Each fall the CBC asks me to predict what will happen in the coming year in bioethics/biotechnology. To say the least, I have a mixed record. I was more worried about 2009 than turned out to be warranted by events especially about assisted suicide which moved the ball not at all in the USA. (The UK was a different story altogether.). The stem cell predicting the demise of the Bush ESCR funding policy was a gimme, but Obama stepped over the line of expectation–and destroyed a good and uncontroversial policy–by revoking Bush’s 2007 order requiring non embryonic pluripotent stem cell research to be federally funded. That’s when I really knew–I already had suspected–that Obama was not a great compromiser, much less a committed uniter–he is an ideologue.
In any event, here are a few more matters I got right, wrong, and missed altogether. From my column, “2009–A Not so Dark Year After All:”
I made several predictions in other bioethical fields, and proved pretty prescient, but not infallible.
Abortion. I predicted that the Freedom of Choice Act (FOCA) – which would erase all state laws limiting abortion – would not pass. Not only did the bill not pass, no efforts were made to move the bill. However, I was wrong that federal funding for abortion would be permitted by the end of the year. That remains a goal of the Administration and the leaders of Congress, but as of now, it remains an unrealized goal.
Conscience Clauses. A great bioethical battle is coming over whether medical professionals who do not wish to be complicit in life-ending activities – such as abortion or assisted suicide – will be driven out of health care. I predicted that the “Bush Conscience Clause” protecting such dissenting health care workers would be overturned by the Obama Administration. I was certainly right that the effort would be made. Indeed, the effort was one of Obama’s first official acts. But bureaucracy being what it is, as of this writing, the revocation has not been published in the Federal Register. Meanwhile, a Ninth Circuit Court of Appeals ruled in a contraception case that a Washington regulation requiring all legal prescriptions to be filled did not violate the right to freedom of religion. If this case sticks, not only would Washington pharmacists with a religious objection to contraception be required to dispense birth control, but also to provide lethal prescriptions for use in assisted suicide…
Futile Care. Alas, I was right that Texas would not rescind its law legalizing medical futility in 2009. I was wrong that a major lawsuit in the field would make big news. Other than a temporarily stalled attempt to legalize futile care in Idaho, the field was generally quiet in 2009.
Biological Colonialism. I worried that despite legal attempts to restrict the exploitation of the world’s destitute for their body parts, biological colonialism (such as buying organs), would increase in 2009. While there were no reliable studies published about this, it is clear that at the very least, the problem remained undiminished.
Missing the Story of the Year
My greatest failure – and it’s a whopper – was missing the entire brouhaha over Obamacare. I expected health care reform to be introduced. But I never anticipated it would bloat to a 2000-page bill or that Congressional leaders would try and push the behemoth through with such scant opportunity for democratic debate. And because I missed the ruthlessness of Obamacare’s pushers, I also failed to predict the commitment and resiliency of the resistance. In other words, I wrote not a word about what turned out to be the biggest story in bioethics of the year. Why I still have this predictor gig is beyond me.
I am a bit chagrined about not seeing the approach of the big debate over Obamacare. Perhaps I thought he would learn from Hillarycare and not try to do a complete makeover. No such wisdom.
Jennifer Lahl tells me I am still the in-house prophet, so next month, I’ll sacrifice a bull and examine its intestines to tell you what 2010 will look like. Hey, if it was good enough for the Romans…