PCBE: Transcripts (January 16, 2004)
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Bioethics Research Library at Georgetown University https://repository.library.georgetown.edu/handle/10822/503786 Transcripts of the President’s Council on Bioethics (PCBE) Meetings 2001 - 2009 The Bioethics Research Library is collaborating with Georgetown’s University Library to digitize, preserve and extend the history of Bioethics. Please tell us how this access affects you. Your experience matters. Visit us at https://bioethics.georgetown.edu/. Interested in learning more about President’s Council on Bioethics? You can visit their website as it appeared on the last day of its charter. There you can learn about the council members, browse their reports, and locate background materials. The website is hosted by the Bioethics Research Library and can be found at: https://bioethicsarchive.georgetown.edu/pcbe/ Materials produced by the President’s Council on Bioethics are government documents and in the public domain. When citing this document please note the source as Bioethics Research Library and the appropriate Digital Georgetown hyperlink Collection Permanent Link: hdl.handle.net/10822/559325 Home Meeting Transcript About Us Meetings January 16, 2004 Reports Wyndham Hotel Transcripts 1400 M Street, NW Washington, D.C. 20005 Background Materials COUNCIL MEMBERS PRESENT Former Bioethics Commissions Leon R. Kass, M.D., Ph.D., Chairman American Enterprise Institute Rebecca S. Dresser, J.D. Washington University School of Law Daniel W. Foster, M.D. University of Texas, Southwestern Medical School Francis Fukuyama, Ph.D. Johns Hopkins University Michael S. Gazzaniga, Ph.D. Dartmouth College Robert P. George, D.Phil., J.D. Princeton University Mary Ann Glendon, J.D., L.L.M Harvard University Alfonso Gómez-Lobo, Dr. phil. Georgetown University William B. Hurlbut, M.D. Stanford University Charles Krauthammer, M.D. Syndicated Columnist William F. May, Ph.D. Southern Methodist University Paul McHugh, M.D. Johns Hopkins University School of Medicine Gilbert C. Meilaender, Ph.D. Valparaiso University Janet D. Rowley, M.D., D.Sc. The University of Chicago Michael J. Sandel, D.Phil. Harvard University INDEX Session 5: Toward a "Richer Bioethics" Council's Report to the President Release of "Being Human: Readings from the President's Council on Bioethics" Session 6: Discussion of the Council's Future Work Public Comments SESSION 5: TOWARD A "RICHER BIOETHICS" COUNCIL'S REPORT TO THE PRESIDENT 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