiring
godlike powers of deciding which genetic defects disqualify
one for birth or about how we will regard our own identity
should we come to be defined as largely a collection of genes.
We worry much about issues of safety or unfairness when athletes
use steroids or college students take stimulants, but little
about the way these (and other mediating) technologies might
distort the character of human activity, severing performance
from effort or pleasure from the activity that ordinarily
is its foundation. We worry much about the obstacles to living
longer, but little about the relation between trying to live
longer and living well.
In a word, we are quick to notice dangers to life, threats
to freedom, and risks of discrimination or exploitation. But
we are slow to think about the need to uphold human dignity
and the many ways of doing and feeling and being in the world
that make human life rich, deep, and fulfilling. Indeed, it
sometimes seems as though our views of the meaning of our
humanity have been so transformed by the technological approach
to the world that we may be in danger of forgetting what we
have to lose, humanly speaking.
To enlarge our vision and deepen our understanding, we need
to focus not only on the astonishing new technologies but
also on those (in truth, equally astonishing) aspects of “being
human” on which the technologies impinge and which they
may serve or threaten. For bioethical dilemmas, though generated
by novel developments in biomedical science and technology,
are not themselves scientific or technological matters. They
are human dilemmas—individual, familial, social, political,
and spiritual—confronted by human beings at various
stages in the human lifespan, embedded in networks of meaning
and relation, and informed by varying opinions and beliefs
about better and worse, right and wrong, and how we are to
live. Often, competing human goods are at stake (for example,
seeking cures for disease versus respecting nascent life);
in other cases, the evils we seek to avoid are deeply intertwined
with the goods we ardently pursue (for example, eliminating
genetic defects without stigmatizing those who have them).
Moreover, both in practice and in our self-understanding,
bioethical issues generally touch matters close to the core
of our humanity: birth and death, body and mind, sickness
and health, sex and procreation, love and family, identity
and individuality, freedom and dignity, aspiration and contentment,
the purposes of knowledge, the aim of technology, the meaning
of suffering, the quest for meaning. A richer bioethics would
attend to these matters directly and keep them central to
all bioethical inquiry and judgment. A richer bioethics would
feature careful and wisdom-seeking reflection regarding the
full range of human goods at stake in bioethical dilemmas.
In all of its work to date, the President’s Council
on Bioethics has tried to practice and foster such an approach.
For the Council, “bioethics” is not an ethics
based on biology, but an ethics in the service of bios—of
a life lived humanly, a course of life lived not merely physiologically,
but also mentally, socially, culturally, politically, and
spiritually. Even as we have tackled specific issues such
as human cloning or the uses of biotechnology that lie “beyond
therapy,” we have sought to probe the meanings of the
intersections of biology and biography, where life as lived
experientially encounters the results of life studied scientifically.
We have sought as best we can to clarify, promote, and defend
“being human.”
Where might we seek help in thinking about “life lived
humanly,” about birth and death, freedom and dignity,
the meaning of suffering, or any of the other marks of a genuinely
human experience? Since the beginnings of human self-consciousness,
these matters have been the subjects of humanistic reflection
and writing, capturing the attentions of great thinkers and
authors. Works of history, philosophy, poetry, imaginative
literature, and religious meditation have pondered and commented
upon—and continue to ponder and comment upon—these
matters. In the Council’s own discussions and reports,
we have on several occasions looked to these works for their
insights and instruction (roughly a dozen of the works included
in this volume have explicitly entered the conversations at
our meetings or the pages of our writings). And each of us
individually, explicitly or tacitly, relies on what we have
learned throughout our lives from texts such as these, as
we grapple with the difficult bioethical issues before us.
Early recognizing the value of such readings, we have featured
many selections “From Our Bookshelf” on the Council’s
website (www.bioethics.gov). Now, “to facilitate a greater
understanding of bioethical issues,” we have collected
and organized them in this volume in the hope that others
may discover for themselves the help that is available from
wise, sensitive, and thoughtful authors, many of whom come
from other times and places. As we strive to stay human in
the age of biotechnology in ever-better and fuller ways, we
must take whatever help we can get in deepening our appreciation
of “being human.”
We do not offer these readings as authoritative or as authorities.
As readers will discover, they differ too much among themselves
to constitute any single coherent teaching. Rather, we offer
them in the wisdom-seeking—rather than wisdom-delivering—spirit,
as writings that make us think, that challenge our unexamined
opinions, expand our sympathies, elevate our gaze, and illuminate
important aspects of our lives that we have insufficiently
understood or appreciated.
Each reading is accompanied by a brief introduction directing
readers toward the bioethical implications of the text, not
by drawing conclusions but by asking questions. As any teacher
knows, most good books do not teach themselves. We are all
frequently lazy readers, who pass off what is puzzling or
unfamiliar, and, even worse, who fail to see the depth in
what is, by contrast, familiar and congenial. Often our prejudices
get in the way. Sometimes, our inexperience blinds us to crucial
subtleties and nuances. Accordingly, we have prefaced each
reading with some observations and questions designed to make
for more active and discerning reading. These questions should
be suitable for discussion by groups reading together or for
study by individuals reading alone. In some cases, where the
text seemed more remote or where we thought it helpful, we
have taken a more didactic tone, asking the reader to come
at the text with certain questions and concerns in mind. We
have done this with mixed feelings; we do not wish to get
between author and reader, nor do we wish to imperil understanding
of texts written by subtler and greater minds because of our
limited understandings and specialized concerns. We thus encourage
the readers to use the introductions if they find them helpful,
but to treat them with the proverbial grain of salt.
Readers will note, though, that in our choice of readings
we have not excluded texts that evince strong moral viewpoints
or that are rooted in particular religious faiths. We have
welcomed all valuable anthropological or moral insights, regardless
of whether they are rooted in religious faith, philosophy,
or ordinary personal experience. Respect for American pluralism
does not mean excluding deeply held religious (or non-religious)
viewpoints or sensibilities. On the contrary, with the deepest
human questions on the table, we should be eager to avail
ourselves of the wisdom contained in all the great religious,
literary, and philosophical traditions.
One of the virtues of an anthology is that readers are free
to pick and choose what they wish to read, skipping around
in no particular order. Yet, as we will now indicate—and
as the introductions to each of the chapters will make even
clearer—there is method in our ordering, and we think
there is additional advantage in following the text straight
through.
It remains, therefore, only to sketch the structure of this
volume. The (ninety-five) readings are divided into ten chapters;
each chapter opens with a brief introduction, setting forth
the topic at hand and providing a synoptic view of the readings
that follow. The ten chapters are in turn arranged in three
sections.
The first section, “Natural Imperfection and Human Longing,”
introduces a central human question that lurks beneath the
surface of many bioethical issues: Which is the proper human
attitude or disposition in the world: molding or beholding?
When and to what extent should we strive to change and alter
nature and especially our own given nature, in an effort to
improve or save it? When and to what extent should we strive
to accept and appreciate nature and our own given nature,
in an effort to know or savor it? This section, comprising
three chapters, also introduces the means we have for acting
upon these dueling impulses and longings: biomedical science
and the art of medicine, both major players in the dramas
of bioethics today.
In Chapter
One, “The Search for Perfection,” readings
explore the age-old human aspiration to improve our native
lot, removing our imperfections and bringing our nature closer
to our ideal. Does our flourishing depend on our ability to
better our form and function? Or does it depend, conversely,
on our ability to accept and even celebrate our natural limitations?
In Chapter
Two, “Scientific Aspirations,” readings from
biographies and memoirs of great scientists explore the motives
and goals of scientific activity. Both as a mode of inquiry
and as a body of knowledge, science has served both human
aspirations—beholding and molding—although its
utility as the basis of technological innovation is one of
the central features of modern science. Yet science is also
a human—and ethical—activity, the fulfillment
of personal human desires. How do scientists themselves see
the relation between theory and practice? What guides their
own scientific quest?
In Chapter
Three, “To Heal Sometimes, To Comfort Always,”
we turn from the pursuit of knowledge to the age-old medical
dream: by means of such knowledge, to bring healing to the
sick and wholeness to the broken, and, in the limit, to perfect
our vulnerable and mortal human bodies. Readings explore the
purposes of medicine, seen from the perspective of doctor
and patient, and examine a vocation not only to heal but also
to care and comfort.
