Presidential commissions are not famous for producing stylish prose, flights of poetry or literary and philosophical references. Government-speak rarely appeals to contemplation or reflection beyond the most urgent public concerns. Policy recommendations usually follow, not precede, crisis.
But there's an extraordinary exception in the report by the President's Council on Bioethics, "Beyond Therapy: Biotechnology and the Pursuit of Happiness." This report forces the most challenging questions confronting the 21st century over the ways biotechnology can be used beyond therapeutic healing, the ways it could lead to a brave new world of our own making.
The ethical inquiry as presented in "Beyond Therapy" is just now below the radar screens in the newsrooms of newspapers and television networks. "Given its potential importance," the authors write, "it is arguably the most neglected topic in public bioethics." That should change as soon as enough editors, teachers, politicians - citizens all - digest this report. (It's available online at www.bioethics.gov.)
President Bush formed the Council on Bioethics to advise him on the moral issues arising from the latest biomedical advances in science and technology. The primary purpose of this report is to inform and educate the public of the latest scientific findings, possibilities and hazards that could change, alter and perhaps even control biological nature as we know it.
These experts don't present mere hard facts, but confront the ethical and social questions that could have serious consequences, good and bad, affecting personal behavior and public policy.
We know, for example, that physicians prescribe drugs now to alter memory and moods. Question: "Should we use (these drugs) only to prevent or treat mental illness or also to blunt painful memories of shameful behavior, transform a melancholic temperament, or ease the sorrows of mourning?"
Drugs can have an effect on the consciousness that deprive us of insight and empathy, blunting emotions that make us human, reducing sensitive reactions to suffering and perhaps numbing our perception of wrongdoing. Drugs offer consolation. They can also coerce. If science can restore what's normal, can it transform normality, too?
We have techniques for increasing muscle strength and athletic performance. Question: "Shall we use them only to treat muscular dystrophy and the weak muscles of the elderly or also to enable athletes to attain superior performance?"
We must consider the tradeoffs of such enhancements. It's possible that increased physical attainments can obscure moral, intellectual and emotional understanding. Retarding physical decay of aging can also retard maturity. A stretched spectrum of life could increase the time of decline, debility and dependency. It could also reshape economic competition and the pressures between generations. We have no idea how high the price would be for the gift of longevity as it rearranges relationships in families and in society
We can already both prevent and promote fertility. We can screen for genetic and biological defects in the embryo. How much might we meddle? China, with its one-child policy, has created one generation already top-heavy with boys (117 boys to 100 girls) who will compete aggressively for the limited supply of girls, inevitably leading to trouble. Sex selection is a dangerous tool.
The authors consider the impact of biotechnology on issues of safety, fairness, equality and freedom. They pose the worrisome possibility that biotech enhancements could create a biological "aristocracy" further stratifying classes of people. Trend watchers, looking in another direction, suggest that such power could lead to a greater homogenization of society - extending to human nature what Alexis de Tocqueville saw as leveling influences in democracy.
"Beyond Therapy" is written with such clarity of language that it forces the reader to reflect on philosophical and policy issues for the sheer pleasure of thought. Creators of the biotech "tool kit" empower us to fight disease, restore physical and mental health, foster excellence and encourage self-improvement improving the lot of humankind. How do they also affect our notions of free will and moral responsibility?
Dr. Leon R. Kass, chairman of the President's Council on Bioethics, believes that Sept. 11 deepened America's moral seriousness and rallied support for the values of life, liberty, the rule of law and the pursuit of progress. But moral concerns in bioethics are more ambiguous. C.S. Lewis warned that mastering nature without guiding knowledge could lead to nature's mastery of man.
We can't afford to neglect this subject, no matter how difficult it may be to arrive at answers. Life, liberty and the pursuit of happiness have become more complex than the Founding Fathers dreamed of.
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