Biotech and theodicy: what can and what ought we to do in procreative technology?

Part I of this article deals with some theoretical issues concerning the way our culture arrives at moral judgments and the way the law functions relative to public moral concerns. I will illustrate my points with reference to, and through discussion of, the report promulgated by the National Bioethics Advisory Commission (NBAC) of 1999, which was established to advise former President Clinton on the ethics and law of stem cell research. Part II will focus on some philosophical and religious issues connected to the nature of the humanhood of embryos and fetuses. Specifically, it asks--and answers--two questions: (1) What provides human dignity to embryos? and (2) When does humanity begin in the embryological development? Part III contains some concrete proposals about what types of stem cell research or cloning can be ethically and legally allowed. Finally, in a brief Part IV, I will directly address a point implicit in the previously discussed issues. It is the argument that our scientific capacities require us to "play God," and that the recognition of this theodiceic requirement enables us to make more precise judgments than would the rejection of any tampering with procreative technology. I will argue that it is necessary to overcome the cultural denial of this theodiceic role in order to make precise ethical judgments. This denial is rooted in a long tradition, especially virulent in the Roman Catholic tradition, of rejecting the legitimacy of modernity and seeking a return to a premodern naivete. (1) But precise ethical judgments require us also to face the unreflected naivete that is evident in some highly progressive futurists who would simply claim that "science knows best." (2) I. SOME THEORETICAL ISSUES UNDERLYING STEM CELL RESEARCH In our attempt to master human diseases, not many areas hold as much promise as stem cell research. (3) However, the ethical difficulty is that, at this time, the most promising and truly pluripotent stem cells can only be derived from human embryos. (4) Because the moral status of the human embryo is the central issue in this debate, (5) the fact that embryonic stem cells (ES cells) at this time hold forth the most promise requires us to focus on this issue. It was Kant's injunction that human beings must never be used as a means to different ends. (6) Bioethicists generally reject nontherapeutic research (7) done on human subjects. So in stem cell research, we are confronted with a classical dilemma. On the one hand, the imperative to promote human well-being by means of this new technology has hardly ever been more urgent. On the other hand, however, the ethical mandate to protect and promote the well-being of human beings, to which embryos possibly belong, has never been higher. (8) Ethics advisory boards have been established during the last twenty years not only to safeguard that well-being, but also to provide guidance on what is permissible and what is not. Such groups, including the governmental National Bioethical Advisory Commission (NBAC) of 1998 and its predecessors, and similar private groups such as the Geron Bioethics Advisory Board, (9) are faced with a plurality of ethical perspectives and traditions. They have to deal with that fact somehow. Throughout its report, the NBAC attempts to balance broad spectrums of views of individuals and groups. That strategy raises the question: Whose values should prevail? But if one hopes to address the question of the ethics of stem cell research realistically, it is not sufficient to observe a pluralism of values in the hope of deriving the most acceptable compromise from that plurality. Hume proclaimed that ethical certainty about what we ought to do can surely not be found in this way. (10) Ethics, in principle, has little to do with that realm of 0the plurality of views, although, of course, a body such as the NBAC must listen to those voices--in the same sense that a politician must. But any politician knows that the common maxim of "govern-ment by the polls" is not such a good idea, and so too the NBAC should have recognized that any moral recommendation of what ought to be done cannot be derived from that plurality of views. …