The second section, “The Human Being and the Life Cycle,”
moves from aspirations of and for human beings to questions
about human nature itself: What is a human being? And what
sort of a life have we human beings been given to live? The
four chapters comprising this section treat various aspects
of these anthropological questions, many of them sorely neglected
in much current bioethical discourse: the meaning for our
identity of our embodiment; the tension between change and
stability as we progress through the life cycle; the place
of begetting and belonging in human flourishing, as we live
with ancestors and descendants; and the meaning of mortality
as the ultimate boundary of any human life. The relevance
of these topics to contemporary bioethical arenas such as
organ transplantation, assisted reproduction and genetic screening,
and research to alter aging and the human lifespan needs only
to be mentioned to be seen.
In Chapter
Four, “Are We Our Bodies?” readings explore
the puzzling question about the relation between our bodies
and our minds (or souls). Are we mostly one or the other?
Are we rather only the two of them together? How are our lofty
aspirations related to our “fleshiness”? How crucial
is our body to our identity and worth?
In Chapter
Five, “Many Stages, One Life,” readings ponder
what it means that we live in time, that we both change constantly
yet continue always as “ourselves.” Is there a
shape or meaning to our temporal journey? What sense are we
supposed to make of life’s various “stages”?
What unites the beginning of our lives with its end?
In Chapter
Six, “Among the Generations,” we move from
the life cycle of individuals to their connections to those
who came before and those who come after. Readings explore
the experience and significance of human procreation and renewal,
as well as our obligations to ancestors and descendants. How
important are biological ties to the work of human parenting
and perpetuation? What is the significance of the family tree?
What do the various branches owe to one another?
In Chapter
Seven, “Why Not Immortality?” we move from
procreation to a more radical response to our finitude: the
quest for personal immortality. The readings consider various
expressions of, and responses to, this ancient human longing.
How does this longing affect the way we spend the time of
our lives? What does it imply regarding the goodness of terrestrial
life? Is mortality only a burden or also a blessing? Does
the answer depend on the truth about an afterlife? Would our
longing for immortality be satisfied by having “more
of the same”? Do we long for an endless existence or
for a perfected one?
The third section, “Cures, Improvements, and Their
Costs: Virtues for a Richer Bioethics,” moves from the
anthropological questions to the ethical and spiritual ones,
with a special eye on possible excellences that may be enhanced
or threatened in the age of biotechnology. The three chapters
in this section deal with some of the deepest bioethical questions:
the value, if any, of vulnerability and suffering; the importance,
for living well, of unmediated and direct engagement with
the world and with our fellow creatures; and the character
of human dignity. Once again, these are matters that tend
to be neglected in current bioethical discussions. Yet on
reflection, their centrality is not difficult to recognize,
especially in such matters as our use of heroic measures to
save and extend life, our increased reliance on psychotropic
drugs to handle the trials and tribulations of life, or our
attempts to describe and explain human life and human freedom
solely in terms of genes, hormones, or neurotransmitters.
In Chapter
Eight, “Vulnerability and Suffering,” the
readings consider the venerable question of why we suffer,
and the further question of whether there is anything to be
said on suffering’s behalf. Would eliminating all suffering
be humanly desirable? Could it be that some forms of suffering
are essential to our identities and our dignity? Or is this
just a rationalizing effort, to make—quite literally—a
virtue out of necessity?
In Chapter
Nine, “Living Immediately,” the readings look
closely at the character of human activities when these are
engaged in at their peak. Of special interest are instances
when we can be at-work in the world wholeheartedly and immediately,
unencumbered by pain and suffering and not deflected by technological
or other “intermediaries.” How can we take advantage
of the powers technology bestows on us without hazarding distortions
of the very activities these powers are meant to serve? What
is required for genuine encounters with the world and with
other people—for what some call “real life”—and
what are the obstacles to their achievement?
Finally, in Chapter
Ten, “Human Dignity,” we turn explicitly to
the theme that has been tacitly present throughout the volume:
the dignity or worth or standing of the human creature. Though
the term, “human dignity,” has a lofty ring, its
content is quite difficult to define. Or rather, to be more
precise, many different authors and traditions define it differently,
as the readings in this chapter make abundantly clear. Yet
they are all struggling to reveal that elusive core of our
humanity, those special qualities that make us more than beasts
yet less than gods, the encouragement and defense of which
may be said, arguably, to be the highest mission of a richer
bioethics. Some readings will do so by argument, others by
presenting instances and exemplars. Taken together, they should
help us see the profoundly special character of human beings
and the special virtue to which we may rise—with and
without the help of biotechnology.
(End of Chairman Kass's inserted remarks.)
CHAIRMAN KASS: To celebrate the release of this volume
but also to subject our enterprise to some critical scrutiny,
we have convened a really wonderful panel this morning to
discuss with us the role of the humanities in bioethics.
We have, first of all, Professor Bruce Cole, distinguished
art historian specializing in the Renaissance, with a keen
eye for being human, who is now the eloquent Chairman of the
National Endowment for the Humanities, the country's leading
voice on the importance of the humanities for our general
culture.
We have Professor Paul Cantor from the University of Virginia,
a long and distinguished career as a teacher of literature
who almost 20 years ago, I believe, did a book on the creator
and creature on the romantic myths, including the discussion
of Frankenstein.
Then we have Dr. Edmund Pellegrino, who is now Professor
emeritus of medicine and medical ethics at the Center for
Clinical Bioethics at Georgetown University School of Medicine.
I think it is fair to say that Ed Pellegrino has, for more
than 50 years, been the most visible and most eloquent exemplar
of the medical humanities in this country and a pioneer in
this field.
Welcome to all three of you. We're simply delighted that
you would come and join us on this occasion. And we look
forward to your remarks. We will go in that order after the
presentations. We will have either discussions amongst the
panelists themselves or involving all of us. Thank you.
And please, Bruce, would you like to start?
DR. COLE: Thank you, Leon.
PANEL DISCUSSION: THE ROLE
OF THE HUMANITIES IN BIOETHICS
DR. COLE: It's an honor to be here and a pleasure
to address this group on such an important occasion. You
began your discussions two years ago not with an assessment
of the latest technology, a list of medical possibilities,
or a survey of the policy together with a story.
Nathaniel Hawthorne's short story "The Birth- mark"
illustrates both the timelessness and the dangers of the pursuit
of human perfection and the revolt against limitations. More
than that, it shows how the stories, poems, philosophy, and
thought of the past have something to say about our future
dilemmas. I think it also shows the unique and thoughtful
approach of this Commission headed by my friend and colleague
Leon Kass.
I want to thank Leon for inviting me here today and for the
opportunity to speak to issues I believe are inextricably
linked with the humanities. I also want to thank Dean Clancy
and the Commission staff for their work in making this meeting
possible. And I would like to congratulate all of the members
of the White House Bioethics Commission on the release of
your book, Being Human.
The National Endowment for the Humanities has sponsored numerous
projects seeking to broaden understanding of these issues.
In the past four years alone, the NEH has spent over a million
dollars on projects to extend bioethics research, establish
endowments for bioethics study, and create fellowships and
underwrite documentary films, studies, and even textbooks.
The NEH funded the Baylor College of Medicine's work, A
History of Medical Ethics, a one- volume history of medical
ethics from antiquity to the twentieth century. It also provided
special support for the Encyclopedia of Bioethics,
the standard reference work in the field. But today we are
here to celebrate this Commission's new book.
Being Human accomplishes something important. It
sheds light on bioethics through the lens of the humanities.
To quote one insightful passage of the introduction, "We
need to focus not only on the astonishing new technologies
but also on those aspects of being human on which the technologies
impinge. For bioethical dilemmas, though generated by novel
developments in the biomedical science and technology, are
not scientific or technological matters. They are human dilemmas,
individual, familial, social, political, and spiritual, confronted
by human beings at various stages of the human life span embedded
in networks of meaning and relations and informed by varying
opinions and beliefs about better or worse, right or wrong,
and how we are to live," unquote.
Over the last several years, the argument that the realm
of bioethics is the province of the medical field and technology
industry appears to be gaining ground, not because it has
been persuasive but because it has been assumed.
The advent of new technologies has been almost universally
celebrated. And questions about where those technologies
may lead us have often been written off as irrational fears
of Luddites or practitioners of an exotic faith. Of course,
advances in human knowledge are grounds for excitement, but
such excitement only increases the need for a dispassionate
consideration of where the applications of such knowledge
takes us.
A purely medical or technical response is not a complete
one. It is all too easy to disregard the categorical imperative
and assume a technological one. I think it is fair to say
that the allure of the technological imperative is particularly
strong in our time and, as a result, the dangers of dehumanization
more stark than ever.
