COMMENTARY

Post Date: March 28, 2002

Comments on a White House Visit

by John F. Kilner, PhD

I spent Tuesday afternoon at the White House with President George Bush, Secretary of Health and Human Services Tommy Thompson, Head of the Human Genome Project Francis Collins, and other national health care leaders. President Bush sketched his national priorities and ethical commitment regarding the health care arena and introduced to the group the two people he has chosen to lead major aspects of his health care agenda. It was a good opportunity to open lines of communication--which are essential in the midst of today's pressing bioethical debate.

As President Bush yesterday described his priorities for medically-related scientific research and health-related initiatives generally, it sounded much like what one would expect from a President. We will conquer diseases and addictions in new ways, we will develop the medical ability to respond well to bio-terrorism, we will become much more effective at preventing health problems from even arising. It is an inspiring set of goals, buoyed by a commitment to providing the resources to get the job done. Those resources include not only funds--which the President has been increasing at a rapid rate--but also leadership--in particular, two people the President introduced to us with enthusiasm: They are his nominees for Director of the National Institutes of Health, Dr. Elias Zerhouni, and for Surgeon General, Dr. Richard Carmona.

What was distinctive, though, was the middle part of the President's remarks. He emphasized that as wonderful as the scientific and other health-related achievements will be, "human life is precious, and should not be exploited or destroyed for the benefits of others." This was an implicit reference to the efforts of some to develop medical treatments through embryonic stem cell research and so-called "therapeutic" cloning--both of which necessarily involve the destruction of embryonic human life at some point. President Bush affirmed the preciousness of human life and the necessity of holding medicine responsible to (sound) medical ethics. He made it clear that the two leaders being introduced to us were his choices to carry forward his agenda--both ethical and medical-scientific.

Accordingly, in my interactions with the President's nominees, I asked about how they saw the ethical dimension of the task before them. Each responded with words to the effect that it will be a daunting but important task. They welcomed the information I gave them, along with the opportunity to learn more about resources that CBHD can provide to help them wrestle with bioethical issues. They undoubtedly would have agreed with the comments of two other people present with whom I spoke at the end of the session: Dr. Francis Collins, Head of the NIH effort to map the human genetic code, and Dr. David Prentice, Science Advisor to the bioscience leader in Congress, Senator Sam Brownback. These two emphasized the pressing need for CBHD to facilitate further cutting-edge thinking so that the ethical guidelines for channeling bioscience research can be more carefully formulated and more widely disseminated.

President Bush's comments and those of the likely Surgeon General and Head of NIH (pending Senate confirmation) suggest that these appointments are about far more than medical science. They are unavoidably about ethics as well. But should they be?

To hear some of the early commentators quoted in the Washington Post, one might wonder. Carl Feldbaum, President of the Biotechnology Industry Organization, maintains that involving ethical considerations in the appointment process is inappropriate--we should only be concerned to find leaders who will best promote scientific and medical progress. Stanford Nobel laureate Paul Berg complains that a nominee who considers certain forms of research unacceptable because they are unethical has an inappropriately "closed mind."

What emerges from such commentators is the view that a President and those whom he selects to carry out his policies ought not, as a matter of principle, conclude that ethical limits should be imposed on science. This view sees science and medicine as value-free enterprises in which anything that yields great benefits is therefore justified, regardless of the scientific means involved. Such a utilitarian approach has been used to justify some of the worst atrocities in scientific history. Others make the opposite mistake by automatically worrying when science attempts to enter new realms such as altering cells or changing the genetic code. This position fails to recognize that such endeavors need not involve more than something which good medical care has always been concerned about: correcting problems of the body. There is a better approach than both these outlooks--one which eagerly pursues developments in bioscience rather than being instinctively suspicious or resistant toward them, but which expects and welcomes ethical limits on bioscience rather than considering them necessarily close-minded and inappropriate.

President Bush made it clear yesterday that he is committed to a close relationship between ethics and science, and that he is directing his leadership team to make that their approach as well. Whether one agrees with Bush's politics or not, this approach to medical science should be applauded.

Nevertheless, the reaction in some quarters is predictable. Some will be upset that Bush would require of his top leaders any basic ethical commitments that might limit what forms of research are acceptable. Others will react to the news of new leadership and renewed energies to speed up developments in bioscience with automatic alarm. May those committed to the preciousness of human life--Christians foremost among them--be the most vocal of all in their support of the appropriateness and, in fact, necessity of a close relationship between ethics and science, for the true good of all human beings.

More specifically, we need to do all we can to make sure that real content is given to medical ethics. Dr. Zerhouni has voiced support for the President's opposition to research involving more killing of human embryos, even though he currently works at an institution doing embryonic stem cell research. It is appropriate and essential that the public hold him accountable, among other things, to this commitment. CBHD

John F. Kilner, PhD is President of The Center for Bioethics and Human Dignity and Franklin Forman Chair of Ethics at Trinity International University, both in Bannockburn, IL.

Copyright 2003 by The Center for Bioethics and Human Dignity. The contents of this article do not necessarily reflect the opinions of CBHD, its staff, board or supporters.  Permission to reprint granted as long as The Center for Bioethics and Human Dignity and the web address for this article is referenced.