What is "Bioethics"? pg.4

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D. The problem of "personhood":

Although bioethics conveniently wants desperately to claim that it does not embody any anthropology - or definition of a "person" - it obviously does. As noted (and referenced above and below), many (if not most) of those who heavily influenced the development of bioethics brought to their several analyses very specific positions on "personhood" -- especially the "personhood" of the early human embryo and the human fetus.

For example, most of them believed in some sort of "delayed personhood", i.e., "personhood" (or, "moral status") did not begin until some magical biological marker event after fertilization. And "personhood" was invariably defined philosophically in very rationalistic and/or empiricist terms -- e.g., "rational attributes" such as autonomy, knowing, willing, self-consciousness, relating to the world around one, etc.; or, "sentience" such as the feeling of pain or pleasure. Obviously early human embryos and fetuses did not possess such "personhood" characteristics (nor do a lot of adult human beings, I might add). Practically speaking, the effect of this within bioethics was to provide "theoretical" support for those who could then take the position that the use of early human embryos and fetuses "for the common good" or "for the advancement of science" was therefore "ethical".

This presumptive position on "personhood" is likewise true for the majority of bioethicists practicing today.100 It is the position, for example, of leading and influential contemporary bioethicists such as: Jonathan Glover, R.M. Hare, Clifford Grobstein, Joseph Fletcher, Tris Engelhardt, Tom Beauchamp, Michael Tooley, Peter Singer, Helga Kuhse, Stephen Buckle, Karen Dawson, Pascal Kasimba, Michael Lockwood, Hans-Martin Sass, Robert Edwards, Donald MacKay, Bernard Haring, Dorothy Wells, Goldenring, Thomasine Kushner, M. Shea, and Richard Frey -- to name but a very few.101 Their philosophical positions on "personhood" have had a profound influence on public policy -- here and around the world.

It is the issue of "personhood" that this writer considers pivotal to any legitimate academic debate on "ethics" or "bioethics". Historians of philosophy routinely dwell in great depth on the "anthropology" (or, "personhood") claims of any particular philosopher in history as a means of grounding and explaining the "pros" and "cons" of a philosopher's particular brand of ethics. That is, the ethics flows from the anthropology -- either explicitly or implicitly, whether intended or not intended. [These texts also routinely focus on how a specific anthropology, in turn, flows necessarily from specific metaphysical and epistemological presuppositions. In fact, each historical philosopher's work is classified according to the several parts of the study of philosophy, i.e., as natural philosophy, metaphysics, epistemology, anthropology, ethics and politics -- and usually in that order].102 Some of the greatest failures of philosophers in the history of philosophy are caused specifically because of a failure to adequately develop a coherent and defensible anthropology.

And the questions arise: If the anthropology inherent to "bioethics" -- explicitly or implicitly -- cannot be justified or successfully defended, then how can the "theory" of bioethics itself be justified or successfully defended? And if the "theory" can't be justified or successfully defended, or doesn't work, then why use it?

Perhaps one of the most salient failures in modern times was the quite controversial and monumentally flawed anthropology of Descartes, with its infamous "mind/body split" (although the theoretical faults of Descartes' "mind/body" split are hardly new, reaching back to Plato at least). Most of the "philosophical" dogmas bandied about since the beginning of bioethics have drawn heavily from Descartes' immediate -- and likewise theoretically flawed -- rationalist and empiricist successors. Most likely the reason why most contemporary bioethicists do not want to get into the pure philosophical anthropology (or the philosophical metaphysics and epistemology grounding it) is because they don't know their history of philosophy, their metaphysics or epistemology (having never studied it), or because they already know that academically they cannot successfully defend it, any more than Descartes and his successors could. E.g., simply consider this: If there is a real split or a gap between the "mind" (or "soul") entity, and the "body" or "matter" entity -- which is required if there is any "delay" in "personhood" -- then one cannot successfully explain any causal interaction whatsoever between these two separate entities. In historical terms, this is referred to as the "chorismos" (or "separation") problem originated by Plato in his famous Theory of Forms. Descartes tried, and was literally laughed out of the academy.103