New technologies are tools which can be used to help or harm,
edify, or demean, protect, or destroy. A knife can be used
to perform life- saving surgery or murder. New biotechnologies
have the potential to do far more than merely save or end
a life.
Cloning creates a new life in the form of a carbon copy.
Genetic advances hold out hope for designing our offspring
according to our wish and promises to redefine what it means
to be human.
The new discoveries and knowledge undergirding these technologies
hold out promise and hope of curing disease, overcoming disability,
and even extending life, but they also contain great dangers,
the commodification of people, the reduction of human life
to disposable resource, nor is this a distant danger, repellent
as it is. It requires that we take stock before taking action.
As Leon has said, there is often wisdom in repugnance.
President Bush charged this Council to "conduct fundamental
inquiry into the human and moral significance of developments
in biomedical and behavioral science and technology."
His instructions assumed that the ultimate significance of
biotechnology was broader and deeper than its utility and
that such an inquiry must include those outside the technology
industry. Without such an inquiry, we stand in danger of
ambling blithely but blindly into a brave new world. Ultimately,
this inquiry is incomplete without the humanities.
The humanities are, quite simply, the study of what it means
to be human. The legacy of our past, the ideas and principles
that motivate us, and the eternal questions that we still
ponder, the classics and archaeology show us from whence our
civilization came.
The study of literature and art shapes our sense of beauty.
And the knowledge of philosophy and religion gives meaning
to our sense of justice and goodness. At their core, issues
of life and death, identity and connectedness, aspiration
and limits, healing and death all pertain to what it means
to be human and, thus, are questions for the humanities.
Not only do the humanities have profound implications for
bioethics, but the reverse is true as well. Many of the new
technologies you discuss have the potential to fundamentally
redefine what it means to be human. Germ line manipulations,
genetic engineering, and other procedures would alter DNA
and human character. It is hardly an exaggeration to say
that the future of humanity has some implications for the
future of the humanities. We're all in this together.
I would like to make one last point. As many of you know,
I am an art historian by background and training. I hope
you forgive a plug for including great works of visual arts — I can't give any remarks without mentioning art; I'm sorry — in the survey of sources you consult in your studies here.
Before we had evidence of the written word, we had cave paintings.
There are millennias' worth of evidence that the instinct
and drive to make art is a human universal, transcending time,
place, culture, religion, language, and ethnicity. Many of
the great masterpieces in the history of art deal directly
with issues you grapple with here: human origins, dignity,
death, limitations, and desire for perfection.
One of the great advantages of art is that it concretizes
the abstract and gives it physical shape. It provides a new
and powerful way of looking at and learning from the wisdom
of the ages.
This Commission has a difficult task. I commend and congratulate
it for its exceptional work and readiness to draw deeply from
the humanities in delving into the perplexing dilemmas of
biotechnology.
In a time when many are tempted or pressured to resolve bioethics
questions by reference to market pressure or interest groups,
it is essential for thoughtful citizens to consider the full
implications of new technologies and knowledge. Both the
arts and the humanities give us a way to approach these great
issues. No inquiry worth the name is complete without them.
Thank you.
(Applause.)
CHAIRMAN KASS: Thank you very much.
Paul Cantor?
DR. CANTOR: It is a pleasure to be here this morning.
It is especially a pleasure to celebrate the publication of
this wonderful anthology, extraordinary event. I think the
last time a government body produced an anthology of literature,
it was under the orders of the Emperor Augustus.
So I'll sum up the importance of the humanities for the study
of bioethics by saying science can tell us how to do things,
but it can't tell us whether to do things. And that's where
the humanities come in.
The humanities help us to imagine the consequences of what
we are doing with science. This anthology is very good in
raising the issue of immortality, for example. The ultimate
promise of modern science is immortality. That's why it gets
the big bucks when it comes to funding.
But literature can help us imagine what immortality might
really be like and in the case of the Swift, Jonathan Swift,
excerpt you have here, show that there might be a down side
to the seemingly wonderful prospect of living forever. And
so that I think has been the great function of literature,
the humanities in general.
I really applaud this anthology. It has an extraordinarily
wide range of selections. That's one of its best features,
I think. There are some of the obviously great and profound
authors, like Homer and Tolstoy, but I was very pleased to
see an excerpt from Gattaca, from a film, reminding
us that literature doesn't just cease with the printed word.
And that film, representative of the whole genre, really is
one of the ways that helps us do this imagining. I would
have put Blade Runner in the book if I had had a choice.
Another wonderful selection was the one from J. M. Barrie
on Peter Pan. It made me go back and reread the original
play. I hadn't realized how serious it was in its own way.
Indeed, I now think there is no better way of confronting
the problem of what it is to grow up and what the choices
are between staying an eternal child, which many of us might
like to do, and then facing responsibilities of adulthood.
So I think this anthology has a great deal to offer. The
selections were very well chosen. And I hope it gets widely
disseminated and people can draw upon it.
To pursue this question of the relation of the humanities
to bioethics, I would like to concentrate on a period that
I specialize in, the Romantic period, the early Nineteenth
Century, say a few remarks about that because, in a way, this
was the first period that confronted modern science and modern
technology. These are the first writers, around 1800, who
are dealing with the beginnings of the Industrial Revolution.
They help us raise one question about turning to the humanities,
a point that I think a lot of scientists might raise. That
is, who are these poets, who are these people, the humanities,
to say anything about science? We worry that they don't know
anything about science. And can they have anything reasonable
to say if they argue?
Moreover, there is a kind of occupational tension between
poets and scientists. I'll talk about that in a few minutes.
There is a sense in which poets in the Nineteenth Century
felt themselves being crowded out by science. And maybe if
they say warning things about the direction science is taking
us, it's out of a kind of professional envy.
Well, I think if we actually look at this period in question,
it turns out that a number of the Romantic poets and other
writers of the time actually were quite knowledgeable about
science.
We have the standard view that the Romantics were anti- technology — and to a large extent, they were — and that they were
anti- science. But, in fact, they were the first people to
realize the imaginative possibilities of science. It's no
accident that, in effect, the first work of science fiction,
Frankenstein, which I will speak about in a minute,
grows out of this period, but even someone like Wordsworth
was impressed by science.
I am going to read you a little sonnet he wrote called "Steamboats,
Viaducts and Railways." Now, we normally think about
Wordsworth writing about daffodils, but he actually could
get pretty turned on by railways as well. "Motions and
Means, on land and sea at war with old poetic feeling, not
for this, shall ye, by Poets even, be judged amiss."
As he starts off there, he knows that these new technologies
are somehow at war with poetry, but he's not going to judge
them negatively for that reason, "Nor shall your presence,
howsoever it mar the loveliness of Nature, prove a bar to
the Mind's gaining that prophetic sense of future change,
that point of vision, whence may be discovered what in soul
ye are. In spite of all that beauty may disown in your harsh
features, Nature doth embrace her lawful offspring in Man's
art; and Time, pleased with your triumphs over his brother
Space, accepts from your bold hands the proffered crown of
hope, and smiles on you with cheer sublime."
"Sublime" was in a way the master word of the whole
Romantic generation. Again, we normally think of Wordsworth
thinking of the great mountains of the Lake District as being
sublime. But here he can look at steamboats, viaducts, and
railways and think of them as sublime.
And as the wave of the future, you see here that, in fact,
this Romantic generation was quite impressed with the new
possibilities of modern technology. I bring that up just
so that when they criticize it, we can say it wasn't simply
out of ignorance or a kind of reactionary spirit.
Percy Shelley and Lord Byron are another example of Romantic
poets who were quite knowledgeable about modern science, who
were studying contemporary geology and biology and very much
fired up and inspired by the new imaginative prospects raised
by modern science and modern technology.
Nevertheless, this generation did put up a number of red
flags of caution. The greatest example of that is Mary Shelley's
Frankenstein. I want to speak about that. I see,
you know, the volume begins with "The Birth- mark."
"The Birth- mark" would not have been possible without
Frankenstein, one of the works that inspired it.
Since you did discuss "The Birth- mark," I just
want to show you that literary critics do have something to
say I hope you noticed with the character Aminadab, spelled
backwards, his name is bad anima, bad. So I think that's
a little clue to what is going on in that work.
Anyway, I really think you should have included Frankenstein
somehow in this volume. That's my one criticism. It actually
has gone on to become in the popular imagination the great
example of a warning against the dangers of modern technology.
