THE WEEKEND INTERVIEW
Soul Man
Leon Kass sounds a warning about the perils of biotechnology.
WASHINGTON--Leon Kass is willing--reluctantly willing--to indulge a request. I have asked him to refresh our interview of several weeks ago by reflecting on the case of Hwang Woo Suk, the internationally celebrated South Korean researcher who recently admitted to fabricating cloned stem cells. Dr. Kass thinks that a decennial White House conference on aging might make for an equally timely news peg. Health and longevity; dementia and death; euthanasia and living wills; performance enhancement and life-prolonging genetic manipulations--these are the subjects that really engage the mind of this 66-year-old physician and ethicist (and former philosophy professor of mine). As for embryos, stem cells, cloning and the uses and abuses thereof, they are "not the most profound of subjects," he told me over a pot of tea in the kitchen of his Washington apartment. "The embryo question is really about the means. The real question has to do with the ends to which we put this."
As far as Dr. Hwang is concerned, Dr. Kass is merciless, and he fires grapeshot: "Scientific fraud is always revolting, but it is fortunately rare and, in the end, truth will out. But in this case, American scientists and the American media have been complicit in the fraud, because of their zeal in the politics of stem-cell and cloning research and their hostility to the Bush funding policy. Concerted efforts have been made these past five years to hype therapeutic cloning, including irresponsible promises of cures around the corner and 'personalized repair kits' for every degenerative disease. The need to support these wild claims and the desire to embarrass cloning opponents led to the accelerated publication of Dr. Hwang's 'findings.' . . . We even made him Exhibit A for the false claim that our moral scruples are causing American science to fall behind."
Still, it says something about the tenor of the times that even now Dr. Kass remains stuck in what he wearily calls "embryoville." Ever since his appointment in 2001 as chairman of the President's Council on Bioethics (a position he relinquished last fall), he has been gamely and evenhandedly trying to work his way through the embryo debate, which really is just a salient in the larger culture war between "choice" and "life." But in an era in which biomedical technologies have already begun to alter the broad and basic contours of human nature, questions about when life begins, or what is permissible in the name of medicine, seem almost quaint. "Killing the creature made in God's image is an old story," he says. "Redesigning him after our own fantasies: That's what's really new."
To get a grip on what Dr. Kass is talking about, consider some topical examples. There is, for instance, the widespread use of performance-enhancement drugs by baseball players and other athletes. Typical arguments against the use of such drugs generally run in the direction that they are unsafe, that their use by some athletes and not others makes them unfair, that they create discontinuities in the nature of the sport (how does one meaningfully compare the home run record of steroid user Barry Bonds against that of Roger Maris), and that they are, at present, illegal.
But for Dr. Kass, the problem hardly ends there. "Let's assume," he proposes, "that you found some kind of steroid that was safe and produced no bad aftereffects. (Unlikely, but.) Let's assume they were legal. Let's assume everybody used it. I think the athletes would still be ashamed to be seen shooting up before they went to bat.
"That has something to do with the fact that what the activity purports to be is an activity of natural human gifts suitably cultivated by practice and effort. . . . I think we should curb [performance enhancers], but I think we need a better account of what it is athletics is really about and why, rightly understood, it's very much like all kinds of other human activities in which to flourish really means deeds that somehow flow in an uninterrupted way from our souls and bodies."
Or take the use of behavior-modifying psychotropic drugs: To what extent should they be prescribed to children not just to correct for abnormal behavior (as Ritalin corrects for attention deficit disorder or Prozac does for depression) but also to improve their performance? Parents generally want to give their kids an edge. But how would the widespread use of, say, concentration-enhancing stimulants by children affect their characters and the character of their childhood, even assuming those stimulants were safe and consistently effective?
"Artificial enhancement can certainly improve a child's abilities and performance," Dr. Kass wrote in "Beyond Therapy: Biotechnology and the Pursuit of Happiness," one of the council's six major reports. (Read them at www.bioethics.gov.) "But it does so in a way that separates at least some element of that achievement from the effort of achieving. It may both rob the child of the edifying features of that effort and teach the child, by parental example, that high performance is to be achieved by artificial, even medical, means."
