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 n Wednesday, a
House committee will hear testimony on the dangers of cloning. NRO
caught up with Wesley J. Smith,
author of The
Culture of Death: The Assault on Medical Ethics in America,
to discuss cloning and other life-altering issues.
Kathryn Jean Lopez: What is bioethics
and why are you so alarmed by it?
Wesley J. Smith: Generally speaking,
bioethics is a branch of philosophy that seeks to work through the
ethical dilemmas presented by high-tech medicine and the intricacies
of modern health-care public policy. But it is actually much more.
I believe it has become something of an ideology.
Bioethicists often claim that they are not a unified movement. To
some degree that is true, but in my view, their differences are
not so much about the direction in which they want to take us but
how fast they want to get there. I see the divisions in bioethics
as akin to the divisions between Baptists and Catholics. Underlying
the divisions are some generally agreed-upon premises.
What is so alarming is that the movers and shakers of the bioethics
movement generally reject Hippocratic medical values, the sanctity/equality
of human life, and believe that moral value is not based on being
a human being. Rather than accepting an "equality of life" ethic,
they propound a "quality of life" ethic. Thus, they have created
a way to divide life — whether human or animal — between
those deemed as having ultimate moral worth, generally called "persons,"
from those with less value, generally called "non persons." Many
bioethicists believe that some animals are persons and some people
— generally, those with poor cognitive capacity — are
non-persons. And even bioethicists who reject animals as persons
accept the premise of the human non-person who can be used as an
object rather than a subject. Thus, some look at non-persons as
sources of organs or as available for "us" to use in medical experiments.
Some even posit that non-persons can be killed morally. The most
famous of these is Princeton's
Peter Singer, but he is certainly not alone.
What is really disturbing is that these folk are not fringe thinkers
but are at the heart of the elite: They serve on presidential bioethics
commissions, work with Congress to create public policy, testify
in court, teach the doctors and civic leaders of tomorrow in our
most elite universities, advise HMOs, etc. They are among our society's
most influential people.
Lopez: How widespread is the "what's-so-special-about-being-human"
mentality?
Smith: It strikes me that it is rampant
within the elite bioethics community, in the biological sciences,
and in the "animal rights" movement. But I am convinced that most
of the rest of us thoroughly reject the idea. It is a very dangerous
concept, really. If humanity isn't special, that is exactly how
we will act.
Lopez: You're not the typical conservative,
pro-life type. You are, for instance, a Naderite, even co-authored
some books with Ralph Nader. What brought you to this topic?
Smith: I don't think you have to be
conservative to oppose most of the agendas promoted by the leading
lights of the bioethics movement. For example, members of the disability-rights
movement are very potent opponents, since they see themselves in
the crosshairs, which of course they are. Most disability-rights
advocates tend to be secular, liberal, and support the legality
of abortion.
I came to oppose the bioethics movement out of my work against assisted
suicide, which I perceive is the proper liberal position, at least
based on what liberalism used to be when its leading lights were
Martin Luther King, John and Bobby Kennedy, and Ralph Nader. As
I dealt with euthanasia, I came to see that assisted suicide was
merely the tip of the iceberg, that people who reject the values
I hold most dear are explicitly advocating many policies that acutely
endanger people who are disabled, elderly, and ill. And once I really
got into what the most influential bioethicists really advocate
and began to understand the bases of their belief system and its
awful consequences, I was appalled and alarmed. So, being a good
Naderite, I decided to see what I could do about it. I am very happy
to report that I have been accepted with open arms by conservatives
in this work despite my "suspect" pedigree. That has been most gratifying.
And I have come to realize that I no longer care so much about left
versus right, as I do about right versus wrong.
Lopez: Is cloning here to stay?
Smith: Not necessarily. Much of Europe
has already outlawed human cloning, which I hope strengthens the
backbones of our state and national leaders, who have been AWOL
on this issue.
I think most people would support a legal ban of human cloning.
Most find the prospect of cloning human beings to be a truly nauseating
proposition, which brings to mind Leon Kass's profound concept of
the "wisdom of repugnance." Queasiness is an appropriate response
to the prospect of cloning. In many ways it is deeply misanthropic.
Cloning is about transforming the mystery and majesty of life into
a mere malleable and marketable commodity, which is not surprising
since many cloning supporters in the bioethics movement embrace
a view of human life as "merely biological," as essentially no different
from the rest of life on the planet. Moreover, cloning is the intended
vehicle by which neo-eugenicists hope to "control" human evolution.
What human attributes should be increased or eliminated to make
for an "improved" species? Eugenicists and many bioethicists often
wax ecstatic about increasing intelligence, as if that were the
end all and be all of humanity. But what about the capacity to love,
selflessness, gentleness, empathy? Somehow, they are rarely, if
ever, mentioned. Ironically, these essential human attributes are
often present most profoundly in people who are developmentally
disabled — the very humans who are to be eliminated by the
new eugenics.
I am also struck by the hubris of the entire cloning enterprise.
Somehow pro-cloners forget that we are the race that built the unsinkable
ship, Titanic. Our fallibility is part of who we are and
it is the one human attribute that the Brave New Worlders always
seem to forget. But it won't go away and that makes any attempt
to mess with human evolution tremendously dangerous.