Most people know the story through the movie and are unaware
of how literate the book is. So I am going to read a couple
of passages from this, which really show how prophetic Mary
Shelley was in questioning some of the consequences of scientific
enterprise set loose without caution.
This is from the chapter where Victor Frankenstein is recounting
his original planning of his creature. Unfortunately, this
displays a great deal of insight into sometimes the lack of
planning in scientific procedures.
This is what Victor says, "I doubted at first whether
I should attempt the creation of a being like myself or one
of simpler organization." In other words, should he
have started with a small project or go straight for creating
human life? Here he says, "But my imagination was too
much exalted by my first success to permit me to doubt of
my ability to give life to an animal as complex and wonderful
as man. The materials at present within my command hardly
appeared adequate to so arduous an undertaking, but I doubted
not that I should ultimately succeed. I prepared myself for
a multitude of reverses. My operations might be incessantly
baffled and, at last, my work be imperfect. Yet, when I considered
the improvement which every day takes place in science and
mechanics, I was encouraged to hope my present attempts would
at least lay the foundations of future successes. Nor could
I consider the magnitude and complexity of my plan as any
argument of its impracticability. It was with these feelings
that I began the creation of a human being. As the minuteness
of the parts formed a great hindrance to my speed, I resolved,
contrary to my first intention, to make a being of a gigantic
stature; that is to say, about eight feet in height, and proportionably
large."
Now, those last lines have the distinction of being quoted
in Mel Brooks' Young Frankenstein, but they also sum
up Mary Shelley's critique of Victor Frankenstein, "As
the minuteness of the parts formed a great hindrance to my
speed, I resolved, contrary to my first intention, to make
the being of a gigantic stature; that is to say, about eight
feet in height."
Now, here Victor does not consider the consequences for the
creature of its being eight feet in height. He's got a problem.
He can't find miniature parts. He's in a real hurry. So
he scraps the original plan and says, "Well, I'll make
it eight feet tall." In some ways, all the problems
that this poor creature has follow from this last- minute
revision of the plans.
Any time scientists tell us, "Well, don't worry about
the consequences. We've just got to get this project underway.
It's really important to do it quickly. We have to use what
we have," I think this passage from Frankenstein
should be read to them.
Moreover, it goes on to say, "Life and death appeared
to be ideal bounds, which I should first break through, and
pour a torrent of light into our dark world." That again
I think very well captures the spirit of modern science that
any limits to human endeavor are merely ideal bounds. And
the great goal is to break through them.
And then, even more tellingly, Victor says, "A new speciess
would bless me as its creator and source; many happy and excellent
natures would owe their being to me. No father could claim
the gratitude of his child so completely as I should deserve
theirs." Now, why can no other father ever claim such
gratitude? Well, every other father somehow needed the help
of a mother to produce a human being up until Victor Frankenstein's
process here.
Here I think, as Shelley brilliantly focuses in on the will
to power behind modern science, "A new speciess would
bless me as its creator; many happy and excellent natures
would owe their being to me," and then that desire to
have the complete gratitude here. It's interesting that Mary
Shelley as a woman identified this masculine aspect of Victor
Frankenstein's science that fundamentally he was turning against
natural means of reproduction in order to be able to do something
that he could get all the credit for himself.
Again, I think Frankenstein is a marvelous work for seeing
the contribution the humanities can make to our understanding
of these sorts of issues of bioethics.
Again, Mary Shelley's husband, Percy, was quite knowledgeable
in science. He almost blew up his room at Oxford with chemistry
experiments. People have said, Alfred North Whitehead I think
was the one who said, that if Shelley had gone into chemistry,
he would have been a genius, "a Newton among chemists,"
I think was his phrase.
So, again, Mary Shelley was not ignorant of science. In
fact, this work was way ahead of the science of her day.
She had studied a bit about Galvani and his battery experiments.
That was all part of the background to Victor Frankenstein.
But what she is able to do is imagine what the consequences
would be to a being who was created this way. That is the
failure she shows on the part of Victor Frankenstein. He
is thinking only as the creator here. He is thinking only
of what will redound to his own glory. That means doing things
quickly and doing them immediately and with what is at hand.
He is not thinking through what it would feel like to be
eight feet tall. Remember, this is in a world with people
who are mostly five feet tall and before the time of the NBA.
So the eight feet was not in any way going to be an advantage
to this creature.
I am going to end now with a quote from Mary Shelley's husband,
Percy Shelley, who wrote a marvelous essay called The Defense
of Poetry, which, again, I really recommend to you.
The circumstances of its origin are relevant. A man named
Thomas Love Peacock had written an essay called The Four
Ages of Poetry, in which he basically argued that science
had made poetry obsolete in the Nineteenth Century, that science
now had demythologized the world. It was fine for Homer to
write poetry when people believed in all of these Olympian
gods, but he said something like, "How can you expect
to find a water nymph in Regent's Canal today? We don't believe
these myths anymore." He basically wrote an essay that
obviously was very upsetting to early Nineteenth Century poets
because he was trying to tell them that science had put them
out of business.
Well, Shelley wrote a very eloquent and profound defense
of poetry, as he calls it, which actually is one of the best
statements on the relevance of the humanities to science because
he does try to make this point that poetry can imagine what
science cannot.
I will just end by a quotation from Shelley where he tries
to tell us what poetry can do for science. We are to "imagine
that which we know; we want the generous impulse to act that
which we imagine; we want the poetry of life; our calculations
have outrun conception; we have eaten more than we can digest.
The cultivation of those sciences which have enlarged the
limits of the empire of man over the external world has for
want of the poetical faculty proportionally circumscribed
those of the internal world, and man, having enslaved the
elements, remains himself a slave."
In some ways, I can think of no better characterization of
the current state of modern science, "our calculations
have outrun conception." I can think of no better warning
than that "having enslaved the elements," man now
"remains himself a slave."
(Applause.)
DR. PELLEGRINO: Good morning. Like my fellow participants,
I am pleased to be with you, but I suffer under two particular
encumbrances. First, I am here because Richard Selzer has
been ill. And I stand, therefore, in the place of someone
I could not possibly emulate, who is himself a personification
of how literature and ethics come together in his own person
and in his eloquent writing, too.
The second impediment is that as you look around the table,
I am reminded of a story, which you probably know but I think
is apposite sufficiently here for me to repeat it. And that
is a story of the man who went to heaven at a time when in
heaven there was a requirement, as there has been for those
who occupy chairs in universities, for an inaugural speech.
An inaugural speech could be on any topic the soul would like
to address. The man from Johnstown said, "I would like
to talk about the Johnstown Flood."
St. Peter said, "Well, we are very liberal here. We
will allow you to talk about anything you want, but let me
warn you Noah will be in the audience."
As I look around this table, I see clones of bioethical Noahs,
friends of mine, sometimes colleagues, sometimes debating
friends. I am very, very much reticent to try to say much
of anything in the presence of people who know so much more
than I do about it.
My only advantage, as Leon said, was having been at this
a long time. So I will be saying something about paleoethics
and hopefully bringing it up to something somewhat more contemporary.
What I have in mind is the following. First, I would like
to make a few quick comments about how much I applaud this
effort of the Council and particularly in its latest volume.
The stories put forth there, the narratives, literature, are
extremely useful and helpful and apposite in bringing the
facts clearly to all of us with moral questions, moral problems,
moral decisions. All of them are unique and personal and
embedded existentially in the lives of individual human beings.
That is something which is just beginning to be emphasized,
although it has been known for a long time in the world of
literature. If you go back to the ending of The Iliad
and the ending of The Aeneid, you find the tremendous
moral challenge of what a victor does with the one he has
vanquished. On the one hand, in The Iliad, we have
an example of mercy, respect for tradition, and the sparing
of the enemy. And in The Aeneid, we have the opposite:
the absolute application of what the hero thinks is justice.
So let me start then on the collection of the one or two
points I want to make in the brief time allowed for me. The
collection itself illustrates beautifully, as I said, the
enfleshment of moral issues and problems.
Note, though, that at the introduction of each of these episodes,
there is a series of penetrating questions. Those penetrating
questions are questions which cannot be asked by returning
to the story. They are philosophical questions. They illustrate
beautiful what Italo Calvino said, that the point in the terrain
at which literature and philosophy — read ethics at this
point — meet is at ethics.
What I would like to do, then, is make three brief observations
on the interaction between ethics and not just literature,
but the humanities in general. I do so under the rubric of
the enrichment of bioethics, which is one of the aims, I gather,
of this particular volume and I think a worthy one.