One of the most popular proponents of the school of "preference" utilitarianism and of "delayed personhood" comes from one of bioethics' most infamous practitioners -- Australian eugenicist and animal rights philosopher/bioethicist Peter Singer. Singer was the first President of the International Institute of Bioethics under the United Nations, and is the newly appointed director of Princeton University's Center for Human Values (a post initially offered to Singer's mentor, British eugenicist Jonathan Glover, who turned it down). Singer defines a "person" only in terms of something actively expressing "rational attributes and/or "sentience".104 Singer, in fact, enthusiastically advocates infanticide of even normal healthy newborn human beings - in fact, even older children. Why? Because they do not actively express "rational attributes" or "sentience", and therefore they may be human beings, but not "persons". On the other hand, he claims that the higher primates, e.g., apes, monkeys, dogs, pigs, chickens - even prawns - are persons because they do actively exercise "rational attributes" and "sentience".105

Philosopher/bioethicist R.G. Frey correctly pushes Singer's "logic" to its inevitable conclusion. In an invited presentation to the Scholars at the Kennedy Institute of Ethics, Frey boldly argued that to be "logically consistent" (with Singer), one would have to agree that the mentally ill, the frail elderly, etc., who are therefore not "persons" (according to Singer's definition) should be substituted for the higher primates, who are "persons" (according to Singer's definition) in purely destructive experimental research. This is ethical -- even morally required for "the greater good".106 Similarly, Norman Fost defines cognitively impaired human beings as "brain dead".

Singer, in enthusiastically promoting eugenics, uses all three bioethics principles at will, depending on which one gets him where he wants to go. Thus adroitly he appeals to our autonomy - e.g., if the parents of a defective newborn, or even a normal newborn, autonomously "choose" to kill their child, then that is "ethical" and we must respect their autonomous rights. However, if the parents won't do this on their own accord and if it is for "the greater good", then the government has the duty to force them to do it, particularly if the child is defective! So much for rights; in fact, Singer does not even believe in rights at all!107 His mentor R.M. Hare is just as articulate when he discusses the role of the government in such issues. For Hare, the maximum duty that is to be imposed by the government is to do the best impartially for all the "possible people" there might be by having an optimal family planning or population policy, which means necessarily excluding some possible people. Indeed, he argues, the best policy will be the one which produces that set of people, of all "possible sets" of people which will have in sum the best life, i.e., the best possible set of future possible people!108

Many of these rationalistic or empiricist arguments for "delayed personhood" sound eerily similar to those of the early eugenicists who heavily participated in the early conferences in the 1960's noted above (to whom Jonsen refers in his book). But such articulations were hardly restricted to those early "savants". Take for example an article that appeared in a 1972 issue of Reason Magazine. The themes of this particular magazine issue, as printed on the cover, were: parahuman reproduction, android cloning, brain transfers, genetic engineering and artificial synthesis. The lead article, "The new biology", was by Winston Duke. Listen to Duke's rationalistic definition of a human "person", and to what it will be applied:

It is quite possible that the advances in human biology in the remainder of the twentieth century will be remembered as the most significant scientific achievement of the animal species known as Homo sapiens. But in order to become a part of medical history, parahuman reproduction and human genetic engineering must circumvent the recalcitrance of an antiquated culture. ... Fit the parts of the puzzle together: nucleus transplant, test tube growth to blastocyst and uterus implant -- the result is clonal man. ... An Eugenic Age is just around the corner. ... Under scientific management, the result can be human parts-farming: the methodical production of precious organs such as eyes, hands, livers, hearts, and lungs. ... The foremost philosophical problem presented by the new biology is semantical: What is a human being? ...Humanity per se is based on cognitive abilities. A philosophy of reason will define a human being as one which demonstrates self-awareness, volition and rationality. Thus it should be recognized that not all men are humans. The severely mentally retarded, victims of lobotomies, the fetus, blastocysts, androids, etc., are not human and therefore obtain no human rights. ... It would seem ... to be more "inhumane" to kill an adult chimpanzee than a newborn baby since the chimpanzee has greater mental awareness. Murder cannot logically apply to a life form with less mental power than a primate. ... It certainly follows that the practice of abortion is not immoral. And it is furthermore conclusive that experiments with fetal material and the engineering of nonthinking Homo sapiens tissues are not immoral. A clear definition of humanity in terms of mental acuity, rather than physical appearance, should be encouraged. And libertarians should continue to defend as absolute the prerogative of humans to conduct their own lives independent of societal norms, whether that conduct involves euthanasia, suicide, abortion, organ transplant, or ownership of genetic material. ... Likewise, the incentive for developing a rational philosophical framework including a psychology of self-esteem will be magnified. ... [I]t would be increasingly obvious that a philosophy of reason is needed to meet the test of present day living, and that it is the only orientation able to readily absorb the ever developing spectrum of scientific discovery.109 (emphases mine)