And then there is the matter of dramatically prolonging the average human lifespan. Already, mice have been genetically engineered to overproduce certain proteins, thereby extending their average lifespan by about a third; sooner or later, similar genetic manipulations will be safely and usefully available for larger mammals, including humans. The question that will confront us then, says Dr. Kass, "is what the hell is wrong with that?"
Dr. Kass is certainly aware that human longevity increased dramatically in the past century, mainly to good effect (although mostly as a result of declining infant and child mortality rates). He is also cognizant of the powerful case, intellectual as well as emotional and intuitive, in favor of prolonging lifespans even further: "If we lived healthily and our friends lived healthily indefinitely, we could earn more, learn more, see more and do more." He is also willing to acknowledge that potential socioeconomic consequences of much longer living--e.g., when does your fit-as-a-fiddle 130-year-old boss retire so you can take his place?--could be resolved in some satisfactory, sustainable way.
But consider the kind of choices people might make if their biological deadlines were to be extended by decades. How long would our de facto adolescence last? How much longer would we postpone childbearing, if many of us didn't abandon the business altogether? How would the balance of social energies tilt between the young and the old? Would it not lead (liberals, take note) to an increasingly conservative and perhaps reactionary society? Would not the bulk of human energies turn toward coarse and selfish attempts at self-preservation? "There are very few people who've been around a long time who see anything with fresh eyes," says Dr. Kass. "We need to put our weight with the young."
It certainly is hard to dismiss this dreary scenario. Equally difficult to ignore is Dr. Kass's warning about the perils of living wills. There is, he says, "this perfectly American way [that] if you don't like what you think might happen to you in the future, write instructions. . . . People rightly want to have some say in how they die, they don't want to be a burden to their families. But it's preposterous to think we can have the kind of foreknowledge to cover the myriad circumstances in which we may find ourselves. Nor can you accurately pass judgment on how you're going to feel about your life in a different circumstance. . . . No kind of legal approach and no kind of medical approach are going to take the place of a lovingly prudent caregiver on the spot." The number of Americans with living wills today, it should be noted, is 29%, up from 12% in 1990, according to a Pew survey.
Then again, who knows, really, whether matters will all shake out so badly in the coming biomedical revolution. Historically, America's default option in the face of sharp social and technological shifts has been to accept, adapt and improve, partly in the recognition that it is usually folly to resist, and partly from the experience that the ills such shifts bring are usually less bad than the ills they overcame.
Dr. Kass's image of a desiccated, frivolous, unfruitful society seems to draw on what Continental Europe today has become. Yet when he agrees to my suggestion that he is effectively proposing that we adopt a kind of "precautionary principle" toward biotechnology, he's agreeing to the political rhetoric of the present-day EU. Then, too, when Dr. Kass speaks of "Life, Liberty and the Pursuit of Dignity" (the title of a collection of his essays), one can't help notice the telling substitution. The thing Americans are genetically conditioned to pursue is happiness, not dignity.
Dr. Kass rejects this. "Life, liberty and the pursuit of happiness," he says, "are fundamental rights which the regime exists to safeguard. But they do not exhaust the things that Americans believe in. . . . People aspire to lead serious lives, they want to be taken seriously, they want to make something of their lives. They respond when there is illness. It's astonishing what the outpouring of human sympathy can do. On the basis of the calculation of utiles a lot of this stuff doesn't make any sense. . . . The very people who you want to say are content with contentment are the very ones who say 'My God, we don't want to go there!'"
It would be a comfort to know that the tide is not, in fact, sweeping us all "there." And, who knows: There may be no there there. But in refusing to discount the possibility that it is, or avert his eyes from what may yet await us, Dr. Kass has performed a national service. Somebody ought to thank him.
Mr. Stephens is a member of The Wall Street Journal's editorial board.