First, a quick historical look. You couldn't avoid that
with someone at my advanced age. I will not give you anecdotes
of my personal involvement. So relax.
Second, a word about the central paradox, central ethical
paradox that must be faced and which I think the Council has
opened up. I would venture to say that if the Council can
pursue this question further and already has I think made
a great contribution, your greatest contribution probably
would be if you could advance this notion of the enrichment
of bioethics because the questions that you deal with and
we deal with are questions for the entire public.
What eventually must be faced is the enrichment of bioethics
and the question which is running through the remarks my fellow
participants have already made, what is it to be human? A
central fundamental question of philosophical anthropology
or theological anthropology, what is man, what is woman, what
is our purpose, what is our destiny? And all of the other
questions are peripheral. But for many, many reasons, we
have not been able to touch that question directly because
of the pluralistic view we have of what it is to be human.
Nonetheless, we cannot avoid it.
And so my first point, historically, is simply this. As
you look at the history of bioethics, which really did not
begin until, in my view as a bystander and not so innocent
a bystander, as a matter of fact, at the beginnings of what
current bioethics is, the development from a 2,500 year- old
tradition of a very narrow but important topic, the ethics
of the profession of medicine, began to change in the '60s,
when, believe it or not, the humanities, bringing together
ethics and human values, were put together as an enterprise
by a group of, believe it or not again, campus ministers — the record is clear on this — who were concerned about
the education of physicians wishing and hoping that they could
somehow marry the technical prowess of medicine, which was
then becoming very obvious with an understanding of what it
is to be a human being and to use these techniques within
the human existential framework. An educational ideal, therefore,
was the beginning.
This is a part of the history that bioethics has not written
about. It was only until the mid '60s that that particular
thrust, which would have been very congenial to the very points
you have been making here today, particularly since some of
the volumes that you were talking about were being used.
Ten medical schools initiated programs, as a matter of fact:
ethics, human values, and the humanities.
Out of that grew a program supported by the National Endowment
for the Humanities for a decade to stimulate the education
and in- house training of faculty members in these 3 dimensions,
which would enrich and broaden the medical ethics of 2,500
years, which was more or less a statement of norms without
justification and norms without realization of the complexities
of their application in the human situation.
It was not until 1972 when bioethics was baptized in two
places, by the way, at the University of Wisconsin, as has
been pointed out, but also at Georgetown, and baptized in
two forms: one, an interdisciplinary broad approach, which
included the humanities; and the one at Georgetown, which
emphasized strongly the philosophical approach, ethics as
a formal discipline.
You know the current development. Currently bioethics has
become so broadened that it embraces almost every discipline
in the humanities and in the humanistic end of the social
sciences spectrum, so that we range from law to psychology
to anthropology to economics, et cetera, et cetera, et cetera,
because the problems involve those issues. But the stories
that one gets from each of these approaches bring us back
to the kinds of questions which your anthology raises, how
do we from the point of view of what it is to be human answer
and respond to those questions?
Bioethics, therefore, has flourished. It has grown. And
in its growing, paradoxically it has moved away from its central
issue or the one that you have pointed out repeatedly, what
is man, what are humans for, and can ethics be, again, as
a phrase from your introduction says, can ethics be in the
service of bios?
My second question, then, is, given that the move away from
normative questions, from questions of a foundation — and
it's popular, as you know, today to resist foundations in
philosophy. To move away from foundations deprives us of
some groundwork to which to return so that the questions you
have asked here, those acute questions, will have some basis
from which to work.
Now, the paradox is my second point. The paradox, of course,
is that we have no agreement on what it is to be human. And,
of course, all of the things we have been talking about contribute
to that dialogue, but we need to return to the tackling of
that question. It is the most difficult question in a democratic,
pluralistic society. Yet, it cannot be avoided.
When one avoids it, bioethics becomes a matter of procedure,
an abandonment of the search for the right and the good.
It becomes a matter of dialogue, a matter of whatever it is
we can agree upon is the right answer to whatever decision
we have facing us.
And that spirit runs through much of the bioethics literature
today when it comes to the application to particular problems.
That, of course, can only be chaos unless one is willing to
accept that the true and the good can be arrived at by plebiscite,
by agreement, by compromise, by contract.
Talk about what it is to be human raises another paradox.
And this is the second one. I'm coming close to my end.
And that is, which of the very ideas and images which emerge
from your anthology should one select? Does one select all
of them to go in all directions at once? Does one select
an idea or an image?
An idea, if I may be permitted — and I ask your forgiveness — an idea in my view to use a more ancient kind of definition
is an intellectual representation of the essence of a thing,
what is it and why is it in a general and universal sense.
An image is a particularized existentially described, multiply
examined, concrete human being. Socrates is an image. Jesus
is an image in many ways.
Do we go the image route? And I think here is where the
humanities help us enormously by giving us images. But then
which image do we follow? As I pointed out, does one go The
Iliad route or does one go The Aeneid route and
the most important question, let's say, of almost capital
punishment, justice, or do we try to discern what it is about
us as human beings that makes us different? That question
we have run away from since the Enlightenment. There are
people around this table who can say much more about that.
And I will say it further. My purpose here is simply to
raise the questions from the point of view of a long involvement
in where we are and the great importance of carrying forward
this notion of bringing together the humanities and the philosophy.
The last point is what can we do about it. Everyone will
talk about interdisciplinary programs, et cetera, et cetera,
et cetera. Yes, ethics is an interdisciplinary activity,
but it has its particular contribution to make, the orderly,
formal, systematic examination, in the light of the concrete
existential situation, those two in dialogue with each other.
And I presume your volume does that, raising the questions,
but does not go further from the resolution, not necessarily
resolution but the fleshing out of those questions in a more
advanced and formal way.
I think if we are to resolve satisfactorily the issues with
which you are wrestling — I was here yesterday as we heard
about whether one should decide about one's granddaughter,
should she be given ballet lessons or ice skating lessons,
so on, which revealed to me a certain lack of understanding
of this very question you are looking at. Whether she, the
granddaughter, has a PET scan which indicates that she would
be a wonderful snowboarder is inconsequential. Is this what
she wants? Is this how her life will develop given its particularities?
And here's where the humanities come in.
And then should one admit into the picture what the PET scan
shows about her and the way her brain lights up when you talk
about skating, as compared to running an automobile around
a track at NASCAR?
So I want to end, therefore, by saying we need to — and
you have heard this over and over again. Having been a university
president and so on, I am rather skeptical about top- down
organizations that have interdisciplinary programs. They
don't work or if they do, they come up with rather mundane
answers to questions. I do think we need to stimulate discussion
among and across faculty members.
This causes me to end my comments with a little anecdote
of the first time I met Richard Selzer. We were both faculty
members at Yale. I had the temerity to organize a cross-
campus colloquium with people from the humanities and those
few in medicine who were interested in that engagement. Richard
was a member of that group.
On those occasions, we were always enlightened by his grasp
of the existential and, on the other hand, by a philosopher
like Maurice Nathanson asking the questions you're asking
in the first part at each of these selections you have chosen.
Is it conceivable that somehow the faculty colloquia could
be one starting point for this, which might spread to students,
as it did in our particular instance, and actually end up
in jointly tought courses.
This won't do it all. The final comment I have to make is
that no democracy can survive without a sufficient aliquot
of its members instructed and able and capable of critical
thinking on the questions that the liberal arts always emphasized,
the questions of what is the right, what is the good, what
is the true, and what is the beautiful.
These are not to be decided by leaders, by congresses, by
democracies, or by anyone else. They are the result of an
educated populace entering into the dialogue and dialectic,
a combination, therefore, of philosophy as well as ethics.
Thank you.
(Applause.)
CHAIRMAN KASS: Chairman Cole has to leave now. Bruce,
thank you very much for being with us this morning.
(Applause.)
CHAIRMAN KASS: Paul, do you want to comment in response
before we simply throw it open?
DR. CANTOR: No, not really. I mean, I just —
CHAIRMAN KASS: You're content?
DR. CANTOR: Yes.
CHAIRMAN KASS: The floor is open for discussion.
Bill May?
DR. MAY: I will just try to compete against the rally
next door.
CHAIRMAN KASS: Let me say a word about that. You
may be wondering what is going on there.
PROF. SANDEL: They are cheering the report we
issued yesterday.
CHAIRMAN KASS: You are very close. It is the staff
retreat for the Washington Post, staff retreat. Let the record
show.
Bill May?