Lopez: Is assisted suicide simply compassionate
in most people's minds?
Smith: I don't think most people give
a lot of thought to assisted suicide, one way, or the other. If
you force them to comment upon it, off the top of their heads they
would probably see it as a way of being compassionate as a last
resort when nothing can be done to alleviate suffering. After all,
that is how the subject is almost always presented in the media,
and more importantly, in popular entertainment. But when they are
forced to look the issue squarely in the eye, they see that assisted
suicide is actually a way of abandoning the most weak and vulnerable
among us and still get a good night's sleep. Think about it. You
have a serious disability or illness and you go to your doctor and
say, I want assisted suicide: if the doctor says, "Okay, it's your
choice," what is the physician actually doing? Confirming your worst
fears about your future life — that it will be agonizing or
that you no longer have a life worth living, or that you are now
a burden to everyone around you. What is needed at these times is
unconditional acceptance, not the false compassion of killing.
And we also must grapple with the economics of the whole thing.
It only costs about $40 for the drugs used in an assisted suicide.
It may cost $40,000 or more provide the kind of appropriate care
that patients need in these circumstances. In the context of HMOs,
many people come to realize that assisted suicide could easily become
a way of controlling costs should killing ever be deemed widely
to be an acceptable medical practice.
These are just a few of the reasons why we have been able to prevent
the assisted-suicide movement from sweeping the country once the
act was legalized in Oregon in 1994. Many people are not aware that
voters in Michigan rejected assisted suicide by 71-29 percent in
1998 and Maine voters rejected it narrowly in 2000. At this moment,
at least, assisted suicide is going nowhere fast.
Lopez: You mention in your book that
polls suggest that people are actually opposed to "futile-care theory."
What accounts for that, given its pervasiveness?
Smith: Futile Care Theory states that
if a doctor believes that the "quality" of a patient's life is unacceptable
to the doctor, he or she can refuse to provide the patient with
WANTED life-extending medical treatment. If the patient refuses
to go along, some futile-care hospital protocols empower institutional
ethics committees to become quasi-judicial decision makers, turning
thumbs up or thumbs down to extending life medically. If the verdict
is that the treatment should cease, these protocols refuse the patient
the right to receive the care in the institution even if another
doctor is found who is willing to provide it. The whole idea is
akin to a hospital putting up a sign that you might see on the door
of a restaurant — we reserve the right to refuse service. These
protocols are quietly being put into place in hospitals all around
the country. They are the foot in the door to medical rationing.
Most people don't know about futile care. But when they find out,
they are appalled. It is a whole new game of "Doctor Knows Best,"
kind of like the bad old days when doctors hooked people up to machines
against their will. Only this time, instead of the impetus being
to extending life, it is to cutting off treatment, other than comfort
care. So of course people oppose it. They want to make these important
decisions themselves.
The good news is that futile care is not yet pervasive. But I fear
unless people wake up to the threat, it will be imposed from on
high by the so-called experts of bioethics and then ratified by
courts, as it has been in England. That is why I am trying so diligently
to be Paul Revere on the subject.
Lopez: Are there any politicians who
understand this stuff?
Smith: A few but not enough. But they
are learning. I am noticing a heightened interest in the halls of
power over these issues because they are going to have to grapple
with bioethics, like it or not. Once they truly understand where
the expert bioethicists who are testifying before their committees
are coming from and that their constituents do not share bioethics'
values, I trust that the movement's influence will begin to wane.
Lopez: You suggest a policy of containment
on these issues. Who can best spearhead the containment movement?
Smith: I have one word: coalitions.
I believe that conservatives who believe in the sanctity of human
life and liberals who passionately espouse equality, share a commitment
to protecting vulnerable people and thus, can find common ground
in opposing many bioethical issues: cloning, futile-care theory,
health-care rationing, personhood theory, redefining death to include
a diagnosis of persistent unconsciousness — a proposal that,
believe it or not, is under intense discussion at the highest levels
of the organ transplant community.
The key to this, I believe, is not to get sidetracked by disagreements
over abortion — certainly no easy task. That is not to say
that pro-lifers should stop being pro-lifers or pro-choicers, pro-choicers.
But it is to say that their strong and principled disagreement over
that volatile issue cannot be allowed to prevent good people from
working together to counter the bioethics movement.
We know it works. This is precisely the potent coalition that has
stopped the advance of assisted suicide. Liberals and conservatives,
pro-choicers and pro-lifers, decided not to allow abortion or other
controversial issues such as gay rights or impeachment to prevent
their coming together to contain assisted suicide.
We also need to move the center of the discussion out of the ivory
tower and into the public square. The wisdom of the American people
may be the great-untapped resource in this entire debate. We have
to demonstrate to the popular media that people care about these
issues and will not be turned off by a frank discussion of bioethics.
Finally, we need funding. The bioethics movement is rolling in dough.
If a few enlightened foundations can see their way through to adequately
financing a counter movement, I know we can more than hold our own
in the marketplace of ideas.
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