It doesn't get much clearer than that -- and that was written in 1972. As with Singer et al today, in order to accomplish the agenda of "the new biology" it is first of all required to change the definition of a "human being", and that is to be accomplished by means of the change from a philosophy of realism to a philosophy of reason -- not to mention by means of deconstructing the science of human embryology as well. If the correct science doesn't support such rationalizations, then just change the science to fit the theory. And to be sure, if only "rational attributes" successfully define the early human embryo, fetus, young children and many older adult human beings out of "personhood", it therefore also defines many adult human beings who are terminally ill and dying out of "personhood" as well.

However, such logical -- and real -- consequences did not seem to daunt the reasoning processes of many budding bioethicists. E.g., Dan Wikler110, in his report to the President's Commission (below) on issues of death and dying, also defined those who were "dead" in terms of a lack of "rational attributes", fueling the sparks which would become the euthanasia and assisted suicide debates to come.111 More recently Wikler, as representative of the World Health Organization, declared that "The state of a nation's gene pool should be subject to government policies rather than left to the whim of individuals, ... The completion of the human genome project would also make it possible to promote some genetic qualities such as intelligence and lower the incidence of others. ... It may be conceivably required by justice itself."112

Wikler's blatantly eugenic position is echoed by quite a multitude of contemporary bioethics leaders, scientists and experts today:113

James Watson, Nobel laureate and founding director of the Human Genome Project: "And the other thing, because no one has the guts to say it, if we could make better human beings by knowing how to add genes, why shouldn't we? What's wrong with it? ... Evolution can be just damn cruel, and to say that we've got a perfect genome and there's some sanctity to it? I'd just like to know where that idea comes from. It's utter silliness."

Gregory Pence, professor of philosophy in the Schools of Medicine and Arts/Humanities at the University of Alabama: "Many people love their retrievers and their sunny dispositions around children and adults. Could people be chosen in the same way? Would it be so terrible to allow parents to at least aim for a certain type, in the same way that great breeders ... try to match a breed of dog to the needs of a family?"

Lee Silver, professor of molecular biology and neuroscience at Princeton University: "[In the future ...] the GenRich -- who account for 10 percent of the American population -- all carry synthetic genes. ... All aspects of the economy, the media, the entertainment industry, and the knowledge industry are controlled by members of the GenRich class ... Naturals work as low-paid service providers or as laborers ... 'Eventually] the GenRich class and the Natural class will become ... entirely separate species with no ability to cross-breed, and with as much romantic interest in each other as a current human would have for a chimpanzee. ... But in all cases, I will argue, the use of reprogenetic technologies is inevitable ... whether we like it or not, the global marketplace will reign supreme."

Francis Fukuyama, professor of public policy at the Institute for Public Policy at George Mason University: "Biotechnology will be able to accomplish what the radical ideologies of the past, with their unbelievably crude techniques, were unable to accomplish: to bring about a new type of human being ... [W]ithin the next couple of generations ... we will have definitively finished human History because we will have abolished human beings as such. And the, a new posthuman history will begin."

Lester Thurow, professor of economics, Sloan School of Management, MIT: Some will hate it, some will love it, but biotechnology is inevitably leading to a world in which plants, animals and human beings are going to be partly man-made. ... Suppose parents could add 30 points to their children's IQ. Wouldn't you want to do it? And if you don't, your child will be the stupidest child in the neighborhood."