DR. MAY: I take it what this book does is attempt
to ratify what is already going on, which is an attempt to
enlarge the canon. So much of bioethics in the 30 years that
I have been involved in it has attempted to draw on a limited
canon. And wonderful things were accomplished: Aristotle,
Kant, Mill, Nozick, and Rawls. And it's been really quite
impressive what ethicists have done pushing the discussion
at issues of autonomy and so forth.
To include this rich range of literature that this volume
does suggests that bioethics needs to enrich what goes on
by working against at least two sources of abstraction in
a society like ours. One of the abstractions is science.
The other is the abstractions of politics.
Again, science accomplishes a great deal through the generalizations
that it achieves, but the very procedure of acquiring knowledge
in science requires so often the elimination of variables
as one gets at something undistracted by its embeddedness
in other things.
The poet Yeats once complained about the abstraction of H2O
by saying, "I would like a little seaweed in my definition
of water." That trafficking in images and metaphors
and so forth, that is, the business the artist does, it insists
that we are not simply in need of universals but sensitivity
to universes, Michelangelo's Pietà, Antigone,
and so forth.
A particular issue, no, not simply a particular issue, but
an imbedded universe. And, after all, in a clinical setting,
physicians deal not simply with the abstraction of diabetes
or prostate cancer, but they deal with this embedded in the
human being, seaweed and all. And so we really do need the
work of the artist in carrying forward the work of those who
wield this enormous power which science has helped to generate.
On the other hand, there is the problem of the abstraction
of politics. And there are tragic limitations to politics.
I do not want to dismiss its extraordinary importance. It
is a way of organizing people around ideas and ideals, which
in certain ways extant political orders may have been insensitive
to.
And so political causes arise in order to retrieve ranges
of human experience and human suffering and human deficit
that you need the society organized in such a way to attend
to. But at the same time, there is a price to pay. Politicians
perforce organize us around ideals, but eventually the idea
of justice and so forth sloganizes.
And in the course of mobilizing people for action, which
is so important, there is an abstraction from the full range
of human experience. There is an impoverishment of language
that goes on which eventually yields an impoverishment of
community.
And so what the artist does — and this book is simply full
of people who come out of especially the verbal arts — is
attempt to retrieve language from its constant perishing.
And in doing that, they're retrieving ranges of human experience
that are out there in the culture at large but that have not
yet been fully articulated and honored in the course of its
needful recovery.
And so when the artist freshens language and freshens insight
and articulates experience, it helps to compensate for the
tragic limitation of politics and retrieve community from
its constant perishing.
So I salute this accomplishment on the part of those in staff
who have worked at it.
CHAIRMAN KASS: Thank you very much, Bill.
Let me raise a question for you, Ed. It's prompted by your
remarks. While embracing the contribution of imaginative
literature to our deliberations for their ability to give
us the concrete particulars, the enfleshments of various ideas
in their particularity, to give us certain kinds of powerful
images that are sometimes more vivid and compelling than abstract
argument, you, nevertheless, I think — and I think it is
more evident in the paper that you gave us as background for
the talk — that you finally think that the court of last
resort is philosophy or philosophy/theology but that finally
the quest for the universals and the ideas has to take primacy.
Second, a second complaint about — and this complaint could
be registered not just about the imaging character of literature
but could even be addressed to the history of philosophy as
a whole, the belief that there must be a singular truth, but
we have multiple opinions about what it is. I wonder how
you would respond to a kind of double- barreled, not such
a critique but to an answer.
First, sometimes the idea and some kind of universal is absolutely
best grasped through a particular in which you see through
a particularly vivid image something that you couldn't possibly
get in an argument but is, nevertheless, the case.
I am not sure that you could make an argument, you could
make an argument that would capture the truth in the meeting
of Achilles and Priam in Book XXIV. You read it. You see
it. You feel it. And if you don't see it, there's something
the matter with you. No amount of argument is going to enable
somebody to see the humanity of that moment where Priam embraces
the killer of his son and both men weep.
So I am wondering whether you don't sell short the capacity
of images to yield intuitions about truths that discursive
speech can't produce for us. That would be one point.
And then while I am not unfriendly to the quest for the answers
to the great questions, we engage in it. It seems to me if
the history of philosophy has taught us anything, it is geniuses
don't agree. And it may very well be that it is sufficient
unto the day to keep the questions alive and keep the most
powerful alternatives in the conversation because the ultimate
truth might, in fact, paradoxically embrace their differences
and not find out which in the end is going to be successful.
So this is an argument that would say the presence of multiplicity
of viewpoints — sure, we have to act. And there comes a
time where you have to say, "This way" or "That."
But the complexity that people face when they face hard choices
may very well be a reflection of the rather complicated truth
of the matter and of these longstanding opponents.
Somebody who is interested in the kind of univocal truth
would say with, say, Descartes, "I looked at the history
of philosophy. There isn't anything on which the great philosophers
agree. They must have been asking the wrong questions. We're
going to start over someplace else; whereas, it seems to me
a wiser person would say when they read Lucretius, "He's
got something here" and when they read Aristotle, "He's
got something here" and one can hold these things in
mind and maybe even have a richer view of what the truth of
the matter is.
So these are two different ways to lean against I think what
I heard you say or what I thought was implied. And I wondered
if you could come back on that.
DR. PELLEGRINO: Well, there is a lot to come back
on, Leon, but I will just take one or two points. First,
I in no way take exception with your point that when we actually
make decisions, we may be making it very often intuitively
without going through any rigorous analysis.
And that's why I think it's so important that there be this
dialogue, the ecumenical model that I put forth on the paper
that I gave you but I did not talk about here. And that does
not give priority to one or the other but assigns to each
its particular task.
What I am propounding here, I suppose, is the Medieval notion
of the formal object or the material object of a study. And
I see the differences between literature and what I called
in the paper the sciences and the studies of particularity,
being valid on their own, and the sciences of the generality
of the universal or the abstract, having theirs to contribute.
I, therefore, applaud the difference. My only concern with
bioethics is that I see one facet of this dynamic equation
being pushed out and people using psychological arguments,
using images, stories, characters.
And I come back to my question, which of the images do you
follow? Do you follow Dostoevsky? Do you follow Nietzsche?
Do you follow any of these figures in literature? They're
all interesting. They all represent aspects of the human
condition and, therefore, are extremely useful.
I happen to be an inveterate reader. So I am continually
torn by these images. But one needs to have some apparatus
to step back. I am not suggesting that having the apparatus
means that everyone will come up with the same answer. What
I really am saying is I want to reserve the critical faculty
when looking at something which is emotionally moving.
I am firmly convinced that if I want to teach something about
compassion, let us say, to medical students — and, by the
way, I am still teaching medical students and still seeing
patients — when I want to get that across, I don't do it,
I can't do it by a speech. I do it through the agency of
a creative writer who can evoke in a young person who has
never experienced death, sorrow, pain, suffering, can evoke
that experience. And then I can begin to work with that to
say, "Well, now, let's step back and look at that experience."
So I do not see it as a mutually exclusive choice in any
way. Merely the concern I have is the push, strong push,
when I hear about narrative ethics. It's important.
But whose narrative do you believe? How do you know the
story is a good story and is a right story? That's the question
I am raising basically. And I am sure this Council is aware
of that. I am belaboring the obvious, but it seems to me
that it is a very important matter as you look at and make
statements, as you will, undoubtedly, probably in the future,
about what enrichment of bioethics entails and requires.
On Bill May's point of politics, Bill, again, I see the realities
of politics in the decisions and so on, but I do think we
need some order of priorities. And politics, it seems to
me, does not determine what is right or good unless you follow
that particular theory of right and wrong. There is, whether
we like it or not, a theory of morals behind every one of
those acceptances or images that we take to our own.
I am reminded of Alan Donagon's preface to his Theory
of Morality, in which he talks about precisely something
like this, Bill, his engagement with the social issue, the
political issue, deep personal engagement, his reading of
George Orwell, the entrance of literature into the picture,
and then his saying to himself, "Now, wait a minute.
How do I decide for myself what is the probity of truth of
Orwell's position in 1984? How do I critique it?"
And so he became a philosopher and produced a wonderful Theory
of Morality.
It doesn't mean everybody should go that way. The point
is here is literature stimulating the philosophical question.
Therefore, I see it, having been trained in chemistry and
physical chemistry, being in my research bag — the idea
of the dynamic equilibrium, in which both sides of the equation
are in constant reaction, one with the other, Bill, is the
metaphor that I would use.
CHAIRMAN KASS: Paul, could I draw you in on this?
