Bioethics, a humble servant to the queen?

Image taken from page 25 of 'The Men in the Moon: or, the 'Devil to pay.' With thirteen cuts [by George Cruikshank], etc. [A satirical poem-chiefly in reference to the proceedings of Messrs Cobbett, Hunt, and others.]'

The role of bioethics has been questioned in an op-ed by the silver-maned experimental psychologist Steven Pinker. Pinker’s piece has generated some heated online responses. While some commentators call for context and nuance in reading Pinker’s piece, others read it in the context of the turf wars over the role of science and the humanities in the modern production of knowledge. Pinker has held a lead role with #TeamScience in these disputes. Until recently, bioethics has been able to negotiate these wars by trying to get along with everyone. However, Pinker’s recent call for bioethics to “Get out of the way” and allow medical science to do its life-saving thing has publicly questioned whether bioethics is helping or hindering medical science.

A questionable lineage

In the not so distant past, theology and philosophy both laid claim to the title “queen of the sciences” – a claim that not many today would grant either. In terms of institutional and financial support, both are in the descent (see, see). This is not to say that we should smooth the pillow and send them off into the quiet night. Both will continue their important work, but many of the hangers-on will continue to retreat to other parties. Vice-Chancellors and politicians won’t be launching books or holding soirees to celebrate a new breakthrough in Hegelian scholarship, for instance.

While the social and economic capital of theology and philosophy declines, their child, Bioethics, is perhaps in a more opportunistic optimistic position. Since the 1970s bioethics has found a role in service of the new queen – medicine. Medicine fulfills the role once held by theology and philosophy in ordering the human sciences.* The importance of medicine and medical research in the modern university is unquestioned. In the same way theology was once essential to Oxford University; medical research has become essential for a major research institution to be taken seriously. Its role is more than this however. Medicine is not only greatly valued, but determines the value of other human sciences. The closer a discipline’s proximity to medicine and the goal of securing human health and preventing curing disease (see), then the greater the value of that discipline.

Bioethics has been placed, or placed itself, within and alongside medical research.

In the 1970s, philosophers and theologians offered initial responses to public scandals in research and clinical practice. For example, Tuskegee syphilis experiments in the US, the experiments on women with cervical cancer at New Zealand’s National Women’s Hospital, or the death of Jesse Gelsinger; who died while participating in a clinical trial at the University of Pennsylvania. Events such as these led to acceptance that ethical oversight of medical research and practice is essential. Ethics committees were established, and ethics education became standard for medical students and researchers. The success of these interventions has led Pinker to conclude that medical researchers have learned to behave and appropriate checks are now in place. Therefore the shackles of bioethics can be loosened.

Keeping medical research “in check” is only part of the story.

A role also opened up for bioethics centres and bioethicists to calmly communicate breakthrough medical research to anxious publics. In Australia, Monash University established the Monash Centre of Human Bioethics in 1980 with Peter Singer as Director. The initial role of the centre was to promote the rapidly advancing research in artificial reproductive technologies at Monash University. Alan Trounson, the former director of the Monash Centre for Early Human Development, recalls:

I had to sort myself out in the early days just like anyone who works in a new area involving something like human embryos. If we hadn’t had Peter Singer around in those days I think we might not have pursued some things to the extent that we have.

Singer, among others, helped further the research of Trouson and his colleagues by communicating to the public that the moral status of an embryo is not something to be concerned about and that so called “test-tube” babies are just fine.

Pinker believes that it is time for bioethics to “get out of the way”. However, rather than saying “stop”, a lot bioethicists have arguably greased the wheels of medical science and widened societal ethical boundaries to allow more and more research to be done. So perhaps in this case, what Pinker meant to say was not “get out of the way”, but “get in your place! Tell the public that editing genomes is not to be worried about because biomedical research is progressing and soon disease will be regressing”.

*This is not to suggest a neat linear progression from theology to philosophy to medicine. The effects of theology, for instances, are still very present in philosophy and medicine (and bioethics).

The March of Medicalisation: Curing the Finitude of Life

Like baldness, old penises and a little girth, grey hair has entered a process of medicalisation. Today’s Sydney Morning Herald announces that scientists have found a cure for going grey. Or at least they have diagnosed the phenomenon as “massive oxidative stress” that results from the “accumulation of hydrogen peroxide in the hair follicle, which causes hair to bleach itself from the inside out.” This all sounds very plausible and scientific. I do not doubt that these scientists are providing an accurate description of the chemical and physiological processes leading to hair going grey.

While this will be welcome news for people with genetic or nutritional conditions associated with greying, the real commercial and media interest in this discovery is not for its impact on the lives of those with vitiligo. In addition to curing a specific biological conditions this technology will prominently be used to “cure” socio-psychological problems in living that inhibit a recognition of the finitude of life. The increasing number of cashed-up-baby-boomers are an enormously profitable market for this discovery and other biomedical technologies that purport to “cure” conditions associated with ageing.

Of course, some say that the lines between therapy and enhancement are arbitrary and we should embrace all that biomedicine has to offer. Perhaps. However, promises of improving, enhancing and extending life may also re-define, transform and undermine the very features of life that we initially wanted to “enhance”.

Biomedical and pharmacological technologies increasingly mask the fragility and vulnerability of the body and human existence. Further, the expansion of biomedicine into areas of life not previously considered medical leads to biomedicine becoming the frame of reference that determines the appropriate course of action to take when a problem arises, medical or otherwise.

Thus biomedicine not only assists us with knowing what to do about our greying, ageing and flaccid bodies, but when we can no longer make the infirm firm, biomedicine continues to shelter us from the realities of finite life. That is, when we have exhausted the biomedical possibilities of shaping and governing life, when our bodies move beyond the biomedical frame, we can use it to deliver us from “the strange, weird, and spooky” condition known as death.

The cure for greyness, like certain aspects of euthanasia, is not so much of a problem for what it is or purports to do, but for the way that it subtly transforms the terms of reference of who we are and how we live.