Gregory Stock, Director of UCLA's Program on Medicine, Technology and Society: [O]nce people begin to reshape themselves through biological manipulation, the definition of human begins to drift. ... Altering even a small number of the key genes regulating human growth might change human beings into something quite different. ... But asking whether such changes are 'wise' or 'desirable' misses the essential point that they are largely not a matter of choice; they are the unavoidable product of ... technological advance ...'

Arthur Caplan: "Absolutely, somewhere in the next millennium, making babies sexually will be rare. ... Many parents will leap at the chance to make their children smarter, fitter and prettier. Ethical concerns will be overtaken by the realization that technology simply makes for better children. In a competitive market society, people are going to want to give their kids an edge. They'll slowly get used to the idea that a genetic edge is not greatly different from an environmental edge."

Or consider the arguments of one of the Founders of bioethics, Tris Engelhardt, whose articles and books on bioethics are still quoted and taught world-wide:

Persons in the strict sense are moral agents who are self-conscious, rational, and capable of free choice and of having interests. This includes not only normal adult humans, but possibly extraterrestrials with similar powers114.

... It is for these reasons that the value of zygotes, embryos, and fetuses is to be primarily understood in terms of the values they have for actual persons. Zygotes, fetuses, and embryos do not have the rich inward life of adult mammals. ... However, one must remember that the sentience of a zygote, embryo, or fetus is much less than that of an adult mammal. One might even develop a suggestion of the natural theologian Charles Hartshorne so as to argue that from the perspective of the Deity the intrinsic value of a human fetus will be less than that of an adult normal member of some other mammalian species. (pp.112-113). ... One also owns what one produces. One might think here of both animals and young children. Insofar as they are the products of the ingenuity or energies of persons, they can be possessions. There are, however, special obligations to animals by virtue of the morality of beneficence that do not exist with regard to things. Such considerations, as well as the fact that young children will become persons, limit the extent to which parents have ownership rights over their young children. However these limits will be very weak with regard to ownership rights in human zygotes, embryos, and fetuses that will not be allowed to develop into persons, or with regard to lower vertebrates, where there is very little sentience. For example, it would appear very plausible that plants, microbes, and human zygotes can be fashioned as products, and be bought and sold as if they were simply things. In contrast, strong claims of ownership would cease, as children become persons and sui juris, self-possessing. This latter moral issue also arises with regard to normal adult nonhuman higher primates. It is much more plausible to suspect that higher nonhuman primates are in possession of themselves than to suspect that such is the case with even one-year-old human infants. At the point that an entity becomes self-conscious, the morality of mutual respect would alienate the property rights of the parents over the children or other animals (129-130). ... These reflections can be encapsulated in what one may term the principle of ownership. This principle will be central to understanding the roles of public and private funding in health care, as well as the rights of physicians to exempt themselves from the constraints of national health services. Owning private property, insofar as such private ownership exists, will always permit patients merely to buy around the established system. So, too, having the right to own one's talents will permit physicians to sell around the constraints of the system. This can be tendentiously summarized as the basic right of persons to the black market (pp. 133-134).115 (emphases mine)

Lest we forget too quickly, such gendre of statements are hardly new. They go back further than even the early bioethicsts, back further than even World War II. Listen to the words of Plato as he describes the necessity of using his "Royal Lie" in the creation of his Ideal State -- recorded centuries ago, and still appealed to today: [The discussion is between Plato and his follower Glaucon; all emphases mine]

[Book V, p. 722] This, Glaucon, like all the rest, must proceed after an orderly fashion; in a city of the blessed, licentiousness is an unholy thing which the rulers will forbid ... Then clearly the next thing will be to make matrimony sacred in the highest degree, and what is most beneficial will be deemed sacred. And how can marriages be most beneficial? -- that is a question which I put to you, because I see in your house dogs for hunting, and of the nobler sort of birds not a few. Now, I beseech you, do tell me, have you ever attended to their pairing and breeding?

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