Does the literature have something to say in response to this
exchange or do you have something?
DR. CANTOR: Well, I basically agree with Mr. Pellegrino
that what it does is make these choices, these issues more
concrete for us. And that's why I was using Victor Frankenstein
as a perfect example of a scientist who ignored the concrete.
I am just so much in agreement that there is not much to contribute.
CHAIRMAN KASS: I have Gil and then Michael Sandel.
PROF. MEILAENDER: First, maybe we could come up with
some readings about how contemplative prayer is the essence
of a retreat.
(Laughter.)
And we could put those forward for reflection by anyone
who might be interested.
Apart from that, I wanted to comment on the two issues that
you had raised, Leon, because in a sense, insofar as you and
Ed are tilting in slightly different directions, I want to
go with you on the first one and Ed on the second one. I
do think it's true that, at least sometimes, it may be possible
that a piece of literature, for instance, actually gives us
a kind of insight that discursive reason actually cannot.
So you read or see Oedipus, and there is a sense in which
you see free will and fate, or determinism reconciled. You
sort of see it and taste it in a way that probably no theory
has ever managed to work out satisfactorily, actually.
I do think that there is something to that. I don't know
how often that is true, but I think sometimes, at least, there
is a kind of insight there that is just not available through
simple discursive reason. So I am with you there.
On the second point, though, I do think that keeping the
questions alive, though a very important undertaking, — I don't dispute its significance — is not sufficient, not
sufficient for this body, not sufficient for anybody in his
or her life. We need something more than that.
I think that it is a mistake for us to suppose that the model
for living is the academy, where we really do just keep the
conversation going sort of, but there is a reason you are
an undergraduate for a certain number of years. There's more
to life than just that.
And there are moments when one really does have to decide,
and your decision may be enriched in countless ways by the
questions having been kept alive and kept alive in sort of
fruitfully complex ways. But that doesn't alter the fact
that you can't just find yourself in the midst of a series
of questions, but you, indeed, must act and decide.
CHAIRMAN KASS: Michael and Frank.
PROF. SANDEL: My question is for Professor Cantor,
though I want to say first that I am sure we all appreciate
your situating our work in the sweep of history from Emperor
Augustine to Emperor Leon.
My question is about the Wordsworth passage that you read
having to do with the relation between science and nature.
It was striking to find a Romantic poet affirming the link,
rather than insisting on the opposition between them.
Often in bioethics arguments, people cast science and argue
against a scientific intervention on the grounds that it is
unnatural, whether it is flying to Mars or embarking on asexual
human reproduction; whereas, other people reply, "Well,
science is natural in the sense that it is an expression of
human nature. So it can't be cast as unnatural, whatever
else might be wrong with it."
The passage from Wordsworth included a striking phrase, the
one that you read, where he described science as "the
lawful offspring" of nature. Is Wordsworth telling us
there that, whatever the pros and cons of a particular scientific
pursuit, that no scientific pursuit can be condemned simply
as being unnatural?
DR. CANTOR: I don't know that he ever worked out
his thoughts sufficiently on that, but it is interesting that
he does see it as part, an integrated part, of the human enterprise.
Shakespeare does something very similar in The Winter's
Tale when some characters complain about grafting, that
the wrong bud has come out of the vine because grafting has
taken place and it is unnatural.
Shakespeare's characters say something like "Art uses
no means, but nature doth make those means," again that
sense that art and nature are not radically opposed, that
we are human beings and part of our nature is to create art
and to pursue science. And it is true.
Even in Wordsworth's famous Preface to Lyrical Ballads,
he talks about the imaginative possibilities of science and
predicts that someday there will be poets drawing their images
from chemistry the way they have hitherto been drawing them
from what we think of as the natural world, the world of trees
and mountains and so on.
I brought up that one sonnet because it does fill out our
picture of Wordsworth. I mean, this is the same man who Ellsworth
says, "We murder to dissect," a much more famous
line from Wordsworth which shows a kind of kind of fear of
science, particularly medical science, and where it draws
its knowledge from.
I hesitate to put too many words into Wordsworth's mouth,
but I think the example I cited from Shakespeare and this
one sonnet show that there have been moments when even the
most romantic of poets have tried to see the continuity between
science and other human activities.
Now, I think the point that Wordsworth would make — and
he does gesture towards it in this Preface to Lyrical Ballads — is that for us to see this connection, science needs to
be integrated into broader human activities. That's, indeed,
the role that Shelley argues in his Defense of Poetry
for the poet that science is potentially in harmony with poetry,
but the two can diverge.
I do think that this romantic generation believed that there
could be an unnatural direction to science. Surely, that's
the thrust of Frankenstein.
So I was just trying to correct what I think is a one- sided
misperception, even of Romantic poetry, but it is really right
to focus on that one line, which is so counter to what we
normally think of the Romantics as doing.
CHAIRMAN KASS: Ed Pellegrino and then Frank.
DR. PELLEGRINO: I just wanted to add that I didn't
mean to shortchange science in this dialogue. For want of
time, I concentrated on what I thought was to be the major
focus of the anthology.
Again, I think just Colvino's thoughts happened to flip into
my mind. He pointed out on his dialogue between literature
and philosophy that it was no longer a double- bed marriage.
It was a menage- a- trois. And science was the trois.
Now, Bill would suggest it would be a- quatre, but I'm not
sure that the bed is big enough for all of them. So I would
put science, philosophy, ethics, and literature into a dialogue
or trialogue with each other. And I think that is essential
today. So I don't want to lose that point at all.
I would see science, again, as among those disciplines of
the particularity, science per se not being able to establish
what we ought to do.
CHAIRMAN KASS: By the way, people should know that
there is a section of the reader called "Scientific Aspirations"
in which we have accounts, in four cases I think first- person
accounts, of the scientific aspiration as told by the practitioners
and a fourth remarkable account of the life of Archimedes
from Plutarch. They don't all say the same thing, and even
the modern ones don't say the same thing. And they don't
exactly say what, Paul, you have characterized to be the intrinsic
aspiration of the activity.
Science's account of its own self- understanding is not excluded
from the humanistic account because science is one of the
human activities par excellence. So I think we have tried
to make a place for that here.
Frank, please.
PROF. FUKUYAMA: I am disappointed for the way
this has gone so far because Paul Cantor, if he is known for
anything, is not known for his high- minded discourse on Wordsworth
but his extremely acute observations on popular culture and
what they tell us about the way we see ourselves. He has
written on The Simpsons and Star Trek. His
most recent book was on Gilligan's Island.
So I don't have a question so much as a Cantor- like observation
about one of the popular culture points of reference that
you mentioned, which I think is actually quite relevant to
the discussion that we had on neuroscience yesterday, which
is the movie Blade Runner. Maybe you can react to
this.
Those of you who have seen the Ridley Scott movie, it is
a brilliant movie. It's based on a book by Phillip K. Dick
called Do Androids Dream of Electric Sheep?
Now, those of you who have seen the movie, it's about these
replicants who are androids that are brought back from an
off- world colony. The whole theme of the movie is that they
actually develop human emotions. They are machines, but they
develop human emotions.
There is a lot of religious symbolism as the end. It turns
out that they suffer and they feel empathy and pain. In fact,
there is an image at the end of the movie where there is a
nail being driven through the hand of the chief replicant
as he is being destroyed. He kills his creator in a Frankenstein-
like way.
What is interesting about that movie is that it is completely
different from the underlying book, which made almost the
exact opposite point. If you read the original Phillip K.
Dick, he was kind of a hack writer who wrote desperately to
keep alive. His writing, he is not a great stylist, but his
imagined android was not one that had developed human characteristics
but one that was missing empathy, was missing a key human
emotion.
Actually, the replicants in that story try to undermine religion.
There is a religion called Mercerism that is based on the
feeling of empathy. And the replicants actually expose Mercer
as a fraud and disabuse people of the need for religion and
so forth.
It does seem to me that it points out a couple of things,
that literature is actually extremely good for enabling us
to picture both what it means to be human but also in a sense
what it means to be inhuman.
So maybe, Rachel, now that you have completed this book,
you can work on one called Being Nonhuman because in
a sense, it might better articulate what some of the fears
about the future are.
It also does seem to me the change between the Phillip K.
Dick version and the Ridley Scott version in a way reflects
the change in the broader culture, this greater confidence
that our materialistic understanding of what it means to be
a human being has somehow displaced an earlier, more religiously
based one, which said that there is something in a certain
sense unduplicatable through any mechanistic device that would
actually truly replicate what it means to be a human being.
So I wonder if you might say something about that.
DR. CANTOR: First of all, I would suggest the next
volume would be called Being Inhuman, pursue that line.
I was trying to justify Leon Kass' choice of me by largely
avoiding popular culture this morning, but I did praise the
volume for including Gattaca and actually mentioned
Blade Runner at that point. Indeed, I do think it
is relevant that the kind of inquiries represented by most
of the selections in this volume are being continued in movies,
in television, and, in fact, our popular culture is coming
to grips with the very issue that is being raised here. I
would, in fact, put in a plug for that.
Half of my book Gilligan Unbound deals with The
X- Files. And nothing in our day has confronted more
directly the very issues that you are talking about in this
volume, the very same issues and what it is the human, with
these aliens trying to imitate humans, the alien bounty hunter
who can take the form of a human but doesn't have human emotions.
I think it is actually fascinating that one of the central
motifs of our popular culture ever since Blade Runner
has been the question of how you can distinguish human beings
from various forms of androids.
Some of what is in the original Dick story does survive in
the movie in that these replicants look like human beings.
They give them psychological tests to try to figure out if
they are human beings or not. And one of the things they
are testing for is whether the being has empathy or not.
The entire Terminator series, I, II, and III, has
raised this issue, especially the very strange Terminator
II, where the Arnold Schwarzenegger character turned out
to be a better dad than the real live human being dad that
the Edward Furlong character had, and the very strange sense
that, again, this machine that had to learn emotion and when
Arnold generates a tear there at the end, we all know he is
a very good actor.
(Laughter.)
DR. CANTOR: So I have been fascinated by the — he's playing a governor now, but —
PROF. GEORGE: Will he be better than the real
live human being governor?
DR. CANTOR: Who knows? It really struck me how much
our popular culture has tried to come to terms with specifically
this issue. As we increasingly enter an electronic and cybernetic,
cybernautic age, we really have had an enormous series of
images in movies and television that raise precisely this
issue, what is the dividing line between a human being and
a machine, when do computers develop consciousness. That's
been a tremendous theme going back to the Kubrick movie 2001.
It came up in a number of X- Files episodes.
So, in fact, I think there is quite a continuity between
what we think of as high culture and our popular culture.
Again, that is why I praise the anthology for including something
from Peter Pan and something from Gattaca.
CHAIRMAN KASS: Dan Foster.
DR. FOSTER: There is a huge movement to try to get
some sort of marriage that's oftentimes used between science
and religion, for example, or in the case here we're talking
about some dialogue or interactions between ethics and philosophy
and serious questions about what it means to be human.
There was a little book that Stephen Jay Gould wrote that
I haven't found very many people read, but I read it and I
thought it was pretty interesting. It's called Rocks of
Ages. He wanted to address what he called the incorrectness
of trying to marry these two disciplines, science and religion.
In several cute ways, he says science is about the ages of
rocks and religion is about the rock of ages. He coins a
term which he calls "NOMAs, non- overlapping magisteria."
He took the term "magisterium" from the Roman Catholic
Church, which decides what questions you can ask and what
answers you can give.
His point is that the magisteria do not really overlap.
They ask different questions. Science is interested in how
the world began. Religion is interested in who may have made
it. Science is interested in how do human beings come to
be. And religion, as has already been said, asks "What
does it mean to be human?" He says these are not overlapping
questions. I think that is something that we need to try
to keep straight.
The disciplines are different. And the focus is different.
In one sense, particularly on the scientific side, there is
not much interest in the issues that we are talking about
here.
Somebody asked me last night — I can't remember — do
scientists in general, particularly the great scientists,
have a sense of the solemnity of human life?
I would say in multiple conversations that I have had, that
that rarely surfaces. The sort of questions that we address
here may surface in terms of personal disaster or risk. If
somebody gets sick or they're dying or something like that,
they will ask sort of universal questions, but I think that
it is a hard sell to try to say what occupies people in literature
and philosophy to get the scientists to think about that in
a serious way. They're too much interested in the science
itself and probably rightfully should be, just as the writers
and so forth are fundamentally interested in what they write.
Now, there is a difference. There is an imbalance here because
my observations are that the people who are in the arts and
philosophy and literature, almost everything that happens
in science can do so enthusiastically, particularly if it
looks like it might relieve suffering or save lives, so that
the flow of information is essentially unilateral or close
to unilateral.
Everything in science gets written up in the newspapers every
week before you even get the journals to read. So this flow,
every one of the people sitting here from the other — I'm
not saying the "other side," but I mean in this
dialogue — will read and be interested in what science is
doing.
But I can tell you that the scientists in general are not
only — this is a very big danger, and I've only talked to
a few scientists. So I don't want to generalize, but I think
it is true that the scientists are not only particularly not
interested in what something like the Council is doing, but
they are fairly hostile toward it because they see it limiting
the science.
So all I am trying to say is that it would be great if we
could reverse some of the flow backwards, but I myself think
that is relatively unlikely and that we are fooling ourselves
and what we ought to try to do is to bring up these most serious
of issues and say, "These are things that you ought to
think about. And some of the things that you are doing, we
are doing in science, are wrong or should not be done"
and get the attention there.
So I am very sympathetic to the late Gould's view that we
need to be sensitive to the non- overlapping nature of the
magisteria of these two very great things that occupy all
human beings.
CHAIRMAN KASS: Ed Pellegrino, do you want to respond?
DR. PELLEGRINO: I very much agree with the reality
of the ordinary, general scientist's response to these kinds
of questions, having spent 25 years in the laboratory myself,
having experienced that and felt it myself from time to time.
However, I think, as you know, from time to time, there is
an upsurge of interest within some scientists. The Asilomar
Conference, for example, is an example of a perception of
the fact that some things ought not to be done, even though
there may be very good "scientific" reasons for
doing so. We have scientists who are concerned about atomic
energy and atomic bombs.
So there are signs of hope among scientists that they will
look at some of these questions as very pertinent to their
own way of behaving. I understand the scientists' concern.
And I very much believe in the difference in the approach
and the methodology and the evidence, but I think it's the
fusion between these three ways of looking at the world that
is essential for the kinds of problems you are facing. I
would hope that, I believe, and I am seeing that more and
more scientists are interested in these questions, quite honestly.
DR. FOSTER: As I have said, I don't want to generalize.
I happen personally to be one person who is interested in
both magisteria. I think that most people I talk to at the
very tiptop of science, like we've got four Nobel guys at
our school and so forth and so on —
DR. PELLEGRINO: I would agree.
DR. FOSTER: So they just are not as interested.
There are exceptions, and those are wonderful exceptions.
But I'm just trying to talk about the general reality here
that I think that we need to take cognizance of.
DR. PELLEGRINO: I think you are absolutely right,
and that's true among medical students as well. I would like
to say that they have been nurtured on their mother's milk
of logical positivism so that it is very hard to disengage
them from that particular addiction to something a little
broader.
CHAIRMAN KASS: Last comment from Michael Gazzaniga.
Then we will break.
DR. GAZZANIGA: I would just be curious to know, if
we took Yale as an example, what percent of your professors
in the liberal arts go to work wondering about right, good,
true, and beautiful as their goal for their week's work.
DR. PELLEGRINO: I am sorry. I am suffering from
a little bit of dysfunction of the auditory apparatus. If
you could say it a little louder, I would appreciate it.
DR. GAZZANIGA: I'm sorry. I'm sorry. You had mentioned
that traditionasl liberal arts goals included seeking right,
good, true, and beautiful. And I was just being a little
bit playful here. What percent of the Yale liberal arts faculty
goes to work and has that on their mind as their week's endeavor?
DR. PELLEGRINO: I have no illusions that we can arrive
at a full perception of these concepts. In the concepts of idea
and image as represented in literature and philosophy, we are wrestling
with the question — what is it to be human? This is a question
the Council has properly and repeatedly raised. What is common to
both literature and philosophy when each engages this question?
We can approach the answer only asymptotically, but in doing so
perhaps we can bring image and idea closer together. This we must
do if we are to have a common notion of human existence against
which to judge whether any particular biotechnological advance is
a good for humans, as humans.
CHAIRMAN KASS: Thank you, Paul Cantor. Thank you, Ed Pellegrino.
Thanks to the Council.
We have a 15- minute break. We will reconvene at 10:20.
(Applause.)
(Whereupon, the foregoing matter went off the record
at 10:04 a.m. and went back on the record at 10:25 a.m.)